Practitioners in ophthalmology in recent years often face the effects of cosmetic procedures on the paraorbital area, as well as directly on the eyelids. Such influences include botox injections in paraorbital area, blepharoplasty, eyelash extensions, injections of various fillers, etc. These manipulations are widely used and often lead to various complications of the vision organ. Eyelash extensions are a popular procedure, especially among urban, young women, but there are potential health risks from the procedure. Tattooing of eyelids leads is the cause of dysfunction of meibomian glands, which can lead to the dry eye syndrome, manifested as complaints about a feeling of chronic discomfort in the eyes. Due to the growing popularity of the age tattoo, it is necessary to pay close attention to the training of specialists who conduct this procedure. The procedure for permanent eyelid make-up should be performed after careful consideration of possible complications, and by special trained professionals. In recent years, various cosmetic procedures for rejuvenating the face plays great role, for example, injections of botulinum toxin, as well as various dermal fillers — the application of which is aimed at eliminating the aging signs. The qualification of the specialist his awareness of the occurrence of possible complications, as well as the awareness of patients who undergo this procedure is an important aspect in the application of botulinum toxin, both for therapeutic and cosmetic purposes. Of great interest are the complications associated with ischemia in the form of soft tissue necrosis and vascular occlusion caused by fillers introduction. It is reported that the frequency of vascular occlusion with dermal fillers is up to 3 per 1000 injections. The only proven elimination of soft tissue ischemia in case of a hyaluronic acid filler use is early high-dose hyaluronidase injections, since this drug helps deactivate the action of hyaluronic acid. Modern ophthalmologic practice is inextricably linked with the latest methods of modern cosmetology medicine, the results of it can effect on the functions of the whole organism as the organ of vision in particular. This fact and the specificity of possible complications arising from cosmetic procedures in the periorbital zone should be taken into account during the anamnesis collecting anamnesis, and examining patients, including preoperative preparation, and in choosing the treatment method.

Modern ophthalmological practice is inseverable linked with cosmetology and esthetic medicine. Every year, the number of patients, especially women, who received various types of cosmetology procedures (botulinum toxin injections, eyelash extensions, eyelid tattooing, dermal fillers injections, etc.) in facial area increases, in particular in the periorbital zone.Purpose: to conduct a comprehensive assessment of clinical and functional parameters characterizing the state of the ocular surface and the tear-producing system in case applying cosmetic procedures in the periorbital area (Botox injections, eyelid tattooing, eyelash extension).Patients and methods. The study included 106 women (212 eyes). Exclusion criteria: early postoperative period after ophthalmosurgical intervention, acute inflammatory diseases of anterior and posterior eye segment, glaucoma, the presence of intraocular pathological changes (hemophthalmia, detachment of the eye membranes, tumors). The average age of the patients included in the study was 36.37 ± 9.0 years.Results and discussion. The results of a comparative evaluation of two groups of patients — a group with a history of cosmetic procedures (tattooing the eyelids, botulinum toxin, dermal fillers, eyelash extensions) in the periorbital zone and patients who did not use such procedures, has showed that cosmetic procedures affect on the clinical and functional eye surfaces state and on morphofunctional state of meibomian glands. Thus, the frequency of detection of symptomocomplex of dry eye syndrome was on 36 % more often determined in the group of patients received cosmetic procedures. It has been shown that the combined effect of cosmetological procedures (tattooing the eyelids, eyelash extensions, injections of dermal fillers and botulinum toxin in the periorbital region) aggravates the course and prognosis of Dry Eye Syndrome and meibomian glands dysfunction. A direct correlation between the severity of complaints characteristic of Dry Eye Syndrome and the number of procedures was found (r = 0.4982, p = 0.0000); the frequency of detecting complaints of dryness and discomfort and the number of procedures (r = 0.6427, p = 0.0000); compression test indices and the number of procedures (r = –0.4712, p = 0.0000); the frequency of occurrence of inflammatory reactions of ocular surface and the number of procedures (r = 0.3778, p = 0.0001). The risk of tear production disturbance — dry eye syndrome and dysfunction of the meibomian glands is higher in patients using botulinum toxin injections and eyelash extension in comparison with patients using eyelid tattooing and injections of fillers with hyaluronic acid in the periorbital zone.

PurposeTo study the factors affecting the corneal endothelium after selective laser trabeculoplasty (SLT) in primary open angle glaucoma (POAG) and primary angle closure glaucoma (PACG).MethodThis prospective interventional study included 56 patients (56 eyes) with POAG and 55 patients (55 eyes) with PACG. All participants received a standard SLT session. Patients with PACG were pretreated with laser peripheral iridotomy for at least 2 months before SLT. Corneal endothelium cell count (ECC), pleomorphism and polymegathism were measured before SLT, as well as at the increments of 1 hour, 1 day, 1 week, 1 month, 3 months and 6 months following SLT using confocal microscopy. A multiple regression analysis was applied to detect the factors affecting the ECC in the long-term post-SLT period.ResultsIn both groups, the mean ECC significantly decreased from the baseline after SLT. While in POAG, corneal endothelium recovered within 1 month, in PACG, its damage persisted throughout the whole follow-up period.According to the multiple analysis, baseline ECC (β=0.891, p=0.000 in POAG and β=0.706, p=0.000 in PACG) and age (β=−0.227, p=0.000 in POAG and β=−0.196, p=0.000 in PACG) were the common risk factors affecting ECC in both glaucoma forms, while the initial anterior chamber depth (β=0.254, p=0.000), only in PACG. The duration of glaucoma treatment (β=−0.317, p=0.043 in POAG and β=−0.302, p=0.047 in PACG) and pigmented deposits on the corneal endothelium in PACG (β=−0.326, p=0.019) were the risk factors determined in the univariate analysis.ConclusionAge and the baseline ECC are the risk factors for corneal endothelium damage after SLT in POAG and PACG. Shallow anterior chamber may affect corneal endothelium in PACG. These data should be considered when choosing an algorithm for glaucoma treatment.

The environmental factors influence, quite often, negatively affects the state of health. Many of them, such as smoking, deterioration in ecology, uncontrolled alcohol intake, are in detail studied in terms of harm to a human body. Nevertheless, new technologies which action is insufficiently studied, are actively introduced into modern life. So, the use of cosmetology procedures can be a striking example. Now the prevalence of such procedures as eyelash extension, a permanent make-up a century, botulotoxin injections in a periorbital zone, assumes a wide scale. In foreign and domestic literature there are more and more messages about development of the complications which arose owing to use of the above-stated procedures. There are two clinical examples from our practice in this article. They demonstrate the complications which arose after holding a procedure of eyelash extension — acute toxic-allergic conjunctivitis and after a permanent make-up — a chemical burn of a cornea. In these clinical cases of a complication arose due to aggressive action of a chemical basis of the glue applied at eyelash extension and cream-anesthetic which is applied on eyelids before a permanent make-up a century. Treatment of patients included antiinflammatory, antihistaminic, antibacterial therapy and also a long course of the tear replacement therapy applied as keratoproteсtive therapy and for prevention of development of a dry eye syndrome. Considering scales of prevalence of cosmetology procedures in recent years, it is necessary to inform specialists and patients on potential risk of development of the complications connected with the above-stated procedures. The clinical examples given in the article and literature data, demonstrate that in case of cosmetology procedures complications it is necessary to carry out timely rendering the qualified medical ophthalmologic care. It is connected with the fact that, quite often, the cosmetology manipulations, even positioned as harmless, in particular, a permanent make-up of eyelid and eyelash extension can lead to heavy complications, up to vision loss.

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.