The OSI based on the double-pass system was correlated with the Scheimpflug-measured lens density, subjective lens grading, and CDE. The OSI may improve the preoperative evaluation of nuclear cataract and help predict phacodynamics in cataract surgery.

PurposeWe evaluate a matrix metalloproteinase-9 (MMP-9) point-of-care immunoassay (InflammaDry) as a prognostic tool for topical cyclosporine treatment.MethodsA total of 20 healthy subjects and 40 patients meeting >3 dry eye disease (DED) criteria (ocular surface disease index [OSDI] score ≥ 12, tear film breakup time [TBUT] ≤10 seconds, Schirmer I test result ≤10 mm/5 minutes, corneal staining ≥1) were included. DED patients were treated with topical cyclosporine ophthalmic emulsion 0.05% twice daily for 1 month. The InflammaDry test was used to grade MMP-9 levels in the tear film. Treatment response was monitored using the OSDI score, TBUT, and Schirmer, corneal staining, and InflammaDry tests.ResultsOf the eyes, 18 (22.5%) were negative, 29 (36.3%) trace-positive, 16 (20.0%) weak-positive, 11 (13.8%) positive, and six (7.5%) strong-positive for MMP-9 at baseline. MMP-9 levels correlated with OSDI (P = 0.049), TBUT (P = 0.001), corneal staining (P = 0.002), and Schirmer test (P = 0.027) results. MMP-9–positive patients displayed decreased post-treatment MMP-9 levels (P = 0.001) and corneal staining score (P < 0.001), improved OSDI score (P < 0.001), and increased TBUT (P < 0.001) and Schirmer (P = 0.009) test values.ConclusionsSemiquantitative MMP-9 grading correlated well with DED symptoms and signs, and could be used to predict patient status and monitor treatment response. MMP-9–positive patients responded more favorably to topical cyclosporine than did MMP-9–negative patients. Thus, the InflammaDry test may inform decisions regarding initiating topical cyclosporine treatment.Translational RelevanceSemiquantitative MMP-9 could be used to predict patient status and monitor treatment response.

Our results suggest that autologous serum eye drops might not be effective for the treatment of secondary SS because of elevated serum proinflammatory cytokine levels.