Vestnik oftalmologii · 2021
[Ocular surface changes after cataract phacoemulsification].
СтатьяНазвание и аннотация: Оригинал на русском
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Sakhnov S N, Yanchenko S V, Malyshev A V, Karapetov G Yu
Аннотация
PURPOSE: To assess the effects of phacoemulsification cataract surgery (PCS) and its pharmacological support on the prevalence of dry eye (DE) type ocular surface changes.
MATERIAL AND METHODS: The study included 550 patients with age-related (369 patients) or complicated (181 patients) cataracts (247 men, 303 women; mean age 71.6±7.3 years) who were assessed using the Ocular Surface Disease Index (OSDI), tear break-up test (TBUT), Shirmer-1 test, lipid interference test, OCT meniscometry, examined for xerosis indicators and «lid vipers» symptom in order to detect DE before PCS, as well as on days 1, 7, 30 after PCS. Meibomian gland dysfunction (MGD) was determined by the Norn compression test, which was performed before PCS. The significance of differences was assessed using Pearson χ2 test.
RESULTS: Before PCS the prevalence of DE was 51.1%, asymptomatic subclinical DE - 28.9%. MGD was detected in 79.4% of DE patients and in 50.3% subclinical DE patients. After PCS, an increase in DE prevalence was noted (due to increase in the prevalence of mild DE): on the 1st day - up to 58% (χ2=5.295; p=0.022; p<0.05), on the 7th day after surgery - up to 63.1% (χ2=16.165; p=0.001; p<0.01), on the 30th day - up to 55.6% (χ2=2.283; p=0.131; p>0.05).
CONCLUSION: The study revealed a trend towards an increase in DE prevalence after PCS (due to an increase in the proportion of hypersecretory mild DE), which was statistically significant on days 1 and 7 after the operation and statistically insignificant by the 30th day after surgery. Apparently, it could be associated with aggravation of "background" asymptomatic ocular surface changes. From our point of view, the high prevalence of DE and subclinical DE in cataract patients before PCS makes it advisable to carry out preoperative preparation aimed at normalizing the condition of ocular surface. At the same time, the high prevalence of MGD in DE and subclinical DE patients determines one of the directions of preoperative treatment - eyelids hygiene.
MATERIAL AND METHODS: The study included 550 patients with age-related (369 patients) or complicated (181 patients) cataracts (247 men, 303 women; mean age 71.6±7.3 years) who were assessed using the Ocular Surface Disease Index (OSDI), tear break-up test (TBUT), Shirmer-1 test, lipid interference test, OCT meniscometry, examined for xerosis indicators and «lid vipers» symptom in order to detect DE before PCS, as well as on days 1, 7, 30 after PCS. Meibomian gland dysfunction (MGD) was determined by the Norn compression test, which was performed before PCS. The significance of differences was assessed using Pearson χ2 test.
RESULTS: Before PCS the prevalence of DE was 51.1%, asymptomatic subclinical DE - 28.9%. MGD was detected in 79.4% of DE patients and in 50.3% subclinical DE patients. After PCS, an increase in DE prevalence was noted (due to increase in the prevalence of mild DE): on the 1st day - up to 58% (χ2=5.295; p=0.022; p<0.05), on the 7th day after surgery - up to 63.1% (χ2=16.165; p=0.001; p<0.01), on the 30th day - up to 55.6% (χ2=2.283; p=0.131; p>0.05).
CONCLUSION: The study revealed a trend towards an increase in DE prevalence after PCS (due to an increase in the proportion of hypersecretory mild DE), which was statistically significant on days 1 and 7 after the operation and statistically insignificant by the 30th day after surgery. Apparently, it could be associated with aggravation of "background" asymptomatic ocular surface changes. From our point of view, the high prevalence of DE and subclinical DE in cataract patients before PCS makes it advisable to carry out preoperative preparation aimed at normalizing the condition of ocular surface. At the same time, the high prevalence of MGD in DE and subclinical DE patients determines one of the directions of preoperative treatment - eyelids hygiene.