Corneal and Refractive Surgery Department

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

Corneal and Refractive Surgery Department of UERI was founded in 2010 under the direction of Prof. M. M. Bikbov.  The creation of Department contributed to organization of highly specialized ophthalmic care based on fundamental scientific research. For various reasons (the growing popularity of laser eye surgery,  progressive development of cataract surgery)  demand for this sector of ophthalmology has significantly increased. Currently the equipment of the Department meets the latest requirements and is highly competitive with the leading foreign clinics. Employees of the department deliver full line of specialized eye care, including anterior segment eye surgery.

Department

The activity of Department includes the development of diagnostic methods, surgical techniques and therapeutic treatments for cornea and lens diseases, surgical correction of ametropia.
Department provides conservative and surgical treatment for cornea and lens diseases through the introduction of the most modern techniques. The results of the treatment contribute to development of medical devices and medical equipment.
The «jewel» of ophthalmology – cataract surgery has taken a big leap forward, from intracapsular cataract extraction to phacoemulsification. On the basis of department different methods of cataract surgeries are implemented including complicated cases.
 Ophthalmologists of Department conduct phacoemulsification, femtolaser assisted cataract surgery with implantation of intraocular lenses (monofocal, multifocal, toric, additional). The surgery is performed by qualified ophthalmosurgeons using the most up-to-date equipment. The surgery lasts for 5-7 to 20-25 minutes depending on the complexity of cases.
Femtolaser surgery used in some cases avoids the necessity of some stages of operation (f.e. capsulorhexis, nuclear fragmentation) performed by surgeon, reducing the likelihood of medical error and human factor. The implantation of premium lenses (additional, toric and multifocal) is widely introduced.   

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 Special attention is given to the surgical treatment of various cornea diseases. Due to popularization of laser vision correction  the number of patients with late postoperative complications has dramatically increased.
 Corneal ectasias are the focus area of scientific and practical activities of the department. Specialists have extensive experience in surgical treatment and long-term management of patients who underwent a surgery for degenerative cornea diseases.

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                                                                          Acute keratoconus

On the basis of department a wide range of operations for such diseases as keratoconus, corneal dystrophy, secondary corneal ectasias after LASIK, secondary keratopathy after abdominal operations.
Here for the first time in Russia such techniques as corneal collagen crosslinking, «MYORING» corneal rings implantation were implemeted. Doctors perform all types of keratoplasty: epikeratoplasty, penetrating keratoplasty, anterior lamellar keratoplasty and endothelial keratoplasty. These operations are carried out with the use of modern equipment («POCKETMAKER DIOPTEX»), tools and trephines. 

 SCIENTIFIC ACTIVITY

The work of department is based on experimental and clinical research collection on development and introduction of new improved methods for the treatment of various cornea and lens pathologies. The developed methods and medical devices are covered by various patents and diplomas.
Annually staff of department publishes more than 50 publications in various domestic and foreign editions.

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Patents and inventions


FOCAL AREAS:
  • Planning and implementation of innovative projects for the diagnosis and treatment of cornea and lens diseases
  • Conservative and surgical treatment of degenerative cornea diseases;
  • Stepped therapy for corneal ectasia;
  • Keratoplasty in various cornea pathologies; 
  • Methods to prevent graft rejection by subconjunctival injection of anti-VEGF drugs;
  • Investigation of the structure of aberrations after surgical treatment of keratoconus;
  • Development of medical products for ophthalmology;
  • Intraocular and keratorefractive surgical correction of ametropia in children and adults;
  • Analyses of implantation of aspherical, toric, multifocal and additional IOL in cataract surgery;
  • Creation of eye bank of donor material and development of methods for graft material conservation.
     
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 25 years of experience in the study of corneal ectasia was implemented in the publication of the monograph edited by Prof. M.M. Bikbov  "Corneal ectasia". The monograph is devoted to etiology, pathogenesis, diagnosis and treatment of various corneal ectasias. It reflects the trends in disease treatment, modern methods of early diagnosis and surgery. It presents experience and the results over the past 20 years.




Diagnostic measures

Ophthalmoscopy is a basic and essential research method tha to estimate the eye condition.

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Corneal topography measures the curvature and refractive power of the cornea in the range of several thousand points (from 6000 to 15000) and the results are issued in the form of a color map of the cornea.Standard topographer is based on the principle of Placido rings reflection  where data is translated into curvatures.


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Pachymetry is a method  to determine the thickness of the cornea at different points. The survey can be conducted on different devices that fundamentally differ from each other what can cause  differences in these results. There are various methods for determining the thickness of the cornea:

• Contact – performed by contact pachymeter  (ultrasonic wave determines the distance between anterior and posterior surface of the cornea)
• Sheimpflug –  on a rotating camera - the distance between reflected front and rear surfaces of the light-slit
• OCT pachymetry  - where laser scanning allows to calculate the distance between anterior and posterior surfaces of the cornea.

OD1.jpegOCT of the anterior segment allows to scan the front segment of the eye (cornea, anterior chamber, iris, lens anterior segment) and to assess the state of the cornea in high resolution. Such measurments as thickness, condition of all layers of the cornea, presence and location of corneal implants.

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Confocal microscopy (HTR III) is an intravital microscopy of corneal tissues at the cellular level in a state of physiological activity. This survey allows detecting morphological changes in the cornea even in the pre-clinical stage of t cornea disease.
Aberrometry is used to detect errors in the optical system of the eye and depending on the severity and nature of these errors detect early signs of disease.

Surgical activity      

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Prof. M.M. Bikbov performing epikeratoplasty

 

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  Corneal Collagen Crosslinking 

On the basis of department there is new equipment for carrying out surgical and conservative treatment, assessment of epithelium condition, donor tissue sampling considering the depth of the transplant for keratoplasty.

Surgeries performed by the staff of Department:

 ·         Standard Corneal Collagen Crosslinking
·         Transepithelial Corneal Collagen Crosslinking
·         Implantation of intrastromal corneal segments «KERARING» and «FERRARA»
·         Implantation of intrastromal corneal rings «MYORING»
·         Epikeratoplasty
·         Lamellar endokeratoplasty
·         Penetrating keratoplasty
·         Photorefractive keratectomy
·         Refractive lens replacement
·         Implantation of additional pseudophakic IOL
·         Laser correction of various forms of ametropies
·         Facoemulsification with implantation of IOL
·         Femtolaser assisted cataract surgery
·         Femto excimer laser vision correction  

Much attention is paid to the preparation of donor material for all types of keratoplasty.

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                        Femtolaser-assisted cataract surgery 

                              

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                                                        Keratoconus treatment

Nowadays there is a wide range of therapeutic measures for treatment of corneal ectasias but most of them are aimed at improvement and correction of refractive error. Methods of pathogenetic therapy for keratokonus include UV  irradiation - crosslinking and keratoplasty.

Methods of keratokonus used in Ufa Eye Research Institute:

·         Selection of rigid contact lenses
·         Corneal collagen crosslinking 
·         Implantation of intrastromal corneal segments Keraring and Ferrara 
·         Implantation of corneal rings Myoring 
·         Epikeratoplasty
·         Penetrating keratoplasty

Corneal collagen crosslinking in early and advanced stages of disease is the method of keratoconus treatment which is implemented and being improved. In stable forms intrastromal rings implantation is effective, a combination of implantation and crosslinking is possible. In advanced stages in order to stop the progression of disease epikeratoplasty is conducted, cataract penetrating keratoplasty is used in the case of stable corneal opacity, in bullous keratopathy and Fuchs' dystrophy endothelial keratoplasty is carried out.
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Corneal Collagen Crosslinking
Basic research is related to development of certain aspects of keratoconus pathogenesis, bullous keratopathy, inflammatory and degenerative diseases. The focus of research activities shifted towards nanotechnology and creation of competitive products. The department develops medical devices, medicines, new eye surgery techniques.

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Eye of the patient after epikeratoplasty: after 1 week and after removal of sutures (from left to right)

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 Since 2007, medical device "UFalink" and cornea protector "Dextralink" are developed and implemented, their therapeutic action is based on correction of biomechanism of pathologically altered optical structure of the eye - the cornea. There are registration documents authorizing the production, sale and use of this production in Russia.Serial production of goods is implemented due to productive cooperation with manufacturing companies of the Republic of Bashkortostan. The produced equipment is reliable and competitive. Domestic manufacturers don’t produce anything alike. Projects of the Institute were represented at many exhibitions in Moscow, St. Petersburg (2010-2011) and Madrid (Spain, 12-15 May 2011), were awarded "100 best goods of Russia - 2010" and "100 Best Products of the Republic of Bashkortostan - 2011" certificates.

UFalink

The department staff provides: 
– advanced training courses for ophthalmologists on new methods of corneal collagen crosslinking; 
– submission of the latest achievements on the rehabilitation of patients with cornea pathology during seminars and scientific and practical conferences with international participation. 

The training courses extend the knowledge and skills to fulfill the individual stages of treatment. On the basis of the Department medical residents, graduate students, practitioners are training.  
Each patient with cornea disease or cornea damage is able to obtain optimal care with the following improvement of vision and as a result the higher quality of life.


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Every patient with cornea disease or injury has an opportunity to receive the best care which will improve vision and improve the quality of life.

  


Through careful analysis of treatment results, improvement and development of modern techniques Ufa Eye Research Institute is in the forefront of both domestic and world ophthalmology.





Doctors