The influence of some general diseases for changes on the ocular surface after trabeculectomy

Abstract

BACKGROUND: By now, possible effects of diabetes mellitus and arterial hypertension on the ocular surface changes after trabeculectomy have not been evaluated.

AIM: Analysis of the effects of arterial hypertension therapy and diabetes mellitus on the ocular surface changes after trabeculectomy.

MATERIALS AND METHODS: The study group consisted of 443 patients, including those with arterial hypertension (179 patients), non insulin dependent compensated type 2 diabetes mellitus (25 patients) and their combination (53 persons), operated in 2016–2020 in the City Multifield Hospital No. 2, Saint-Petersburg, for primary open-angle noncompensated glaucoma and then observed for 6 to 24 months. The dynamics of ocular surface disease index (OSDI), tear film break-up time (TBUT), and amount of total tear production has been studied.

RESULTS: The probability of the trabeculectomy success did not depend on the concomitant comorbidity. In contrast to intraocular pressure, the criteria for subjective and objective assessment of the ocular surface state were not subject to such obvious changes. In diabetic patients, the studied criteria have not changed compared to the baseline.

CONCLUSIONS: The mentioned systemic diseases do not influence the state of the ocular surface in patients with glaucoma, and are not an independent risk factor for the failure of the IOP-lowering surgical procedure. The presence of diabetes mellitus prevents the accompanying a successful trabeculectomy regression of symptoms and clinical and functional signs of dry eye disease.

Keywords

glaucoma / arterial hypertension / diabetes mellitus / trabeculectomy / ocular surface / dry eye disease / preservative load / ocular surface disease index / OSDI / tear film break-up time / TBUT / Norn test / Schirmer I test

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