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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">glaucoma</journal-id><journal-title-group><journal-title xml:lang="ru">Национальный журнал Глаукома</journal-title><trans-title-group xml:lang="en"><trans-title>National Journal glaucoma</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2078-4104</issn><issn pub-type="epub">2311-6862</issn><publisher><publisher-name>Federal State Budgetary Institution of Science “Krasnov Research Institute of Eye Diseases”</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.53432/2078-4104-2025-24-3-66-75</article-id><article-id custom-type="elpub" pub-id-type="custom">glaucoma-586</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>ОБЗОР ЛИТЕРАТУРЫ</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>REVIEW OF LITERATURE</subject></subj-group></article-categories><title-group><article-title>Проблема избыточного рубцевания в хирургии глауком. Часть 2: Противовоспалительная терапия, антиметаболиты, ингибиторы ангиогенеза</article-title><trans-title-group xml:lang="en"><trans-title>Excessive scarring in glaucoma surgery. Part 2: Anti-inflammatory therapy, antimetabolites, angiogenesis inhibitors</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-4043-456X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Юсеф</surname><given-names>Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Yusef</surname><given-names>Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н., директор </p><p>119021, Москва, ул. Россолимо, 11А</p></bio><bio xml:lang="en"><p>Dr. Sci. (Med.), Director </p><p>11A Rossolimo St., Moscow, 119021 </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5171-8261</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Антонов</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Antonov</surname><given-names>А. А.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н., заведующий отделом глаукомы </p><p>119021, Москва, ул. Россолимо, 11А</p></bio><bio xml:lang="en"><p>Dr. Sci. (Med.), Head of the Department of Glaucoma </p><p>11A Rossolimo St., Moscow, 119021 </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-8258-6011</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Суббот</surname><given-names>А. М.</given-names></name><name name-style="western" xml:lang="en"><surname>Subbot</surname><given-names>А. М.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.м.н., заведующая лабораторией фундаментальных исследований в офтальмологии </p><p>119021, Москва, ул. Россолимо, 11А</p></bio><bio xml:lang="en"><p>Cand. Sci. (Med.), Head of the Laboratory of Fundamental Research in Ophthalmology </p><p>11A Rossolimo St., Moscow, 119021 </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-2893-0173</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Виткова</surname><given-names>И. И.</given-names></name><name name-style="western" xml:lang="en"><surname>Vitkova</surname><given-names>I. I.</given-names></name></name-alternatives><bio xml:lang="ru"><p>аспирант </p><p>119021, Москва, ул. Россолимо, 11А</p></bio><bio xml:lang="en"><p>postgraduate student </p><p>11A Rossolimo St., Moscow, 119021 </p></bio><email xlink:type="simple">ivitkova.niigb@gmail.com</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0009-0009-4800-870X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Емец</surname><given-names>Е. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Emets</surname><given-names>E. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>младший научный сотрудник лаборатории фундаментальных исследований в офтальмологии </p><p>119021, Москва, ул. Россолимо, 11А</p></bio><bio xml:lang="en"><p>junior researcher at the Laboratory of Fundamental Research in Ophthalmology </p><p>11A Rossolimo St., Moscow, 119021 </p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-7735-9650</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Витков</surname><given-names>А. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Vitkov</surname><given-names>A. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.м.н., научный сотрудник отдела глаукомы </p><p>119021, Москва, ул. Россолимо, 11А</p></bio><bio xml:lang="en"><p>Cand. Sci. (Med.), researcher at the Department of Glaucoma </p><p>11A Rossolimo St., Moscow, 119021 </p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>ФГБНУ «НИИГБ имени М.М. Краснова»</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Krasnov Research Institute of Eye Diseases</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2025</year></pub-date><pub-date pub-type="epub"><day>13</day><month>09</month><year>2025</year></pub-date><volume>24</volume><issue>3</issue><fpage>66</fpage><lpage>75</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Юсеф Ю., Антонов А.А., Суббот А.М., Виткова И.И., Емец Е.В., Витков А.А., 2025</copyright-statement><copyright-year>2025</copyright-year><copyright-holder xml:lang="ru">Юсеф Ю., Антонов А.А., Суббот А.М., Виткова И.И., Емец Е.В., Витков А.А.</copyright-holder><copyright-holder xml:lang="en">Yusef Y., Antonov А.А., Subbot А.М., Vitkova I.I., Emets E.V., Vitkov A.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.glaucomajournal.ru/jour/article/view/586">https://www.glaucomajournal.ru/jour/article/view/586</self-uri><abstract><p>Главным осложнением хирургии глаукомы является избыточное рубцевание вновь сформированных путей оттока внутриглазной жидкости. Для борьбы с формированием рубцово измененной ткани интраоперационно и в раннем послеоперационном периоде используются медикаментозные средства различного механизма действия.Основной группой противовоспалительных препаратов, используемых при хирургии глаукомы, являются топические стероиды. Особо высокая противовоспалительная эффективность показана у импланта с медленно высвобождающимся дексаметазоном, который помещают под склеральный лоскут. Нестероидные противовоспалительные средства, помимо прямого действия, способны потенцировать гипотензивный эффект аналогов простагландинов, а также снижать выраженность их местных нежелательных явлений. Использование антиметаболитов, таких как митомицин и 5-фторурацил, оправдано наличием у них антифибротической активности, реализующейся за счет ингибирования синтеза ДНК и как следствие, пролиферации клеток, в том числе миофибробластов. Однако высока вероятность развития гипотонических осложнений. Ингибиторы ангиогенеза подавляют продукцию фактора роста эндотелия сосудов, тем самым блокируя пролиферацию.Применение ранибизумаба, бевацизумаба и инфликсимаба в дополнение к стандартной терапии позволяет увеличивать долговременную эффективность хирургии глаукомы. В свою очередь, их применение в настоящее время ограничено и не до конца изучено.</p></abstract><trans-abstract xml:lang="en"><p>The main complication of glaucoma surgery is excessive scarring of newly created aqueous humor outflow pathways. To prevent fibrotic tissue formation, medications with different mechanisms of action are used intraoperatively and during the early postoperative period.The primary group of anti-inflammatory drugs used in glaucoma surgery are topical steroids. A particularly high antiinflammatory efficacy has been demonstrated with a slowrelease dexamethasone implant placed under the scleral flap.Nonsteroidal anti-inflammatory drugs, in addition to their direct effect, can potentiate the hypotensive action of prostaglandin analogs and reduce the severity of their local side effects. The use of antimetabolites such as mitomycin C and 5-fluorouracil is justified by their antifibrotic activity, which inhibits DNA synthesis and, consequently, the proliferation of cells including myofibroblasts. However, they are associated with a high risk of hypotonic complications. Angiogenesis inhibitors suppress vascular endothelial growth factor production and thus block proliferation.The use of ranibizumab, bevacizumab, and infliximab as adjuncts to standard therapy can enhance the longterm effectiveness of glaucoma surgery. However, their use remains limited and not fully explored.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>глаукома</kwd><kwd>хирургия глаукомы</kwd><kwd>фиброз</kwd><kwd>рубцевание</kwd><kwd>внутриглазное давление</kwd></kwd-group><kwd-group xml:lang="en"><kwd>glaucoma</kwd><kwd>glaucoma surgery</kwd><kwd>fibrosis</kwd><kwd>intraocular pressure</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Петров С.Ю. Современная концепция борьбы с избыточным рубцеванием после фистулизирующей хирургии глаукомы. Противовоспалительные препараты и новые тенденции. Офтальмология 2017; 14(2):99-105. https://doi.org/10.18008/1816-5095-2017-1-5-11</mixed-citation><mixed-citation xml:lang="en">Petrov S.Ju. Modern concept of fight against excessive scarring after fistulizing glaucoma surgery. Anti-inflammatory drugs and new trends. 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