medsovetМедицинский СоветMeditsinskiy sovet = Medical Council2079-701X2658-5790REMEDIUM GROUP Ltd.10.21518/ms2022-027medsovet-7525Research ArticleОФТАЛЬМОЛОГИЯOPHTHALMOLOGYКоличественная оценка структурных изменений роговицы на фоне длительного ношения контактных линз по результатам конфокальной микроскопииQuantitative assessment of structural changes in the cornea against the background of long-term wearing of contact lenses according to the results of confocal microscopyhttps://orcid.org/0000-0001-5692-1800СурнинаЗ. В.SurninaZ. V.

Сурнина Зоя Васильевна, к.м.н., старший научный сотрудник отдела патологии оптических сред глаза 

119021, Москва, ул. Россолимо, д. 11а

Zoya V. Surnina, Cand. Sci. (Med.), Senior Researcher, Department of Pathology of the Optical Media of the Eye 

11A, Rossolimo St., Moscow, 119021

medzoe@yandex.ruhttps://orcid.org/0000-0001-5778-4123АверичВ. В.AverichV. V.

Аверич Вероника Валерьевна, к.м.н., младший научный сотрудник отдела патологии оптических сред глаза 

119021, Москва, ул. Россолимо, д. 11а

Veronika V. Averich, Cand. Sci. (Med.), Junior Researcher, Department of Pathology of the Optical Media of the Eye 

11A, Rossolimo St., Moscow, 119021

veronikky@mail.ruНаучно-исследовательский институт глазных болезнейРоссияResearch Institute of Eye DiseasesRussian Federation20231105202306214219Copyright © Сурнина З.В., Аверич В.В., 20232023Сурнина З.В., Аверич В.В.Surnina Z.V., Averich V.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.med-sovet.pro/jour/article/view/7525

Введение. В статье рассмотрена объективная оценка состояния морфофункционального статуса роговицы на фоне длительного ношения мягких контактных линз (МКЛ). Цель. Оценить качественное и количественное изменение микроструктуры роговицы с помощью лазерной конфокальной микроскопии на фоне многолетнего ношения МКЛ, а также комбинированной слезозаместительной терапии на основе трегалозы и гиалуроновой кислоты. Материалы и методы. В исследование включены 62 пациента (124 глаза), разделенные на три группы. В первые две входили 32  пациента  (64  глаза) с  миопией различной степени, использующие в  качестве оптической коррекции МКЛ в  течение 7–15 лет (в среднем 11 лет): первая группа – 15 пациентов (30 глаз), использующих слезозаместительную терапию в виде препарата на основе трегалозы и гиалуроновой кислоты 2 раза в день в течение 3 мес., вторая группа – 17 пациентов (34 глаза), не получавших какой-либо слезозаместительной терапии. Лазерную конфокальную микроскопию роговицы проводили на гейдельбергском ретинальном томографе HRT III с последующей цифровой обработкой снимков при помощи авторских программных обеспечений с акцентом на состоянии нервных волокон и дендритиформных макрофагов (клеток Лангерганса). Результаты и обсуждение. Лазерная конфокальная микроскопия роговицы с оценкой структуры нервных волокон роговицы и клеток Лангерганса может быть использована в ходе динамического наблюдения за состоянием переднего отрезка глаза у пользователей МКЛ. При выявлении патологических изменений пациенту может быть рекомендована корнеотрофическая терапия и (или) переход на другой тип контактных линз. Заключение. Применение слезозаместительного препарата на основе трегалозы и гиалуроновой кислоты улучшает субъективную переносимость МКЛ, а также позволяет в значительной степени снизить выраженность эпителиопатии у пациентов, длительно использующих МКЛ в качестве оптической коррекции.

Introduction. The article presents an objective assessment of the morphofunctional status of the cornea during the long-term wear of soft contact lenses (SCLs). Aim. To assess the qualitative and quantitative changes in the cornea microstructure using the laser confocal microscopy during the long-term wear of SCLs, as well as combined tear replacement therapy based on formulations consisting of trehalose and hyaluronic acid.  Materials and methods. The study included 62 patients (124 eyes) divided into three groups. The first two groups included 32 patients (64 eyes) with different degrees of myopia, using SCLs as an optical correction for 7–15 years (11 years on average): Group 1 included 15 patients (30 eyes) using tear replacement therapy in the form of a drug containing trehalose and hyaluronic acid twice a day for 3 months, Group 2 included 17 patients (34 eyes) who did not receive any tear replacement therapy. The laser corneal confocal microscopy was performed using Heidelberg Retinal Tomograph III followed by digital image processing aided by author software with the focus on the state of nerve fibers and dendritiform macrophages (Langerhans cells). Results and discussion. The laser corneal confocal microscopy with assessment of the structure of the corneal nerve fibers and Langerhans cells can be used for the dynamic monitoring of the state of the anterior segment of the eye in SCL users. When pathological changes are detected, a patient may be recommended the corneotrophic therapy and (or) switching to another type of contact lenses. Conclusion. The use of tear replacement medications containing trehalose and hyaluronic acid improves the subjective tolerance of SCLs and also makes it possible to significantly reduce the severity of epitheliopathy in patients, who use SCLs as optical correction for a long time.

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The authors declare that there are no conflicts of interest present.