Cataract Surgery in Dry Eye Disease: Visual Outcomes and Complications

Donthineni, Pragnya Rao; Das, Anthony Vipin; Shanbhag, Swapna S; Basu, Sayan

doi:10.3389/fmed.2020.575834

Cited by 23 publications

(28 citation statements)

References 29 publications

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“…Surface stabilization procedures should be performed before undertaking cataract surgery. Three studies from India have described the outcomes of cataract surgery in patients with SJS/TEN (34)(35)(36). Phacoemulsification was the most common surgical procedure performed.…”

Section: Cataract Surgery In Sjs/tenmentioning

confidence: 99%

Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India

et al. 2021

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Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN) is a spectrum of rare, severe immunological blistering skin reactions which are triggered by medication intake or infections. The acute phase is characterized by necrolysis of the skin and desquamation of mucosa, primarily oral and ocular, with significant mortality rates. The chronic phase is characterized by multi-organ sequelae with increased rates of morbidity and reduced quality of life for patients who have survived the acute phase. Since the primary goal in the acute phase is saving the life of the patient, ocular involvement is often missed and a significant proportion of patients present to an ophthalmologist with the chronic ocular sequelae. In India, chronic ocular sequelae and low vision are observed in two-thirds of patients who present in the chronic phase of SJS/TEN. In the chronic phase of ocular involvement, there are definite windows of opportunity which if targeted with specific interventions such as scleral lenses and mucous membrane grafts can help reduce the incidence of corneal blindness and improve the quality of life for patients with SJS/TEN. Over the last decade, several studies from India have advanced the understanding of the natural course of ocular involvement in SJS/TEN and the outcomes of timely interventions in the chronic phase of the disease. We present an overview of the epidemiology of ocular complications of SJS/TEN in India, the specific challenges faced in the management of ocular complications in the acute stage and recent advances in management of the chronic ocular complications of the disease.

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Section: Cataract Surgery In Sjs/tenmentioning

confidence: 99%

Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India

et al. 2021

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“…Exclusion criteria were : patients (a) wearing contact lenses, or (b) having a history of eye trauma (acid-base burns), or (c) having had an eye surgery recently ( 9 ), or (d) with congenital abnormality or dysplasia of meibomian glands, or (e) with eye tattoos, (f) with immune system diseases such as Sjogren's syndrome ( 10 ), or (g) who have had long-term meibomian gland massage or fumigation, or (h) who have taken hormone drugs for a long time were excluded from the study.…”

Section: Methodsmentioning

confidence: 99%

Correlation Study Between Abnormal Morphology of Meibomian Glands and Meibum in Patients With Dry Eye Disease Under in vivo Confocal Microscopy

Qian

Zhang

et al. 2022

Front. Med.

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Objective: To observe differences in meibomian gland morphology among patients with meibomian gland dysfunction (MGD) with liquid meibum, with solid meibum, and a non-MGD group by laser scanning in vivo confocal microscopy (IVCM), and then analyze the correlation between meibomian gland abnormalities and dry eye disease.Methods: Twenty-one patients with MGD (42 eyes) with liquid meibum, 21 patients with MGD (38 eyes) with solid meibum, and 24 non-MGD patients (39 eyes) were enrolled in the study. IVCM examination and Schirmer II test were performed, and non-invasive tear-film breakup time (NIBUT) was measured.Results: Data obtained from all the patients were normally distributed; therefore, one-way analysis of variance was performed. The meibomian gland opening diameter and gland opening area of the patients with MGD were greater than those of the non-MGD patients, and values of the liquid meibum group were greater than those of the solid meibum group (F = 17.96, p < 0.001; F = 8.84, p < 0.001, respectively). Due to changes in meibomian gland opening diameter and dilation of meibomian gland acini, the acinar longest diameter and unit area of the patients with MGD were also greater than those of the non-MGD patients, and the values of the solid meibum group were greater than those of the liquid meibum group (F = 36.52, p < 0.001; F = 27.81, p < 0.001, respectively). In the aspect of acinar shortest diameter, there was no difference among the three groups (F = 0.24, P > 0.05). Highest inflammatory cell density was observed in the solid meibum group, followed by the liquid meibum group, and the non-MGD group (F = 111.54, p < 0.001). Similarly, the results of the Schirmer II test and NIBUT showed that the condition of the patients with MGD in the solid meibum group was worst, followed by that of the liquid meibum group and the non-MGD group (F = 99.57, p < 0.001; F = 11.87, p < 0.001, respectively).Conclusions: The different meibum in the patients with MGD is accompanied by different meibomian gland morphologies. Compared with the patients with liquid meibum, those with solid meibum have more obvious dilatation of meibomian glands under confocal microscopy and in these patients, the density of inflammatory cells among glands is higher, and the quality of tears is worse.

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“…Some patients may have significant ocular morbidity that would need surgical interventions to either prevent or manage complications and for visual rehabilitation. Cataract surgery is safe and beneficial in patients with DED across various etiologies [ 67 ]. In the presence of a visually significant cataract, it is preferable to plan a cataract surgery as soon as possible, before significant keratopathy sets in.…”

Section: Levels Of Prevention Of Dedmentioning

confidence: 99%

An Evidence-Based Strategic Approach to Prevention and Treatment of Dry Eye Disease, a Modern Global Epidemic

2021

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Dry eye disease (DED) is an emerging health concern causing significant visual, psychological, social, and economic impact globally. In contrast to visual rehabilitation undertaken at late stages of DED, measures instituted to prevent its onset, establishment, or progression can alter its natural course and effectively bring down the associated morbidity. This review attempts to present the available literature on preventive strategies of DED at one place, including strategies for risk assessment and mitigation, targeting a wide range of population. A literature search was conducted using PubMed and an extensive literature review on preventive strategies for DED was compiled to put forth a holistic and strategic approach for preventing DED. This can be undertaken at various stages or severity of DED directed at different tiers of the health care system. Conclusion: This review intends to put emphasis on preventive strategies being adopted as an integral part of routine clinical practice by general ophthalmologists and specialists to tackle the burden of DED and improve the quality of the lives of the patients suffering from it.

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Cataract Surgery in Dry Eye Disease: Visual Outcomes and Complications

Cited by 23 publications

References 29 publications

Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India

Clinical Aspects of Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis With Severe Ocular Complications in India

Correlation Study Between Abnormal Morphology of Meibomian Glands and Meibum in Patients With Dry Eye Disease Under in vivo Confocal Microscopy

An Evidence-Based Strategic Approach to Prevention and Treatment of Dry Eye Disease, a Modern Global Epidemic

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