New Therapeutic Strategy and Innovative Lubricating Ophthalmic Solution in Minimizing Dry Eye Disease Associated with Cataract Surgery: A Randomized, Prospective Study

Fogagnolo, Paolo; Favuzza, Eleonora; Marchina, Daniele; Cennamo, Michela; Vignapiano, Roberto; Quisisana, Chiara; Rossetti, Luca; Mencucci, Rita

doi:10.1007/s12325-020-01288-z

Cited by 21 publications

(27 citation statements)

References 28 publications

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“…In our study, similarly to previous reports, 1,3,4,10,11 we found an increase of DED symptoms and an impairment of tear film stability, evaluated using BUT, especially in the group which did not receive the HPG/HA solution.…”

Section: Discussionsupporting

confidence: 91%

“…The changes in ocular signs and symptoms of DED during the study period were generally lower than in other reports, 1,3,4,11 in the group not treated with artificial tears as well: a possible cause is the inclusion of patients without pre-existing dry eye or risk factors.…”

Section: Discussioncontrasting

confidence: 58%

“…10 Moreover, preoperative identification of patients with DED is crucial in order to prevent its exacerbation; [4][5][6][7] nevertheless, optimizing their ocular surface before surgery may be useful for all phacoemulsification candidates. 11 Artificial tears are the first-line treatment for DED. 10 The two polymers hydroxypropyl guar (HPG) and hyaluronic acid (HA) are important constituents of many commercially available lubricating eyedrops.…”

Section: Introductionmentioning

confidence: 99%

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<p>Protecting the Ocular Surface in Cataract Surgery: The Efficacy of the Perioperative Use of a Hydroxypropyl Guar and Hyaluronic Acid Ophthalmic Solution</p>

Favuzza¹,

Cennamo²,

Vicchio³

et al. 2020

OPTH

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To evaluate the effects of a hydroxypropyl guar (HPG) and hyaluronic acid (HA) ophthalmic solution in terms of post-cataract surgery dry-eye disease (DED) prevention. Patients and Methods: In this retrospective study, the data of 419 patients not previously affected by DED, who had undergone unilateral cataract surgery in 17 Italian centers with different perioperative lubricating regimens, were retrospectively reviewed. Patients who had instilled HPG/HA solution 3 times/day in the preoperative week and for two postoperative months were included in group A; group B only instilled HPG/HA for two postoperative months; group C did not instill any perioperative artificial tears. All patients followed the same antibiotic and anti-inflammatory postoperative topical regimen. The scores of SPEED (Standard Patient Evaluation of Eye Dryness) questionnaire, tear break-up time (BUT) and corneal fluorescein staining (CFS, Oxford scale), performed at the preoperative visit and at one, four and eight postoperative weeks, were evaluated. Results: In groups A and B, the SPEED scores were significantly lower than group C in the whole postoperative period. In group A, the SPEED scores were significantly lower than group B 1 and 4 weeks after surgery (p<0.001 and p=0.021). In group C, 25% of patients reported symptom scores corresponding to mild-moderate dry eye 4 and 8 weeks after surgery. The fluorescein tear BUT in groups A and B was significantly higher than group C in the whole postoperative period (p<0.001). In group A, BUT was significantly higher than group B 4 weeks after surgery (p=0.016). More patients showed no corneal fluorescein staining (CFS grade=0) in groups A and B than group C at all the postoperative visits. Conclusion:The hydroxypropyl guar and hyaluronic acid ophthalmic solution was effective at reducing post-cataract surgery ocular discomfort and tear instability, particularly if also administered in the preoperative period.

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Section: Discussionsupporting

confidence: 91%

Section: Discussioncontrasting

confidence: 58%

Section: Introductionmentioning

confidence: 99%

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<p>Protecting the Ocular Surface in Cataract Surgery: The Efficacy of the Perioperative Use of a Hydroxypropyl Guar and Hyaluronic Acid Ophthalmic Solution</p>

Favuzza¹,

Cennamo²,

Vicchio³

et al. 2020

OPTH

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“…The use of these eyedrops is associated with epithelial toxicity and worsening of goblet cell density. Therefore, in cases of postoperative DED, epitheliotoxic antibiotics should be avoided or used with caution and/or for a short duration [ 51 , 65 ]. In case of severe inflammation of the ocular surface, more aggressive treatment, including pulse topical steroid therapy or even topical immunomodulatory drugs, can be considered [ 37 , 66 ].…”

Section: Postoperative Managementmentioning

confidence: 99%

Iatrogenic Dry Eye Disease: Dealing with the Conundrum of Post-Cataract Discomfort. A P.I.C.A.S.S.O. Board Narrative Review

et al. 2021

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The incidence and prevalence of dry eye disease (DED) after cataract surgery is greatly underestimated. The severity of dry eye symptoms has been reported to peak 7 days after cataract surgery and may persist for months, significantly affecting patients' quality of life (QoL). The importance of considering surgical outcomes not only in terms of visual acuity, but also in terms of the patients' QoL, necessitates the assessment and evaluation of the ocular surface by the cataract surgeon prior to the procedure. This narrative review, drafted by the P.I.C.A.S.S.O. (Italian Partners for the Correction of Ocular Surface Alterations) board, analyses the physiopathology of post-cataract surgery DED and highlights the pre-, intra-and postoperative risk factors that may alter ocular surface homeostasis; it proposes a practical comprehensive algorithm for the prevention, treatment and management of DED associated with cataract surgery. Particular attention needs to be paid to the pre-and intraoperative risk factors to reduce the incidence of postoperative dry eye and to improve cataract surgery outcome.

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“…When the tear secretion volume is too high and the drainage is insu cient, the tear storage is on the high side; conversely, when the tear secretion is insu cient and the drainage is suitable, the tear storage is low; nally, when the tear secretion is insu cient and the drainage is insu cient, the tear storage may be normal [10,11,12]. SIt is a typical quantitative method for determining the composition of tear uid samples and can re ect the basic secretion of tears, and SIt is also a common detection index for patients with dry eyes [13,14].…”

Section: Discussionmentioning

confidence: 99%

Analysis of the changes in the lacrimal system before and after endoscopic dacryocystorhinostomy

Sha¹,

Zheng²,

Zhang³

et al. 2020

Preprint

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BackgroundWe aimed to analys and explore the changes in the lacrimal system before and after endoscopic dacryocystorhinostomy (EN-DCR).MethodsA series of case studies was reviewed. The clinical data of 104 patients (120 eyes) who underwent EN-DCR in our hospital from March 2019 to October 2019 were selected for the study. The tear meniscus height (TMH) and the Schirmer I test (SIt) values were compared preoperatively and 1 month and 3 months postoperatively and statistically analysed by Mauchly's test of sphericity and the Pearson correlation coefficient.ResultsThe TMH decreased across all 3 timepoints, and the differences were statistically significant (P<0.05). The TMH values were measured 3 times in 120 eyes and showed three patterns: increased steadily (34 eyes), descended first and then ascended (32 eyes), and decreased steadily (54 eyes); the changes in the three patterns were statistically significant (P<0.05). There were a significant increases in SIt values among the three timepoints, and the SIt values gradually increased when the SIt values were < 10 mm/5 min preoperatively. However, there was no significant difference in SIt values when the SIt values were ≥ 10 mm/5 min preoperatively. The TMH was highly correlated with the SIt value preoperatively (r = 0.763), moderately correlated at 1 month postoperatively (r = 0.515), and not correlated at 3 months postoperatively (r = 0.097).ConclusionsEN-DCR has a certain degree of influence on the tear system, which is not only reflected in the tear drainage system, but also in the tear secretion system and the interaction between the two systems; however, excess tear drainage, can also alleviate dry eyes.Funding programmeJoint Fund Project of Hubei Provincial Health Select Committee (No. WJ2019H318); General Key Projects of Medical Research in Wuhan City, Hubei Province (No. WX19A03)

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New Therapeutic Strategy and Innovative Lubricating Ophthalmic Solution in Minimizing Dry Eye Disease Associated with Cataract Surgery: A Randomized, Prospective Study

Cited by 21 publications

References 28 publications

<p>Protecting the Ocular Surface in Cataract Surgery: The Efficacy of the Perioperative Use of a Hydroxypropyl Guar and Hyaluronic Acid Ophthalmic Solution</p>

<p>Protecting the Ocular Surface in Cataract Surgery: The Efficacy of the Perioperative Use of a Hydroxypropyl Guar and Hyaluronic Acid Ophthalmic Solution</p>

Iatrogenic Dry Eye Disease: Dealing with the Conundrum of Post-Cataract Discomfort. A P.I.C.A.S.S.O. Board Narrative Review

Analysis of the changes in the lacrimal system before and after endoscopic dacryocystorhinostomy

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