Vol 13, No 3 (2018)

Purpose. To present the fundamentals of transpalpebral rheoophtalmography development and its clinical testing on myopic children. Material and Methods. In transpalpebral rheoophtalmography development, we used our own electrophysical multilayer eye model involving the choroid and the upper eyelid, a biotechnical tetrapolar electrode system and a device for its fixation. To assess the clinical potentials of transpalpebral rheoophtalmography, we examined 128 patients aged 5-22 (ave. 13±1.1 years) with myopia of various degrees. Of these, 35 children were examined before and after functional treatment and scleroplastic surgery. Another group consisted of 70 myopic children aged 13.03±0.28 years, who were examined before and after a low-invasive sclera reinforcement procedure in which biologically active grafts were used. A comparative parallel study of transpalpebral rheoophtalmography and color Doppler ultrasonography involved 17 children (34 eyes) aged 12.5±1.8 with various clinical refractions. Results. The modeling helped assess the contribution of the eyelid blood supply into the rheographic index (which was found not to exceed 16%), demonstrated the need to replace the bipolar electrode system used in traditional rheoophtalmographyа with a tetrapolar system which provides more complete data on pulse blood filling of the choroid and ensures optimal positioning of the electrodes on the eyelid. A special helmet was designed to fix the electrodes and adjust their pressing force. We also developed a program for an automatic analysis of transpalpebral rheoophtalmography signals. A statistically significant rheographic index drop accompanying refraction increase was revealed. Rheographic index increased after functional and surgical treatment of myopia. transpalpebral rheoophtalmography was found to be more informative than Doppler ultrasonography when examining children with low and moderate myopia. Conclusion. The fundamental approach to the development made transpalpebral rheoophtalmography a highly informative and precise method of objective assessment of blood supply to the choroid. Transpalpebral rheoophtalmography uses low-cost equipment, is convenient, mobile, requires no contact with the eye and takes little time to be applied, which is especially important in pediatric practice. Transpalpebral rheoophtalmography may be used to produce new data on the pathogenesis of eye diseases, to ensure their early diagnosis and monitoring, and to assess the effectiveness of treatment.

Purpose. To determine the indications for eye prosthetics in subatrophy and a comparative assessment of its results with anophthalmos after enucleation and evisceration. Material and methods. The article deals with the idea of the possibility of increasing cosmetic indicators when using ocular prosthetics and contact lenses after severe trauma and subatrophy. Results. The results of ocular prothetics in post-traumatic subatrophy (with 210 patients taking part in the experiment) are presented; prescriptions for applying such methods of rehabilitation are given. It was proved that the use of an eye prosthesis without following strict rules and medical prescriptions in the period of post-traumatic pathology could lead to an aggravation of uveitis, progression of the process, worsening of its prognosis and outcome. A comparative characterization of two groups of patients was carried out to estimate the cosmetic parameters of prosthetics: I - anophthalmos (150 cases) after enucleation with the formation of a musculoskeletal stump by orbital implants (carbotextim or polytetrafluoroethylene); II - anophthalmos (200 cases) after evisceration with resection of the posterior pole, nevrectomy and plastic stump with the same implants. Summary. During the evisceration the achieved results were close to the main experimental group when instrumental and subjective indicators were estimated. This fact gives proof to the fact that this surgical procedure is far more efficient in comparison with enucleation.

The hypothesis of possible connection between the development of myopia and peripheral refraction determines high interest to thorough examination of peripheral defocus and the influence of different means of correction on it. Experimental and clinical data, showing the important role of peripheral refraction in the regulation of eye growth, are collected in this review. The review proves that optical strategies of myopia correction with possible induction of peripheral myopic defocus are more effective in myopia progression prevention compared to single vision spectacle lenses and contact lenses.