Tear Film Changes After Closed Vitrectomy And Effects Of Atrificial Tears On Tear Film After Vitrectomy

Objective:To evaluate tear film changes,recoveries and the effects of artificail tears on tear film after closed vitrectomy.Methods:1. To evaluate tear film function changes after vietretomy: according to the selection and exclusion criterias of this study, 42 consecutive patients undergoing vitrectomy (42 eyes)were involved in this prospective study and internalized A group. Postoperatively, A group (42 eyes) were dropped with TobraDex, and given mydriasis and antiglaucoma eyedrops when necessary. Uncomfortable symptoms(dry sensation, foreign body sensation,Burning sensation) were inquired, as well as tear break-up time(BUT), Schirmer test(ST) value and corneal fluorescein staining(CFS) were measured 1 day preoperatively plus 1, 3, 7, 14, 30 days postoperatively. The results were analysed statistically.2. To evaluate the effects of artificail tears on tear film after closed vitrectomy: according to the selection and exclusion criterias of this study, 36 patients (36 eyes) undergoing vitrectomy were followed up for the tear film changes after vitrectomy and internalized B group. Postoperatively, B group (36 eyes) were dropped with TobraDex and artificial tears(Dextran 70 Eye Drops), and were given mydriasis and antiglaucoma eyedrops when necessary. Uncomfortable symptoms ( dry sensation, foreign body sensation,Burning sensation) were inquired, as well as tear break-up time(BUT), Schirmer test(ST) value and corneal fluorescein staining(CFS) were measured 1 day preoperatively plus 3, 7, 14, 30 days postoperatively. The results were analysed statistically.Results:1. Tear film function changes after vietretomy: At 1 day postoperatively, the uncomfortable symptoms scores and CFS scores increased significantly (P<0.01), while the stable tear film failed to form. However, the ST value of 35 patients exceeded 30 mm,while the ST value of the rest 7 patients exceeded 25 mm. At 3, 7 days postoperatively, the uncomfortable symptoms scores incresed singficantly (P<0.01, P<0.05), and returned to their preoperative values at 14 days postoperatively (P>0.05). At 3, 7, 14 days postoperatively, the mean BUT decreased significantly (P<0.01), the mean ST value scores and CFS scores increased significantly (P<0.01). At 30 days postoperatively, the mean BUT still decreased significantly (P<0.05), the mean ST value and CFS scores returned to their preoperative values (P>0.05).2. To evaluate the effects of artificail tears on tear film after closed vitrectomy: (1) No significant differences existed in two groups at 1 day preoperatively; (2) At four postoperative checkpoints, the BUT values in group B were significantly higher than those in group A, and returned to their preoperative values at 30 days postoperationly, while there were no significant differences in ST between group A and B; (3) At 7 and 14 days postoperatively, the Uncomfortable symptoms scores and CFS scores were less in group B with signigicant differences.Conclusions:1. Vitrectomy significantly alters the stability of tear film. Only partial tear film function returned to preoperative values until 30 days postoperatively.2. Auxiliary artificial tears after vitrectomy could accelerate the early recovery of tear film stability and reduce the uncomfortable symptoms effectively.