Full Text:   <1783>

Summary:  <1330>

CLC number: R779.65

On-line Access: 2018-03-05

Received: 2017-02-22

Revision Accepted: 2017-05-01

Crosschecked: 2018-02-07

Cited: 0

Clicked: 3560

Citations:  Bibtex RefMan EndNote GB/T7714

 ORCID:

Yu-feng Yao

https://orcid.org/0000-0003-1494-9711

-   Go to

Article info.
Open peer comments

Journal of Zhejiang University SCIENCE B 2018 Vol.19 No.3 P.218-226

http://doi.org/10.1631/jzus.B1700095


Assessments of tear meniscus height, tear film thickness, and corneal epithelial thickness after deep anterior lamellar keratoplasty


Author(s):  Wen-jia Xie, Ye-sheng Xu, Xia Zhang, Yu-feng Yao

Affiliation(s):  Department of Ophthalmology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou 310016, China

Corresponding email(s):   yaoyf@zju.edu.cn

Key Words:  Tear meniscus height, Corneal epithelial thickness, Tear film, Deep anterior lamellar keratoplasty (DALK), High-definition optical coherence tomography (HD-OCT), Keratoconus


Wen-jia Xie, Ye-sheng Xu, Xia Zhang, Yu-feng Yao. Assessments of tear meniscus height, tear film thickness, and corneal epithelial thickness after deep anterior lamellar keratoplasty[J]. Journal of Zhejiang University Science B, 2018, 19(3): 218-226.

@article{title="Assessments of tear meniscus height, tear film thickness, and corneal epithelial thickness after deep anterior lamellar keratoplasty",
author="Wen-jia Xie, Ye-sheng Xu, Xia Zhang, Yu-feng Yao",
journal="Journal of Zhejiang University Science B",
volume="19",
number="3",
pages="218-226",
year="2018",
publisher="Zhejiang University Press & Springer",
doi="10.1631/jzus.B1700095"
}

%0 Journal Article
%T Assessments of tear meniscus height, tear film thickness, and corneal epithelial thickness after deep anterior lamellar keratoplasty
%A Wen-jia Xie
%A Ye-sheng Xu
%A Xia Zhang
%A Yu-feng Yao
%J Journal of Zhejiang University SCIENCE B
%V 19
%N 3
%P 218-226
%@ 1673-1581
%D 2018
%I Zhejiang University Press & Springer
%DOI 10.1631/jzus.B1700095

TY - JOUR
T1 - Assessments of tear meniscus height, tear film thickness, and corneal epithelial thickness after deep anterior lamellar keratoplasty
A1 - Wen-jia Xie
A1 - Ye-sheng Xu
A1 - Xia Zhang
A1 - Yu-feng Yao
J0 - Journal of Zhejiang University Science B
VL - 19
IS - 3
SP - 218
EP - 226
%@ 1673-1581
Y1 - 2018
PB - Zhejiang University Press & Springer
ER -
DOI - 10.1631/jzus.B1700095


Abstract: 
Objective: To assess the lower tear meniscus height (LTMH), central tear film thickness (CTFT), and central corneal epithelial thickness (CCET) after deep anterior lamellar keratoplasty (DALK). Methods: This was a retrospective cross-sectional study of 20 patients who had DALK in one eye over a three-month period. LTMH, CTFT, and CCET of the operated eyes and the unoperated fellow eyes were measured using high-definition optical coherence tomography (HD-OCT). Correlations between three OCT assessments and age, time following surgery, graft size, bed size, and the number of residual sutures were analyzed. Results: Compared to patients with keratoconus, patients with other corneal conditions had significantly higher CCET in the fellow eye (P=0.024). For all patients, CCET in the operated eye was significantly negatively correlated with the number of residual sutures (R=−0.579, P=0.008), and was significantly positively correlated with time following surgery (R=0.636, P=0.003). In the fellow eye, a significant positive correlation was found between age and CCET (R=0.551, P=0.012), and a significant negative correlation between age and CTFT (R=−0.491, P=0.028). LTMH was found to be significantly correlated between operated and fellow eyes (R=0.554, P=0.011). There was no significant correlation between LTMH and age, bed/graft size, time following surgery, or residual sutures (all possible correlations, P>0.05). Conclusions: Patients with keratoconus tend to have a thinner central corneal epithelium. Corneal epithelium keeps regenerating over time after DALK. DALK did not induce a significant change in tear volume compared with the fellow eye. Postoperative tear function might depend on an individual’s general condition, rather than on age, gender, bed/graft size, time following surgery, or residual sutures.

前部深板层角膜移植术后泪新月高度、泪膜厚度及角膜上皮厚度的评估

目的:评估前部深板层角膜移植(DALK)术后的下泪新月高度(LTMH)、中央泪膜厚度(CTFT)及中央角膜上皮厚度(CCET).
创新点:首次利用高清光学相干断层扫描成像技术(HD-OCT)定量测量DALK术后的CCET、CTFT和LTMH,并发现各个参数之间及与其他临床数据的相关性.
方法:回顾性横断面分析20例单眼DALK术后3月以上的患者.使用HD-OCT定量分析并比较术眼和对侧未手术眼的LTMH、CTFT和CCET.对各个OCT参数之间及与年龄、术后时间、植片直径、植床直径和残余缝线数量进行相关性分析.
结论:本研究显示,圆锥角膜患者的中央角膜上皮倾向变薄;DALK术后角膜上皮随着时间推移而持续再生;与对侧未手术眼相比,DALK并不引起显著的泪液量变化.因此,术后的泪液功能可能取决于患者的整体状况而非年龄、性别、植片/植床直径、术后时间或残余缝线.

关键词:泪新月高度;角膜上皮厚度;泪膜;前部深板层角膜移植(DALK);高清光学相干断层扫描成像技术(HD-OCT);圆锥角膜

Darkslateblue:Affiliate; Royal Blue:Author; Turquoise:Article

Reference

[1]Arriola-Villalobos P, Fernández-Vigo JI, Díaz-Valle D, et al., 2015. Assessment of lower tear meniscus measurements obtained with Keratograph and agreement with Fourier-domain optical-coherence tomography. Br J Ophthalmol, 99(8):1120-1125.

[2]Bunya VY, Fuerst NM, Pistilli M, et al., 2015. Variability of tear osmolarity in patients with dry eye. JAMA Ophthalmol, 133(6):662-667.

[3]Campbell C, 2005. The effect of tear film on higher order corrections applied to the corneal surface during wavefront-guided refractive surgery. J Refract Surg, 21(5):S519-S524.

[4]Cui XH, Hong JX, Wang F, et al., 2014. Assessment of corneal epithelial thickness in dry eye patients. Optom Vis Sci, 91(12):1446-1454.

[5]Czajkowski G, Kaluzny BJ, Laudencka A, et al., 2012. Tear meniscus measurement by spectral optical coherence tomography. Optom Vis Sci, 89(3):336-342.

[6]Darwish T, Brahma A, Efron N, et al., 2007. Subbasal nerve regeneration after penetrating keratoplasty. Cornea, 26(8):935-940.

[7]Diez-Feijóo E, Durán JA, 2015. Optical coherence tomography findings in recurrent corneal erosion syndrome. Cornea, 34(3):290-295.

[8]Francoz M, Karamoko I, Baudouin C, et al., 2011. Ocular surface epithelial thickness evaluation with spectral-domain optical coherence tomography. Invest Ophthalmol Vis Sci, 52(12):9116-9123.

[9]Hara S, Kojima T, Dogru M, et al., 2013. The impact of tear functions on visual outcome following keratoplasty in eyes with keratoconus. Graefes Arch Clin Exp Ophthalmol, 251(7):1763-1770.

[10]Hu L, Xie W, Liu J, et al., 2015. Tear menisci and corneal subbasal nerve density in patients after laser in situ keratomileusis. Eye Contact Lens, 41(1):51-57.

[11]Kanellopoulos AJ, Asimellis G, 2014. In vivo 3-dimensional corneal epithelial thickness mapping as an indicator of dry eye: preliminary clinical assessment. Am J Ophthalmol, 157(1):63-68.e2.

[12]Kung JS, Sáles CS, Manche EE, 2014. Corneal sensation and dry eye symptoms after conventional versus inverted side-cut femtosecond LASIK: a prospective randomized study. Ophthalmology, 121(12):2311-2316.

[13]Lee M, Ahn J, 2016. Effects of central corneal stromal thickness and epithelial thickness on intraocular pressure using goldmann applanation and non-contact tonometers. PLoS ONE, 11(3):e0151868.

[14]Levitt AE, Galor A, Weiss JS, et al., 2015. Chronic dry eye symptoms after LASIK: parallels and lessons to be learned from other persistent post-operative pain disorders. Mol Pain, 11(1):21.

[15]Li Y, Tan O, Brass R, et al., 2012. Corneal epithelial thickness mapping by Fourier-domain optical coherence tomography in normal and keratoconic eyes. Ophthalmology, 119(12):2425-2433.

[16]Liang Q, Liang H, Liu H, et al., 2016. Ocular surface epithelial thickness evaluation in dry eye patients: clinical correlations. J Ophthalmol, 2016:1628469.

[17]Lin X, Xu B, Sun Y, et al., 2014. Comparison of deep anterior lamellar keratoplasty and penetrating keratoplasty with respect to postoperative corneal sensitivity and tear film function. Graefes Arch Clin Exp Ophthalmol, 252(11):1779-1787.

[18]Murdoch IE, Morris SS, Cousens SN, 1998. People and eyes: statistical approaches in ophthalmology. Br J Ophthalmol, 82(8):971-973.

[19]Nichols KK, Mitchell GL, Zadnik K, 2004. The repeatability of clinical measurements of dry eye. Cornea, 23(3):272-285.

[20]Savini G, Prabhawasat P, Kojima T, et al., 2008. The challenge of dry eye diagnosis. Clin Ophthalmol, 2(1):31-55.

[21]Schmidl D, Schmetterer L, Witkowska KJ, et al., 2015. Tear film thickness after treatment with artificial tears in patients with moderate dry eye disease. Cornea, 34(4):421-426.

[22]Shimmura S, Tsubota K, 2006. Deep anterior lamellar keratoplasty. Curr Opin Ophthalmol, 17(4):349-355.

[23]Situ P, Simpson TL, 2010. Interaction of corneal nociceptive stimulation and lacrimal secretion. Invest Ophthalmol Vis Sci, 51(11):5640-5645.

[24]Tao A, Shen M, Wang J, et al., 2010. Upper and lower tear menisci after laser in situ keratomileusis. Eye Contact Lens, 36(2):81-85.

[25]Tervo T, Vannas A, Tervo K, et al., 1985. Histochemical evidence of limited reinnervation of human corneal grafts. Acta Ophthalmol (Copenh), 63(2):207-214.

[26]Trabucchi G, Brancato R, Verdi M, et al., 1994. Corneal nerve damage and regeneration after excimer laser photokeratectomy in rabbit eyes. Invest Ophthalmol Vis Sci, 35(1):229-235.

[27]Watson SL, Ramsay A, Dart JK, et al., 2004. Comparison of deep lamellar keratoplasty and penetrating keratoplasty in patients with keratoconus. Ophthalmology, 111(9):1676-1682.

[28]Werkmeister RM, Alex A, Kaya S, et al., 2013. Measurement of tear film thickness using ultrahigh-resolution optical coherence tomography. Invest Ophthalmol Vis Sci, 54(8):5578-5583.

[29]Wu SQ, Zhou P, Zhang B, et al., 2012. Long-term comparison of full-bed deep lamellar keratoplasty with penetrating keratoplasty in treating corneal leucoma caused by herpes simplex keratitis. Am J Ophthalmol, 153(2):291-299.e2.

[30]Xie W, 2016. Recent advances in laser in situ keratomileusis-associated dry eye. Clin Exp Optom, 99(2):107-112.

[31]Xie W, Zhang D, Chen J, et al., 2014. Tear menisci after laser in situ keratomileusis with mechanical microkeratome and femtosecond laser. Invest Ophthalmol Vis Sci, 55(9):5806-5812.

[32]Xu YS, Xie WJ, Yao YF, 2017. Satisfactory clinical outcome following delayed repositioning of a traumatic post-LASIK flap with dislocation and shrinkage managed by irrigation, stretching, and debridement. J Zhejiang Univ Sci-B (Biomed & Biotechnol), 18(6):539-543.

[33]Xu Z, Jiang J, Yang C, et al., 2016. Value of corneal epithelial and Bowman’s layer vertical thickness profiles generated by UHR-OCT for sub-clinical keratoconus diagnosis. Sci Rep, 6:31550.

[34]Yao YF, 2008. A novel technique for performing full-bed deep lamellar keratoplasty. Cornea, 27(Suppl 1):S19-S24.

[35]Yao YF, Zhang B, Zhou P, et al., 2002. Autologous limbal grafting combined with deep lamellar keratoplasty in unilateral eye with severe chemical or thermal burn at late stage. Ophthalmology, 109(11):2011-2017.

[36]Yokoi N, Bron AJ, Tiffany JM, et al., 2004. Relationship between tear volume and tear meniscus curvature. Arch Ophthalmol, 122(9):1265-1269.

[37]Zhang F, Deng S, Guo N, et al., 2012. Confocal comparison of corneal nerve regeneration and keratocyte reaction between FS-LASIK, OUP-SBK, and conventional LASIK. Invest Ophthalmol Vis Sci, 53(9):5536-5544.

[38]Zhang YM, Wu SQ, Yao YF, 2013. Long-term comparison of full-bed deep anterior lamellar keratoplasty and penetrating keratoplasty in treating keratoconus. J Zhejiang Univ-Sci B (Biomed & Biotechnol), 14(5):438-450.

Open peer comments: Debate/Discuss/Question/Opinion

<1>

Please provide your name, email address and a comment





Journal of Zhejiang University-SCIENCE, 38 Zheda Road, Hangzhou 310027, China
Tel: +86-571-87952783; E-mail: cjzhang@zju.edu.cn
Copyright © 2000 - 2022 Journal of Zhejiang University-SCIENCE