The main link in the treatment of congenital cataracts (VK) is the extraction of the lens with the
subsequent correction of ametropia by various methods, one of which is the implantation of an
intraocular lens (IOL). The aim of the study was to study the features of the course of the postoperative period in frequently ill children (FBI) after VC extraction. We examined 35 children
(59 eyes) with VK who are undergoing surgical treatment in the eye department of the clinic of the Tashkent Pediatric Medical Institute. A comparative analysis showed significant changes in the hydrodynamic parameters of the eyes and a high percentage of intra- (hyphema in 71%, fibrin
reaction in 59%, prolapse of the vitreous in 47% of cases) and postoperative complications (corneal
edema in 36 %, inflammatory exudative reaction in the anterior Chambers: 1+, 2+ in 64% of cases) in FWB compared to children who are not in the category of frequently ill. The revealed feature
indicates the need for adequate management of the preoperative and postoperative periods in
Frequently ill children
The study showed that 66 chi/dren aged from 8
months to 13 years with cataracts of different etiology
showed high efficiency in the primary implantation of
soft spherica/ monohlock intraoci1lar /ensf!S. Тhе high-
est rates of viziometry after treatment were observed in
chi/dren with congenital bl/ateral and traumatic cata-
racts. After _treatment, children with uveal and uni/at-
era/ congenital cataracts had relative/y /ow visua/ acu-
ity va/ues.
Cataract in children, which is one of the leading causes of primary blindness, is a clouding of the lens. The prevalence of cataracts in developed countries, as well as in Russia, is 1.6–2.4 per 100,000 children. Intraocular lens (IOL) implantation has become widespread in recent decades and is considered the most optimal method for correcting aphakia. Despite the introduction of new high-tech methods of surgical treatment of congenital cataracts, there is currently a fairly high percentage of complications. All of the above does not reduce the urgency of the problem of treating children with congenital cataract (CC) and requires further research.
AIM: To analyze clinicofunctional and echobiometric indicators of the eyes in children with target refraction, pseudofacial myopia, and their mothers.
MATERIAL AND METHODS: In the eye department of the clinic of the Tashkent Pediatric Medical Institute, a correlation analysis of optical and echobiometric indicators was conducted in 30 children (30 eyes) with artifakia and their mothers (60 eyes). Visiometry, keratorefractometry, and ultrasound examination (A/В scan of the eyeball) were conducted. Children were examined 12-14 months after CC extraction with intraocular lens (I0L) implantation.
RESULTS: A strong direct correlation was determined between the optical power of lOLs in children and their mothers who were theoretically planned for I0L implantation of lOLs in the group that has achieved target refraction. This may indicate the possibility that the child has the same optical power as the mother and the optical power of lOLs in a child is the same as that in adults. No correlation was found between the optical power of the I0L in the eyes of children with pseudophakic myopia and maternal artificial lenses theoretically planned for implantation.
CONCLUSION: The direct strong correlations between the optical power of the I0L of children and the lenses of their mothers in the group with the target refraction achieved by this age make it possible to use the optical power of maternal lenses as a “guideline" when calculating the power of the I0L implanted in children to achieve the target refraction. The lack of correlation between the refractive powers of the I0L in children with pseudophakic myopia and the lenses of mothers may indicate that the SRKII formula with age-related hypocorrection is not adapted to calculate the I0L power in children at risk of excessive refractive enhancement after surgery.
The length parameter of anterior-posterior axis is compared for children’s hyperopic eyes (302 eyes, hyperopia of 0.5 to 3.0 D). 109 eyes (109 children) with unilateral congenital cataract (UCC), and 132 eyes (90 children) with congenital glaucoma, aged 1 month to 15 years. Extended observation of anterior-posterior axis growth and refraction in eyes with artifakia showed a partial tendency to myopisation (3— 7%), which requires additional research of the pathogenetic process and should be taken into account when calculating the optical power of 1OL. The analysis of data on age-related growth of the anterio-posterior axis of eyes with congenital glaucoma showed the agreement with average figures for the developed and advanced stages of the condition. In contrast, terminal and advanced glaucoma (in children aged 2 to 3) the obtained data showed a reliable increase as compared to previously published values
The length parameter of anterior-posterior axis is compared for children’s hyperopic eyes (302 eyes, hyperopia of 0.5 to 3.0 D). 109 eyes (109 children) with unilateral congenital cataract (UCC), and 132 eyes (90 children) with congenital glaucoma, aged 1 month to 15 years. Extended observation of anterior-posterior axis growth and refraction in eyes with artifakia showed a partial tendency to myopisation (3— 7%), which requires additional research of the pathogenetic process and should be taken into account when calculating the optical power of 1OL. The analysis of data on age-related growth of the anterio-posterior axis of eyes with congenital glaucoma showed the agreement with average figures for the developed and advanced stages of the condition. In contrast, terminal and advanced glaucoma (in children aged 2 to 3) the obtained data showed a reliable increase as compared to previously published values
Congenital cataracts occupy a significant place in the structure of blindness and low vision and are one of the main causes of visual disability since childhood. Currently , cataract in children is one of the urgent problems of pediatric ophthalmology , given its fairly high prevalence and significant role in the structure of blindness and low vision . Due to clouding of the lens, the development of the visual analyzer is disrupted and amblyopia is formed, the treatment of which requires significant and lengthy efforts on the part of ophthalmologists and parents. Among the causes of blindness in children, the share of congenital cataracts varies from 7.5% (in developed countries) to 27.4% (in socially disadvantaged regions). The prevalence of cataracts in developed countries, as well as in Russia, is 1.6-2.4 per 100,000 children [25.].
For parents, a child of any age seems vulnerable, so adults take care of him, they want protection from all difficulties. Unfortunately, a person is not strong and some diseases are very dangerous for the life of children. Some pathologies pass quickly and affect the future life, otherwise others will significantly affect the future life of the child. In order to reduce the impact of pathologies on the child's body, it is possible to diagnose the disease in the early stages, it is necessary to identify and immediately begin treatment. Among these diseases are ophthalmic we can not do without the introduction of diseases. If a child has vision problems from an early age, it can lead to a delay in the development of the child in the future. Ophthalmic diseases the main part: eye injuries, glaucoma, cataracts, glaucoma, retinopathy, myopia, cataract diseases, etc. More than 20% of diseases in ophthalmological practice, depending on the injury, damage the orbit and the eyeball. From an eye injury, then in 13% of cases, subatrophy of the eye develops, in 25% anophthalmos may occur. As for the characteristics of injuries, 10% of children suffer from damage to the organ of vision. This leads to various pathologies of the eye, in 30-60% of cases it can lead to one- or two-sided blindness. The most important traumatic factors in children are: knives, bullets, stones and clubs, hockey sticks, spears, nails, wire, etc. Glaucoma is one of these diseases. The disease also requires special attention. Reason: Prevalence of glaucoma in children Occurs in 1:10,000-1:12,000 cases. Its share in eye pathology is 0.1%. enough. More than 75% of glaucoma cases are bilateral. In parallel, there was glaucoma in 5 to 15% among children, blind and non-blind schoolchildren. Blindness in children, the proportion of this pathology ranges from 2 to 15%. in the Russian Federation Congenital glaucoma accounts for 10.1% of childhood blindness.
Biochemical studies of blood and chamber moisture in children with congenital cataract
are of great clinical importance. Chamber moisture is an ultrafiltrate of blood plasma and can be
an indicator of various pathological conditions of the body as a whole, and the eye in particular.
The study of the level of protein, glucose in the blood and chamber moisture of all the examined
children was carried out. As an indicator of inflammatory complications in the postoperative period,
the threshold value of total blood protein of 62.2±1.3 g/l and an increase protein content in chamber
moisture to 3.5±0.09 g/l can be used.
Врожденная расщелина неба (ВРН) может возникать отдельно или одновременно с расщелиной верхней губы. При ВРН возникает не только деформация мягких тканей, но и дефекты и деформации костной ткани разной степени которые намного серьезнее, чем ВРГ, с точки зрения физиологической дисфункции, такой как сосание, еда и язык. Из-за роста и развития челюстей часто происходит коллапс середины лица. В тяжелых случаях оно имеет форму тарелки и имеет нарушенный прикус. Таким образом, различные физические дисфункции, вызванные деформацией волчьей пасти, особенно такие как языковая дисфункция и расстройство зубов, оказывают неблагоприятное воздействие. Оба эти заболевания являются врожденными и в медицине называются врожденными пороками развития ротовой полости.
Врожденная дисфункция коры надпочечников (ВДКН) - (врожденная гиперплазия надпочечников, адреногенитальный синдром, синдром Апера-Галле) относительно редкое заболевание с аутосомнорециссивным характером наследования иобусловленное генетическим дефектом синтеза андрогенов в надпочечниках вследствие недостаточности одного из ферментов
To study the results of IOL implantation in children with frequent respiratory diseases - conditionally frequently ill children (FCCI) taking into account the parameters of the composition of the chamber moisture of the eye. Material and methods: A retrospective and prospective analysis of the case histories of 50 children (50 eyes) aged from 1 to 5 years, who were treated in the eye department of the TashPMI clinic, was carried out. All patients underwent ophthalmological, clinical and laboratory studies: biochemical studies of blood and chamber moisture of the eye (EC). Results: The children were divided into 2 groups: the 1st group - 28 UCBD, the 2nd group (control) - 22 patients with no pathology from the somatic status. In patients of the 1st group, intraoperative complications occurred 1.8 times more often than in patients of the 2nd group, postoperative complications - 2.5 times more often. Of the late postoperative complications in patients of the 1st group, there was fibrosis of the posterior lens capsule (61%), poste-rior synechia (18%), and IOL dislocation (14%), which were indications for repeated surgical interventions. Conclu-sions: UCBD has a higher percentage of early postoperative inflammatory and late proliferative reactions. In patients of the 1st group, a significant increase in the protein content in the chamber moisture and a significant decrease in the protein level in the blood before cataract extraction were also revealed.
The paper presents the results of extraction of congenital cataract with IOL implantation in 50 (86 eyes) children aged 7 months to 12 years. In the examined patients, intraoperative complications were noted, such as posterior capsule rupture (8%), hyphema (6%), postoperative: fibrin effusion on the IOL (7%) and corneal edema (4.6%). With congenital bilateral cataracts after treatment, visual acuity increased on average from pr.l.certae to 0.1; with unilateral - from pr.l.certae to 0.01.
The article presents the results of the clinical efficacy of the calculation formula with the correction factor of the optical force of the intraocular lens in children with congenital cataracts at risk of development of pseudophakic myopia. Personalized Rm corrective coefficient in the formula for calculating the force of IOL in children with risk of development of pseudophakic myopia makes it possible to achieve target refraction in 83.3% cases and reduce the development of reduce myopic refraction.
Actuality. Prevention of visual disability should begin in childhood. To plan high-tech specialized ophthalmic care for young patients, it is necessary to monitor the structure of ophthalmopathology in infants in leading domestic children's medical
institutions. Purpose of the study. The study of the structure of eye diseases in infants based on the materials of the department of ophthalmology of the clinic of the Tashkent Pediatric Medical Institute (TashPMI). Material and methods. A retrospective analysis of statistical coupons of case histories of 685 patients aged 0 to 1 years who were hospitalized in the ophthalmological department of the TashPMI clinic for 2018-2021 was carried out. Results and conclusion. The spectrum of nosological units revealed the
predominance of glaucoma (41.3%) and lens diseases (30.4%). At the same time, it was noted that eye injuries (10.5%), diseases of the eyelids, lacrimal ducts (phlegmon of the lacrimal sac) and orbit (9.2%), although they did not occupy a leading position, nevertheless represented severe acquired lesions that could be prevent. Age-related aspects of nosologies are due to the timing of clinical manifestations, diagnosis and treatment of pathologies, the anatomical and physiological characteristics of the child’s body,
and a decrease in parental control over children.
A clinical case of familial congenital cataract in two patients is presented. born from consanguineous marriage. The studies were carried out in the department of ophthalmology clinics of the Tashkent Pediatric Medical Institute. Patients underwent standard laboratory and instrumental studies, as well as ophthalmological examination , including visometry , biomicroscopy , ophthalmoscopy . The a clinical case indicates the risk of having children from a closely related marriage with congenital cataract, optic nerve hypoplasia, which can further lead to visual impairment.