Ouch: Another study of persistent dry eye after cataract surgery

Who is most likely to get dry eye after cataract surgery?

In this study, they looked at patients who underwent cataract surgery. If their OSDI scores were greater than 12 three months after surgery, they deemed them as having persistent dry eye symptoms.  The point of the study was to analyze what was different about those patients at the time of surgery and soon after: is it possible to predict who will have persistent dry eye after cataract surgery?

One-third (31 of 96) of the patients had persistent dry eye symptoms after cataract surgery. Ouch!

Risk factors were determined to be:

• High OSDI scores before surgery
• Low TBUT 1 month after surgery
• Low MG orifice obstruction score
• Increased MG dropout

In other words, if they were symptomatic before cataract surgery, and/or if they had meibomian gland issues. 

Eye doctors need to be screening cataract patients for dry eye, advising them on risks and advising them on treatments for dry eye prior to cataract surgery.

Perioperative Ocular Parameters Associated With Persistent Dry Eye Symptoms After Cataract Surgery.

Cornea. 2018 Mar 14. doi: 10.1097/ICO.0000000000001572. [Epub ahead of print]

Choi YJ1, Park SY, Jun I, Choi M, Seo KY, Kim EK, Kim TI.

Abstract

PURPOSE:

To evaluate perioperative dry eye (DE) syndrome and meibomian gland dysfunction (MGD) parameters associated with persistent DE symptoms after cataract surgery.

METHODS:

We enrolled patients who underwent uncomplicated cataract surgery without previous ocular comorbidities and previous use of ophthalmic treatment except for artificial tears at a single tertiary hospital. Lipid layer thickness, meibomian gland (MG) dropout, tear breakup time, Oxford staining score, lid margin abnormality, meibum quality, meibum expressibility, MG orifice obstruction, MGD stage, Ocular Surface Disease Index (OSDI), and Schirmer test score were prospectively assessed in order at baseline and 1 and 3 months postoperative. Patients with an OSDI score >12 at 3 months postoperative were defined as patients with persistent DE symptoms after cataract surgery. Multivariate logistic regression was then used to determine risk factors for persistent DE symptoms.

RESULTS:

A total of 116 eyes of 116 patients were enrolled, and 96 patients completed all examinations until 3 months postoperative. Thirty-one patients had persistent DE symptoms at 3 months postoperative. The Oxford staining score, lid margin abnormality, meibum quality, and MGD stage were improved over time. Baseline high OSDI scores [odds ratio (OR), 1.072; P = 0.001] and 1 month postoperative low tear breakup time, low MG orifice obstruction scores, and increased MG dropout (OR, 0.322; P < 0.001, OR, 0.291; P = 0.015, OR, 1.145; P = 0.007, respectively) were determined as risk factors for persistent DE symptoms after cataract surgery.

CONCLUSIONS:

Ocular parameters at baseline and at 1 month postoperative were important in predicting persistent DE symptoms after cataract surgery.