Dry eye management with diquafosol 3% eyedrops before and after cataract surgery: a retrospective observational case series

Cataract surgery is the most common surgical procedure performed to restore visual function due to opacification of the lens. One of the side effects of cataract surgery is the appearance of dry eye symptoms that can occur one to three weeks after surgery. Dry eye symptoms were reduced visual acuity can affect daily work, so that it can interfere with work productivity and quality of life. This paper is a literature review to identify dry eye management in patients after cataract surgery. The search was carried out on Web of Science, EBSCO, PubMed, and Google Scholar. The results showed that the management of dry eyes can be done with drugs, healthy living behaviors especially maintaining eye health and hygiene and also avoiding various risk factors for dry eyes. Assessment of early signs and symptoms of the dry eye needs to be done before surgery so that it can reduce the risk of dry eye events. Management of dry eye in post-cataract surgery patients needs to be done comprehensively so that it can improve the patient's visual ability and a better quality of life. Keywords: cataracts, dry eyes, dry eye management

Background:The prevalence of dry eye following cataract surgery was reported as high as 55.7%, this acute and iatrogenic disorder urgently required appropriate clinical management. The purpose of this study is to compare the efficacy of diquafosol sodium ophthalmic solution (DQS) and conventional artificial tears (AT) for the treatment of dry eye following cataract surgery.Methods:The PubMed, Embase, and the Cochrane Central Register of Controlled Trials were searched from their earliest entries through June 2017 to obtain the studies, which evaluated the efficacy of DQS for patients with dry eye after cataract surgery. The relevant data were analyzed using StataSE 12.0 software. The PRISMA checklist was used as protocol of the meta-analysis and the guideline was followed. The weighted mean difference, relative risk, and their 95% confidence interval were used to assess the strength of the association.Results:The authors identified 21 references of which 4 studies evaluating the efficacy of DQS for patients with dry eye after cataract surgery were included. The dataset consisted of 291 patients of dry eye following cataract surgery (371 postoperative eyes). The pooling result of our study suggested that the DQS could significantly better improve the indices like corneal and conjunctival fluorescein staining scores, tear breakup time, and Schirmer I test than AT (P < .05). Although the scores of symptom questionnaire could not be pooled, the results of each study also proved that DQS could significantly better relieve the symptoms of postoperative dry eye.Conclusion:Based on the available evidence, topical DQS has a superior efficacy than AT in the management of dry eye after cataract surgery; however, further researches with larger sample sizes and focus on indicators such as higher-order aberrations, symptom questionnaire scores, and cost-effective ratio are required to reach a firmer conclusion.

Evaluation of cyclosporine 0.05% and artificial tears for the management of dry eye disease following cataract surgery: a randomized controlled trial.

Dry eye is a common ocular surface disease that can occur in part of patients before cataract surgery. A variety of incentives during the perioperative period can decrease the stability of the tear film, cause or aggravate dry eye symptoms, and therefore reduce the visual outcome and life quality of the patients. In order to standardize the management of dry eye during the perioperative period of cataract surgery, the Cataract Group of the Ophthalmology Branch of the Chinese Medical Association conducted a comprehensive discussion on the evaluation and improvement of the preoperative ocular surface conditions, the intraoperative ocular surface protection, as well as the diagnosis and treatment of postoperative dry eye. The consensus of opinions has been reached for reference of Chinese ophthalmologists. (Chin J Ophthalmol, 2021, 57:17-22).

To provide a summary of the mechanisms that may cause dry eye after cataract surgery and discuss available and upcoming treatment modalities. Development or worsening of dry eye symptoms after cataract surgery is multifactorial with corneal nerve transection, inflammation, goblet cell loss, and meibomian gland dysfunction commonly cited as underlying disorders. With increasing awareness of the prevalence of dry eye disease, current surgical techniques are being analyzed for their contribution to the issue. Although many classic interventions, such as artificial tears and anti-inflammatory drops, remain first-line treatment options, they may not adequately address abnormalities of the tear film. The trend has been to create new drugs and technologies that target meibomian gland deficiencies and restore goblet cell numbers. Therapy for postoperative dry eye symptoms should be determined based on symptom severity and which underlying cause is most prominent at a given time. Patients with high-level risk factors for dry eye should be evaluated preoperatively to determine whether they have preexisting dry eye disease or if they are susceptible to developing disease after surgery.

Dry eye symptoms and signs are common following cataract surgery. Topical cyclosporine A (CsA) is an approved treatment of moderate-to-severe dry eye disease. However, its effectiveness in managing postoperative dry eye remains debated. This systematic review and meta-analysis aimed to evaluate the efficacy of topical CsA in managing dry eye symptoms and signs after cataract surgery. Randomized controlled trials (RCTs) assessing topical CsA in cataract surgery patients were identified through searches of PubMed, EMBASE, Web of Science, ClinicalTrials.gov, the Cochrane Library, and Google Scholar up to August 31, 2024. Outcomes included postoperative tear break-up time (TBUT), Schirmer's test (with or without anesthesia), the Ocular Surface Disease Index (OSDI), corneal fluorescein staining, and treatment-related adverse events. Nine RCTs involving 451 patients (558 eyes) were included. Topical CsA was significantly associated with prolonged TBUT (mean difference [MD] = 1.95s, 95% confidence interval [CI]: 1.38 to 2.53, P < 0.001), improved Schirmer's test scores without anesthesia (MD = 2.14mm, 95%CI: 0.68 to 3.59, P = 0.004), and reduced corneal fluorescein staining (standardized MD = - 1.62, 95%CI: - 3.16 to - 0.08, P = 0.039). However, CsA did not significantly improve Schirmer's test scores with anesthesia (MD = 1.73mm, 95%CI: - 0.11 to 3.56 to 2.79, P = 0.066) or OSDI scores (MD = - 2.73, 95%CI: - 7.42 to 1.97, P = 0.255) compared to control. All treatment-related adverse events were mild. Topical CsA significantly improves ocular surface and tear film parameters following cataract surgery and may be considered for the postoperative management of ocular surface disturbance and dry eye. However, considering the very low to moderate certainty of evidence, further high-quality RCTs are needed to validate for these findings.

Introduction Dry eye disease (DED) impacts all phases of cataract and refractive surgery, from preoperative planning to postoperative recovery. Accurate diagnosis and effective management are critical to achieving optimal visual outcomes and high levels of patient satisfaction. Despite its frequency, DED is often underdiagnosed or inadequately managed prior to surgery. Areas covered This narrative review discusses the rationale, methods, and clinical impact of ocular surface optimization, and presents evidence-based strategies for preoperative ocular surface optimization. PubMed was searched from inception through September 2025, and studies were selected based on relevance and contribution to the scope of the review. Expert opinion As an ophthalmic community it would behoove us to consistently manage DED prior to cataract and refractive surgery. A structured diagnostic and treatment approach that prioritizes ocular surface health should be integrated into standard preoperative protocols. It is important to clearly educate patients on the value of proactive DED management to improve compliance and temper expectations regarding surgical outcomes. Surgeons should be open to newer innovations and algorithms to meet patient needs.

This Issue At A Glance

Surgical intervention is the most effective treatment for decreased vision resulting from cataracts. Although the current procedures for cataract surgery are safe and effective, it is well known that several complications can develop after surgery. Postoperative cystoid macular edema (CME) is a well-known complication, and prophylactic medications such as steroids and/or nonsteroidal antiinflammatory drugs are routinely used for its prevention. Ocular surface abnormalities, such as dry eye, have also been reported to develop after cataract surgery. However, the causative mechanisms for postoperative dry eye have not been definitively determined. At present, there are no prophylactic medications that are commonly used to prevent the development of postoperative dry eye. Although nonsteroidal antiinflammatory drugs are very effective in reducing the incidence and degree of postoperative CME, it is known that they can cause adverse side effects, including ocular surface abnormalities. Thus, perioperative medications must be carefully selected to improve surgical outcomes and patient satisfaction. Here, we summarize the results of recent studies on postoperative dry eye and CME that can develop after cataract surgery. We suggest appropriate combinations of medications that can be used to minimize these postsurgical complications.

PurposeTo evaluate the clinical efficacy of newly developed guidelines for the diagnosis and management of dry eye.MethodsThis retrospective, multi-center, non-randomized, observational study included a total of 1,612 patients with dry eye disease who initially visited the clinics from March 2010 to August 2010. Korean guidelines for the diagnosis and management of dry eye were newly developed from concise, expert-consensus recommendations. Severity levels at initial and final visits were determined using the guidelines in patients with 90 ± 7 days of follow-up visits (n = 526). Groups with different clinical outcomes were compared with respect to clinical parameters, treatment modalities, and guideline compliance. Main outcome measures were ocular and visual symptoms, ocular surface disease index, global assessment by patient and physician, tear film break-up time, Schirmer-1 test score, ocular surface staining score at initial and final visits, clinical outcome after three months of treatment, and guideline compliance.ResultsSeverity level was reduced in 47.37% of patients treated as recommended by the guidelines. Younger age (odd ratio [OR], 0.984; p = 0.044), higher severity level at initial visit, compliance to treatment recommendation (OR, 1.832; p = 0.047), and use of topical cyclosporine (OR, 1.838; p = 0.011) were significantly associated with improved clinical outcomes.ConclusionsKorean guidelines for the diagnosis and management of dry eye can be used as a valid and effective tool for the treatment of dry eye disease.

To characterize the temporal occurrence of retinal detachments (RD) after cataract surgery. In this retrospective, consecutive case series, we reviewed the charts of 798 pseudophakic patients with primary rhegmatogenous RD that underwent surgery between 1999 and 2009, at the Center of Ophthalmology, University of Cologne, Germany. Twenty-five percent of all pseudophakic RDs occurred within 1 year after cataract surgery, 50% within 3.2 years and 90% within 9.9 years. Risk was increased for at least 11 years. The time interval was significantly shorter in vitrectomized eyes (2.49 versus 4.31 years, p = 0.016). Women showed a statistical trend towards longer time intervals (4.72 versus 3.93 years, p = 0.052), whereas myopic patients and different age groups showed no significant difference. After cataract surgery, the risk for RD was highest in the beginning and decreased continuously over time. However, the risk was increased for at least 11 years. Therefore, most studies have underestimated the incidence of RD after cataract surgery.

Topic- Dry Eyes (Shuskakshipaka) and its management through Ayurveda – A case study Name of the student- Dr. Nita Sureshrao Pawar Name of the guide- Degree-BAMS MS(Scholar) Dr.R.D.Deshmukh College-Govt.Ayurved college and Hospital,Nagpur Associate Professor Contact no.- 7030357037 College- Govt. Ayurved college&Hosital nagur Email ID.- nitapawar71292@gmail.com Abstract-Dry eye is one of the most commonly observed problem in routine ophthalmic practice.At present, the treatment present in modern medicine is not sufficient. The main aim of treatment is to relieve symptoms and give supplementation for existing tears by artificial tear drops, gels and ointments & punctum occlusion. Prevalence from around 5% to 35 % difference that might be due to sampling methods & population demographics. Ayurvedic principle and procedure like Pariseka Tarpana and other kriyakalpa may relief symptoms of Dry eyes (Shushka-Akshipaka). Aims –To study role of Ayurveda in management of Dry eyes with special reference to Shushka-akshipaka. Objective- To study role of Ayurveda to reduce Symptoms of Dry eyes with special reference to Shushka-akshipaka in modern era. Material and Method- Single clinical trialTarpana with Laghutriphala Ghrita was given for 7 days with 7 days gap after that Nasya with Anutaila for 7 days with 7 days gap along with 10 min regular eye exercise this treatment was followed alternatively with 2 settings for 2 months. Conclusion- Ayurvedic therapies and medicines can help in curing Dry eyes. Keywords- Dry Eyes, Asthenopic symptoms, Tarpana, Nasya. Sukshakashipaka.

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