RESUMO
Purpose@#To evaluate changes of ocular surface dynamics using Keratograph 5M for 3 months after vitreoretinal surgery. @*Methods@#Eighty-three patients were divided into three groups: phacoemulsification group, vitrectomy group, and combined group. Keratograph 5M was performed for all patients at 1 week, 1 month, and 3 months after the surgery. Ocular surface dynamics parameters measured by Keratograph 5M, including noninvasive keratograph first tear film breakup time (NifBUT), noninvasive keratograph average tear film breakup time (NiaBUT), and tear meniscus height (TMH) were compared among the three groups over time. @*Results@#The mean age of all patients (46 men and 37 women) was 62.2 ± 8.4 years. NifBUT and NiaBUT were significantly decreased at 1 week after surgery compared to those at baseline in all three groups (all p < 0.001). NifBUT and NiaBUT in the phacoemulsification group almost recovered to the preoperative level, while those in the vitrectomy group and the combined group were still significantly less than those at baseline. NifBUT and NiaBUT in the phacoemulsification group were significantly longer than those in the vitrectomy group and the combined group at 3 months. After 1 week, TMHs were significantly higher in the vitrectomy group (p = 0.001) and the combined group (p = 0.022) than in the phacoemulsification group, while TMHs were significantly less in the vitrectomy group (p = 0.010) and the combined group (p < 0.001) than in the phacoemulsification group at 3 months after surgery. @*Conclusions@#These results suggest that vitreoretinal surgery could induce alteration of ocular surface dynamics for 3 months. The vitrectomy group and the combined group showed tear film instability compared to the cataract surgery alone group. Patients who underwent vitreoretinal surgery experienced more severe dry eye syndrome symptoms than those who underwent cataract surgery. Thus, managing dry eye syndrome after vitreoretinal surgery should be considered important for patients.
RESUMO
Purpose@#To report a vitrectomy performed on a patient with an endocapsular hematoma whose visual acuity changed with her position.Case summary: A 92-year-old woman visited our hospital complaining of a visual acuity change in her left eye with good visibility while standing but poor visibility when lying. She was taking aspirin, had underlying hypertension, diabetes, and heart failure, and underwent left eye cataract surgery 15 years previously. At presentation, her best-corrected visual acuity in the left eye was 0.5, with an intraocular pressure of 23 mmHg. An endocapsular hematoma that partially covered the fundus in the left eye was found. The left eye was observed for 3 months. However, there was no change in the endocapsular hematoma and the discomfort persisted with the position shift; therefore, a vitrectomy, posterior capsulotomy, and anterior chamber irrigation were performed. One month postoperatively, the visual acuity in the left eye was 0.4 and there was no longer a change in the visual acuity with position. @*Conclusions@#A patient with an endocapsular hematoma may have changes in visual acuity with position, and a vitrectomy can be used to treat the endocapsular hematoma.