Influence of specialized medical devices intended for microsurgeries on the dynamic characteristics of the IOP-level, refraction and the ocular surface of ophthalmic surgeons
Authors: Kosakovskaya M. V. , Gorodnichii V. V. , Kuroedov A. V. , Kulikov A. N. , Bakunina N. A. , Basinskii A. S. , Gar’kavenko V. V. , Getmanova A. M. , Gusarevich A. A. , Zhavoronkov S. A. , Isakov I. N. , Konovalov K. A. , Korytin S. M. , Nagornova Z. M. , Pavlov V. A. , Podyanov D. A. , Rozhko Yu. I. , Seleznev A. V. , Serik A. N. 
Published: September 2022

Most ophthalmic interventions are examples of microinvasive surgery using microscopes of various modifications, which can have a negative impact on the eye condition of ophthalmic surgeons. Thus, presumably, a prolonged and repeated change in the accommodation of surgeons can contribute to a change in the dynamic refraction of the eye; separate articles began to appear describing the development of artifical dry eye syndrome (DES). It seems obvious that systematic work in the operating room and the conduct of microsurgical operations affect the organ of vision of ophthalmic surgeons.

Purpose: to determine the degree of influence of equipment intended for microsurgical ophthalmic operations on the dynamic characteristics of the level of intraocular pressure, refraction and the state of the eye surface of ophthalmic surgeons.

Materials and Methods. As part of a multicenter analytical scientific cross‑sectional study, data from 48 people (48 eyes, men – 50% and women – 50%) were analyzed. The indicators of total tear production (Schirmer test, I), as well as individual tonometry and refractive index characteristics of volunteers at the beginning and at the end of the surgical day, were studied. Individual risk factors for the development and progression of the dry eye syndrome (age, smoking, use of hormonal systemic drugs, wearing soft contact lenses), as well as instillation of artificial tears, were recorded. Additionally, all subjects completed the Ocular Surface Disease Index (OSDI) questionnaire.

Results. After the operation day, which averaged 2.8 ± 0.2 hours, the subjects (mean age – 41.9 ± 1.1 years) had a statistically significant change in the index of tear production (from 11.9 ± 0.9 to 10.8 ± 1.7 mm, p = 0.01; Z = 2.407). A significant decrease in the parameters of the Schirmer test 1 was found in the age group of surgeons under 40 years old (p = 0.018; Z = 2.353), and in persons over 40 years old, there was a tendency for a decrease in tear production parameters, which was not statistically significant (p = 0.213; Z = 1.244). There was a tendency to increase the IOP‑level in surgeons of both age groups (p = 0.314; Z = 1.006 and p = 0.632; Z = 0.407, respectively). In addition, in surgeons older than 40 years, there was a change in accommodation, expressed in an increase in myopic refraction by 0.5 diopters at the end of the surgical day (p = 0.076; Z = 1.771).

Conclusions. The use of specialized professional equipment (operating microscope) was found to have a negative effect on total tear production regardless of the presence of traditional risk factors for DES. The severity of violations depended on the age category of the subjects. The data obtained are of particular relevance in the period of development and progression of methods of surgical treatment of ophthalmic diseases and substantiate the need to develop specific preventive measures.