J Korean Ophthalmol Soc.  2013 Mar;54(3):408-415. 10.3341/jkos.2013.54.3.408.

Changes in Corneal Sensation, Tear Film Stability and Ocular Surface after Advanced Surface Ablation

• Lee BH
• Kim EJ
• Kim JH
• Lee GJ
• Lee KW
• Park YJ

• KMID: 2216759
• DOI: http://doi.org/10.3341/jkos.2013.54.3.408

Abstract

PURPOSE
To evaluate the changes in tearfilm, corneal sensation and ocular surface after advanced surface ablation.
METHODS
Tearfilm break-up time (BUT), Schirmer test without local anesthesia, fluorescein staining, corneal sensitivity test, ocular surface disease index (OSDI), and conjunctival impression cytology were evaluated in 50 eyes of 25 patients who underwent advanced surface ablation preoperatively and postoperatively at 2 weeks and at 1, 2, 3, and 6 months. Each value was compared to the preoperative value.
RESULTS
OSDI diminished by 2 weeks postoperatively, and corneal sensation diminished by 1 month postoperatively (p < 0.05). There were significant decreases in BUT by 2 weeks to 1 month postoperatively as well as decreases in the Schirmer test by 2 to 3 months postoperatively (p < 0.05). Fluorescein staining increased at 2 weeks postoperatively (p < 0.05). Goblet cells decreased substantially by 1 month postoperatively and conjunctival squamous metaplasia increased significantly by 2 months postoperatively (p < 0.05).
CONCLUSIONS
Advanced surface ablation may affect tearfilm, corneal sensation and ocular surface up to 3 months postoperatively. Early treatment of dry eye syndrome following advanced surface ablation should strongly be considered.

Keyword

Advanced surface ablation; Dry eye; Impression cytology

MeSH Terms

Anesthesia, Local
Dry Eye Syndromes
Eye
Fluorescein
Goblet Cells
Humans
Metaplasia
Sensation
Tears
Fluorescein

Figure

• 

  Figure 1. Impression cytological finding of goblet cell density before and after advanced surface ablation. Photograph exhibits a sharp reduction in goblet cells at 2 weeks post-op, then shows a gradual recovery returning to a pre-op level at between 2-3 months post-op. The increase in goblet cell number continues to 6 months post-op (PAS-H&E, ×100).

• 

  Figure 2. Impression cytological finding of squamous metaplasia before and after advanced surface ablation. The photograph shows that epithelial metaplasia grade worsens drastically at two weeks post-op, maximizing at 4 weeks post-op. Then it improves gradu-ally, returning to the pre-op level at 3 months post-op, yet to improve further all the way up to 6 months post-op (PAS-H&E, ×400).

Reference

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