Abstract
BackgroundFor patients who experience dry eye after phacoemulsification, vision and quality of life can significantly deteriorate. In this study, the efficacy and safety of carboxymethylcellulose sodium (CMC) 1% ophthalmic solution combined with conventional therapy in treating dry eye signs and symptoms after phacoemulsification were evaluated.MethodsIn this prospective, multicenter, open-label, controlled study, 180 patients with age-related cataract were randomized to treatment with conventional therapy plus CMC 1% (n = 90) or to conventional therapy only (control group, n = 90) after phacoemulsification and intraocular lens implantation. Tear breakup time (TBUT), the Schirmer test with anesthesia, and fluorescein and lissamine green staining were performed. The Ocular Surface Disease Index (OSDI) questionnaire and a patient subjective symptom evaluation were administered preoperatively (baseline) and postoperatively at 7 and 30 days.ResultsTBUT was significantly longer in the treatment group compared with the control group at day 7 (8.5 ± 5.5 versus 6.6 ± 3.8 s; P = 0.0475) and day 30 (9.0 ± 5.9 versus 6.7 ± 4.8 s; P = 0.0258) after surgery. Compared with baseline, TBUT significantly increased in patients in the treatment group (P < 0.001 at both day 7 and day 30) with a presurgical diagnosis of dry eye, but significantly decreased in patients in the control group (P < 0.02 at both day 7 and day 30) with no prior diagnosis of dry eye. Fluorescein and lissamine staining, OSDI questionnaire and subjective symptom scores all improved from baseline, with no significant differences between the two groups. No significant differences in tolerability and safety were observed between the group receiving CMC and conventional therapy, and those receiving conventional therapy only.ConclusionTreatment with CMC 1% can provide significant improvement in tear film stability after phacoemulsification for age-related cataract.Trial registrationClinicalTrials.gov identifier NCT02028754 (Date of registration: Jan. 6, 2014).
Highlights
For patients who experience dry eye after phacoemulsification, vision and quality of life can significantly deteriorate
Various factors may further impact the health of the ocular surface following cataract surgery, including age, the external environment, poor systemic health, concurrent ocular surface disease, reflex secretory block caused by nerve injury, and ocular epithelial injury during the operation [1,8]
The objective of this study was to investigate the efficacy and safety of carboxymethylcellulose sodium (CMC) 1% ophthalmic solution added to conventional therapy in stabilizing tear film and treating preexisting dry eye or dry eye resulting from phacoemulsification
Summary
For patients who experience dry eye after phacoemulsification, vision and quality of life can significantly deteriorate. Dry eye is a multifactorial disease of the tears and ocular surface that results in symptoms of discomfort, visual disturbance, and tear film instability, with potential damage to the ocular surface [1,2]. With the advancement of medical technology, cataract surgery (phacoemulsification with intraocular lens [IOL] implantation) has become a routine procedure; for patients who experience dry eye after phacoemulsification, vision and quality of life can significantly deteriorate. Clinical evaluation of dry eye after cataract surgery has demonstrated worsening of patient subjective symptom scores, reductions in tear film breakup time (TBUT) and goblet cell density, as well as increased corneal and conjunctival staining, indicating deteriorating disease [5,6,7]. Increased ocular discomfort reported after cataract surgery may be a result of failure to diagnose dry eye before surgery and/or subsequent inadequate treatment after cataract surgery
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