Сравнение клинического использования индекса заболевания глазной поверхности, времени разрыва слезной пленки и состояния слезопродукции в диагностике послеоперационного синдрома сухого глаза

Abstract

Purpose. To compare clinical use of the Ocular Surface Disease Index (OSDI), tear breakup time (TBUT) and state of tear production (TP) in diagnosis of postoperative dry eye syndrome (DES). Material and methods. 161 patients (161 eyes) aged 62 to 83 years with senile cataract. All patients were assessed state of total TP (Schirmer I test), determined the TBUT and were questioned using the OSDI questionnaire. The patients were divided into 4 groups depending on level of TP before the operation. Phacoemulsification (PE) was performed in all eyes according to the standard technique with IOL implantation. Results. On the 10th day after PE, in all groups TP was below the initial level by 22–35 %, TBUT – by 30–41 %. Patients of all groups had high OSDI values. By the 30th day after PE, the TP indices did not reach the initial values in 29 eyes of patients of the 3rd group and 18 eyes of patients of the 4th group. A similar trend was observed in patients with normal and mildly depressed TP. Schirmer test was lower in 8 eyes (19.5 %) of the 1st and 21 eyes (36.2 %) of the 2nd group. The OSDI of the 1st and 2nd groups decreased by 40–50 %, in the 3rd and 4th groups – by 22–35 %, respectively. Indices of the OSDI, TP, and TBUT in 1st and 2nd groups corresponded to mild and moderate DES, in 3rd and 4th groups – to severe DES. Conclusion. The study comparing the OSDI, the dynamics of TP and TBUT in patients with senile cataract at different times after PE showed a direct dependence of indices obtained from the OSDI questionnaire on indices of TP and TBUT. OSDI questionnaire in patients after PE is quite effective in early diagnosis of DES. Keywords: senile cataract, phacoemulsification, tear production, OSDI questionnaire, tear breakup time.