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Perioperative Ocular Parameters Associated With Persistent Dry Eye Symptoms After Cataract Surgery

Choi, Young Joon MD, PhD; Park, Si Yoon MD; Jun, Ikhyun MD, PhD; Choi, Moonjung MD; Seo, Kyoung Yul MD, PhD; Kim, Eung Kweon MD, PhD; Kim, Tae-im MD, PhD

doi: 10.1097/ICO.0000000000001572
Clinical Science
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Purpose: To evaluate perioperative dry eye (DE) syndrome and meibomian gland dysfunction (MGD) parameters associated with persistent DE symptoms after cataract surgery.

Methods: We enrolled patients who underwent uncomplicated cataract surgery without previous ocular comorbidities and previous use of ophthalmic treatment except for artificial tears at a single tertiary hospital. Lipid layer thickness, meibomian gland (MG) dropout, tear breakup time, Oxford staining score, lid margin abnormality, meibum quality, meibum expressibility, MG orifice obstruction, MGD stage, Ocular Surface Disease Index (OSDI), and Schirmer test score were prospectively assessed in order at baseline and 1 and 3 months postoperative. Patients with an OSDI score >12 at 3 months postoperative were defined as patients with persistent DE symptoms after cataract surgery. Multivariate logistic regression was then used to determine risk factors for persistent DE symptoms.

Results: A total of 116 eyes of 116 patients were enrolled, and 96 patients completed all examinations until 3 months postoperative. Thirty-one patients had persistent DE symptoms at 3 months postoperative. The Oxford staining score, lid margin abnormality, meibum quality, and MGD stage were improved over time. Baseline high OSDI scores [odds ratio (OR), 1.072; P = 0.001] and 1 month postoperative low tear breakup time, low MG orifice obstruction scores, and increased MG dropout (OR, 0.322; P < 0.001, OR, 0.291; P = 0.015, OR, 1.145; P = 0.007, respectively) were determined as risk factors for persistent DE symptoms after cataract surgery.

Conclusions: Ocular parameters at baseline and at 1 month postoperative were important in predicting persistent DE symptoms after cataract surgery.

Department of Ophthalmology, Institute of Vision Research, Yonsei University College of Medicine, Seoul, Republic of Korea.

Correspondence: Tae-im Kim, MD, PhD, Department of Ophthalmology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemoon-Gu, Seoul 03722, Republic of Korea (e-mail: tikim@yuhs.ac).

Supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education, Science, and Technology (NRF-2016R1A2B4009626).

The authors have no conflicts of interest to disclose.

Y. J. Choi, S. Y. Park, K. Y. Seo, E. K. Kim, and T.-i. Kim designed the study. Y. J. Choi, S. Y. Park, I. Jun, and M. Choi collected and managed the data. Y. J. Choi, S. Y. Park, I. Jun, M. Choi, and T.-i. Kim analyzed and interpreted the data. Y. J. Choi and T.-i. Kim wrote and edited the article. K. Y. Seo, E. K. Kim, and T.-i. Kim made critical revisions. All authors approved the final version of the article.

Received September 22, 2017

Received in revised form December 28, 2017

Accepted January 29, 2018

Copyright © 2018 Wolters Kluwer Health, Inc. All rights reserved.