Effects of Preservative-free 3% Diquafosol in Patients with Pre-existing Dry Eye Disease after Cataract Surgery: A Randomized Clinical Trial

Ikhyun Jun,Kyoung Yul Seo,Hyung Keun Lee,Seonghee Choi,Tae-Im Kim,Geun Young Lee,Eung Kweon Kim,Young Joon Choi

doi:10.1038/s41598-019-49159-0

Abstract

Dry eye disease (DED) after cataract surgery has become a critical concern, and various therapeutic options have been developed. Recently, preservative-free diquafosol ophthalmic solution has been introduced; however, its therapeutic effect on DED after cataract surgery has not been reported. We investigated the efficacy of preservative-free diquafosol in patients with pre-existing DED after cataract surgery. We divided subjects who were diagnosed with DED and scheduled to undergo cataract surgery, into 3 groups (preservative-free diquafosol, group 1; preservative-containing diquafosol, group 2; preservative-free hyaluronate, group 3), and each eye drops was administered 6 times daily after surgery. Tear break up time (TBUT), Ocular Surface Disease Index (OSDI), corneal staining score, lid margin abnormality, and meibum quality improved over time in group 1. Groups 1 and 2 had significantly superior TBUT, meibomian gland dysfunction grade, and meibomian gland expressibility throughout the study period than group 3. Meibum quality of group 1 was significantly better than group 2 at 1 and 3 months after surgery. Preservative-free diquafosol showed better efficacy in treating DED after cataract surgery than preservative-containing diquafosol or preservative-free hyaluronate. Preservative-free diquafosol may serve as a reliable option for the management of patients with pre-existing DED after phacoemulsification.

Highlights

Many options to treat Dry eye disease (DED) after cataract surgery have been developed[8]
There were no significant differences in preoperative tear break up time (TBUT) (4.6 ± 2.2, 5.0 ± 2.5, and 4.6 ± 1.8 s for groups 1, 2, and 3, respectively) or Ocular Surface Disease Index (OSDI) (22.10 ± 12.93, 23.49 ± 11.38, and 22.30 ± 9.01 for groups 1, 2, and 3, respectively) among the 3 groups
The present study investigated the clinical efficacy of preservative-free diquafosol 3% ophthalmic solution compared with preservative-containing diquafosol 3% ophthalmic solution and preservative-free sodium hyaluronate 0.15% ophthalmic solution in pre-existing DED patients who underwent cataract surgery

Summary

Introduction

Many options to treat DED after cataract surgery have been developed[8]. Artificial tears are commonly used as a first line management strategy for postoperative DED, with several studies revealing their effectiveness at reducing DED signs and symptoms[9,10]. Diquafosol sodium ophthalmic solution has been used for the management of DED after cataract surgery[2,5,6,13]. Studies have shown that diquafosol is very effective in treating and alleviating symptoms of DED after cataract surgery[2,5,6,13]. Several studies have shown that topical diquafosol is more effective for managing DED after cataract surgery than artificial tears[5,6]. The use of other eye drops without preservatives has been shown to play an important role in the treatment of DED after cataract surgery with reduced adverse reactions[16]. There is no study that has evaluated the therapeutic effect of preservative-free diquafosol ophthalmic solution on DED after cataract surgery. In this study, we compared the efficacy of preservative-free diquafosol ophthalmic solution with that of preservative-containing diquafosol and preservative-free sodium hyaluronate ophthalmic solutions, which are widely used in patients with DED after cataract surgery

Methods

Results

Conclusion