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Signs and Symptoms of Dry Eye in Keratoconus Patients Before and After Intrastromal Corneal Rings Surgery

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Carracedo Rodríguez, Juan Gonzalo and Recchioni, Alberto and Alejandre Alba, Nicolás and Martín Gil, Alba and Batres Valderas, Laura and Jiménez Alfaro-Morote, Ignacio and Pintor, Jesús (2017) Signs and Symptoms of Dry Eye in Keratoconus Patients Before and After Intrastromal Corneal Rings Surgery. Current Eye Research, 42 (4). pp. 513-519. ISSN 0271-3683

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Official URL: http://dx.doi.org/10.1080/02713683.2016.1200098




Abstract

Purpose: Based on the relationship between keratoconus and dry eye, the aim of this study was to evaluate changes in signs and symptoms of dry eye in keratoconus patients before and after intrastromal corneal ring surgery.
Methods: Fifteen keratoconus patients were enrolled in Fundación Jiménez-Díaz of Madrid and University Clinic of Optometry of the Universidad Complutense de Madrid (Madrid, Spain). Tear break up time (TBUT), Schirmer test without anesthesia, corneal staining, diadenosine tetraphosphate (Ap4A) concentration, and ocular surface disease index (OSDI) were evaluated. Impression cytology combined with laser confocal microscopy was performed to evaluate goblet cell density, mucin cloud height (MCH), and cell layer thickness (CLT). All measurements were performed before (pre) surgery, 1 month (post) and 6 months after surgery (post6m).
Results: We found no statistical differences in time in Schirmer test, TBUT, and corneal staining. OSDI scores were 44.96  ±  8.65, 26.30 ± 6.79, and 19.31 ± 4.28 for (pre), (post), and (post6m) surgery, respectively (p < 0.001). Impression cytology showed a decrease in cell density at (post6m) compared with presurgery (47.36 ± 35.15 cells/mm2 and 84.88 ± 32.08 cells/mm2, respectively, p = 0.04). At post6m, the MCH increased compared with presurgery values (13.97 ± 4.26 µm and 6.77 ± 2.51 µm, respectively, p < 0.001). There was a statistically significant increase in CLT in time. Ap4A tear concentrations were lower post6m than presurgery (1.02  ±  0.65 and 2.56   ± 1.10  µM, respectively, p < 0.001). Conclusion: Intrastromal corneal ring surgery induces changes improving dry eye symptoms but no changes were found in signs of dry eye after surgery in keratoconus patients except for the MCH that increases drastically. More studies are needed to clarify the reason of its improvement.


Item Type:Article
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Received 10 May 2015; Revised 11 May 2016; Accepted 7 Jun 2016; Published online: 22 Jul 2016

Uncontrolled Keywords:3D impression cytology ; Dinucleotide ; Dry eye ; ICRS; Keratoconus
Subjects:Medical sciences > Medicine > Surgery
Medical sciences > Medicine > Ophtalmology
Medical sciences > Optics > Visual perception
Medical sciences > Optics > Eyes anatomy
ID Code:44623
Deposited On:14 Sep 2017 12:51
Last Modified:15 Sep 2017 07:39

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