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Phacoemulsification surgery in diabetic patients and how it affected tear film parameters

Poster Details

First Author: T.Stavropoulou GREECE

Co Author(s):    D. Pagoulatos   P. Dimitrakas   K. Mani   I. Georgalas           

Abstract Details

Purpose:

Evaluation of the tear film affection and tear osmolarity after standard phacoemulsification surgery in diabetic patients.

Setting:

1st Ophthalmology Department, “G. Gennimatas” Hospital, University of Athens

Methods:

Three groups of patients were formed.1st group included twenty non-diabetic cataract patients, 2nd group included twenty patients with insulin dependent diabetes and the 3rd one twenty patients with non-insulin dependent diabetes. Exclusion criteria for both groups included patients with diagnosed ocular surface disease ,or severe dry eye patients already on treatment for dry eye. All patients underwent phacoemulsification ,that lasted approximately the same time. Tear osmolarity ,tear film break-up time (TFBUT) and Schirmer test (SIT) were measured preoperatively, and postoperatively at the 1st day, 1st month and 3 months consecutively. The results were compared between the three groups.

Results:

Preoperatively the mean tear osmolarity was 307 mOsm/L in the insulin dependent group of diabetics,295 mOsm/L in the non-insulin dependent group and 296.5 mOsm/L in the group of the non-diabetic patients. The mean TBUT and SIT were 10.2 sec and 13mm in the insulin dependent group, 14,5 sec and 17mm in the non-insulin dependent group and 14.2sec and 17,2mm in the non-diabetics. TBUT was reduced on day 1 and recovered 3 months postoperatively in all groups. SIT was increased after phacoemulsification, but returned to preoperative levels at 3 months in non-diabetics. However, it was lower than preoperative level in diabetics.

Conclusions:

This study showed that patients with insulin dependent diabetes had higher tear hyperosmolarity and more abnormal tear film function than patients with non-insulin dependent diabetes and non-diabetic patients. This worsened dry eye symptoms and thus affected the quality of vision. Early administration of topical lubricants in diabetic patients may help the dry eye symptoms that accompany the phacoemulsification procedure.

Financial Disclosure:

None

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