Research Article: Comparative study of the therapeutic effects of different medications on DM-associated dry eye syndrome after vitrectomy
Abstract:
No prior studies have compared ciclosporin (CsA) and sodium hyaluronate (SH) eye drops for treating diabetes mellitus-associated dry eye syndrome (DMDES) after vitrectomy. To evaluate their relative efficacy and inform postoperative management, we conducted a retrospective comparative cohort study of 204 patients with DMDES who underwent vitrectomy for diabetic vitreous hemorrhage. Postoperatively, 104 patients received 0.05% CsA eye drops and 100 cases received SH eye drops. Noninvasive breakup time (NIBUT), tear meniscus height (TMH), Schirmer I test (SIT), and corneal fluorescein staining score (CFSS) were assessed preoperatively and at 1 and 3?months postoperatively. Longitudinal analysis of clinical outcomes using Linear Mixed-Effects Model (LMM) (for NIBUT, TMH, and SIT) and Generalized Estimating Equations (GEE) model (for CFSS). The LMM revealed a significant group × time interaction in favor of the CsA group for NIBUT, TMH, SIT. Specifically, compared to the SH group, the CsA group was associated with greater relative improvements at 1?month for NIBUT, TMH, and SIT. Covariates including age and gender did not show significant main effects on these outcomes (all p >?0.05). The GEE model revealed significant, negative interaction terms for the CsA group at 1?month and 3?months postoperatively. A lower CFSS indicates less corneal epithelial damage, these negative coefficients suggest that the CsA group showed a decrease in corneal staining scores compared to the SH group over the follow-up period. Age and gender were not significantly associated with CFSS changes (all p >?0.05). Overall, 0.05% CsA eye drops were associated with improved tear film quality and stability after vitrectomy for DMDES, showed a trend of better relative improvement compared to SH eye drops.
Introduction:
The global population of patients with diabetes mellitus (DM) is projected to reach 643 million by 2030 ( 1 ). With the continuous increase in the number of patients with diabetes, the prevalence of diabetes-related chronic ocular diseases has also risen, including diabetic retinopathy (DR) and dry eye disease (DED). DED is an ocular surface disorder characterized by tear film instability and hyperosmolarity, leading to inflammation and damage of the ocular surface ( 2 ). Its pathogenesis involves multiple…
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