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H. Heimann, R. Gochman, M. Hellmich, M.H. Foerster; Dry Eye Symptoms Following Vitreo-retinal Surgery and Ocular Tumor Therapy . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3759.
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Purpose: Dry eye symptoms can commonly be observed following vitreoretinal operations. However, little is known about the frequency and severity of these postoperative problems. Methods: Retrospective study of 192 patients (32 patients vitreoretinal surgery, 76 ruthenium106-brachytherapy, 33 proton beam radiation and 54 controls). In the treatment group, a minimum of 6 months between the last surgery and the examination was required for inclusion. Patients were interviewed using a standardized questionnaire. A slit lamp examination of the anterior segment, the tear break-up time and a Schirmer II test were performed. Results: 69% of all treated patients vs. 52% of the controls complained of dry eye symptoms (p=0.004). The tear break-up time was decreased in the treated patients (median 15s vs. 20s, p < 0.001). The Schirmer II test revealed slightly lower values in the treated group (median 12mm vs. 13mm, p=0.72). A conjunctival injection could be seen in 53.9% of treated patients vs. 40.7% (p=0.111). Most patients stated that dry eye symptoms were more severe on the operated eye compared to their fellow eye, and that they either worsened or occurred de novo after the surgery. Subgroup analysis revealed no significant differences between patients following vitreoretinal surgery, brachytherapy or proton beam radiation. Conclusion: Vitreoretinal surgery and ocular tumor therapy can cause or worsen dry eye symptoms in a large proportion of patients. This observation is not limited to the early postoperative period but can be observed months to years after surgery.
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