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@#AIM: To compare the ocular surface changes of one-site versus two-site phacotrabeculectomy in angle-closure glaucoma associated with cataract.<p>METHODS: This retrospective, randomized study included 52 patients(52 eyes)with coexisting angle-closure glaucoma and cataract. The patients were randomly divided into 2 groups: one group had the phacotrabeculectomy in the superior quadrant through the same incision(one-site group; <i>n</i>=26), while the other group had the trabeculectomy through a superior quadrant incision, and the phacoemulsification through another separate, temporal, clear corneal incision(two-site group; <i>n</i>=26). In each group, the values such as tear break-up time(BUT), Schirmer I test(SⅠt), and corneal fluoresce(FL)in staining score were measured at 1d, 1wk, 1mo and 3mo postoperatively.<p>RESULTS: All patients were operated under local anesthesia and followed up for 3mo. The SⅠt of two-site group and one-site group 1wk and 1mo postoperatively were significantly shorter than those before the operation(<i>P</i><0.01). The SⅠt of two-site group were significantly shorter than those of one-site group 1wk and 1mo postoperatively(<i>P</i><0.05). The FL scores of two-site group were significantly higher than those of one-site group 1wk postoperatively(<i>P</i><0.05). However, 1mo postoperatively, the FL scores of two groups were basically equal(<i>P</i>>0.05). Three months postoperatively,the BUT, SⅠt and FL were basically equal to the preoperative level(<i>P</i>>0.05).<p>CONCLUSION: Phacotrabeculectomy through two incisions is more likely to affect the ocular surface, and those abnormal related values appear in the early 1mo postoperatively.
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@#AIM:To investigate the effects of laser <i>in situ</i> keratomileusis(LASIK)on ocular surface by femtosecond laser or mechanical microkeratome for creating corneal flap, and to study the effect of different corneal flap method on ocular surface after operation. <p>METHODS: This study included 218 cases(436 eyes)myopia patients from January 2016 to January 2017 in our hospital for refractive surgery, their medical records were retrospectively analyzed. They all underwent LASIK surgery treatment and complained of different degree of dry eye postoperatively, foreign body sensation and discomfort. Mechanical microkeratome was used in 61 cases(122 eyes)of patients and they were as control group, with femtosecond laser, 157 cases(314 eyes)were set as observation group. We compared dry eye symptom scores, corneal fluorescein staining(FL)score, break-up time(BUT)and basic tear secretion test(SⅠt)between the two groups preoperatively and postoperatively 1wk, 1, and 3mo. <p>RESULTS: Before surgery, dry eye symptoms scoring of two groups had no statistically significant difference(<i>P</i>>0.05); the scores of the two groups were significantly different before and after surgery(<i>P</i><0.05); postoperatively 1wk, dry eye symptoms score of control group was greater than that of the observation group with significant difference(<i>P</i><0.05), the sores at 1 and 3mo after surgery were not different between the two groups(<i>P</i>>0.05). There was no significant differenc on the preoperative BUT between the two groups(<i>P</i>>0.05). BUT before and after surgery was significantly different of both groups(<i>P</i><0.05). BUT of control group was significantly lower than that of observation group postoperatively(<i>P</i><0.05). Before surgery, FL score of two groups had no statistically significant difference(<i>P</i>>0.05); the scores of the two groups were significantly different before and after surgery(<i>P</i><0.05); postoperatively 1wk and 1mo, FL score of control group was greater than that of the observation group with significant difference(<i>P</i><0.05), the sores at 3mo after surgery were not different between the two groups(<i>P</i>>0.05). Before surgery, SⅠt of two groups had no statistically significant difference(<i>P</i>>0.05); the scores of the two groups were significantly different before and after surgery(<i>P</i><0.05); postoperatively 1wk and 1mo, SⅠt of control group was lower than that of the observation group with significant difference(<i>P</i><0.05); SⅠt at 3mo after surgery were not different between the two groups(<i>P</i>>0.05). Two groups of patients had no serious postoperative complications occurred.<p>CONCLUSION: Compared with the mechanical microkeratome for creating corneal flap, LASIK with femtosecond laser for creating corneal flap has less effect on ocular surface and has mild symptoms of dry eye, the effect time is also shortened.
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@#AIM: To analyze ocular surface changes and risk factors in patients with type 2 diabetes mellitus(T2DM). <p>METHODS: Totally 118 cases of T2DM patients(236 eyes)admitted from May 2017 to May 2018 were selected as T2DM group, and 100 non-T2DM patients(200 eyes)were selected as control group. The patients were given routine ophthalmic testing, Schirmer Ⅰ test(SⅠt), tear film break-up test(BUT), corneal fluorescein staining test(FL)and conjunctive impression cytology. The cases data were collected for univariate and multivariate Logistic regression analysis so as to analyze the independent risk factors for ocular surface changes in T2DM patients. <p>RESULTS: The incidence rate of ocular surface changes in T2DM group was significantly higher than that in control group(22.5% <i>vs</i> 7.5%,<i> P</i><0.05). The SⅠt, BUT and conjunctival goblet cell count in T2DM group were significantly lower than those in control group while the FL and conjunctival squamous metaplasia degree were significantly higher than those in control group(<i>P</i><0.05). Univariate analysis results suggested that there were significantly differences between T2DM patients with ocular surface changes and T2DM patients without ocular surface changes in terms of age, disease duration, fasting plasma glucose(FPG), plasma total cholesterol(TC), triglycerides(TG), low-density lipoprotein cholesterol(LDL-C), glycosylated hemoglobin(HbA1c), urea, creatinine(Cr), glomerular filtration rate(GFR)and 24h urinary protein(24h UP)(<i>P</i><0.05). Multivariate Logistic regression analysis showed age, disease duration, TC, TG, LDL-C, HbA1c and Cr were independent risk factors for ocular surface changes in T2DM patients. <p>CONCLUSION: Ocular surface changes of T2DM patients are more obvious than those of normal people, and T2DM patients have high incidence of ocular surface changes, thus it is necessary to actively correct lipid metabolism disorder and given early prevention for T2DM patients so as to reduce the risk of ocular surface changes.