Выбор оптимального способа предоперационной оценки риска развития синдрома «сухого глаза» у пациентов с миопией

Abstract

Aim. Comparative analysis of the effectiveness of keratotopography methods and classical Norn’s test in assessing the stability of the tear film (TF) in patients with myopia before photorefractive surgery. Methods. The study involved 26 patients. All of them were planned for keratorefractive surgery to correct myopic refraction and astigmatism. Their age averaged 32.5±14.5 years (18-47 years). The stability of pre-corneal tear film was assessed using computed keratotopography and Norn’s test - the tear film rupture time (TFRT) was determined. A standard questionnaire was also used to assess the severity of symptoms of dry eye syndrome (DES). A comparison was made of the indicators of tear film, stability obtained by the methods of keratotopography and Norn’s test, with their subsequent comparison with the data of the questionnaire. Results. In 17 patients (65.4 %), TFRT index corresponded to the age norm. In the remaining 9 people (34.6 %), indicators of tear film stability were reduced both by keratotopography (12±4 sec) and by Norn’s test (13.5± 4.5 sec), and there were also subjective signs of dry eye syndrome according to questionnaire data. The data turned out to be comparable. Conclusion. The incidence of impaired stability of the TF and subjective manifestations of DES among patients planned for keratorefractive surgery for myopia and myopic astigmatism was significant and, according to our data, made 34.6 %. To prevent complicated postoperative course of photorefractive surgery, it is necessary to assess the condition of the ocular surface immediately before refractive surgery, to identify the risk group for DES development. Key words: dry eye syndrome; tear film; keratotopography; Norn’s test; tear film rupture time.