سیزدهمین همایش تحقیقات چشم پزشکی و علوم بینایی ایران

Dry Eye Signs and Ocular Surface Changes After Sleeve Gastrectomy

Seyed Hashem Daryabari¹ *, Mahmoud Hasani¹ , Seyyed Morteza Hosseini Imeni²

Baghiatollah University of Medical Sciences, Tehran, Islamic Republic of Iran
Shahid Beheshti University Of Medical Sciences

Abstract: This study aimed to assess ocular surface health in patients undergoing sleeve gastrectomy, focusing on the incidence of dry eye symptoms, ocular surface health indices, and related parameters preoperatively and at one and three months postoperatively.

Methods: Thirty-three patients (84.8% female, mean age 39.94 ± 10.70 years) were included. Preoperative medical history revealed that 6.1% had diabetes, 21.2% had hypertension, and 15.2% had prior contact lens use; none were smokers. Ocular assessments included tear break-up time (TBUT), Schirmer test scores, corneal staining, and the Ocular Surface Disease Index (OSDI).

Results: Postoperative TBUT analysis showed a significant increase in dry eye signs in the left eye, with 90.9% of patients experiencing symptoms at three months, up from 51.5% preoperatively (p < 0.001). TBUT prevalence rose from 48.5% preoperatively to 87.9% at three months (p < 0.001). Schirmer test scores followed a similar trend, with 93.9% of patients in the left eye and 90.9% in the right eye showing dry eye disease three months post-surgery, compared to 66.7% and 69.7% preoperatively, respectively.Tear meniscus height (TMH) scores did not significantly change in the left eye (p = 0.086), but did show significant changes in the right eye (p = 0.016). Corneal staining increased substantially from 24.2% pre-surgery to over 60% at three months postoperatively (p < 0.001 for both eyes). Pre-surgery, 42.4% of patients were symptom-free but developed symptoms postsurgery, while only one patient (3%) with preoperative symptoms experienced resolution. This difference was significant (p = 0.001). OSDI scores also worsened, from a mean of 1.62 preoperatively to 2.45 at three months (p < 0.001).

Conclusion: Sleeve gastrectomy is associated with a significant increase in dry eye disease and ocular surface changes over three months. These findings suggest a need for close monitoring and possible preventive measures for ocular health in patients undergoing this procedure, as notable increases in ocular discomfort and tear film instability were observed postoperatively.