Clinical Study Of The Clinical Relationship Between Scleral Buckling And Dry Eye

Background: Dry eye is a diseases that cause eye discomfort and affect visual dysfunction,cataract,refractive surgery can cause or aggravate dry eye,studies have found that scleral buckling postoperative have changes in ocular surface and tear film function,with dry eye Chinese expert consensus in 2013 and it is necessary to combine the new consensus and objective examination indicators the presence of dry eye and its relationship to make a further study on the sclera buckling.Objective: To observe the clinical symptoms and results of dry eye related examination of scleral buckling(SB)in patients with retinal detachment.Observe the relationship between SB and dry eye.The relevant indexes of the operation also were analyzed.Methods: Prospective self-controlstudy and non randomized double blind trial.Surgical inpatients undergoing SB in the people's Hospital of the Guangxi Zhuang Autonomous Region from May 2016 to June 2017,30 patients(30 eyes)was included in the study with inclusion and exclusion criteria,extract the information of dryness,foreign body sensation,burning sensation,fatigue,discomfort and other subjective symptoms in 1-3 days before surgery,postoperative 24-48 h,postoperative 1 month(m),postoperative 3 m,postoperative 6 m of patients,Use Keratograph 5M and other equipment collect the first tear film break-up time(first noninvasive Keratograph tear breakup time NIKBUTf),tear meniscus height,Schirmer I test(Schirmer 1)and other indicators,combined with expert consensus version 2013,use SPSS17.0 for statistical analysis.Results: 1.They has no dry eye patients were found before SB operation.The subjective symptoms of dry eyes,SIt,NIKBUTf,Corneal fluorescein staining and TMH were the same before operation.2.After 24-48 h,shortened NIKBUTf(there were statistically significant differences with preoperative and postoperative 1m,3m,6m,p=0.049,p=0.001,p=0.006,p=0.000),TMH with no change(in the preoperative and postoperative 1m,postoperative 3m,6m.p=0.327,p=0.14,p=0.083,p=0.059).SIt Increased(with the preoperative and postoperative 1m,3m,6m: there were statistically significant differences p=0.000,p=0.000,p=0.000,p=0.000),corneal fluorescent staining was positive in 9 cases,dry eye diagnosised 13 cases(with preoperative and postoperative 1m,postoperative 3m,6m p=0.000 0,p=0.002,p=0.000,p=0.000)3.Postoperative 1m,NIKBUTf,TMH,SIt and corneal fluorescein color staining had been restored to the preoperative level.SIt was lower than that of 24-48 h after operation.2 cases were diagnosed dry eye(compared with preoperative,postoperative 24-48 h,3m,6m,p=0.492,p=0.002,p=0.492,p=0.492).4.Postoperative 3m,all the indexes recovered to the preoperative level,and there was no obvious change in 6m.No dry eye patients were found.5.There is no statistically significant difference in the ratio of subjective symptoms of dry eyes about the 2013 consensus before and after operation in patients.6.Postoperative 24-48 h,non dry eye patients with symptoms and corneal fluorescein is light than dry eye patients,Postoperative 1m dry eye patients with high TMH and long NIKBUTf.7.Postoperative 24-48h: NIKBUTf was positively correlated with TMH(r=+0.412,p=0.024);dry eye diagnosis was positively correlated with subjective symptoms and corneal fluorescein staining(r=+0.818* p= 0)(r=+0.749,p=0.000);CFS was positively correlated with subjective symptoms of dry eye(r=+0.612,p= 0.000).After operation 1m,the diagnosis of dry eye was negatively correlated with TMH(r=-0.402,p= 0.028),and was negatively correlated with NIKBUTf(r=-0.432,p= 0.017).8.Postoperative SB dry eye related indicators were NIKBUTf,SIt and CFS.These indexes were not correlated with surgical operators,age,sex,operation time,Pad position and range,distance from the limbal of corneal.Conclusion: Dry eye can occur after SB.The main related indicators of dry eye diagnosis are subjective symptoms and CFS after operation 24-48 h.There is a negative correlation between the dry eye diagnosis and TMH,NIKBUTf postoperative 1m.The changes of dry eye index after SB were mainly NIKBUTf,SIt and CFS,these indexes were not correlated with surgical operators,age,sex,operation time,Pad position and range,distance from the limbal of corneal.Use Keratograph 5M and the 2013 consensus on patients with retinal detachment after SB has good effect in diagnosis DE and observation of ocular surface condition,can improve the sensitivity of dry eye diagnosis after operation,combined with drug therapy can improve the postoperative symptoms and promote ocular surface,reduce the operation risk and provide some help for complications;reference for future clinical work.