J Korean Ophthalmol Soc.  2009 Oct;50(10):1483-1488. 10.3341/jkos.2009.50.10.1483.

The Effect of Artificial Tear Application on Central Corneal Thickness in Dry Eye

• Seo SG

• KMID: 2212764
• DOI: http://doi.org/10.3341/jkos.2009.50.10.1483

Abstract

PURPOSE
To examine the effect of artificial tear use on central corneal thickness (CCT) in dry and normal eyes as a standard diagnosis for indicating dry eye.
METHODS
Thirty eyes of 30 patients with symptomatic dry eyes and 25 eyes of 25 controls were examined in this study. Artificial tear therapy consisting of 6 drops/day was given to both groups for 2 weeks. The CCT was measured with ultrasonic pachymetry before and after the therapy. Results were analyzed with a paired t-test and Mann-Whitney U-test.
RESULTS
The mean CCT in the dry eye group before and after the 2 weeks of therapy was 528.9+/-17.3 micrometer and 556+/-25.3 micrometer, respectively, which is an increase of 5.28% (27.1+/-9.2 micrometer, p<0.01). The mean CCT in the control group before and after the 2 weeks of therapy was 546.3+/-36.5 micrometer and 549.6+/-39.3 micrometer, respectively, which is an increase of 0.61% (3.3+/-2.8 micrometer, p=0.08).
CONCLUSIONS
The CCT in the dry eye group increased significantly compared to the eyes in the control group after use of artificial tears. The results indicate that the increase could be used as a standard in the diagnosis and follow-up of dry eyes, and the increase in thickness should be considered in intraocular pressure measurements as well as in refractive surgical procedures.

Keyword

Artificial tear; Central corneal thickness; Dry eye; Pachymetry

MeSH Terms

Eye
Follow-Up Studies
Humans
Intraocular Pressure
Ophthalmic Solutions
Refractive Surgical Procedures
Tears
Ultrasonics
Ophthalmic Solutions

Reference

References

1. Lemp MA. Report of the National Eye Institute/Industry work-shop on Clinical Trials in Dry Eyes. CLAO J. 1995; 21:221–32.

2. Heo H, Kang IS, Wu MH, Yoon KC. Therapeutic Effect of Topical Testosterone Gel in Patients with Dry Eye Syndrome. J Korean Ophthalmol Soc. 2006; 47:1259–65.

3. Stern ME, Beuerman RW, Fox RI, et al. The pathology of dry eye: the interaction between the ocular surface and lacrimal glands. Cornea. 1998; 17:584–9.

4. Stern ME, Gao J, Siemasko KF, et al. The role of the lacrimal functional unit in the pathophysiology of dry eye. Exp Eye Res. 2004; 78:409–16.

5. Dana MR, Hamrah P. Role of immunity and inflammation in corneal and ocular surface disease associated with dry eye. Adv Exp Med Biol. 2002; 506:729–38.

6. Kim WJ, Kim HS, Kim MS. Current Trends in the recognition and treatment of dry eye: A survey of ophthalmologists. J Korean Ophthalmol Soc. 2007; 48:1614–22.

7. Nichols KK, Nichols JJ, Zadnik K. Frequency of dry eye diagnostic test procedures used in various modes of ophthalmic practice. Cornea. 2000; 19:477–82.

8. Nichols KK, Mitchell GL, Zadnik K. The repeatability of clinical measurements of dry eye. Cornea. 2004; 23:272–85.

9. Korb DR. Survey of preferred tests for diagnosis of the tear film and dry eye. Cornea. 2000; 19:483–6.

10. Schein OD, Munoz B, Tielsch JM, et al. Prevalence of dry eye among the elderly. Am J Ophthalmol. 1997; 124:723–8.

11. Lin PY, Tsai SY, Cheng CY, et al. Prevalence of dry eye among an elderly Chinese population in Taiwan: the Shihpai Eye Study. Ophthalmology. 2003; 110:1096–101.

12. Brewitt H, Sistani F. Dry eye disease: the scale of the problem. Surv Ophthalmol. 2001; 45:199–202.

13. Hikichi T, Yoshida A, Fukui Y, et al. Prevalence of dry eye in Japanese eye centers. Graefes Arch Clin Exp Ophthalmol. 1995; 233:555–8.

14. Green K, Downs S. Reduction of corneal thickness with hypertonic solutions. Am J Ophthalmology. 1973; 75:507–10.

15. Cohen SR, Polse KA, Brand RJ, Mandell RB. Humidity effects on corneal hydration. Invest Ophthalmol Vis Sci. 1990; 31:1282–7.

16. Liu Z, Pflugfelder SC. Corneal thickness is reduced in dry eye. Cornea. 1999; 18:403–7.

17. Dayanir V, Sakarya V, Ozcura F, et al. Effect of corneal drying on central corneal thickness. J Glaucoma. 2004; 13:6–8.

18. Bovelle R, Kaufman SC, Thompson HW, Hamano H. Corneal thickness measurements with the Topcon SP-2000P specular microscope and an ultrasound pachymeter. Arch Ophthalmol. 1999; 117:868–70.

19. Nakayasu K. Stromal changes following removal of epithelium in rat cornea. Jpn J Ophthalmol. 1988; 32:113–25.

20. Gilbard JP, Farris RL, Santamaria J. Osmolarity of tear microvo-lumes in keratoconjunctivitis sicca. Arch Ophthalmol. 1978; 96:677–81.

21. Mishima S. Some physiological aspects of the precorneal tear film. Arch Ophthalmol. 1965; 73:233–41.

22. Kwon JD, Park DH, Park D, Lee CH. Clinical Investigation of Therapeutic Effect and Extrusion Rate of Punctal Plug for Dry Eye Syndrome. J Korean Ophthalmol Soc. 2006; 47:1204–11.

23. Matsuo T, Tsuchida Y, Morimoto N. Trehalose eye drops in the treatment of dry eye syndrome. Ophthalmology. 2002; 109:2024–9.

24. Chia EM, Mitchell P, Rochtchina E, et al. Prevalence and associations of dry eye syndrome in an older population: the Blue Mountains Eye Study. Clin Experiment Ophthalmol. 2003; 31:229–32.

25. Han YS, Ahn JH, Lew HM. The effects of dry eye on the corneal thickness measured by orbscan and ultrasonic pachymetry. J Korean Ophthalmol Soc. 2002; 43:17–22.

26. Cho SI, Lee JH. Ocular manifestations of patients with rheumatic disease and dry eye symptom. J Korean Ophthalmol Soc. 2002; 43:1847–51.

27. Begley CG, Caffery B, Chalmers RL, et al. Use of the dry eye questionnaire to measure symptoms of ocular　 irritation in patients with aqueous tear deficient dry eye. Cornea. 2002; 21:664–70.

28. Liu Z, Pflugfelder SC. Corneal surface regularity and the effect of artificial tears in aqueous tear deficiency. Ophthalmology. 1999; 106:939–43.

29. Lin PY, Cheng CY, Hsu WM, et al. Association between symptoms and signs of dry eye among an elderly Chinese population in Taiwan: The Shihpai Eye Study. Invest Ophthalmol Vis Sci. 2005; 46:1593–8.

30. Goto E, Yagi Y, Matsumoto Y, Tsubota K. Impaired functional visual acuity of dry eye patients. Am J Ophthalmology. 2002; 133:181–6.

31. Goto E, Yagi Y, Kaido M, et al. Improved functional visual acuity after punctal occlusion in dry eye patients. Am J Ophthalmol. 2003; 135:704–5.

32. Behrens A, Doule JJ, Stern L, et al. Dysfunctional tear syndrome: a Delphi approach to treatment recommendations. Cornea. 2006; 25:900–7.

33. Goto E, Shimazaki J, Monden Y, et al. Low-concentration homo-genized castor oil eye drops for noninflamed obstructive meibomian gland dysfunction. Ophthalmology. 2002; 109:2030–5.

34. Bron AJ. Diagnosis of dry eye. Surv Ophthalmol. 2001; 45:221–6.

35. Kallarackal GU, Ansari EA, Amos N, et al. A comparative study to assess the clinical use of fluorescein meniscus time with tear break up time and Schirmer's tests in the diagnosis of dry eyes. Eye. 2002; 16:594–600.

36. Bawazeer AM, Hodge WG. One-minute　 schirmer test with anesthesia. Cornea. 2003; 22:285–7.

37. Yokoi N, Komuro A. Non-invasive methods of assessing the tear film. Exp Eye Res. 2004; 78:399–407.

38. van Bijsterveld OP. Diagnostic tests in sicca syndrome. Arch Ophthalmol. 1969; 82:10–4.

39. Jones LT. The lacrimal secretory system and its treatment. Am J Ophthalmol. 1966; 62:47–60.

40. Karadayi K, Ciftci F, Akin T, et al. Increase in central corneal thickness in dry and normal eyes with application of artificial tears: a new diagnostic and follow-up criterion for dry eye. Ophthalmic Physiol Opt. 2005; 25:485–91.

41. Albietz JM, Lenton LM, McLennan SG. Chronic dry eye and regression after laser in situ keratomileusis　 for myopia. J Cataract Refract Surg. 2004; 30:675–84.

42. Ko YC, Liu CJ, Hsu W. Varying effects　 of corneal thickness on intraocular pressure measurements with different tonometres. Eye. 2005; 19:327–32.