May 2004
Volume 45, Issue 13
Free
ARVO Annual Meeting Abstract  |   May 2004
Smoking and Ocular Surface: Damage on lipid layer?
Author Affiliations & Notes
  • D. Dursun
    Ophthalmology,
    Baskent Univ Ankara, Ankara, Turkey
  • Y.A. Akova
    Ophthalmology,
    Baskent Univ Ankara, Ankara, Turkey
  • S. Akca
    Ophthalmology,
    Baskent Univ Ankara, Ankara, Turkey
  • S. Bozbeyoglu
    Ophthalmology,
    Baskent Univ Ankara, Ankara, Turkey
  • B. Bilezikci
    Pathology,
    Baskent Univ Ankara, Ankara, Turkey
  • E. Goto
    Ophthalmology, Tokyo Dental College, Tokyo, Japan
  • M. Dogru
    Ophthalmology, Tokyo Dental College, Tokyo, Japan
  • K. Tsubota
    Ophthalmology, Tokyo Dental College, Tokyo, Japan
  • Footnotes
    Commercial Relationships  D. Dursun, None; Y.A. Akova, None; S. Akca, None; S. Bozbeyoglu, None; B. Bilezikci, None; E. Goto, None; M. Dogru, None; K. Tsubota, None.
  • Footnotes
    Support  none
Investigative Ophthalmology & Visual Science May 2004, Vol.45, 97. doi:
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      D. Dursun, Y.A. Akova, S. Akca, S. Bozbeyoglu, B. Bilezikci, E. Goto, M. Dogru, K. Tsubota; Smoking and Ocular Surface: Damage on lipid layer? . Invest. Ophthalmol. Vis. Sci. 2004;45(13):97.

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      © ARVO (1962-2015); The Authors (2016-present)

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Abstract

Abstract: : Purpose: To evaluate the effects of smoking on ocular surface. Methods: Sixty patients (33 male, 27 female), who were known to be smokers, were enrolled in this prospective clinical study. The mean age of the patients was 46.9 years (range, 22–78). Patients who had associated ophthalmic diseases like meibomian gland disease, severe dry eye etc.were excluded. Three groups were formed regarding the patients’ smoking habits: Group I (n=10) included mild smokers (less than 1 pack/day), Group II (n=35) included moderate smokers (1 pack/day), Group III (n=15) included heavy smokers (more than 1 pack/day). The average duration of smoking was 13.1 years (range, 1–35 years). Ocular surface evaluation was performed in terms of central corneal and bulbar conjunctival sensitivity using Cochet–Bonnet esthesiometer, surface staining with fluorescein, break–up time (BUT) and conjunctival goblet cell density using impression cytology and Schirmer–1 tests and symptoms were scored using a questionnaire. The sensitivity values were graded between 0–60 mm. Cytology specimens were taken from the temporal and nasal conjunctiva of each eye, stained with periodic acid shift (PAS) and they were graded by using Nelson’s classification. Kinetic analysis of sequential tear interference images obtained by DR–1 was used to investigate the precorneal lipid layer spread. Results were compared with age and sex matched control group (n=10). Results: The mean Schirmer–1 value was 10.8mm/5min. (range, 8 –14). The mean BUT time was 5.3 sec. (range, 1–10 sec.). Conjunctival sensitivity was average 26.2 mm (range, 0– 45 mm.). The average central corneal sensitivity was 37.6mm (range, 5–60). The mean sum of the questionnaire score was statistically significantly different from the control group (p<0.05). Interestingly, there was not a statistically significant change in goblet cell density. 14 out of 15 heavy smokers were graded as 0 and only one patient had Grade 1 surface changes. All patients in Group I and II were graded as 0. There was no statistically significant difference between the groups considering impression cytology gradings (p> 0.05) or the Schirmer–1 values. However, lipid layer interferometry studies of the tear film of heavy smokers revealed significant lipid layer changes revealing failure of smooth lipid spread. Conclusions: Smoking causes dry eye symptoms and has deteriorating effects on lipid layer of the precorneal tear film.

Keywords: lipids • cornea: tears/tear film/dry eye • cornea: clinical science 
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