The Effect of Hyaluronic Acid-contained Artificial Tear on Refractive Accuracy of Cataract Surgery in Dry Eye Population: A Retrospective Cohort Study.

Background/aim: This study aimed to investigate the association between the perioperative usage of hyaluronic acid (HA)-containing artificial tears and the refractive accuracy of cataract surgery in patients with dry eye disease (DED).

Patients and methods: In this retrospective cohort study, patients with DED who underwent cataract surgery were categorized based on their use of HA-containing artificial tears. A total of 62 eyes were assigned to the non-HA group and 54 eyes to the HA group. The primary outcomes were the uncorrected distance visual acuity (UDVA), postoperative spherical equivalent (SE), and astigmatism assessed via vector analysis. The independent t test and the generalized linear regression were applied for the statistical analysis.

Results: Three months postoperatively, the UDVA in the HA group was significantly better than that in the non-HA group (p<0.001). At the same time, the residual SE was significantly higher in the non-HA group than in the HA group (p =0.001). In addition, the HA group showed a higher surgery-induced astigmatism (SIA), lower difference vector (DV), lower magnitude of error (ME), and higher correction index (CoI) compared to the non-HA group (all p>0.05). The high axial length (AXL) significantly correlated to the higher residual SE in the HA group (p=0.001), while the low preoperative tear break-up time, high corneal astigmatism and high AXL correlated to the higher residual SE in the non-HA group (all p<0.05).

Conclusion: Perioperative use of HA-containing artificial tears is associated with improved refractive accuracy following cataract surgery in patients with DED.