Ocular Surface Analysis of Dry Eye Disease After Cataract Surgery

Cornea Open Pub Date : 2024-02-02 DOI:10.1097/coa.0000000000000027

W. Tangpagasit, Onnicha Srivanich

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Abstract

We aimed to compare the efficacy and safety of 0.3% hydroxypropyl methylcellulose/dextran (HPMC/Dextran) and 0.3% sodium hyaluronate (SH) in the treatment of dry eye disease (DED) in postcataract surgery patients by analyzing the presurgery and postsurgery ocular surface. This double-blinded, randomized, parallel-group study enrolled 96 patients with ocular surface dysfunction, specifically DED, after phacoemulsification. Patients were randomized to receive either HPMC/Dextran (n = 56) or 0.3% SH (n = 40). All patients received 1 drop per eye, 4 times per day. Data from OCULUS Keratograph 5M and Schirmer I tests without anesthesia were collected at baseline and 1 week, 1 month, and 3 months postoperatively. Three months postsurgery, the ocular surface, Schirmer I test, tear meniscus height (TMH), noninvasive tear film break-up time (NITBUT), meibography, redness, and Ocular Surface Disease Index were significantly improved. The Schirmer I test, TMH, and NITBUT improved significantly (P = 0.07, 0.17, and 0.43, respectively; analysis of variance, P < 0.05) in the SH group compared with the HPMC/Dextran group. In a subgroup analysis of patients with severe dry eye, Schirmer I test ≤ 5 mm/5 minutes and NITBUT < 5 significantly improved (P = 0.00 and 0.001, respectively) at 3 months in the SH group compared with the HPMC/Dextran group. Thus, 0.3% SH gave significantly superior tear secretion and tear film instability outcomes. Both types of preservative-free artificial tears are effective in treating postsurgery DED. Compared with HPMC/Dextran, 0.3% SH artificial tears showed more improvements in Schirmer I test and NITBUT postsurgery.

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白内障手术后干眼症的眼表分析

我们的目的是通过分析手术前和手术后的眼表，比较 0.3% 羟丙基甲基纤维素/右旋糖酐（HPMC/Dextran）和 0.3% 透明质酸钠（SH）治疗白内障手术后患者干眼症（DED）的疗效和安全性。这项双盲、随机、平行组研究共招募了 96 名接受过超声乳化术的眼表功能障碍（尤其是 DED）患者。患者随机接受 HPMC/Dextran（56 人）或 0.3% SH（40 人）。所有患者每天 4 次，每次 1 滴。在基线期、术后 1 周、1 个月和 3 个月，收集了 OCULUS 角膜塑形镜 5M 和 Schirmer I 测试（无麻醉）的数据。术后三个月，眼表、Schirmer I 测试、泪液半月板高度（TMH）、无创泪膜破裂时间（NITBUT）、meibography、眼红和眼表疾病指数均有明显改善。与 HPMC/Dextran 组相比，SH 组的 Schirmer I 试验、TMH 和 NITBUT 均有明显改善（P = 0.07、0.17 和 0.43；方差分析，P < 0.05）。在对重度干眼症患者进行的亚组分析中，与 HPMC/Dextran 组相比，SH 组的 Schirmer I 测试 ≤ 5 mm/5 分钟和 NITBUT ＜ 5 在 3 个月时有明显改善（P = 0.00 和 0.001，分别为 0.00 和 0.001）。因此，0.3% SH 在泪液分泌和泪膜不稳定性方面的效果明显优于 HPMC/Dextran。两种不含防腐剂的人工泪液都能有效治疗术后 DED。与HPMC/Dextran相比，0.3% SH人工泪液在手术后的Schirmer I测试和NITBUT方面有更大的改善。

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Cornea Open

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