Sullivan Benjamin D, Palazón de la Torre Marta, Yago Ines, Duarte Raúl, Schallhorn Julie M, Nijm Lisa M, White Darrell E, Berg Michael S, Artal Pablo
Trukera Medical, Southlake, TX, USA.
Oftalmología en Murcia, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain.
Clin Ophthalmol. 2024 Aug 28;18:2419-2426. doi: 10.2147/OPTH.S484840. eCollection 2024.
To study the association between tear film hyperosmolarity and ocular light scatter in a cataract surgery population.
Contiguous, 20-second objective scatter index (OSI) scans were recorded in hyperosmolar (≥320 mOsm/L) and normal subjects (<308 mOsm/L) with cataract nuclear opacity ≥3. OSI was measured at screening, baseline and 90 days following surgery. Along with symptoms of ocular surface disease, slit-lamp examination included corneal staining (0-3), tear film breakup time (TBUT) and evaluation of meibomian gland disease (MGD). An additional cohort of hyperosmolar subjects were measured for OSI at screening, baseline, and 5, 10, 15 and 30 minutes following instillation of 0.18% sodium hyaluronate (HA).
Thirty-one eyes of 31 patients were included. There was a significant difference in post-operative OSI variation when comparing hyperosmolar (0.65±0.30, N=11) to normal subjects (0.33±0.11, N=10, p=0.005). Of note, there were no significant differences in OSI variation when subjects were sorted by staining (p=0.9), TBUT (p=0.7), symptoms (p=0.7), or MGD status (p=0.9). Instillation of 0.18% HA (N=10) did not alter OSI at 5 minutes, but significant reductions in OSI of 28.8%, 38.5% and 36.7% (all p < 0.001) were observed at 10, 15 and 30 minutes.
Hyperosmolar patients exhibited significantly increased variation in light scatter following cataract surgery that was undifferentiated by staining or TBUT. Elevated osmolarity may be indicative of light scatter equivalent to that of a grade 2-3 cataract.
研究白内障手术人群中泪膜高渗与眼内光散射之间的关联。
对白内障核混浊程度≥3级的高渗（≥320毫摩尔/升）和正常受试者（<308毫摩尔/升）进行连续20秒的客观散射指数（OSI）扫描记录。在筛查、基线及术后90天时测量OSI。除眼表疾病症状外，裂隙灯检查包括角膜染色（0 - 3级）、泪膜破裂时间（TBUT）及睑板腺疾病（MGD）评估。另一组高渗受试者在滴入0.18%透明质酸钠（HA）后，于筛查、基线及5、10、15和30分钟时测量OSI。
纳入31例患者的31只眼。比较高渗组（0.65±0.30，N = 11）与正常受试者（0.33±0.11，N = 10，p = 0.005）时，术后OSI变化存在显著差异。值得注意的是，按染色情况（p = 0.9）、TBUT（p = 0.7）、症状（p = 0.7）或MGD状态（p = 0.9）对受试者进行分类时，OSI变化无显著差异。滴入0.18% HA（N = 10）后5分钟时OSI未改变，但在10、15和30分钟时观察到OSI显著降低，分别为28.8%、38.5%和36.7%（均p < 0.001）。
高渗患者在白内障手术后光散射变化显著增加，且不受染色或TBUT的影响。渗透压升高可能表明光散射程度相当于2 - 3级白内障。
