Objective. To evaluate integrated pulmonary index (IPI) and its prognostic value in anesthesia with sevoflurane and propofol in patients with cardiac comorbidities undergoing ophthalmic surgery. Material and methods. A prospective study included 40 patients with concomitant cardiac diseases undergoing elective ophthalmic surgery. Induction of anesthesia and insertion of a laryngeal mask was followed by randomization of patients into groups of inhalation anesthesia with sevoflurane (n=20) and intravenous anesthesia with propofol (n=20). Hemodynamic and respiratory parameters including IPI were assessed upon admission to the operating theatre, after induction of anesthesia and then every 30 minutes. Cognitive function was assessed before surgery and 24 hours later using the Montreal cognitive assessment scale. Results. We observed a decrease of IPI in the propofol group in 30 min after surgery onset (p=0.009). After induction of anesthesia and during the operation, administration of propofol was followed by increased SpO2 and reduced EtCO2 as compared to the sevoflurane group (p<0.05). By the end of surgery, we observed an increase of mean blood pressure in the propofol group (p<0.05), in the recovery unit — reduced heart rate and cardiac index (p<0.05). IPI <8 measured after induction of anesthesia was associated with postoperative cognitive dysfunction with area under curve of 0.77, sensitivity of 100% and specificity of 70% (p=0.04). Conclusion. Inhalation anesthesia with sevoflurane in patients with cardiac diseases undergoing ophthalmic surgery attenuates intraoperative hyperoxia, hypocapnia and hypertension and ensures increase of IPI. The use of sevoflurane prevents postoperative bradycardia and decrease of cardiac index. IPI after anesthesia induction correlates with cognitive function after intervention.