Influence Of Cataract Surgery On Meibomian Gland Morphology, Team Film And Ocular Surface In Diabetic And Non Diabetic Population: A Comparative Clinical Trial
Published 2022 - 40th Congress of the ESCRS
Reference: PP23.10 | Type: ESCRS 2022 - Posters | DOI: 10.82333/9d5n-qz14
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 investigator masked comparative clinical trial conducted in the department of Cornea & Ocular surface diseases, at a Tertiary Eye Institute, Tirunelveli, South India.
Methods
Cataracts with and without Diabetes were recruited based on age & grouped as Group 1 (No DM and age<60 yrs; N=43) Group 2 (DM and age <60 yrs; N=39) Group 3 (No DM and age >60 yrs; N=51), Group 4 (DM and age >60 yrs; N=67). Preoperative meibography and functional tear film assessments 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.
OP| <1 was considered susceptible to surface damages.
OP| <1 was considered susceptible to surface damages.
Results
Baseline NIBUT was 11.80, 9.50, 10.30 & 7.88 sec. 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. Gr-4 had poor OPI score of less than 1 at all time points No significant difference in tear meniscus height across the groups. Age adjusted DM influence on Meibomian gland- loss was 12.1% compared with non-DM, 6.64%
Conclusions
Subjects over 60 years of age irrespective of concomitant DM had borderline OPI, are susceptible to develop surface damages post cataract surgery. Subjects with DM irrespective of age had borderline OPI, likely to suffer surface damages post- cataract. Subjects who are over 60 years with existing DM had suboptimal OPI & require a long-term ocular surface protectors.