Вплив буферних систем і консервантів у складі очних крапель на безпечне й тривале лікування пацієнтів із хворобою сухого ока Резюме. У статті висвітлено особливості різних складових офтальмологічних препаратів, залежність ефективності й переносимості терапії хвороби сухого ока від властивостей і характеристик очних крапель. Основу медикаментозної терапії протягом останніх років становлять препарати штучної сльози, або сльозозамінники. До їх складу входять різні буферні системи й консерванти. Детально висвітлені питання впливу консервантів, буферних систем на очну поверхню й можливість застосування альтернативних засобів. Наведено дані доклінічних і клінічних досліджень, які підтверджують переваги виключення консервантів зі складу очних крапель і наявність ризику виникнення ускладнень при тривалому застосуванні препаратів із консервантами.

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Background. The purpose was the choice of the type of tunnel incision on the basis of mathematical calculations in cataract patients with a previous anterior radial keratotomy. Materials and methods. During the calculations, the formula for the chord length of a circle was used: L = 2R · sin(α/2), where R is the radius of the cornea, α is the angle (in degrees) between the two corneal incisions. The chord length was measured on the limbus (upper edge of the tunnel incision) and 2 mm from the limbus (lower edge of the tunnel incision). The chord 2 mm from the limbus is more important because the distance between kerato­tomy incisions at this site is smaller. From 0.4 to 1.0 mm must be added to the width of the knife blade, depending on the type of postoperative corneal healing, which will be the key to crossing the incisions. Results. The most common knives are those 2.2 mm long with a tunnel length of 2 mm. Therefore, we perform calculations based on this knife in patients with 8 and 12 keratotomy incisions and a corneal diameter of 12 mm vertically and 11 mm horizontally. In patients with 8 keratotomy incisions, a 2.2 mm knife can be used for a corneal tunnel incision, and in patients with 16 incisions, it is impossible to use a corneal tunnel. Conclusions. In cataract patients who have previously undergone anterior radial keratotomy, a special approach is needed to the choice of tunnel incision. The choice of access depends on the diameter of the cornea, the number of keratotomy incisions and the width of the knife and is calculated using the formula for the chord length of a circle.

Decrease and loss of vision are extremely important problems, quite common conditions that lead to disability. The most common causes are ischemic optic neuropathy, diabetic retinopathy, and amblyopia. The pathogenesis of these disea­ses is characterized by neurodegeneration, loss of structure and function of neurons. Citicoline may be considered for neuroprotection as the drug of choice in these clinical situations. Citicoline has antioxidant and anti-inflammatory properties, it reduces lipid peroxidation and the formation of free radicals, has anti-apoptotic and membrane-protective effects. The drug has a neuromodulatory effect and also contributes to the pre­servation of sphingomyelin, which ensures signal transmission in nerve cells. In ischemic optic neuropathy, oral citicoline can reduce nerve fiber loss and improve retinal ganglion cell function and visual tract function. In diabetic retinopathy, citicoline prevents synapse loss and improves macular and retinal ganglion cell function. In amblyopia, citicoline stimulates the function of neurotransmitters and neuromodulators, including an increase in the activity of endogenous dopamine and, at the same time, an improvement in the vascular aspects of neurological function. Axobrex is a convenient oral form of citicoline. With oral administration, the bioavailability of citicoline exceeds 90 %, Axobrex is non-toxic and very well-tolerated. The dosage regimen of Axobrex is simple, which contributes to satisfactory patient adherence to treatment. The use of Axobrex in patients with ischemic optic neuropathy, diabetic retinopathy, and amblyopia has an optimal balance of benefits and safety and is advisable for neuroprotection.