The purpose was to determine the effectiveness of endothelial-epithelial dystrophy treatment with subconjunctival injection of low molecular weight hyaluronic acid.Prospective material of 14 corneas with different epithelialepithelial dystrophy forms were examined and treated. To study the morphological features of keratopathy with the background of glaucoma staining of histological preparations with hematoxylin and eosin; histochemical staining (PAS reaction, MSB,Masson,Congored; IHC with CD44, MMP9, TGFβ1 were used.According to the results obtained, in the group of patients with EED, with the background of the use of an injectable form of hyaluronic acid, the activity of inflammation decreases due to a decrease in the epithelial and stromal expression of CD44 and MMP9. The proapoptotic and profibrotic action of TGFβ1 decreases.

The efficiency of the treatment of dry eye disease patients with keratopathy at a subconjunctival injection of 1 % sodium hyaluronate was studied. This review describes the functions of hyaluronic acid depending on its molecular weight. The performed study shows the necessity of using the injection form of sodium hyaluronate in the treatment of patients with dry eye disease.

The results of corneal graft disease treatment using low molecular weight sodium hyaluronate are presented.The study included 19 patients (20 eyes) aged 24 to 87 years, who developed graft disease after keratoplasty because of chronic dystrophic corneal diseases. The severity of symptoms during treatment was evaluated weekly during the course of therapy using the OSDI (Ocular Surface Disease Index). To assess the dynamics of objective signs of Dry eye disease in dynamics, visometry, biomicroscopy, Schirmer’s test and LIPCOF test were performed weekly before the next injection. A follow-up study was carried out a week after the last injection, with a 1-year dynamic observation following the treatment.Changes in objective indicators of the anterior eye surface were characterized by positive dynamics during therapy. The Schirmer test (p < 0.00001) increased most rapidly and significantly with a lasting effect for a month, demonstrating a beneficial therapeutic effect on both the aqueous and mucinous layer of the tear film. A decrease in the OSDI index was noted after the first injection and decreased progressively during the course of treatment and after its completion up to one month after the last injection (p < 0.00001).

An analysis of changes in the CD44 and MMP9 expression during the keratopathy after corneal inflammatory diseases treatment with injected hyaluronic acid is presented.

Treatment of chronic dystrophic diseases of the ocular surface always requires concomitant correction of severe dry eye disease (DED). The purpose of this publication was to analyze the literature data illustrating the current trends in the development of drug therapy for severe dry eye disease of non-Shegren’s etiology.The search for thematic publications was carried out in the PubMed database. The query “(dry-eye-disease AND treatment) NOT Sjögren” (filter: clinical trials, randomized controlled clinical trials, meta-analyzes) found 56 results since 2019.The review included 11 publications describing the results of clinical studies of the effectiveness of drug methods in the treatment of severe DED.In the treatment of severe DED, the prevailing direction of research is the relief of inflammation in the ocular surface tissues. Among the non-steroidal immunomodulatory drugs, the majority of studies were dedicated to cyclosporine, including its nanoemulsion form, diquafosol and bevacizumab. Their effectiveness and safety have been proven. In the Republic of Belarus, there is no unified approach to the management of patients with severe and comorbid DED. The main focus is on the activation of regenerative processes. Platelet rich plasma and subconjunctival administration of low molecular weight sodium hyaluronate demonstrated high efficiency.