[Infection prevention in operations on the eyeball].
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Biomedical subjects
Publications and source records attributed to G L Prokof'eva.
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Clinical trial of eye films with apilac used in complex treatment of 47 patients with thermic and chemical corneal burns has shown acceleration of corneal epithelialization in 37 (78.7%) patients as compared with the control group. Rise of visual acuity from 0.1-0.4 to 0.5-0.9 was recorded in patients with burns of a moderate degree and from 0.005-0.02 to 0.03-0.07--with severe eye burns. Better results after apilac therapy were observed when the films were used in combination with low-intensity helium-neon laser radiation of the cornea.
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He-Ne laser stimulation was used in multiple-modality treatment of 512 patients with various corneal conditions: 217 with perforating wounds, 75 with chemical and thermal burns, 48 with ulcers of various origins, and 162 with endothelial-epithelial dystrophy resulting from cataract extraction with implantation of the intraocular lens. A course of treatment consisted of 6 to 10 daily 3 min exposures at radiation power density of 50-100 micro W/cm2 on the cornea. The effect achieved by laser stimulation was significantly superior to that of routine methods of treatment used in the reference groups. He-Ne laser stimulation was conducive to a sooner reduction of the inflammatory processes, to recovery of the corneal sensitivity and epithelialization, and to shortening hospital treatment.
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The authors offer a hypothesis on the possibility of development of vertical components of deviation in concomitant eso- or exotropia as a result of specific functioning of horizontal muscles in subjects with oblique palpebral fissure. Such a vertical deviation clinically corresponds to dysfunction (imbalance) of oblique muscles in its symmetrical variant and is therefore termed by the authors "pseudodysfunction of oblique muscles". Differential diagnostic basis for differentiation between true and false dysfunction of oblique muscles in concomitant strabismus is formulated.
Status of tears was studied in patients with penetrating wounds to the eyes using polarization optic microscopy to assess the type of morphological types of crystals, measurements of secretory IgA to assess local immunity status, and screening methods to estimate protein level from the relative coefficient. A total of 122 patients with penetrating corneal and corneoscleral wounds were examined, 48 of these without clinical signs of infection and 74 with clinical manifestations of an infection. For control 88 subjects without somatic diseases or ocular diseases were examined. Crystallography revealed predominance of two morphologic types, Nos. 3 and 5, whose crystal structures were taken as the normal types. Their detection rate was reduced in penetrating wounds to the eye. Secondary morphologic types Nos. 14 and 16 reliably predominated in "pure" injuries and a secondary morphologic type 14 M in patients with developing infection (in 19 patients this type predominated during the preclinical form of infection of the eye). Increased IgA levels were observed in patients with noninfected injuries and reduced ones during infection. An infection was found associated with reduced protein level.
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Safe doses of low-intensive infrared laser (LIIL) exposure for the structures of the eye were searched for in rabbit experiments, and the potentials of such lasers in ophthalmology were assessed. Uzor, a therapeutic laser device with gamma = 0.89 mm, was employed. The doses varied from 0.0001 to 1.0 J/cm2, this corresponding to exposure duration of 0.3 to 45 min. Experiments were carried out on 20 animals. The right eyes were exposed, and the left ones were control. An increase of intraocular pressure was recorded at a dose of 0.1 J/cm2 (4.5 min) and higher; morphological study showed dilated, well-filled and newly formed vessels in the ciliary body and iris, as well as edema and destruction of the external layers of the retina. Exposure to a dose of 0.05 J/cm2 and lower did not lead to destruction of ocular structures and increase of intraocular pressure. The maximal LIIL dose causing no side effects for the organ of vision was established at 0.05 J/cm2, this corresponding to 2.5 min exposure.
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