Artificial tear preparations are important in the management of dry eye syndrome. We present the findings from four recently published studies conducted in Russia assessing Hylabak® (marketed as Hyabak® in Europe), a preservative-free hyaluronic acid preparation, for the treatment of dry eye syndrome. All studies had an open, noncomparative design, but one compared the findings with those from 25 patients treated with Tear Naturale® in previous studies. A total of 134 children and adults were enrolled, and the etiologies of dry eye syndrome included contact lens use, intensive office work, adenovirus eye infection, postmenopausal status, persistent meibomian blepharitis, Sjögren’s syndrome, phacoemulsification with intraocular lens implantation, and refractive surgery. The patients were treated with Hylabak for 2 weeks to 2 months. All studies showed that Hylabak resulted in marked improvement as assessed by subjective sensations/complaints, Schirmer’s test, Norn’s test, impression cytology and biomicroscopy, staining, and tear osmolarity. Greater benefits were also reported compared with Tear Naturale, including a faster onset of action. Hylabak was well tolerated. In conclusion, Hylabak provided rapid and safe relief from the signs and symptoms of dry eye syndrome, as well as improvement in objective measures, in a wide range of patients.

Depending on the cause of a “dry eye” the treatment of some patients continues to be a problem. While treatment is usually limited to tear replacement, other therapies may be needed based on the cause of the dry eye syndrome. In the article, the literature is summarized as to the agents used to treat the “dry eye syndrome” basssed on the etiology. and presence of accompanying xerosis complications In addition, the article describes additional treatment trends such as anti-inflammatories, immunosuppressives, and drops stimulating tear production. Attention is also paid to the lacrimal pathway occlusion methods in using punctual plugs and other surgical methods. The authors advocate for the wide use of the different treatment methods available to treat complex “dry eye” syndrome patients.

The development of the dry eye syndrome in glaucoma patients is a pressing challenge during last 10 years. As reported by multiple investigators, the main causes for the development of corneal and conjunctival xerosis in such patients are: toxic action of preservatives in hypotensive ophthalmic medications, pharmacological effect of beta-blockers, and corneal trauma at the time of diagnostic manipulations. A meaningful action to prevent this disease is a to switch to either a preservative-free hypotensive ophthalmic medications, or to those containing a non-toxic preservative. A review of the literature was also done to find the causes, prevention and treatment methods of the dry eye syndrome in glaucoma patients