Влияние низкомолекулярного натрия гиалуроната на течение дистрофических заболеваний роговицы при глаукоме

Abstract

Introduction. Chronic dystrophic corneal diseases (cdcd) are often accompanied by increased intraocular pressure, which has a negative effect on the regeneration processes in the tissues of the anterior surface of the eye. this leads to the progression of dystrophic lesions and dry eye disease. Purpose. Development, experimental substantiation and proof of clinical efficacy of photo-induced 1 % low molecular weight sodium hyaluronate (lm-nah) for the treatment of patients with cdcd in glaucoma, based on the increased activity of local regenerative processes. Materials and methods. The clinical study was carried out on the basis of health care institution «3 municipal clinical hospital named after E. V. Klumov» in minsk from 2016 to 2020. the study group included 21 patients (24 eyes) with cdcd in glaucoma. The comparison group included 16 patients (22 eyes), comparable in gender and age. there was no positive dynamics from standard treatment during 2–10 years with the use of instillations of tear substituting solutions. This was the indication for the use of subconjunctival injections of 1 % lm-nah once a week for 3 weeks. When dense central lenses were formed, keratoplasty was performed with histological, histochemical and immunohistochemical studies of corneal explants and determination of TGF-β1 expression level in 10 patients (10 eyes) with glaucoma and 3 healthy donor corneas. Results. Application of 1 % lm-nah solution has a positive effect on objective indices of anterior ocular surface condition with normalization of Schirmer’s test, tear film break-up time, oSdI index, corneal thickness. a high level of TGF-β1 expression is detected in patients with cdcd in glaucoma compared with the level of expression in healthy corneal tissues. This marker of inflammation and fibrosis is significantly reduced to normal values with subconjunctival injections of 1 % lm-nah. Conclusion. Application of 1 % lm-nah promotes activation of regenerative processes in the cornea and restores its structure. Key words: hyaluronic acid, corneal dystrophy, TGF-β1, intraocular pressure, dry eye disease, OSDI index