J Korean Ophthalmol Soc.  2018 Jan;59(1):17-22. 10.3341/jkos.2018.59.1.17.

The Use of Keratography to Study Changes on the Ocular Surface after Absorbable Plug Insertion

• Shin HJ
• Park CH
• Na KS
• Kim HS

• KMID: 2401673
• DOI: http://doi.org/10.3341/jkos.2018.59.1.17

Abstract

PURPOSE
The aim of our study was to evaluate short-term changes in corneal surface status via Keratography in dry eye patients after placement of an absorbable collagen plug (UltraPlugâ„¢; Surgical Specialties Corporation, Reading, PA, USA).
METHODS
Patients (n = 20 eyes, 20 subjects) diagnosed with dry eye were recruited for this prospective, 1-month clinical trial. The lacrimal puncta were blocked using absorbable collagen plugs. We evaluated clinical parameters and symptoms 1 month later. We assessed visual acuity, the score on the Ocular Surface Disease Index (OSDI) questionnaire, and keratographic tear meniscus height (TMH) and tear break-up time (TBUT) (K5M; Oculus Optikgerate GmbH, Wetzlar, Germany). We also measured TBUT classically, the corneal fluorescein staining score, and the Schirmer test result.
RESULTS
Significant improvements in the corneal staining and OSDI scores were observed 1 month after treatment (p = 0.006, p = 0.001, respectively), but no significant differences in the keratographic TMH and TBUT, the classical TBUT, or the Schirmer test data was observed (all p > 0.05).
CONCLUSIONS
Blocking of the lacrimal punctum with an absorbable collagen plug effectively improved clinical symptoms and objective indicators in dry eye patients, the corneal staining score and OSDI scores improved significantly. However, no significant improvements in keratographic TMH and TBUT were observed; this was of concern. Longer-term studies with more patients are required.

Keyword

Absorbable plug; Dry eye syndrome; Keratograph

MeSH Terms

Collagen
Dry Eye Syndromes
Fluorescein
Humans
Lacrimal Apparatus
Prospective Studies
Specialties, Surgical
Tears
Visual Acuity
Collagen
Fluorescein

Figure

• 

  Figure 1 Examination images using Keratograph. (A) Tear break-up time (TBUT) using Keratograph. (B) Tear meniscus height (TMH) using Keratograph. From the moment the patient was last blinking, TBUT was measured by the time the ring shape of the cornea surface change and was automatically detected. TMH was measured vertically from the center of the lower eyelid border to the center of the pupil.

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