Authors
Semak G.R., Hramyka Ul.V.
Belarusian State Medical University, Minsk, Belarus
Abstract
A method for minimally invasive correction of lagophthalmos and its complications has been developed. Subcutaneous injections of low-molecular and high-molecular sodium hyaluronate (LM-NaH and HM-NaH) forms with different concentrations of the active substance have been proposed as a new method. The experiment has proven the maximum efficiency of 2% high-molecular sodium hyaluronate in maintaining the shape and width of the palpebral fissure (the effect lasts for 4 weeks). Low-molecular sodium hyaluronate form had the best effect on the condition of the ocular surface. These properties can be explained by the large size of high-molecular sodium hyaluronate molecules and the viscosity of the preparation, which allows the substance to be retained in the thickness of the eyelids for a long time, but does not allow it to penetrate the hematophthalmic barrier. The positive results of the experiment made it possible to use this method in clinical practice for patients with lagophthalmos. To date, one patient has been treated who suffered from facial nerve neuritis with subsequent development of lagophthalmos. A combined technique was used with simultaneous use of subcutaneous injections of 2% high-molecular and subconjunctival injections of 1% low-molecular sodium hyaluronate. After three procedures with an interval of 3 weeks between them, positive dynamics were noted in the form of improved closure of the palpebral fissure, an increase in the Schirmer test, and the absence of complaints from the cornea. Thus, we can talk about the effectiveness of this minimally invasive technique for patients with lagophthalmos and its complications with a one-time impact on the maximum possible number of pathogenesis links.
Keywords: sodium hyaluronate, lagophthalmos, cornea, experiment.
References
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