Dry Eye Epidemiology in Patients before Refractive Operations

Sakhnov, S.N.; Янченко, С. В.; Малышев, А. В.; Калантаевская, Ю. А.; Исмайлова, Р. А.; Ехиева, Э. М.; Грищенко, М. В.; Горбунова, И. В.; Ожуг, О. Ф.; Klokova, O.A.

doi:10.18008/1816-5095-2018-1-92-101

Cited by 9 publications

(13 citation statements)

References 13 publications

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“…Вместе с тем режим однократных инстилляций, с одной стороны, повышает комплаенс пациентов, улучшает качество их жизни и уменьшает стоимость лечебных мероприятий, а с другой, минимизирует воздействие консерванта, входящего в глазные капли, на глазную поверхность [10][11][12]. Последнее обстоятельство является существенным, учитывая высокую вероятность развития вторичного синдрома «сухого глаза» (ССГ) у пациентов с АК [14][15][16][17]. В связи с этим необходимо отметить, что препарат Визаллергол® дополнительно содержит в своем составе фармакологическую основу искусственной слезы -поливинилпирролидон, который, помимо указанного действия, является пролонгатором активного компонента лекарственного средства.…”

Section: Ophthalmology In Russia 2019;16(3):378-385unclassified

Clinical Experience of Using 0.2 % Olopatadin in the Allergic Conjunctivitis Treatment

Янченко¹,

Малышев²,

Сахнов³

et al. 2019

Oftalʹmologiâ

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Purpose:to evaluate the efficacy and safety of complex therapy of allergic conjunctivitis, including 0.2 % olopatodin.Patients and methods:In 40 allergic conjunctivitis (AK) patients were performed: assessment of the intensity of itching and tearing, as well as conjunctival hyperemia and folliculosis (points); Schirmer’s test (SHT; mm); tear film break up time (TFBUT, s); assessment of the lid wiper epitheliopathy symptom (LWES, points); calculation of the xerosis indicator (XI; points, according to Bijsterveld). In the 1 group (20 pollen AK patients) were given: 0.2 % olopatadine instillations (1 time per day); preservative free polyvinylpyrrolidone and polyvinyl alcohol fixed combination (2–3 times a day, from 7 days of therapy). Control points: 7 and 30 days of therapy. Patients of 2 group with pollen AK and chronic blepharitis (saprophytic flora and Demodex) were performed: 0.2 % olopatadine instillations (1 time per day); eyelid hygiene (poloxamer 188 and PEG-90 gel; 2 times per day); ointment containing gentamicin and dexamethasone (application on the eyelids margins, 2 times a day, 14 days); acaricidal gel (based on preparations of sulfur, sodium hyaluronate and aloe extract; 2 times a day, from 15 days of therapy); preservative free polyvinylpyrrolidone and polyvinyl alcohol fixed combination (2–3 times a day, from 15 days of therapy). Control points: 14 and 30 days of treatment. Statistical analysis included: calculation of an average and its standard deviation (М ± s); evaluation of reliability of differences in control points (Wilcoxon’s T-criterion; χ2 criterion). Statistically significant was p < 0,05.Results:Patients of both groups had good tolerability of the treatment; no significant systemic and local side effects of treatment were noted. In 1 group patients by the 7th and 30th day of therapy, a significant decrease in the severity of itching, tearing and conjunctival hyperemia was observed. By the 30th day of observation, the complete absence of itching was noted in 85 % of individuals, the absence of hyperemia — in 80 %. The rest of the observed severity of these signs did not exceed the level of one point, and their manifestations were non-permanent. Conjunctival follicular response significantly decreased by 30 days of observation. SHT showed a significant decrease in all control points, remaining within normal limits. Dynamics of TFBUT and XI by 7 days of therapy was unreliable. By the 30th day of treatment, there was a significant positive dynamics of TFBUT and XI, compared with the state before the therapy and 7 days of observation. At the same time, TFBUT and XI have reached values close to normal. In 2 group patients by the 14th and 30th day of therapy, a significant decrease in the severity of itching, tearing, hyperemia and follicular conjunctival reaction was recorded (by 1–2 points). The value of SHT showed a significant decrease in all control points (within the normal values of the indicator). By the 14th day of therapy, a significant decrease of LWES was noted; the NT and XI the dynamics were statistically insignificant. By the 30th day of observation, significant positive dynamics of NT, XI, and LWES were noted, compared with the state before the start of treatment and 14 days of therapy. Despite the almost complete relief of symptoms and signs of allergy and ocular surface condition improvement, by 30 days of observation, the magnitudes of NT, XI and LWES still did not reach the normal state, which determined the need for further artificial tear therapy, eyelid hygiene and acaricide treatment.Conclusion:Combined therapy, including 0.2 % olopatadin instillation, demonstrated high efficacy in relieving symptoms (itching, tearing) and signs (hyperemia and follicular conjunctival reaction) of allergic conjunctivitis, as well as a good safety profile.

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Section: Ophthalmology In Russia 2019;16(3):378-385unclassified

Clinical Experience of Using 0.2 % Olopatadin in the Allergic Conjunctivitis Treatment

Янченко¹,

Малышев²,

Сахнов³

et al. 2019

Oftalʹmologiâ

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“…1, Г-Е) в баллах 3-балльной шкалы (0 баллов -отсутствие окрашивания края век; 1 балл -легкое окрашивание; 2 балла -умеренное окрашивание; 3 балла -выраженное окрашивание); фоторегистрацию состояния глазной поверхности (методика КубГМУ) [5,8,18,20]. Наличие ДМЖ и ее клиническую тяжесть определяли при помощи компрессионного теста Норна в модификации D. Korb [21] с оценкой результатов в баллах 3-балльной шкалы (0 баллов -отсутствие ДМЖ; 1 балллегкая ДМЖ; 2 балла -умеренная ДМЖ; 3 баллатяжелая ДМЖ) [5,8,9]. Наличие липидодефицита верифицировали при отрицательном тесте на липидинтерференцию и снижении функциональной активности мейбомиевых желез.…”

Section: материал и методыunclassified

“…В качестве дополнительного критерия использовали симптом «дворников», указывающий на присутствие эпителиопатии края века вследствие липидодефицита, обусловленного ДМЖ (рис. 1, Г-Е) [8,9,21]. Вододефицит фиксировали при значении суммарной слезопродукции менее 15 мм и высоте нижнего слезного мениска менее 300 мкм.…”

Section: материал и методыunclassified

“…Кроме этого, предоперационный ССГ может приводить к ошибкам при определении параметров абляции в ходе кератотопографии и, соответственно, снижает прогнозируемость результатов вмешательства [2,5]. Вместе с тем актуальность данной проблемы определяется и довольно высокой распространенностью ССГ у лиц перед рефракционными вмешательствами (от 10-32 до 75 % в зависимости от диагностических критериев) [2,3,7,8].…”

unclassified

“…ССГ, диагностируемый у пациентов перед рефракционной хирургией, в большинстве случаев характеризуется легкой степенью клинической тяжести и связан с повышенной испаряемостью слезной пленки вследствие липидодефицита, наиболее частой причиной которого является дисфункция мейбомиевых желез (ДМЖ) [2,4,5,[8][9][10]. При этом у части пациентов, помимо липидодефицита, имеет место и дефицит «заякоренных» муцинов (эпителиопатия, визуализирующаяся при витальном окрашивании конъюнктивы и роговицы лиссаминовым зеленым) [8].…”

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Dry eye treatment optimization in patients prior to refractive surgery

Sakhnov

Yanchenko

Малышев

et al. 2018

Rossijskij oftalʹmologičeskij žurnal

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Purpose. To evaluate the effectiveness of dry eye syndrome (DES) treatment in patients with meibomian gland dysfunction (MGD) before refractive surgery.Materials and methods. We examined 48 women (aged 29.6 ± 3.9 years) with myopia, DES, and MGD of noninfectious etiology before performing LASIK. Group 1 of these patients received presurgical correction of DES for 2 months, including instillation of 3 % trehalose as a bioprotector (Thealoz®; 3–4 times a day); application of 5 % dexpanthenol in the conjunctival cavity (before going to bed); eyelid hygiene (2 times per day), which included cleaning (Theagel®), warm compresses on eyelid area, massage of eyelid margin (Blephaclean wipes). Group 2 only received bioprotective and reparative therapy for 2 months. Testing included a standard ophthalmological examination; assessment of DES symptoms (OSDI scale, points); BUT test (sec) and Schirmer-1 test (Sh-1, mm); measuring the height of the lower tear meniscus (optical coherence tomography, μm); lissamine green staining with calculation of xerosis index by Bijsterveld (points); assessment of MGD severity (points). Processing of the results included calculation of M ± s; Wilcoxon t-test, Mann Whitney U-test.Results. A positive change of OSDI (decrease from 31.9 ± 2.9 to 8.71 ± 1.1 points), xerosis index (decrease from 4.71 ± 0.5 to 2.1 ± 0.3 points) and BUT test (increase from 4.14 ± 0.53 to 8.66 ± 0.93 sec) was significantly stronger in patients of group 1 (p < 0.05) in comparison with patients of group 2 (decrease in OSDI from 33.2 ± 3.1 to 15.6 ± 2.4 points; decrease of xerosis index from 4.75 ± 0.50 to 3.7 ± 0.5 points; BUT increase from 4.21 ± 0.47 to 6.05 ± 0.73 sec). Apparently, this was caused by a significant decrease in the severity of MGD (from 2.1 ± 0.3 to 0.9 ± 0.2 points) and a decrease in the severity of lipid deficiency due to eyelid hygiene in patients of group 1. In group 2, MGD severity change proved unreliable. Change of Sh-1 and the height of the lower tear meniscus was unreliable in all cases. Conclusion. The inclusion of eyelid hygiene (Theagel and Blephaclean) in the pre-surgery preparation of patients with DES and MGD leads to a more significant correction of eye surface condition compared to isolated bioprotective and reparative therapy, thus providing an opportunity of more favorable conditions for carrying out surgical correction of ametropia.

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