Rokohl Alexander C, Trester Marc, Guo Yongwei, Adler Werner, Jaeger Viktoria K, Loreck Niklas, Mor Joel M, Pine Keith R, Heindl Ludwig M
Department of Ophthalmology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany.
Trester-Institute for Ocular Prosthetics and Artificial Eyes, Cologne, Germany.
Ocul Surf. 2020 Jul;18(3):453-459. doi: 10.1016/j.jtos.2020.05.001. Epub 2020 May 6.
To assess symptoms and signs of the dry anophthalmic socket syndrome (DASS) in a standardized manner.
87 unilateral anophthalmic patients were evaluated using the Ocular Surface Disease Index (OSDI), the 5-Item Dry Eye Questionnaire (DEQ-5), and a modified version of Symptom Assessment iN Dry Eye (SANDE) questionnaire separately for the anophthalmic socket and for the healthy fellow eye. Conjunctival inflammation was semi-quantitatively graded and Schirmer I test with topical anesthesia was performed bilaterally. The correlations between scores of the dry eye questionnaires and the results of the Schirmer tests, conjunctival inflammation, and demographic data were examined.
Patients had significantly higher OSDI, DEQ-5 and SANDE scores at the anophthalmic side compared to the healthy eye (p ≤ 0.019, respectively). 63% of patients complained of anophthalmic socket dryness in at least one of the three questionnaires. Patients had higher inflammation (p < 0.001) and more tear volume in the Schirmer I test with topical anesthesia (p ≤ 0.024) on the anophthalmic side compared to the fellow eye.
Most anophthalmic patients have significantly more subjective dryness complaints on their anophthalmic side compared to the healthy fellow eye, even in absence of tear deficiency and clinical blepharitis. Eye care practitioners should consider the diagnosis criteria and the definition for DASS proposed in this study, when counseling anophthalmic patients. However, research should be undertaken to investigate the role and the interactions of causative etiological causes for DASS. Furthermore, there is a high priority to establish a standardized examination protocol and to develop an evidence-based treatment algorithm for DASS.
以标准化方式评估干性眼球摘除术后眼窝综合征（DASS）的症状和体征。
分别使用眼表疾病指数（OSDI）、5项干眼问卷（DEQ-5）以及干眼症状评估（SANDE）问卷的修改版，对87名单侧眼球摘除患者的患侧眼窝和健侧眼进行评估。对结膜炎症进行半定量分级，并双侧进行表面麻醉下的Schirmer I试验。检查干眼问卷得分与Schirmer试验结果、结膜炎症及人口统计学数据之间的相关性。
与健侧眼相比，患者患侧眼的OSDI、DEQ-5和SANDE得分显著更高（p值分别≤0.019）。63%的患者在至少一份问卷中抱怨患侧眼窝干燥。与健侧眼相比，患者患侧眼在表面麻醉下的Schirmer I试验中炎症更重（p<0.001），泪液量更多（p≤0.024）。
与健侧眼相比，大多数眼球摘除患者患侧眼的主观干燥症状明显更多，即使不存在泪液缺乏和临床睑缘炎。眼科护理人员在为眼球摘除患者提供咨询时，应考虑本研究中提出的DASS诊断标准和定义。然而，应开展研究以调查DASS致病病因的作用和相互作用。此外，当务之急是建立标准化的检查方案，并制定基于证据的DASS治疗算法。
