Makashova N V, Vasilieva A E, Kolosova O Yu
Research Institute of Eye Diseases, 11 A, B Rossolimo St., Moscow, Russian Federation, 119021.
I.M. Sechenov First Moscow State Medical University, Chair of Ophthalmology, 8 b. 2 Trubetskaya St., Moscow, Russian Federation, 119991.
Vestn Oftalmol. 2018;134(2):59-65. doi: 10.17116/oftalma2018134259-65.
To study the effects of long-term instillation of 0.18% sodium hyaluronate artificial tears VISMED multi on ocular surface in glaucomatous patients with long-term instillation of preserved anti-glaucoma drops.
The study included 79 patients (40 female and 39 male; 79 eyes in total) with primary open-angle glaucoma (POAG) divided into 3 groups according to disease stage: mild or early (stage I) glaucoma - 15 patients (15 eyes), moderate (stage II) glaucoma - 30 patients (30 eyes), advanced or severe (stage III) glaucoma - 34 patients (34 eyes). Conjunctival and corneal changes were assessed with Norn's test, Schirmer I test and corneal fluorescein staining test. All patients completed Ocular Surface Disease Index (OSDI) questionnaire. Corneal compensated intraocular pressure (IOPcc) was measured using Ocular Response Analyzer (ORA) (Reichert Optics Inc., USA). In addition to hypotensive therapy, all patients received instillations of 0.18% sodium hyaluronate (VISMED multi) three times every day. After 14 days, all examinations were repeated.
The condition of eye surface in patients with moderate and advanced (stage II and III) glaucoma depends on the degree of IOPcc compensation. As glaucoma increases in severity, the pathological changes in the ocular surface progress. Instillations of 0.18% sodium hyaluronate solution lead to significant improvement of the test results in all groups, and in early glaucoma patients it restores all objective indicators to normal values.
Treatment with 0.18% sodium hyaluronate solution (VISMED multi) leads to statistically significant (p<0.05) improvement of ocular surface condition in glaucoma patients with long-term instillation of preserved antiglaucoma eye drops.
研究长期滴注0.18%透明质酸钠人工泪液VISMED multi对长期滴注含防腐剂抗青光眼滴眼液的青光眼患者眼表的影响。
本研究纳入79例原发性开角型青光眼（POAG）患者（40例女性，39例男性；共79只眼），根据疾病阶段分为3组：轻度或早期（I期）青光眼 - 15例患者（15只眼），中度（II期）青光眼 - 30例患者（30只眼），晚期或重度（III期）青光眼 - 34例患者（34只眼）。采用诺恩试验、泪液分泌试验I和角膜荧光素染色试验评估结膜和角膜变化。所有患者完成眼表疾病指数（OSDI）问卷。使用眼反应分析仪（ORA）（美国瑞特光学公司）测量角膜补偿眼压（IOPcc）。除降压治疗外，所有患者每天接受3次0.18%透明质酸钠（VISMED multi）滴眼。14天后，重复所有检查。
中度和重度（II期和III期）青光眼患者的眼表状况取决于IOPcc的补偿程度。随着青光眼严重程度增加，眼表的病理变化进展。滴注0.18%透明质酸钠溶液使所有组的检查结果显著改善，早期青光眼患者的所有客观指标恢复至正常水平。
对于长期滴注含防腐剂抗青光眼滴眼液的青光眼患者，使用0.18%透明质酸钠溶液（VISMED multi）治疗可使眼表状况得到具有统计学意义（p<0.05）的改善。
