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Given the prevalence of refractive surgery in modern ophthalmological practice, when preparing a patient for this type of surgery, it is important to understand the multifactorial mechanism of the development of dry eye syndrome in this group of patients. Analysis of the literature data made it possible to identify key factors in the disruption of the tear formation process after refractive surgery, which include the intersection of the nerve endings of the cornea, which in turn reduces the frequency of blinking and the distribution of the tear film over the ocular surface, and also causes a violation regarding neurotrophic factors secreted by the nerve endings of the cornea . The presence of a postoperative inflammatory reaction, which has a specific course, manifested in a change in the biochemical properties of the tear, damage to the goblet cells of the conjunctiva during the creation of a vacuum during LASIK and SMILE, leading to a subsequent deficiency of mucin in the tear, changes in the curvature of the cornea caused by laser refractive surgery are factors influencing the development of dry eye syndrome after refractive surgery. When preparing a patient for refractive surgery, to reduce the risk of developing severe forms of dry eye syndrome, including corneal ulceration, it is necessary to take into account a history of systemic diseases and allergic reactions, especially in patients with high myopia. The influence of cosmetic procedures, such as eyelash extensions, eyelid tattooing, blepharoplasty, and the use of botulinum toxin in the periorbital area on the course of the postoperative period during refractive surgery, has been poorly studied. Research in this area opens up a new range of opportunities to reduce the incidence of dry eye syndrome in patients after refractive surgery and improve the quality of life of patients and patient satisfaction with the surgical intervention.

The increasing patient demands for quality of life after surgery necessitate optimization of approaches in the field of surgical intervention, reduction of the frequency of refractive errors and correction of tactics of postoperative interventions. Literature data indicate that refractive errors are possible after surgical treatment for cataracts associated with the presence of dry eye syndrome in the preoperative period. Tear film is used as the first refractive medium, and the size of the refractive change at air­tear film interfaces is the most innovative of any interface in any other optical system. Thus, changes of tear film physiology affect overall vision with higher order aberrations and irregular astigmatism occurring. The presented literature review analyzes data from scientific studies aimed at studying risk factors for the development of dry eye syndrome and diseases associated with it when phacoemulsification of cataracts occurs. Considering the fact that, according to various studies, the incidence of dry eye syndrome after cataract surgery ranges from 9.8 to 96.6% in cataract surgery in collaboration with dry eye surgery, adequate approaches within the framework of preoperative preparation are an urgent development. The lack of clear recommendations for effective preoperative screening and respiratory preparation for surgery, unreliable biometric data, and lack of treatment strategy for postoperative dry eye syndrome are indicators of detectors to obtain the desired results. Adequate diagnosis and preparation of ocular surfaces before biometric measurements can reduce refractive errors after surgery.

In recent years, the Delphi method (DMt) has been widely used in scientific practice. It is based on an expert assessment of the object under study, which is formed on the basis of a survey of a group of experts in a particular field. The application of the Delphi method in various areas of ophthalmological practice has made it possible to develop practical recommendations for the diagnosis of visual stress, methods for diagnosing and treating keratoconus, to develop clinical guidelines for the diagnosis and treatment of patients with Sjögren’s syndrome, to classify the signs and symptoms of dry eye syndrome in accordance with the main mechanism of its occurrence and etc. A survey ophthalmologist expert conducted during the study, performed in accordance with the Delphi method, aimed at developing a differential algorithm in the treatment of patients with one of the most common pathologies among diseases belonging to the category of “red eye syndrome” — conjunctivitis, allowed identify key symptoms for prescribing different groups of drugs. In accordance with the clinical guidelines developed by the Russian Association of Ophthalmologists, the following groups of drugs are recommended for use: antibacterial, antiseptic, antihistamine, non-steroidal anti-inflammatory drugs, steroidal anti-inflammatory drugs, antiviral drugs. This article presents the results obtained in determining the indications for the use of non-steroidal anti-inflammatory therapy in the treatment of conjunctivitis. These include: the presence of a history of systemic diseases, the duration of inflammation for more than 7 days, the absence or presence of mucous discharge, complaints of a feeling of pain, discomfort in the eyes, their redness, as well as biomicroscopic signs of inflammation, which manifest themselves as mild to moderate conjunctival hyperemia expressiveness. The result obtained is of fundamental practical importance for primary outpatient ophthalmologists for choosing rational drug therapy in the treatment of one of the most common pathologies encountered in ophthalmic practice — conjunctivitis. A differentiated approach in choosing the volume and type of drug therapy based on the severity of the inflammatory process will reduce the drug load on the ocular surface. In accordance to the data presented in the first part of this article, it will lead to a decrease the risk of developing signs of dry eye syndrome against the background of a stopped inflammatory process in the long-term period and improving the quality of life in patients.

Diagnosis of conjunctivitis is an urgent problem in ophthalmic practice, since conjunctivitis is one of the most common reasons for patients to visit a doctor. An important aspect in diagnosing of the conjunctivа’s inflammation is to determine the intensity of the inflammatory process in each case, in which hyperemia is given priority, as the most demonstrative sign of inflammation. Currently, there are many subjective and non-invasive instrumental methods for assessing conjunctival hyperemia. Taking into account the fact that most of the instrumental methods are aimed to assess the state of the bulbar conjunctiva and there are practically no methods that allow assessing the severity of tarsal hyperemia, it is necessary to develop a methodology that allows to evaluate both these indicators in combination. In this regard, it is great interest to determine the degree of hyperemia during a biomicroscopic examination in combination with visualization and fixation of hyperemia indicators using the software of the MediWorks Dixion S 350 slit lamp (weak, medium, significant, severe) depending on the index of hyperemia obtained by fixing the image on the slit lamp. Standardization of the severity indicators of conjunctival hyperemia allows to obtaine objective data on the state of the tarsal and bulbar conjunctiva at all stages of observation. In addition, based on the above indicators in clinical practice, the ophthalmologist can prescribe an adequate amount of drug therapy, this will increase the level of safety and effectiveness of the therapy, which is especially important at the stage of primary outpatient admission, when treatment is usually prescribed empirically

The revolution in understanding the etiology and clinical manifestations of the disruption of the tearing process and the development of dry eye syndrome (CVS) has occurred in last 20–30 years. It has been established that the loss of the tear film homeostasis can occur not only because of a violation of systemic and autoimmune disorders, but also as a result of a blinking disorder and distribution of the tear film over the ocular surface. Therefore, new pathogenetic disease development mechanisms have been identified. The prevalence of diseases of the ocular surface and CVD in recent years has increased significantly. It is mostly caused not only by scientific discoveries in the field of understanding, for example, the etiological and pathophysiological role of the neurosensory mechanism of development of CVS. An important aspect is the emergence of new risk factors that potentiate the development of ocular surface diseases and CVL. These factors include the use of various drugs — antidepressants, antihistamines, hormone therapy, and others; instillation of eye drops — antiglaucoma drugs, etc., as well as the appearance of little-studied factors such as cosmetology procedures (eyelids tattooing, eyelash extensions, botulinum toxin injections for aesthetic purposes, etc.). They are carried out in proximate close to the eye and eyelids, causing multiple pathological reaction. The experience of observing patients, literature data, and the conducted study have showed that various cosmetological effects in the periorbital zone, whose popularity has increased in recent years, may cause the appearance of iatrogenic dry eye syndrome. The following most vivid clinical examples will help, encountered in our practice, to illustrate the data presented. Collecting the anamnesis, it is necessary to identify the presence of risk factors for the development of diseases of the ocular surface and CVD, to eliminate them, if possible, and to carry out adequate pathogenically based therapy.

The prevalence off allergic diseases has been significantly increased among adults and children during last 30-40 years. International study has shown that the frequency of atopy in developed countries, including Russia, is higher than in developing. Often atopic dermatitis, started in infancy, can develop into an “allergic march” — food allergy, followed by the formation of allergic rhinitis, allergic conjunctivitis and other allergic diseases. The problem of prophylaxis and treatment of allergic pathology becomes actual for these reasons. An opinion according some preventive measures has changed in recent. It was noted that in families with many children, where children were often sick with respiratory infections, the incidence of allergic diseases was lower than among rarely sick children. It is explained by the “hygienic theory” — insufficient “training” of the Th1 response in rarely sick children. Allergic diseases, which are based on IgE-mediated inflammation, have a common pathogenetic nature and, consequently, general principles of therapy, in which, as is well known, antihistamines take a significant place. This is cased by the mandatory involvement of histamine in the mechanism of development of the main symptoms of allergic diseases. Current capabilities of local ophthalmologic antiallergic therapy includes medicines with multiple action mechanisms, such as mast cell stabilizers, antihistamines, combined agents, steroids and nonsteroidal anti-inflammatory effects. The latest generation antihistamine drug — olopatadine hydrochloride 0.2% is a new form of the molecule of olopatadine, which is intended to increase the duration of the action. The article considers the main modern directions in prevention and treatment of allergic diseases, including allergic eye diseases, which are a manifestation of the underlying disease and have a common pathogenetic nature to all atopic diseases, based on the IgE-mediated inflammation reaction.

Cataract is one of the most common diseases, especially in the elderly. Despite the fact that the share of elderly people in economically developed countries is higher than in developing countries, the incidence of cataract in people over 50 years in Western countries is 15% and it is about 40% in developing countries. The reasons are unbalanced nutrition, lack of specialized ophthalmic care at the initial stages of the disease, the impact of adverse environmental conditions, etc. Surgical treatment is the only curative method. However, there are not always enough indications for this treatment on the one hand, and it is not always possible due to patient’s unfavorable physical status, on the other hand. The supportive anti-cataract therapy should be provided with the dynamic follow-up in such cases. The pharmaceutical industry offers anti-cataract drugs with a different composition and properties, they are based on the mechanisms of the onset and development of the disease. “Oxidative stress” is one of the main factors, which can be the cause of both nuclear and cortical cataracts. There are scattering zones in the mature nucleus of the lens, an increase in extracellular spaces between corrugated membrane protein-like deposits in case of cataract. It is generally believed that the basis of these deposits are denatured, initially water-soluble proteins, which turn into opaque substances due to the action of quinoids products formed through the disturbed metabolism of aromatic aminoacids (tryptophan, tyrosine, etc.). Based on this theory, an anti-cataract substance — pirenoxine was developed. It inhibits the action of quinoids and prevents the formation of the len’s opacities and the cataracts progression.

The relevance of the modern diagnosis of meibomian glands dysfunction (MGD) increases daily. Firstly, it is caused by changing of the perception about the prevalence of this disease, according to various data it is from 40 to 71% of the population in different age groups. Considering the increasing number of patients suffering from MGD, there is the need to develop screening methods for diagnosis of this disease. Screening methods should be available not only for specialists involved in the treatment of xerosis keratoconjunctival in specialized ophthalmology clinics, but also in out-patient sector. An important aspect in the diagnosis of the severity of the functionaldisorders of the meibomian glands is the assessment of morphological status that determines the further choice of therapy. To evaluate the morphological and functional state of the meibomian glands proposed to use biometrics of meibomian glands. A slit lamp is used for examination. Furthermore, objective data characterizing the morpho-functional state of the meibomian glands, can be obtained by carrying out meibography. Authors used not only white light but also infrared light for the visualization of meibomian glands during meibography. The multifunctional ophthalmic devices equipped with infrared lighting can be used for lighting. For example, specialized slit lamps, corneal topographs, Sheympflyug camera, the fundus camera and others. We applied nonmidriatic fundus camera TOPCON TRC-NW300, using for fotoregistration of the ocular fundus. A feature of the proposed method — meyboskopy — was simplicity and absence of necessity of the investigator skills by scanning with the fundus camera of the inner surface of the eyelid. Meiboskopy doesn’t require additional equipment and software of the fundus camera and allows to receive objective quality video of meibomian glands, it opens new diagnostic possibilities. Extending of the range of diagnostic capabilities in detecting of MGD based on the screening methods will allow time to assess the severity of this disease and to appoint pathogenetically substantiated therapy.

The authors study the problem of inertia in the medical practice of ophthalmology, which implies the absence of any modification of the treatment in the presence of objective necessity or clinical indications. The treatment of multifactorial diseases, including primary glaucoma is particularly critical. An anonymous survey of 147 ophthalmologists from different regions of Western Siberia — Altai Territory, Kemerovo Region and the Republic of Khakassia, has been conducted. Most of the surveyed doctors believed that their treatment was successful in 40‑80 % of patients. According to literature data, ithe target value of IOP level is achieved in practice in under half of the patients receiving regular therapy. Another reason of medical inertia was the fear of polypragmasy. Almost 54 % of doctors said they are afraid to prescribe several medications, which limits their desire to intensify therapy. The results of our study suggest that the cost of glaucoma treatment, i.e. the fear to prescribe an expensive treatment for patients does not significantly determine the doctors’activity. Doctors often exaggerate the fear of patients for the treatment, believing that a particular medical drugwill not be taken by the patient, without trying to figure out the patient’s intention. The economic barrier has become an essential factor for our doctors, as 35 % ophthalmologists believe that 300‑500 Rubles for the therapy per month is expencive for a patient. Over 30 % respondents discussed with the patient the prescribed treatment with cost about 700‑900 Rubles. This could potentially lead to the fact, that the second and third medical drugs would be less likely prescribed due to the increased cost of treatment. Thus, we have set up the structure of the causes of medical inertia — a psychological unwillingness to achieve target values of IOP, overestimation of the therapy success. Less important reasons were the lack of doctor’s awareness and the economic barrier forthe decision making.

Recurrent corneal erosion (RCE) syndrome is characterized by episodes of recurrent spontaneous epithelial defects. Main clinical symptoms (pain, redness, photophobia, lacrimation) occurred at night. Corneal lesions revealed by slit lamp exam vary depending on the presence of corneal epithelium raise, epithelial microcysts or epithelial erosions, stromal infiltrates and opacities. Microtraumas, anterior corneal dystrophies, and herpesvirus give rise to RCE. Other causes or factors which increase the risk of RCE syndrome include meibomian gland dysfunction, keratoconjunctivitis sicca, diabetes, and post-LASIK conditions. Basal membrane abnormalities and instability of epithelial adhesion to stroma play a key role in RCE pathogenesis. Ultrastructural changes in RCE include abnormalities of basal epithelial cells and epithelial basal membrane, absence or deficiency of semi-desmosomes, loss of anchor fibrils. Increase in matrix metalloproteinases and collagenases which contribute to basal membrane destruction results in recurrent erosions and further development of abnormal basal membrane. The goals of RCE therapy are to reduce pain (in acute stage), to stimulate re-epithelization, and to restore «adhesion complex» of basal membrane. In most cases, RCE responds to simple conservative treatment that includes lubricants, healing agents, and eye patches. RCEs that are resistant to simple treatment, require complex approach. Non-invasive methods include long-term contact lens use, instillations of autologous serum (eye drops), injections of botulinum toxin (induces ptosis), antiviral agent use or oral intake of metalloproteinase inhibitors. Cell membrane stabilizers, i.e., antioxidants, should be included into treatment approaches as well. Antioxidant effect of Emoxipine promotes tissue reparation due to the prevention of cell membrane lipid peroxidation as well as due to its anti-hypoxic, angioprotective, and antiplatelet effects. If conservative therapy is ineffective, surgical procedures (Bowman’s membrane polishing with diamond drill, anterior stromal puncture, excimer laser phototherapeutic keratectomy) are required. RCE therapy decision making should consider disease severity, the presence of concurrent pathology, medical experience and surgical instrument availability if needed.

The value of dry eye for general public health increases due to its high occurence in elderly persons and aging population. Non-specific questionnaires are adopted for dry eye. Additionally, 36‑item Medical Outcomes Study-Short Form (MOS-SF-36) and benefit evaluation method were developed. Methods. Information analysis and mathematical methods and public health technology evaluation methods (i.e., modelling, analysis of disease burden, and budget impact analysis) were applied to economic aspect study. Decision tree model based on these finding was developed and applied to cost estimating of blepharoconjunctival and exogenous dry eye treatment in computer vision syndrome. Two scenarios of patient management were considered, i.e., typical management and management using therapeutic eyelid hygiene. Similar model was developed for early postoperative period after LASIK. Short-run analysis (1 year) was performed, direct medical costs were considered. This analysis implies the calculation of overall cost (economic burden) of the disease. Official data on adult population size in 2014 and the occurrence of the disease were used to assess prevalence. Budget impact analysis evaluates the difference in total economic effects due to comparison technology use in money terms. Sensitivity analysis assesses the stability of simulation results. Medical treatment cost was considered the most valuable parameter. Results and conclusions. Direct medical costs of typical management and management using therapeutic eyelid hygiene in demodicosis, computer vision syndrome, and after LASIK were 14,623 RUB and 9,200 RUB (savings of 37 %), 17,630 RUB and 9,200 RUB (savings of 47 %), 4,425.5 RUB and 3,004 RUB (savings of 32 %), respectively. Analysis of economic burden with respect to disease occurrence and typical management costs demonstrated that in 2015 this parameter was estimated as 576,198,416,556 RUB. In terms of direct medical costs, therapeutic eyelid hygiene saves 44 % (on average).

Serotonin plays an important role in maintaining homeostasis due to a broad spectrum of receptors localized in nearly every part of the body, i.e., central nervous system, vegetative ganglia, cardiac and lung reflexogenic zone, smooth muscles, internal organs and microcirculatory bloodstream, ocular tissues and optic tract. Serotonin levels can be altered by serotonin receptor blockade. Dusopharm (naftidrofuryl), a drug with complex mechanism of action, inhibits 5-HT2 receptors. Selective inhibiting of 5-HT2 receptors of vascular endothelial and smooth muscle cells decreases vasoconstrictor effects of serotonin that releases from atherosclerosisand hypoxia-damaged vascular endothelium and prevents thrombocyte aggregation. In addition, naftidrofuryl is the antagonist of vasoconstrictor action of endothelin-1 expressed by vascular endothelium. Experiments with isolated rabbit smooth myocytes demonstrate that naftidrofuryl prevents endothelin-1 binding with endothelial serotonin receptors and smooth myocyte contraction. Naftidrofuryl improves blood flow owing to its effect on blood rheological properties (increases erythrocyte deformability and decreases their aggregation). This paper reviews the studies of Dusopharm in patients with intermittent claudication, post-insult conditions, diabetic retinopathy, age-related macular degeneration (AMD), glaucoma, and central retinal vein and its branches occlusion. These data allow to include Dusopharm in the complex therapy of central retinal vein and its branches occlusion, diabetic retinopathy, age-related macular degeneration (AMD), glaucoma, peripheral retinal degeneration, and retinal detachment to improve and stabilize visual functions and microcirculation.

Currently, ultrasound biomicroscopy (UBM) is the only diagnostic method that uses a 50‑100 MHz transducer with a depth of penetration of 4 mm. This provides greater sensitivity and resolution.Aim. To visualize meibomian glands and to evaluate their morphological and functional status using UBM.Methods. UBM was performed in 14 patients aged 29‑81 with obvious meibomian gland dysfunction (MGD) and healthy meibomian glands. 6 patients had no biomicroscopic signs of blepharitis while 8 patients had biomicroscopic signs of blepharitis, blepharoconjunctivitis, and MGD.Results. UBM provides detailed information on meibomian glands and eyelid margins and their pathological conditions, i.e., eyelid margin thickening due to inflammation, meibomian gland orifice obstruction, increase in distance between meibomian glands due to their atrophy, and cartilaginous tissue destruction. UBM findings may depend on patient age as well as on disease stage and severity. When re-positioning UBM transducer, bullous conjunctiva and subconjunctival cysts can be visualized. This provides differential diagnosis between opaque cysts and tumors.Conclusion. UBM combined with standard exams increases information value, reliability, and accuracy of the diagnostics of anterior segment disorders and facilitates the development of targeted therapeutic approaches. Further studies on diagnostic value of conjunctiva and eyelids UBM are required.

Purpose: to evaluate the efficiency and tolerance of drops replacing tear with hyaluronic acid 0.15% (Hylabak, thea, France) for the treatment of tear film diseases, in particular blepharoconjunctival form of dry eye syndrome.Methods: 32 patients (range 38 to 72 years) with blepharoconjunctival form of dry eye syndrome were treated lubricant Hylabak 2-4 times a day during 7-30 days.Results: After treatment was detected the elimination of complaints in 30 of 32 people, increasing the stability of the tear film (increasing values of the samples Norn test from 7.3 ±0.5 to 10.1±0.6 seconds), as well as normalization of Schirmer test (from 8.8±0.4 to 15.2±0.5 mm).Conclusion: the study was showed high efficacy of lubricant Hylabak and subjective tolerability at blepharoconjunctival form of dry eye syndrome.

A novel method that provides complex assessment of meibomian glands morphological and functional state — biometry of meibomian glands — was developed. The results of complex examination (including meibomian glands biometry), correlation analysis data and clinical findings demonstrate direct association between the objective (i.e., meibomian glands dysfunction by biomicroscopy, tear film break-up time / TBUT, symptomatic TBUT, compression testing) and subjective signs of meibomian glands dysfunction (patient’s complaints) and the parameters of meibomian glands biometry. High direct correlation between biometrical index and compression test result was revealed (p = 0.002, Spearman’s rank correlation coefficient = 0.6644). Meibomian glands dysfunction is characterized by biometric parameters abnormalities, i.e., dilatation of meibomian glands orifices, decrease of distance between meibomian glands orifices, partial or total atrophy of meibomian glands (even up to gland collapse with its visual reduction and increase of distance between the glands). The suppression of inflammatory process and the recovery of meibomian glands secretion improve biometric parameters and result in the opening of meibomian glands orifices, liquefaction of clogs, evacuation of meibomian glands secretion, narrowing of meibomian glands orifices and increase of distance between them. The proposed method expands the armamentarium of meibomian glands dysfunction and lipid-deficient dry eye diagnosing. Meibomian glands biometry can be applied in specialized ophthalmological hospitals and outpatient departments. It is a simple procedure of short duration that does not require any special equipment or professional skills. Meibomian glands biometry enables to prescribe pathogenically targeted therapy and to improve quality of life.

The review presents possibilities of dry eye prophylaxis and treatment caused blepharitis and blepharoconjunctivitis after refrac- tive surgery. Among modern prophylactic approaches therapeutic eyelids hygiene is most promising for the everyday clinical practice.

The hygienic complex for the eyelids and magnetic field actions were studied in the prophylactic and treatment of the blepharocon- junctival form of dry eye. It was placed the actions with tear’s substitute and antibacterial eye drops got to disappears of the symptoms, restorations of the tear film and improvement quality of live. the hygienic complex involved all eyelids glands but did not injure theeyelids and did not pain in the eyes.

Purpose: To evaluate the results of DSAEK with thin grafts in patients suffered bullous keratophaty with low preoperative visual acuity.Methods: DSAEK with thin grafts the thickness of which was 150‑70 μm was fulfilled in 47 patients (47 eyes) suffered bullous keratophaty without visible leukomas in the corneal stroma. Visual acuity prior to the operation with a maximum spectacle correction accounted for an average of 0.05±0.04. Tear film osmolarity of 20 patients (20 eyes) who participated in the research was measured. Results: In follow-up period graft kept transparency in 39 patients. Visual acuity in 3 months after the operation, on average, without correction was 0.38±0.16, with a maximum of spectacle correction is 0.51± 0.18. The spherical component varied in the range from 0 to 3.75 D, with an average of 1.63 per±1.1 D. Corneal astigmatism was from 0.5 to 4.0 D, an average of 1.8±0.98 D. At preoperative osmolarity indicators were within the normal reference for both operated and non-operated eyes — 292.3±10.4 и 279.3±3.51. In a first postoperative week osmolarity was not detected while on a non-operated eye it was 278.4±1.4. After 1, 3 and 6 months osmolarity indicators on both eyes were within normal reference. Spherical component ranged from 0 to 3.75 D, averaging 1.1±1.63 D. Corneal astigmatism ranged from 0.5 to 4.0 (D), with an average of 1.8±0.98 D 1.63 per±1.1 D.Conclusion: DSAEK with thin grafts is an effective modern methods of surgical treatment of bullous keratophaty. For old patients with severe ocular pathology — concomitant eye diseases, repeated surgery of the eye, the developed stage of the keratophaty — we have not noted the apparent correlation between the thickness of the transplant, visual acuity and the time of recovery of visual functions after keratoplasty. Osmolarity in an early postoperative period is a non-informative method of diagnostics. Restoration of osmolarity level to preoperative level is expected within one month after the surgery.

Purpose: to assess the effectiveness of pre-operative therapeutic eyelid hygiene in the prevention and treatment of dry eye and meibomian glands dysfunction following excimer laser vision surgery.Methods: In enrolled 144 patients (288 eyes), ocular surface and meibomian glands functions were evaluated before and following refractive surgery (LASIK and REIK). In pre- and post-operative period, standard ophthalmological studies were performed, including best-corrected visual acuity determination, biomicroscopy, Schirmer’s test and Norn’s test (tear break-up time). In pre-operative pe- riod, ocular surface microbial profile was assessed. Subjective symptoms of impaired tear production were revealed via questioning. In study group (70 patients, 140 eyes), therapeutic eyelid hygiene using Blefarogel 1 or Blefarogel 2 (Ltd. Heltec-Medica, Moscow, Russia) was prescribed one week before surgery. In control group, no therapeutic eyelid hygiene was prescribed. All patients were received antibacterial treatment including Vigamox (Alcon, Fort Worth, tX). In both groups, Natural tears and Systane Ultra (Alcon) were used as tear replacement therapy.Results: Complex treatment, including therapeutic eyelid hygiene in study group, significantly improved tear film and ocular sur- face health as well as meibomian glands functions. Inflammatory complications rate was estimated as 5.7% in study group and 10.6% in control group.Conclusion: therapeutic eyelid hygiene is highly effective in the prophylaxis and treatment of post-operative complications duу to ocular surface pathology and meibomian glands dysfunction. the procedure is safe and can be recommended as a part of complex preventive treatment before excimer laser vision correction.

In this article, authors present the new terminology and classification one of wide-spread ophthalmologic diseases is syndromedry eye.