1
|
Caruso C, D'Andrea L, Rinaldi M, Senese I, Piscopo R, Costagliola C. Modified Sodium hyaluronate conjugated to riboflavin (Har® 0.1 %) as lubricant eyedrops in the treatment of dry eye: A prospective randomised study. Heliyon 2024; 10:e35527. [PMID: 39170271 PMCID: PMC11336708 DOI: 10.1016/j.heliyon.2024.e35527] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 07/30/2024] [Accepted: 07/30/2024] [Indexed: 08/23/2024] Open
Abstract
Background This study evaluates the therapeutic efficacy of HAr® (a novel ophthalmic solution containing modified hyaluronic acid covalently linked to riboflavin) compared to hyaluronic acid eye drops in patients with dry eye disease (DED). Methods Sixteen consecutive patients with bilateral medium to severe DED were divided into two groups. Group 1 received HAr® 0.1 % (Ribohyal®), while Group 2 received HA 0.1 % eye drops. Parameters such as Ocular Surface Disease Index (OSDI) score, osmolarity, break-up time (BUT), non-invasive BUT (NIBUT), tear meniscus measurement, Schirmer test, and Oxford Staining were evaluated. This study has been successfully registered on ClinicalTrials.gov public (Identifier NCT06122428). Results The Ribohyal group showed faster improvement in OSDI scores, with a statistically significant difference at 2 h (mean classification difference: -51.75; p = 0.0003). Photophobia significantly reduced at 2 h, 4 weeks, and 8 weeks in the Ribohyal group compared to baseline (p < 0.0001). Osmolarity improved significantly after 8 weeks in both groups (p < 0.0001). Conclusions HAr® 0.1 % (Ribohyal®) effectively reduced DED symptoms and improved photophobia within 2 h of instillation, lasting up to 8 weeks.
Collapse
Affiliation(s)
- Ciro Caruso
- Corneal Transplant Center, Pellegrini Hospital, Naples, Italy
| | - Luca D'Andrea
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Department of Public Health, Naples, Italy
| | - Michele Rinaldi
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Naples, Italy
| | - Ivana Senese
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Naples, Italy
| | - Raffaele Piscopo
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Naples, Italy
| | - Ciro Costagliola
- Department of Neurosciences, Reproductive Sciences and Odontostomatology, University of Naples “Federico II”, Naples, Italy
| |
Collapse
|
2
|
Ahmadi H, Tahmasbian S, Janbazi M, Amiri A, Heidari Z. Evaluation of cyclosporine 0.05% and artificial tears for the management of dry eye disease following cataract surgery: a randomized controlled trial. Ann Med Surg (Lond) 2024; 86:1983-1988. [PMID: 38576912 PMCID: PMC10990346 DOI: 10.1097/ms9.0000000000001795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Accepted: 01/23/2024] [Indexed: 04/06/2024] Open
Abstract
Purpose To compare the effects of cyclosporine 0.05% and artificial tears on dry eye disease following cataract surgery. Methods This prospective, double-masked, randomized clinical trial enroled 60 eyes of 60 eligible cataract patients who completed the study. Patients were randomized to receive either cyclosporine 0.05% or artificial tear four times daily for 1 month following cataract surgery. Clinical assessments included refraction, corrected distance visual acuity, tear break-up time (TBUT), Schirmer's test, and the visual analogue scale (VAS). An independent sample t-test was used to compare the means of the variables between the two groups. Results Mean patient age was 64.15±9.17 (range, 45-90), of which 53% (n=32) were female. There was no significant difference in mean age (P=0.308) between the two groups. One month postoperatively, the cyclosporine 0.05% group had a significantly higher TBUT value (P=0.004). Schirmer's result (P=0.095) and the VAS questionnaire scores (P=0.374) did not show a statistically significant difference between the two groups. There was no significant difference in the visual outcomes (P>0.05). Conclusion Cyclosporine 0.05% was superior to artificial tears in improving tear stability after cataract surgery in the management of immediate postoperative dry eye. It may provide a more effective therapeutic option for the management of dry eye symptoms in the clinical setting.
Collapse
Affiliation(s)
- Hanieh Ahmadi
- Department of Ophthalmology, Bu-Ali Sina Hospital, Faculty of Medicine
| | - Saeed Tahmasbian
- Department of Ophthalmology, Bu-Ali Sina Hospital, Faculty of Medicine
| | - Maryam Janbazi
- Department of veterinary medicine, Babol branch Islamic Azad University, Babol, Iran
| | - Arvin Amiri
- Department of veterinary medicine, Babol branch Islamic Azad University, Babol, Iran
| | - Zahra Heidari
- Department of Ophthalmology, Bu-Ali Sina Hospital, Faculty of Medicine
- Psychiatry and Behavioral Sciences Research Center, Mazandaran University of Medical Sciences, Sari, Iran
| |
Collapse
|
3
|
Chen D, Xu D, Wu X, Wang J, Sheng S, Yu X, Lin X, Liu L, Ge X, Zhao H, Xu W. The efficacy of bandage contact lens in relieving the aggravation of dry eye disease after complicated cataract or/and IOL surgery. BMC Ophthalmol 2024; 24:141. [PMID: 38549070 PMCID: PMC10976755 DOI: 10.1186/s12886-024-03385-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 03/07/2024] [Indexed: 04/01/2024] Open
Abstract
PURPOSE In the present study, we aimed to evaluate the efficacy of the bandage contact lens (BCLs) in the treatment of dry eye disease (DED) after complicated cataract or/and intraocular lens (IOL) surgery. METHODS In this retrospective, single-centered, observational study, we collected data from 69 patients who underwent complicated cataract or/and IOL surgery. Of these, 35 cases wore their own BCLs immediately after the operation, while the other 34 cases did not have their own BCLs and were instead covered with gauze. The Ocular Surface Disease Index (OSDI) questionnaire, slit-lamp microscope examination, keratograph analysis, and Schirmer I test were measured at baseline, 1 week and 1 month postoperatively. RESULTS In the BCL group, the score of the OSDI questionnaire was significantly decreased at 1 week and 1 month postoperatively compared with baseline levels (P = 0.000, collectively). Moreover, the fluorescein staining score of the BCL group was remarkably decreased 1-week and 1-month postoperatively compared with the non-BCL group (P = 0.000 and P = 0.000, respectively). Furthermore, the redness score of the BCL group was also better compared with the non-BCL group at 1 week and 1 month postoperatively (P = 0.014 and P = 0.004, respectively). CONCLUSIONS Complicated cataract or/and IOL surgery would intensify the DED. Early application of BCLs postoperatively improved patients' comfort and alleviated dry eye-related symptoms and signs. Furthermore, this mechanism might involve the acceleration of corneal epithelial healing, the alleviation of ocular stress response and the stabilization of the tear film. TRIAL REGISTRATION Trial registration ClinicalTrials, NCT04120389. Registered 10 October 2019-retrospectively registered.
Collapse
Affiliation(s)
- Dan Chen
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Dejian Xu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
- Lemolight Ophthalmology Hospital, Hangzhou, Zhejiang, China
| | - Xingdi Wu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Jingwen Wang
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Siting Sheng
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Xuewen Yu
- Department of Ophthalmology, The First People's Hospital of Xiaoshan District, Xiaoshan Affiliated Hospital of Wenzhou Medical University, Hangzhou, Zhejiang, China
| | - Xueqi Lin
- Department of Ophthalmology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Lirui Liu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Xian Ge
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
- Jianyang Eye Hospital of Jianhu County, Jiangsu, China
| | - Huiling Zhao
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China
| | - Wen Xu
- Eye Center, The Second Affiliated Hospital, School of Medicine, Zhejiang Provincial Key Laboratory of Ophthalmology, Zhejiang Provincial Clinical Research Center for Eye Diseases, Zhejiang University, Zhejiang Provincial Engineering Institute on Eye Diseases, Hangzhou, Zhejiang, China.
| |
Collapse
|
4
|
Sarnicola E, Sarnicola C, De Bernardo M, Rosa N, Sarnicola V. Cataract surgery in setting of ocular surface disease. Curr Opin Ophthalmol 2024; 35:155-162. [PMID: 38018802 DOI: 10.1097/icu.0000000000001024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
PURPOSE OF REVIEW The purpose of this article is to review the available strategies to successfully identify and manage ocular surface disease (OSD) pre, intra and post-cataract surgery. RECENT FINDINGS Cataract surgery and OSD have an intricate relationship: the surgical procedure can induce or exaggerate OSD symptoms, while OSD can negatively impact surgical refractive outcomes and increase the rate of postoperative complications. SUMMARY Improving the health and stability ocular surface is the key to enhance post cataract surgery refractive outcomes and avoid complications. This is pivotal for patients affected by severe OSD, but is also important for patients with minimal signs or symptoms. A correct diagnosis and a stepwise approach are the keys to improve the quality of life of such patients.
Collapse
Affiliation(s)
- Enrica Sarnicola
- Ambulatorio di Chirurgia Oculare Santa Lucia
- Clinica degli Occhi Sarnicola, Grosseto
- Università degli Studi di Salerno, Salerno
| | - Caterina Sarnicola
- Clinica degli Occhi Sarnicola, Grosseto
- Ophthalmology department, Ospedale San Donato AUSL Toscana Sud-Est, Arezzo, Italy
| | | | | | - Vincenzo Sarnicola
- Ambulatorio di Chirurgia Oculare Santa Lucia
- Clinica degli Occhi Sarnicola, Grosseto
| |
Collapse
|
5
|
Jensen P, Nilsen C, Gundersen M, Gundersen KG, Potvin R, Gazerani P, Chen X, Utheim TP, Utheim ØA. A Preservative-Free Approach - Effects on Dry Eye Signs and Symptoms After Cataract Surgery. Clin Ophthalmol 2024; 18:591-604. [PMID: 38435373 PMCID: PMC10906276 DOI: 10.2147/opth.s446804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 02/15/2024] [Indexed: 03/05/2024] Open
Abstract
Purpose To compare the effect of treatment with preservative-free dexamethasone, NSAIDs and trehalose/hyaluronic acid eye drops with the preservative benzalkonium chloride containing dexamethasone and NSAIDs after cataract surgery in dry versus non-dry eyes. Patients and Methods In this prospective randomized intervention study, dry eye tests were performed before and 6 weeks after cataract surgery. Patients were considered as having dry eye, SDE (sign of dry eye), if at least one of the following dry eye tests were abnormal; corneal fluorescein staining (CFS), non-invasive keratograph breakup time (NIKBUT) or tear osmolarity. Patients with SDE were randomly assigned to one of two groups. Group 1 patients were treated with dexamethasone and bromfenac eye drops with the preservative benzalkonium chloride (BAC). Group 2 patients were treated with preservative-free dexamethasone and preservative-free diclofenac, as well as a preservative-free lubricant with trehalose and hyaluronic acid both before and after surgery. Patients with normal tear film status acted as the control group (group 3) and received same treatment as group 1. Results A total of 215 patients were enrolled six weeks after surgery, the number of patients with SDE decreased significantly in groups 1 and 2 (p <0.001). Subjective symptoms and objective measures including osmolarity, NIKBUT, CFS, and tear film thickness (TFT) improved after surgery, tear production remained unchanged, while corneal sensitivity and meibomian gland dysfunction (MGD) parameters worsened. In the control group with normal tear-film status, SDE increased significantly after the surgery (p <0.001). There were no statistically significant differences in tear film parameters between the three groups after surgery. Conclusion After cataract surgery, patients with mild to moderate dry eyes may experience improved tear film status and reduced symptoms. However, we found no additional beneficial effect on dry eye parameters with treatment with preservative-free dexamethasone, NSAIDs, and lubricants compared to preservative-containing eye drops.
Collapse
Affiliation(s)
| | | | | | | | | | - Parisa Gazerani
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Xiangjun Chen
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway
- Department of Ophthalmology, Vestre Viken Hospital Trust, Drammen, Norway
| | - Tor P Utheim
- Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- Department of Ophthalmology, Sørlandet Hospital Arendal, Arendal, Norway
- Department of Ophthalmology, Vestre Viken Hospital Trust, Drammen, Norway
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
- The Norwegian Dry Eye Clinic, Oslo, Norway
| | - Øygunn A Utheim
- Department of Medical Biochemistry, Oslo University Hospital, Oslo, Norway
- Department of Ophthalmology, Oslo University Hospital, Oslo, Norway
- The Norwegian Dry Eye Clinic, Oslo, Norway
| |
Collapse
|
6
|
Carlo C, Poddi M, Mocini S, Boni N, Damiani F, Battini MA, Mirabella G, Tataranno M. Clinical evaluation of tear substitute utility after anti-VEGF intravitreal injection. Eur J Ophthalmol 2024:11206721241234427. [PMID: 38389327 DOI: 10.1177/11206721241234427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024]
Abstract
PURPOSE The purpose of this study is to evaluate the role of a polyethylene glycol 400 - propylene glycol - hydroxypropyl guar - hyaluronic acid eye drops in relieving the symptoms of dry eye syndrome after anti-VEGF intravitreal injection. METHODS In this randomized, parallel-group study, patients were randomized to receive standard therapy alone or study eye drops plus standard therapy. Patients enrolled were older than 50 with exudative age-related macular degeneration, who have never had intravitreal injections, and without severe dry eye condition or severe ocular or systemic conditions. Patients had baseline preoperative evaluation (V0), and successively after 15 (V1) and 30 (V2) days. At VO and V1 T-BUT, Schirmer's test, fluorescein staining, DEQ5 and OSDI questionnaires were performed and at V2 (30) the OSDI questionnaire was administered. RESULTS 80 patients were included in the study, of them 40 received standard therapy plus study eye drops. DEQ5 questionnaire showed an increase in the control group between the values at V0 and V1, while in the study group a decrease was observed. No changes in T-BUT, Schirmer, and fluorescein staining values between V0 and V1 were observed in both groups. OSDI data in the control group showed no statistically significant differences, while in the study group they showed a statistically significant difference. CONCLUSIONS In our study patients undergoing for the first time intravitreal treatment presented dry eye symptoms in the postoperative period: in this group of patients the use of a tears substitute reduces postoperative ocular discomfort.
Collapse
Affiliation(s)
- Cagini Carlo
- Department of Medicine and Surgery, Ophthalmology Section, University of Perugia, Perugia, Italy
| | - Maria Poddi
- Department of Medicine and Surgery, Ophthalmology Section, University of Perugia, Perugia, Italy
| | - Stefano Mocini
- Department of Medicine and Surgery, Ophthalmology Section, University of Perugia, Perugia, Italy
| | - Niccolò Boni
- Department of Medicine and Surgery, Ophthalmology Section, University of Perugia, Perugia, Italy
| | - Francesco Damiani
- Department of Medicine and Surgery, Ophthalmology Section, University of Perugia, Perugia, Italy
| | - Michele Apponi Battini
- Department of Medicine and Surgery, Ophthalmology Section, University of Perugia, Perugia, Italy
| | - Giuseppe Mirabella
- Department of Medicine and Surgery, Ophthalmology Section, University of Perugia, Perugia, Italy
| | - Mario Tataranno
- Department of Medicine and Surgery, Ophthalmology Section, University of Perugia, Perugia, Italy
| |
Collapse
|
7
|
Zhao T, Jiang X, Hao R, Ding Y, Jing D, Li X. Efficacy of 2% Hydroxypropyl Methylcellulose and Bandage Contact Lens for the Management of Dry Eye Disease after Cataract Surgery. J Ophthalmol 2024; 2024:8415425. [PMID: 38333732 PMCID: PMC10853018 DOI: 10.1155/2024/8415425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 07/28/2023] [Accepted: 01/18/2024] [Indexed: 02/10/2024] Open
Abstract
Objectives To investigate the effect of 2% hydroxypropyl methylcellulose (HPMC) and bandage contact lens (BCL) on dry eye disease after cataract surgery. Methods This prospective randomized controlled trial included 63 eyes which were divided into the balanced salt solution (BSS), HPMC, BCL, and combined HPMC and BCL (H&B) groups. The Ocular Surface Disease Index (OSDI), tear meniscus height (TMH), and average tear break-up time were measured before cataract surgery and 30 days postoperatively. Differences in corneal nerve fiber (CNF) and dendritic cell (DC) density in various directions were evaluated and compared. The CNFs and DCs in central and infratemporal directions were observed using in vivo confocal microscopy. Data were evaluated using the Kruskal-Wallis rank-sum test and analysis of variance. Results The differences in variations in OSDI and TMH after cataract surgery between the four groups were statistically significant (P < 0.05). The postoperative OSDI of the HPMC group decreased compared with their preoperative OSDI. A statistically significant difference in the variations of OSDI score was observed between the HPMC and other groups (P < 0.05). The postoperative variations in TMH in the HPMC group were significantly higher than those observed preoperatively and significantly differed between HPMC and BCL groups and between BCL and H&B groups (P < 0.05). Postoperatively, the density of corneal DCs decreased in BSS and HPMC groups and increased in BCL and H&B groups (P < 0.001). Conclusions The application of 2% HPMC in cataract surgery has a certain effect on managing dry eye after cataract surgery. Although the use of BCLs after cataract surgery has some benefits, it may cause mild ocular surface inflammation. Nevertheless, using 2% HPMC with BCLs in the perioperative phase of cataract surgery can alleviate the subjective discomfort of patients and can safely and effectively replace eye patch after cataract surgery.
Collapse
Affiliation(s)
- Tianyao Zhao
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Xiaodan Jiang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Ran Hao
- Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing, China
| | - Yi Ding
- Medical Oncology College, Beijing Shijitan Hospital, Capital Medical University, Beijing, China
| | - Dalan Jing
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Xuemin Li
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| |
Collapse
|
8
|
Wu C, Chen Q, Zhang G. Application of three-dimensional visualization technology in phacoemulsification benefits the dry eye symptoms of patients after cataract surgery. Front Med (Lausanne) 2024; 10:1247904. [PMID: 38293303 PMCID: PMC10824889 DOI: 10.3389/fmed.2023.1247904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 12/28/2023] [Indexed: 02/01/2024] Open
Abstract
Purpose To investigate the effects of the three-dimension visualization system on dry eye in patients after cataract phacoemulsification. Methods Seventy-one patients (104 eyes) were enrolled in this study and assigned to the conventional microscopic group (CM group) or three-dimension group (3D group). Ocular Surface Disease Index, The Schirmer I test (SIt), lipid layer thickness (LLT), noninvasive tear breakup time (NIBUT) and other factors associated with dry eye were recorded before and 1 week and 1 month after surgery. The operation time and intraoperative light intensity (ILI) were also recorded. Results The ILI in the 3D group was significantly lower than that in the CM group (33% vs. 60%, p < 0.01). There was an interaction (group and time) effect for first NIBUT (NIBUT-F), average NIBUT (NIBUT-Ave), tear meniscus height (TMH) and the score of eye redness (Pinteraction < 0.05). The main effects of group on SIt, LLT, NIBUT-F, NIBUT-Ave and the score of eye redness were significant (Pgroup < 0.05). In the CM group, SIt, LLT, NIBUT-F, NIBUT-Ave, TMH were lower than those of the 3D group, the score of eye redness was higher than that of the 3D group at 1 week and 1 month after surgery (all p < 0.05). The changes in NIBUT-F and NIBUT-Ave between before surgery and 1 week after surgery showed negative correlations with ILI (p < 0.01). Conclusion Compared with microscopic surgery, the 3D visualization system can provide better tear film stability for patients after cataract surgery.
Collapse
Affiliation(s)
- Chen Wu
- Xiamen Eye Center Affiliated to Xiamen University, Xiamen, China
- Aier School of Ophthalmology, Central South University, Changsha, China
| | - Qingzhong Chen
- Xiamen Eye Center Affiliated to Xiamen University, Xiamen, China
| | - Guangbin Zhang
- Xiamen Eye Center Affiliated to Xiamen University, Xiamen, China
| |
Collapse
|
9
|
Lee SH, Chun YS, Kim KW. Ocular surface parameter changes in the untreated fellow eye after unilateral cataract surgery with short-term administration of anti-inflammatory eye drops. Sci Rep 2024; 14:1080. [PMID: 38212520 PMCID: PMC10784480 DOI: 10.1038/s41598-024-51764-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 01/09/2024] [Indexed: 01/13/2024] Open
Abstract
This study aimed to investigate the changes in clinical parameters of dry eye disease and meibomian gland dysfunction in both the operated and untreated fellow eyes of patients who underwent unilateral cataract surgery with the short-term administration of anti-inflammatory eye drops in the surgical eye. The medical charts of 57 consecutive patients who underwent unilateral cataract surgery and received 1% prednisolone acetate and non-steroidal anti-inflammatory drug (NSAID, 0.1% bromfenac sodium) eye drops were reviewed. The preoperative ocular surface disease index questionnaire score (38.9 ± 20.5) decreased significantly to 15.2 ± 16.4 at post-surgical 1 week and further to 12.8 ± 11.4 after 1 month. Although meibum quality grade increased and corneal sensitivity decreased at 1 week in operated eyes, corneal erosion scores and Sjogren's International Collaborative Clinical Alliance ocular staining scores even improved over a month in the untreated fellow eyes. The tear matrix metalloproteinase (MMP)-9 grade decreased in both operated eyes and untreated fellow eyes after 1 month from surgery. In conclusion, the short-term topical anti-inflammatory treatment using steroid and NSAID eye drops in the operated eye after cataract surgery decreased subjective ocular surface discomfort and improved ocular surface staining scores and tear MMP-9 expression in the untreated fellow eyes.
Collapse
Affiliation(s)
- Seung Hyeun Lee
- Department of Ophthalmology, Chung-Ang University College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea
| | - Yeoun Sook Chun
- Department of Ophthalmology, Chung-Ang University College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea
| | - Kyoung Woo Kim
- Department of Ophthalmology, Chung-Ang University College of Medicine, Chung-Ang University Hospital, 102 Heukseok-ro, Dongjak-gu, Seoul, 06973, Republic of Korea.
| |
Collapse
|
10
|
Hwang GE, Lee ES, Kim HD. Influence of Vitreoretinal Surgery on Ocular Surface Dynamics Using Keratograph 5M. KOREAN JOURNAL OF OPHTHALMOLOGY 2023; 37:417-428. [PMID: 37670615 PMCID: PMC10587454 DOI: 10.3341/kjo.2023.0061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Revised: 07/25/2023] [Accepted: 09/05/2023] [Indexed: 09/07/2023] Open
Abstract
PURPOSE To evaluate changes of ocular surface dynamics using Keratograph 5M for 3 months after vitreoretinal surgery. METHODS Eighty-three patients were divided into three groups: phacoemulsification group, vitrectomy group, and combined group. Keratograph 5M was performed for all patients at 1 week, 1 month, and 3 months after the surgery. Ocular surface dynamics parameters measured by Keratograph 5M, including noninvasive keratograph first tear film breakup time (NifBUT), noninvasive keratograph average tear film breakup time (NiaBUT), and tear meniscus height (TMH) were compared among the three groups over time. RESULTS The mean age of all patients (46 men and 37 women) was 62.2 ± 8.4 years. NifBUT and NiaBUT were significantly decreased at 1 week after surgery compared to those at baseline in all three groups (all p < 0.001). NifBUT and NiaBUT in the phacoemulsification group almost recovered to the preoperative level, while those in the vitrectomy group and the combined group were still significantly less than those at baseline. NifBUT and NiaBUT in the phacoemulsification group were significantly longer than those in the vitrectomy group and the combined group at 3 months. After 1 week, TMHs were significantly higher in the vitrectomy group (p = 0.001) and the combined group (p = 0.022) than in the phacoemulsification group, while TMHs were significantly less in the vitrectomy group (p = 0.010) and the combined group (p < 0.001) than in the phacoemulsification group at 3 months after surgery. CONCLUSIONS These results suggest that vitreoretinal surgery could induce alteration of ocular surface dynamics for 3 months. The vitrectomy group and the combined group showed tear film instability compared to the cataract surgery alone group. Patients who underwent vitreoretinal surgery experienced more severe dry eye syndrome symptoms than those who underwent cataract surgery. Thus, managing dry eye syndrome after vitreoretinal surgery should be considered important for patients.
Collapse
Affiliation(s)
- Gyu Eun Hwang
- Department of Ophthalmology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan,
Korea
| | - Eung Suk Lee
- Department of Ophthalmology, Ain Hospital, Ain Medical Foundation, Incheon,
Korea
| | - Hoon Dong Kim
- Department of Ophthalmology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan,
Korea
| |
Collapse
|
11
|
Kim AY, Moon JY, Jun RM, Kim HJ, Han KE. Ocular Surface and Tear Cytokine Changes after Cataract Surgery in Patients with Type 2 Diabetes. Ocul Immunol Inflamm 2023; 31:1615-1622. [PMID: 35787222 DOI: 10.1080/09273948.2022.2088565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 06/06/2022] [Indexed: 10/17/2022]
Abstract
PURPOSE To evaluate changes in ocular surface indices and tear cytokines after cataract surgery in type 2 diabetic patients. METHODS Ocular surface indices and concentrations of tear cytokines (MCP-1, IL-6, IL-8, and VEGF) were evaluated at baseline and one week and one month postoperatively. RESULTS Patients (30 diabetic and 30 control) were enrolled. In the diabetic group, changes in ocular symptom and tear breakup time remained until one month postoperatively (P < .05, respectively); in the control group, ocular symptom increased at one week postoperatively (P = .015). MCP-1 level in the diabetic group significantly increased postoperatively (all P < .05); however, in the control group, the IL-8 level was significantly decreased postoperatively (all P < .05). MCP-1 concentration was negatively correlated with TBUT in the diabetic group. CONCLUSION Diabetic patients can experience more prominent changes after surgery and these changes were accompanied by an increase of several tear cytokines.
Collapse
Affiliation(s)
- Ah Young Kim
- Department of Ophthalmology, Ewha Womans Univsersity, Seoul Hospital, Seoul, South Korea
| | - Ji Young Moon
- Department of Ophthalmology, Ewha Womans Univsersity, Mokdong Hospital, Seoul, South Korea
| | - Roo Min Jun
- Department of Ophthalmology, Ewha Womans Univsersity, Seoul Hospital, Seoul, South Korea
| | - Hyun Jin Kim
- Department of Ophthalmology, Ewha Womans Univsersity, Mokdong Hospital, Seoul, South Korea
| | - Kyung Eun Han
- Department of Ophthalmology, Ewha Womans Univsersity, Mokdong Hospital, Seoul, South Korea
| |
Collapse
|
12
|
Guo R, Jiang J, Zhang Y, Liang Q, Liu J, Hu K. The effects of chalazion and the excision surgery on the ocular surface. Heliyon 2023; 9:e19971. [PMID: 37809549 PMCID: PMC10559556 DOI: 10.1016/j.heliyon.2023.e19971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 07/16/2023] [Accepted: 09/07/2023] [Indexed: 10/10/2023] Open
Abstract
Purpose To evaluate the effects of chalazion excision on the ocular surface, taking into account the subjective symptoms and the objective parameters of the tear film. Methods This prospective, interventional clinical study included 52 eyes from 26 patients with eyelid chalazion who underwent excision of the lesions between March and August 2022. Chalazion excision was performed on the patient's chalazion eye, and the contralateral eye served as the control. The following parameters were investigated both preoperatively and 1 week, 1 month, and 3 months postoperatively: the Ocular Surface Disease Index (OSDI), Schirmer I test, corneal fluorescein stain (CFS), tear meniscus height (TMH), noninvasive first breakup time (NifBUT), noninvasive average breakup time (NiaBUT), bulbar conjunctival redness score, the thickness of the lipid layer, and meibomian gland loss. Results Before surgery, the OSDI score of the chalazion eye was significantly higher than the contralateral eye. The bulbar conjunctival redness score (p = 0.043) and the OSDI score (p = 0.004) improved significantly in the first month after surgery. In the third month after surgery, the objective parameters showed significant improvements, including TMH (p = 0.032), NiaBUT (p = 0.028), bulbar conjunctival redness score (p < 0.001), the thickness of the lipid layer (p = 0.021), and meibomian gland loss (p = 0.005). Conclusions Our study revealed that chalazion excision can significantly improve the subjective symptoms and the objective tear film parameters of the ocular surface.
Collapse
Affiliation(s)
- Rongjie Guo
- Department of Ophthalmology, The Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jiaxuan Jiang
- Department of Ophthalmology, The Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Yanan Zhang
- Department of Ophthalmology, The Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Qi Liang
- Department of Ophthalmology, The Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Jiao Liu
- Department of Ophthalmology, The Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| | - Kai Hu
- Department of Ophthalmology, The Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
| |
Collapse
|
13
|
Maehara H, Norikawa K, Tanaka K, Kato Y, Kasai A, Omori T, Machida T, Sekine H, Sekiryu T. Tear fluid and complement activation products in tears after ocular surgery. BMC Ophthalmol 2023; 23:329. [PMID: 37464366 DOI: 10.1186/s12886-023-03037-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 06/11/2023] [Indexed: 07/20/2023] Open
Abstract
PURPOSE Due to technological advancements, surgical invasiveness has been reduced. However, cataract surgery has been implicated in causing postoperative inflammation, including dry eye syndrome. The innate immune system may be involved in postoperative inflammation, and complement activation could potentially play a crucial role in defense against pathogens, homeostasis, and wound healing. To investigate changes in the tear film complement activation products (CAPs) and ocular surface after vitrectomy combined with cataract surgery. METHODS Forty-three patients (23 women; median age, 69 years) were enrolled in this prospective study and underwent phacoemulsification and vitrectomy. We measured Schirmer's test (ST) and CAPs in the tears at baseline (the day before surgery), 4 days and 1 month after the surgery. Tears were collected in microtubes. The CAPs in the tear fluid were analyzed by cytometric bead array. RESULTS The median ST (8.5 mm) at baseline increased to 16 mm at 4 days ( P < 0.001) and 10 mm at 1 month (P = 0.44). The C3a levels (1202 pg/ml) at baseline increased to 2753 pg/ml at 4 days (P < 0.001), and 1763 pg/ml at 1 month (P = 0.049). The C4a levels (476 pg/ml) at baseline increased to 880 pg/ml at 4 days (P < 0.001), and 657 pg/ml at 1 month (P = 0.013). The C5a levels (22.6 pg/ml) at baseline increased to 470.9 pg/ml at 4 days (P < 0.001), and 38.3 pg/ml at 1 month (P = 0.0048). The surgical eyes were divided into the short ST group (≦ 10 mm, n = 22) and long ST group (> 10 mm, n = 21) based on the preoperative ST values. At 1 month postoperatively, the C3a levels were 2194 pg/ml in the preoperative short ST group and 1391 pg/ml in the long ST group, with significantly higher C3a concentrations in the short ST group (P < 0.001). CONCLUSIONS The CAPs levels in tears increased after vitrectomy combined with cataract surgery. A preoperative deficit in tear secretion might induce prolonged complement activation and delayed recovery of ocular surface parameters postoperatively.
Collapse
Affiliation(s)
- Hiroki Maehara
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukushima, 960-1247, Japan
| | - Koki Norikawa
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukushima, 960-1247, Japan
| | - Keiichiro Tanaka
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukushima, 960-1247, Japan
| | - Yutaka Kato
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukushima, 960-1247, Japan
| | - Akihito Kasai
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukushima, 960-1247, Japan
| | - Tomoko Omori
- Department of Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Takeshi Machida
- Department of Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Hideharu Sekine
- Department of Immunology, Fukushima Medical University School of Medicine, Fukushima, Japan
| | - Tetsuju Sekiryu
- Department of Ophthalmology, Fukushima Medical University School of Medicine, Hikarigaoka 1, Fukushima, 960-1247, Japan.
| |
Collapse
|
14
|
Gomes JAP, Azar DT, Baudouin C, Bitton E, Chen W, Hafezi F, Hamrah P, Hogg RE, Horwath-Winter J, Kontadakis GA, Mehta JS, Messmer EM, Perez VL, Zadok D, Willcox MDP. TFOS Lifestyle: Impact of elective medications and procedures on the ocular surface. Ocul Surf 2023; 29:331-385. [PMID: 37087043 DOI: 10.1016/j.jtos.2023.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 04/10/2023] [Indexed: 04/24/2023]
Abstract
The word "elective" refers to medications and procedures undertaken by choice or with a lower grade of prioritization. Patients usually use elective medications or undergo elective procedures to treat pathologic conditions or for cosmetic enhancement, impacting their lifestyle positively and, thus, improving their quality of life. However, those interventions can affect the homeostasis of the tear film and ocular surface. Consequently, they generate signs and symptoms that could impair the patient's quality of life. This report describes the impact of elective topical and systemic medications and procedures on the ocular surface and the underlying mechanisms. Moreover, elective procedures performed for ocular diseases, cosmetic enhancement, and non-ophthalmic interventions, such as radiotherapy and bariatric surgery, are discussed. The report also evaluates significant anatomical and biological consequences of non-urgent interventions to the ocular surface, such as neuropathic and neurotrophic keratopathies. Besides that, it provides an overview of the prophylaxis and management of pathological conditions resulting from the studied interventions and suggests areas for future research. The report also contains a systematic review investigating the quality of life among people who have undergone small incision lenticule extraction (SMILE). Overall, SMILE refractive surgery seems to cause more vision disturbances than LASIK in the first month post-surgery, but less dry eye symptoms in long-term follow up.
Collapse
Affiliation(s)
- José Alvaro P Gomes
- Dept. of Ophthalmology and Visual Sciences, Federal University of Sao Paulo/Paulista School of Medicine (UNIFESP/EPM), Sao Paulo, SP, Brazil.
| | - Dimitri T Azar
- University of Illinois College of Medicine, Chicago, IL, USA
| | - Christophe Baudouin
- Quinze-Vingts National Eye Hospital & Vision Institute, IHU FOReSIGHT, Paris, France
| | - Etty Bitton
- Ecole d'optométrie, Université de Montréal, Montréal, Canada
| | - Wei Chen
- Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China
| | | | - Pedram Hamrah
- Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA, USA
| | - Ruth E Hogg
- Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Belfast, UK
| | | | | | | | | | - Victor L Perez
- Foster Center for Ocular Immunology, Duke University Eye Center, Durham, NC, USA
| | - David Zadok
- Shaare Zedek Medical Center, Affiliated to the Hebrew University, School of Medicine, Jerusalem, Israel
| | - Mark D P Willcox
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| |
Collapse
|
15
|
Sakimoto T, Sugiura T. Clinical features of anterior blepharitis after cataract surgery. Sci Rep 2023; 13:6615. [PMID: 37095268 PMCID: PMC10126137 DOI: 10.1038/s41598-023-33956-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 04/21/2023] [Indexed: 04/26/2023] Open
Abstract
We evaluated the clinical features of postoperative anterior blepharitis following cataract surgery and the efficacy of topical azithromycin retrospectively. Thirty eyes of 30 patients with a clinical diagnosis of anterior blepharitis by 6 months postoperatively among those who underwent cataract surgery at our institution between November 2020 and June 2022 were included. The diagnosis of anterior blepharitis and the assessment of objective and subjective findings were based on the American Academy of Ophthalmology Blepharitis Preferred Practice Pattern®. Azithromycin eye drops were prescribed for all patients, and findings and symptoms before and after the drops were reviewed. The time of onset ranged from 2 weeks to 6 months after cataract surgery, with the most common onset at 2 to 3 months postoperatively (mean time of onset 79.4 ± 39.6 days). The type of anterior blepharitis was staphylococcal blepharitis in 26 eyes and seborrheic blepharitis in 4 eyes, while mixed type with posterior blepharitis was noted in 6 eyes. Symptoms at the time of examination included irritation (including foreign body sensation) in 24 eyes, tearing in 4 eyes, and redness in 3 eyes. The findings and symptoms of anterior blepharitis were alleviated or resolved with azithromycin eye drops in 26 of the 30 eyes, but the blepharitis recurred in 6 of these eyes, requiring azithromycin eye drops to be re-prescribed. The onset of anterior blepharitis after cataract surgery may be related to a gradual decrease in postoperative eye drops. Patients tended to complain of irritation and foreign body sensation, and azithromycin eye drops were effective in such cases.
Collapse
Affiliation(s)
- Tohru Sakimoto
- Sugiura Eye Clinic, 22 Kawanarishinmachi, Fuji-shi, Shizuoka, 416-0955, Japan.
| | - Takeshi Sugiura
- Sugiura Eye Clinic, 22 Kawanarishinmachi, Fuji-shi, Shizuoka, 416-0955, Japan
| |
Collapse
|
16
|
Hirabayashi MT, Barnett BP. Solving STODS-Surgical Temporary Ocular Discomfort Syndrome. Diagnostics (Basel) 2023; 13:diagnostics13050837. [PMID: 36899981 PMCID: PMC10000827 DOI: 10.3390/diagnostics13050837] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Revised: 01/02/2023] [Accepted: 01/04/2023] [Indexed: 02/24/2023] Open
Abstract
The term STODS (Surgical Temporary Ocular Discomfort Syndrome) has been coined to describe the ocular surface perturbations induced by surgery. As one of the most important refractive elements of the eye, Guided Ocular Surface and Lid Disease (GOLD) optimization is fundamental to success in achieving refractive outcomes and mitigating STODS. Effective GOLD optimization and the prevention/treatment of STODS requires an understanding of the molecular, cellular, and anatomic factors that influence ocular surface microenvironment and the associated perturbations induced by surgical intervention. By reviewing the current understanding of STODS etiologies, we will attempt to outline a rationale for a tailored GOLD optimization depending on the ocular surgical insult. With a bench-to-bedside approach, we will highlight clinical examples of effective GOLD perioperative optimization that can mitigate STODS' deleterious effect on preoperative imaging and postoperative healing.
Collapse
Affiliation(s)
- Matthew T. Hirabayashi
- Department of Ophthalmology, University of Missouri School of Medicine, 1 Hospital Dr, Columbia, MO 65212, USA
| | - Brad P. Barnett
- California LASIK & Eye, 1111 Exposition Blvd. Bldg. 200, Ste. 2000, Sacramento, CA 95815, USA
- Correspondence:
| |
Collapse
|
17
|
Nibandhe AS, Donthineni PR. Understanding and Optimizing Ocular Biometry for Cataract Surgery in Dry Eye Disease: A Review. Semin Ophthalmol 2023; 38:24-30. [PMID: 35989638 DOI: 10.1080/08820538.2022.2112699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
PURPOSE To understand the impact of dry eye disease (DED) on the components of ocular biometry and ways to optimize the visual outcomes of cataract surgery in eyes with DED. METHODOLOGY A thorough literature review of the components pertaining to this review was undertaken using the databases, PubMed (from the year 2000), MEDLINE, CENTRAL (including Cochrane Eyes and Vision Trials Register; Cochrane Library: Issue 12 of 12 December 2019), metaRegister of Controlled Trials (mRCT) (www.controlled-trials. com), ClinicalTrials.gov (www.clinicaltrial.gov) and WHO International Clinical Trials Registry Platform (www.who.int/ictrp/search/en). The keywords used for the search included "cataract surgery" or "phacoemulsification" combined with "dry eye", "dry eye disease","biometry", "keratometry". RESULTS Publications considered for this review included meta-analysis, systematic reviews, case-control and cohort studies, case series, and laboratory-based studies. Published articles reporting tear film alteration in DED, its impact on the quality of vision and optical aberrations, the effect of topical medications on keratometry variations, and reports on optimizing the ocular surface before cataract surgery were included. CONCLUSIONS DED is a common entity seen in patients presenting to routine cataract clinics and is known to impact the accuracy, reliability, and repeatability of ocular biometry and IOL power calculations in them. This review intends to emphasize the preoperative screening for the presence of DED, initiation of appropriate medical management for optimization of the ocular surface before cataract surgery, and recommendations for performing biometry. The algorithmic approach proposed will help the general ophthalmologists in routine practice to provide quality care and acceptable visual outcomes in patients with pre-existing DED.
Collapse
|
18
|
Lee D, Kim C, Lee K, Chung JK. Clinical Outcomes of Cataract Surgery in Patients with Sjögren's Syndrome. Diagnostics (Basel) 2022; 13:diagnostics13010057. [PMID: 36611349 PMCID: PMC9818369 DOI: 10.3390/diagnostics13010057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/22/2022] [Accepted: 12/22/2022] [Indexed: 12/28/2022] Open
Abstract
This study compared the biometric accuracy and refractive outcomes, and ocular surface changes after cataract surgery in patients with Sjögren’s syndrome (SS, S group), non-SS dry eye patients (D group), and healthy controls (C group). The medical records of patients who underwent cataract surgery and met certain inclusion criteria were reviewed. In total, 167 eyes of 87 patients were enrolled. Refractive parameters were analyzed via optical biometry and combined ultrasound biometry and automated refractokeratometry. The mean absolute errors (MAEs), the uncorrected distance visual acuities (UDVAs), changes in the ocular staining score (OSS), and anterior chamber cell grades were compared for 12 months postoperatively. The S group evidenced more severe and persistent OSS exacerbation after cataract surgery; the OSS returned to baseline by 3 months postoperatively. The mean keratometric values showed a significant linear correlation. There was no significant intergroup difference in either the MAEs (p > 0.530) or anterior chamber inflammation (p > 0.436). The postoperative UDVA of the S group was poorer than that of the C group from 3 months postoperatively (p < 0.047) but not different from that of the D group (p > 0.311). With preoperative ocular surface optimization and optimal postoperative treatment of superficial keratitis, the refractive outcomes of SS patients were comparable to those of other groups and the postoperative UDVA was not inferior to that of non-SS dry eye patients.
Collapse
Affiliation(s)
| | | | | | - Jin Kwon Chung
- Correspondence: ; Tel.: +82-2-709-9354; Fax: +82-2-710-3196
| |
Collapse
|
19
|
Lu H, Guan Y, Su Y, Nan N, Yuan Y. Effect of sodium hyaluronate eye drops combined with tobramycin, dexamethasone and pranoprofen eye drops in the treatment of dry eye after phacoemulsification. Indian J Ophthalmol 2022; 70:4319-4324. [PMID: 36453338 PMCID: PMC9940536 DOI: 10.4103/ijo.ijo_1652_22] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Purpose To investigate the clinical effect of sodium hyaluronate eye drops combined with tobramycin, dexamethasone, and pranoprofen eye drops in the treatment of dry eye after phacoemulsification. Methods Medical records of 188 patients with dry eye after phacoemulsification, treated in our hospital from August 2020 to August 2021, were included and divided into groups based on the type of dry eye treatment. Patients in the control group (n = 90) were treated with tobramycin, dexamethasone, and pranoprofen eye drops. Patients in the test group (n = 98) were treated with sodium hyaluronate, tobramycin, dexamethasone, and pranoprofen eye drops. The tear secretion test (TST), film rupture time (BUT), corneal fluorescence staining (FS) score, levels of interleukin (IL)-6, and tumor necrosis factor (TNF)-α before the treatment and at 1 month follow-up, the overall total effective rate and the number of completely cured cases were compared between the two groups. Multiple linear regression was used to calculate coefficients for predicting clinical variables. Ordinal logistic regression was used to compute coefficients and odds ratios for predicting effective scores. Results The total effective rate in the observation group (99%) was significantly higher than that in the control group (80.00%). After the treatment, the TST and BUT indexes of the observation group were higher compared to the control group, and the FS score of the observation group was lower than that of the control group. TNF-α and IL-6 levels of the observation group were lower compared to the control group. Logistic regression analysis demonstrated that the differences in the effective rate and clinical variables between the two groups remained significant after adjusting for the effect of age. Conclusion A combination of sodium hyaluronate, tobramycin, dexamethasone, and pranoprofen eye drops for the treatment of dry eye after phacoemulsification can improve the curative effect, reduce corneal fluorescein staining and inflammatory factor index levels compared to the treatment regimen lacking sodium hyaluronate eye drops.
Collapse
Affiliation(s)
- Hongwei Lu
- Department of Ophthalmology the Fourth Hospital of Hebei Medical University, Shijiazhuang City, Hebei Province, China
| | - Yongqing Guan
- Department of Ophthalmology the Fourth Hospital of Hebei Medical University, Shijiazhuang City, Hebei Province, China
| | - Yudan Su
- Department of Ophthalmology the Fourth Hospital of Hebei Medical University, Shijiazhuang City, Hebei Province, China
| | - Na Nan
- Department of Ophthalmology the Fourth Hospital of Hebei Medical University, Shijiazhuang City, Hebei Province, China
| | - Yazhen Yuan
- Department of Ophthalmology the Fourth Hospital of Hebei Medical University, Shijiazhuang City, Hebei Province, China,Correspondence to: Dr. Yazhen Yuan, Departments of Ophthalmology the Fourth Hospital of Hebei Medical University, 12 Jiankang Road, Shijiazhuang City, Hebei Province - 050000, China. E-mail:
| |
Collapse
|
20
|
Prinz J, Maffulli N, Fuest M, Walter P, Bell A, Migliorini F. Efficacy of Topical Administration of Corticosteroids for the Management of Dry Eye Disease: Systematic Review and Meta-Analysis. LIFE (BASEL, SWITZERLAND) 2022; 12:life12111932. [PMID: 36431067 PMCID: PMC9697326 DOI: 10.3390/life12111932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/10/2022] [Accepted: 11/15/2022] [Indexed: 11/22/2022]
Abstract
The efficacy of corticosteroids (CS) for dry eye disease (DED) has been investigated in the clinical setting. The present study investigated whether topical CS application improves the clinical outcome at last follow-up compared to the baseline. The present study was conducted according to the PRISMA 2020. All the randomized clinical trials (RCTs), which investigated the efficacy of corticosteroids in the management of DED, were accessed. In September 2022, the following databases were accessed: Pubmed, Web of Science, Google Scholar, and Embase. The following data were extracted at baseline and at last follow-up: Ocular Surface Disease Index (OSDI), tear breakup time test (TBUT), Schirmer I test (SIT), and corneal staining. Data from 425 patients were retrieved. A total of 69.4% (295 of 425 patients) were women. CS were effective to improve SIT (p = 0.02) and corneal staining (p = 0.003) at the last follow-up of 10.0 ± 15.3 weeks. TBUT was greater in the CS than in the control group at the last follow-up (p = 0.002). Concluding, topical CS administration led to an increase of SIT and a reduction of corneal staining at a mean of 10 weeks follow-up in patients with DED. Compared to a control group, topical CS administration evidenced greater values of TBUT. Altogether, a good safety profile was witnessed in DED patients receiving CS. However, different safety profiles of different CS formulations were not investigated due to a lack of quantitative data. The exact dosing frequency, duration of therapy, and favorable potency of the CS are still under investigation. Future randomized, controlled trials with larger sample sizes are warranted to provide higher-quality evidence to establish the role of CS in DED.
Collapse
Affiliation(s)
- Julia Prinz
- RWTH University Hospital of Aachen, 52074 Aachen, Germany
| | - Nicola Maffulli
- Department of Medicine, Surgery and Dentistry, University of Salerno, 84081 Baronissi, Italy
- Centre for Sports and Exercise Medicine, Barts and The London School of Medicine and Dentistry, Queen Mile End Hospital, Mary University of London, 275 Bancroft Road, London E1 4DG, UK
- School of Pharmacy and Bioengineering, Keele University Faculty of Medicine, Thornburrow Drive, Stoke on Trent ST4 7QB, UK
| | - Matthias Fuest
- RWTH University Hospital of Aachen, 52074 Aachen, Germany
| | - Peter Walter
- RWTH University Hospital of Aachen, 52074 Aachen, Germany
| | - Andreas Bell
- Eifelklinik St. Brigida, 52152 Simmerath, Germany
| | - Filippo Migliorini
- RWTH University Hospital of Aachen, 52074 Aachen, Germany
- Eifelklinik St. Brigida, 52152 Simmerath, Germany
- Correspondence: ; Tel.: +49-0241-80-35529
| |
Collapse
|
21
|
Chen N, Zhang JS, Zhang TX, Fan BL, Ning Y. The effect of sodium hyaluronate on tear film stability in patients with dry eye syndrome after cataract surgery. Graefes Arch Clin Exp Ophthalmol 2022; 261:1011-1017. [PMID: 36378338 DOI: 10.1007/s00417-022-05880-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 09/07/2022] [Accepted: 10/20/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This study aimed to observe the changes in the ocular surface after phacoemulsification in patients with age-related cataracts with respect to the addition of varying concentrations of hyaluronate. METHODS Patients with dry eye syndrome were treated with 0.3% and 0.1% sodium hyaluronate eye drops to evaluate the clinical improvement in each treatment group. A total of 73 patients (91 eyes) with age-related cataracts suffering from dry eye syndrome after phacoemulsification were divided into treatment group A (30 eyes), undergoing conventional therapy and treatment with 0.3% sodium hyaluronate; treatment group B (31 eyes), undergoing conventional therapy and treatment with 0.1% sodium hyaluronate; and the control group (group C; 30 eyes), undergoing conventional therapy only. Two groups were given different concentrations of sodium hyaluronate eye drops four times a day (should be completed between 8 AM and 8 PM), one drop at a time. RESULTS Seven days, 2 weeks, 1 month, and 2 months postoperatively, there were significant differences in the Schirmer I test (SIt), first noninvasive tear film break-up time (NIBUTf), average noninvasive tear film break-up time (NIBUTav), tear meniscus height (TMH), and irregularity (when the refractive force of different parts of different meridians on the same meridian is different. The main manifestation is that the two meridians on the anterior surface of the cornea do not show a 90-degree vertical distribution, which cannot be corrected by conventional astigmatism lenses) between the three groups (p < 0.05). When compared with group C, there were significant differences in the SIt, NIBUTf, NIBUTav, TMH, and irregularity of group A and group B (p < 0.05). When compared with group B, there were significant improvements in the SIt, NIBUTf, NIBUTav, and TMH in group A (p < 0.05). CONCLUSIONS In the early stage after phacoemulsification, the stability of the tear film is reduced. Adding sodium hyaluronate eye drops can restore tear film structure and improve corneal surface regularity, and a 0.3% solution of sodium hyaluronate eye drops is more effective than a 0.1% solution.
Collapse
Affiliation(s)
- Nan Chen
- Department of Ophthalmology, Key Laboratory of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Ophthalmological Center of China Medical University, China Medical University, No. 102 of Nanqi Street, Heping District, Shenyang, 110005, Liaoning, China
| | - Jin-Song Zhang
- Department of Ophthalmology, Key Laboratory of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Ophthalmological Center of China Medical University, China Medical University, No. 102 of Nanqi Street, Heping District, Shenyang, 110005, Liaoning, China
| | - Tian-Xiao Zhang
- Department of Ophthalmology, Key Laboratory of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Ophthalmological Center of China Medical University, China Medical University, No. 102 of Nanqi Street, Heping District, Shenyang, 110005, Liaoning, China
| | - Bao-Liang Fan
- Department of Ophthalmology, Key Laboratory of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Ophthalmological Center of China Medical University, China Medical University, No. 102 of Nanqi Street, Heping District, Shenyang, 110005, Liaoning, China
| | - Yuan Ning
- Department of Ophthalmology, Key Laboratory of Ophthalmology, The Fourth Affiliated Hospital of China Medical University, Ophthalmological Center of China Medical University, China Medical University, No. 102 of Nanqi Street, Heping District, Shenyang, 110005, Liaoning, China.
| |
Collapse
|
22
|
Zhang Y, Qi Y, Xie X, Zhang F. The effect of 3% diquafosol on the improvement of ocular surface post cataract surgery: A meta-analysis for time of intervention. ADVANCES IN OPHTHALMOLOGY PRACTICE AND RESEARCH 2022; 2:100063. [PMID: 37846290 PMCID: PMC10577826 DOI: 10.1016/j.aopr.2022.100063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 05/02/2022] [Accepted: 05/09/2022] [Indexed: 10/18/2023]
Abstract
Purpose The effect of interventional time for 3% Diquafosol reatment in post-cataract surgery has not been well established. A meta-analysis was performed to evaluate the improvement of ocular surface condition in post-cataract surgery patients who received 3% DQS for various treatment durations. Methods Studies were performed based on 5 databases: PubMed, Cochrane Library, Web of Science, Embase, and China National Knowledge Infrastructure. Data on changes in Schirmer's test, tear breakup time (TBUT), corneal staining score, and OSDI score were collected for meta-analysis. Results A total of 621 affected eyes from 9 independent clinical studies were included. 6 studies conducted Schirmer's test after the application of 3% DQS. Meta-analysis showed that the difference between 3% DQS and control groups was not statistically significant for short-term application (less than or equal to 1 month) (WMD = 0.14, P = 0.27, 95% CI:-0.11 to 0.39), but was statistically different for long-term application (longer than or equal to 3 months) (WMD = 0.76, P = 0.03, 95% CI:0.08 to 1.45). For the corneal fluorescence staining score, the data from 6 studies indicated that the improvement was statistically significant for short-term application (WMD = -0.40, P <0.00001, 95% CI:-0.72 to -0.08) and but not long-term application (WMD = -0.21, P = 0.26, 95% CI:-0.57 to 0.15). For TBUT, the data from 9 studies indicated that both short-term and long-term application showed significant improvement (WMD = 1.70, P <0.00001, 95% CI:1.38 to 2.03; WMD = 1.52, P <0.00001, 95% CI:1.09 to 1.95). Similar results were observed in data from 5 studies with OSDI scores, where both short-term and long-term application showed statistically significant improvements (WMD = -5.41, P <0.00001, 95% CI: -7.02 to -3.81; WMD = -6.10, P <0.00001, 95% CI:-8.52 to -3.67). Conclusions The application of 3% DQS in post-operative cataract patients has a positive effect on improving the ocular surface conditions. Short-term application resulted in lower corneal staining scores, prolonged TBUT, and improved OSDI scores. Long-term application improved Schirmer's test results, TBUT, and subjective symptoms. Key messages The updated article suggests that 3% Diquafosol is less effective in the short term after cataract surgery, and that application over three months can improve the patient's ocular surface condition.
Collapse
Affiliation(s)
- Yuhang Zhang
- The Division of Ophthalmology and Vision Science, Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Ying Qi
- The Division of Ophthalmology and Vision Science, Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaohang Xie
- College of Medicine, Zhengzhou University, Zhengzhou, China
| | - Fengyan Zhang
- The Division of Ophthalmology and Vision Science, Department of Ophthalmology, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| |
Collapse
|
23
|
Dry Eye Following Femtosecond Laser-Assisted Cataract Surgery: A Meta-Analysis. J Clin Med 2022; 11:jcm11216228. [PMID: 36362459 PMCID: PMC9658977 DOI: 10.3390/jcm11216228] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/19/2022] [Accepted: 10/21/2022] [Indexed: 01/25/2023] Open
Abstract
This study investigates the dry eye effect after femtosecond laser-assisted cataract surgery (FLACS) and also compares the risk of postoperative dry eye between FLACS and manual cataract surgery (MCS). We searched various databases between 1 January 2000 and 15 October 2022 and included peer-reviewed clinical studies in our review. Dry eye parameters were extracted at baseline and postoperative day one, week one, one month, and three months. Parameters included were the ocular surface discomfort index (OSDI), tear secretion (tear meniscus height, Schirmer's test), microscopic ocular surface damage (fluorescein staining), and tear stability (first and average tear breakup time). Additionally, the differences of each parameter at each time point were compared between FLACS and MCS. In total, six studies of 611 eyes were included. On postoperative day one, increased, pooled standardised mean differences (SMDs) were noted in the OSDI, tear secretion, tear film instability, and microscopic damage. During postoperative week one, dry eye worsened. Fortunately, dry eye achieved resolution afterwards and nearly returned to the baseline level at postoperative three months. When the parameters were compared between FLACS and MCS, those of FLACS had higher severities, but most were not statistically significant. Dry eye impact was approximately the same in FLACS and MCS at postoperative three months.
Collapse
|
24
|
Yamazaki K, Yoneyama J, Kimoto R, Shibata Y, Mimura T. Prevention of Surgery-Induced Dry Eye by Diquafosol Eyedrops after Femtosecond Laser-Assisted Cataract Surgery. J Clin Med 2022; 11:jcm11195757. [PMID: 36233625 PMCID: PMC9572360 DOI: 10.3390/jcm11195757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/17/2022] [Accepted: 09/27/2022] [Indexed: 12/05/2022] Open
Abstract
Purpose: To analyze the protective effects of diquafosol eyedrops on the ocular surface following femtosecond laser-assisted cataract surgery (FLACS). Design: A prospective, randomized contralateral study. Methods: Bilateral FLACS with a trifocal IOL (PanOptix) implantation was performed in 40 eyes in 20 patients (10 males, 10 females, average age 68.8 ± 6.3 years old). Patients received 3% diquafosol eyedrops six times daily in one randomly chosen eye (diquafosol group), and physiological saline six times a day in the other eye (control group). Other medication included 1.5% levofloxacin, 0.1% dexamethasone and 0.1% diclofenac three times daily in both eyes. The pre and post-operative tear break-up time (BUT), superficial punctate keratopathy (SPK) scores and visual function were compared between both eyes, and all patients answered the dry-eye-related quality of life score (DEQS) questionnaire. Results: The BUT between groups was similar pre-operatively and on the first day post-op; however, the BUT was statistically longer in the diquafosol group compared to saline at 1 week (5.5/3.7 s) and 2 weeks (4.8/3.0 s) (p < 0.05). There was no difference in the SPK score, best corrected distance visual acuity, tear meniscus height, contrast sensitivity, DEQS and Schirmer test at all time points. Spherical aberration was statistically lower in the diquafosol group at 1 week. The protective effects of diquafosol on the BUT was more pronounced in patients with a pre-operative BUT of less than 5 s compared with those with a BUT longer than 6 s. Conclusions: Diquafosol eyedrops prevented the shortening of the BUT following FLACS, even in patients with short pre-operative BUT values.
Collapse
Affiliation(s)
- Kenichiro Yamazaki
- Department of Ophthalmology, Omiya Nanasato Eye Institute, Saitama 330-0017, Japan
- Correspondence: ; Tel.: +81-48-686-7000
| | - Junko Yoneyama
- Department of Ophthalmology, Omiya Nanasato Eye Institute, Saitama 330-0017, Japan
| | - Ryuta Kimoto
- Department of Ophthalmology, Omiya Nanasato Eye Institute, Saitama 330-0017, Japan
| | - Yuko Shibata
- Department of Ophthalmology, Omiya Nanasato Eye Institute, Saitama 330-0017, Japan
| | - Tatsuya Mimura
- Department of Ophthalmology, Teikyo University, Tokyo 173-8605, Japan
| |
Collapse
|
25
|
Jing D, Jiang X, Ren X, Su J, Wei S, Hao R, Chou Y, Li X. Change Patterns in Corneal Intrinsic Aberrations and Nerve Density after Cataract Surgery in Patients with Dry Eye Disease. J Clin Med 2022; 11:jcm11195697. [PMID: 36233565 PMCID: PMC9572385 DOI: 10.3390/jcm11195697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/12/2022] [Accepted: 09/22/2022] [Indexed: 11/16/2022] Open
Abstract
This study aimed to evaluate the change patterns in corneal intrinsic aberrations and nerve density after cataract surgery in dry eye disease. The preoperative, 1- and 3-month postoperative dry eye-related parameters were obtained by the Oculus keratograph and the ocular surface disease index questionnaire. The corneal intrinsic aberrations were measured using the Pentacam HR system. In vivo confocal microscopy was performed to observe the vortical and peripheral corneal nerves. An artificial intelligence technique run by the deep learning model generated the corneal nerve parameters. Corneal aberrations on the anterior and total corneal surfaces were significantly increased at 1 month compared with the baseline (p < 0.05) but gradually returned to the baseline by 3 months (p > 0.05). However, the change in posterior corneal aberration lasted up to 3 months (p < 0.05). There was a significant decrease in the corneal vortical nerve maximum length and average density after the operation (p < 0.05), and this damage lasted approximately 3 months. The corneal vortical nerve maximum length and average density were negatively correlated with the anterior corneal surface aberrations before and 1 month after the operation (correlation coefficients, CC = −0.26, −0.25, −0.28; all p < 0.05). Corneal vortex provided a unique site to observe long-term corneal nerve injury related to eye dryness. The continuous damage to the corneal vortical nerve may be due to the continuous dry eye state.
Collapse
Affiliation(s)
- Dalan Jing
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing 100191, China
| | - Xiaodan Jiang
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing 100191, China
| | - Xiaotong Ren
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing 100191, China
| | - Jie Su
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing 100191, China
| | - Shanshan Wei
- Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100069, China
| | - Ran Hao
- Beijing Ophthalmology & Visual Sciences Key Laboratory, Beijing Tongren Eye Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100069, China
| | - Yilin Chou
- Department of Ophthalmology, BenQ Medical Centre, The Affiliated BenQ Hospital of Nanjing Medical University, Nanjing 210017, China
- Correspondence: (Y.C.); (X.L.); Tel.: +86-18600862321 (Y.C.); +86-13911254862 (X.L.)
| | - Xuemin Li
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, 49 North Garden Rd., Haidian District, Beijing 100191, China
- Correspondence: (Y.C.); (X.L.); Tel.: +86-18600862321 (Y.C.); +86-13911254862 (X.L.)
| |
Collapse
|
26
|
Identified risk factors for dry eye syndrome: A systematic review and meta-analysis. PLoS One 2022; 17:e0271267. [PMID: 35984830 PMCID: PMC9390932 DOI: 10.1371/journal.pone.0271267] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 06/28/2022] [Indexed: 01/04/2023] Open
Abstract
A meta-analytic approach was used to identify potential risk factors for dry eye syndrome. PubMed, Embase, and the Cochrane library were systematically searched for studies investigated the risk factors for dry eye syndrome from their inception until September 2021. The odds ratio (OR) with 95% confidence interval (CI) was calculated using the random-effects model. Forty-eight studies comprising 493,630 individuals were included. Older age (OR: 1.82; P<0.001), female sex (OR: 1.56; P<0.001), other race (OR: 1.27; P<0.001), visual display terminal use (OR: 1.32; P<0.001), cataract surgery (OR: 1.80; P<0.001), contact lens wear (OR: 1.74; P<0.001), pterygium (OR: 1.85; P = 0.014), glaucoma (OR: 1.77; P = 0.007), eye surgery (OR: 1.65; P<0.001), depression (OR: 1.83; P<0.001), post-traumatic stress disorder (OR: 1.65; P<0.001), sleep apnea (OR: 1.57; P = 0.003), asthma (OR: 1.43; P<0.001), allergy (OR: 1.38; P<0.001), hypertension (OR: 1.12; P = 0.004), diabetes mellitus (OR: 1.15; P = 0.019), cardiovascular disease (OR: 1.20; P<0.001), stroke (OR: 1.32; P<0.001), rosacea (OR: 1.99; P = 0.001), thyroid disease (OR: 1.60; P<0.001), gout (OR: 1.40; P<0.001), migraines (OR: 1.53; P<0.001), arthritis (OR: 1.76; P<0.001), osteoporosis (OR: 1.36; P = 0.030), tumor (OR: 1.46; P<0.001), eczema (OR: 1.30; P<0.001), and systemic disease (OR: 1.45; P = 0.007) were associated with an increased risk of dry eye syndrome. This study reported risk factors for dry eye syndrome, and identified patients at high risk for dry eye syndrome.
Collapse
|
27
|
Alterations in the ocular surface and tear film following keratoplasty. Sci Rep 2022; 12:11991. [PMID: 35835841 PMCID: PMC9283544 DOI: 10.1038/s41598-022-16191-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2022] [Accepted: 07/06/2022] [Indexed: 12/02/2022] Open
Abstract
The purpose of this study was to evaluate any alterations in the tear film and ocular surface beyond the early postoperative period following penetrating keratoplasty (PK) and deep anterior lamellar keratoplasty (DALK). This cross-sectional, contralateral-eye study compared ocular surface and tear film parameters of eyes with a previous PK or DALK in one eye and no prior surgery in the contralateral eye. Overall, 14 (87.5%) participants underwent PK, and 2 (12.5%) underwent DALK using a mechanical dissection. The median time from surgery was 3.4 years (range 1.5 to 38.7 years). The indication for unilateral keratoplasty was keratoconus in 15 (94%) participants, and corneal scarring in 1 (6%) eye, secondary to microbial keratitis. Operated eyes exhibited poorer non-invasive tear film breakup time, lower corneal sensitivity, lower sub-basal nerve density and more severe fluorescein staining scores than unoperated fellow eyes (all Q < 0.05). There were no significant differences in tear film lipid layer quality, tear meniscus height, conjunctival hyperaemia, lissamine green staining score, or meibography grade between operated and fellow eyes (all Q ≥ 0.20). Higher corneal esthesiometry threshold (lower corneal sensitivity) was correlated with shorter non-invasive tear film breakup time (Spearman’s rho = − 0.361, p = 0.04) and increased fluorescein staining score (Spearman’s rho = 0.417, p = 0.02). Keratoplasty can induce persistent changes in the ocular surface and tear film, including: increased fluorescein staining, decreased tear film breakup time, decreased corneal sub-basal nerve plexus density, and reduced corneal sensitivity.
Collapse
|
28
|
Rossi GCM, Tinelli C, Milano G, Lanteri S, Ricciarelli G, Giannì L, Pasinetti GM, Scudeller L. Randomised, Single Blind, Controlled, Three-Month Clinical Trial on the Evaluation and Treatment of the Ocular Surface Damage Following Phacoemulsification. Vision (Basel) 2022; 6:vision6030042. [PMID: 35893759 PMCID: PMC9326562 DOI: 10.3390/vision6030042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Revised: 06/07/2022] [Accepted: 06/14/2022] [Indexed: 11/16/2022] Open
Abstract
Background: To determine efficacy of two lacrimal substitutes on signs and symptoms of ocular surface disease after phacoemulsification; to determine impact of surgery on patients’ vision related quality of life. Monocentric, randomised, physician blinded, three parallel groups clinical trial. Design and Methods: Patients in the operative list for phacoemulsification have been screened for eligibility; they underwent (at time 0, 15, 45 and 90 days): slit lamp examination; tear film break-up time (BUT); corneal staining; tear volume; 25-item National Eye Institute Visual Function Questionnaire (NEI-VFQ); Ocular Surface Disease Index (OSDI). Treatments to be compared were: 1. standard of care-SOC (lomefloxacine and tobramicine/dexamethasone fixed combination 4 times a day for 2 weeks), 2. SOC + carboxymethylcellulose sodium 0.5% and glycerin 0.9%, 3. SOC + Sodium Hyaluronate 0.15%. Study treatment started at T15. Groups were compared with parametric or nonparametric tests, and with Pearson’s χ2 test. Correlation between continuous variables was assessed by means of Pearson’s or Spearman’s coefficient. Results: Fifty-three patients were enrolled. At 45 and at 90 days from surgery, the group receiving lacrimal substitutes presented better BUT and Schirmer I test (p = 0.009, <0.001, <0.001 and 0.001, respectively); dry eye presence showed significant difference by group at time 90 (p = 0.019). General vision, near activity and vision-specific dependency subscales improved after surgery (p = <0.001, 0.004 and 0.048, respectively). At 45 and 90 days from surgery, the OSDI score significantly changed (p < 0.001).Conclusions: Cataract surgery causes the onset or the worsening of dry eye. Use of artificial tears can significantly reduce symptoms and signs of dry eye in patients after phacoemulsification.
Collapse
Affiliation(s)
- Gemma Caterina Maria Rossi
- Department of Surgical Sciences, University Eye Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (G.M.); (S.L.); (G.R.); (L.G.)
- ASST Bergamo Est, Ospedale Locatelli, 24020 Piario, Italy
- Correspondence:
| | - Carmine Tinelli
- Clinical Epidemiology and Biometric Unit, Scientific Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (C.T.); (L.S.)
| | - Giovanni Milano
- Department of Surgical Sciences, University Eye Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (G.M.); (S.L.); (G.R.); (L.G.)
- Medicine and Surgery Faculty, University of Pavia, 27100 Pavia, Italy
| | - Sara Lanteri
- Department of Surgical Sciences, University Eye Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (G.M.); (S.L.); (G.R.); (L.G.)
| | - Gabriella Ricciarelli
- Department of Surgical Sciences, University Eye Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (G.M.); (S.L.); (G.R.); (L.G.)
| | - Laura Giannì
- Department of Surgical Sciences, University Eye Clinic, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (G.M.); (S.L.); (G.R.); (L.G.)
| | | | - Luigia Scudeller
- Clinical Epidemiology and Biometric Unit, Scientific Direction, Fondazione IRCCS Policlinico San Matteo, 27100 Pavia, Italy; (C.T.); (L.S.)
| |
Collapse
|
29
|
Kim S, Ko BY, Koh JW, Kim EC, Kim HK, Shin YJ, Song JS, Lee DH, Lee JE, Lee HK, Chung SH, Kim HS. Comparison of a preservative-free nonsteroidal anti-inflammatory drug and preservative-free corticosteroid after uneventful cataract surgery: multicenter, randomized, evaluator-blinded clinical trial. J Cataract Refract Surg 2022; 48:710-716. [PMID: 34629379 PMCID: PMC9119399 DOI: 10.1097/j.jcrs.0000000000000841] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2020] [Accepted: 10/05/2021] [Indexed: 12/05/2022]
Abstract
PURPOSE To compare the efficacy of nonsteroidal anti-inflammatory drugs (NSAIDs) and steroidal eyedrops for inflammation management after cataract surgery using slitlamp indicators. SETTING 11 eye centers in South Korea. DESIGN Randomized prospective multicenter study with a blinded evaluator. METHOD In 125 (250 eyes) patients who underwent cataract surgery, bromfenac sodium hydrate 0.1% (NSAID group) was applied twice a day in 1 eye, whereas the other eye was treated with fluorometholone 0.1% (steroid group), 4 times a day for 4 weeks postoperatively. The primary efficacy outcome was the presence of anterior chamber cells and flare at 1 week postoperatively. Anterior chamber cells and flare at 4 to 8 weeks, corrected distance visual acuity, central corneal thickness, conjunctival hyperemia, dry eye parameters, foveal thickness, and ocular and visual discomfort were evaluated as secondary outcomes. RESULTS At week 1, residual anterior chamber inflammation was not statistically significantly different between the groups (-1.03 ± 1.27 vs -0.95 ± 1.24, P = .4850). However, the NSAID group recovered from conjunctival hyperemia more rapidly than the steroid group (0.30 ± 0.52 vs 0.44 ± 0.81, P = .0144 at week 1). The increase in central corneal thickness in the NSAID group was less than that in the steroid group 1 week postoperatively (7.87 ± 22.46 vs 29.47 ± 46.60 μm, P < .0001). The change in foveal thickness in the NSAID group was significantly less than that in the steroid group (18.11 ± 68.19 vs 22.25 ± 42.37 μm, P = .0002). Lower levels of postoperative ocular and visual discomfort were reported in the NSAID group than in the steroid group under treatment. CONCLUSIONS Preservative-free bromfenac was as effective as preservative-free fluorometholone eyedrops in anterior chamber inflammation control and showed better signs and symptoms after cataract surgery.
Collapse
Affiliation(s)
- Seonjoo Kim
- From the Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (S.J. Kim, Chung, H.S. Kim); Department of Ophthalmology, Konyang University College of Medicine, Daejeon, South Korea (Ko); Department of Ophthalmology, Chosun University College of Medicine, Gwangju, South Korea (Koh); Department of Ophthalmology, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, South Korea (E.C. Kim); Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, South Korea (H.K. Kim); Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea (Shin); Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea (Song); Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea (D.H. Lee); Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea (J.E. Lee); Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (H.K. Lee)
| | - Byung-Yi Ko
- From the Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (S.J. Kim, Chung, H.S. Kim); Department of Ophthalmology, Konyang University College of Medicine, Daejeon, South Korea (Ko); Department of Ophthalmology, Chosun University College of Medicine, Gwangju, South Korea (Koh); Department of Ophthalmology, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, South Korea (E.C. Kim); Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, South Korea (H.K. Kim); Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea (Shin); Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea (Song); Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea (D.H. Lee); Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea (J.E. Lee); Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (H.K. Lee)
| | - Jae Woong Koh
- From the Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (S.J. Kim, Chung, H.S. Kim); Department of Ophthalmology, Konyang University College of Medicine, Daejeon, South Korea (Ko); Department of Ophthalmology, Chosun University College of Medicine, Gwangju, South Korea (Koh); Department of Ophthalmology, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, South Korea (E.C. Kim); Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, South Korea (H.K. Kim); Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea (Shin); Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea (Song); Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea (D.H. Lee); Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea (J.E. Lee); Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (H.K. Lee)
| | - Eun Chul Kim
- From the Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (S.J. Kim, Chung, H.S. Kim); Department of Ophthalmology, Konyang University College of Medicine, Daejeon, South Korea (Ko); Department of Ophthalmology, Chosun University College of Medicine, Gwangju, South Korea (Koh); Department of Ophthalmology, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, South Korea (E.C. Kim); Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, South Korea (H.K. Kim); Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea (Shin); Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea (Song); Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea (D.H. Lee); Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea (J.E. Lee); Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (H.K. Lee)
| | - Hong Kyun Kim
- From the Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (S.J. Kim, Chung, H.S. Kim); Department of Ophthalmology, Konyang University College of Medicine, Daejeon, South Korea (Ko); Department of Ophthalmology, Chosun University College of Medicine, Gwangju, South Korea (Koh); Department of Ophthalmology, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, South Korea (E.C. Kim); Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, South Korea (H.K. Kim); Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea (Shin); Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea (Song); Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea (D.H. Lee); Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea (J.E. Lee); Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (H.K. Lee)
| | - Young Joo Shin
- From the Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (S.J. Kim, Chung, H.S. Kim); Department of Ophthalmology, Konyang University College of Medicine, Daejeon, South Korea (Ko); Department of Ophthalmology, Chosun University College of Medicine, Gwangju, South Korea (Koh); Department of Ophthalmology, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, South Korea (E.C. Kim); Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, South Korea (H.K. Kim); Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea (Shin); Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea (Song); Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea (D.H. Lee); Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea (J.E. Lee); Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (H.K. Lee)
| | - Jong-Suk Song
- From the Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (S.J. Kim, Chung, H.S. Kim); Department of Ophthalmology, Konyang University College of Medicine, Daejeon, South Korea (Ko); Department of Ophthalmology, Chosun University College of Medicine, Gwangju, South Korea (Koh); Department of Ophthalmology, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, South Korea (E.C. Kim); Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, South Korea (H.K. Kim); Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea (Shin); Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea (Song); Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea (D.H. Lee); Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea (J.E. Lee); Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (H.K. Lee)
| | - Do Hyung Lee
- From the Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (S.J. Kim, Chung, H.S. Kim); Department of Ophthalmology, Konyang University College of Medicine, Daejeon, South Korea (Ko); Department of Ophthalmology, Chosun University College of Medicine, Gwangju, South Korea (Koh); Department of Ophthalmology, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, South Korea (E.C. Kim); Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, South Korea (H.K. Kim); Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea (Shin); Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea (Song); Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea (D.H. Lee); Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea (J.E. Lee); Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (H.K. Lee)
| | - Ji Eun Lee
- From the Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (S.J. Kim, Chung, H.S. Kim); Department of Ophthalmology, Konyang University College of Medicine, Daejeon, South Korea (Ko); Department of Ophthalmology, Chosun University College of Medicine, Gwangju, South Korea (Koh); Department of Ophthalmology, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, South Korea (E.C. Kim); Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, South Korea (H.K. Kim); Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea (Shin); Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea (Song); Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea (D.H. Lee); Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea (J.E. Lee); Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (H.K. Lee)
| | - Hyung Keun Lee
- From the Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (S.J. Kim, Chung, H.S. Kim); Department of Ophthalmology, Konyang University College of Medicine, Daejeon, South Korea (Ko); Department of Ophthalmology, Chosun University College of Medicine, Gwangju, South Korea (Koh); Department of Ophthalmology, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, South Korea (E.C. Kim); Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, South Korea (H.K. Kim); Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea (Shin); Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea (Song); Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea (D.H. Lee); Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea (J.E. Lee); Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (H.K. Lee)
| | - So-Hyang Chung
- From the Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (S.J. Kim, Chung, H.S. Kim); Department of Ophthalmology, Konyang University College of Medicine, Daejeon, South Korea (Ko); Department of Ophthalmology, Chosun University College of Medicine, Gwangju, South Korea (Koh); Department of Ophthalmology, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, South Korea (E.C. Kim); Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, South Korea (H.K. Kim); Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea (Shin); Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea (Song); Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea (D.H. Lee); Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea (J.E. Lee); Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (H.K. Lee)
| | - Hyun Seung Kim
- From the Department of Ophthalmology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, South Korea (S.J. Kim, Chung, H.S. Kim); Department of Ophthalmology, Konyang University College of Medicine, Daejeon, South Korea (Ko); Department of Ophthalmology, Chosun University College of Medicine, Gwangju, South Korea (Koh); Department of Ophthalmology, Bucheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Bucheon, South Korea (E.C. Kim); Department of Ophthalmology, School of Medicine, Kyungpook National University, Daegu, South Korea (H.K. Kim); Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea (Shin); Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea (Song); Department of Ophthalmology, Ilsan Paik Hospital, Inje University College of Medicine, Goyang, South Korea (D.H. Lee); Department of Ophthalmology, Pusan National University Yangsan Hospital, Pusan National University School of Medicine, Yangsan, South Korea (J.E. Lee); Department of Ophthalmology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea (H.K. Lee)
| |
Collapse
|
30
|
Impact of Perioperative Dry Eye Treatment with Rebamipide Versus Artificial Tears on Visual Outcomes After Cataract Surgery in Japanese Population. Ophthalmol Ther 2022; 11:1479-1491. [PMID: 35588046 PMCID: PMC9253222 DOI: 10.1007/s40123-022-00523-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 05/03/2022] [Indexed: 11/03/2022] Open
Abstract
Introduction The present study aimed to compare the effects of rebamipide and artificial tears during the perioperative period of cataract surgery on the postoperative visual outcomes. Methods Seventy-two eyes from 36 patients with a cataract were enrolled. Rebamipide (group R) was administered in one eye and Mytear® artificial tear ophthalmic solution (group A) in the other eye from 4 weeks preoperatively to 3 months postoperatively. Tear breakup time (TBUT), high-order aberrations (HOAs), superficial punctate keratopathy in the central part of the cornea (C-SPK), and corrected distance visual acuity (CDVA) were assessed at baseline, 1 week, 1 month, and 3 months after cataract surgery with trifocal intraocular lens (IOL) implantation. Contrast sensitivity and disability glare with visual angle values compatible with spatial frequencies of 1.1, 1.8, 2.9, 4.5, 7.1, and 10.2 cycles/degree (CPD) were evaluated postoperatively. Between-group differences of all variables were analyzed. Results At baseline, no significant differences in the variables were noted between the two groups. Mean TBUT was significantly higher, while mean C-SPK and HOAs were significantly lower in group R than in group A at each assessment. Mean CDVA was significantly higher at 1 week and 1 month postoperatively in group R compared with group A; this value was not significant at 3 months. Between-group differences in contrast sensitivity and disability glare were statistically significant at all spatial frequencies, 1 week and 1 month postoperatively. At 3 months postoperatively, there were significant differences in contrast sensitivity and disability glare at most spatial frequencies. Conclusion Dry eye management with rebamipide in the perioperative period of cataract surgery with trifocal IOL implantation was significantly more effective than artificial tears in improving ocular surface condition, contrast sensitivity, and disability glare postoperatively. Supplementary Information The online version contains supplementary material available at 10.1007/s40123-022-00523-w.
Collapse
|
31
|
Prevalence and Characteristics of Dry Eye Disease After Cataract Surgery: A Systematic Review and Meta-Analysis. Ophthalmol Ther 2022; 11:1309-1332. [PMID: 35534685 PMCID: PMC9253209 DOI: 10.1007/s40123-022-00513-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Accepted: 04/04/2022] [Indexed: 12/15/2022] Open
Abstract
Dry eye disease (DED) after cataract surgery is associated with various risk factors, while causing a wide range of heterogeneous symptoms including decreased quality of vision. This systematic review and meta-analysis aimed to determine the prevalence and characteristics of DED after cataract surgery. We searched PubMed and EMBASE and included studies on patients with DED after cataract surgery, between January 2011 and June 2020. Study-specific estimates (DED prevalence rates after cataract surgery in patients without preexisting DED) were combined using one-group meta-analysis in a random-effects model. We included 36 studies published between 2013 and 2020. We included nine of these in the meta-analysis of DED prevalence after cataract surgery. Overall 37.4% (95% CI 22.6-52.3; 206/775) of patients without preexisting DED developed DED after cataract surgery. The risk factors for DED after cataract surgery included age, female sex, systemic diseases, systemic medications, psychiatric conditions, preexisting DED, meibomian gland dysfunction, preservatives in eye drops, surgery techniques, and lifestyle. DED severity peak occurred 1 day postoperatively and persisted for at least 1-12 months following cataract surgery; therefore, consistent follow-up for DED is warranted for at least 1 month after cataract surgery. Topical administration of preservative-free diquafosol tetrasodium solution and preoperative meibomian gland treatment were effective in preventing and treating DED following cataract surgery. As more than one-third of patients develop DED after cataract surgery, careful DED management and treatment is needed after cataract surgery to improve satisfaction and vision quality.
Collapse
|
32
|
Schechter B, Mah F. Optimization of the Ocular Surface Through Treatment of Ocular Surface Disease Before Ophthalmic Surgery: A Narrative Review. Ophthalmol Ther 2022; 11:1001-1015. [PMID: 35486371 PMCID: PMC9114189 DOI: 10.1007/s40123-022-00505-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 03/23/2022] [Indexed: 11/30/2022] Open
Abstract
Ocular surface disease commonly exists in individuals requiring ophthalmic surgery and may compromise the structure and function of ocular surface components. Ophthalmic surgery may further affect the ocular surface by injuring the epithelium and sensory nerves, disrupting the tear film, or causing local inflammation. Medical management of ocular surface disease prior to ophthalmic surgery aids in reducing inflammation, resolving infection, improving epithelial pathology, stabilizing the tear film, and easing patient symptoms, promoting positive long-term outcomes and minimizing the incidence of postoperative complications. This review summarizes frequently encountered ocular surface diseases and available preoperative medical management options, discusses common ophthalmic surgeries and their effects on the ocular surface, examines potential postoperative complications, and defines recommendations for postoperative ocular surface maintenance.
Collapse
Affiliation(s)
- Barry Schechter
- Florida Eye Microsurgical Institute, 1717 Woolbright Rd, Boynton Beach, FL, 33426, USA.
| | | |
Collapse
|
33
|
Vera J, Redondo B, Molina R, Jiménez R. Effects of wearing swimming goggles on non-invasive tear break-up time in a laboratory setting. JOURNAL OF OPTOMETRY 2022; 15:154-159. [PMID: 33478924 PMCID: PMC9068525 DOI: 10.1016/j.optom.2020.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 09/07/2020] [Accepted: 09/18/2020] [Indexed: 06/12/2023]
Abstract
PURPOSE The use of swimming goggles (SG) has demonstrated to alter different ocular parameters, however, the impact of wearing SG on the tear film stability remain unknown. The main objective of this study was to determine the short-term effects of wearing SG on tear film surface quality break-up time (TFSQ-BUT). METHODS Twenty-eight young healthy adults (14 men and 14 women) wore a drilled SG, and TFSQ-BUT was measured before, during and after SG use. Dynamic-area high-speed videokeratoscopy was used for the non-invasive assessment of TFSQ-BUT. RESULTS TFSQ-BUT was significantly reduced while SG wear in comparison to the baseline measurement (4.8 ± 4.5 s vs. 8.8 ± 6.9 s; corrected p-value = 0.017, d = 0.57, mean difference = 4.0 [0.6, 7.3]; 45% reduction). Immediately after SG removal, TFSQ-BUT rapidly recovered baseline levels (8.2 ± 5.9 s vs. 8.8 ± 6.9 s; corrected p-value = 0.744). The impact of wearing SG on TFSQ-BUT were independent of the gender of the participants (p = 0.934). CONCLUSION The use of SG induces a TFSQ-BUT reduction, with these changes returning to baseline levels immediately after SG removal. These data may be of relevance for the management of dry eye patients, who need to avoid circumstances that exacerbate tear film instability. Nevertheless, these results must be interpreted with caution since the experiment did not entirely mimic real-life conditions (e.g., eye cup piece drilled, time of exposure, environmental conditions). Future studies should consider the inclusion of dry eye patients and older individual in order to explore the generalizability of these findings.
Collapse
Affiliation(s)
- Jesús Vera
- Department of Optics, Faculty of Sciences, University of Granada, Spain
| | - Beatríz Redondo
- Department of Optics, Faculty of Sciences, University of Granada, Spain.
| | - Rubén Molina
- Department of Optics, Faculty of Sciences, University of Granada, Spain
| | - Raimundo Jiménez
- Department of Optics, Faculty of Sciences, University of Granada, Spain
| |
Collapse
|
34
|
Gehlsen U, Faust C, Blecha C, Dietrich-Ntoukas T, Eberwein P, Issleib S, Meyer-Ter-Vehn T, Braun R, Westekemper H, Steven P. Outcomes and complications of cataract surgery in patients with chronic ocular graft-versus-host-disease-a multicenter, retrospective analysis. Graefes Arch Clin Exp Ophthalmol 2022; 260:2613-2622. [PMID: 35254513 PMCID: PMC9325851 DOI: 10.1007/s00417-022-05613-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2021] [Revised: 02/20/2022] [Accepted: 02/22/2022] [Indexed: 11/25/2022] Open
Abstract
PURPOSE To evaluate the outcome of phacoemulsification in patients with chronic ocular Graft-versus-host disease (oGVHD) after allogeneic hematopoietic stem cell transplantation (aHSCT). METHODS Retrospective, observational multicenter study from 1507 oGVHD patients. From the patient files, data were collected including best-corrected visual acuity (BCVA), intraocular pressure (IOP), Schirmer's test I, tear film break-up time (TFBUT), corneal fluorescein staining score, postoperative complications, and pre- and post-operative topical therapy. RESULTS Seventy-three patients underwent cataract surgery in 104 eyes. In n = 84 eyes, the oGVHD NIH grade was documented; 12% (n = 12) of analyzed eyes were staged oGVHD NIH grade 1, 31% (n = 32) NIH 2 and 39% (n = 41) NIH 3. The mean BCVA improved in 82% of the eyes (n = 86 eyes). BCVA significantly increased from 0.7 ± 0.5 to 0.4 ± 0.4 LogMAR after surgery independent from oGVHD severity. The mean IOP decreased from 14 ± 4 to 13 ± 4 mmHg after surgery. Visual acuity was moderately correlated to the pre-operative degree of corneal staining (Pearson p = 0.26, p = 0.002, Cohen's effect size f = 0.29). The visual acuity decreased by 0.078 LogMar units (95% CI = 0.027-0.141) with each increase of corneal staining by one grade (p = 0.05). After surgery, corneal epitheliopathy increased significantly in 42% (n = 44) of the eyes. Postoperative complications included corneal perforation (n = 6, 6%), cystoid macular edema (n = 4, 4%), and endophthalmitis (n = 1, 1%). CONCLUSION Phacoemulsification in patients with chronic oGVHD significantly improves visual acuity, but is associated with an increased risk of complications in particular corneal epitheliopathy and corneal perforations.
Collapse
Affiliation(s)
- Uta Gehlsen
- Division for Dry-Eye and Ocular GvHD, Department of Ophthalmology, Medical Faculty, University and University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
- Cluster of Excellence: Cellular Stress Responses in Ageing-Associated Diseases, CECAD, University of Cologne, Cologne, Germany
| | - Christiane Faust
- Division for Dry-Eye and Ocular GvHD, Department of Ophthalmology, Medical Faculty, University and University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany
| | - Christiane Blecha
- Department of Ophthalmology, University Hospital Regensburg, Regensburg, Germany
| | - Tina Dietrich-Ntoukas
- Department of Ophthalmology, Charité - Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin, Humboldt Universitaet Berlin, and Berlin Institute of Health, Berlin, Germany
| | - Philipp Eberwein
- Eye Center, University Medical Center Freiburg, Freiburg, Germany
- AugenCentrum Rosenheim, Rosenheim, Germany
| | - Susanne Issleib
- Eye Center, University Medical Center Freiburg, Freiburg, Germany
| | | | - Regine Braun
- Department of Ophthalmology, University Hospital Regensburg, Regensburg, Germany
| | - Henrike Westekemper
- Department of Ophthalmology, University Hospital Essen, University Duisburg Essen, Essen, Germany
| | - Philipp Steven
- Division for Dry-Eye and Ocular GvHD, Department of Ophthalmology, Medical Faculty, University and University Hospital of Cologne, Kerpener Strasse 62, 50937, Cologne, Germany.
- Cluster of Excellence: Cellular Stress Responses in Ageing-Associated Diseases, CECAD, University of Cologne, Cologne, Germany.
| |
Collapse
|
35
|
Hamed MA, Aldghaimy AH, Mohamed NS, Amer AA. The Incidence of Post Phacoemulsification Surgery Induced Dry Eye Disease in Upper Egypt. Clin Ophthalmol 2022; 16:705-713. [PMID: 35300035 PMCID: PMC8921793 DOI: 10.2147/opth.s358866] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 02/18/2022] [Indexed: 12/02/2022] Open
Abstract
Background Dry eye is described as a multifactorial disorder of the tear film that occurs due to excessive tear evaporation or tears insufficiency, and so leads to ocular discomfort sensation and ocular tissue damage with time. Objective To assess the incidence of dry eye disease after uncomplicated phacoemulsification surgery in patients with no pre-existed dry eye. Patients and Methods This hospital-based cross-sectional study was conducted to assess the incidence of dry eye at 100 eyes of 100 patients who underwent uncomplicated phacoemulsification surgery, with age more than 45 years old. It is measured by dry eye tests Schirmer 1 and tear break up time. Results This study showed that 22% of the patients who underwent uncomplicated phacoemulsification surgery suffered from dry eye with significant results at 1st week post-operative that improved over time. Conclusion There was a statistically significant drop in the results of the Schirmer test 1 and TBUT post phacoemulsification surgery, but with no clinical significance as they still at the normal range. The tear film assessment results at the 1st week post-operative were out of the normal range with TBUT and were borderline with ST1 in 22% of the patients. These results improved over time to return to the normal values within 12 weeks postoperatively.
Collapse
Affiliation(s)
- Mohamed Ateto Hamed
- Ophthalmology Department, Luxor University, Luxor, Egypt
- Correspondence: Mohamed Ateto Hamed, Email
| | | | | | - Ahmed Ali Amer
- Ophthalmology Department, South Valley University, Qena, Egypt
| |
Collapse
|
36
|
The Effect of Past Cataract Surgery within the Medium to Long-Term Period on Patients with Dry Eye Disease. J Clin Med 2022; 11:jcm11040972. [PMID: 35207244 PMCID: PMC8878219 DOI: 10.3390/jcm11040972] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/07/2022] [Accepted: 02/10/2022] [Indexed: 11/30/2022] Open
Abstract
This study investigates the effects of cataract surgery on dry eye parameters of patients with dry eye disease (DED) in the medium- to long-term post-surgical period (6 months to 5 years). A cross-sectional study was conducted on 438 eyes on first visit to a tertiary clinic (219 eyes with cataract surgery within timeframe, i.e., pseudophakic dry eye group, 219 comparison eyes without such history, i.e., comparison dry eye group). Parameters evaluated include Ocular Surface Disease Index (OSDI) and standard examination for DED. A significantly greater proportion of pseudophakic dry eye group (50%) experienced frequent blurred vision (≥1 episode per week) compared to dry eye control group (38%) (OR = 1.66, 95%CI 1.13, 2.44). Those with ocular discomfort before surgery were more likely to experience blurring at least once a day. However, a significantly greater proportion of the pseudophakic dry eye group (34%) had Schirmer’s I >8mm compared to the comparison group (25%) (OR = 0.605, 95% CI 0.398, 0.921), though the difference was not clinically significant (7.51 mm versus 6.51 mm, p > 0.05). Other DED signs (e.g., overall OSDI score, Tear Break-up Time) were not found to be worse among pseudophakic dry eye group. Pre-operative counselling and preventative measures should be undertaken, especially those with suggestive symptoms pre-operatively.
Collapse
|
37
|
Fujimoto H, Ochi S, Inoue Y, Kiryu J. Upper Eyelid Meibomian Gland Dysfunction is a Risk Factor for Dry Eye Symptoms Following Cataract Surgery in the Early Phase. Clin Ophthalmol 2022; 16:293-302. [PMID: 35153474 PMCID: PMC8828079 DOI: 10.2147/opth.s346606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/27/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Hisataka Fujimoto
- Department of Ophthalmology, Kawasaki Medical School, Kurashiki, 701-0192, Okayama, Japan
- Correspondence: Hisataka Fujimoto, Department of Ophthalmology, Kawasaki Medical School, 577 Matsushima, Kurashiki, 701-0192, Okayama, Japan, Tel +81-86-462-1111, Fax +81-86-462-1199, Email
| | | | - Yasushi Inoue
- Inoue Eye Clinic, Tamano, 706-0011, Okayama, Japan
- Yasushi Inoue, Inoue Eye Clinic, 1-14-31 Uno, Tamano, 706-0011, Okayama, Japan, Tel +81-86-331-1030, Fax +81-86-331-1114, Email
| | - Junichi Kiryu
- Department of Ophthalmology, Kawasaki Medical School, Kurashiki, 701-0192, Okayama, Japan
| |
Collapse
|
38
|
Miura M, Inomata T, Nojiri S, Sung J, Nagao M, Shimazaki J, Midorikawa-Inomata A, Okumura Y, Fujio K, Akasaki Y, Kuwahara M, Huang T, Nakamura M, Iwagami M, Hirosawa K, Fujimoto K, Murakami A. Clinical efficacy of diquafosol sodium 3% versus hyaluronic acid 0.1% in patients with dry eye disease after cataract surgery: a protocol for a single-centre, randomised controlled trial. BMJ Open 2022; 12:e052488. [PMID: 35105626 PMCID: PMC8808423 DOI: 10.1136/bmjopen-2021-052488] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION The number of cataract surgeries, the most common ophthalmic surgery, is expected to increase due to ageing populations. Dry eye disease (DED) is a frequent side effect of cataract surgery, contributing to lower postoperative patient satisfaction and suboptimal quality of vision. It is unclear which eye-drops commonly used in these patients should be recommended for postoperative DED treatment. This study aims to compare the efficacy of topical administration of diquafosol sodium 3% vs hyaluronic acid 0.1% eye-drops in patients with DED after cataract surgery. METHODS AND ANALYSIS The study is designed as a single-blind randomised controlled trial. The participants will be randomly (1:1) allocated to either the diquafosol sodium 3% topical administration group (n=21) or the hyaluronic acid 0.1% topical administration group (n=21). Each group will receive its assigned eye-drop intervention over a 12-week period. The primary outcome will be measured using the total score of the Japanese version of the Ocular Surface Disease Index during the visit 5 weeks postoperatively. Both groups will be followed up after their respective eye-drop application for 12 weeks according to the intervention regimens. Secondary outcome measures including meibomian gland function assessment, tear film break-up time, keratoconjunctival staining score, maximum blink interval and tear secretion volume using Schirmer's test I will be assessed at 1, 5, 9, 13 and 25 weeks postoperatively. ETHICS AND DISSEMINATION This study has been approved by the Juntendo Hospital Certified Review Board, Tokyo, Japan (Approved protocol V.7.0 dated 7 May 2021. Approval number: J20-018) and has been registered with the Japan Registry of Clinical Trials. Written informed consent will be collected from every patient prior to study participation. The results of this trial will be presented at local and international meetings and submitted to peer-reviewed journals for publication. TRIAL REGISTRATION NUMBER jRCT1031210018.
Collapse
Affiliation(s)
- Maria Miura
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Takenori Inomata
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Strategic Operating Room Management and Improvement, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Shuko Nojiri
- Medical Technology Innovation Center, Juntendo University, Bunkyo-ku, Tokyo, Japan
| | - Jaemyoung Sung
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Masashi Nagao
- Medical Technology Innovation Center, Juntendo University, Bunkyo-ku, Tokyo, Japan
- Department of Orthopedic Surgery, Juntendo University Faculty of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Sports Science, Juntendo University Faculty of Health and Sports Science, Chiba, Japan
| | - Jun Shimazaki
- Department of Ophthalmology, Tokyo Dental College Ichikawa General Hospital, Ichikawa, Chiba, Japan
| | - Akie Midorikawa-Inomata
- Department of Hospital Administration, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Yuichi Okumura
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Strategic Operating Room Management and Improvement, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Kenta Fujio
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Yasutsugu Akasaki
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Mizu Kuwahara
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Tianxiang Huang
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Masahiro Nakamura
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
- Precision Health, Department of Bioengineering, Graduate School of Engineering, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Masao Iwagami
- Department of Health Services Research, University of Tsukuba, Tsukuba, Japan
- Department of Non-Communicable Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, UK
| | - Kunihiko Hirosawa
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Keiichi Fujimoto
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| | - Akira Murakami
- Department of Ophthalmology, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
- Department of Digital Medicine, Juntendo University Graduate School of Medicine, Bunkyo-ku, Tokyo, Japan
| |
Collapse
|
39
|
Effects of Intravitreal Injection on Ocular Surface and Anterior Segment Parameters. BEYOGLU EYE JOURNAL 2022; 6:84-89. [PMID: 35005499 PMCID: PMC8651022 DOI: 10.14744/bej.2021.65487] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 04/25/2020] [Indexed: 01/01/2023]
Abstract
Objectives: This study was designed to investigate the long-term effects of intravitreal anti-vascular endothelial growth factor (VEGF) injections on ocular surface and anterior segment parameters. A comparison was performed of the treated eye and the fellow healthy eye. Methods: The study group included patients who had received at least 3 intravitreal injections of anti-VEGF agents (bevacizumab, ranibizumab, or aflibercept) for retinal vascular disorders. All of the subjects were treated in only 1 eye. A complete ophthalmological examination, including evaluation of tear break-up time (TBUT), the Schirmer 1 test, the Oxford Grading Scale, and the Ocular Surface Disease Index (OSDI) questionnaire, corneal topography, and specular microscopy were performed in both eyes 1 month after the last injection. Results: In this study, 49 eyes of 49 patients who underwent regular intravitreal injection in 1 eye were enrolled. The mean age was 63.85±9.8 years (range: 29-86 years). A mean of 4.06±1.7 (range: 3-11) injections were administered. There was no significant difference in the intraocular pressure, TBUT, Schirmer 1, fluorescein staining, or specular microscopy parameters (p>0.05). The mean non-invasive TBUT first and average values; the central, thinnest, and apex corneal thickness measurements; the anterior chamber depth, irido-corneal angle, corneal volume, and keratometry values were similar in each individual (p>0.05 for all parameters). The mean OSDI score was 27.5±17.6 for the injected eyes and 15.9±12.9 for the non-injected eyes (p<0.0001). Conclusion: Intravitreal anti-VEGF injections had no effect on ocular surface, corneal endothe-lium, and anterior segment parameters.
Collapse
|
40
|
Strong Caldwell A, Patnaik JL, Ackerman M, Christopher KL, Lynch AM, Singh JK. Risk of Refractive Prediction Error After Cataract Surgery in Patients with Thyroid Eye Disease. Clin Ophthalmol 2021; 15:4431-4438. [PMID: 34795474 PMCID: PMC8593354 DOI: 10.2147/opth.s337360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Accepted: 10/15/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose To investigate the risk of unexpected refractive prediction error after cataract surgery in patients with thyroid eye disease (TED) at the University of Colorado. Patients and Methods A retrospective observational study was performed using records of patients who underwent cataract surgery (2014 to 2018) who were included in a Cataract Surgery Outcomes database. Any patient with documentation of thyroid eye disease (TED) in the medical record was classified as TED. Post-operative refraction error greater than or equal to ±1.0 diopter from the target refraction was the main outcome of this study. Eyes with history of refractive surgery, ocular trauma, retinal detachment, non-Graves’ disease thyroid conditions or Graves’ disease without TED, and eyes without refractive error at follow-up were excluded. Results A total of 5716 eyes from 3692 patients who underwent cataract surgery were analyzed. Sixty-five eyes of thirty-nine patients (1.1%) had TED. Former and/or current cigarette use was associated with having TED (p = 0.0504). Patients with TED had a statistically significant shorter axial length as compared to eyes without TED (p = 0.0257). Three hundred and forty-nine eyes (6.1%), including 9 eyes (13.8%) in patients with TED, had refractive prediction error greater than ±1.0 diopter following surgery (univariate OR = 2.5, 95% CI: 1.1–5.7, p = 0.0274). After multivariate analysis controlling for race, tobacco use, combined surgery, and axial length, TED was associated with an increased risk of our primary outcome, refractive prediction error greater than ±1.0 diopter (OR = 2.4, 95% CI: 1.0–5.7, p = 0.0506). Conclusion Patients with TED are at increased risk for refractive prediction error following cataract surgery. Discussion with patients regarding their risk and possible need for glasses following surgery is important for setting realistic patient expectations.
Collapse
Affiliation(s)
- Anne Strong Caldwell
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Jennifer L Patnaik
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Melisa Ackerman
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Karen L Christopher
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Anne M Lynch
- Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO, USA
| | - Jasleen K Singh
- Department of Ophthalmology, Children's Hospital of Colorado, Aurora, CO, USA
| |
Collapse
|
41
|
Abstract
Background: To study the safety and efficacy provided by a minimal and localized anesthesia in cataract surgery. Methods: Randomized controlled trial. A total of 100 patients undergoing cataract surgery were randomly divided into two groups of 50, which respecitvely received conventional topical anesthesia consisting of preservative-free Oxibuprocaine hydrochloride 0.4% drops or minimal localized anesthesia, administered with a cotton bud soaked in preservative-free Oxibuprocaine hydrochloride 0.4% applied to clear cornea on the access sites for 10 s immediately before surgery. The mean outcome measures were intraoperative pain and the incidence of postoperative ocular discomfort. Results: All patients tolerated well the procedure, giving patin scores between 1–3. Fifteen patients (30%) of group 1 and ten of group 2 (25%) required supplemental anesthesia. No intraoperative complications were recorded. No eyes had epithelial defects at the end of the surgery or at postoperative check-ups. Conclusions: Minimal anesthesia in cataract surgery resulted quick, safe and non-invasive.
Collapse
|
42
|
Improved accuracy of intraocular lens power calculation by preoperative management of dry eye disease. BMC Ophthalmol 2021; 21:364. [PMID: 34645396 PMCID: PMC8515725 DOI: 10.1186/s12886-021-02129-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 09/24/2021] [Indexed: 11/29/2022] Open
Abstract
Background To evaluate the effects of pretreatment for dry eye disease (DED) on the accuracy of intraocular lens (IOL) power calculation. Methods Patients who underwent uneventful cataract surgery were included in the study. IOL power was determined using the SRK/T and Barrett Universal II (Barrett) formulas. The patients were divided into non-pretreatment and pretreatment groups, and those in the pretreatment group were treated with topical 0.5% loteprednol etabonate and 0.05% cyclosporin A for 2 weeks prior to cataract surgery. Ocular biometry was performed in all groups within 2 days before surgery. The mean prediction error, mean absolute error (MAE), and proportions of refractive surprise were compared between the non-pretreatment and pretreatment groups at 1 month postoperatively. Refractive surprise was defined as MAE ≥ 0.75D. Results In a total of 105 patients, 52 (52 eyes) were in the non-pretreatment group and 53 (53 eyes) in the pretreatment group. The MAE was 0.42 ± 0.33, 0.38 ± 0.34 (SRK/T, Barrett) and 0.23 ± 0.19, 0.24 ± 0.19 in the non-pretreatment and pretreatment groups, respectively (p < 0.001/=0.008). The number of refractive surprises was also significantly lower in the pretreatment group. [non-pretreatment/pretreatment: 9/2 (SRK/T); 8/1 (Barrett); p = 0.024/0.016]. Pretreatment of DED was related to a reduction in postoperative refractive surprise. [SRK/T/Barrett: OR = 0.18/0.17 (95% CI: 0.05–0.71/0.05–0.60), p = 0.014/0.006]. Conclusions The accuracy of IOL power prediction can be increased by actively treating DED prior to cataract surgery.
Collapse
|
43
|
Park J, Yoo YS, Shin K, Han G, Arita R, Lim DH, Chung TY. Effects of Lipiflow Treatment Prior to Cataract Surgery: A Prospective, Randomized, Controlled Study. Am J Ophthalmol 2021; 230:264-275. [PMID: 33992615 DOI: 10.1016/j.ajo.2021.04.031] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 04/05/2021] [Accepted: 04/28/2021] [Indexed: 12/13/2022]
Abstract
To investigate the effects of preoperative Lipiflow (Johnson & Johnson, Jacksonville, FL, USA) treatment before cataract surgery on meibomian gland dysfunction (MGD) and dry eye induced by surgery. DESIGN Prospective, randomized controlled study. METHODS This study comprised 124 eyes of 124 patients with planned surgery for senile cataract. Participants were randomly allocated into control and Lipiflow groups based on administration of Lipiflow treatment 3 weeks before cataract surgery. For meibomian gland (MG) evaluation, MG atrophy, degree of gland expressibility, and quality of gland secretions were examined at the baseline visit and 1 and 3 months postoperatively. Ocular surface parameters of tear film break-up time, Oxford corneal staining score, and tear film lipid layer thickness were measured at each visit. Ocular Surface Disease Index and Dry Eye Questionnaire were also assessed. RESULTS The control group exhibited a significant decrease in MG expressibility, worsened meibum quality, decreased lipid layer thickness, and worsened corneal staining after cataract surgery. Also, dry eye symptom showed significant worsening. Conversely, the Lipiflow group showed significantly improved MG patency and meibum quality, increased tear film break-up time, and reduced corneal staining, and presented improved subjective outcomes reported on both Ocular Surface Disease Index and Dry Eye Questionnaire. The improvement of each parameter in the Lipiflow group showed a linear correlation with baseline MGD grade. In addition, patients without baseline MGD showed less worsening or improvement of MGD and dry eye induced by surgery, with preoperative Lipiflow treatment. CONCLUSIONS Preoperative Lipiflow treatment conducted before cataract surgery may be a safe and effective intervention for relieving MGD and dry eye induced by surgery. It might be recommended not only for the patients with preoperative MGD but also for those without baseline MGD, to prevent the development of MGD and dry eye induced by ocular surgeries.
Collapse
|
44
|
Hovanesian JA, Berdy GJ, Epitropoulos A, Holladay JT. Effect of Cyclosporine 0.09% Treatment on Accuracy of Preoperative Biometry and Higher Order Aberrations in Dry Eye Patients Undergoing Cataract Surgery. Clin Ophthalmol 2021; 15:3679-3686. [PMID: 34511871 PMCID: PMC8420800 DOI: 10.2147/opth.s325659] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 08/23/2021] [Indexed: 11/23/2022] Open
Abstract
Purpose To determine the effect of topical cyclosporine 0.09% on ocular surface regularity and the predictive accuracy of preoperative corneal power measurements in patients undergoing cataract surgery. Setting Private practice. Design Open-label, multicenter, prospective study. Methods Seventy-five patients (75 eyes) who presented for cataract surgery evaluation with signs of dry eye disease were prescribed topical cyclosporine 0.09% for 28 days BID. Corneal curvature measurements, slit lamp exam, and Standardized Patient Evaluation of Eye Dryness (SPEED) questionnaire were evaluated at the initial and follow-up visits. Cataract surgery occurred 1 to 3 weeks after the second biometry visit. Refraction and corrected distance visual acuity measurements were performed 1-month post-surgery. The primary outcome was the difference in absolute prediction error of 1-month spherical equivalent refractive outcome before and after cyclosporine treatment. Secondary outcomes included the effect of topical cyclosporine 0.09% on ocular surface irregularity. Results Sixty-four patients completed the study. The absolute prediction error of 1-month spherical equivalent refractive outcome was 0.39 ± 0.30 D vs 0.33 ± 0.25 D (P < 0.03) before and after treatment, respectively. The proportion of eyes that achieved the target refraction was greater based on measurements after topical cyclosporine 0.09% than would have occurred using pre-treatment measurements. Conclusion Cataract surgery patients with dry eye who are prescribed topical cyclosporine 0.09% BID for 28 days pre-surgery showed a statistically significant improvement in the prediction error of the spherical equivalent outcome of surgery. Other measures of dry eye severity showed significant improvements after treatment.
Collapse
|
45
|
Garg P, Gupta A, Tandon N, Raj P. Dry Eye Disease after Cataract Surgery: Study of its Determinants and Risk Factors. Turk J Ophthalmol 2021; 50:133-142. [PMID: 32630999 PMCID: PMC7338747 DOI: 10.4274/tjo.galenos.2019.45538] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Objectives To study the incidence of dry eye and its determinants in patients undergoing cataract surgery. Materials and Methods One hundred twenty patients with senile cataract underwent Schirmer's test, tear break-up time (TBUT) test, lissamine green staining of the cornea and conjunctiva, and Ocular Surface Disease Index (OSDI) for evaluation of dry eye preoperatively and again at first and second follow-up examinations at 1 week and 1 month after cataract surgery. Results Mean age of the patients was 59.25+9.77 years and 73 (60.8%) were men. None of the patients had dry eye at the time of enrollment as per the criteria of our study. Postoperatively, Schirmer's test values ranged from 12-35 mm and 8-24 mm at first and second follow-ups, respectively. Mean TBUT was 13.16±2.45 and 9.64±2.20 seconds, while lissamine green staining score was 3 in 67 (55.8%) and 1 in 67 (55.8%) subjects at first and second follow-up, respectively. OSDI values ranged from 1-30 and 10-33 with a mean of 25.97±5.34 and 11.96±7.47 respectively at first and second follow-up. At first follow-up, 89.1% of the 56 patients who underwent phacoemulsification were found to have grade 2 dry eye (p<0.001), while 92.2% of the 64 patients who underwent small-incision cataract surgery (SICS) had grade 2 dry eye (p<0.001). At second follow-up, grade 0 dry eye was observed in 92.2% of the patients who underwent phacoemulsification and 82.1% of the patients who underwent SICS (p<0.001). Conclusion The incidence of dry eye after cataract surgery was high and mostly independent of demographic and anthropometric profile, type of surgical procedure, time of microscope exposure, and amount of energy used. This dryness was transient in nature and showed a declining trend, tending to achieve normalization by the end of 1 month.
Collapse
Affiliation(s)
- Pragati Garg
- Era's Lucknow Medical College and Hospital, Clinic of Ophthalmology, Lucknow, India
| | - Aditi Gupta
- Era's Lucknow Medical College and Hospital, Clinic of Ophthalmology, Lucknow, India
| | - Nishi Tandon
- Era's Lucknow Medical College and Hospital, Clinic of Pathology, Lucknow, India
| | - Priyanka Raj
- Era's Lucknow Medical College and Hospital, Clinic of Ophthalmology, Lucknow, India
| |
Collapse
|
46
|
Starr CE, Dana R, Pflugfelder SC, Holland EJ, Zhang S, Owen D, Brazzell K. Dry eye disease flares: A rapid evidence assessment. Ocul Surf 2021; 22:51-59. [PMID: 34303844 DOI: 10.1016/j.jtos.2021.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/14/2021] [Accepted: 07/18/2021] [Indexed: 12/12/2022]
Abstract
PURPOSE Characteristics of periodic flares of dry eye disease (DED) are not well understood. We conducted a rapid evidence assessment to identify evidence for and characteristics of DED flares. METHODS Literature searches were performed in Embase® via Ovid®, MEDLINE®, and PubMed®. Clinical trials and observational studies published 2009-2019 were included if they investigated patients aged ≥18 years with clinically diagnosed DED who experienced a flare, defined as a temporary or transient episode of increased ocular discomfort, typically lasting days to a few weeks. Triggers of flares, patient-reported outcomes (symptoms), clinician-measured outcomes (signs), and changes in tear molecules were captured. RESULTS Twenty-one publications that included 22 studies met inclusion criteria. Five observational studies described evidence of DED flares in daily life, 5 studies reported changes following cataract/refractive surgery in patients with preoperative DED, and 12 studies employed controlled environment (CE) models. Real-world triggers of DED flares included air conditioning, wind, reading, low humidity, watching television, and pollution. CE chambers (dry, moving air) and surgery also triggered DED flares. Exacerbations of symptoms and signs of DED, assessed through varied measures, were reported during flares. Across studies, matrix metalloproteinase-9 and interleukin-6 increased and epidermal growth factor decreased during DED flares. CONCLUSIONS Evidence from 22 studies identified triggers and characteristics of DED flares. Further research is needed to assist clinicians in early diagnosis and treatment of patients experiencing flares.
Collapse
Affiliation(s)
- Christopher E Starr
- Department of Ophthalmology, Weill Cornell Medicine, New York-Presbyterian Hospital, New York, NY, USA.
| | - Reza Dana
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Stephen C Pflugfelder
- Ocular Surface Center, Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA
| | - Edward J Holland
- Department of Ophthalmology, Cincinnati Eye Institute, University of Cincinnati, Cincinnati, OH, USA
| | | | | | | |
Collapse
|
47
|
Kim TH, Chung B, Kim KY, Jun I, Seo KY, Kim EK, Kim TI. Effect of 0.15% Preservative-free Sodium Hyaluronate on Dry Eye Disease after Femtosecond Laser-assisted Cataract Surgery. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.7.922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Purpose: The efficacy of using preservative-free 0.15% sodium hyaluronate eyedrops for dry eye disease after femtosecond laser- assisted cataract surgery (FLACS) was evaluated. Methods: This prospective randomized study was conducted on patients with dry eye who were scheduled for FLACS among those with Tear Film & Ocular Surface Society Dry Eye Workshop II Dry Eye Levels 1 and 2. In total, 37 eyes scheduled for FLACS were randomized to the treatment group (n = 19) or control group (n = 18). Corneal and conjunctival fluorescein staining (CFS), tear breakup time (TBUT), Schirmer I test (SIT) value, ocular surface disease index (OSDI), meibomian gland evaluation result, and lipid layer thickness were evaluated for all patients, preoperatively and at 1 and 3 months postoperatively. Results: In the treatment group, the OSDI and CFS scores were significantly lower at 3 months postoperatively than at baseline, but the TBUT and SIT values were significantly increased. In the control group, TBUT was significantly shorter at 3 months postoperatively than at baseline, SIT values were significantly decreased at 1 and 3 months postoperatively compared with the baseline, and meibum quality was significantly aggravated at 1 month postoperatively compared with the baseline. In the treatment group, OSDI improved significantly from baseline at 1 and 3 months. TBUT increased significantly in the treatment group at postoperative 3 months. Meibomian gland quality showed clinically better results in the treatment group than in the control group at postoperative 3 months. There were no significant differences in corneal and CFS, lipid layer thickness, and other dry eye disease parameters between the treatment and control groups. Conclusions: Preservative-free 0.15% sodium hyaluronate eyedrops were effective for improving dry eye symptoms and tear film stability after FLACS.
Collapse
|
48
|
Igarashi T, Takahashi H, Kobayashi M, Kunishige T, Arima T, Fujimoto C, Suzuki H, Okuda T, Takahashi H. Changes in Tear Osmolarity after Cataract Surgery. J NIPPON MED SCH 2021; 88:204-208. [PMID: 34193743 DOI: 10.1272/jnms.jnms.2021_88-405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND The purpose of this study was to examine changes in the ocular surface before and after phacoemulsification with small incisions and to examine the changes in tear osmolarity. METHODS This was a prospective, observational study involving 55 eyes of 39 patients (19 male, 20 female patients; average age 72.0±7.3 years) who had cataract surgery at a Nippon Medical School Hospital between December 2013 and June 2018. Compromised tear dynamics were determined by the Schirmer test or the tear break-up time (BUT). An abnormal ocular surface was identified by positive vital staining with fluorescein or lissamine green. Moreover, tear osmolarity (Tosm) and corneal sensitivity were measured. All assessments were done preoperatively and 1 and 4 weeks (P1W and P4W) after the surgery. RESULTS None of the operations had any complications. Operating time was 17.8±9.3 minutes. BUT was significantly decreased at P1W, and it recovered at P4W. The Schirmer test did not change significantly. The fluorescein staining score (FSS) increased significantly at P1W and recovered at P4W. The Lissamine green score (LSS) did not change significantly. Tear osmolarity increased significantly at P1W and did not recover at P4W. Corneal sensitivity decreased significantly at P1W and recovered at P4W. CONCLUSION In the present study, there were temporary changes in dry eye-related examinations including tear osmolarity after cataract surgery. In particular, tear osmolarity increased significantly 4 weeks after surgery compared to before surgery, and it showed long-term changes, unlike other factors. After cataract surgery, tear osmolarity, BUT, and FSS increase, resulting in dry eye symptoms. Therefore, it is necessary to pay attention to discomfortable eye symptoms of patients after cataract surgery.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | - Takahisa Okuda
- Division of Legal Medicine, Department of Social Medicine, Nihon University School of Medicine
| | | |
Collapse
|
49
|
Ma KK, Luo ZK. Novel Method to Determine Target Refraction in Cataract Surgery for Patients Dependent on Therapeutic Scleral Lenses. Eye Contact Lens 2021; 47:352-355. [PMID: 33017330 PMCID: PMC8132607 DOI: 10.1097/icl.0000000000000747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate a novel approach to determine the refractive target for patients undergoing cataract surgery who are dependent on therapeutic scleral lenses, to avoid the need for postoperative scleral lens replacement. METHODS Retrospective single-surgeon case series. The target refraction for intraocular lens selection was determined by considering the effective scleral lens system power. This was calculated by adding the known scleral lens spherical power to the difference between the scleral lens base curve and the average keratometry value. RESULTS Six eyes from three patients with moderate myopia or emmetropia with ocular graft versus host disease dependent on therapeutic scleral lenses underwent cataract surgery with intraocular lens selection based on this method. All six eyes had corrected visual acuities of 20/30 or better while wearing their previous scleral lenses at the postoperative week 1 visit. All six eyes resumed full-time scleral lens use 1 week after phacoemulsification and did not require scleral lens replacement. CONCLUSIONS Using this method, patients requiring therapeutic scleral lenses can quickly experience optimal vision, comfort, and ocular surface protection 1 week after cataract surgery. These patients can continue to use their existing scleral lenses and avoid the costs and burdens associated with lens replacement.
Collapse
Affiliation(s)
- Kevin K Ma
- Massachusetts Eye and Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA
| | | |
Collapse
|
50
|
Souki S, Cochener B, Labetoulle M, Güell JL. Phase IV clinical study to evaluate the effects of an intracameral combined mydriatic and anesthetic agent and standard topical mydriatics and anesthetics on the ocular surface after cataract surgery. J Cataract Refract Surg 2021; 47:570-578. [PMID: 33196565 DOI: 10.1097/j.jcrs.0000000000000491] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 10/10/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE To compare intracameral and topical mydriatics and anesthetics in cataract surgery. SETTING Institute of Ocular Microsurgery, Barcelona, Spain. DESIGN Phase IV, open-label, randomized, single-center study. METHODS Patients were randomized in a 1:1 ratio to receive intracameral mydriatic-anesthetic (Mydrane/Fydrane) and anesthetic eyedrops or control (topical eyedrops only). The other treatment was administered for the second cataract surgery. Assessments were performed at presurgery and immediately postsurgery, at 12 to 36 hours postsurgery (day 1), and 7 days postsurgery. The primary endpoint was the change from baseline in corneal/conjunctival surface staining. The secondary endpoints included assessments of epithelial alterations, point-spread function, ocular surface disease index, conjunctival hyperemia, vision breakup time, ocular symptoms/signs, adverse events (AEs), corrected distance visual acuity, intraocular pressure, patient/investigator satisfaction, and procedure time. RESULTS A total of 50 patients undergoing sequential cataract surgery in both eyes were included. Baseline assessments were similar in each group. The difference between Fydrane and control groups for the change from baseline at day 1 in corneal and conjunctival surface staining was not statistically significant. For Fydrane, postoperative epithelial alterations were fewer at day 1 (P < .005), folliculopapillary reaction was less frequent (P < .05), some ocular symptoms were less frequent and milder (P < .05), length of procedure was shorter (P < .001), and patient and investigator satisfaction were better (P < .05). There were few AEs in both groups. CONCLUSIONS Fydrane reduced ocular surface damage by decreasing corneal epithelial and conjunctival toxicity with faster recovery of surface integrity compared with topical eyedrops, improved patient and investigator satisfaction, and reduced procedure time.
Collapse
Affiliation(s)
- Spyridoula Souki
- From the Institute of Ocular Microsurgery, Barcelona, Spain (Souki, Güell); CHU Morvan, Brest, France (Cochener); Hôpital Bicêtre, Université Paris Sud, Paris, France (Labetoulle)
| | | | | | | |
Collapse
|