TEAR BIOMARKERS IN ADVANCE KERATOCONUS SUBJECTS WITH SCLERAL CONTACT LENS USAGE
Published 2024 - 28th ESCRS Winter Meeting
Reference: FP59 | Type: Submission | DOI: 10.82333/t8q9-sr41
Authors: Kusumitha Bhaktha Ganesh* 1 , MURUGESAN VANATHI 1 , sneha aggarwal 1
1OPTHALMOLOGY,DR RAJENDRA PRASAD INSTITUTE FOR OPHTHALMIC SCIENCES ,AIIMS.NEW DELHI,DELHI,India
Purpose
Evaluation of tear film biomarkers in advanced keratoconus subjects wearing scleral contact lenses- A prospective interventional study.
Setting
A total of 25 patients with advanced keratoconus fitted with scleral contact lenses who gave consent for participation were included
Methods
A total of 25 patients with advanced keratoconus (after slit lamp examination and Scheimpflug imaging) were fitted with scleral contact lenses voluntarily participated in our study. An initial baseline examination consisted of UCVA, SVA, BCVA CL, Kmean, Kmax, and thinnest pachymetry, along with refractive corrections. Further, ocular surface characteristics, including TBUT, Schirmer's test, corneal and conjunctival staining scores, OSDI, tear osmolarity, and tear film biomarkers were assessed pre and post scleral contact lens wear (≥6 months). Tear samples were collected non-invasively using micropipette, cryopreserved and assessed by Multiplex ELISA method.
Results
The study comprised of 25 eyes of advance KC with average Kmean (58.48±11.27), Kmax (72.98±15.01), thinnest pachymetry (389.44±65.45), posterior elevation (106.52±55.70) UCVA (1.05±0.55) and SCVA (0.53±0.33) respectively. BCVA with ScCL (0.16±0.12) improved significantly (p<0.01) thus, visually rehabilitating these patients. The mean values of Schirmer’s test (p value-0.04), corneal staining score (p value-0.0001), conjunctival staining score (p value-0.001, OSDI (p value-0.000) and tear osmolarity (pvalue-0.03), improved significantly. Pre/post tear biomarkers (pg /ml) such as IL-4, IL-8, MMP-7, MMP-9, TIMP-1 to 3 were raised and significantly with respect to MMP-7 (0.003) and TIMP-3 (0.0001). However, MMP-10 and TIMP-4 levels were decreased but not significant (0.2114 and 0.095) respectively.
Conclusion
Scleral contact lenses help in visually rehabilitating advance KC patients with improved ocular surface parameters. Upregulation of Interleukins, MMPs and TIMPs was observed in post scleral contact wear with significantly elevated levels of MMP-7 and TIMP-3