The Choice of Dry Eye Therapy Depending on Ocular Surface Condition

Purpose: to develop approaches to differentiated substitution therapy in patients with dry eye (DE) of mild and moderate severity.Patients and methods. We examined 86 DE patients (22–45 years old; 38 men, 48 women). Group-1 included 54 patients (54 eyes) with mild DE under conditions of combined lip...

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Main Authors: S. V. Yanchenko, A. V. Malyshev, S. N. Sakhnov
Format: Article
Language:Russian
Published: Ophthalmology Publishing Group 2021-07-01
Series:Oftalʹmologiâ
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Online Access:https://www.ophthalmojournal.com/opht/article/view/1552
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author S. V. Yanchenko
A. V. Malyshev
S. N. Sakhnov
author_facet S. V. Yanchenko
A. V. Malyshev
S. N. Sakhnov
author_sort S. V. Yanchenko
collection DOAJ
description Purpose: to develop approaches to differentiated substitution therapy in patients with dry eye (DE) of mild and moderate severity.Patients and methods. We examined 86 DE patients (22–45 years old; 38 men, 48 women). Group-1 included 54 patients (54 eyes) with mild DE under conditions of combined lipid-mucose-deficiency, group-2 32 patients (32 eyes) with moderate DE against the background of combined lipid-aqua-mucose-deficiency. Conducted: DE symptoms registration (OSDI scale); Norn and Shirmer-1 tests; OCT meniscometry; assessment of the Bijsterveld xerosis index and ‘lid-vipers’ symptom identification; Norn’s compression test. To assessment the therapy effectiveness, patients in both groups were divided into subgroups. Patients of subgroup 1.1 (18 eyes) carried out ‘fat-water’ type emulsion instillations, subgroup 1.2 (18 eyes) — 0.15 % sodium hyaluronate instillation (Hylabak®), subgroup 1.3 (18 eyes) — 3.0 % trehalose (Thealoz®) — 1–2 drops, 4 times a day. All persons included in group-1 were additionally recommended to apply 5.0 % dexpanthenol gel at night. Patients of subgroup 2.1 (16 eyes) received 0.15 % sodium hyaluronate instillation (Hylabak®), patients of subgroup 2.2 (16 eyes) 0.15 % sodium hyaluronate (Hylabak®) and 3.0 % trehalose (Thealoz®) instillation — 4 times a day. All patients included in group-2 were additionally recommended to apply ointment with vitamin A at night. The main criterion for the therapy effectiveness was the tear film brake up time (TBUT, s) two months after the start treatment. Statistical processing included: calculation the mean and its standard deviation (M ± s); assessment of the significance of differences (Wilcoxon’s t-test, KruskalWallis test, Mann-Whitney U-test).Results. In group-1 patients the following TBUT dynamics was recorded: in subgroup 1.1 — from 5.4 ± 0.5 to 6.2 ± 0.6 s (p < 0.05); in subgroup 1.2 — from 5.2 ± 0.4 to 6.6 ± 0.6 s (p < 0.05); in subgroup 1.3 — from 5.3 ± 0.5 to 7.1 ± 0.7 s (p < 0.05). The most pronounced TBUT increase was noted in subgroup 1.3 (trehalose instillation). In group-2, the increase in TBUT was: in subgroup 2.1 — from 3.5 ± 0.3 to 4.7 ± 0.3 s (p < 0.05); in subgroup 2.2 — from 3.4 ± 0.2 to 5.2 ± 0.4 s (p < 0.05). A significantly more pronounced TBUT increase was noted in subgroup 2.2 (sodium hyaluronate and trehalose instillation).Conclusion. In our opinion, differentiated approaches to DE replacement therapy may be included: for mild DE in conditions of lipid-mucose-deficiency — instillation of bioprotector based on 3.0 % trehalose (Thealose®); in case of moderate DE against the background of lipid-aqua-mucose-deficiency — 0.15 % sodium hyaluronate (Hylabak®) instillation in combination with a bioprotector based on 3.0 % trehalose (Thealoz®).
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spelling doaj-art-7df5b2905f094dfe8f5dc5f0672c20722025-08-20T03:22:18ZrusOphthalmology Publishing GroupOftalʹmologiâ1816-50952500-08452021-07-0118234635410.18008/1816-5095-2021-2-346-354765The Choice of Dry Eye Therapy Depending on Ocular Surface ConditionS. V. Yanchenko0A. V. Malyshev1S. N. Sakhnov2Kuban State Medical University; Scientific Research Institution — S.V. Ochapovsky Regional Clinic HospitalKuban State Medical University; Scientific Research Institution — S.V. Ochapovsky Regional Clinic HospitalKuban State Medical University; Krasnodar branch of the S. Fyodorov Eye Microsurgery Federal State InstitutionPurpose: to develop approaches to differentiated substitution therapy in patients with dry eye (DE) of mild and moderate severity.Patients and methods. We examined 86 DE patients (22–45 years old; 38 men, 48 women). Group-1 included 54 patients (54 eyes) with mild DE under conditions of combined lipid-mucose-deficiency, group-2 32 patients (32 eyes) with moderate DE against the background of combined lipid-aqua-mucose-deficiency. Conducted: DE symptoms registration (OSDI scale); Norn and Shirmer-1 tests; OCT meniscometry; assessment of the Bijsterveld xerosis index and ‘lid-vipers’ symptom identification; Norn’s compression test. To assessment the therapy effectiveness, patients in both groups were divided into subgroups. Patients of subgroup 1.1 (18 eyes) carried out ‘fat-water’ type emulsion instillations, subgroup 1.2 (18 eyes) — 0.15 % sodium hyaluronate instillation (Hylabak®), subgroup 1.3 (18 eyes) — 3.0 % trehalose (Thealoz®) — 1–2 drops, 4 times a day. All persons included in group-1 were additionally recommended to apply 5.0 % dexpanthenol gel at night. Patients of subgroup 2.1 (16 eyes) received 0.15 % sodium hyaluronate instillation (Hylabak®), patients of subgroup 2.2 (16 eyes) 0.15 % sodium hyaluronate (Hylabak®) and 3.0 % trehalose (Thealoz®) instillation — 4 times a day. All patients included in group-2 were additionally recommended to apply ointment with vitamin A at night. The main criterion for the therapy effectiveness was the tear film brake up time (TBUT, s) two months after the start treatment. Statistical processing included: calculation the mean and its standard deviation (M ± s); assessment of the significance of differences (Wilcoxon’s t-test, KruskalWallis test, Mann-Whitney U-test).Results. In group-1 patients the following TBUT dynamics was recorded: in subgroup 1.1 — from 5.4 ± 0.5 to 6.2 ± 0.6 s (p < 0.05); in subgroup 1.2 — from 5.2 ± 0.4 to 6.6 ± 0.6 s (p < 0.05); in subgroup 1.3 — from 5.3 ± 0.5 to 7.1 ± 0.7 s (p < 0.05). The most pronounced TBUT increase was noted in subgroup 1.3 (trehalose instillation). In group-2, the increase in TBUT was: in subgroup 2.1 — from 3.5 ± 0.3 to 4.7 ± 0.3 s (p < 0.05); in subgroup 2.2 — from 3.4 ± 0.2 to 5.2 ± 0.4 s (p < 0.05). A significantly more pronounced TBUT increase was noted in subgroup 2.2 (sodium hyaluronate and trehalose instillation).Conclusion. In our opinion, differentiated approaches to DE replacement therapy may be included: for mild DE in conditions of lipid-mucose-deficiency — instillation of bioprotector based on 3.0 % trehalose (Thealose®); in case of moderate DE against the background of lipid-aqua-mucose-deficiency — 0.15 % sodium hyaluronate (Hylabak®) instillation in combination with a bioprotector based on 3.0 % trehalose (Thealoz®).https://www.ophthalmojournal.com/opht/article/view/1552dry eyereplacement therapyocular surfacebioprotectiontrehalosesodium hyaluronate
spellingShingle S. V. Yanchenko
A. V. Malyshev
S. N. Sakhnov
The Choice of Dry Eye Therapy Depending on Ocular Surface Condition
Oftalʹmologiâ
dry eye
replacement therapy
ocular surface
bioprotection
trehalose
sodium hyaluronate
title The Choice of Dry Eye Therapy Depending on Ocular Surface Condition
title_full The Choice of Dry Eye Therapy Depending on Ocular Surface Condition
title_fullStr The Choice of Dry Eye Therapy Depending on Ocular Surface Condition
title_full_unstemmed The Choice of Dry Eye Therapy Depending on Ocular Surface Condition
title_short The Choice of Dry Eye Therapy Depending on Ocular Surface Condition
title_sort choice of dry eye therapy depending on ocular surface condition
topic dry eye
replacement therapy
ocular surface
bioprotection
trehalose
sodium hyaluronate
url https://www.ophthalmojournal.com/opht/article/view/1552
work_keys_str_mv AT svyanchenko thechoiceofdryeyetherapydependingonocularsurfacecondition
AT avmalyshev thechoiceofdryeyetherapydependingonocularsurfacecondition
AT snsakhnov thechoiceofdryeyetherapydependingonocularsurfacecondition
AT svyanchenko choiceofdryeyetherapydependingonocularsurfacecondition
AT avmalyshev choiceofdryeyetherapydependingonocularsurfacecondition
AT snsakhnov choiceofdryeyetherapydependingonocularsurfacecondition