Hyaluronat-Trehaloz Çözeltisinin Katarakt Cerrahisi Sonrası Oküler Konfor ve Gözyaşı Filmi İnstabilitesi Üzerine Etkisi

Yıl 2020, Cilt: 3 Sayı: 1, 34 - 43, 12.08.2020

Özgür Balta , Hande Hüsniye Telek

Öz

Giriş ve Amaç: Katarakt cerrahisi sonrası trehaloz ve sodyum hiyalüronat çözeltisinin oküler konfor ve gözyaşı filmi instabilitesi üzerine etkilerini değerlendirmek.Gereç ve Yöntem: Bu prospektif çalışma Mayıs 2017 ve Ocak 2018 tarihleri arasında gerçekleştirildi. Tek taraflı katarakt ameliyatı geçiren 18 yaş üstü hastalar çalışmaya alındı. Ameliyat öncesi tüm hastalara Schirmer testi ve gözyaşı filmi kırılma zamanı (TBUT) ölçümü yapıldı. Postoperatif 1. ayda oküler yüzey; Oküler Yüzey Hastalığı İndeksi (OSDI), Schirmer testi, TBUT ve kornea floresein boyaması kullanılarak değerlendirildi. Hastalardan kuru göz semptomlarının şiddetini (yabancı cisim hissi, yanma ve batma, gözlerini kapatma isteği, gözlerini kırpma sıklığı) görsel analog skalada (VAS) derecelendirmeleri istendi. Bulgular: Çalışma grubunda; Schirmer test sonuçlarında başlangıç ve postoperatif 1 ay arasında istatistiksel olarak anlamlı bir değişiklik görülmedi (p = 0.086), iki grupta da preoperatif TBUT değeri eşitti (her ikisi için 11 s, p> 0.05). Postoperatif 1. ayda TBUT değeri çalışma grubunda kontrol grubuna göre daha uzun saptandı (12 sn. 9 sn, p <0.001). Postoperatif 1. ayda OSDI skorları çalışma grubunda kontrol grubuna göre anlamlı olarak düşük bulundu (2.27'ye karşı 20, p <0.001). yabancı cisim hissi, yanma ve batma hissi çalışma grubunda kontrol grubuna göre anlamlı derecede düşük saptandı ( sırasıyla p = 0.002 ve p = 0.004). Floresein kornea boyama skorları da çalışma grubunda kontrol grubuna göre anlamlı olarak düşük bulundu (p = 0.005).Sonuç: Bu çalışma katarakt cerrahisi sonrası% 3 trehaloz ve% 0.15 sodyum hiyalüronat çözeltisinin kullanımının kuru göz semptomlarını azalttığını, gözyaşı filmi tabakasını stabilize ettiği ve kornea hücresi canlılığını arttırdığını göstermektedir.

Anahtar Kelimeler

Hyaluronate solution, trehalose solution, ocular comfort, tear-film instability

Effect of a Hyaluronate–Trehalose Solution on Ocular Comfort and Tear-Film Instability After Cataract Surgery

Öz

Background and Aim: To evaluate the effects of trehalose and sodium hyaluronate solution on ocular comfort and tear-film instability after cataract surgery Materials and Methods: This prospective study was conducted between May 2017 and January 2018. Patients over the age of 18 years who underwent unilateral cataract surgery were included in the study. Preoperatively, all patients underwent Schirmer test and tear film break-up time (TBUT) measurement. At postoperative month 1, the ocular surface was evaluated using the Ocular Surface Disease Index (OSDI), Schirmer test, TBUT, and corneal fluorescein staining. patients were asked to rate the severity of their dry eye symptoms (foreign body sensation, burning and stinging, desire to close the eyes, increased blinking frequency) on a visual analogue scale (VAS). Results: The study group showed no statistically significant change in Schirmer test results between baseline and postoperative 1 month in the study group (p=0.086), Preoperative TBUT was equivalent in the two groups (11 s for both, p>0.05). TBUT at postoperative 1 month was longer in the study group than the control group (12 s vs. 9 s, p <0.001). At postoperative 1 month, OSDI scores were significantly lower in the study group than the control group (2.27 vs. 20, p<0.001) .Foreign body sensation and burning and stinging sensation were significantly lower in the study group than in the control group (p=0.002 and p=0.004, respectively). Fluorescein corneal staining scores were also significantly lower in the study group than in the control group (p=0.005) . Conclusion: This study indicates that 3% trehalose and 0.15% sodium hyaluronate solution reduces dry eye symptoms, stabilized tear film layer, and increased corneal cell viability after cataract surgery. Key words: Hyaluronate solution , trehalose solution , ocular comfort, tear-film instability

Anahtar Kelimeler

Hyaluronat çözeltisi, trehaloz çözeltisi, oküler konfor, gözyaşı filmi instabilitesi

Kaynakça

• 1. Bourne RR, Stevens GA, White RA, Smith JL, Flaxman SR, Price H, Jonas JB, Keeffe J, Leasher J, Naidoo K, Pesudovs K, Resnikoff S, Taylor HR, VisionLossExpertGroup. Causes of visionlossworldwide, 1990–2010: a systematicanalysis. LancetGlobHealth. 2013;1(6):339-49.
• 2. Kasetsuwan N, Satitpitakul V, Changul T, Jariyakosol S (2013) Incidence and pattern of dry eye after cataract surgery. PLoS ONE. 2013; 8(11):78657
• 3. Cho YK, Kim MS (2009) Dry eye after cataract surgery and associated intraoperative risk factors. Korean J Ophthalmol. 2009; 23(2):65–73
• 4. Li X-M, Hu L, Hu J, Wang W. Investigation of dry eye disease and analysis of the pathogenic factors in patients after cataract surgery. Cornea 2007; 26(suppl 1):S16–S20
• 5. Walker T. Benzalkonium toxicity. Clin Experiment Ophthalmol. 2004;32:657.
• 6. Kohlhaas M. Corneal sensation after cataract and refractive surgery. JCataractRefractSurg. 1998; Oct;24(10):1399-409
• 7. Xue W, Zhu M, Zhu B. et al. Long-term Impact of Dry Eye Symptoms on Vision-Related Quality of Life After Phacoemulsification Surgery ,Int Ophthalmol ,2019 Feb;39(2):419-429
• 8. Mencucci R, Boccalini C, Caputo R, Favuzza E. Effect of a hyaluronic acid and corboxymethylcellulose ophthalmic solution on ocular comfort and tear-film instability after cataract surgery. J CataractRefract Surg.2015(41): 1669- 1704.
• 9. Mohammadpour M, Mehrabi S, Hassanpour N, Mirshahi R. Effects of adjuvant omega-3 fatty acid supplementation on dry eye syndrome following cataract surgery: A randomized clinical trial. J CurrOphthalmol. 2017;29(1):33-38.
• 10. Aragona P, Papa V, Micali A, Santocono M, Milazzo G. Long term treatment with sodiumhyaluronate-containing artificial tears reduces ocular surface damage in patients with dry eye. Br J Ophthalmol 2002; 86:181–184.
• 11. Chen W, Zhang X, Liu M, et al. Trehalose protects against ocular surface disorders in experimental murine dry eye through suppression of apoptosis. ExpEyeRes. 2009;89(3):311-318.
• 12. Bron AJ, EvansVE, Smith JA. Grading of corneal and conjunctival staining in the context of other dry eye tests. Cornea 2003;22(7):640- 50.
• 13. Minassian DC, Rosen P, Dart JK, et al. Extracapsular cataract extraction compared with small incision surgery by phacoemulsification: a randomised trial.Br J Ophthalmol. 2001 Jul;85(7):822-9.
• 14. Lekhanont K, Rojanaporn D, Chuck RS, Vongthongsri A. Prevalence of dry eye in Bangkok, Thailand. Cornea 2006;25:1162-7.
• 15. Gibbons A, Ali TK, Waren DP, Donaldson KE.Causes and correction of dissatisfaction after implantation of presbyopia-correcting intraocular lenses. ClinOphthalmol. 2016 Oct 11;10:1965-1970
• 16. Park DH, Chung JK, Seo DR, Lee SJ. Clinical effects and safety of 3% diquafosol ophthalmic solution for patients with dry eye after cataract surgery: A randomized Controlled Trial. Am J Ophthalmol. 2016 Mar;163:122-131
• 17. Hill-Bator A, Misiuk – Hojlo M, Marycz K, Grzesiak J. Trehalose-based eye drops preserveviability and functionality of cultured human corneal epithelial cells during desiccation.BiomedResInt. 2014;2014:292139.
• 18. Schmidl D, Schmetterer L, Witkowska KJ, et al. Tear film thickness after treatment with artificial tears in patients with moderate dry eye disease. Cornea. 2015;34(4):421–426.
• 19. Matsuo T. Trehalose protects corneal epithelial cells from death by drying. Br J Ophthalmol. 2001: 85(5): 610-2.