INFLUENCE OF CATARACT SURGERY ON MEIBOMIAN GLANDS, TEAR FILM & OCULAR SURFACE IN DIABETIC AND NON DIABETIC POPULATION: A COMPARATIVE TRIAL

Published 2022 - 26th ESCRS Winter Meeting

Reference: P138 | Type: Abstracts | DOI: 10.82333/aw43-dm16

Authors: Lional Raj Daniel Raj Ponniah* ¹

¹Cataract, Cornea and Refractive Surgery,DR AGARWALS EYE HOSPITALS,Tirunelveli,India

Purpose

To evaluate and compare the morphological changes of meibomian glands and the functional changes of the tear film and its impact in diabetic and non-diabetic subjects who underwent uneventful phacoemulsification procedures

Setting

A Prospective comparative clinical trial conducted in the department of Cornea & Ocular surface diseases, at a tertiary eye care hospital and teaching institution

Methods

A Prospective investigator-masked comparative clinical trial. Cataracts with and without Diabetes were recruited based on age & grouped as Group 1 (No OM and age <60 yrs; N=43) Group 2 (OM and age <60 yrs; N=39) Group 3 (No OM and age> 60 yrs; N=51), Group 4 (OM and age >60 yrs; N=67). Preoperative meibography and functional tear film using quantitative measurements of tear meniscus studies, non invasive tear break-up time (NIBUT), blink rate were analysed & compared with 21 days and 3 months post-surgery. Ocular Protection Index (OPI) was calculated as a function of ocular surface health by dividing tear break up time by interblink interval. OPI <1 is susceptible to surface damages

Results

Baseline NIBUT was 11.80, 9.50, 10.30 & 7.88 respectively across Gr 1 through 4, which reduced to 8.34, 7.31, 7.36 and 6.11 21days post surgery, restored to baseline at 3 months. Mean OPI was 1.37 at baseline, 0.97 at 21days, 1.10 at 3 months. ANOVA for OPI had significant time effect, Wilk's Lambda = 0.813, p<0.0001. Preop OPI was 1.88, 1.26, 1.67 and 0.88 respectively across Gr 1 through 4, which reduced to 1.68, 0.91, 1.03 and 0.75 at 21days, restored to baseline at 3 months. Gr4 had poor OPI score of less than 1 at all time points No significant difference in tear meniscus height across the groups. Age adjusted OM influence on Meibomian gland loss was 12.1% compared with non-OM, 6.64%

Conclusion

Subjects over 60 years of age irrespective of concomitant OM had borderline OPI, are susceptible to develop surface damages post cataract. Subjects with OM irrespective of age had borderline OPI, likely to suffer surface damages post cataract. Subjects who are over 60 years with OM had suboptimal OPI & require a long-term ocular surface protectors