Ocular surface changes with applanation contact lens and coupling fluid use after argon laser photocoagulation in noninsulin-dependent diabetes mellitus

To describe the effect of coupling solutions used during laser photocoagulation on the ocular surface of patients with noninsulin-dependent diabetes mellitus (NIDDM). A prospective case-controlled study. Ninety-two eyes of 46 NIDDM patients with clinically significant macular edema, poor metabolic c...

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Veröffentlicht in:American journal of ophthalmology 2004-09, Vol.138 (3), p.381-388
Hauptverfasser: Dogru, Murat, Kaderli, Berkant, Gelisken, Oner, Yücel, Ali, Avci, Remzi, Goto, Eiki, Shimmura, Shigeto, Shimazaki, Jun, Tsubota, Kazuo
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container_issue 3
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container_title American journal of ophthalmology
container_volume 138
creator Dogru, Murat
Kaderli, Berkant
Gelisken, Oner
Yücel, Ali
Avci, Remzi
Goto, Eiki
Shimmura, Shigeto
Shimazaki, Jun
Tsubota, Kazuo
description To describe the effect of coupling solutions used during laser photocoagulation on the ocular surface of patients with noninsulin-dependent diabetes mellitus (NIDDM). A prospective case-controlled study. Ninety-two eyes of 46 NIDDM patients with clinically significant macular edema, poor metabolic control of diabetes, and peripheral neuropathy and 100 eyes of 50 normal control subjects were studied. The patients' eyes were assigned to argon green focal/grid laser photocoagulation using an applanation contact lens and one of the coupling fluids; 2% methocel, Thilo-Tears Gel, 1.4% sodium hyaluronate, or 0.9% simple saline. The control subjects received time-matched three-mirror contact lens fundus examinations. All subjects underwent corneal sensitivity measurements, Schirmer test, tear film breakup time, and corneal fluorescein staining before as well as 3 and 8 days after the laser procedures and contact lens examinations. Patients with corneal problems persisting after 8 days were followed longer. Diabetic eyes assigned to 2% methocel and 1.4% sodium hyaluronate had significantly lower mean corneal sensitivities and break-up time values as well as significantly higher mean fluorescein staining scores at all examination points after laser photocoagulation. All diabetic eyes with aqueous deficiency assigned to 2% methocel and 1.4% sodium hyaluronate developed delayed corneal epithelial healing. The use of viscous coupling solutions during applanation contact lens–aided laser procedures may be detrimental for the corneal epithelium in poorly controlled NIDDM patients with peripheral neuropathy and coexisting aqueous deficiency.
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Diabetic eyes assigned to 2% methocel and 1.4% sodium hyaluronate had significantly lower mean corneal sensitivities and break-up time values as well as significantly higher mean fluorescein staining scores at all examination points after laser photocoagulation. All diabetic eyes with aqueous deficiency assigned to 2% methocel and 1.4% sodium hyaluronate developed delayed corneal epithelial healing. The use of viscous coupling solutions during applanation contact lens–aided laser procedures may be detrimental for the corneal epithelium in poorly controlled NIDDM patients with peripheral neuropathy and coexisting aqueous deficiency.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>15364219</pmid><doi>10.1016/j.ajo.2004.04.008</doi><tpages>8</tpages></addata></record>
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subjects Adult
Aged
Biological and medical sciences
Case-Control Studies
Contact Lenses
Corneal Diseases - chemically induced
Corneal Diseases - metabolism
Corneal Diseases - physiopathology
Diabetes
Diabetes Mellitus, Type 2 - complications
Diabetes Mellitus, Type 2 - surgery
Diabetic neuropathy
Diabetic retinopathy
Diabetic Retinopathy - etiology
Diabetic Retinopathy - surgery
Diseases of the eye
Epithelium, Corneal - drug effects
Epithelium, Corneal - metabolism
Epithelium, Corneal - physiopathology
Female
Fluids
Fluorescein - metabolism
Fluorophotometry
Humans
Hyaluronic Acid - adverse effects
Laser Coagulation
Lasers
Macular degeneration
Macular Edema - etiology
Macular Edema - surgery
Male
Medical sciences
Metabolism
Methylcellulose - adverse effects
Middle Aged
Ophthalmic Solutions - adverse effects
Polyvinyl alcohol
Prospective Studies
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Studies
Tears - physiology
Wound Healing - drug effects
title Ocular surface changes with applanation contact lens and coupling fluid use after argon laser photocoagulation in noninsulin-dependent diabetes mellitus
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