Efficacy of bandage contact lens for the management of dry eye disease after cataract surgery

Xingdi Wu,Yajuan Ma,Xueqi Lin,Xuewen Yu,Suhong He,Xiang Chen,Wen Xu,Weijie Chen,Chenqi Luo

doi:10.1007/s10792-021-01692-6

Abstract

PurposeWe aimed to evaluate the efficacy of bandage contact lens (BCL) for the management of dry eye disease (DED) after cataract surgery.MethodsA total of 120 patients (140 eyes) with age-related cataract and DED were enrolled in this study. Patients underwent standard micro-incision phacoemulsification surgeries and were divided into control or BCL groups. Slit-lamp biomicroscopic examination, Ocular Surface Disease Index, keratograph analysis and Schirmer I test were executed, and the levels of tear inflammatory molecules were detected.ResultsIn the control group, the NIAvg-BUT and Schirmer I test scores were significantly decreased at 1 week post-operation compared with baseline levels (P = 0.035 and P = 0.009, respectively). In the BCL group, the NIF-BUT and Schemer I test scores were significantly improved at 1 month after operation compared with the control group (P = 0.012 and P < 0.001, respectively). Levels of IL-6, IL-8 and ICAM-1 were significantly increased in the control group at 1 month after the operation (P = 0.005, P = 0.038 and P = 0.022, respectively), while there was no difference in the BCL group. The increase in the IL-6 level in the control group was significantly higher compared with that in the BCL group (P = 0.047). In DED patients, there were significant correlations between ocular surface parameters and inflammatory molecules.ConclusionsCataract surgery could lead to the development or worsening of DED. The application of BCLs after cataract surgery could stabilize the ocular surface and tear film, improve the corneal healing and reduce the inflammation. Collectively, our findings suggested that proper use of BCLs after cataract surgery played an effective role in the management of DED.Trial registrationClinicalTrials, NCT04100031. Registered 18 September 2019—retrospectively registered

Highlights

Cataract surgery remains one of the most effective interventions to improve vision and quality of life
Levels of IL-6, IL-8 and ICAM-1 were significantly increased in the control group at 1 month after the operation (P = 0.005, P = 0.038 and P = 0.022, respectively), while there was no difference in the bandage contact lens (BCL) group
Cataract surgery could lead to the development or worsening of dry eye disease (DED)

Summary

Introduction

Cataract surgery remains one of the most effective interventions to improve vision and quality of life. Many patients are still dissatisfied with the postoperative dry eye symptoms, which disturb their daily life. Various studies have demonstrated that cataract surgery may lead to the development and progression of dry eye disease (DED) [1,2,3]. DED is regarded as a multifactorial disorder, which can cause several ocular symptoms of discomfort, visual disturbance and tear film instability with potential damage to the ocular surface [4]. The possible mechanisms of postoperative DED are various, such as a reduction in tear production and corneal sensitivity, alteration in tear dynamics and stability, increased tear osmolarity, worsening of meibomian gland function, squamous metaplasia of conjunctiva or goblet cell loss [5,6,7,8]. The levels of inflammatory molecules, which play an important role in DED [9, 10], can alter after cataract surgery, resulting in exacerbation of dry eyerelated symptoms

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