I Microsurgical Department

90 Pushkin Street
Ufa
450008      
Russia
Ph. +7 (347) 272-11-84


The 1st microsurgical department is a clinical division of the Institute designed for 65 beds. Department is occupying two floors (second and third) of the "West" building (Pushkin Street, 90).  There is a nurse's station, a procedure, dressing and diagnostic rooms on each floor. Patient’s rooms are cosy and comfortable, basically for two or three people. There work 5 doctors, 3 of them are PhDs in medical sciences.

Modern diagnostic equipment, surgical equipment and trained professionals provide a highly specialized care for various diseases of visual organs. 

   

The main field of concern is a surgical treatment of patients with cataracts, glaucoma, corneal diseases (keratoconus, corneal dystrophy, etc.), refractive surgery of severe myopia and hypermetropia. Each year the department performs more than 3,800 operations of different complexity.


Cataract is the most frequent disease in people over 50 years, the only treatment possible is surgery. Nonsuture cataract surgery (phacoemulsification) is the advanced technique of cataract surgery. The best clinics perform up to 90% of all operations using this method. Cataract surgery takes 15-20 minutes under local anesthesia, and in a few hours a patient can see. Therefore, this operation can performed without age or other diseases restrictions. 

In 2013 a broad-scale reconstruction and re-equipment of operating units were conducted. Both operating rooms are equipped with balanced system of ventilation and climate control, automatic doors, segregation of patient stream.

Operation unit on the 2nd floor has a combined laser platform including excimerlaser TECHNOLAS 217 P system, operating включающая эксимерлазерную систему и фемтосекундную систему VICTUS, операционный microscope Carl Zeiss OPMI Lumera 700 and ultrasound surgical system STELLARIS Vision Enhancement System (Bausch&Lomb). 

As is known, TECHNOLAS 217P is one of the fastest and technologically advanced lasers in the world. The system allows performing various types of laser vision correction including LASIK, PRK, and the PTK:

  • standard LASIK technique - for  correction of myopia, hypermetropia and astigmatism;
  • TISSUESAVE LASIK  allows to keep a safe thickness of the cornea during the surgery in patients with relatively thin corneas;
  • aspheric LASIK technique significantly reduces the likelihood of problems with night vision in patients after the surgery;
  • personalized LASIK technique (Super Lasik) takes into account the individual characteristics of each patient's eyes in order to reduce adverse optical effects;
  • SupraCor - vision correction in patients with presbyopia.

The usage of TECHNOLAS PERFECT VISION enables complete examination to identify hidden pathologies and performing of the most accurate and safe laser vision correction.

Femtosecond laser VICTUS is the newest system allowing to perform both corneal and refractive surgeries. The system provides a personalized approach to each operation by means of easy-to-use software CUSTOMFLAP, CUSTOMLENS, CUSTOMSHAPE and INTRACOR.

 CUSTOMLENS is a new procedure of femtolaser cataract surgery which involves performing capsulorhexis, tunnel incision, cuts for paracentesis and  nuclear fragmentation. Femtolaser stage in cataract surgery can reduce the dose of used ultrasound and operation time.

 CUSTOMFLAP is a method of corneal flap formation which makes laser vision correction more delicate. The advantages of the system are reduced operation time, formation of a qualitatively new stromal slice, free choice of thickness, diameter and position of pedicle of the flap, as well as variable angle of incision.

Combined laser platform TECHNOLAS & VICTUS expands and improves the efficiency of refractive and cataract surgery and provides a seamless workflow for the surgeon and more efficient use of space.

Operating Microscope OPMI Lumera 700 is one of the most modern microscopes. It has stereo coaxial illumination providing a high image quality and excellent visualization of the smallest details, higher contrast, brightness and stability of the red reflex. Fundus monitoring system RESIGHT allows performing surgery on posterior eye segment. Central management interface - Callisto eye and wireless foot control panel ensures maximum ease of use. OPMI Lumera 700 is provided with integration of fundus monitoring systems - RESIGHT, Intvertertube E and built-in video camera. The microscope is equipped with a USB-port video monitor 22 ", and a video camera that allows video recording of a very high quality. Integrated assistant's microscope provides high quality imaging, its zoom can be synchronized with the main microscope or controlled separately. Systems Deep View, RESIGHT, keratoscope with the wavelength 610 nm and many other features provide broad opportunities in many different areas of eye microsurgery.

This operating unit is meant for performing cataract surgery, cornea and refractive surgery which are conducted by doctors of the 1st microsurgical department and scientific department of corneal and refractive surgery. Modernization and re-equipment of operating units brought refractive, cataract and corneal surgery to a qualitatively new level.

Lumera700-Keratoskop-224x168.jpgLUMERA-700-HD-Video-Solution-224x168.jpg
c1e60e9caf6e21eab2af61cfa93e2a55.jpg
1d8e6368b06593ec83a195f8deb7017d.jpg

Operating unit on the 3d floor has 2 working places equipped with OPMI Lumera T and ultrasound surgical system Infiniti Vision System Ozil. Operating microscopes OPMI Lumera Т («CarlZeiss», Germany) are special devices used in different areas of ophthalmosurgery. Microscopes have a Red reflex illumination which significally reduces phototoxic effect on patient’s retina. Deep View function improves visualization of microstructures. Integrated MediLive 3CCD and Medialink systems provide recording on USB and hard drive.

Conducted reconstruction and reequipment of operating units provided a further intensification and effectiveness of surgical treatment of cataract, glaucoma, corneal pathology. 

Cataract surgeries are carried out by means of femtolaser surgery and ultrasound phacoemulsification with implantation of folding IOLs of various models including multifocal and toric Premium lenses. After cataract surgery vision is already restored when patient is on the operating table but stabilization of visual function occurs gradually, in a period of several days to several months, depending on the presence of other eye diseases.







Department conducts: 
1. 
Femtolaser cataract surgery (VICTUS laser system (Germany).

2. Ultrasound facoemulsification with implantation of folded IOLs including aspheric, multifocal and toric (ALCON (USA),  RAYNER (UK), ABBOT (USA), VARTAMANA INTERNATIONAL Ltd (India) etc. 

3.
 Refractive surgery in myopia and hypermyopia with IOL implantation, implantation of phakic posterior chamber IOLs.

Phacoemulsification of age-related cataractImplantation of aspheric IOL
AcrysofNatural (Alcon, USA)




Eye of the patient with age-related cataract before surgery 


The same patient on the 2nd day after phaco with implantation of aspheric IOL  Centerflex (Rayner, UK)


Eye with toric IOL AcrysofToric (Alcon, USA) 

Eye with multifocal IOL M-flex 
(Rayner, UK) 

Eye with multifocal toric  IOL
RESTOR Toric IQ (Alcon, USA) 

Eye with  aspheric IOL 
GalaxyFold Ultrasmart 
(Ellis Ophtalmic Technologies INC., USA) 

Eye of the patient (26 years old) with congenital cataract 

The same patient after phaco with implantation of с toric IOL T-flex (Rayner, Великобритания) 

3. Surgical treatment of lens subluxation of various etiology and ectopia lentis with IOL implantation.

Patient with congenital ectopia lentis
(
Marfan syndrome) 


Patient after  phacoaspiration with IOL implantation 
(intrascleral fixation)
 

4. Intraocular vision correction in capsular-ligament disorders, correction of acapsular aphakia with the use of posterior chamber IOL with additional (iris, scleral, intrascleral) fixation.

Phakoemulsification with fixation of lens cap by iris retractor in relaxation of ligaments. 

Introduction of intracapsular ring for stabilization of lens cap in partial disorder  of lens ligaments.

5. Correction of residual ametropia in pseudophakic eyes (hypermetropia, myopia, astigmatism) with the use of additional pseudophakic IOL «Sulcoflex» 

Eye with implanted additional pseudophakic IOL «Sulcoflex» RAYNER (bipseudophakia)
Additional pseudophakic IOL «Sulcoflex» RAYNER (UK)  
Bipseudophakia.In optical section of anterior eye segment 2 IOLs visualize:  (the 1st one is on the lens cap. The 2nd one is between anterior capsule and the iris) 
Bupseudophakia. OCT of anterior eye segment. 

6. Surgical treatment of glaucoma including microinvasive non-penetrating intervention, combined surgeries in cataract and glaucoma with the use of implants, shunt drainages, etc.

Non-penetrating deep sclerectomy                            Stages of the surgery

Cataract phacoemulsification (IMASTER system) with implantaition of Galaxy Fold IOL

Cataract phacoemulsification (IMASTER system) with implantaition of Galaxy Fold IOL.


Patient after phacoemulsification with GalaxyFold IOL implantion (narrow pupil and mydriasis). Visual acuity - 1,0.

The Department successfully conducts treatment of various corneal diseases including combined therapy of keratectasia, as follows:

      7. Corneal collagen crosslinking in keratoconus, endothelial-epithelial dystrophy, marginal corneal degeneration.
At initial and advanced stages of keratoconus corneal collagen crosslinking is performed. The therapeutic effect of the method is based on correcting biomechanism of diseased corneal structure. Treatment is carried out with the use of device for CXL "UFalink" and corneal protector "Dextralink."


Patient at 1st day after CXL for keratoconus
 

Patient at 5th day after CXL  

     8. Implantation of intrastromal corneal segments and rings. For correction of myopia and astigmatism (as well as stable keratoconus and marginal degeneration) implantation of intrastromal corneal segments Keraring (Mediphacos, Brazil) and rings Myoring (Dioptex, Austria). Implantation is carried out with the use of Pocket Maker device(Dioptex, Austria).

Eye after implantation of intrastromal corneal segments  "Keraring" in keratoconus.

OCT after implantation of intrastromal corneal segments "Keraring" 

Patient at 1st day after implantation of intrastromal corneal segment "Myoring" for keratoconus.


 

 9. Epikeratoplasty.  Epikeratoplasty is a process of suturing the donor corneal material to patient’s cornea. The surgery is conducted at advanced stages of keratoconus  to stop disease progression.We use  self-engineered products and world modern technologies for biolens production. Epikeratoplasty is also performed for high  ametropia.

Eye after epikeratoplasty performed for keratokonus of 3-4 stage. (ambient lighting)


 
  10. Lamellar  endokeratoplasty. 

Posterior lamellar keratoplasty  is a procedure of replacement of diseased posterior layers of cornea and endothelium by donor material  preserving anterior layers. This technique is a golden standard in treatment of epithelial and endothelial dystrophy.

Surgical indications:  primary and secondary epithelial and endothelial dystrophy of 1-3 stages.  

Eye with epithelial and endothelial dystrophy.
Eye
after endothelial keratoplasty

OCT of anterior eye segment with endothelial transplant

11. Photorefractive keratectomy for correction of residual ametropia after earlier performed epikeratoplasty, etc. Excimerlaer vision correction os performed using Navex complex (NIDEK, Japan) which includes diagnostic device  OPD-scan, microkeratome МК-2000 and laser system EC-5000. Such surgeries as laser in-situ keratomileusis and photorefractive keratectomy are performed. фоторефрактивная кератэктомия, причем как на собственной роговице, так и на подшитом донорском роговичном трансплантате.