LENTICULE EXTRACTION LEADS TO ALTERED SUBJECTIVE SYMPTOMS AND TEAR FILM BIOMARKERS CHANGES
Published 2024 - 28th ESCRS Winter Meeting
Reference: P202 | Type: Presented Poster & Poster | DOI: 10.82333/mpcs-2108
Authors: Teresa Tsai 1 , Mohannad Alwees 1 , Anika Foerster 2 , Janine Theile 1 , H. Burkhard Dick 1 , Stephanie C. Joachim* 1 , Suphi Taneri 2
1University Eye Hospital, Ruhr-University Bochum,Experimental Eye Research Institute,44892 Bochum,Germany, 2Eye Department, St. Francis-Hospital Münster,Center for Refractive Surgery Münster,48145, Münster,Germany
Purpose
Dry eye is generally considered a possible complication after refractive surgery. After lenticule extraction, patient satisfaction may be influenced by symptoms resembling dry eye. The aim of our study was to investigate the influence of lenticule extraction on both objective biomarkers and subjective symptoms of dry eye. The focus was on clarifying possible connections between these markers and to find preoperative indicators for increased subjective symptoms after lenticule extraction.
Setting
Right eyes of myopic patients (mean age 33.58±7.73 years) undergoing lenticule extraction surgery (n=35) were examined preoperatively as well as 5 and 90 days postoperatively. A patient subset was also examined after 1 year (n=14). Postoperatively, unpreserved ofloxacin and dexamethasone eye drops were given (four times a day for 10 days).
Methods
Clinical dry eye examination methods like tear film break-up time (BUT), Schirmer test, lissamine green and fluorescein staining, as well as Ocular Surface Disease Index (OSDI) questionnaire were performed. Moreover, tear samples were eluted from Schirmer strips and then measured with enzyme-linked immunosorbent assays for calcitonin gene-related peptide (CGRP), interleukin-1β (IL-1β), IL-6, IL-8, matrix metallopeptidase 9 (MMP-9), nerve growth factor (NGF), and tumor necrosis factor-α (TNF-α).
Results
BUT decreased at days 5 (p=0.023) and 90 (p=0.025). Lissamine green staining increased at day 90 (p=0.036). OSDI values increased at day 5 (total values, vision-related function, ocular symptoms, all p<0.001, but not environmental triggers) and at day 90 (vision-related function, p=0.017). A downregulation of CGRP (p=0.006) and MMP-9 levels (p=0.042) was observed on day 5 compared to day 90.
Conclusion
Some patients reported increased discomfort after lenticule extraction. However, due to incongruity of patient symptoms, clinical signs, and tear protein changes, no predictive indicator was found. Therefore, changes after lenticule extraction are not exclusively due to dry eye and may be referred to as "Surgical Temporary Ocular Discomfort Syndrome (STODS)".