J Korean Ophthalmol Soc.  2016 Dec;57(12):1932-1938. 10.3341/jkos.2016.57.12.1932.

Analysis of Tear Meniscus Change after Strabismus Surgery Using Optical Coherence Tomography

• Kim JH
• Kim CR
• Kim SJ
• Chung IY
• Seo SW
• Yoo JM

• KMID: 2362712
• DOI: http://doi.org/10.3341/jkos.2016.57.12.1932

Abstract

PURPOSE
In this study, the changes in ocular surface parameters and tear meniscus after strabismus surgery when treated with or without artificial tears were evaluated using optical coherence tomography (OCT).
METHODS
The present study included 30 patients who received bilateral lateral rectus recession surgery for exotropia. The patients instilled artificial tear eye drops only in the left eye. Before and 2, 4, 8, and 12 weeks after surgery, tear film break-up time (BUT), Schirmer's test, corneal staining test, tear meniscus height and area were measured using OCT and compared in both eyes. Before and 8 weeks after surgery, conjunctival compression cytology test was performed.
RESULTS
The mean patient age was 8.7 years. After 8 weeks, BUT and corneal staining scores were 12.3 ± 1.5 seconds and 1.3 ± 0.4 in patients treated with artificial tears and 9.5 ± 1.0 seconds and 2.0 ± 0.7 in patients not treated with artificial tears (both p < 0.000). Four weeks after surgery, tear meniscus height and area using OCT were 290.2 ± 42.3 µm and 566.7 ± 48.2 pixels in patients treated with artificial tears and 246 ± 45.5 µm and 504.0 ± 29.7 pixels in patients not treated with artificial tears (p = 0.045 and p = 0.019, respectively). Goblet cell count was significantly different between the eyes 8 weeks after surgery (p = 0.033).
CONCLUSIONS
Instability of tear meniscus can be detected after strabismus surgery using BUT, Schirmer's test, corneal staining test, tear meniscus height and area, and OCT. After surgery, artificial tears help treat dry eye symptoms by corneo-conjunctival wound healing mechanism and increasing tear meniscus stability.

Keyword

Optical coherence tomography; Strabismus; Tear meniscus

MeSH Terms

Exotropia
Goblet Cells
Humans
Lubricant Eye Drops
Ophthalmic Solutions
Strabismus*
Tears*
Tomography, Optical Coherence*
Wound Healing
Lubricant Eye Drops
Ophthalmic Solutions

Figure

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  Figure 1. Tear meniscus measurement. (A) Optical coherence tomography image of the lower tear meniscus showing the tear me-niscus height. (B) Optical coherence tomography image of the lower tear meniscus exported to ImageJ software for measuring me-niscus area.

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  Figure 2. Impression cytology (Periodic acid-Schiff, ×400). (A) 8 weeks after surgery, specimen from a patient treated artificial tear shows normal nuclear/cytoplasmic ratio and goblet cells. (B) 8 weeks after surgery, specimen from a control group patient shows normal nuclear/cytoplasmic ratio and depletion of goblet cells.

Reference

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