S. S. Strakhova

Introduction. The Ahmed glaucoma valve (GV) type drainage implantation is characterized by high efficiency and low complication rate, and is finding an increasing application in clinical practice. Although GV provides better intraocular pressure (IOP) control and higher surgical success rates compared to trabeculectomy, the so-called hypertensive phase (HP), typically defined as an IOP elevation more than 21 mmHg, can occur at the period from one to three months postoperatively, related to the fibrous capsule reservoir formation, which does not have the character of persistent hypertension.Aim. To analyze the effectiveness of the Dorzolamide-Optic carbonic anhydrase inhibitor and the Latanoprost-Optic prostaglandin analogue as the drugs of choice in clinical conditions at different periods during postoperative follow-up when antihypertensive therapy after GV implantation is needed.Materials and methods. The study included 80 glaucoma patients who underwent GV implantation in the clinic “Eye Surgery Rascheskov” with a postoperative follow-up period of at least one year. In order to increase the effectiveness of surgical intervention and preserve visual functions, hypotensive therapy was prescribed in studied patients either when IOP exceeded the target pressure, or when there was a tendency to a constant increase between control visits. 180 operated patients with IOP level within the target level during the follow-up period were excluded from the study.Results. The overall incidence rate of the hypertensive phase (GF) was 44.4%. In all studied patients to compliance with the operation technique and early therapy appointment, Dorzolamide-Optic monotherapy was sufficient to achieve stabilization of visual functions for up to 3 months after surgery. During a follow-up period more than 3 month, 15 patients (18.8%) required additional appointment of Latanoprost-Optic to achieve the target IOP level. After 2 months following the implantation, the antihypertensive therapy was discontinued under the IOP control in 17 patients (21.3%).Conclusions. Medical management of HP is crucial for preventing further optic nerve damage and preserving visual functions, as reduction of the incidence and severity of HP are known to be associated with higher operative success rates and a better long-term IOP control.

Introduction. Dry eye syndrome (DES) is a common cause of blurred vision and discomfort in patients after eye surgery, which has a great impact on the on the patients’ mental state. Evaluation of the presence of DES during the preoperative examination is important not only for obtaining a high postoperative result, but also for the timely administration of therapy in order to improve the patient's quality of life.Aim. Thus, the aim of this study was to establish the features of the clinical course of dry eye syndrome and to determine the effectiveness of ultra-high viscosity hyaluronic acid therapy in patients with anxiety and depression after cataract and keratorefractive surgery.Materials and methods. The study involved 100 patients (150 eyes). Preoperative examination included DES diagnostic and psychotesting. DES in all studied subjects was treated with ultra-high viscosity hyaluronic acid 3 times a day for 3 months after surgery in combination with topical combination of glucocorticoids, antibacterial and non-steroidal anti-inflammatory drugs, which were administered within 1 week after surgery. There were no intraoperative complications in all studied cases.Results. It was found that patients with depressive and/or anxiety symptoms (46% of the subjects) had higher OSDI scores, while there were no differences in clinical and functional tests of dry eye syndrome between the studied groups. There was a significant improvement in the results of OCT meniscometry and Norn's test during therapy with ultra-high viscosity hyaluronic acid. The given clinical examples show the importance of timely diagnosis and treatment of DES.Conclusions. The study showed the importance of dry eye syndrome evaluation and timely artificial tear therapy prescribing for both to achieve a high postoperative result and to reduce the patients’ subjective discomfort and improve patients’quality of life.