Optical reconstructive surgery of the anterior segment of the eye in the far eastern federal district – achievements and unsolved problems

Abstract

The aim was to analyze organizational and technical difficulties in introducing modern technologies of optical reconstructive surgery, and to find the options of their elimination. Materials and methods. Organizational arrangements to develop and to introduce into clinical practice modern technologies of optical reconstructive surgery in treatment of corneal opacities of different origin in the Khabarovsk branch of the S. Fedorov Eye Microsurgery Federal State Institution of the Ministry of Health of the Russian Federation has been analyzed. Results and conclusions. An unified register of patients of the Far Eastern Federal district who need optical keratoplasty (bullous keratopathies, keratoconus stages 3–4, post-traumatic leukomas, hereditary corneal dystrophies) – a waiting list – has been created. The necessary equipment and instruments were acquired, 4 surgeons were trained who mastered the technologies of deep anterior lamellar keratoplasty and Descemet membrane transplantation along with penetrating keratoplasty. From 2014 to 2018, 160 optical keratoplasty were performed using donor material; by 2019, the need for this type of high-tech treatment has been reduced by 2 times. To date, more than 30% of optical keratoplasties are performed using lamellar technology. The organizational sequence of ordering biological material, performing surgeries; the postoperative care system is got up and running; the outpatient departments’ophthalmologists of the region are trained to use clear objective criteria for dynamic follow-up of these patients.