New tear test for dry eye syndrome after LASIK and PRK surgery

Session Details

Session Title: Presented Poster Session: Laser Refractive Surgery

Session Date/Time: Sunday 06/09/2015 | 15:00-16:30

Paper Time: 15:50

Venue: Poster Village: Pod 2

First Author: : J.Sanchez Naves SPAIN

Co Author(s): :    G. Carracedo   J. Pintor   I. Cacho        

Abstract Details

Purpose:

The purpose of this study was to measure The diadenosine polyphosphate on tears flow before and after the surgery and others test that we perform in order to evaluate the dry eye after Lasik and PRK. This new molecules Ap4A (adenosine tetraphopsphate) has a secretagogue action on tear flow, improve the rate of corneal wound healing and the goblet cell production as we have been seen in animals. Ap4A and Ap5A (adenosine pentaphosphate) rise in patients with dry eye and Sjogren syndrome ,suggesting that this compounds could be objective markers to score dry eye.

Setting:

I.B.O. (Baleáric Institute of opthalmology) for patients schedule and Molecular biology laboratory at U.C.M. (Complutense university of Madrid) for the showns analisys.

Methods:

We schedule 50 eyes from Lasik technique and 50 from PRK. We perform the test for dry eye that include the subjective DEQ (dry eye questionnaire) scores pre and postoperative , and objective ones: T.B.U.T., fluorescein and bengal rose stain grading scales accordin to C.C.L.R.U. ,schirmer I test Jones test). For the nucleotid measurements we use the HPLC (high pressure liquid cromatography) as we have been published elsewhere. All the surgeries were made by the same surgeon (J.S.N). Using the XP microkeratome and the technolas 217z excimer laser platform.

Results:

Ap4A showed and increase of 5 fold after LASIK and 3.5 fold after PRK the one day postop, from 0.100 microM to 0.500 and 0.39 in Lasik and PRK, returns to normal level at 2 weeks visit while remaining up to abnormal levesl in LASIK patients even 3 months later (0.180 microM). Schirmer Test in Lasik shows a reduction by 30% at 2 weeks and 20% less at 3 months postop while in PRK returns to normal levels by 1 month. The TBUT at 3 months visit shows lower levels than preop but it was not statistically significant, was restored to normal levels in PRK at 3 visit month. Symptoms discomfort and dryness worst for LASIK.

Conclusions:

As we know previously the LASIK technique shows worst results concerning dry eye complainings than the PRK, We confirm this scores by a molecular biology test, the diadenosine Ap4A shows the worst result the day after in both groups and returning to normal levels in 2 weeks in PRK group and remeining out of normal levels and in LASIK even three months later were up to preoperative values, that means that the mechanism healing the wound are still working in the LASIK procedure.

Financial Interest:

NONE