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@#AIM:To analyze the effects of corneal surface morphology and tear-film with different incisions guided by corneal topography after phacoemulsification.<p>METHODS: Retrospective study. Totally 56 patients(60 eyes)were selected and divided into clear corneal incision group and angle scleral margin incision group who were treated by phacoemulsification in our hospital from June 2019 to December 2020. Best corrected visual acuity(BCVA), ocular surface disease index(OSDI)questionnaire, tear film break-up time(TBUT), corneal surface regularity index(SRI), corneal surface asymmetry index(SAI)and corneal surface astigmatism(CYL)were measured preoperatively and postoperatively, the results were statistically analyzed.<p>RESULTS: BCVA in both groups increased after operation(<i>P</i><0.01). The OSDI score of the two groups increased significantly after surgery(<i>P</i><0.01). TBUT was shortened to varying degrees after surgery(<i>P</i><0.05). SAI and SRI increased to varying degrees in both groups after surgery, and SAI value of angle scleral margin incision group in 1wk and 1mo postoperatively was significantly lower than that in clear corneal incision group(<i>P</i><0.05). The corneal astigmatism at 1wk postoperatively was significant increased in both groups(<i>P</i><0.05). The astigmatism increase of clear corneal incision group at 3mo postoperatively was still higher than that before surgery.<p>CONCLUSION: Angle scleral margin incision has less effect on stability of tear film and corneal surface morphology, which is reliable on phacoemulsification.
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@#AIM: To study the clinical changes related to dry eye and evaluate the severity of ocular surface diseases in patients with posterior chamber intraocular lens(ICL)implantation. <p>METHODS: Prospective study. Totally 50 eyes of 50 cases with myopia who were underwent ICL surgery from September 2019 to October 2019. Ocular surface disease index questionnaire(OSDI), fluoresceine staining of cornea tear break up time(TBUT), Schirmer Ⅰ test(SⅠt), and tear meniscus were measured before and 1wk, 1 and 3mo after surgery.<p>RESULTS: The scores of OSDI questionnaire and corneal staining were significantly increased at 1wk and 1mo after operation(<i>P</i><0.05). There was a difference between 3mo and 1wk pastoperatve(χ<sup>2</sup>=5.267,<i>P</i>=0.022), and recovered to the preoperative level at about 3mo. Corneal staining scores were significantly positively correlated with OSDI questionnaire scores at all time points(<i>r<sub>s</sub></i>>0, <i>P</i><0.05). TBUT decreased significantly at 1wk and 1mo after operation(<i>P</i><0.05), and returned to the preoperative level 3mo after operation. There was no significant difference in the basal tear volume(SⅠt)and the height of lacrimal river in the middle of lower eyelid between before and after operation(<i>P</i>>0.05). <p>CONCLUSION: The stability of tear film on the ocular surface will be affected by ICL implantation in the early postoperative period, and the patients will have different degrees of dry eye related symptoms. OSDI questionnaire score can be used to evaluate their subjective discomfort symptoms. However, at 3mo after operation, the stability of tear film on the surface of eyes recovered to the preoperative level. The higher the positive score of corneal staining was, the more obvious the subjective discomfort was.
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Background There are two types of different questionnaires in dry eye diagnosis.But the associations about two questionnaires or questionnaire and clinical examination are still unclear.To effectively quantize the symptoms is helpful for a correct diagnosis of dry eye disease.Objective This survey was to evaluate the Standard Patient Evaluation of Eye Dryness (SPEED) and Ocular Surface Disease Index(OSDI) questionnaire for the diagnosis of dry eye and investigate the correlation between the clinical examinations and questionnaires. Methods A perspective cohort study was designed.Sixty-six patients were enrolled in this study.This study was approved by the Ethic Committee of Peking University First Hospital,and written informed consent was obtained from each subject before any ocular examination.SPEED-based and OSDI-based questionnaires were used to score the dry eye symptom and grouped according to severity of complains.Corneal fluorescence staining,tear film breakup time(BUT),Schirmer I test and tear film interferometry were performed in all patients.The correlations between two questionnaires scores and their association with clinical examinations were evaluated.Results The negative correlations were found between the SPEED-based score or OSDI-based score with BUT value(r=0.390,P=0.001 ;r=-0.395,P=0.001 ),but no significant correlations were seen between the SPEED-based score or OSDI-based score with Schirmer test( r=-0.081,P=0.515; r=-0.080,P=0.525)and tear film interferometry score(r=0.158,P=0.204;r=0.219,P=0.077).The BUT was significantly prolonged in mild symptom group compared with serious group(t=2.339,P=0.022),but no significant difference was seen in Schirmer Ⅰ test and tear film interferometry scores using SPEED-based questionnaire ( t =0.404,P =0.687 ; t =- 0.947,P =0.347 ) ; while the positive fluorescence staining rate between two groups was significantly different (x2 =0.164,P =0.685 ).When using OSDI-based questionnaire,significant difference in BUT was seen among mild,moderate and serious symptom groups ( F =11.871,P =0.000 ),and BUT in mild symptom group was delayed in comparison with moderat and serious groups( P=0.000,0.000).No significant differences were found in Schirmer Ⅰ test,tear film interferometry scores and fluorescence staining rate among three groups(F=1.432,P =0.246; F =2.799,P =0.068; x2 =6.026,P =0.050).SPEED score showed a positive correlation with OSDI score ( r =0.697,P =0.000 ). Conclusions Both OSDI and SPEED are effective tools for the evaluation of symptoms of dry eye.The two types of questionnaires are consistent in symptoms evaluation.