Alterations in tear biochemistry associated with postanesthetic chronic dry eye syndrome

Abstract

Perioperative dry eye syndrome (DES) is a common ocular complication of long-term general anesthesia. Chronic DES can lead to permanent damage to the cornea and disturbance of visual function, up to total loss of vision. Here, a relationship between the duration of general anesthesia and the risk of chronic DES in patients was demonstrated. Using an experimental model of perioperative corneal abrasions in rabbits, it was found that introduction of animals to 3-h general anesthesia resulted in clinically significant chronic damage to the cornea in 50% of cases. The development of the complication was not associated with irreversible or long-term impairment of tear secretion, but it was accompanied by a decrease in tear film stability and growth of the total protein content as well as decrease in total antioxidant activity of the tear induced by low molecular weight antioxidants. In addition, anesthesia-induced changes in activity of tear antioxidant enzymes including superoxide dismutase and enzymes providing homeostasis of reduced glutathione (glutathione peroxidase, glutathione-S-transferase, glutathione reductase) were observed. All these alterations were protracted (up to 1-2 weeks) and therefore might account for transition of the perioperative DES into the chronic form. These findings can be useful in the development of novel approaches for the prevention and treatment of chronic forms of DES in the postanesthetic period.

Mitochondria‐Targeted Antioxidant SkQ1 Prevents Anesthesia‐Induced Dry Eye Syndrome

“…A rabbit model of anesthesia-induced DES developed in our previous studies [ 6 , 39 ] was selected for further trialing of the antioxidant therapy using SkQ1 eye drops. In order to characterize the basic parameters of the model, we determined the incidence of DES symptoms in rabbits depending on the duration of general anesthesia.…”

“…Overall, by the end of 3–6 h general anesthesia, the full-scaled pathomorphological picture of DES was developed in the majority of the animals. Considering that exposure to anesthesia of similar duration reduces tear secretion significantly [ 6 ], the condition developed after 6 h narcosis was recognized as a model of severe DES, which is feasible for the proper trialing of the proposed antioxidant therapy.…”

“…Indeed, the decline in tear production and tear film stability under general anesthesia leads to erosive processes involving all layers of corneal epithelium, which are highly reminiscent of DES-associated corneal lesions [ 5 ]. Furthermore, under these conditions, significant alterations in biochemical and antioxidant properties of tears are observed, similar to those in DES patients [ 6 , 10 ]. All these features make the rabbit model of anesthesia-induced DES highly convenient for investigating therapeutic strategies for the disease, including antioxidant treatment using SkQ1.…”

“…Ageing, prolonged eye strain, environmental factors, medication intake, and refractive surgery are the major contributors to DES development [ 4 ]. General anesthesia is another risk factor for DES, which is becoming more prominent with wider use of surgical interventions in modern medicine [ 5 , 6 ].…”

Mechanisms and Treatment of Light-Induced Retinal Degeneration-Associated Inflammation: Insights from Biochemical Profiling of the Aqueous Humor

“…The total antioxidant activity in AH was analyzed via hemoglobin/H 2 O 2 /luminol system, as described in our previous works [68][69][70]. Briefly, the AH samples were diluted 200-fold with PBS and added to the reaction mixture, containing 0.01 mm luminol and 0.5 mm hemoglobin.…”