Ocular urface change with applanation contact len and coupling fluid ue after argon laer photocoagulation in noninulin-dependent diabete mellitu

Purpoe To decribe the effect of coupling olution ued during laer photocoagulation on the ocular urface of patient with noninulin-dependent diabete mellitu (NIDDM). Deign A propective cae-controlled tudy. Method Ninety-two eye of 46 NIDDM patient with clinically ignificant macular edema, poor metabolic control of diabete, and peripheral neuropathy and 100 eye of 50 normal control ubject were tudied. The patientʹ eye were aigned to argon green focal/grid laer photocoagulation uing an applanation contact len and one of the coupling fluid; 2% methocel, Thilo-Tear Gel, 1.4% odium hyaluronate, or 0.9% imple aline. The control ubject received time-matched three-mirror contact len fundu examination. All ubject underwent corneal enitivity meaurement, chirmer tet, tear film breakup time, and corneal fluorecein taining before a well a 3 and 8 day after the laer procedure and contact len examination. Patient with corneal problem periting after 8 day were followed longer. Reult Diabetic eye aigned to 2% methocel and 1.4% odium hyaluronate had ignificantly lower mean corneal enitivitie and break-up time value a well a ignificantly higher mean fluorecein taining core at all examination point after laer photocoagulation. All diabetic eye with aqueou deficiency aigned to 2% methocel and 1.4% odium hyaluronate developed delayed corneal epithelial healing. Concluion The ue of vicou coupling olution during applanation contact len–aided laer procedure may be detrimental for the corneal epithelium in poorly controlled NIDDM patient with peripheral neuropathy and coexiting aqueou deficiency