THE RESULTS OF LOW MOLECULAR WEIGHT HYALURONAN IMPLEMENTA TION IN PA TENTS WITH CORNEAL TRANSPLANT DISEASE
Concomitant dry eye disease exacerbates the course of chronic dystrophic diseases of the cornea and worsens the results of corneal transplantation. Keratoplasty for corneal transplant disease without effective relief of xerosis results in transparent engrafment in only 30% of cases. Aim: in clinical study to establish the effectiveness of the hyaluronic acid with a molecular weight of 500-700 kDa implementation in the corneal transplant disease treatment. Materials and methods: the study included 19 patients (20 eyes) aged 24 to 87 years, who developed transplant disease after keratoplasty because of chronic dystrophic corneal diseases. The dynamics of the severity of symptoms during treatment was evaluated weekly during the course of therapy using the OSDI (Ocular Surface Disease Index). To assess the dynamics of objective signs of Dry eye disease visometry, biomicroscopy, Schirmer's test, LIPCOF test were performed weekly before the next injection. A control study of the patient was carried out a week after the last injection. Results: changes in objective indicators of the eye surface state were characterized by positive dynamics during therapy. The Schirmer test (p<0.00001) increased most rapidly and significantly with a lasting effect for a month. A decrease in the OSDI index was noted after the first injection and continued to decrease progressively during the course and after its completion until the control one month after the last injection (p <0.00001). Conclusion: complex treatment with the inclusion of weekly subconjunctival administration of sodium hyaluronate (500-700 kDa) positively affects the condition of the graft, potentially extending its lifespan.