[Changes in corneal nerve fibers after microinvasive cataract surgery (a preliminary report)]

[Confocal microscopy of the corneal nerve fibers]

This article presents the results of confocal microscopy of the corneal nerve fibers (CNF). The transparency of the cornea provides a unique potential for in vivo visualization of thin unmyelinated nerve fibers at the level close to morphological study. Modern software eliminates the need for manual tracing of the confocal image fragments, allows objectifying the process of assessment of CNF structure based on quantitative indicators characterizing the length, density and tortuosity of the main nerve trunks. Clinical application of structural analysis of the CNF has two potential directions associated with immediate tasks of ophthalmology, as well as with interdisciplinary affairs. In terms of ophthalmology, this primarily concerns various surgical interventions potentially affecting the state of the cornea, and chronic pathological processes in the cornea of different nature. Such studies could analyze the degree of changes in the CNF, or the particularities of corneal reinnervation. The potential for interdisciplinary studies lies in using CNF as biomarkers of systemic polyneuropathies. Relative simplicity, high level of direct visualization of the thin nerve fibers, and the obtained results allow recommending corneal confocal microscopy as a tool for primary screening and consequent monitoring of neuropathies in addition to the conventional methods.

[Hybrid (femtolaser) phacoemulsification: technical aspects and functional results]

This article summarizes scientific and practical results of hybrid femtosecond laser-assisted phacoemulsification (HFE) including study of clinical and technical aspects of the intervention and evaluation of post-surgical functional state of the eye on the basis of clinical, morphological and biomechanical data. The HFE technology should be considered the method of choice for microinvasive phaco surgery, its main advantage being the possibility of controlled handling of such important surgical stages as anterior circular continuous capsulorhexis and nucleus fragmentation on a closed eyeball, which significantly reduces the risk of complications and decreases of effective ultrasound time.

[Phacosurgery effects on the condition of corneal nerve fibers]

The question of potential changes in the nerve fibers of the cornea induced by phacosurgery remains poorly investigated. This is a review of results of many individual studies aimed at assessing the condition of corneal nerve fibers following different techniques of cataract removal. The authors substantiate the necessity for structural analysis of fiber changes based on in vivo confocal microscopy of the cornea. Functional assessment of corneal sensitivity (esthesiometry) does not allow objective conclusions, for several reasons. Further studies on corneal nerve changes after phacosurgery could be directed at improving software products for objective quantitative assessment of corneal nerve fibers and analyzing long-term results of various phacosurgery techniques.