[Artificial tears and immunosuppressive therapy for immune-mediated disorders of the ocular surface]

Immune-mediated ocular surface disorders represent a group of diseases associated with hypersensitivity reactions. Most of these conditions have a chronic progressive course, which can lead to severe consequences, including loss of visual function. In addition to necessary systemic therapy that depends on the underlying condition, the basic approach to the treatment of immune-mediated ocular surface diseases consists of immunosuppressants and artificial tears. In the acute stage or during exacerbations of severe immune-mediated lesions, the drug of choice is the glucocorticosteroid (GCS) dexamethasone. Fluorometholone and loteprednol considered to be "soft", i.e., low-potency GCSs. Although the use of cyclosporine A, including in the form of a cationic emulsion (Ikervis), is considered ineffective for most forms of dry eye disease, it may be used in a selected group of patients with moderate immune keratoconjunctivitis. In more severe cases, the use of the more potent agent tacrolimus is advisable. As for mandatory tear substitution therapy in this patient population, combined formulations containing hyaluronic acid and the reparative agent dexpanthenol appear promising. The composition of Stillavit Intensive provides reliable hydration of ocular surface tissues due to sodium hyaluronate 1.8 mg, additional anti-inflammatory effects mediated by sodium chondroitin sulfate, and regeneration of the conjunctival and corneal epithelium through D-panthenol 50.0 mg.