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Biomedical subjects

E P Tarutta

Publications and source records attributed to E P Tarutta.

At least 19 recordsLinked to original sources
PubMed1997

Nonsurgical and surgical methods of sclera reinforcement in progressive myopia.

PURPOSE: As shown by the clinical picture of progressive myopia, derangements in biomechanical properties of sclera may be more or less manifested. The study aims at the development of a discriminating approach to their correction. METHODS: Patients with the condition were given a sclera strengthening injection, in which a dose of liquid polymeric composition is injected under the Tenon's capsule on the scleral surface. After polymerization, the composition forms over the scleral surface a layer of elastic foamed gel. RESULTS: Complex experiments on 146 rabbit eyes showed that the injected material promotes collagen formation. Gradually dissolving, the gel stimulates the growth of connective tissue on the surface of the sclera, whose stress-strain parameters improve. A thorough clinical study of 240 eyes of patients aged 8-25 years with progressive 6-10 D myopia showed that the refraction remained stable in 79.6% eyes 1 year after the sclera strengthening injection and in 52.9% cases 4-9 years after the sclera strengthening injection. At the same time, fellow intact eyes have shown, respectively, 40.3% and 13.3% of myopia stabilization, and 212 untreated eyes of the control group 26.0% and 11.1%, respectively. 612 children and adolescents with high myopia and a yearly progression of over 1.0 D were subjected to a scleroplastic operation. It was found that the myopia remained stable in 95.7% cases 1 year after the operation, and in 71.9%, 7 years after the operation. If myopia progression continued after a sclera strengthening injection or scleroplasty, a second procedure was performed. Second interventions were effected on 118 eyes of 102 patients, including 42 eyes where a sclera strengthening injection followed a sclera strengthening injection, 27 eyes where scleroplasty followed a sclera strengthening injection, 31 eyes where a sclera strengthening injection followed scleroplasty, and 18 eyes on which a second scleroplasty was performed. Second interventions provide a double decrease of myopia progression rate and, in 63% of patients, stop the progression altogether. CONCLUSION: It can be concluded that nonsurgical and surgical techniques of correcting the biomechanical properties of sclera for the treatment of progressive myopia as well as discriminative methods of determining the indications to these procedures have proven to be effective.

Acrylamides↗
PubMed1989

[Indications for keratotomy].

The paper analyses indication to anterior radial keratotomy. Results of the study carried out concerning the influence of uncorrected myopia on successful fulfillment of different tasks (aiming from a sporting gun, operation of a bridge crane, take off and landing on the airplane trainer, etc.) have shown that myopia of 2. OD doesn't influence the fulfillment of work not only with objects situated at near distance from the eyes but at far distance as well. Thus the mentioned myopia cannot serve as a professional indication to keratotomy. The analysis of typical complaints of patients after keratotomy allowed to distinguish 8 main complaints and to assess their incidence and causes as well as causes their of appearance. It is established that even uncomplicated keratotomy can lead to functional changes in vision lowering visual capacity for work. On the basis of all mentioned above a scheme of indications and contraindications to keratotomy is proposed.

Humans↗
PubMed1989

[An analysis of the late results of scleroplasty in progressive myopia].

Analysis of remote (to 9 years) results after 256 sclera-enhancing operations in patients with progressive myopia, aged from 7 to 48 years, revealed stabilization of the process in 72% of patients, the dependence of the effect on the form of myopia and the patient's age. As to prognosis, early acquired myopia and the children age are less favourable. The number of surgical failures increases in remote terms; in some patients the effect can be transitory. Therefore, surgical results should be judged about minimum 3 years after operation. Comparative examination of the state of a complex "graft-sclera" by means of computer tomography in satisfactory and unsatisfactory surgical results has shown that myopia continues to progress, as a rule, in case of reduced scleral density and the absence of roentgenologic signs of the graft. The action of scleroplasty on the appearance and course of central chorioretinal dystrophies has been studied.

Adolescent↗
PubMedDate not supplied

[The morphological characteristics of the take of synthetic transplants following experimental scleroplasty].

The morphology of taking in of synthetic transplants after scleroplasty is studied in 24 eyes of chinchilla rabbits. Polytetrafluorethylene-based materials (composite filtration fluoroplast membrane--Teflon) and polyester jersey with reticular structure (scleracod) were used for transplantation. Study of two materials showed common processes and differences in the grafts taking in. Implants made of both materials are characterized by good biocompatibility, which prompts further investigation of their probable use in sclera-fortifying treatment of progressive myopia.

Animals↗
PubMedDate not supplied

[Reinforcement of the sclera with new types of synthetic materials in progressive myopia].

The possibility of using a new synthetic material mersilene for scleroplastic operations has been evaluated in experiments and clinical trials were carried out in patients with progressive myopia subjected to sclera fortification. Morphological studies showed the formation of a connective tissue capsule round mersilene; new collagen fibers grow through its cellular structures, thus fortifying the strength of the sclera-graft complex. Clinical results indicate that sclera fortification by a mersilene graft arrested the progress of myopia in almost all (98%) patients by the end of the first year postoperation; by the end of the second year, myopic refraction stabilized in 92% patients. Hence, mersilene transplants are recommended for scleroplasty in progressive myopia.

Adolescent↗
PubMedDate not supplied

[Scleroplasty with plasma-modified homoslceral grafts: experimental morphological study].

Healing of homoscleral grafts treated by gas discharge low-temperature plasma has been studied. Such treatment leads to formation of a modified surface layer in scleral tissue; the presence of such a layer improves the hydrophilic properties and biocompatibility of the sclera, thus promoting better adaptation of the graft to further restructuring and healing during the postoperative period. Experiments on 32 eyes of chinchilla rabbits showed that after scleroplasty with thus treated transplants, complete replacement of fibroblasts and collagen carcass of the graft was observed as early as after 7.5 months (vs. 12 months in the control); the graft was stabilized and tightly grown into the sclera to form a solid sclera-graft complex which fortifies the scleral membrane of the eye. Use of plasma-modified transplants may improve the efficiency of scleroplastic operations in progressive myopia and ocular injuries.

Animals↗
PubMedDate not supplied

[Significance of lacrimal fluid peroxidation and anti-radical defense parameters for prediction and treatment of complicated myopia].

Study of lipid peroxidation and antiradical defense parameters in the lacrimal fluid from 270 eyes of children and adolescents with progressive myopia demonstrated a relationship between the development of peripheral vitreochorioretinal dystrophies and imbalance between antioxidant activity (AOA) of lacrimal fluid and intensity of radical formation evaluated by chemiluminescence (CL) intensity. The AOA/CL ratio is proposed as a reliable indicator for predicting the course of progressive myopia. A value < 30 indicates poor level of antioxidant defense of ocular media and tissues and is a prognostically unfavorable sign as regards development of peripheral vitreochorioretinal dystrophy. A local antioxidant remedy has been developed and clinically tried for preventing and treating complicated myopia: ocular medicinal films with emoxipin and pyridoxine hydrochloride.

Adolescent↗
PubMedDate not supplied

[Plasma-modified silicone graft for scleroplasty in progressive myopia].

Plasma-chemical modification of synthetic transplant material (proliferous silicone) intended for scleroplasty in progressive myopia was theoretically substantiated, developed in the experiment and tested in practice. This treatment was shown to enhance the biocompatibility of a graft which tightly joins the sclera through the connective tissue intergrown from the surrounding capsule into the graft. The efficacy of the proposed plasma-modified grafts in stabilizing progressive myopia in 18 patients operated on (33 eyes) aged 6 to 49 years (spherical equivalent myopia degree 3.0-28.0 D) during 3- year followup was 97%. There was an elevation of uncorrected and corrected visual acuity, are active course of the postoperative period.

Adolescent↗
PubMedDate not supplied

[Prognostication of a complicated course of myopia in children].

The aim of the case study was to define the earliest criteria of the transformation of myopia into its aggravated form. Two related risk factors were isolated on the basis of a comprehensive examination of 135 children and teenagers with uncomplicated myopia of 0.5-16 d and with myopia complicated by different-type peripheral vitreochorioretinal dystrophies (PVCRD). They are primarily a reduced acoustic sclera density in the excavation zone and in the region of the posterior eye pole, diminished antioxidant reserve of the lachrymal fluid and heredity (presence of PVCRD in close relatives). Besides, a mild relationship was established between the eye fundus status in children and teenagers with myopia, on the one hand, and myopia progression rate, linear blood-flow velocity in the ciliary body, relative accommodation reserve and a value of the anterior-posterior eye axis, on the other hand. No reliable correlation was found between the eye fundus status and the below parameters: volumetric and linear blood flows in the ocular artery and in the posterior ciliary arteries, volumetric blood flow velocity in the ciliary body, intraocular pressure values, elastic elevation and rigidity factor. The most significant differences between the complicated and uncomplicated types of myopia in children were registered in its mild degree.

Adolescent↗
PubMedDate not supplied

[Choice of a scleroplasty method in progressive myopia in children].

Dynamic analysis of the results of sclera-fortifying interventions (scleroplasty and sclera-fortifying injection) in children aged 8 to 12 has demonstrated that in many cases myopia stabilized but temporarily after sclera fortification in children with progressive myopia. Repeated sclera-fortifying interventions reduced the rate of postoperative myopia progress approximately twofold, the myopia stabilization period lasting for 1 to 2 years; in some cases myopia progress ceased after a repeated intervention. In 67% of patients myopia on the second eye did not progress for 6 months after sclera-fortifying injection and for a year after scleroplasty on the first eye. Sclera fortification in the paired eye is advisable within these periods. Analysis of the results from the viewpoint of the general mechanisms of scleroplasty effect has lead the authors to a conclusion that sclera-fortifying therapy of children with high progressive myopia should be carried out in several stages. A system of sclera-fortifying treatment of progressive myopia has been developed, and the continuity of methods used for this purpose validated. Effects of this treatment scheme on refraction and status of the fundus oculi are estimated.

Age Factors↗
PubMedDate not supplied

[Scleral fortification in children at high risk of progressive myopia].

To improve scleroplasty efficacy in children at a high risk of postoperative progress of myopia the authors have developed a new surgical method involving increase of the transplant size and its preoperative treatment with a foamy composition intended for filling the body cavities. Experimental biomechanical and morphologic studies have demonstrated that such treatment improves the transplant elasticity and strength, provides its better adhesion and fixation to the sclera at the expense of excellent adhesive properties of the foamy composition, and intensifies revascularization and stabilization processes in the connective tissue. Such surgery was effectively performed in 46 patients.

Adolescent↗
PubMedDate not supplied

[Progressing myopia in children: does it need treatment or not?].

The purpose of the case study was to evaluate the remote consequences of a complex of laser and repeated surgical sclerorestorative procedures made in progressing myopia and its complications. Three hundred and forty-six children, aged 8-10, with rapidly progressing uncomplicated myopia of 4.25 to 9.5 D were shared between 2 groups. Two hundred and forty patients of the experimental group were made sclerorestorative procedures and transscleral low-energy laser stimulation of the ciliary muscle by means of infrared laser MACDEL-09. No such treatment was applied to patients of the control group. When indicated, preventive laser coagulation of the retina was made in both groups. The dynamic 10-year follow-up over the status of refraction and eye bottom showed that the complex scheme of repeated sclerorestorative procedures and low-energy laser treatment combined with preventive peripheral laser coagulation of the retina cut the rate of progressing myopia and prevented peripheral vitreoretinal dystrophy and retinal detachment in children and teenagers with progressing myopia.

Age Factors↗
PubMedDate not supplied

[Potentialities of preventing progressive and complicated myopia in the light of present-day knowledge].

The paper generalizes the present-day principles of prevention of progressive and complicated myopia. The risk factors of complications and disability due to congenital and acquired myopia are defined. Methods of spectacle, contact, and surgical correction in congenital myopia are discussed. There is evidence for the importance of studies dealing with the etiological factors and pathogenetic mechanisms in determining the ways of preventing myopia. Recommendations are given for the prevention of disabling forms of myopia.

Disease Progression↗
PubMedDate not supplied

[Evaluation of corneal changes induced by orthokeratological contact lenses].

The authors have studied a response of the cornea (a change in its thickness, shape, refraction, and endothelium) to nocturnal orthokeratotology - a procedure for temporarily diminishing or removing myopic refraction, which is accomplished by wearing rigid gas-permeability contact lenses that change corneal shape and optical strength. The orthokeratological technique has been ascertained to be an effective modality for the temporary reversible reduction of mild and moderate myopic refraction. In some cases, the refractive effect of the technique may run up to 7.5 diopters. The mechanism of action of orthokeratological contact lenses is to form an epithelial diverging biolens onto the corneal surface by transferring epithelial cells from the center to the paracentral parts. Wearing of orthokeratological contact lenses does not cause clinically significant symptoms of damages to the epithelium and corneal stroma or lead to altered endothelial cell density.

Adolescent↗
PubMedDate not supplied

[Reflex therapy, massage, and manual therapy in the treatment of progressive myopia in children and adolescents].

The paper describes the methods and results of multimodality treatment for progressive myopia in children and adolescents, by applying acupuncture, massage, and manual therapy. Thirty-three patients aged 7 to 17 years who had progressive myopia of 0.5 to 10.8 diopters were treated by an original procedure as repeated courses. Their follow-up lasted 2 years. A beneficial therapeutic effect as increases in uncorrected and subcorrected visual acuity, ocular accommodation reserves, and myopia regression rates was observed in 64% of the patients. Two-year myopia stabilization was achieved in 45% of cases. There were neither complications nor side effects. The possible mechanism of the remedial effect of the procedure is discussed in the paper.

Accommodation, Ocular↗
PubMedDate not supplied

[Copper metabolism in scleral tissue and possibilities of its correction in myopia].

Copper measurements in scleral tissue of 14 cadaveric emmetropic eyes and in 10 eyes with myopia of various degrees have shown a significant reduction of these levels in the equatorial and posterior segments of myopic sclera and abnormal distribution of copper in the tissue, this indicating disordered metabolism of this trace element. A method for drug correction of the detected disorder has been experimentally tried, consisting in administration under the Tenon's capsule of a copper coordination compound on a foam composition base, used for sclera-fortifying injections in progressive myopia. This resulted in elevation of scleral copper concentration, activization of collagen biosynthesis processes, and improvement of scleral tissue elasticity.

Adult↗