Background. Among patients seeking ophthalmic care in outpatient settings, inflammatory eye diseases occupy the leading position, accounting for approximately 16 million cases annually in the Russian Federation. The limited efficacy of topical pharmacotherapy for ulcerative and dystrophic corneal diseases, along with the risk of adverse reactions, necessitates the search for new treatment methods. One such approach is the use of therapeutic ion-exchange contact lenses (TICLs).

Purpose: To evaluate the efficacy of therapeutic ion-exchange contact lenses (TICLs) as part of combination therapy for inflammatory and dystrophic corneal diseases.

Materials and methods. A clinical study was conducted in 79 patients (79 eyes) with corneal pathology between March and April 2024. Depending on the treatment approach, patients were divided into two groups. The main group (n = 41) included 26 patients with ulcerative stromal keratitis and 15 with bullous keratopathy. The comparison group (n = 38) included 24 patients with ulcerative stromal keratitis and 14 with bullous keratopathy. In the main group, in addition to standard pharmacotherapy, “Universal TICLs” were applied 1–2 times at 3–4-day intervals depending on disease severity and clinical dynamics. The comparison group received only topical pharmacotherapy. At baseline and 1, 3, 7, 14, and 30 days after TICL application, all patients underwent visual acuity testing, autorefractometry, pneumotonometry, slit-lamp biomicroscopy, anterior segment optical coherence tomography (AS-OCT), indirect binocular ophthalmoscopy, ultrasound examination, and pachymetry. The observation period was one month. The primary endpoints were complete epithelialization of the ulcer defect in patients with stromal keratitis and corneal thinning in patients with bullous keratopathy.

Results. Incorporation of TICLs into the comprehensive treatment of ulcerative keratitis accelerated epithelialization of the ulcer defect by 1.8 times and reduced hospitalization duration by 1.5 times. A smaller, less dense corneal opacity was observed, accompanied by stable improvement in visual function. In bullous keratopathy, combined therapy with TICLs relieved corneal syndrome, reduced corneal edema, increased transparency, and restored normal corneal thickness, leading to improved visual function compared with conservative pharmacotherapy alone.

Conclusion. The use of therapeutic ion-exchange contact lenses in the management of inflammatory and dystrophic corneal diseases shortens rehabilitation time, does not cause complications, and is characterized by an absence of adverse effects, making this approach suitable for routine clinical practice.

Background. Peripheral retinal degeneration (PRD) is among the key risk factors for rhegmatogenous retinal detachment (RRD), particularly in patients with myopia. Despite the accumulated data, the threshold values of axial length and refractive error associated with prognostically significant forms of PRD remain unclear. Clarifying these relationships is essential to optimizing patient management and informing decisions on prophylactic interventions.

Purpose: to assess the prevalence of peripheral retinal degenerations—including prognostically significant forms–and their associations with clinical refraction, axial length, and age.

Materials  and  methods. This retrospective study included 75 patients (150 eyes) examined by a retina specialist at the National Institute of Myopia in 2023. All eyes underwent automated refractometry, optical biometry, and dilated fundus examination using a 90-diopter Volk double aspheric noncontact lens (Volk Optical, USA). Binomial generalized linear models were applied to estimate relative risks (RRs) and odds ratios (ORs) with 95% confidence intervals (CIs).

Results. PRD was identified in 71.3% of eyes. Prognostically significant forms (lattice degeneration and snail-track degeneration) were detected in 6.7% of cases, and retinal breaks in 8.0%. The prevalence of PRD was significantly higher with greater axial length (p = 0.001) and increasing myopic refraction (OR = 0.73; p < 0.001). The frequency of lattice degeneration increased with age (OR = 1.04; p = 0.018). No statistically significant associations were found between prognostically significant PRD, refractive error magnitude, and axial length. Astigmatism showed no significant correlation with PRD risk.

Conclusions. No statistically significant associations were detected for prognostically significant PRD, underscoring the need for adequately powered studies focused on populations with clinically significant retinal degenerations.

Background. Corneal refractogenesis is influenced by intraocular pressure (IOP), which helps shape the anterior segment profile. Reduced corneal structural strength in corneal ectatic disorders and after laser refractive procedures diminishes resistance to IOP, disrupting the corneal rigidity/IOP balance and promoting the development or progression of corneal ectasia.

Purpose: To assess patterns of local corneal topography associated with changes in the corneal rigidity/IOP balance in keratoconus.

Materials and methods. A total of 96 patients were allocated to four groups. Group 1 (31 patients; 62 eyes without ophthalmic pathology) served to define the reference range of corneal topographic parameters. Group 2 (23 patients; 46 eyes without corneal pathology) constituted the comparison cohort. Group 3 (21 patients; 42 eyes) had confirmed keratoconus (stages I–III). Group 4 (21 patients; 40 eyes) was examined 1 month after laser refractive surgery (LASIK or SMILE). All participants underwent a vacuum-compression test (VCT); corneal topographic indices were recorded before and during transient, vacuum-induced IOP elevation.

Results. With IOP elevation, Group 2 exhibited localized peripheral corneal protrusion. During the vacuum-compression test (VCT) in Group 3 (keratoconus), the corneal apex flattened, while the periphery consistently bulged. IOP increased significantly in Groups 2 and 3 (both p < 0.05). In Group 3, an IOP rise of 13.2 ± 0.9 mmHg (vacuum level 80 mmHg) was accompanied by a decrease in corneal hysteresis (CH) of 4.1 ± 0.8 mmHg; in the control group, CH decreased by 2.4 ± 1.5 mmHg. In Group 4, the corneal rigidity–IOP balance was disrupted due to a localized, clinically insignificant ectasia along the flap margin.

Conclusion. Transient IOP elevation caused corneal deformation characterized by apical flattening and mid-peripheral steepening, indicating areas of reduced corneal rigidity. Structural alterations after laser refractive surgery weaken the cornea between the optical zone and the limbus, leading to predominantly peripheral deformation that may contribute to the development or progression of corneal ectasia.

Background. The high prevalence of Demodex-associated blepharitis underscores the importance of studying eyelid microcirculation. Laser Doppler flowmetry (LDF) provides an objective method for assessing microcirculatory changes during therapy.

Purpose: To assess treatment-associated changes in eyelid microcirculation during acaricidal therapy in patients with mixed Demodex blepharitis and to determine their value for monitoring treatment efficacy.

Materials and methods. The study included 48 patients (96 eyes; mean age, 64.7 ± 5.1 years) diagnosed with chronic mixed Demodex blepharitis. Patients were divided into three equal groups (16 patients, 32 eyes each). All participants underwent a standard ophthalmic examination, completed the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire to assess and quantify symptoms, and had laboratory testing of the eyelid margins for the presence of Demodex mites. In Group 1, treatment included a cosmeceutical preparation containing wormwood (Artemisia) extract and a lipid-containing tear substitute instilled three times daily for 1.5 months. Group 2 received a cosmetic eyelid cream containing a 2-methyl-nitroimidazole derivative in combination with a tear substitute, and Group 3 used an eyelid gel containing sulfo-concentrol. Eyelid microcirculation (MC) parameters were evaluated by LDF at baseline and after 1 week, 1.5 months, and 3 months of therapy.

Results. After 7 days of treatment, changes in Group 1 were more pronounced than in Groups 2 and 3, which showed mainly a reduction in the contribution of passive microcirculatory regulatory mechanisms. The wormwoodbased gel demonstrated anti-inflammatory and circulation-stimulating effects on the eyelids. A decrease in the shunting index indicated a reduction in blood flow velocity through arteriolovenular anastomoses and tissue ischemia, accompanied by moderate enhancement of vasomotor microvascular activity. Preservation of compensatory microcirculatory processes was reflected in high modulation of blood and lymph flow. These microcirculatory changes were accompanied by improved quality-of-life scores (SPEED) in Groups 1 and 2 and by a reduction in Demodex infestation in Group 1. Longitudinal observation demonstrated moderate activation of tissue metabolism and regulatory system activity with a marked decrease in tissue ischemia in Group 1, whereas in Groups 2 and 3, the role of active microcirculatory regulatory mechanisms was reduced.

Conclusion. Conservative treatment of mixed Demodex blepharitis induces measurable changes in eyelid microcirculation, supporting the importance of microcirculatory monitoring as an objective tool for evaluating therapeutic efficacy.

Background. Monovision is a well-established method for presbyopia correction in which the dominant eye is corrected for distance vision, while the non-dominant eye is adjusted for near vision. Initially developed for contact lens correction, this approach has subsequently been adapted for use in refractive surgery. To date, no reports have been found describing the application of the monovision concept in myopic presbyopic patients undergoing laser vision correction using the Corneal Lenticule Extraction for Advanced Refractive Correction (CLEAR) technique, which underscores the relevance of the present study.

Purpose: to evaluate the functional outcomes of the monovision technique following lenticule extraction in myopic patients of presbyopic age.

Materials and methods. The study included 20 patients (40 eyes), divided into two groups of 20 eyes each. The mean patient age was 40.6 ± 2.7 years. The study was conducted at the Department of Laser Refractive Surgery, S. Fedorov Eye Microsurgery Federal State Institution, from July to December 2024. In Group 1, surgery was performed using the CLEAR technique with the monovision approach, leaving a residual myopia of 1.25–1.75 D in the non-dominant eye. Group 2 underwent standard CLEAR surgery. All patients had mild to moderate myopia and a preoperative best-corrected visual acuity (BCVA) of at least 1.0. Before surgery, postoperative visual acuity was simulated with soft contact lenses, and a comprehensive ophthalmological examination, including binocular vision assessment, was performed. In both groups, the femtosecond laser FEMTO LDV Z8 (Ziemer, Switzerland) was used. Distance and near visual acuity, type of vision, and visual fields were evaluated before and after surgery. The follow-up period was three months.

Results. Postoperatively, uncorrected distance visual acuity (UDVA) improved in both eyes in Group 1, though it was slightly lower in the non-dominant eye (0.98 and 0.76, respectively). In Group 2, UDVA improved to 0.99 and 0.96, respectively. The target refraction was achieved in all cases without loss of BCVA and remained stable throughout the follow-up. The postoperative values of UDVA, BCVA, and spherical equivalent showed no significant change over time. Near visual acuity was evaluated binocularly—preoperatively with maximum distance correction and postoperatively without correction. In Group 1 (monovision), postoperative uncorrected near visual acuity (UNVA) increased to 0.99 – 1.0, whereas in Group 2 it reached only 0.37. Binocular vision was preserved in all patients, and visual field parameters remained within normal limits before and after surgery in all cases.

Conclusion. Corneal lenticule extraction using the CLEAR technique with the monovision approach provides high postoperative visual acuity at both distance and near in presbyopic myopic patients while maintaining binocular and peripheral vision.

Background. Cardiovascular diseases (CVDs) remain the leading cause of mortality worldwide. Early diagnosis and risk stratification in individuals without clinically manifest pathology is of particular importance. Retinal microcirculation parameters ob tained using optical coherence tomography angiography (OCTA) are regarded as promising noninvasive biomarkers of subclinical vascular dysfunction.

Purpose: To assess the diagnostic value of retinal microcirculation parameters for detecting microvascular alterations in individuals without established cardiovascular disease and to determine their association with cardiovascular risk level.

Materials and methods. The study included 220 patients aged 35–65 years with no clinical signs of CVD. All subjects underwent comprehensive clinical and laboratory evaluation, cardiovascular risk assessment using the SCORE2 algorithm, and retinal OCTA with quantitative analysis of vascular parameters.

Results. Participants with moderate and high cardiovascular risk demonstrated a decrease in vessel density and vessel length in the macular region, enlargement of the foveal avascular zone (FAZ) area, an increased FAZ acircularity index, and expansion of flow voids within the choriocapillaris layer. Statistically significant correlations were identified between OCTA parameters and blood pressure, lipid profile, and SCORE2-derived cardiovascular risk.

Conclusion. OCTA-derived metrics have high prognostic value for evaluating subclinical vascular dysfunction. Their application may facilitate the early detection of microvascular impairment and enable more accurate cardiovascular risk stratification in individuals without overt clinical manifestations of disease.

This article presents a 6-year follow-up of a patient who first presented at the age of 15 and underwent orthokeratology as a method of myopia control. Baseline visual acuity: OD = 0.1 with sph –2.5D = 1.0; OS = 0.3 with sph –1.25D = 1.0. After five years of wearing individually designed orthokeratology lenses (OK lenses) by OK Vision, a decrease in axial length (AL) was recorded: 0.39 mm in the right eye and 0.28 mm in the left eye. The reduction in AL was accompanied by a 1.0D decrease in myopic refraction in both eyes. The observed change in AL cannot be explained by an increase in choroidal thickness and/or a decrease in central corneal thickness and therefore requires further investigation. The impact of myopia control and accommodation management methods on axial length change remains insufficiently studied. Future research should include evaluation of accommodative function and choroidal thickness as part of standard clinical protocols for patients undergoing myopia control therapy. 

Fibrotic remodeling of the filtration area after glaucoma surgery remains a major cause of surgical failure, driving the development of multi-tiered preventive strategies.

Purpose. To summarize and critically appraise contemporary strategies for modulating the wound-healing response after glaucoma surgery—encompassing surgical approaches, physical and biological barrier technologies, nanostructured surface coatings, and geneand cell-based therapies—to prevent and control postoperative fibrosis.

Materials and methods. This review draws on 30 peer-reviewed articles published within the past decade and indexed in PubMed, Scopus, and Web of Science. The analysis focused on studies addressing reparative mechanisms following glaucoma surgery, fibrosis prevention strategies, and emerging biomedical technologies.

Results. Analysis of modern surgical optimization techniques shows that the use of adjustable sutures, Ahmed and Baerveldt drainage devices, and minimally invasive implants (iStent, Hydrus, XEN Gel Stent) helps reduce inflammation, ensure uniform aqueous humor outflow, and suppress fibroblast activity. Minimally invasive technologies demonstrate favorable clinical outcomes in patients with early-stage glaucoma, whereas drainage devices provide more sustained intraocular pressure reduction in patients at high risk of fibrosis. Anti-adhesive membranes and nanostructured coatings based on titanium or silver effectively prevent cellular adhesion and exhibit additional anti-inflammatory and antibacterial properties. Gene therapy and mesenchymal stem cells show high potential in suppressing fibrosis at the preclinical level but require further investigation to confirm safety and efficacy. The most clinically applicable developments include antiproliferative gels and implantable physical barriers that provide long-term protection of the filtration area after surgery.

Conclusion. Modern technologies for preventing postoperative fibrosis in glaucoma surgery represent varying degrees of translational maturity—from clinically implemented methods to those still undergoing preclinical validation. The most evidence-based options for clinical use are minimally invasive drainage devices, anti-adhesive coatings, and physical barriers, whereas geneand cell-based therapies require additional proof of efficacy and safety.

A considerable proportion of ocular disorders represent manifestations of systemic diseases. Periodontal diseases rank among the most prevalent chronic conditions worldwide and are the leading cause of tooth loss in adults. In the early 21st century, the concept of periodontal medicine emerged, emphasizing the bidirectional relationship between periodontal pathology and systemic conditions. Despite the anatomical proximity of the eyes and the mouth, the association between ocular and periodontal diseases and the potential mechanisms underlying this link have received little attention in the Russian literature. This review summarizes current evidence on the comorbidity between ocular disorders and periodontal pathology. A systematic search of PubMed and Scopus databases identified publications from January 1, 2011, to February 23, 2025, examining this association. Forty-four studies met the inclusion criteria. Epidemiological and clinical data suggest comorbidity between several ocular diseases–age-related macular degeneration, diabetic retinopathy, cataract, glaucoma, dry eye disease, and uveitis–and periodontal pathology. Proposed mechanisms include hematogenous dissemination of periodontopathogenic microorganisms and inflammatory mediators, interactions along the oral–gut–eye axis, and indirect multimorbidity pathways, including oral–cardiometabolic–eye and oral– immune-mediated–eye links. The review highlights the need for further prospective studies to elucidate the association between prevalent and clinically significant ocular diseases and periodontal pathology. It underscores the importance of interdisciplinary approaches in understanding the systemic consequences of periodontal diseases and their potential impact on ocular health.

Background. This article examines the ophthalmology residency training process at the M.M. Krasnov Research Institute of Eye Diseases (hereinafter, the Krasnov Institute). Simulation-based education has become one of the most effective approaches to physician training. In recent decades, simulation learning has evolved into a structured sequence that begins with mastering fundamental skills, progresses to procedural training, and concludes with team-based learning in realistic clinical settings. Simulation helps residents acquire specialized competencies, refine procedural techniques, and consolidate practical knowledge.

Purpose. To assess the feasibility and educational value of integrating a simulator-based module into the ophthalmology residency curriculum.

Methods. Several established curriculum-design frameworks were reviewed. The simulation module was planned and implemented following the key stages of curriculum development—analysis, design, development, implementation, and evaluation. The EYESI Surgical Simulator was used as the core training platform. Evidence from previous studies suggests that simulation training enhances both individual and team performance, strengthens confidence, and improves surgical proficiency. Embedding a simulation module in residency training encourages deliberate practice and structured debriefing, helping residents transfer their skills more effectively to the operating room. This study applied a stepwise cognitive formation model and a simulationbased design approach. At the first stage, we defined the technical procedures residents should competently perform by the end of their specialty training. The second stage focused on characterizing each procedure by its frequency, team size, patient risk or discomfort, and suitability for simulation-based learning. The third stage established the priority and sequence of these procedures within the curriculum.

Results. Published studies vary considerably in their design and analytical methods, and their findings remain inconsistent. Although many reports demonstrate clear benefits of simulation for developing procedural skills, additional evidence is needed to determine its overall educational impact. Future work should aim to create validated assessment tools and to examine how simulation-acquired competencies influence patient outcomes.

Conclusion. Integrating simulation modules into ophthalmology residency programs can meaningfully strengthen residents’ clinical competence and readiness for independent practice. Structured simulation-based training, such as EYESI modules, has the potential to raise the overall quality of postgraduate ophthalmic education.

As the range of multifunctional contact lens (CL) care solutions continues to expand, it is increasingly important to provide users with products that ensure both safety and quality. During lens wear, contact lenses become contaminated with tear film deposits and environmental impurities. This article reviews the key components of multifunctional solutions responsible for cleaning, disinfection, hydration, and storage of contact lenses.

Dry eye disease (DED) is a common and underrecognized condition of the ocular surface. Patient management is complicated by uneven access to diagnostic tools, lack of standardized algorithms, and fragmented approaches to diagnosis and treatment. This article presents the Dry Eye Wheel concept – a stepwise framework adaptable to any level of resources, from optometry practices to specialized clinics. The model, based on the World Council of Optometry (WCO) initiative, integrates validated clinical tools including symptom questionnaires (OSDI), tear film stability tests, ocular surface staining methods, tear osmolarity assessment, blink analysis, tear meniscus height measurement, and meibography. The patient pathway is outlined from screening and simple functional tests to refined diagnostics and subtype identification (aqueous-deficient, evaporative, or mixed), followed by personalized treatment and ongoing monitoring. A structured approach based on the Dry Eye Wheel promotes consistency and clarity in diagnosis and therapy, reduces decision-making time, and enhances patients’ quality of life.