Dry Eye-Like Ocular Surface Dysfunction in Post-Vitreoretinal Surgery Eyes

Objective: Dry eye is associated with reduced QoL and with the relevant social and economic costs. We evaluated the prevalence of dry eye signs and symptoms in a group of patients who underwent vitreoretinal surgery for epiretinal membrane removal for at least 6 months. Method: Fourty-one consecutive patients were enrolled. Ocular surface symptoms were evaluated using a structured form and a Visual Analogue Scale (VAS). Blink completeness, Break-Up Time (BUT), fluorescein and lissamine green staining and thickness of the lower tear meniscus were also assessed. Lissamine green staining was used to evaluate the mucocutaneous junction. Results: Symptoms were present up to 1 year from surgery in 80% of population. Foreign body and burning sensations were reported by 14 (34.1%) and 11 (26.8%) patients. Blinking was incomplete in 36.8% of patients; eyelid mucocutaneous junction was abnormal in 68.3% of patients. Mild or moderate eyelid injection were reported by 29 (70.7%) and 12 (21.3%) patients; moderate and peri-keratic hyperemia were reported by 22 (53.7%) and 15 (36.6%) patients. Only 26.2% of patients showed a normal BUT (>10 s). Corneal sensitivity was absent in 4 patients (9.8%) and strongly decreased in 2 patients (7.3%). The lower tear meniscus was <0.2 mm in 21 patients (51.2%). Fluorescein staining of the cornea was positive in 56% of patients. Conclusion: Patients who underwent vitreoretinal surgery showed, in the long-term, signs and symptoms of ocular surface dysfunction (dry eye) with a frequency that is more than double the expected frequency of the disease.