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Cataract
Dry Eye

Dry eye parameters after cataract surgery similar after various treatments

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Although postop cataract surgery patients with mild to moderate dry eyes may experience improved tear film status and reduced symptoms, researchers found no additional beneficial effect on dry eye parameters with treatment using preservative-free dexamethasone, NSAIDs, and lubricants compared to preservative-containing eye drops, according to a recent prospective randomized intervention.

In the study that compared treatments after cataract surgery in dry vs non-dry eyes, dry eye tests were performed before and 6 weeks after cataract surgery. Patients were considered as having dry eye, sign of dry eye (SDE), if a corneal fluorescein staining (CFS), non-invasive keratograph breakup time (NIKBUT), or tear osmolarity test was abnormal. Patients with SDE were randomly assigned to 2 groups. Group 1 patients were treated with dexamethasone and bromfenac eye drops with the preservative benzalkonium chloride (BAC), while 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.

Two hundred and fifteen patients were enrolled 6 weeks postop. Results showed the number of patients with SDE decreased significantly in groups 1 and 2. Subjective symptoms and objective measures (osmolarity, NIKBUT, CFS, and tear film thickness) improved after surgery, and 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. No statistically significant differences in tear film parameters were found between the 3 groups after surgery.

Reference:

Jensen P, Nilsen C, Gundersen M, et al. A preservative-free approach – effects on dry eye signs and symptoms after cataract surgery. Clin Ophthalmol. 2024;18:591-604. doi:10.2147/OPTH.S446804

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