Ocular Surface & Tear Film Changes in Patients Undergoing Small Incision Cataract Surgery - A Hospital Based Prospective Clinical Study in South Kerala

2021 ◽  
Vol 8 (29) ◽  
pp. 2650-2655
Author(s):  
Arya Amala Rajagopal ◽  
Mini Mathew
Keyword(s):  
Cataract Surgery ◽  
Dry Eye ◽  
Ocular Surface ◽  
Tear Film ◽  
Prospective Clinical Study ◽  
Low Grade ◽  
Ocular Surface Disease Index ◽  
Small Incision Cataract Surgery ◽  
Dry Eyes ◽  
Small Incision

BACKGROUND Dry eye is an important factor affecting the quality of life especially elderly. The major cause of adult blindness in India is cataract. After cataract surgery many are beleaguered by dry eye symptoms. Since small incision cataract surgery remains the most commonly performed surgical procedure for cataract in India the ocular surface and tear film changes occurring in patients after cataract surgery in our hospital was studied. METHODS A prospective observational study was conducted among 120 patients who underwent uncomplicated cataract surgery at RIO, Thiruvananthapuram for a period of 12 months from July 2019 - June 2020 to assess the changes that occur in ocular surface and tear film after small incision cataract surgery. The dry eye status was measured using Schirmer tests, tear film breakup time, tear film height, fluorescein and lissamine green staining and finally graded using OSDI score. The score was assessed preoperatively & postoperatively at 1 week, 4 weeks & 12 weeks. RESULTS Pre & postoperative OSDI score showed that 1 week after surgery only 5 % patients remained with no dry eye changes. 4 weeks after the surgery mild dry eye was found in 35 %, moderate dry eye in 40 % & severe dry eye in 23 % patients. 12 weeks after surgery mild dry eye was found in 53.3 %, moderate in 33.3 % & severe in 1.7 %. The occurrence of dry eye was seen to increase 1wk postoperatively & peak around 4weeks postoperatively. CONCLUSIONS Small incision cataract surgery induces significant dry eye changes in patients whose ocular surface & tear film was normal preoperatively. The dry eye changes were noted to worsen maximum at 4 weeks after surgery & these changes persisted in low grade even at 12 weeks after surgery. KEYWORDS Dry Eyes, Small Incision Cataract Surgery (SICS), OSDI (Ocular Surface Disease Index) Score

scholarly journals Comparative Study of Dry Eye Indices Following Cataract Surgery

2021 ◽  
Vol 13 (1) ◽  
pp. 104-111
Author(s):  
Bipin Bista ◽  
Padam Raj Bista ◽  
Sharad Gupta ◽  
Raghunandan Byanju ◽  
Simanta Khadka ◽  
...  
Keyword(s):  
Comparative Study ◽  
Cataract Surgery ◽  
Dry Eye ◽  
Ocular Surface Disease Index ◽  
Small Incision Cataract Surgery ◽  
Subjective Analysis ◽  
Small Incision ◽  
Surgery Group ◽  
Surface Staining ◽  
Breakup Time

Background: This study aims to assess dry eye indices following cataract surgery. Materials and Methods:  A single center descriptive and comparative study was performed. A total of 100 eyes of 100 cases fulfilling the inclusion criteria from 1st June 2017 to 30th May 2018 were enrolled. Out of 100 eyes, 50 eyes each went through manual small incision cataract surgery (MSICS) and phacoemulsification respectively. For objective analysis : schirmer 1 test(ST-I), tear breakup Time(TBUT) along with lissamine Green Surface Staining(LGSS) was performed on pre-operative day, 1st, 4th and 12th week respectively. Ocular Surface Disease Index (OSDI) was done for subjective analysis on pre-operative day and at 12th week. Results: The mean age of the patient was 53.66 ± 7.839 years with 34 (68%) being female in a small incision cataract surgery group.  In the phacoemulsification group, mean age was 54.72 ± 7.985 years and 32 (64%) were female.  On analyzing the objective dry eye indices: ST-I,TBUT and  LGSS at 12thweek was 18.80 ± 7.393 mm, 11.30 ± 5.456 seconds and 1.62 ± 1.193 in Small incision cataract surgery group and 27.10 ± 6.326 mm, 16.60 ± 4.699 seconds and 0.38 ± 0.602 in Phacoemulsification group respectively which was statistically significant. (p< 0.001).  Conclusion: Regardless of the type of cataract surgery, dry eye disease is unavoidable affecting both tear quality and quantity postoperatively. In our study, phacoemulsification had lesser effect in dry eye indices than small incision cataract surgery.

Comparative Evaluation of Tear Film Parameters Following Cataract Surgery in Diabetic Patients.

2021 ◽  
Author(s):  
Sagarika Dash
Keyword(s):  
Cataract Surgery ◽  
Outcome Measures ◽  
Dry Eye ◽  
Tear Film ◽  
Diabetic Patients ◽  
Small Incision Cataract Surgery ◽  
Fluorescein Staining ◽  
Small Incision ◽  
Group A ◽  
Group B

Purpose: To compare the propensity of manual small incision and phacoemulsification cataract surgery in causing tear film dysfunction and dry eye syndrome in diabetic patients. Methods: Diabetic patients in group A underwent manual small Incision Cataract surgery whereas in group B underwent phacoemulsification with similar post-operative regimes. The primary outcome measures were the Ocular Surface Disease Index (OSDI), a Subjective questionnaire. The secondary outcome measures were the Subjective Dry Eye (DE) questionnaire, Corneal Fluorescein staining, Tear meniscus height, Schirmer’s II test, and Tear film break-up time. All parameters were measured pre and then postoperatively. Result: 126 patients were divided into group A (undergoing small incision cataract surgery) and group B (undergoing phacoemulsification). The OSDI and subjective DE scores continued to be worse for Group A until the first month after which they became similar to group B with no statistically significant difference (p-value of 0.726 and 0.347 respectively). The OSDI and subjective DES at 3 months were better in both groups as compared to baseline (p <0.0001). The objective tear film parameters (Schirmer’s, TBUT, TMH, and fluorescein staining scores) showed statistically significant changes from the baseline in both groups but the scores remained in the normal range clinically. Schirmer’s test scores were different between the two groups at three months (p=0.007) in SICS group being higher. Conclusion: Manual Small Incision Cataract Surgery (SICS) causes subjective dry eye symptoms more than phacoemulsification until 1 month of surgery in diabetic patients after which the subjective symptoms become similar to phacoemulsification at 3 months.

scholarly journals Changes of Dry Eye Related Markers and Tear Inflammatory Cytokines After Upper Blepharoplasty

2021 ◽  
Vol 8 ◽  
Author(s):  
Songjiao Zhao ◽  
Nan Song ◽  
Lan Gong
Keyword(s):  
Inflammatory Cytokines ◽  
Dry Eye ◽  
Ocular Surface ◽  
Clinical Manifestations ◽  
Tear Film ◽  
Ocular Surface Disease Index ◽  
Necrosis Factor Alpha ◽  
Tnf Α ◽  
Break Up ◽  
Upper Blepharoplasty

Objectives: To investigate the changes of dry eye-related clinical manifestations, ocular surface parameters, and tear inflammatory cytokines after upper blepharoplasty.Methods: Forty eyes of 20 who underwent upper blepharoplasty were divided into either the group with or the group without preexisting dry eye before upper blepharoplasty. Ocular Surface Disease Index (OSDI), Schirmer I test, tear meniscus height, lipid layer thickness, non-invasive tear break-up time (NIKBUT), fluorescein tear film break-up time (FBUT), corneal fluorescein staining, meibum expression, lid margin changes, and tear inflammatory cytokines were assessed preoperatively and at 1, 3, and 6 months postoperatively. Correlations between inflammatory cytokines and dry eye-related parameters were determined.Results: The OSDI scores increased significantly at 1 month (p = 0.040) and subsequently decreased to the preoperative levels at 6 months postoperatively in subjects with dry eye. First (f)-NIKBUT and FBUT were significantly shortened at 1, 3, and 6 months postoperatively in subjects with dry eye (f-NIKBUT: p &lt;0.001, p = 0.010, p = 0.042; FBUT: p = 0.002, p = 0.005, p = 0.037, respectively), but were only shortened at 1 month (p = 0.028, p = 0.005) and returned to baseline levels at 6 months postoperatively in subjects without preexisting dry eye. A significant increasing trend of interleukin (IL)-6 was found in both dry eye and subjects without preexisting dry eye (p = 0.016, p = 0.008), while IL-8 and tumor necrosis factor alpha (TNF-α) were only found to be increased in subjects with dry eye postoperatively (p = 0.031, p = 0.031). The levels of IL-8 and TNF-α were positively correlated with OSDI scores (p = 0.046, p = 0.043, respectively) and negatively correlated with f-NIKBUT and FBUT (p = 0.026, p = 0.006, respectively).Conclusions: Upper blepharoplasty might increase the release of tear inflammatory cytokines and tear film instability that contribute to the development of postoperative dry eye in the early postoperative period and the changes most relieved in 6 months. Preexisting dry eye is a higher risk factor for worse and persistent ocular surface damage after upper blepharoplasty.

A study to assess the efficacy of topical cyclosporine A 0.05% in the management of dry eye with meibomiam gland dysfunction

2022 ◽  
Vol 7 (4) ◽  
pp. 667-671
Author(s):  
Prajwalli Reddy ◽  
Wajeeha Umam
Keyword(s):  
Dry Eye ◽  
Cyclosporine A ◽  
Ocular Surface ◽  
Tear Film ◽  
Meibomian Gland ◽  
Meibomian Gland Dysfunction ◽  
Control Group ◽  
Dry Eyes ◽  
Group A ◽  
Group B

: Dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability with potential damage to the ocular surface. It is accompanied by increased osmolarity of the tear film and inflammation of the ocular surface. Meibomian Gland Dysfunction (MGD) is an abnormality of the meibomian gland that blocks the secretion of lipids. Without sufficient lipid production, tears evaporate quickly causing Dry Eye.MGD is associated with multiple pathological mechanisms including inflammation, microbial factors and lipid deficiencies. Topical Cyclosporine A (CsA) 0.05% is a calcineurin inhibitor that reduces inflammation by specifically inhibiting T‑cell activity, which reduces ocular surface inflammation and improves tear film dynamics. This was a prospective observational study done on 100 patients at the Department of Ophthalmology Basaveshwar teaching and general hospital, on patients of dry eyes due to meibomian gland dysfunction. Patients who were diagnosed with dry eyes due to meibomian gland dysfunction were invited to take part in the study. Patients were divided randomly into two groups of 50 patients each. This study, was explained in detail to them. An informed consent was obtained. Patients fulfilling the inclusion criteria were listed.All OSDI scores (symptom intensity, frequency and aggravation) revealed decreasing patterns throughout the observation period in both the groups. In single analysis, the cyclosporine A 0.05% group showed a significant improvement for each score at 3 months (p &#60; 0.01, p = 0.01, p = 0.02, respectively). The mean TBUT after treatment in the group A (cyclosporine A group) increased to 12.36± 3.58(p&#60;0.001) seconds, and in the group B (Control group) the TBUT score increased to 11.01±3.06 seconds. After 3 Months, there was statistically significant improvement in the mean Schirmer’s scores in both the treatment groups, however improvement was significantly greater in Cyclosporine A group. Prior to the treatment in group A (Cyclosporine A) mean Lissamine staining score was 2.73±0.15 and post treatment it reduced to 1.32±0.15 which was statistically significant (P&#60;0.001). In group B (Control group) score before treatment was 2.46±0.15 and after treatment it reduced to 2.39±0.27 (p=0.11), not much difference was seen. : Findings from our study showed that there were significant improvements in the dry eye conditions due to defect in meibomian gland by treatment of topical Cyclosporine A 0.05% and sodium hyaluronate 0.1%.

scholarly journals Ocular Surface Epithelial Thickness Evaluation in Dry Eye Patients: Clinical Correlations

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Qingfeng Liang ◽  
Hong Liang ◽  
Hanruo Liu ◽  
Zhiqiang Pan ◽  
Christophe Baudouin ◽  
...  
Keyword(s):  
Dry Eye ◽  
Ocular Surface ◽  
Tear Film ◽  
Conjunctival Epithelium ◽  
Ocular Surface Disease Index ◽  
Control Subjects ◽  
Significant Difference ◽  
Epithelium Thickness ◽  
Oxford Score ◽  
Schirmer I Test

Purpose.To evaluate the relationship between corneal and conjunctival epithelium thickness and ocular surface clinical tests in dry eye disease (DED) patients.Patients and Methods.Fifty-four patients with DED and 32 control subjects were included. Each patient underwent an ocular surface evaluation using the ocular surface disease index (OSDI), tear film break-up time (TBUT), corneal and conjunctival staining, tear film lipid layer analysis, and Schirmer test. The central corneal (CET), limbal (LET), and bulbar conjunctival epithelium thickness (BET) were acquired using spectral-domain optical coherence tomography (SD-OCT).Results.Compared to control subjects, mean BET was significantly thicker and mean LET was significantly lower in the DED group. There was no significant difference in mean CET between the two groups. The mean LET was correlated with OSDI and TBUT. The inferior LET was correlated with OSDI, Schirmer I test, TBUT, Oxford score, and corneal sensitivity. Mean BET was correlated with OSDI and TBUT, but not with Schirmer I test and Oxford score.Conclusions.In dry eye patients, a thinner limbal epithelium and a thicker bulbar conjunctival epithelium were observed. These changes were correlated to the severity of dry eye symptoms and tear film alterations.

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