The Change of Corneal Sensation and Tear Film Stability after Cataract Surgery in Diabetic Patients

PURPOSE: To evaluate the change of corneal sensitivity and tear film stability before and after cataract surgery using a temporal clear corneal incision in diabetic patients. METHODS: This study included 16 eyes of 16 patients in the diabetic group and 20 eyes of 20 patients in the control group. All patients had phacoemulsification with 3 mm temporal clear corneal incision. All patients were examined for the corneal sensitivity, Schirmer test, tear break-up time, fluorescein staining for ocular surface, and ocular irritation symptom. All values were compared before and after surgery (1, 7, 30, 60, and 90 days). RESULTS: Before surgery, the Schirmer test and tear break-up time were lower in the diabetic group than the normal group, but the difference was not statistically significant. The values of the Schirmer test tended to temporarily increase after surgery and then decrease. The tear break-up time decreased more in the diabetic group than the normal group until postoperative day 7 (P<0.05). The fluorescein staining scores and ocular irritation symptoms were increased in both groups at postoperative day 1 (P<0.05). The temporal corneal sensitivity decreased more in the both groups until postoperative day 7. The central corneal sensitivity decreased more in the diabetic group until postoperative day 7, more in the non diabetic group until postoperative day 1 (P<0.05). Corneal sensitivity decreased more in the diabetic group than the normal group at postoperative day 1 (P<0.05). CONCLUSIONS: Clear corneal incision affected corneal sensitivity and tear film stability in the diabetic group more than the normal group after cataract surgery. The diabetic group experienced temporarily altered corneal sensitivity and tear film stability.

Change of Eye Position after Strabismus Surgery under General Anesthesia

PURPOSE: We studied change of eye position according to surgical amount with strabismus surgery under general anesthesia. METHODS: The 101 horizontal strabismus patients were classified into 5 groups and analyzed according to strabismus type, surgical method, and surgical amount. Group I had less than 7 mm recession in exotropia;, group II, was more than 7 mm recession in exotropia;, group III, was recession and resection in exotropia;, group IV, was less than 5.5 mm recession in esotropia;, group V, was more than 5.5 mm recession in esotropia. We measured eye position, corneal reflex and medial limbus by photographic measurement taken at a distance of 40 cm form the patient in the supine position. RESULTS: The mean amount of convergence in exotropia group I was 8.93+/-2.21PD, exotropia group II was 9.64+/-3.50PD, exotropia group III was 10.77+/-4.11PD. The mean amount of divergence of esotropia group IV was 6.62+/-2.10PD, esotropia group V was 7.88+/-2.90PD. The exotropia and esotropia groups were not statistically different from each other (P>0.05). The correlation coefficient according to surgical amount was 0.18 in exotropia groups, 0.01 in esotropia groups. CONCLUSIONS: The change of eye position according to surgical amount showed a weak positive correlation in exotropia groups, but showed no correlation in esotropia groups. Postoperative mean change in eye position was distributed from 9.26PD to 10.90PD in the exotropia group, from 6.10PD to 7.83PD in the esotropia group with 95% confidence interval and was difficult to expect overcorrection and undercorrection after awaking from anesthesia.