Features of the functional lacrimal complex in different age groups of children after keratorefractive operations

    Features of the functional lacrimal complex in different age groups of children after keratorefractive operations

    N.P. Pashtaev, I.L. Kulikova, O.V. Shlenskaya

    The Cheboksary Branch of the S. Fyodorov Eye Microsurgery Federal State Institution, Cheboksary, Russia

    Purpose

    To reveal peculiarities of the functional lacrimal complex (FLC) in different age groups of children after the keratorefractive operations (KRO).

    Material and methods

    There were examined in the study 99 patients (aged 6-17 years) during the first year after the laser FemtoLASIK in situ keratomielesis and LASIK: the first group – aged 6-9 (n=61); the second – aged 10-13 (n=28); the third group – aged 14 -17 (n=10).

    Results

    The FLC indices were comparable before operation in all patients, the FLC 1 year after the KRO averaged: time of lacrimal film rupture (TLFR) at the corneal flap edge – 6.6±1.2 sec. (pw=0.005), in the optical zone – 10.27±3.34 sec. (pw=0.028); osmolarity of lacrimal fluid (LF) – 299.11±5.6 mOsm\l (pw=0.036), the functional coefficient of a superficial tension (FCST) – 1.21±0.45×10-3 N/m (pw=0.084). A statistically significant difference between two subgroups after the KRO was in all patients after 6 months in the TLFR optical zone (pm-u=0.03) and in 6-9-year children 3 months after the KRO in osmolarity of LF (pm-u =0.049).

    Conclusions

    1. Before operation no reliable difference was revealed in FLC indices between the age groups.

    2. Restoration of a lacrimal film stability after the FemtoLASIK occurred after 6 months and 1 year after the LASIK, the index of osmolarity of lacrimal fluid in children aged 6-9 years after 3 months was statistically significant higher after the LASIK.

    3. One year after KRO all patients had a stability of lacrimal film in the optical zone and its decrease at the edge of corneal flap, tear production was restored according to the index of osmolarity of LF and FCST.

    4. Data of FLC in the period from 3 to 6 months are critical in the development of dry eye syndrome in children that has a transitory nature.

    Key words: refractive operations in children, functional lacrimal complex, dry eye syndrome.