We aimed to find out whether thin (≤500 μm) or normal (>500 μm, control) corneal thickness would impact efficacy and safety outcomes of small-incision lenticule extraction (SMILE). We retrospectively analyzed medical records of adult patients who had undergone SMILE. A total of 57 eyes were included in the “thin corneas” group and 180 eyes in the “control” group. At one month after surgery, rates of patients with uncorrected distance visual activity (UDVA) ≥ 0.8 were significantly higher in patients from the control group compared to the “thin corneas” group (87 vs. 71%, respectively p < 0.01), though rates were comparable at 3 months (87 vs. 76%, respectively, p > 0.05). SMILE had comparable safety in patients with thin and normal corneas. Procedure result predictability was comparable between groups. Regression analysis demonstrated that cap thickness impacted posterior corneal biomechanics, and the volume of removed tissue had a higher influence in patients with thin corneas. Moreover, an increase in cap thickness was associated with better final BCVA. Further study is needed for the evaluation of the impact of thin corneas on SMILE outcomes and planning. Our study also indicates that patients with thin corneas might require a different approach to nomogram calculation.

Цель: оценить эффективность применения препарата «Теалоз» у пациентов, перенесших поверхностные кераторефракционные операции (ФРК и Транс-ФРК). Пациенты и методы: Были обследованы 50 пациентов (100 глаз) обоего пола: группа «Теалоз» и группа «Контроль» по 25 пациентов (50 глаз) с близорукостью средней степени. Всем пациентам была выполнена ФРК или трансэпителиальная ФРК с использованием эксимерлазерной установки Schwind Amaris® 500E (Германия). Были проведены стандартные и дополнительные офтальмологические исследования: оценка стабильности слезной пленки (проба Норна), ба-зальной слезопродукции (Тест Ширмера), индекса заболеваний глазной поверхности (ODSI©) и выраженности эпителиопатии по «Оксфордской» шкале. Результаты: Стабильность слезной пленки в группе «Теалоз» до операции составила 6,76±3,59 секунд, через 7 дней после операции — 7,22±2,99 секунд, через 1 месяц после операции — 9,36±3,68 секунд. В группе «Контроль» до операции — 7,07±3,61 секунд, через 7 дней — 5,21±0,25 секунд, через 1 месяц — 7,21±2,85 секунд. Послеоперационные показатели в обеих группах достоверно отличались друг от друга (рвыводы: Применение препарата «Теалоз» способствует уменьшению проявлений синдрома сухого глаза (ССГ) после эксимерлазерных операций, а именно, повышает стабильность слезной пленки и снижает выраженность изменений переднего эпителия роговицы и конъюнктивы. Препарат на основе трегалозы проявил не менее выраженные увлажняющие свойства, чем препарат на основе гиалуроновой кислоты, что нашло подтверждение в результатах опроса пациентов по опроснику ODSI©, в динамике восстановления некорригированной остроты зрения (НКОЗ) и теста Ширмера. Применение препарата на основе трегалозы — «Теалоз» — целесообразно для улучшения состояния глазной поверхности у пациентов, перенесших керторефракционные операции по типу «ФРК».

A systematic review was performed in the RSCI and PubMed databases using the following keywords: Computer vision syndrome, Digital eye strain, Accommodation, Accommodative asthenopia, RTS, and Quality of life. Eligible articles were evaluated in accordance with the criteria for prospective or retrospective studies. A total of 792 sources were analyzed, further using systematic review filters and authors knowledge of the topic. The retrospective analysis spanned 7 years (20162022). Data indicated that accommodative asthenopia (AA), as a functional visual disorder, is a natural state of the accommodative system of the eye caused by long-term exposure to visually intense work on a personal computer. AA is characterized by a wide range of subjective manifestations (complaints) and indicators of the examination of the patients vision, associated primarily with objective accommodation. A differentiated approach to the diagnosis of various forms of AA, such as habitual excessive stress of accommodation and asthenic form of accommodative asthenopia, is important to provide adequate treatment based on methods with direct physical effects on the eye (such as low-energy laser radiation, magnetophoresis, and stimulation of accommodation), opto-reflex treatment, and an outpatient course as part of home training.

Background: Presbyopia treatment in pseudophakic patients with a monofocal IOL is challenging. This study investigates the refractive results of femto-PresbyLASIK and analyzes presbyopia treatment in pseudophakic eyes. Methods: 14 patients with 28 pseudophakic eyes were treated with femto-PresbyLASIK. The dominant eye was targeted at a distance and the non-dominant eye at −0.5 D. The presbyopic algorithm creates a steepness in the cornea center by using an excimer laser that leads to corneal multifocality. Results: 6 months after surgery a refraction of −0.11 ± 0.13 D (p = 0.001), an uncorrected distance visual acuity of 0.05 ± 1.0 logMAR (p < 0.001) and an uncorrected near visual acuity of 0.15 ± 0.89 logMAR (p = 0.001) were achieved in the dominant eye. For the non-dominant eye, the refraction was −0.28 ± 0.22 D (p = 0.002), the uncorrected distance of visual acuity was 0.1 ± 1.49 logMAR, and the uncorrected near visual acuity was 0.11 ± 0.80 logMAR (p < 0.001). Spherical aberrations (Z400) were reduced by 0.21–0.3 µm in 32% of eyes, and by 0.31–0.4 µm in 26% of eyes. Conclusion: By steepening the central cornea while maintaining spherical aberrations within acceptable limits, PresbyLASIK created a corneal multifocality that safely improved near vision in both eyes. Thus, femto-PresbyLASIK can be used to treat presbyopia in pseudophakic eyes without performing intraocular surgery.

The problems of controlling inflammatory and proliferative response of the retina and correcting tear production in the post-operative period after photorefractive keratectomy (PRK) have not been fully solved yet. Patients intolerable to local steroids require an alternative. One drug that covers those needs is Cyclosporine 0.05%. To analyze clinical effectiveness of Restasis eye drops in solving inflammatory-degenerative response and tear production insufficiency (dry eye syndrome) for post-PRK patients with steroid eye drops intolerance accompanied with increasing intraocular pressure (IOP). Retrospective analysis of 14 myopic patients (28 eyes) was conducted; mean patient age was 25.9±6 years; myopia was (-)5.65±1.5 Diopters of spherical equivalent (SE); corneal-compensated IOP was 16.98±3.68 mm Hg before the surgery. All patients underwent excimer laser correction (PRK or Trans-PRK) with Schwind Amaris (SCHWIND eye-tech-solutions). After epithelization, all patients were prescribed 0.1% Dexamethasone solution 4 times a day (with decreasing dosing frequency) for 2 months, as well as local lubricants. The article also describes a separate clinical case of subepithelial fibroplasia that occurred post-PRK and was successfully stopped. All patients had transitory IOP increase caused by local steroid therapy. Mean IOP at 1-month post-op was 20.5±7 mm Hg. At that point local steroids were replaced with 'Restasis' 0.05% (Cyclosporine) eye drops prescribed 2 times per day for 2 months. As the result, IOP values decreased to 16.2±3.21 mm Hg (without any additional therapy); at 6 months mean uncorrected visual acuity reached 0.98±0.05, best corrected visual acuity achieved 1.03±0.06 and SE was 0.04±0.12 Diopters. Local Cyclosporine ('Restasis') is the method of choice for regulation of inflammatory and degenerative response and tear production insufficiency (dry eye syndrome) for post-PRK patients with intolerance to steroid eye drops.