Evaluation of the ocular surface following bariatric surgery

ABSTRACT Purpose: To identify and evaluate changes in the ocular surface in obese patients with bariatric surgery. Methods: The study included 89 randomly selected patients; 81 (91.0%) were women, 35 were preoperative, 32 were included 0-12 months after surgery, and 22 were included >12 months after surgery. All patients completed a dry eye-specific questionnaire and were evaluated by the tear ferning test, tear-film breakup time (BUT), Schirmer's test I, examination of the ocular surface by 1% rose Bengal staining, and impression cytology. Patients were questioned about compliance with nutritional supplementation. Results: The pre- and postoperative groups did not differ significantly in age (p=0.082), but did differ in body mass index (p<0.001). All test values are within the normal range and there was no statistically significant difference in ocular surface disease index score between the preoperative and postoperative periods. The mean tear-film BUT was lower than that considered normal (10 s) at each time it was tested. No statistically significant group differences were observed in Schirmer's test, BUT, rose Bengal staining, or impression cytology. A high rate of noncompliance with nutritional supplementation was observed. Conclusions: No symptoms of xerophthalmia developed in this series of bariatric surgery patients. No changes were observed in any of the specific tests used to evaluate the ocular surface up to 5 years after surgery compared with presurgery results.

摘要

研究目的：识别并评估肥胖患者接受减重代谢手术（bariatric surgery）后眼表的变化情况。

研究方法：本研究共纳入89名随机选取的受试者，其中81名（91.0%）为女性；35名为术前受试者，32名为术后0~12个月的受试者，22名为术后随访时长超过12个月的受试者。所有受试者均完成干眼特异性问卷，并接受了泪蕨试验、泪膜破裂时间（tear-film breakup time, BUT）、席默I试验（Schirmer's test I）、1%孟加拉玫瑰红（rose Bengal）染色眼表检查以及印迹细胞学检查。研究人员同时对受试者的营养补充剂依从性进行了问询。

研究结果：术前组与术后各组受试者的年龄无显著统计学差异（p=0.082），但体质量指数（body mass index, BMI）存在显著统计学差异（p<0.001）。所有检测指标均处于正常参考范围内，术前与术后阶段的眼表疾病指数评分未观察到统计学意义上的显著差异。各检测节点的平均泪膜破裂时间均低于正常参考值（10秒）。席默I试验、泪膜破裂时间、孟加拉玫瑰红染色以及印迹细胞学检查的结果在各组间均未发现统计学意义上的显著差异。同时，本研究观察到受试者对营养补充剂的依从率较低。

研究结论：本研究纳入的减重代谢手术患者未出现干眼症相关症状。与术前检测结果相比，术后最长可达5年的随访周期内，所有用于评估眼表的特异性检测指标均未观察到显著变化。