Study of Influence of Various Methods of Intraoperative Keratoprotection on Morphological and Functional State of Ocular Surface System in Early Period after Phacoemulsification in Senile Cataract

Abstract

Purpose: to study the effect of various methods of intraoperative keratoprotection on morphological and functional state of ocularsurface system (OSS) in early period after phacoemulsification (PE) in senile cataract (SC). Patients and methods. 240 patients (240 eyes) who applied for surgical treatment of SC. Age: 65 ± 4 years. 109 men, 131 women. All patients were divided into three observation groups according to the method of intraoperative keratoprotection: 1st group — 60 patients, corneal irrigation with balanced solution; 2nd group — 60 patients, ophthalmic viscosurgical device was applied to the cornea; 3rd group: 3a subgroup — 60 patients, soft contact lens (SCL) was applied to the cornea; subgroup 3b — 60 patients, SCL impregnated with riboflavin solution was applied to the cornea. In addition to the standard ophthalmological examination, Schirmer I test, OCT-scanning were performed, and tear breakup time (TBUT) was determined. Results. Operations were performed without complications. On the 1st day after the operation, the parameters of the Schirmer I test were higher in the eyes of 1st and 2nd groups. On the 5th day after the operation, tear production decreased sharply in all eyes. On the 10th day, an increase in tear production was observed in all groups, the maximum increase — in 3b subgroup. On the 1st day after the operation, TBUT decreased in all examined eyes. The largest significant TBUT decrease was noted in 1st group, the smallest — in 3b subgroup. On 1st day, corneal epithelial thickness (CET) decreased in all eyes, the maximum decrease was detected in 1st group. On the 5th day, CET continued to decrease in all eyes, the minimum decrease occurred in the 3b subgroup. On the 10th day — a decrease in CET in all groups with minimal significant dynamics in 3b subgroup. Conclusion. The study showed that the state of OSS in the early period after PE in SC depends on the method of intraoperative keratoprotection. The most optimal method of intraoperative protection of corneal epithelium and prevention of negative morphological and functional state of OSS after PE in SC is using of SCL impregnated with riboflavin.