Russian Medical Inquiry
(RMZh. Meditsinskoe Obozrenie) ISSN 2587-6821 (Print), 2686-9918 (Online)

Modern possibilities of tear film stability restoration

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DOI: 10.32364/2311-7729-2024-24-3-7

V.V. Brzheskiy, G.G. Кim, V.А. Bobryshev

St. Petersburg State Pediatric Medical University, St. Petersburg, Russian Federation

The pathogenetic basis of therapy for patients with dry eye syndrome consists of measures aimed at precorneal tear film restoration, including deficiency compensation of its lipid layer and aqueous mucin layer (with aqueous and mucin components) respectively.

Among the numerous medications, artificial tear substitutes based on the sodium hyaluronate are drawing increasing attention. They differ from other lacrimal substitutes by their high hygroscopicity, thixotropy, mucomimeticity and other metabolic properties (biocompatibility, biodegradability, nonimmunogenicity, anti-inflammatory and regenerative activity, etc.). One of the ways to increase the viscosity, ocular surface stability and humectant duration is the cross-linking of hyaluronic acid using so-called "cross-linking agents" (carbodiimide hydrochloride, urea, divinyl sulfone, thiol-ene reaction, etc.). In vitro and in vivo experiments have proven the possibility of using such modified hyaluronic acid as an artificial tear substitute.

The article presents a case study of a patient — a student suffering from computer vision syndrome who unsuccessfully used low viscosity tear substitutes while working at a computer. The use of cross-linked sodium hyaluronate 0.2% (hyaluronic acid sodium salt) in the background mode "by feeling" and at intervals of every 1.5 hours while working at the computer, significantly improved the condition of the patient's ocular surface and increased the duration of his "asymptomatic" time working at the computer.

Keywords: dry eye syndrome, cross-linked hyaluronic acid, treatment efficacy.

For citation: Brzheskiy V.V., Кim G.G., Bobryshev V.А. Modern possibilities of tear film stability restoration. Russian Journal of Clinical Ophthalmology. 2024;24(3):151–157 (in Russ.). DOI: 10.32364/2311-7729-2024-24-3-7.

About the authors:

Vladimir V. Brzheskiy — Dr. Sc. (Med.), Professor, Head of the Department of Ophthalmology, St. Petersburg State Pediatric Medical University; 2, Litovskaya str., St. Petersburg, 194100, Russian Federation; ORCID iD 0000-0001-7361-0270.

German G. Kim — postgraduate student of the Department of Ophthalmology, St. Petersburg State Pediatric Medical University; 2, Litovskaya str., St. Petersburg, 194100, Russian Federation; ORCID iD 0000-0002-7621-4019.

Vsevolod A. Bobryshev — assistant of the Department of Ophthalmology, St. Petersburg State Pediatric Medical University; 2, Litovskaya str., St. Petersburg, 194100, Russian Federation; ORCID iD 0000-0002-3999-7173.

Contact information: Vladimir V. Brzheskiy, e-mail: vvbrzh@yandex.ru.

Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.

There is no conflict of interest.

Received 02.06.2024.

Revised 28.06.2024.

Accepted 21.07.2024.

References
1. Jones L., Downie L.E., Korb D. et al. TFOS DEWS II Management and therapy report. Ocular Surface. 2017;15:575–628. DOI: 10.1016/j.jtos.2017.05.006. 2. Бржеский В.В., Егорова Г.Б., Егоров Е.А. Синдром «сухого глаза» и заболевания глазной поверхности: клиника, диагностика, лечение. М.: ГЭОТАР-Медиа; 2016.Brzheskiy V.V., Egorova G.B., Egorov E.A. Dry eye syndrome and ocular surface diseases: clinic, diagnosis, treatment. M.: GEOTAR-Media; 2016 (in Russ.). 3. Zhuang-Yan A., Syed Y.Y. Perfluorohexyloctane ophthalmic solution: A Review in dry eye disease. Drugs. 2024;84(4):441–448. DOI: 10.1007/s40265-024-02016-5. 4. Miura M., Inomata T., Nojiri S. et al. Clinical efficacy of diquafosol sodium 3% versus hyaluronic acid 0.1% in patients with dry eye disease after cataract surgery: a protocol for a single-centre, randomized controlled trial. BMJ Open. 2022;12:e052488. DOI: 10.1136/bmjopen-2021-052488. 5. Ballesteros-Sanches A., Borroni D., De-Hita-Cantalejo C. et al. Efficacy of bilateral OC-01 (varenicline solution) nasal spray in alleviating signs and symptoms of dry eye disease: A systematic review. Cont Lens and Anterior Eye. 2024;47(1):e102097. DOI: 10.1016/j.clae.2023.102097. 6. Бржеский В.В., Голубев С.Ю., Лебедев О.И. и др. Новые возможности комплексной терапии больных с синдромом сухого глаза различной этиологии. Офтальмология. 2020;17(3):481–489. DOI: 10.18008/1816-5095-2020-3-481-489.Brzheskiy V.V., Golubev S.Yu., Lebedev O.I. et al. New Opportunities for Complex Therapy in Patients with Dry Eye Syndrome of Various Etiologies. Ophthalmology in Russia. 2020;17(3):481–489 (in Russ.) DOI: 10.18008/1816-5095-2020-3-481-489. 7. Бржеский В.В., Радхуан М.Р. Сравнительная эффективность методов обтурации слезоотводящих путей в лечении пациентов с синдромом сухого глаза. Вестник офтальмологии. 2019;135(1):12–20. DOI: 10.17116/oftalma201913501112.Brzheskiy V.V., Radhuan M.R. Comparative effectiveness of lacrimal duct obstruction methods in the treatment of patients with dry eye syndrome. Vestnik oftal'mologii. 2019;135(1):12–20 (in Russ.). DOI: 10.17116/oftalma201913501112. 8. Eom Y., Chung S.H., Chung TY. et al. Efficacy and safety of 1% and 2% rebamipide clear solution in dry eye disease: a multicenter randomized trial. BMC Ophthalmol. 2023;23:343. DOI: 10.1186/s12886-023-03004-1. 9. Becker L.C., Bergfeld W.F., Belsito D.V. et al. Final report of the safety assessment of hyaluronic acid, potassium hyaluronate, and sodium hyaluronate. Int J Toxicol. 2009;28(4S):5–67. DOI: 10.1177/1091581809337738. 10. Бржеский В.В., Попов В.Ю. Современные возможности применения натрия гиалуроната в слезозаместительной терапии больных с синдромом «сухого глаза». РМЖ. Клиническая офтальмология. 2018;4:179–185. DOI: 10.21689/2311-7729-2018-18-4-179-185.Brzheskiy V.V., Popov V.Yu. Modern possibilities of sodium hyaluronate in tear substitutive therapy of patients with "dry eye"syndrome. RMJ "Clinical ophthalmology". 2018;4:179–185 (in Russ.). DOI: 10.21689/2311-7729-2018-18-4-179-185. 11. Prosdocimi M., Bevilacqua C. Exogenous hyaluronic acid and wound healing: an updated vision. Panminerva Med. 2012;54(2):129–135. PMID: 22525567. 12. Krasinski R., Tchorzewski H. Hyaluronan-mediated regulation of inflammation. Postepy Hig Med Dosw. (Online). 2007;61:683–689 (in Polish). PMID: 18033205. 13. Бржеский В.В., Бобрышев В.А., Ким Г.Г. Эволюция препаратов искусственной слезы на основе гиалуроновой кислоты. Медицинский совет. 2023;(23):303–309. DOI: 10.21518/ms2023-430.Brzhesky V.V., Bobryshev V.A., Kim G.G. The evolution of artificial tears based on hyaluronic acid. Medical Council. 2023;(23):303–309 (in Russ.). DOI: 10.21518/ms2023-430. 14. Shimojo A.A., Pires A.M., Lichy R. et al. The crosslinking degree controls the mechanical, rheological, and swelling properties of hyaluronic acid microparticles. J Biomed Mater Res. 2015;103:730–737. DOI: 10.1002/jbm.a.35225. 15. Fallacara A., Manfredini S., Durini E., Vertuani S. Hyaluronic acid fillers in soft tissue regeneration. Facial Plast Surg. 2017;33:87–96. DOI: 10.1055/s-0036-1597685. 16. Schanté C.E., Zuber G., Vandamme T.F. Chemical modifications of hyaluronic acid for the synthesis of derivatives for a broad range of biomedical applications. Carbohydrate Polymers. 2011;85(3):469–489. DOI: 10.1016/j.carbpol.2011.03.019. 17. Fallacara A., Vertuani S., Panozzo G. et al. Novel artificial tears containing cross-linked hyaluronic acid: An in vitro re-epithelialization study. Molecules. 2017;22:2104. DOI: 10.3390/molecules22122104. 18. Lai J.Y., Li Y.T. Influence of cross-linker concentration on the functionality of carbodiimide cross-linked gelatin membranes for retinal sheet carriers. J Biomater Sci Polym Ed. 2011;22(1–3):277–295. DOI: 10.1163/092050609X12603600753204. 19. Lu P.L., Lai J.Y., Ma D.H., Hsiue G.H. Carbodiimide cross-linked hyaluronic acid hydrogels as cell sheet delivery vehicles: characterization and interaction with corneal endothelial cells. J Biomater Sci Polym Ed. 2008;19:1–18. DOI: 10.1163/156856208783227695. 20. Leach J.B., Bivens K.A., Collins C.N., Schmidt C.E. Development of photocrosslinkable hyaluronic acid-polyethylene glycol-peptide composite hydrogels for soft tissue engineering. J Biomed Mater Res A. 2004;70(1):74–82. DOI: 10.1002/jbm.a.30063. 21. Schramm C., Spitzer M.S., Henke-Fahle S. et al. The crosslinked biopolymer hyaluronic acid as an artificial vitreous substitute. Invest Ophthalmol Vis Sci. 2012;53:613–621. DOI: 10.1167/iovs.11-7322. 22. Posarelli C., Passani A., Del Re M. et al. Cross-linked hyaluronic acid as tear film substitute. J Ocul Pharmacol Ther. 2019;35(7):381–387. DOI: 10.1089/jop.2018.0151. 23. Yang G., Espandar L., Mamalis N., Prestwich G.D. A cross-linked hyaluronan gel accelerates healing of corneal epithelial abrasion and alkali burn injuries in rabbits. Vet Ophthalmol. 2010;13:144–150. DOI: 10.1111/j.1463-5224.2010.00771.x. 24. Williams D.L., Mann B.K. A сrosslinked HA-based hydrogel ameliorates dry eye symptoms in dogs. Int J Biomater. 2013;2013:460437. DOI: 10.1155/2013/460437. 25. Williams D.L., Mann B.K. Efficacy of a crosslinked hyaluronic acid-based hydrogel as a tear film supplement: a masked controlled study. PLoS One. 2014;9(6):e99766. DOI: 10.1371/journal.pone.0099766. 26. Williams D.L., Wirostko B.M., Gum G., Mann B.K. Topical cross-linked HA-based hydrogel accelerates closure of corneal epithelial defects and repair of stromal ulceration in companion animals. Invest Ophthalmol Vis Sci. 2017;58:4616–4622. DOI: 10.1167/iovs.16-20848. 27. Park S.K., Ha M., Kim E.J. et al. Hyaluronic acid hydrogels crosslinked via blue light-induced thiol-ene reaction for the treatment of rat corneal alkali burn. Regen Ther. 2022;20:51–60. DOI: 10.1016/j.reth.2022.03.005. 28. Cagini C., Torroni G., Fiore T. et al. Tear film stability in Sjogren syndrome patients treated with hyaluronic acid versus crosslinked hyaluronic acid-based eye drops. J Ocul Pharmacol Ther. 2017;33(7):539–542. DOI: 10.1089/jop.2016.0149. 29. Postorino E.I., Rania L., Aragona E. et al. Efficacy of eyedrops containing cross-linked hyaluronic acid and coenzyme Q10 in treating patients with mild to moderate dry eye. Eur J Ophthalmol. 2018;28:25–31. DOI: 10.5301/ejo.5001011. 30. Durrie D.S., Wolsey D., Thompson V. et al. Ability of a new crosslinked polymer ocular bandage gel to accelerate reepithelialization after photorefractive keratectomy. J Cataract Refract Surg. 2018;44:369–375. DOI: 10.1016/j.jcrs.2018.01.018. 31. Eftimov P., Yokoi N., Melo A.M. et al. Interactions of meibum and tears with mucomimetic polymers: a hint towards the interplay between the layers of the tear film. Int J Mol Sci. 2021;22(5):27–47. DOI: 10.3390/ijms22052747. 32. Masmali A.M., Purslow C., Murphy P.J. The tear ferning test: A simple clinical technique to evaluate the ocular tear film. Clin Exp Optom. 2014;97(5):399–406. DOI: 10.1111/cxo.12160. 33. Сомов Е.Е., Бржеский В.В. Слеза (Физиология, методы исследования, клиника). СПб.: Наука; 1994.Somov E.E., Brzheskiy V.V. Lacryma (Physiology, research methods, clinic): SPb.: Nauka; 1994 (in Russ.). 34. Georgiev G.A., Eftimov P., Yokoi N. Contribution of mucins towards the physical properties of the tear film: A modern update. Int J Mol Sci. 2019;20(24):6132. DOI: 10.3390/ijms20246132. 35. Svitova T.F., Lin M.C. Dynamic interfacial properties of human tear-lipid films and their interactions with model-tear proteins in vitro. Adv Colloid Interface Sci. 2016;233:4–24. DOI: 10.1016/j.cis.2015.12.009. 36. Schiffman R., Christianson D., Jacobsen G. et al. Reliability and validity of the Ocular Surface Disease Index. Arch Ophthalmol. 2000;118(5):615–621. DOI: 10.1001/archopht.118.5.615. 37. Bron A.J., Evans V.E., Smith J.A. Grading of corneal and conjunctival staining in the context of other dry eye tests. Cornea. 2003;22(7):640–650. DOI: 10.1097/00003226-200310000-00008.

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