Currently, secondary corneal dystrophy is a common cause of corneal blindness. In addition to a significant decrease of vision, this pathology is accompanied by a significant corneal syndrome and damage to all layers of corneal tissue. The article presents the data of light microscopy of a fragment of the surface layer of pathologically altered corneal tissue obtained during surgical treatment of secondary corneal dystrophy of traumatic genesis. It was found that in this pathology there is a expressed fibrinoid swelling of the main substance and neovascularization of the subepithelial structures of the cornea. Keywords: secondary corneal dystrophy, pathomorphology, fibrinoid swelling, neovascularization

Goal. To study the features of the local cytokine profile of patients with secondary corneal dystrophy of various etiologies. Material and methods. The study was conducted among 4 patients: 1 – with bullous kerathopathy, 1 – with secondary postherpetic corneal dystrophy, 1 – with secondary keratectasia and 1 – with secondary corneal dystrophy of neurogenic origin. The quantitative content of cytokines in the lacrimal fluid was studied: interleukin (IL) 1β, 6, 4, 10, transforming growth factor β2 (TGF-β2). Results. All patients had in 3.0-4.3-fold increase in IL-1β and a 2.0-4.1-fold increase in IL-6. In bullous kerathopathy and secondary corneal dystrophy of neurogenic origin, there was in 1.1-and 1.2-fold increase in IL-4 in both cases, and a slight increase in IL-10 and TGF-β2. At the same time, in secondary keratectasia and secondary postherpetic corneal dystrophy, there was a decrease in the level of these cytokines: IL-4 by 1.7 and 1.3 times, respectively, IL-10 by 1.2 times in both cases, and TGF-β2 by 1.5 and 1.3 times, respectively. Conclusion. The study of the local cytokine profile in patients with secondary corneal dystrophy of different etiologies indicates the presence of similar aspects of pathogenesis, which is of some interest and deserves further study. The obtained results open up prospects for the development of personalized cytokine therapy for secondary corneal dystrophy of various etiologies. Key words: secondary corneal dystrophy, immunology, cytokines.

Background. Today we have active development of ophthalmic surgery, but the role of cytokines in the pathogenesis of bullous keratopathy of the cornea remains insufficiently studied at present.The aim. To study the dynamics of the local cytokine profile in bullous keratopathy by using personalized treatment with suspension of autologous blood mononuclears.Material and methods. Two groups of patients with bullous keratopathy were formed: the main group (30 people, 30 eyes), who received an intrastromal injection of a suspension of autologous blood mononuclears and comparison (28 people, 28 eyes), who received a course of pharmacotherapy. The level of interleukins (IL) – IL-10, IL-4, IL-6, IL-1ß, transforming growth factor beta-2 (TGF-β2), tumor necrosis factor alpha (TNF-α) was determined in the lacrimal fluid of the patient’s eye by enzyme immunoassay.Results. All patients before treatment showed an increase of IL-1ß in the lacrimal fluid by 3.3 times, IL-6 – by 4.2 times, TNF-α – by 2.0 times (p < 0.05); an increase in the level of IL-4, IL-10 and TGF-β2 by 1.1 times (p > ˂ 0.05). In the main group, after treatment, there was a decrease in IL-1ß by 2.0 times, IL-6 – by 2.1 times and TNF-α – by 1.8 times, and an increase in IL-10 by 1.5 times, IL-4 – by 1.9 times, TGF-β2 – by 1.4 times (p < 0.05), persisting for 12 months. There was a short-term decrease of IL-1ß by 1.7 times, IL-6 and TNF-α – by 1.2 times and an increase of IL-10, IL-4, TGF-β2 by 1.2 times (p >< 0.05) in the comparison group which then reached the initial values. Conclusion. There is an imbalance in the system of pro- and anti-inflammatory cytokines in bullous keratopathy in the lacrimal fluid. Injection of autologous mononuclear cells in the stroma of the cornea reduces the severity of the imbalance of the local cytokine system compared to the course of pharmacotherapy. Key words: bullous keratopathy, cellular technologies, autologous mononuclear leukocytes, cytokines>˂ 0.05), persisting for 12 months. There was a short-term decrease of IL-1ß by 1.7 times, IL-6 and TNF-α – by 1.2 times and an increase of IL-10, IL-4, TGF-β2 by 1.2 times (p ˂ 0.05) in the comparison group which then reached the initial values.Conclusion. There is an imbalance in the system of pro- and anti-inflammatory cytokines in bullous keratopathy in the lacrimal fluid. Injection of autologous mononuclear cells in the stroma of the cornea reduces the severity of the imbalance of the local cytokine system compared to the course of pharmacotherapy.

The purpose: to explore the clinical effectiveness of a new cell-based surgical method for the treatment of bullous keratopathy that includes intrastromal injection of autologous mononuclear leukocytes into the posterior third of the cornea stroma.Material and methods. The study included 58 patients with diagnosis of bullous kerathopathy. They were divided into 2 groups — the main group received surgical treatment by the presented method; and the comparison group received a course of conservative therapy.Results. In 10 days the patients in the main group had a normal structure of the cornea epithelium, slight edema of the stroma, thin folds of the Descemet’s membrane and moderate edema of the endothelium. Similar results in the comparison group were achieved in 1 month, and it was the best condition of the cornea. Later corneal edema increased. In 3 months the patients of the main group had a normal structure of corneal epithelium, single thin folds of the Descemet’s membrane, slight edema of the posterior third of the stroma only in the optical zone, and slight edema of the endothelium. The achieved results were preserved for 12 months. The best correct visual acuity (BCVA) in the main group was achieved by the 6th month. It increased 10 times from the initial level, and the corneal thickness decreased by 27 % from the initial level by the 9th month. In the comparison group, the BCVA was achieved by the 1st month. It increased 2.7 times from the initial level; the maximum decrease in the index of pachymetry by 6.7 % was achieved by the 3rd month from the initial level, and then these parameters increased.Conclusion. The using of a surgical method for the treatment of bullous keratopathy, including intrastromal injection of suspension of autologous mononuclear leukocytes, contributes to the relief of corneal syndrome, increases the transparency of the cornea and restores its normal thickness. These changes are accompanied by increase of BCVA in the postoperative period compared to the course of conservative therapy.

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