Effectiveness of inflammation treatment in patients with anophthalmos and an eye prosthesis

One of the objectives of effective ocular prosthetics is to prevent the development of pathological processes in the conjunctival cavity.

Purpose: to evaluate the effectiveness of the antimicrobial drug Mitraseptin-OftalmoLOR and its combination with the antibacterial drug MoxifloxacinOptik for the treatment of the inflammatory process of the conjunctival cavity, including bacterial conjunctivitis, in patients with anophthalmos and an ocular prosthesis, as well as the quality of life of patients during the treatment.

Material and methods. The study included 34 patients aged 22 to 77 years (mean age 49.5 ± 8.3 years), including 13 men (38.2 %); women — 21 (61.8 %) with anophthalmos and an ocular prosthesis due to a previous eye removal surgery. The patients were divided into 2 groups: Group I (n = 18) — patients with moderate inflammation without signs of bacterial conjunctivitis received monotherapy with the antiseptic Mitraseptin-OftalmoLOR, Group II (n = 16) — patients with signs of severe inflammation and bacterial conjunctivitis received combination therapy with the antiseptic drug Mitraseptin-OftalmoLOR and the antibacterial drug Moxifloxacin-Optik. The observation period was 15 days. All patients had smears and cultures taken from the conjunctiva, and a microbiological study was performed. The effectiveness of the treatment was assessed based on the analysis of the dynamics of clinical symptoms of inflammation. The safety and tolerability of the therapy were also assessed using a visual analogue scale, its impact on the change in the quality of life of patients using the WHOQOL-BREF scale. Ophthalmologic examination was performed dynamically at the screening stage (1 day), 7–8 and 14–15 days after the start of treatment.

Results. Positive dynamics of the disease was observed in all 34 cases. Patients of group I noted significant improvement after 7–8 days, clinical recovery was noted in 100 % of cases after 14–15 days. In group II, after 7–8 days of combination therapy, 7 patients (43.7 %) had a clinical picture of recovery, after 14–15 days, no signs of inflammation in the conjunctival cavity were detected in any of the patients. All patients noted good tolerability of the prescribed therapy. Antimicrobial therapy improved the quality of life of patients with anophthalmos and an ocular prosthesis.

Conclusion. The results of the study indicate high efficiency, safety and good tolerability of antimicrobial therapy using instillations of Moxifloxacin-Optik and Mitraseptin-OftalmoLOR in patients with symptoms of conjunctival inflammation and secondary bacterial infection in anophthalmos. In this case, it is advisable to prescribe a differentiated therapy regimen. The anti-inflammatory therapy regimens used in the work contributed to improving the quality of life of patients.

1. Filatova IA, Kharlampidi MP. Change of priorities when selecting the method of eye removal: enucleation versus evisceration. Vestnik oftal’mologii. 2019; 135 (2): 16–21 (In Russ.). doi: 10.17116/oftalma201913502116

2. Verigo E.N., Gundorova R.A., Lavrentyeva N.V., Tuchin A.V., Kharlampidi M.P. Priority areas for improving the efficiency of ophthalmological care in the Russian Federation. Russian ophthalmological journal. 2010; 3 (3): 8–14 (In Russ.).

3. Filatova I.A. Anophthalmos: pathology and treatment. Moscow, 2007 (In Russ.).

4. Quaranta-Leoni FM, Fiorino MG, Quaranta-Leoni F, Di Marino M. Anophthalmic socket syndrome: Prevalence, impact and management strategies. Clin Ophthalmol. 2021 Aug 6; 15: 3267–81. doi: 10.2147/OPTH.S325652

5. Sirotkina I.A., Semenova L.E., Vardanyan L.A. Conjunctivitis when using an ocular prosthesis. Prevention and choice of effective therapy. Reflection. 2024; 1 (17): 37–41 (In Russ.).

6. Okolov I.N. Eye infection (diagnosis, prevention, treatment). In: Danilichev V.F., ed. Modern ophthalmology. 2nd edition. St.-Petersburg, 2009: 557–70 (In Russ.).

7. Okolov I.N., Gurchenok P.A., Vokhmyakov A.V. Resistance of coagulonegative staphylococci isolated from patients with conjunctivitis and postoperative endophthalmitis to antibacterial drugs. In: Materials of VIII Congress of Ophthalmologists of the Republic of Belarus. 2007: 452–7 (In Russ.).

8. Labinskaya A.S. Handbook of Medical microbiopogy. General and sanitary microbiology. Moscow, 2014 (In Russ.).

9. Filatova I.A., Shemetov S.A., Kondratyeva Yu.P. Treatment and prevention of infectious complications at various stages of reconstructive surgery. Russian ophthalmological journal. 2024; 17 (3): 58–65 (In Russ.). doi:10.21516/2072-0076-2024-17-3-58-65

10. Tsurova L.M., Tatarenko I.G., Bratko O.V., et al. Features of the treatment of chronic conjunctivitis in patients using ocular prostheses. Point of view. East-West. 2018; 4: 54–6 (In Russ.). doi:10.25276/2410-1257-2018-4-54-56

11. Dushin N.V., Shklyaruk V.V., Kravchinina V.V., Balikoev T.M., Kuzina L.D. Ways to improve the efficiency of ocular prosthetics. Vestnik oftal’mologii. 2002; 118 (6): 25–8 (In Russ.).

12. Al Khatib N.S., Frolov M.A., Shklyaruk V.V., Odinaeva K.N. Factors affecting the efficiency of ocular prosthetics in patients with diabetes mellitus. Bulletin of postgraduate medical education. 2020; 1: 35–7 (In Russ.).

13. Barry P, Seal DV, Gettinby G, et al; ESCRS Endophthalmitis Study Group. ESCRS study of prophylaxis of postoperative endophthalmitis after cataract surgery: Preliminary report of principal results from a European multicenter study. J Cataract Refract Surg. 2006 Mar; 32 (3): 407–10. doi: 10.1016/j.jcrs.2006.02.021

14. Ioshin I.E., Tolchinskaya A.I. Prevention of infectious inflammatory complications in cataract phacoemulsification. Eye World. 2011; 4 (3): 52–3; 56 (In Russ.).

15. Avetisov S.E., Egorov E.A., Neroev V.V. Ophthalmology. National leadership. Brief edition Moscow: GEOTAR-Media, 2019 (In Russ.).

16. Stebnev S.D. Experience in the use of the drug Okomistin in pre- and postoperative in patients with cataract. Ophthalmology in Russia. 2012; 9 (4): 69–72 (In Russ.). doi:10.18008/1816-5095-2012-4-69-72