The Effect Of Artificial Tears With Or Without Preservatives On The Ocular Surface In Dry Eye Patients

Objective: To observe the changes of ocular surface in dry eye patients using artificial tears with or without preservatives.To explore the effect of using artificial tears with or without preservatives on the ocular surface of dry eye patients,and it provides reference for clinical Choosing of artificial tear medicine by examining the changes of tear film function on the ocular surface of patients in the observation group and the control group and the effect of subjective symptoms of patients.Method: According to the inclusion criteria and exclusion criteria,30 dry eye patients(60 eyes)from October 2018 to October 2019 in Yan’an University Affiliated Hospital were selected and randomly divided into: 15 patients(30 eyes)in the study group were treated with Ellie eye drops;15(30 eyes)patients in the control group were treated with Hailu eye drops.Before and 1month and 3 months after the treatment,Ocular surface disease index questionnaire survey(OSDI),Schirmer I test(S Ⅰ t),break-up time of tear film(BUT),corneal fluorescein staining,tear fern test(TFT)and conjunctival impression cytology(CIC)were used to evaluate the tear film function of the observation group and the control group.Spss19.0 statistical software package was used to test and analyze all the data.Result: 1.Ocular surface disease index questionnaire(OSDI): There was no obvious difference in OSDI score between the observation group and the control group before treatment(P> 0.05).In the observation group,the average OSDI of 1month and3 months before and after treatment were 12.93±1.36,10.73±1.41 and 8.33±2.25,respectively.The average OSDI scores of the control group before and after treatment were 12.60±1.27,10.53±1.28 and 7.67±1.37,respectively.OSDI scores of patients in the two groups of 7d,1month and 3months after treatment were significantly improved compared with those before treatment.There were obviously improved compared with before treatment.Before and after treatment,the difference between the two groups was statistically significant(P <0.05).There was no obviously difference between the observation group and the control group(P> 0.05).2.Break-up time of tear film(BUT): There was no obvious difference in the average tear film rupture time between the observation group and the control group before treatment(P> 0.05).The mean values of BUT before and after treatment in the observation group were 3.87±1.91,5.07±1.96 and 6.00±1.68,respectively.The mean values of BUT before and after treatment in the control group were 3.60±1.87,5.20±1.79 and 6.10±1.47,respectively.One month and three months after treatment,the average tear film rupture time of the two groups was obviously improved than before treatment.The difference between the two groups before and after treatment at 1 month and 3months was statistically significant(P < 0.05).There was no significant difference between the two groups at 1 month after treatment(P> 0.05).Three months after treatment,the control group was superior to the observation group,and the difference was statistically significant(P <0.05).3.Corneal fluorescein staining test: There was no obvious difference in corneal fluorescein staining score between the observation group and the control group before treatment(P> 0.05).The mean values of corneal fluorescein staining scores in the observation group before and after treatment were 1.97±0.85,1.07±0.85 and 0.43±0.50,respectively.The mean score of corneal fluorescein staining before and after treatment of1 month and 3months in the control group was 2.13±0.73,1.13±0.73 and 0.53±0.51,respectively.Corneal fluorescein staining score was obviously improved before treatment compared with 1 month and 3 months after treatment.There were obviously improved compared with before treatment.Before and after treatment,the difference between the two groups was statistically significant(P <0.05).There was no obviously difference between the observation group and the control group(P> 0.05).4.Schirmer I test(SIt): There was no obvious difference in SIt score between the observation group and the control group before treatment(P> 0.05).The mean values(mm / 5min)of the SIT values in the observation group before and after 1 month,and 3months were 5.10±1.47,5.87±1.41 and 7.03±0.96,respectively.The mean values of the control group before and after treatment at 1 month and 3 months were 4.97±1.54,5.77±1.43 and 7.63±1.16,respectively.SIt score was obviously improved before treatment compared with 1 month and 3 months after treatment.There were obviously improved compared with before treatment.Before and after treatment,the differencebetween the two groups was statistically significant(P <0.05).There was no obviously difference between the observation group and the control group(P> 0.05).5.conjunctival impression cytology(CIC):There was no obvious difference in the average value of conjunctival goblet cells(per high-power field of view)between the observation group and the control group before treatment(P> 0.05).The average value of conjunctival goblet cells in the observation group before treatment and at 1month and3months(per high-power field of view)were 32.43±3.80,35.40±3.80 and 38.10±3.86,respectively.In the control group,the average values of conjunctival goblet cells before and 1month and 3months(fields / high power field of view)were 32.77±3.57,35.67±3.65 and 40.00±2.67,respectively.One month and three months after treatment,the average value of conjunctival goblet cells(one / high-power field of view)of the two groups was obviously improved than before treatment.The difference between the two groups before and after treatment at 1 month and 3 months was statistically significant(P< 0.05).There was no significant difference between the two groups at 1 month after treatment(P> 0.05).Three months after treatment,the control group was superior to the observation group,and the difference was statistically significant(P <0.05).6.Tear Fern Test(TFT):There was no obvious difference in the grade of lacrimal crystal test of tear fluid between the observation group and the control group before treatment(P> 0.05).In the observation group,18 eyes(60%)had normal fernular crystals(gradeⅠ andⅡ)before treatment;10 eyes(33.33%)had Ⅲ,and 2 eyes(6.67%)had Ⅳ.One month after treatment in the observation group,20 eyes(66.67%)of normal fernular crystals(gradesⅠandⅡ),9 eyes(30%)of grade Ⅲ,1 eye(3.33%)of grade Ⅳ,Ⅰ,Grade Ⅱ ratio increased.However,there was no statistically significant difference between before and after treatment(P > 0.05).Three months after treatment in the observation group,22 eyes(73.33%)of normal fern crystals(gradesⅠandⅡ),8 eyes(26.67%)of grade Ⅲ,0 eyes(0%)of grade Ⅳ,Ⅰ,Grade Ⅱ gradually increased.However,there was no statistically significant difference between before and after treatment(P > 0.05).In the control group,19 eyes(63.33%)of normal fern crystals(grades and Ⅱ),9 eyes(30%)of grade Ⅲ,and 2 eyes(6.67%)of grade Ⅳ were different from those in the observation group before treatment.No statistical significance(P>0.05).One month after treatment,21 eyes(70%)of normal fernular crystals(gradesⅠandⅡ),8 eyes(36.67%)of grade Ⅲ,1 eye(3.33%)of grade Ⅳ,gradeⅠandⅡThe proportion increased.However,there was no statistically significant difference between before and after treatment(P > 0.05).Grade Ⅰ and Ⅱ were more than those in the observation group,but there was no significant difference with the observation group 1month after treatment(P > 0.05).In the observation group,24 eyes(80%)of normal fernular crystals(gradesⅠandⅡ)3 months after treatment,6 eyes(20%)of grade Ⅲ,0eyes(0%)of grade Ⅳ.Grades Ⅰ and Ⅱ gradually increased.However,there was no statistically significant difference between before and after treatment(P> 0.05).GradesⅠandⅡwere more than the observation group,but there was no significant difference with the observation group 3 months after treatment(P> 0.05).Conclusion: 1.Sodium hyaluronate eye drops for mild to moderate dry eyes can safely and effectively improve eye discomfort,promote repair of corneal epithelium damage,improve tear film stability,reduce inflammation,increase the number of conjunctival goblet cells,and thus effectively treat Dry eyes.2.There was no significant difference in the ocular surface disease index questionnaire(OSDI),basic tear secretion test(SIt),and Corneal fluorescein staining test(CFS),between preservative-containing artificial tears and preservative-free artificial tears after treatment.After 3 months of treatment,there were significant differences in the conjunctival blot cytology(CIC),and tear film rupture time(BUT).3.In terms of increasing tear film stability,reducing tear evaporation and improving the living environment of goblet cells,long-term use of artificial tears without preservatives has more advantages than that of artificial tears with preservatives in the treatment of light and medium dry eyes.