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AIM: To investigate the effect of unilateral endoscopic dacryocystorhinostomy on binocular surface indexes.METHODS: Totally 45 cases with monocular primary acquired nasolacrimal duct obstruction(PANDO)who successfully underwent endoscopic dacryocystorhinostomy between 1 December 2022 and 31 July 2023 were enrolled in the study. Ocular surface indexes, including the non-invasive tear break-up time(NIBUT), Sjögren's International Collaborative Clinical Alliance ocular staining score(SICCA OSS), Korb score of lid wiper and Schirmer test scores, were collected preoperatively and at 0.5, 1 and 3 mo post-operatively. Subsequently, various indexes were compared at each time point between the operated and healthy eyes pre- and post-operatively.RESULTS: There was no significant differences between operated and healthy eyes in NIBUT, SICCA OSS, Korb scores and Schirmer test(all P>0.05). Furthermore, the Korb scores of operated eye at 0.5, 1 and 3 mo post-operatively were significantly lower than the preoperative value(P=0.034, 0.044, 0.027). Moreover, the Schirmer test score of the operated eye at 1 mo post-operatively was significantly lower than the preoperative value(P=0.0461).CONCLUSION:After a successful endoscopic dacryocystorhinostomy, tear drainage is restored, however, ocular surface damage worsens. These changes typically peak at 1 mo post-operatively before gradually improving.
Résumé
Purpose: Lid wiper epithliopathy (LWE) was stuided in symptomatic and asymptomatic dry eye subjects. This is the first such study to be conducted in the Indian population. LWE is a clinical condition associated with vital staining in the lower and upper eyelids on increased friction of the lid margin over to the cornea. Our aim was to study LWE in symptomatic and asymptomatic (control) dry eye subjects. Methods: Out of 96 subjects screened, 60 subjects were enrolled in the study and were divided into two groups, symptomatic and asymptomatic dry eye subjects, based on the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire and the Ocular Surface Disease Index (OSDI) scores. The subjects were examined to rule out clinical dry eye findings and assessed for LWE with two different dyes (fluorescein and lissamine green). Descriptive analysis was done and Chi?square test was used for statistical analysis. Results: A total of 60 subjects were enrolled in a study with a mean age of 21.33 ± 1.88 years, out of which the majority of LWE patients (99.8%) was seen in the symptomatic group than the asymptomatic group (73.3%); the difference was statistically significant (p = 0.00) and also clinically significant. LWE was found to be significantly higher in symptomatic dry eye subjects (99.8%) compared to asymptomatic dry eye subjects (73.3%). LWE severity was also found to be more (56.6% of grade 3) among symptomatic dry eye subjects compared to asymptomatic subjects (40% of grade 2). Conclusion: It is important to assess the lid wiper region (LWR) and treat LWE in routine clinical practice.
Résumé
Lid-wiper epitheliopathy(LWE)refers to the corresponding pathological changes in the palpebral conjunctiva after the skin-mucosa junction area of the palpebral margin, and staining occurs after using dyes such as fluorescein sodium or lissamine green. Current studies suggest that LWE mainly results from the increase of friction between the lid wiper and the ocular surface. The specific mechanism of LWE is not clear, but the common causes include wearing contact lenses, abnormal tear film, blink abnormalities and inflammation. Clinical studies have found that LWE appears when the conventional dry eye index is negative, so the diagnosis of LWE plays an important role in the early diagnosis and treatment of dry eye. However, there are few studies on the correlation between LWE and dry eye in clinical practice. Based on the existing clinical studies, the etiology, pathogenesis, clinical manifestations and treatment of LWE are introduced, and the research progress of LWE and dry eye is reviewed, hoping to provide reference for further investigation and the clinical application of LWE.
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Objective@#To determine the tear and ocular surface profile of the anophthalmic socket in relation to the contralateral normal eye.@*Methods@#Twenty-five adult patients with unilateral anophthalmic sockets were included into the study. They were at least 2 months post-enucleation or post-evisceration and without any topical medications on the anophthalmic socket and control eye for at least 2 weeks. Assessment was performed using the following parameters: (1) meibomian gland evaluation, (2) ocular surface staining, (3) degree of conjunctival inflammation, (4) Schirmer I and II, and (5) conjunctival impression cytology. @*Results@#Mucoid discharge (52%) was the most common complaint in anophthalmic sockets, followed by itchiness (40%), tearing (36%), and dryness (4%). Compared to control eyes, the anophthalmic sockets had more pronounced and statistically significant lid wiper epitheliopathy, conjunctival staining, and bulbar inflammation. Meibomian gland dysfunction, Schirmer I and II, and conjunctival impression cytology showed no difference between the 2 groups. There was a correlation between the symptoms complained and the ocular staining patterns of the anophthalmic sockets.@*Conclusion@#Anophthalmia predisposes to various ocular surface problems, such as a change in the composition of tears, specifically an increase in the mucin component and a decrease in the aqueous and lipid components, resulting to increased tear viscosity.
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Biologie cellulaireRésumé
Objective Current research proposed that lid-wiper epitheliopathy may be a early symptom of dry eye.At present,there are seldom studies on lid-wiper epitheliopathy in both home and abroad.This study was to investigate the effect of artificial tears without antiseptic in the treatment of lid-wiper epitheliopathy and discuss the method of treatment of lid-wiper epitheliopathy. MethodsThis is a case-observative study.Seventy patients with lid-wiper epitheliopathy and with negative results in tear film break-up test,SchirmerⅠtest and corneal fluorescine staining were enrolled in the Peking University First Hospital during September 2006 and June 2008.The treatment group included 54 eyes of 54 patients who received topically free-antiseptic artificial tears (dextran 70 eye drops) four times per day for two weeks,and the control group included 16 eyes from 16 patients who were not treated.Dry Eye Questionnaire were taken from the patients before the administration of drug and 2 weeks after treatment.Fluorescein and Lissamine green double-staining was used before and after treatment for the evaluation of lid-wiper epitheliopathy.The disease was graded into 0 (absence) to 3(severe),and the symptoms and dye were scored following the Standard Patient Evaluation of Eye Dryness (Korb criteria).Informed consent and good compliance were obtained before initial and during the therapy duration. ResultsIn the treatment group,the scores of symproms and staining were significantly different between before and after administration of drug (12.91±2.55 vs 2.78±2.27 in symptom,t=22.70,P＜0.05;1.79±0.78 vs 0.19±0.31 in dye,Z=-6.40,P＜0.05),indicating the symptoms and dye results were obviously improved after therapy.In the control group,no significant differences were found in the symptom score and dye score in the corresponding time period (12.63±2.60 vs 12.94±2.11,t=-1.10,P＞0.05 in symptom;1.97±0.74 vs 1.98±0.72,Z=-0.58,P＞0.05 in dye).According to the grade of disease,the magnitude of the staining after treatment was considerably improved in comparison with before treatment (Z_1=-3.47 for mild,Z_2=-4.04 for moderate,Z_3=-3.74 for severe),showing statistically significant differences between them (P＜0.05).ConclusionThe use of artificial tears is an efficacious treatment for treating lid wiper epitheliopathy.The topicaly utilization of artificial tears can alleviate the symptoms and pathological changes of lid wiper epitheliopathy.