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Renata Loureiro, Rossen Hazarbassanov, Joyce Covre, Priscila Cristovam, Jeison Barros, Jose Gomes; Immunocytochemical analysis after treatment with osmoprotective and oil containing lubricants in dry eye and refractive surgery patients. Invest. Ophthalmol. Vis. Sci. 2013;54(15):1021.
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© ARVO (1962-2015); The Authors (2016-present)
To evaluate immunostaining patterns of inflammation and osmoprotection markers after treatment with osmoprotective lubricant compared to oil containing and non-osmoprotective lubricants, in evaporative dysfunctional tear syndrome (EDTS) post refractive surgery patients.
45 patients (74,28 % female)(Mean age ± SD, 32.5 ±10.35) were enrolled. Participants were randomized to receive topical drops QID for the 1st month and BID for the following 2 months of Optive®, FreshTears®, (Allergan, Inc., Irvine, California).They were divided into 2 groups, (A) 15 patients with EDTS, (B) 30 patients without EDTS who were referred to either LASIK (15) or PRK (15). In group A, 5 patients (10 eyes) were treated with either Optive®, FreshTears® or Endura®, as well as 5 patients (10 eyes) from group B/PRK and 5 patients (10 eyes) from group B/LASIK. All patients were submitted to the following tests for EDTS diagnose: Ocular Surface Disease Index (OSDI), patient symptomatology questionnaire, visual acuity (VA), biomicroscopy, Schirmer I test without anesthesia, tear film osmolarity, fluorescein break up time (FBUT), fluorescein and lissamine green 1% staining (Oxford grading), impression cytology (IC) and immunocytochemistry (ICC) for an inflammation marker (HLA-DR) and L-carnitine, osmoprotective component.
Pre-treatment and 3 month follow-up exams are completed for both groups. ICC of conjunctiva samples showed 42.86% positivity for HLA-DR staining, on group A and 20% for group B/LASIK, 30% for PRK, before treatment (p=0.4896, χ2 test). There was lower HLA-DR staining for EDTS patients treated with Optive® and Endura® (28.11% and 35.6%). ICC for L-carnitine staining was 53.33% positive for A, 22% for LASIK and10% for PRK subgroup, before treatment (p=0.041, χ2 test). L-carnitine ICC staining post-treatment showed high positivity for FreshTears® and Endura® groups, in contrast to a lower staining for Optive® subgroup.
Conjunctival cells showed tendency of higher expression of inflammation marker HLA-DR on EDTS patients, and for L-carnitine as well, which could be reduced after osmoprotective therapy. Those markers could be used to detect EDTS in early stage and as prognostic tool for EDTS treatment.
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