Tear Measurement in Prosthetic Eye Users with Fourier-Domain Optical Coherence Tomography

PURPOSE: To investigate whether Fourier-domain (FD) optical coherence tomography (OCT) can measure the tear meniscus of anophthalmic patients using prosthetic eyes and to compare the characteristics of normal and artificial eyes. DESIGN: Prospective, nonrandomized, observational case series. METHODS: Thirty-one patients who had undergone anophthalmic surgery in 1 eye and had been wearing artificial eyes for more than 6 months were included. Subjects with socket inflammation, contracted sockets, or other known lid disorders were excluded. Patients were asked to complete a questionnaire regarding their demographic status and dry eye symptoms before treatment, and FD OCT scanning and the Schirmer test were performed. Three images were obtained by FD OCT on each normal and anophthalmic eye, and the tear meniscus height, tear meniscus depth, and tear meniscus angle were measured with computer calipers. RESULTS: FD OCT was able to visualize the tear meniscus of both normal and artificial eyes. The mean tear meniscus height of artificial eyes was significantly lower than that of normal eyes (200.59 +/- 79.68 pm vs 261.24 +/- 86.17 mu m; P < .001). Mean tear meniscus depth, tear meniscus area, and tear meniscus volume also were significantly lower in artificial eyes than in normal eyes. The dry eye symptom score showed significantly negative correlation with tear meniscus height. The Schirmer test results correlated with tear meniscus parameters in normal eyes, but not in artificial eyes. CONCLUSIONS: FD OCT is a valuable clinical tool in the evaluation of tear meniscus height in normal and artificial eyes. In addition, tear meniscus height can be a useful clinical parameter that estimates symptoms of ocular dryness and discomfort in both normal and artificial eyes. (Am J Ophthalmol 2010;149:602-607. (C) 2010 by Elsevier Inc. All rights reserved.)