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Assessment of meibomian glands and tear film in post-refractive surgery patients

Authors
 Ji Won Jung  ;  Jung Yong Kim  ;  Hee Seung Chin  ;  Young Ju Suh  ;  Tae‐im Kim  ;  Kyoung Yul Seo 
Citation
 CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY, Vol.45(9) : 857-866, 2017 
Journal Title
 CLINICAL AND EXPERIMENTAL OPHTHALMOLOGY 
ISSN
 1442-6404 
Issue Date
2017
Keywords
chronic tear film dysfunction ; corneal refractive surgery ; keratography ; meibomian glands ; tear films
Abstract
IMPORTANCE: Corneal refractive surgery may impact meibomian gland and tear film in post-refractive surgery patients. BACKGROUND: To compare ocular surface parameters between post-refractive surgery patients and normal controls. DESIGN: Cross-sectional single centre study. PARTICIPANTS: A total of 120 eyes of 120 subjects were divided into three groups: (i) 60 controls and 60 patients underwent corneal refractive surgery at least 12 months ago; (ii) 30 post-laser in-situ keratomileusis (LASIK) patients and (iii) 30 post-laser epithelial keratomileusis (LASEK)/photo-refractive keratectomy (PRK) patients. METHODS: Tear meniscus height, non-invasive keratographic tear film break-up time and meibography were measured using the Keratograph® 5M. Fluorescein break-up time, ocular surface staining, examination of lid margins and meibomian glands, Schirmer's test and Ocular Surface Disease Index questionnaire were performed. MAIN OUTCOME MEASURES: Ordinary logistic regression was performed to evaluate the impact of clinical variables including refractive surgery on the meiboscores. RESULTS: In post-LASIK patients, ocular surface parameters including Ocular Surface Disease Index scores, fluorescein break-up time and staining scores, except Schirmer's scores, were significantly worse than those in controls (P < 0.050). Ocular surface staining scores in post-LASEK/PRK patients was higher than that in the controls (P = 0.001). In post-refractive surgery patients, grade of meibomian gland parameters and meiboscores were worse than those of controls (all P < 0.050). Histories of refractive surgery were associated with high meiboscore (β = 1.100, P = 0.043 for LASIK and β = 1.039, P = 0.042 for LASEK/PRK). CONCLUSIONS AND RELEVANCE: Corneal refractive surgery may adversely affect the ocular surface, and a reduction of functional meibomian glands can contribute to chronic tear film dysfunction after corneal refractive surgery.
Full Text
https://onlinelibrary.wiley.com/doi/abs/10.1111/ceo.12993
DOI
10.1111/ceo.12993
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Ophthalmology (안과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Tae Im(김태임) ORCID logo https://orcid.org/0000-0001-6414-3842
Seo, Kyoung Yul(서경률) ORCID logo https://orcid.org/0000-0002-9855-1980
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/165043
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