Anterior Segment Optical Coherence Tomography-derived Assessments Of Tear Meniscus Height And Tear Meniscus Depth On Dry Eye After Cataract Surgery

Objective: Anterior segment optical coherence tomography(AS-OCT)was used to measure tear meniscus(TM)supplemented by traditional methods of dry eye detection.The development of dry eye after cataract surgery was observed.To study the possibility of diagnosing dry eye after cataract surgery by AS-OCT and to find the threshold values of TMH and TMD for diagnosis of dry eye.Methods: A prospective,observational,longitudinal study was conducted in 22patients(32 eyes)who underwent cataract phacoemulsification and intraocular lens implantation surgery in the Department of Ophthalmology,Shengjing Hospital,China Medical University from October 2017 to March 2018.Tear meniscus height(TMH),tear meniscus depth(TMD),schirmer test(ST-I)and tear breakup time(TBUT)were examed on1 week,2 weeks and4 weeks after operation.The changes of the values of each group after operation were compared with those of the preoperative groups,the tear index measured by AS-OCT was compared to those tested by traditional methods on diagnosis of dry eye,the threshold values of TMH and TMD for diagnosis of dry eye were determined.Results:Compared with pre-operation,TMH,TMD,ST-I and TBUT were significantly decreased after 1 week and 2 weeks after operation(P<0.05).Four weeks after operation,TMH,ST-I,and TBUT recovered to levels before surgery,the difference was not statistically significant compared with the pre-level(P<0.05),and TMD did not return to the pre-operative level,which was significantly different from the preoperative level(P<0.05).Correlation analysis of various parameters: preoperative TMH was significantly associated with TMD,ST-I,TBUT(P<0.01),TMD was highly correlated with TBUT(P<0.01),but there was no correlation between TMD and STI,neither of ST-I and TBUT.There was a significant correlation between the parameters of TMH,TMD,ST-Iand TBUT(P<0.01)at 1 week postopeartion.The levels of TMH,TMD,ST-I and TBUT were highly correlated(P<0.01)in the 2 weeks after operation,except for TMD and TBUT(P <0.05).Four weeks after surgery,TMH was highly correlated with TMD,ST-I and TBUT(P<0.01),TMD was significantly associated with TBUT(P<0.01),ST-I was significantly associated with TBUT(P<0.01),but TMD and ST-I showed no obvious correlation.The receiver operating characteristic curve(ROC curve)was plotted.When the threshold for TMH diagnosis was set at 270.00 ? m,the sensitivity was 95.20% and the specificity was 80.30%.When the TMD diagnosis threshold was set to 180.50?m,the sensitivity was 68.3.%,with a specificity of 74.2%.Conclusion: The application of AS-OCT on dry eye after cataract surgery compared with the traditional dry eye detection methods has a correlation,the AS-OCT as a detection method which is non-contact,convenient,repeatable and quantitative evaluation of tear,have a certain reference value in judgment of short-term postoperative dry eye.