Posters

Ocular surface disease improvement after glaucoma surgery

Poster Details

First Author: M.Radenkovic SERBIA

Co Author(s): G. Stankovic Babic   J. Djordjevic Jocic   P. Jovanovic   M. Zivkovic   M. Petrovic   S. Cekic     

Abstract Details

Purpose:

Ocular Surface Disease (OSD) occurs due to multifactorial etiology (age, drugs, nutrition, systemic diseases, surgery, trauma, contact lenses, environment). Anterior segment surgical approach disrupts tear film. Dry eye symptoms occur after: cataract, glaucoma, refractive, corneal or vitreoretinal surgery. Pathomechanism varies due to procedure: nerves cutting in corneal surgery, conjunctival damage with goblet cells reduction, distributional mucin changes, chronic inflammation. Artificial tears are first-line therapy that increases tear film volume, mucus adhesion, reduces tear osmolarity and evaporation, so improve tear film structure.

Setting:

This clinical research was conducted in glaucoma department at Eye Clinic (Clinical Center Nis) to determine the existence of postoperative difference in tear film parameters after trabeculectomy with and without additional therapy with artificial tears.

Methods:

Retrospective-prospective study in 96 eyes (patients) with OAG (POAG and XFG). Postoperatively 60 subjects did not apply artificial tears (group 1) but 36 subjects used different types of tears (hyaluronic acid - group 2, carboxymethyl cellulose – group 3). Obtained results of fluorescein staining and TBUT, Schirmer test, Delphi panel grade before and after (at day 7, 30, 60) conventional fornix based flap trabeculectomy without antimetabolites were statistically analyzed by SPSS18.

Results:

42 subjects without artificial tears(group 1) were POAG(70%) and 18(30%)XFG. Group 2(HA): 9(75%)POAG and 3(25%)XFG. Group 3(CMC):17(70.8%) POAG and 7(29.2%)XFG. Reduced TBUT(5-10s): 58% subjects preoperatively, after 1 month 81%, but recovered one month faster in group 2(HA). Schirmer test reduced(<15s) in 82% preoperatively, increased after surgery due to reflex secretion, returned to preoperative level faster in group 2/3. Most respondents has IIa/IIb OSD grade(32%/ 34%) preoperatively, shifted to higher IIb/III grade(52%/ 7%) 7days postoperativelly, retained IIb grade(78%) one month postoperatively but recovered faster to lower grade(I/IIa) in group 2/3 one month faster. Group 1without tears maintained IIb grade(65%).

Conclusions:

Tear film parameters analyzing determined postoperative difference in group without and with artificial tears. Preoperative status of ocular surface and topical eye drops use may have a role in the exacerbation of postoperative OSD or manifestation of advanced forms. Results of this clinical study indicate that symptom recognition and early treatment improve the quality of life and tear film integrity. Unaltered tear film is important in preserving the integrity of entire ocular surface of the eye.

Financial Disclosure:

None