Changes in Tear Osmolarity and Matrix Metalloproteinase-9 Relative to Ocular Discomfort after Femtosecond Laser-Assisted Cataract Surgery

Kyu Sang Eah,Jae Yong Kim,Hun Lee,Hungwon Tchah

doi:10.3390/app112411878

Kyu Sang Eah, Jae Yong Kim + Show 2 more

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https://doi.org/10.3390/app112411878

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Abstract

The aim of this study was to evaluate the changes in tear osmolarity and matrix metalloproteinase-9 (MMP-9) and their relationships with ocular discomfort in patients after femtosecond laser-assisted cataract surgery (FLACS). This retrospective observational case series reviewed medical records of 51 eyes of 51 patients who underwent FLACS. Tear osmolarity and MMP-9 were evaluated preoperatively and at 1 day, 1 week, and 1 month postoperatively. Tear osmolarity ≥ 310 mOsm/L and MMP-9 ≥ trace positive were defined as abnormal results. The ocular surface disease index (OSDI) was evaluated preoperatively and postoperatively at 1 month. Tear osmolarity level and the number of eyes with abnormal tear osmolarity results did not change significantly up to 1 month after surgery. MMP-9 level and the number of eyes with abnormal MMP-9 results increased at 1-day postoperatively and then decreased at 1-month postoperatively (all p < 0.001). Among the OSDI subscales, ocular discomfort was aggravated (p < 0.001) but the visual function score improved at 1 month postoperatively (p < 0.001). Ocular discomfort aggravated after FLACS without an increase in either tear osmolarity or MMP-9. Ocular discomfort which patients commonly experience after FLACS may be due to etiology other than development or aggravation of dry eye disease.

Highlights

Cataract surgery is one of the most commonly performed surgical procedures worldwide, and phacoemulsification has enabled surgeons to achieve promising results with no major complications [1]
We evaluated the change in tear osmolarity and the matrix metalloproteinase-9 (MMP-9) level after femtosecond laser-assisted cataract surgery (FLACS)
The ocular discomfort subscale score was aggravated significantly at M1. These results suggest that the aggravated or persistent symptoms of ocular discomfort that are commonly reported by patients after FLACS may be due to factors other than an increase in tear film osmolarity or inflammatory conditions

Summary

Introduction

Cataract surgery is one of the most commonly performed surgical procedures worldwide, and phacoemulsification has enabled surgeons to achieve promising results with no major complications [1]. One of the recent changes in cataract surgery is the introduction of femtosecond laser-assisted cataract surgery (FLACS), allowing safer and more efficient surgery This new technology uses a photodissection laser and has the advantages of executing precise corneal incisions, arcuate keratotomy, circular anterior capsulotomy, and lens nucleus fragmentations [2,3,4,5]. Despite these advanced technologies and excellent postoperative visual acuity results for most patients, many patients complain of dry eye symptoms, such as dryness, burning sensation, foreign body sensation, and pain [6,7,8,9]. We evaluated the changes in tear osmolarity and MMP-9, and their relationship with ocular surface disease index (OSDI) in patients undergoing FLACS

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