Corneal Sensitivity After Ocular Surgery

Lum, Edward; Corbett, Melanie C.; Murphy, Paul J.

doi:10.1097/icl.0000000000000543

Cited by 17 publications

(14 citation statements)

References 161 publications

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“…Another study disclosed that the number of subbasal nerve fibers decreased one month after cataract surgery in patients without epithelial defects and returned to normal values 8 months postoperatively [ 25 ]. A similar research even found that patients undergoing cataract surgery exhibited bilateral alterations of the corneal subbasal nerve plexus [ 26 ], which led to the decrease of corneal sensation [ 27 ]. However, both of the two studies excluded patients with diabetes.…”

Section: Discussionmentioning

confidence: 99%

Clinical Features, Risk Factors, and Therapy of Epithelial Keratitis after Cataract Surgery

Wang

et al. 2021

Journal of Ophthalmology

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Purpose. The study aimed to assess the clinical characteristics, risk factors, and therapy of epithelial keratitis after cataract surgery. Methods. Medical data of 89 consecutive patients who developed epithelial keratitis after cataract surgery, including 37 patients with diabetes mellitus (37 eyes) and 52 patients without diabetes mellitus (52 eyes), were retrospectively reviewed. The clinical characteristics, risk factors, and therapy in those patients were evaluated. Results. The preoperative tear film function determined by the tear breakup time, meibomian gland atrophy score, and low tear meniscus height in diabetic patients was poorer than nondiabetic patients ( P < 0.001 ). Of diabetic patients, 83.78% (31/37) had been diagnosed with meibomian gland dysfunction before cataract surgery and treated with topical nonsteroidal anti-inflammatory drugs after cataract surgery for 44.69 ± 10.51 days, compared to 42.31% (22/52) of nondiabetic patients receiving the topical nonsteroidal anti-inflammatory treatment for 33.35 ± 5.16 days (both P < 0.001 ). Epithelial lesions progressed within three to four days following cataract surgery in 59.46% (22/37) of diabetic patients, versus 30.77% (16/52) of the nondiabetic patients ( P = 0.025 ). Patients with combined meibomian gland dysfunction and epithelial defects accounted for 48.65% (18/37) in the diabetic group and 25.00% (13/52) in the nondiabetic group ( P < 0.001 ). In vivo confocal microscopy showed absence of subbasal never fibers in eyes with epithelial defects, and central corneal sensation was also significantly depressed in those eyes, but there was no significant difference between the two groups ( P = 0.227 ). Corneal ulceration and herpes simplex keratitis were found in 2.70% (1/37) and 5.41% (2/37) of diabetic patients, respectively. Amniotic membrane transplantation was required in 32.43% (12/37) of patients in the diabetic group, and the proportion was higher than 1.92% (1/52) in the nondiabetic group ( P < 0.001 ). Average healing time of the corneal epithelium in the diabetic group was 40.62 ± 20.0 days, much longer than 21.74 ± 6.94 days in the nondiabetic group ( P = 0.002 ). Conclusion. Epithelial keratitis after cataract surgery in diabetic patients has the characteristics of rapid development, severe epithelial damage, and slow repair of the corneal epithelium. Amniotic membrane transplantation is a good choice for persistent epithelial defects associated with such epithelial keratitis. Attention should be paid to the tear film function and use of topical nonsteroidal anti-inflammatory drugs in patients undergoing cataract surgery.

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Section: Discussionmentioning

confidence: 99%

Clinical Features, Risk Factors, and Therapy of Epithelial Keratitis after Cataract Surgery

Wang

et al. 2021

Journal of Ophthalmology

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“…The technologies employed for this approach include cell therapy and tissue engineering 87 . The cornea is an excellent model for the emerging regenerative medicine field because it avoids key challenges faced by other tissues in that it has a simple structure with no vasculature, 88,89 a degree of immune privilege, 90 few cell types, and innervation that is not critical for function, 91 as seen in PK 92 . Clinical trials are facilitated because the cornea is a visible low‐risk anatomical location.…”

Section: Methods To Increase Supply or Limit Need For Corneal Donor Tissuementioning

confidence: 99%

Corneal supply and the use of technology to reduce its demand: A review

Baird

Machin

Brown

2021

Clinical Exper Ophthalmology

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Recovery and access to end‐of‐life corneal tissue for corneal transplantation, training and research is globally maldistributed. The reasons for the maldistribution are complex and multifaceted, and not well defined or understood. Currently there are few solutions available to effectively address these issues. This review provides an overview of the system, key issues impacting recovery and allocation and emphasises how end‐user ophthalmologists and researchers, with support from administrators and the wider sector, can assist in increasing access long‐term through sustaining eye banks nationally and globally. We posit that prevention measures and improved surgical techniques, together with the development of novel therapies will play a significant role in reducing demand and enhance the equitable allocation of corneas.

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“…In addition to the reduction of conjunctival goblet cells, the traumatic injury of corneal epithelium caused by manipulations performed during the cataract surgery must also be taken into consideration (Cha et al, 2004) (Adeeb M Rushdi, 2018). Delayed healing of epithelial scars, increased epithelial permeability, reduced metabolic activity of the epithelium and loss of cytoskeleton structures are observed after the surgery (Lum et al, 2019). Clinically, inflammation of the cornea is observed with a reduction in sensitivity and tear secretion (X.…”

Section: Difference In Osmolarity Between Eyes As An Indicator Of Loss Of Homeostasismentioning

confidence: 99%

Tear Film Osmolarity of the Eye after Cataract Surgery. Summary of the Doctoral Thesis

Elksnis¹

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Almost every cataract surgeon has encountered a situation during the postoperative period when, even though, the primary goal – improvement of visual acuity – has been achieved, yet the patient felt frustrated because of subjective discomfort in the operated eye. Sometimes this issue is more disturbing for the patient than the hope for a perfect visual outcome. Although it has been established that the ocular surface is affected during the postoperative period, there is still no generally accepted opinion about the changes in tear osmolarity after cataract surgery despite several studies dedicated to evaluation of these changes. The present study was designed to elucidate the effect of cataract surgery on the characteristic feature of ocular surface homeostasis – tear film osmolarity in the early postoperative period. Aim. The aim of the study was to evaluate the changes in tear film osmolarity after a cataract surgery in a healthy ocular surface. Methods. For this purpose two examination groups were formed. The study group included voluntary patients undergoing cataract surgery not having any complaints about subjective symptoms typical of dry eye disease. In order to correspond to the criteria of healthy ocular surface, the study group excludes the following types of patients and conditions: contact lens wearers, patients with diabetes, pseudoexfoliation, pterygia and eye drop users. The eye that has not undergone the surgery was classified as the control group. This single–center, prospective study was held at Ophthalmology department of Pauls Stradins Clinical university hospital. All cataract surgeries were done by the same surgeon. The tear osmolarity tests were evaluated with TearLab Osmolarity System (TearLab Corporation, San Diego, CA, the USA) before surgery, in the next morning, one week and one month after the surgery. Results. No statistically significant difference was observed between the groups before operation when comparing the mean tear osmolarity – in the study group it was 296.87 mOsm/L, and in the control group it was 297.27 mOsm/L (p = 0.84). The tear osmolarity results changed significantly during early postoperative period in the study group (p < 0.001), while in non–operated eye no significant tear film osmolarity changes were observed (p = 0.86). Significant changes were recognized on the next day after the surgery – the tears became hypoosmolar (< 275 mOsm/L). One week later the tear osmolarity increased significantly, and the tears became hyperosmolar (312.64 mOsm/L). Over the course of one month, the test values for the study and control groups equalized (297.87 in the study group and 298.93 in the control group (p = 0.66)), when compared to preoperative tear osmolarity results. Conclusion. The results achieved lead towards a more detailed understanding of the changes in the ocular surface homeostasis after a cataract surgery. The obtained data indicate that tear osmolarity changes considerably during the first postoperative month after a cataract surgery. Also, there is a huge difference in measurements between operated and non–operated eye on the next day and one week after the surgery. One month after the surgery tear osmolarity returns to preoperative test results, and there is no difference determined between the eyes.

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Corneal Sensitivity After Ocular Surgery

Cited by 17 publications

References 161 publications

Clinical Features, Risk Factors, and Therapy of Epithelial Keratitis after Cataract Surgery

Clinical Features, Risk Factors, and Therapy of Epithelial Keratitis after Cataract Surgery

Corneal supply and the use of technology to reduce its demand: A review

Tear Film Osmolarity of the Eye after Cataract Surgery. Summary of the Doctoral Thesis

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