Effects Of Artificial Tears Administration Before And After Phacotrabeculectomy On Ocular Surface And Filtering Blebs

PurposeTo study the effect of artificial tears on the ocular surface and filtering bleb of glaucoma and dry eye patients after phacotrabeculectomy.MethodThirty-two glaucoma and dry eye patients from October 2018 to October 2019 in Tianjin Medical University Eye Hospital were prospectively enrolled in this study and were randomly divided into two groups.The artificial tears group was given sodium hyaluronate eye drops from 1 week before surgery until 3 months after surgery,and the non-artificial tear group was not given sodium hyaluronate eye drops.All the patients underwent OSDI score,SchirmerⅠ test,tear film rupture time examination at 1 week before surgery,1 day before surgery,1 week after surgery,1 month after surgery,and 3 months after surgery.All the patients underwent intraocular pressure measurement 1 week before surgery,1 day before surgery,3 days after surgery,1 week after surgery,1 month after surgery,and 3 months after surgery.The height of the filtering bleb was measured at 1 week after surgery,1 month after surgery,and 3 months after surgery by AS-OCT.Statistical analysis was performed using SPSS 19.0.Result1、OSDI score: There was a statistically significant difference between 3 months after surgery and 1 week before surgery in the artificial tears group(t=3.385,P <0.01).There was no statistically significant difference between the artificial tears group and the non-artificial tear group at 1 week before surgery,1 day before surgery,1 week after surgery,1 month after surgery,and 3 months after surgery.2、SchirmerⅠtest:There was a statistically significant difference between 1 week after surgery and 1 week before surgery in the artificial tears group(t=2.802,P <0.01).There was a statistically significant difference between 1 week after surgery in the non-artificial tear group 1 week before surgery(t=2.357,P <0.05).There was a statistically significant difference between the artificial tears group and the non-artificial tear group at 3 months after surgery(t=2.730,P <0.05).3、TBUT examination: There was a statistically significant difference at 1 month after surgery and 3 months after surgery compared with 1 week before surgery in the artificial tears group.There was a statistically significant difference between the artificial tears group and the non-artificial tear group at 1 month and 3 months after surgery.4、Intraocular pressure: The intraocular pressure in the artificial tears group and the non-artificial tear group decreased to varying degrees after the operation.There was a statistically significant difference between the artificial tears group and the non-artificial tear group at 1 month after surgery(t=2.272,P <0.05).5、Filtering bleb: There was no statistically significant difference between the artificial tears group and the non-artificial tear group at 3 days after operation(z=0.596,P> 0.05).There was a statistically significant difference between the artificial tears group and the non-artificial tear group at 1 week and 1 month after surgery.No patients in the artificial tears group and non-artificial tear group were able to measure the height of the filtering bleb at 3 months after surgery.Conclusion1、Phacotrabeculectomy did not change the ocular surface state of the patients in this study.2、Artificial tears administration in the artificial tears group reduced the postoperative OSDI score,prolonged the tear film rupture time and increased the amount of tear fluid secretion.3、Intraocular pressure was decreased after phacotrabeculectomy in both groups.Sodium hyaluronate eye drops had a significant effect on the maintenance of filtering bleb within 1 month after surgery.4、AS-OCT is a useful tool to monitor and quantify postoperative filtering blebs.