Turkiye Klinikleri Journal of Ophthalmology

.: ORIGINAL RESEARCH
Ocular Surface After Trabeculectomy: Association Between Bleb and Dry Eye Disease: Cross Sectional Study
Trabekülektomi Sonrası Oküler Yüzey: Bleb ve Kuru Göz Hastalığı Arasındaki İlişki: Kesitsel Çalışma
İbrahim UZARa , İhsan ÇAKIRa , Gülay YALÇINKAYA ÇAKIRa , Çiğdem ALTANa , Seren PEHLİVANOĞLUa , Tekin YAŞARa
aUniversity of Health Sciences Beyoğlu Eye Training and Research Hospital, Department of Ophthalmology İstanbul, Türkiye
Turkiye Klinikleri J Ophthalmol. 2024;33(4):210-8
doi: 10.5336/ophthal.2024-103210
Article Language: EN
Full Text
ABSTRACT
 Objective: To evaluate the frequency of dry eye disease (DED) and the relationship between the morphology of the filtering bleb and ocular surface instability in patients with functional filtering blebs. Material and Methods: Patients who had undergone trabeculectomy and had a functional filtering bleb and healthy individuals were included in the study and control groups, respectively. The bleb morphology, tear break-up time (TBUT), meibomian gland dysfunction, fluorescein corneal staining, Schirmer's test, and results of an ocular symptom questionnaire were evaluated. The coexistence of TBUT<10 seconds and superficial punctate keratitis was considered DED. Results: Thirty-seven eyes with functional filtering blebs and 40 healthy eyes were analyzed. TBUT was significantly lower (p=0.01) and the corneal staining score was significantly higher in the study group (p=0.01). Schirmer's test were similar in both groups (p=0.30). DED was more prevalent in the study group (p=0.02). The study group exhibited higher occurrences of dryness (p=0.007), feeling grittiness (p=0.005), watering and tearing (p=0.04), and itching (p=0.02). The height of bleb and microcystic structure scores were significantly higher in the DED group (p=0.03 and p<0.001, respectively). Microcystic structure in the bleb and height of bleb were positively correlated with the presence of DED (r=0.590, p=0.009 and r=0.355, p=0.03, respectively). Conclusion: DED is more common in eyes with functional filtering bleb following trabeculectomy and is associated with the height of the bleb and microcystic structure. The evaluation of the patients in terms of ocular surface and DED may be more important in eyes with these types of blebs.

Keywords: Bleb morphology; corneal staining; dry eye disease; ocular surface; trabeculectomy
ÖZET
 Amaç: Fonksiyonel filtran blebi olan hastalarda kuru göz hastalığı (KGH) sıklığını ve filtran bleb morfolojisi ile oküler yüzey instabilitesi arasındaki ilişkiyi değerlendirmek. Gereç ve Yöntemler: Trabekülektomi geçirmiş ve fonksiyonel filtran blebi olan hastalar ve sağlıklı bireyler sırasıyla çalışma grubuna ve kontrol gruplarına dâhil edildi. Bleb morfolojisi, gözyaşı kırılma zamanı (GKZ), meibomian bez disfonksiyonu, floresein kornea boyama, Schirmer testi ve oküler semptom anketinin sonuçları değerlendirildi. GKZ<10 sn ve yüzeyel punktat keratit birlikteliği KGH olarak kabul edildi. Bulgular: Fonksiyonel filtran blebi olan 37 göz ve 40 sağlıklı göz analiz edildi. GKZ çalışma grubunda anlamlı derecede düşüktü (p=0,01) ve korneal boyanma skoru anlamlı derecede yüksekti (p=0,01). Schirmer testi her iki grupta benzerdi (p=0,30). KGH çalışma grubunda daha yaygındı (p=0,02). Çalışma grubunda kuruluk (p=0,007), kumlu his (p=0,005), sulanma ve yaşarma (p=0,04) ve kaşıntı (p=0,02) daha sık görüldü. Bleb yüksekliği ve mikrokistik yapı skorları KGH grubunda anlamlı derecede yüksekti (sırasıyla p=0,03 ve p<0,001). Blebdeki mikrokistik yapı ve bleb yüksekliği KGH varlığı ile pozitif korelasyon gösterdi (sırasıyla r=0,590, p=0,009 ve r=0,355, p=0,03). Sonuç: KGH, trabekülektomi sonrası fonksiyonel filtran blebi olan gözlerde daha yaygındır ve bleb yüksekliği ve mikrokistik yapı ile ilişkilidir. Bu tip blebleri olan hastaların oküler yüzey problemleri ve KGH açısından değerlendirilmesi önemlidir.

Anahtar Kelimeler: Bleb morfolojisi; korneal boyanma; kuru göz hastalığı; oküler yüzey; trabekülektomi
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