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[Comparison of corneal and conjunctival rose bengal staining before and after punctal occlusion]
Yumi Hirotani1, Norihiko Yokoi, Hirokatsu Tsuzuki
1Department of Ophthalmology, Kyoto Prefectural University of Medicine, 465 Kajiicho, Hirokoji-agaru, Kawaramachi-dori, Kamigyo-ku, Kyoto 602-0841, Japan.
Purpose:
In severely tear-deficient dry eye patients whose puncta had been occluded, corneal and conjunctival rose bengal (RB) staining were graded and compared to before occlusion.
Subjects And Methods:
Subjects were 17 eyes of 13 severely tear-deficient dry eye patients whose puncta had been successfully occluded (corneal fluorescein staining showed A 0 D 0 after occlusion). Corneal and conjunctival RB staining were graded 0, 1, 2 or 3, according to severity [B 1] at the cornea and at the temporal and nasal bulbar conjunctiva. The scores were then compared to those before punctal occlusion. To enable comparison of pre- and post-occlusion ocular surface concentrations of RB [B 2], post-occlusion concentration was adjusted by absorbing tears from the conjunctival sac with Schirmer's test paper until the lower meniscus height was equal to that before occlusion, as monitored by video-meniscometer. RB dye was then instilled into the patients conjunctival sac.
Results:
RB staining score at the cornea decreased significantly; in contrast, no significant improvement was found at the nasal and temporal conjunctiva (p = 0.0025, p = 0.05, p = 0.7, respectively, Wilcoxon test).
Conclusion:
In accordance with the basic interpretation of RB staining, these results imply that RB positive staining [B 3] on the conjunctival surface is caused by a factor other than aqueous deficiency.
