| Objective: With the coming of information era, the new-tech induced habits, like reading from a mobile phone, may influence postoperative rehabilitation of patients treated by keratoplasty. The purpose of this study was to investigate the possible changes in transplanted corneal grafts and to assess the impact of different time durations of constant mobile phone reading on patients after keratoplasty for keratoconus.Methods: A retrospective study was followed by a confirmatory study. Ninety-two patients(92 eyes) who received deep lamellar keratoplasty(DLKP) for treatment of advanced-stage keratoconus, with an average follow-up period of 3 months, at Shandong Eye Hospital of Shandong Eye Institute from January 2009 to July 2014 were included. In the retrospective study, 58 patients were divided into three groups according to the mobile phone reading time. In group A, 20 patients did not use their mobile phones after surgery; in group B, the mobile phone reading time of 19 patients was !2h per day; in group C, the time of 19 patients were>2h per day. During the postoperative weeks 2 to 3, fluorescent staining and anterior segment optical coherence tomography were applied to keep track of the corneal epithelial healing process. From postoperative day 2 to month 3, when postoperative complications occurred, the tear break-up time and Schirmer tests were performed to compare the performances among the groups. We calculated the mean eye-blink rate and preferred viewing distance of 38 patients in group B and group C(they have daily mobile phone reading habit). In the confirmatory study, 34 randomly selected patients(34 eyes) were asked to strictly follow the doctor’s order of not reading from a mobile phone. The postoperative complication, corneal epithelial defect with wound dehiscence, was evaluated.Result:1. There was significant difference in the days needed for the epithelial healing between groups A(4.45±1.28 days) and C(7.68±3.78 days)(P 2<0.001), between groups B(5.68±1.70 days) and C(P 3= 0.018), but not between groups A and B(P1=0.359). There was significant difference in the tear break-up time between groups A(5.11±1.46 s) and C(3.60±1.45 s)(P 2=0.004), between groups B(4.71±1.02 s) and C(P 3= 0.043), but not between groups A and B(P1=0.776). The extent of wetting of the strip of the Schirmer test was 11.40±3.36 mm, 8.13±4.22 mm, and 5.12±2.30 mm in groups A, B, and C, respectively. The difference was significant between any two groups(groups A and B, P1=0.003; groups A and C, P2=<0.001; groups B and C, P3=0.008).2. Thirty-four eyes in group D showed similar progression of epithelial healing and postoperative complications to group A.3.There were two eyes in group A, four eyes in group B, ten eyes in group C and no eye in group D had occurred corneal epithelial defect with wound dehiscence,and that was mainly located in the corresponding zone of palpebral fissure of the cornea.4.The mean preferred viewing distance of 39 participants was 193±7mm,and the mean eye-blink rate was 9±7 blinks/min during mobile phones use.Conclusion: Constant reading from a mobile phone presents an impact on ocular recovery of patients treated by keratoplasty. The epithelial healing can be prolonged in the early postoperative period, and complications often occur in the latter period. |
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