Changes in tear film osmolarity after 25G+ PPV
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Changes in tear film osmolarity after 25G+ PPV J. Němčanský1,2, A. Kopecký1,2*
and P. Mašek1,2
Abstract Background: The aim of our study was to assess changes of tear film osmolarity after micro-incision 25G+ pars plana vitrectomy (PPV) in a prospective study. Methods: The group consisted of 21 patients (17 women, 4 men) with an average age of 70,52 years [48; 85]. All patients underwent 25G + PPV surgery due to a disorder of the vitreomacular interface (macular hole or epimacular membrane). Only patients who did not use artificial tears before the surgery and who had not been diagnosed with dry eye syndrome at ours or another institution were included in the study. Except cataract surgery, all ocular surface diseases, intraocular diseases, trauma or surgery were exclusion criterias. Tear film osmolarity was measured in both eyes in every patient before surgery, 10 days after surgery and 30 days after surgery. A paired test was used for statistical evaluation. Results: No statistically significant change in osmolarity was found in the operated eyes (p > 0.05). No statistically significant changes in time (p > 0.05) were found when both eyes were compared. There were no postoperative complications or failure to observe the study protocol. Conclusion: Micro-incision 25G + PPV does not affect the osmolarity of the tear film. Keywords: Pars plana vitrectomy, Anterior segment, Osmolarity, Ocular surface disease, Tear film
Search strategy and selection criteria For the discussion and review, we have searched PubMed and Web of Science databases for scientific articles on the presented topic. As there is a relative dearth of literature, we used as many published articles with related terms as possible. Some articles were based on a very small samples. Background The tear film protects the eye surface and takes part in refraction. Traditionally, it is divided into 3 layers aqueous, lipid and mucin [1]. Recently, however, there is more talk about the muco-aqueous, a single layer * Correspondence: [email protected] 1 Ophthalmology Clinic, University Hospital Ostrava, 17. Listopadu 1790, 708 52 Ostrava-Poruba, Czech Republic 2 Department of Craniofacial Surgery, Faculty of Medicine, University of Ostrava, Syllabova 19, 703 00 Ostrava–Vítkovice, Czech Republic
forming a compact gel [1]. Tear film dysfunction is called dry eye, but the term ocular surface disease is common. Ocular surface or dry eye disease is a multi-factorial disorder of the ocular surface due to loss of balance of the tear film, and ocular symptoms, in which tear film instability and hyperosmolarity, ocular surface inflammation and damage, and neurosensory abnormalities play etiological roles [2]. The above implies that the tear film’s insufficiency or instability manifests as hyperosmolarity [3]. Evaluation of tear film osmolarity is therefore an important examination in the diagnosis of ocular surface disease. However, it should be noted that the tear film hyperosmolarity can also develop in patients with normal measured
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