title: Ocular surface changes after lateral rectus muscle recession.
abstract: OBJECTIVE
  To evaluate the changes in the integrated ocular surface/lacrimal gland unit after strabismus surgery.
  
  
  METHODS
  The authors prospectively studied 23 patients undergoing lateral rectus muscle recession via fornix incision. At 1 week preoperatively and 1, 2, 3, and 4 months postoperatively, McMonnies' dry eye questionnaire, corneal fluorescein staining, corneal and conjunctival sensitivity with an esthesiometer, tear film break-up time, Schirmer I test, and impression cytology were performed. Impression cytology was performed in the inferotemporal and superotemporal bulbar conjunctiva and the goblet cell density (GCD) was measured.
  
  
  RESULTS
  McMonnies' dry eye questionnaire scores increased significantly after surgery (P < .05 at 7 days and 1, 2, and 3 months) and returned to baseline at 4 months postoperatively. A temporary increase in corneal staining was observed, but it returned to baseline by 2 months. The tear film break-up time score was decreased at 1 week postoperatively and recovered slowly, but did not return to normal by 4 months. GCD in the inferotemporal area was significantly decreased until 2 months postoperatively.
  
  
  CONCLUSIONS
  Tear film instability resulted from GCD depletion and conjunctival sensitivity could be one of the causative factors of ocular irritation symptoms after strabismus surgery. The ocular surface parameters returned to baseline at 4 months postoperatively.
authors: Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
authors: Sohee
authors: S
authors: Jeon
authors: Shin Hae
authors: SH
authors: Park
authors: Jun-Sub
authors: JS
authors: Choi
authors: Sun Young
authors: SY
authors: Shin
mesh_terms: D000328:Adult; D003228:Conjunctiva / Q000166:cytology / Q000502:physiology*; D003315:Cornea / Q000166:cytology / Q000502:physiology*; D015352:Dry Eye Syndromes / Q000209:etiology; D005260:Female; D019793:Fluorescein / Q000493:pharmacokinetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009801:Oculomotor Muscles / Q000601:surgery*; D013508:Ophthalmologic Surgical Procedures / Q000009:adverse effects*; D011446:Prospective Studies; D013285:Strabismus / Q000601:surgery*; D011795:Surveys and Questionnaires; D013666:Tears / Q000502:physiology
chemical_list: D019793:Fluorescein