Use of preservative-free hyaluronic acid (Hylabak&amp;reg;) for a range of patients with dry eye syndrome: experience in Russia

Brjesky, Vladimir Vsevolodovich; Petrayevsky, A.V.; Nagorsky, Peter Gerrievich

doi:10.2147/opth.s47713

Cited by 13 publications

(8 citation statements)

References 22 publications

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“…При высоких показателях лизисной активности конъюнктивальной жидкости (более 700 КЕ/мл) дополнительно в инстилляциях назначали противоферментный препарат гордокс в равном разведении (1 : 1) с гемодезом. В послеоперационный период лечение дополняли инстилляциями препаратов «искусственной слезы» на основе природных полисахаридов [4,19]. При наличии у больных системных заболеваний важным обстоятельством было назначение дополнительной общей противовоспа-лительной терапии по согласованию со смежными специалистами.…”

Section: результаты и обсуждениеunclassified

Clinical and etiological characteristic, classification and treatment of aseptic corneal ulcers

Brzheskaya

Вячеславовна²,

Somov

et al. 2018

Ophthalmology Reports

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Introduction. Aseptic corneal ulcers are among rare, but severe, torpid diseases. The aim is to study the etiology, develop a clinical classification of the corneal aseptic ulcer, and determine the tactics of their treatment. Material and methods. A total of 40 patients (47 eyes) were examined when admitted as emergency with an aseptic ulcer of the cornea. In addition to traditional examination methods, the optical coherence tomography was performed, ulcer area and depth were recorded, and the collagenolytic activity of the tear fluid was also determined. The defect closure with a biological transplant (amniotic membrane preserved in glycerin, allogeneic sclera, self-tissues - a free flap of the sclera or a pedicle flap of the conjunctiva). The procedure was completed by blepharorrhaphy or flap covering with a soft contact lens. Results. Initial procedures were successful in 34 eyes out of 47 (72.3%). In the remaining 13 cases, repeated surgeries were required: in 11 cases - during first three months, and in 2 cases - between 4 and 12 months. In two patients with high lytic tear activity (more than 700 kU/ml) repeated procedures were performed twice, due to rapid lysis of the amniotic membrane during 14 days. Conclusion. All patients with a progressive aseptic corneal ulcer need surgical treatment in the form of its coverage with a biological tissue of allo- or autogenous nature. Anterior stromal ulcers should preferably be covered with a free amniotic flap, and the posterior stromal ulcers should be closed with an autoconjunctival-tenon pedicle flap or with a free flap of the sclera. High collagenolytic activity of the tear fluid is the main cause of biological tissue lysis. Primary and repeated plastic surgery allowed a reliable replacement of the corneal ulcer defect area with scar tissue. (For citation: Brzheskaya IV, Somov EE. Clinical and etiological characteristic, classification and treatment of aseptic corneal ulcers. Ophthalmology Journal. 2018;11(1):25-33. doi: 10.17816/OV11125-33).

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Section: результаты и обсуждениеunclassified

Clinical and etiological characteristic, classification and treatment of aseptic corneal ulcers

Brzheskaya

Вячеславовна²,

Somov

et al. 2018

Ophthalmology Reports

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“…However, information on the dye used was lacking. 22 Clinical research investigating the efficacy of CMC in the treatment of DE has also demonstrated significant beneficial effects: 0.5% CMC improved clinical parameters in mild and moderate forms of DED compared to balanced salt solution. 12 …”

Section: Discussionmentioning

confidence: 99%

Comparative study of 0.1% hyaluronic acid versus 0.5% carboxymethylcellulose in patients with dry eye associated with moderate keratitis or keratoconjunctivitis

Groß¹,

Childs²,

Piaton³

2018

OPTH

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BackgroundEye drops containing 0.1% hyaluronic acid (HA) and 0.5% carboxymethylcellulose (CMC) applied one drop three times a day per affected eye were compared in patients with moderate keratitis or keratoconjunctivitis related to dry eye disease (DED).Patients and methodsThis was a prospective, randomized, multicenter, Phase IIIB noninferiority study, with a single-masked phase in parallel mode with two groups over 84 days. The primary efficacy outcome was change in ocular surface (OS) staining between day 0 (D0) and day 35 (D35). The conjunctiva and cornea were stained with lissamine green and fluorescein. Secondary efficacy measures at day 84 (D84) were OS-staining score (SS), ocular comfort index, tear-film breakup time and how patients and investigators rated treatment efficacy and safety.ResultsAt D35, 0.1% HA achieved a 46.6% reduction in OS-SS (−2.03±1.35 points, n=39 patients) and 0.5% CMC treatment, followed by a 34.9% reduction (−1.61±1.69 points, n=38 patients) compared to D0. At D84, the SS difference to D0 improved by −2.58±1.45 points (−59.2%) for 0.1% HA and −2.59±2.27 points (−54.4%) for 0.5% CMC. Ocular comfort-index scores improved, with significantly lower (better) values for stinging and itching on D84 for 0.1% HA. Patients assessed treatment with 0.1% HA as significantly better than 0.5% CMC (Likert scale, 4.82 vs 3.97; P=0.018). Four adverse events (AEs) occurred in four of 41 patients (9.8%) treated with 0.1% HA, and three AEs in two of 39 patients (5.1%) treated with 0.5% CMC. No serious AEs were noted.ConclusionDED signs and symptoms of DED significantly improved with both eye drops. OS staining improved >54% at D84. Treatment was well tolerated, with only minor AEs <10%. 0.1% HA and 0.5% CMC were equally safe and effective. Significant and nonsignificant results were constantly in favor of 0.1% HA.

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“…In addition, our survey showed that, when switching to a preservative-free AT, DED and SPK improve significantly, thereby confirming the clinical benefit of a preservative-free AT. 25 , 26 …”

Section: Discussionmentioning

confidence: 99%

Real-life results of switching from preserved to preservative-free artificial tears containing hyaluronate in patients with dry eye disease

Nasser

Rozycka²,

Rendon

et al. 2018

OPTH

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BackgroundDry eye disease (DED) is a chronic, multifactorial disease of the ocular surface leading to discomfort, visual disturbance, and tear film instability, with potential damage to the ocular surface.AimThe aim of this study was to assess the clinical benefit of a switch from preserved to preservative-free artificial tears (ATs) containing hyaluronate in patients with DED.Materials and methodsThis is a nationwide, multicenter, noninterventional, and transversal observational survey.ResultsThe mean age was 51.0±15.4 years, ranging from 6 to 96 years. The majority (61.4%) was female. The mean Ocular Surface Disease Index (OSDI) before the switch was surprisingly high at 56.0±23.5, and 73.0% of the patients had superficial punctate keratitis (SPK). The mean duration of use of preserved ATs before the switch was 15.8±12.1 months. OSDI scores and the presence of SPK correlated with the patients’ ages but were independent of the duration of treatment with the preserved AT. The patients using ATs containing “soft” or “vanishing” preservatives presented exactly the same clinical pattern (level of OSDI and frequency of SPK) as those using ATs containing classical preservatives such as benzalkonium chloride (BAK). After switching to preservative-free AT containing hyaluronate (Hyabak®), the OSDI of 97.0% of the patients improved, decreasing from an average of 56.0 to an average of 28.2, with 23% of patients reporting a normal value of OSDI. The SPK frequency as well improved dramatically, with a frequency of positive fluorescein staining dropping from 73% to 46.1% of patients. A total of 94.0% of the patients considered that they preferred being treated with the preservative-free AT.ConclusionIn patients suffering from DED and treated with a preserved AT, switching to a preservative-free AT provides clinical benefit by decreasing the severity of DED and reducing the prevalence of SPK, even after only 3 weeks of daily use of the preservative-free AT.

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Use of preservative-free hyaluronic acid (Hylabak®) for a range of patients with dry eye syndrome: experience in Russia

Cited by 13 publications

References 22 publications

Clinical and etiological characteristic, classification and treatment of aseptic corneal ulcers

Clinical and etiological characteristic, classification and treatment of aseptic corneal ulcers

Comparative study of 0.1% hyaluronic acid versus 0.5% carboxymethylcellulose in patients with dry eye associated with moderate keratitis or keratoconjunctivitis

Real-life results of switching from preserved to preservative-free artificial tears containing hyaluronate in patients with dry eye disease

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