Alteration of tear film in patients with proliferative diabetic retinopathy after vitrectomy

Abstract

Objective To detect the change of tear film in patients with proliferative diabetic retinopathy after vitrectomy. Methods Twenty consecutive patients with PDR and 25 age- and sexmatched control subjects who undergoing vitrectomy by the same operator in Xi’an Forth Hospital from 2014 to 2015 were examined by a masked evaluator. Each patient underwent tear film tests, including Tear Basic Secretion Test (Schirmer I Test, SIT), Tear Breakup Time (TBUT), Corneal Fluorescein Staining (CFS) and In vivo Laser Scanning Confocal Microscopy of the tear film (LSCM) preoperatively and 1 week, 1 month and 3 months postoperatively. Results Compared with control subjects, the preoperative SIT, BUT were significantly lower (P <0.05) and the OSDI, CFS were significantly higher (P =0.000) in diabetic patients. And the noncontact confocal microscopy showed the diabetic lipid layers were more thinner than that in the control (P <0.001). In the control patients, the OSDI, BUT and lipid layer in 1 week postoperative, were abnormal than those preoperative, with the time prolong after operation, the dry eye symptom and the objective tests of tear film recovered gradually, at 3 months, comparing to preoperative, only BUT kept worse (P <0.05). The PDR patients’ tear film was exacerbated after operation. At 3 months postoperative, the BUT, OSDI were more worsen than any other time (P<0.05). Conclusions Compared with control group, vitrectomy is apt to cause more serious dry eye in patients with PDR. And the abnormal tear film is continuing and even more aggravating in 3 months postoperative. Key words: Proliferative diabetic retinopathy; Vitrectomy; Dry eye; Complication