Vol 6, No 1 (2011)

The authors analyzed the real pharmacological provision of pediatric ophthalmologic service basing on the study of standards of medical application of drugs most often used in ophthalmologic practice.

Clinical follow-up in dynamics at the age from 5 to 10 were conducted in 62 myopic children born premature. The patients were divided into 3 groups: 16 children with mild myopia, 18 children with moderate myopia and 28 children with high myopia. The second part of the study included of 63 children (77 eyes) after lensvitrectomy followed-up during 10 years. The authors proved that early adequate contact correction is indicated to the children with highly abnormal refraction for correct and full development of visual analyzer. Increase of visual acuity as well as that of visocontrastometry indices was noted in patients with moderate and high myopia in contact lens wear in comparison with glasses correction. In patients after lensvitrectomy performed in IV-V stage of retinopathy of prematurity in 82% of cases the difference in child's behavior in contact lenses wear and without it was noted. Deviation and amplitude of nystagmus diminished in contact lenses wear. According to electrophysiological indices increase of evoked visual potentials and decrease of latency were noted in these children.

The intraocular pressure and hydrodynamic indices were studied in 190 infants and adolescents (375 eyes) with progressive myopia, 30 infants (60 eyes) with stationary myopia and 30 infants (60 eyes) with emmetropia. Hydrodynamic indices were studied depending on intraocular pressure values. The analysis of the obtained data allowed arriving at the following conclusions: intraocular pressure in patients with progressive myopia was higher (16.39 mm Hg) than in emmetropic patients (14.84 mm Hg) and in patients with stationary myopia (14.69 mm Hg). Regarding this index in the group with stationary myopia and emmetropia no significant differences were detected. Myopia progressing may be accompanied by high IOP norm (31.8% of cases), moderate IOP norm (48.8%), and low IOP norm (19.4%). In these subgroups we could distinguish patients with reduced coefficient of intraocular fluid outflow and its relative hypersecretion. A comparative evaluation of changes of ocular axial length in convergence and after visual load (40 minutes of reading) was conducted. Reasoning from these results of the examination it was possible to suppose that in myopia progressing accompanied by low IOP norm the mechanics of eye elongation in convergence under the influence of extraocular muscles is in existence.

Method of surgical treatment for progressive myopia in children was developed that allowed changing of the direction of tensile stress in equatorial area of myopic eyes sclera. The developed surgical technique for progressive myopia treatment is highly efficient and technologically easy, the material convenient for implantation is available and complications are practically completely absent. Favourable influence of mechanical induction artificially created by distraction of the sclera and stimulating reparative regeneration maintains the level of compensatory-adaptive processes in the sclera of the eye for a long period. Distraction scleroplasty in the authors' opinion is a promising method of surgical treatment for progressive myopia in children with anterior-posterior axis of the eye up to 26.0 mm.

Contrastive analysis of efficiency of progressive axial myopia treatment by medical and surgical methods was conducted. It was detected that these methods could be considered as equivalent at a moderate pace of myopia progressing. It is necessary to treat progressive myopia at an early age in the presence of corresponding indications as at the age over 13 spontaneous stabilization of the process occurs in non-complicated myopia.

A new method of non-invasive palliative treatment in terminal glaucoma stages in children taking into account the peculiarities of the eyes with congenital aniridia and buphthalmos (patent of the Russian Federation for invention ь2220691) was suggested. The method constitutes a diode laser trans-scleral cyclocoagulation (device OcuLight SLx; infrared spectrum, 810 ?m) with circulatory applications made at the ciliary body projection zone determined by means of diaphanoscopy except the zones of staphylomas and preceding surgery. Laser power mode depended on thickness of the sclera and the adherent tunics in the zone of future impact determined by ultrasonic B-scanning. Hypotensive effect was obtained in 84.6% of operations and remained in the long-term periods (3.9+0.4 years) in 61.5% of cases. The application of the aforesaid method allowed salvaging the eye as an organ without eyeball lancing with good cosmetic effect, at that in 84.6% of cases without anesthesia.

The results of histological study of the rabbit's eye structures after impact of LED blue laser "AST" of various light powers are presented. It was detected that the dose of laser radiation under 150 J/cm2 has no damaging effect on the ocular tissues. Starting from the dose of light of 300 J/cm2 tissues morphology and eyeball structures changes of various intensiveness were noted.

The article described a clinical follow-up of Apert's syndrome case in a five-year-old child characterized by the skull and orbits deformation, syndactylism, mental deficiency, ptosis, esophoria, partial atrophy of the optic nerve.