Visual Functions’ Detailed Evaluating in Patients with Sjögren’s Syndrome before and after Intracanalicular Implants’ (Smart Plug) Insertion –⁠ (First Results)

Overview

The aim of the study was to determine exact visual functions (log MAR [minimal angle of resolution] and CS [contrast sensitivity]) and to evaluate corneal topographic maps in patients with established (by means of laboratory and biopsy examinations) Sjögren’s Syndrome, and to determine the difference in subjective symptoms before and after insertion of the intracanalicular implants as well.

Patients and methods:
Twelve eyes (1 man, 6 women) with established Sjögren’s syndrome were examined before and during two months after the insertion of the plugs. The best-corrected visual acuity (BCVA) was assessed on Landolt C rings optotypes. CS was measured on computer-controlled device (Neuroscientific Corp., U.S.A.) in 6 space-frequencies (0.74–29.55 c/deg). The corneal topographic changes (Keraton Opticon) were established by means of comparing total aberrations values before and after the intracanalicular implants’ (Smart Plugs type) insertion. The control group for visual functions assessment consisted of 10 woman (20 eyes) of similar middle age.

Results:
The BCVA on log MAR optotypes was 0.84 (0.69–0.95) before and 0.88 (0.52–1.23) after the insertion, on both occasions, it was lower than in the control group. The CS was before the insertion in all of the spatial frequencies lower, the largest differences were in the frequencies range 1.97–7.29 c/deg (p
The regularity of the corneal surface is the determining factor of visual functions in “dry eyes”. The measurement of the corneal topography is useful in differential diagnosis and helps to distinguish mild and more serious conditions of dry eye. The improvement of BCVA and CS values after insertion corresponds with patients’ subjective evaluating. The best value of the treatment is improvement of the patients’ comfort; furthermore, after insertion of the permanent plugs they feel pronounced subjective relief and lowering of the frequency of drops application.

Key words:
Sjögren’s syndrome, contrast sensitivity, intracanalicular lacrimal plugs