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The revolution in understanding the etiology and clinical manifestations of the disruption of the tearing process and the development of dry eye syndrome (CVS) has occurred in last 20–30 years. It has been established that the loss of the tear film homeostasis can occur not only because of a violation of systemic and autoimmune disorders, but also as a result of a blinking disorder and distribution of the tear film over the ocular surface. Therefore, new pathogenetic disease development mechanisms have been identified. The prevalence of diseases of the ocular surface and CVD in recent years has increased significantly. It is mostly caused not only by scientific discoveries in the field of understanding, for example, the etiological and pathophysiological role of the neurosensory mechanism of development of CVS. An important aspect is the emergence of new risk factors that potentiate the development of ocular surface diseases and CVL. These factors include the use of various drugs — antidepressants, antihistamines, hormone therapy, and others; instillation of eye drops — antiglaucoma drugs, etc., as well as the appearance of little-studied factors such as cosmetology procedures (eyelids tattooing, eyelash extensions, botulinum toxin injections for aesthetic purposes, etc.). They are carried out in proximate close to the eye and eyelids, causing multiple pathological reaction. The experience of observing patients, literature data, and the conducted study have showed that various cosmetological effects in the periorbital zone, whose popularity has increased in recent years, may cause the appearance of iatrogenic dry eye syndrome. The following most vivid clinical examples will help, encountered in our practice, to illustrate the data presented. Collecting the anamnesis, it is necessary to identify the presence of risk factors for the development of diseases of the ocular surface and CVD, to eliminate them, if possible, and to carry out adequate pathogenically based therapy.

Patients, who need cataract surgical treatment, often fail to achieve a high uncorrected visual acuity after surgery due to the concomitant astigmatism involved. Currently, surgeons are increasingly performing combined surgical interventions, including relaxing limbal keratotomic incisions (manual keratotomy) or femtoarcuatous keratotomy, as well as implanting toric intraocular lenses. In recent years, additional toric intraocular lenses have been available. Purpose: to analyze our own clinical experience of implanting an additional toric intraocular lens to correct corneal astigmatism in three clinical cases. The article presents our clinical experience of successful correction of residual corneal astigmatism after previous cataract phacoemulsification with the implantation of a monofocal toric intraocular lens in three patients patients aged 70, 61 and 54 years. In all cases, an additional toric intraocular lens Add-on Torica-sPB pre-filled in the cartridge with a good refractive effect was implanted. The uncorrected visual acuity was 1.0 in all the investigated cases at the follow-upo period of 6 months after the surgical intervention. Calculation of the toric intraocular lens optical power was performed using an online calculator. A feature of surgical intervention was the repositioning of the additional toric intraocular lens into the ciliary sulcus. Changes in the data of keratotopography before and after surgery were absent. In none of the investigated cases, intra- and postoperative complications and dislocation of the implanted additional toric intraocular lens were determined. Based on these cases, high predictability, efficacy and safety of implantation of an additional toric intraocular lens are shown, in the case of residual middle-grade corneal astigmatism after the initial cataract phacoemulsification with the toric intraocular lens implantation. This approach can be successfully used in patients during one-stage surgical treatment of cataract and associated high-grade corneal astigmatism, expanding existing protocols for the treatment of this group of patients.

Purpose. Evaluation of short-term (up to 9 months) results of new one-piece aspherical diffractive trifocal intraocular lens implantation. Patients and Methods. A prospective, open-label study included 65 patients (100 eyes) with presbyopia, who received cataract extraction with the implantation of a new IOL AcrySof PanOptix® trifocal. The average age of the patients was 60.0 ± 12.1 years. 35 patients underwent bilateral correction with multifocal IOLs, and 30 had a monolateral correction. In 21 % (n = 21) cases, femtolaser support of cataract extraction was performed. In 9 eyes (9 %) the primary posterior capsulorhexis was performed. The range of optical power of implanted IOLs was 13 to 30 D. The follow-up period was from 6 to 9 (6.8 ± 0.9) months.Results. On the 1 day after the MIOL implantation, an UCIVA increase was from 0.22 ± 0.19 to 0.76 ± 0.23 (p < 0.05), at follow-up to 6 months up to 0.85 ± 0.22. One day after surgery, the UCIVA increased from 0.23 ± 0.19 to 0.7 ± 0.25 (p < 0.05), with following raise up to 0.84 ± 0.24 in the maximum follow-up period of 6 months. UCFVA in the preoperative period was 0.27 ± 0.23, with an increase to 0.78 ± 0.23 (p < 0.05) for 1 day and 0.93 ± 0.18 at 6 months. The BCNVA increase was from 0.56 ± 0.25 before surgery to 0.8 ± 0.19 on the 1st day after cataract removal (p < 0.05) and 0.98 ± 0.16 at the 6 months follow-up period. Similar data (0.58 ± 0.29, 0.82 ± 0.21, and 0.95 ± 0.14) was noted for BCIVA. An BCFVA increase was from 0.71 ± 0.28 in the preoperative period to 1.0 ± 0.04 (p < 0.05) after 6 months. The primary endpoint of the study (BCFVA = 1.0) in the group was achieved in 83 % of cases (n = 83). The effect of glare was noted in 17 patients (26.1 %), halo in 9 (13.8 %), driving difficulties in 6 (9.2 %). The overwhelming majority of patients (96.9 %) rated the result of the operation as “excellent” (n = 51, 78.5 %) and “good” (n = 14, 21.5 %).Conclusion. Implantation of the examined IOL is associated with a high efficiency for near, intermediate distance and far vision correction. A new trifocal IOL may be recommended for use in clinical practice. Further comparative studies including other multifocal IOLs are needed to determine the indications and contraindications for its implantation.