Object: neurotrophic keratopathy (neurotrophic keratoconjunctivitis). Purpose: to increase the treatment efficiency of neurotrophic keratopathy in patients with long-term use of soft contact lenses based on the study of metabolic disorders in the tear and the use of antioxidant therapy (morpholine-methyl-triazolyl-thioacetate (MMTT)). Methods: general ophthalmologic examination: ocular surface disease index (OSDI), visometry, tear production, tear film break-up test, biomicroscopy, fluorescein tests, sensitivity of the cornea, pachymetry, rheophthalmography; biochemical tests of the lacrimal fluid: state of the lipid peroxidation and the antioxidant system, activity of intracellular enzymes; statistical: STATISTICA 10.0 and MedCallc 9.1 packages. Neurotrophic keratopathy develops after 1 year using of soft contact lenses (SCL), the frequency of development and the degree of manifestation are directly dependent on the duration of use of SCL. For detection of corneal sensitivity disorders in patients with long-term use of soft contact lenses OSDI is recommended, the value of the index 32.5 points and more with high probability (80%) indicates a severe corneal sensation loss. The most pronounced biochemical changes in the tear are observed after 10 years of using of SCL. The activity of intracellular enzymes increased: lactate dehydrogenase (LDH), glucose-6-phosphate dehydrogenase (G-6-FDG) and acid phosphatase (AP) - by 50% on average, succinate dehydrogenase (SDG) - by 35,0% (p<0,001) compared with the patients who use glasses. Thiol status violated: decreased level of reduced glutathione - by 30.8% (p <0.001), increased level of oxidized glutathione - by 33.8% (p <0.01). LPO increased: malonic dialdehyde (MD) increased by 47.0% (p <0.001), diene conjugates (DC) – by 29.8% (p <0.01). It was added scientific data on the features and dynamics of degenerative changes at neurotrophic keratopathy, depending on the duration of use of SCL. The corneal sensitivity during the use of lenses 1-5 years was reduced in 42.1% of cases, with a term> 5≤10 years - in 61.1%, more than 10 years - in 82.0%. Basal tear production was reduced at 1-5 years in 71.1% of cases,> 5≤10 years - in 82.4%, more than 10 years - in 84.6%. Vascularization of the limb at 1-5 years was observed in 73.9%,> 5≤10 years - in 87.2%, more than 10 years - in 96.6% of cases. Corneal vascularization at 1-5 years was found in 21.7%,> 5≤10 years - 48.9%, more than 10 years - in 72.9% of cases. Corneal epitheliopathy at 1-5 years was present in 36.8%,> 5≤10 years in 61.8%, more than 10 years in 61.5%. Reduction of blood circulation of the eye was increased at use of SCL 1-5 years - in 60,5%,> 5≤10 years - in 79,4%, more than 10 years - in 88,5% of cases. For the first time, have been obtained data of the effect of MMTT on the eye surface in patients with neurotrophic keratopathy with the use of SCL, which reduces the degree of LPO, increases antioxidant reserves and stabilizes the state of cellular and intracellular membranes. This is indicated by an increase of reduced glutathione by 23.9% (p <0.05) on average, a decrease of oxidized glutathione by 14.1% (p <0.05), a decrease of MD by 21.1%, DC - by 11.0%, LDH activity decrease by 30.0% (p <0.01), G-6-FDG by 23.6% (p <0.05), SDG by 14.0% (p<0.05), AP - by 18.0% (p <0.05). A new method of treatment of neurotrophic keratopathy has been developed, which consists of a course of transorbital electrophoresis with 1% solution of MMTT and instillations of 1% solution of MMTT for 10 days in traditional treatment, which leads to reduction of pathological changes in the tissues of the eye surface in neurotrophic keratopathy. With instillations and oral administration of MMTT, the total tear production and stability of the tear film increase more. With instillations and combinations with transorbital MMTT electrophoresis, the effect is achieved faster and the volume of the pulse circulation of the eye increases. The results of the work were introduced in the clinical practice of the department of microsurgical treatment of corneal pathology of the SI «Institute of Eye Diseases and Tissue Therapy V.P. Filatov of the NAMS of Ukraine», ophthalmology department of the MI «Odessa Regional Clinical Hospital», ophthalmology department of the «Ukrainian State Research Institute of Medical and Social Disability Problems», department of the «City Center of Eye Microsurgery»" of MNE «Vinnytsia City Hospital», department №3 of Ophthalmic Medical Center of ONMedU. Scope - medicine, ophthalmology.
