scholarly journals Changes the Ocular Surface after Corneal Refractive Surgery. Review

2020 ◽  
Vol 17 (3) ◽  
pp. 344-350
Author(s):  
S. V. Trufanov ◽  
E. V. Sukhanova ◽  
A. A. Tyurina

Modern corneal refractive surgery provides high efficiency, safety, predictability and stability of the different ametropia kinds correction’s clinically-functional results. However, in overwhelming percentage of cases, having spent some time after surgery patients complain about discomfort, eyes dryness, burning, feel gritty, redness, blurred and vision instability. Complaints mentioned above are caused by the appearance of transitory dry eye syndrome. Main etiology and pathogenesis factors of this disease are presented in this review. The results of dry eye syndrome classical diagnosis methods have been analyzed, as well as modern techniques, characterized by high specificity and sensitivity, which allow to increase the dry eye’s diagnostics accuracy. The study of the dry syndrome after corneal refractive surgery is devoted to a huge number of works of domestic and foreign authors. However, at present time there is no unique algorithm for assessing the damage of the ocular surface before and after corneal refractive surgery, which would include a set of high-precision and specific techniques for quickly and reliably evaluate the severity of dry eye syndrome, allowing to develop preventive measures and pathogenetically oriented treatment and, thereby, accelerate rehabilitation of patients after surgery. Research continuation is needed in this direction.

Author(s):  
A.D. Pilipenko ◽  
◽  
R.A. Burya ◽  
A.V. Romanova ◽  
E.L. Sorokin ◽  
...  

The main factor in pathogenesis of postoperative dry eye syndrome (DES) is damage to subbasal nerve plexus and stromal nerve endings. Taking into account the different principles of photorefractive effect on cornea of FemtoLASIK and ReLEx SMILE technologies, we decided on our own clinical experience to evaluate incidence of this undesirable complication. Purpose. Comparative study of frequency and timing of relief of postoperative DES after FemtoLASIK and ReLEx SMILE in patients with myopia. Material and methods. The study involved 32 patients (64 eyes) with varying degrees of myopia. The patients were divided into 2 groups: 1st group - 17 patients (34 eyes) after FemtoLASIK surgery, 2nd group - 15 people (30 eyes) after ReLEx SMILE procedure. Control group consist of 15 patients with comparable myopia who had not undergone refractive surgery was also observed. Patients underwent an assessment of the OSDI index, Norn and Schirmer tests, as well as degree of staining of anterior ocular surface 1, 6 and 12 months after refractive surgery. Results. There was statistically significant difference in total tear production, in tear breakup time (TBUT) and in the OSDI index between study groups 1 month after surgery in favor of ReLEx SMILE procedure. After 6 months, TBUT after FemtoLASIK significantly differed from control values. 12 months after surgery, studied parameters did not differ significantly from control. Conclusion. According to our datas, ReLEx SMILE procedure has lower negative effect on ocular surface compared to FemtoLASIK technique, which is manifested by less pronounced subjective symptoms of DES, as well as their faster relief. Key words: dry eye syndrome, ReLEx SMILE, FemtoLASIK.


2020 ◽  
Vol 20 (4) ◽  
pp. 180-186
Author(s):  
O.A. Klokova ◽  
◽  
R.O. Damashauskas ◽  
M.S. Geidenrich ◽  
◽  
...  

Aim: to analyze the prevalence of dry eye disease (DED) among adult patients with ametropias and the efficacy of its complex treatment when preparing the ocular surface for corneal refractive surgery.Patients and Methods: 1,762 patients with ametropias were examined. In addition to all of the standard eye checks, vital conjunctival and corneal staining, Scheimpflug corneal topography, and anterior segment OCT as well as patient survey were performed. Standard preservative-free tear substitutes with or without a short course of steroids, lubricants, 0.05% anionic cyclosporine emulsion (twice daily), and long-term punctal plugs were prescribed for DED.Results: mild DED was diagnosed in 1,021 patients (57.9%). Of them, corneal lesion was reported in 362 patients (35.4%) and asymptomatic DED in 250 patients (25.5%). Corneal topographic indices of one or both eyes were abnormal (as a result of DED) in 147 patients (14.4%). Significant (p≤0.05) increase in corneal epithelial thickness of one or both eyes was reported in 564 patients (55.2%). Ocular surface treatment in DED patients allowed for uncomplicated corneal refractive procedures while target refraction was achieved in 1,006 patients (98.5%). Conclusion: a complex diagnostic approach to DED involving specific tests, patient survey, corneal topography, and OCT provides the diagnosis of both manifest and latent DED. Combined treatment for conjunctival and corneal xerosis that includes tear substitutes, topical cyclosporine, and punctal plugs, improves ocular surface health in DED thus enlarging the list of indications and the safety of laser eye surgery in these patients.Keywords: dry eye disease, laser eye surgery, corneal refractive procedures, anionic cyclosporine emulsion, punctal plugs, corneal epithelium.For citation: Klokova O.A., Damashauskas R.O., Geidenrich M.S. Ocular surface treatment in dry eye patients before corneal refractive surgery. Russian Journal of Clinical Ophthalmology. 2020;20(4):180–186. DOI: 10.32364/2311-7729-2020-20-4-180-186.


2014 ◽  
Vol 25 (4) ◽  
pp. 264-269 ◽  
Author(s):  
Debora Garcia-Zalisnak ◽  
David Nash ◽  
Elizabeth Yeu

2009 ◽  
Vol 19 (4) ◽  
pp. 572-579 ◽  
Author(s):  
Gemma Caterina Maria Rossi ◽  
Carmine Tinelli ◽  
Gian Maria Pasinetti ◽  
Giovanni Milano ◽  
Paolo Emilio Bianchi

Purpose To verify the presence of dry eye syndrome (DES) in treated patients with glaucoma and to analyze DES's impact on the patients' quality of life (QOL) versus the control group. Methods In this observational cross-sectional study, 61 patients were enrolled at a clinical practice. Patients were divided into three groups by number of glaucoma drops instilled per day (G1=1 drop/day, G2=2 drops/day, G3=3 drops/day). A control group of 20 subjects was also selected (G0). All subjects were submitted to a complete ocular examination (including tear function and ocular surface status) and completed the 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ), Glaucoma Symptom Scale (GSS) questionnaire, and Ocular Surface Disease Index (OSDI). DES was defined as presence of punctate keratitis and decreased break-up time. Statistical analysis was performed applying the Kruskal-Wallis analysis of variance and Mann-Whitney U tests (to compare median values between groups) as well as the χ2 and Fisher test (to verify significant differences). Results A total of 40% of G3 and 39% of G2 patients presented DES versus 11% of G1 and 5% of G0 (p=0.01). QOL was significantly influenced and altered (NEI-VFQ 25 total mean and GSS total mean and symptoms average: p=0.0085, p=0.006, and p=0.03, respectively). OSDI pointed out differences by group: 26% of G2 and 15% of G3 presented moderate OSDI and 15% of G3 and 8.7% of G2 severe OSDI (p>0.05). Conclusions Patients with topically treated glaucoma present DES more often than a similar control group (p=0.01). The presence of DES negatively influences the patient's QOL. The patients with glaucoma's ocular surface status should be evaluated regularly to ensure the timely detection and treatment of pathologic signs on the ocular surface.


2017 ◽  
Vol 96 (2) ◽  
pp. e140-e146 ◽  
Author(s):  
Emilie Courrier ◽  
Didier Renault ◽  
Mathilde Kaspi ◽  
Agathe Marcon ◽  
Victor Lambert ◽  
...  

Nutrients ◽  
2020 ◽  
Vol 12 (11) ◽  
pp. 3245
Author(s):  
Sung-Chul Hong ◽  
Jung-Heun Ha ◽  
Jennifer K. Lee ◽  
Sang Hoon Jung ◽  
Jin-Chul Kim

Dry eye syndrome (DES) is a corneal disease often characterized by an irritating, itching feeling in the eyes and light sensitivity. Inflammation and endoplasmic reticulum (ER) stress may play a crucial role in the pathogenesis of DES, although the underlying mechanism remains elusive. Aster koraiensis has been used traditionally as an edible herb in Korea. It has been reported to have wound-healing and inhibitory effects against insulin resistance and inflammation. Here, we examined the inhibitory effects of inflammation and ER stress by A. koraiensis extract (AKE) in animal model and human retinal pigmented epithelial (ARPE-19) cells. Oral administration of AKE mitigated DE symptoms, including reduced corneal epithelial thickness, increased the gap between lacrimal gland tissues in experimental animals and decreased tear production. It also inhibited inflammatory responses in the corneal epithelium and lacrimal gland. Consequently, the activation of NF-κB was attenuated by the suppression of cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2). Moreover, AKE treatment ameliorated TNF-α-inducible ocular inflammation and thapsigargin (Tg)-inducible ER stress in animal model and human retinal pigmented epithelial (ARPE-19) cells. These results prove that AKE prevents detrimental functional and histological remodeling on the ocular surface and in the lacrimal gland through inhibition of inflammation and ER stress, suggesting its potential as functional food material for improvement of DES.


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