Effects of Panretinal Photocoagulation on the Ocular Surface and Tear Film

Abstract

Purpose : Although research indicates proliferative diabetic retinopathy (PDR) itself is associated with changes in ocular surface parameters, it is still not clear whether panretinal photocoagulation (PRP) further affects these parameters. This study evaluated the effects of PRP, a commonly used treatment for PDR, on the ocular surface and tear film parameters.

Methods : In this prospective study, PRP was performed on 44 eyes of 37 patients with PDR. Patients with previous PRP, vitreoretinal surgery, recent use of contact lens, or cataract surgery within 3 months were excluded. The following were measured before and at 1 and 3 months after PRP: Ocular Surface Disease Index (OSDI) questionnaire, tear breakup time (TBUT), corneal fluorescein staining, conjunctival lissamine green staining, and Schirmer test with anesthesia. Wilcoxon signed-rank test was performed to determine changes in tear film and ocular parameters after PRP.

Results : This study included 19 men and 18 women, with a mean age of 53.6 ± 10.3 years. TBUT decreased from a pre-PRP value of 6.9 ± 2.4 s to 5.5 ± 2.7 s after 1 month (P=0.02) which subsequently increased to 7.0 ± 2.7 s at 3-month visit (P=0.03) and which was not different from the pre-PRP value (P=0.93) (Figure 1). There were no significant changes in other ocular surface or tear film parameters after PRP.

Conclusions : In patients with PDR, PRP causes transient instability of the tear film with values returning to the baseline at 3 months. Such tear film changes can transiently worsen the preexisting dry eye disease in patients with PDR.

This is a 2021 ARVO Annual Meeting abstract.

 

Figure 1. Changes in TBUT, Corneal Fluorescein Staining, Lissamine Green Staining, and Schirmer’s Test after PRP for PDR