Objective To observe the changes in tear film after minimal vitreoretinal surgery in patients with hypertension. Methods One hundred and thirty-three eyes of 133 patients (47 patients with systemic hypertension as group A and 86 eyes without systemic hypertension as group B) underwent 23gauge or 25gauge vitreous microsurgery were enrolled in this study. The contralateral eyes were regarded as the control group. Uncomfortable symptoms score, breakup time (BUT), Schirmer′s Ⅰ test (SⅠT) and corneal fluorescein staining (CFS) were recorded before and after surgery in all patients. Data were analyzed with a Wilcoxon rank sum test, KruskalWallis oneway ANOVA and independent samples t test. Results Comparison between non surgery eyes of group A and group B indicated no statistical difference in CFS and BUT score at each followup (Z=-3.229, -2.780, -2.018, -2.379, -3.374, -3.213: t=-2.452, -2.963, -2.580, -3.018, -2.339, -2.374; P＞0.05). However, statistical difference of SⅠT between the two groups was found either 1 day before surgery or 10 days after surgery (t=-4.668, -5.384; P＜0.05). Comparing the CFS and BUT in group A at 1, 3 days after operation with 1 day before surgery, the differences were statistically significant (Z=-5.229, -4.780; P＜0.05; t=-5.633, -4.884; P=0.001). The statistical significance was noticed in SⅠT between l day before surgery and 1 day after surgery (t=-4.743, P=0.001). Comparison between uncomfortable symptoms scores of operated eyes in group A and group B revealed no significant difference between 1 and 3 days after surgery. Nineteen patients (14%) complained of pain and red eye. There was no statistical difference between CFS score at each follow-up（Z=-3.123, -3.730, -2.198, -3.379, -3.434, -2.393; P＞0.05）. There were significant differences between BUT scores of operated eyes in two groups at 1 and 3 days after operation （t=-5.537, -5.014;P＜0.05). There was also a significant statistical difference between SⅠT 1 and 3 days after operation between groups （t=-3.653, -4.371; P＜0.05). Conclusion The stability of tear film in hypertension patients is poorer than normal patients. The secretion of tears in hypertension patients declines and the tear film recovers slowly after the surgery.
Objective To evaluate the effect of vitreoretinal surgery on tear film.Methods Ninety-seven patients (97 eyes) of retinal detachment undergoing surgical therapy including vitrectomy, scleral buckling or scleral encircling were included in this study. Uncomfortable eye symptoms were inquired and tear break-up time (BUT), Schirmer Ⅰ test (SⅠt), corneal fluorescein staining (CFS), tear meniscus height (TMH) were measured at three days before surgery and at six time-points after surgery (two, 14 days and one, two, three, six months). Thirty patients were randomly chosen to receive impression cytology of conjunctiva at three days before surgery and at four time-points after surgery (one, two, three, six months).Results Comparing with the preoperative results, at the first three time-points after surgery (two, 14 days, one month), uncomfortable symptoms (t=-25.082,-9.966, -4.718,P＜0.01) and CFS scores(t=-6.244,-3.716,-4.683, P＜0.01) increased, tear breakup time (BUT) shortened greatly (t=9.960, 5.627, 4.953; P＜0.01). SⅠt and TMH increased significantly（t=-25.931,-5.839;-25.345,-3.873;P＜0.01） at two and 14 days after surgery. The number of conjunctival goblet cell decreased significantly at one month after surgery（t=2.259, P＜0.05).All those tear film parameters returned to preoperative level at two months after surgery.Conclusion Vitreoretinal surgery influences tear film stability transiently, and the tear film function tends to restore in two months after the operation.
Objective To observe the effect of vitrectomy (PPV) combined with silicone oil filling on the stability of the tear film. Methods A total of 72 eyes of 36 patients with vitreous hemorrhage and retinal detachment were enrolled in the study with PPV combined with silicone oil filling. The operation and contralateral eyes were set up in the operation group and the control group respectively, each had 36 eyes. The tear film rupture time (BUT), the base tear secretion test or Schirmer Ⅰ test (SⅠT) and corneal fluorescein staining (CFS) were performed at 7, 30, 60, and 90 days after operation. The difference of BUT, SⅠT and CFS at different time points after the operation of the two groups were compared. Results After operation 7, 30 days, SⅠT and CFS increased, BUT staining is shortened in the surgery group, the differences were statistically significant (t=1.78, P＜0.05); after operation 60, 90 days, SⅠT, CFS, BUT were same between the surgery group and the contralateral eyes (t=12.39, P＞0.05). Conclusion PPV combined with silicone oil filling can affect the stability of the tear film, which can be recovered to the preoperative level at postoperative 60 days.