Impact of 0.1% sodium hyaluronate and 0.2% sodium hyaluronate artificial tears on postoperative discomfort following cataract extraction surgery: a comparative study

Panagiota Ntonti,Georgios Labiris,Georgios Karastatiras,Sevasti Tsironi,Nektarios Breyannis,Eirini-Kanella Panagiotopoulou

doi:10.1186/s40662-019-0131-8

Abstract

BackgroundRecent artificial tear preparations have provided 0.2% concentration of sodium hyaluronate. However, no published data exist on their potential superiority against 0.1% in alleviating dry-eye-disease symptoms in cataract extraction surgery.MethodsA total of 180 patients that underwent cataract extraction surgery were randomly divided into 2 groups according to their postoperative regime: Study group (SG) received fixed combination of tobramycin and dexamethasone (FCTD) quid for 3 weeks, and additionally 0.2% sodium hyaluronate provided in the COMOD® device quid for 6 weeks. Control group (CG) received fixed combination of tobramycin and dexamethasone (FCTD) quid for 3 weeks, and additionally 0.1% sodium hyaluronate provided in the COMOD® device quid for 6 weeks. The following indexes were evaluated at 3 postoperative checkpoints: 1) Surface discomfort index (SDI) which was derived by four direct 10-scale Likert-type questions that were addressed to the patient and pertained to: a) foreign body sensation (FBS), b) blinking discomfort (BD), c) stinging sensation (SS), d) tearing sensation (TS), 2) Tear break-up time (TBUT), 3) Schirmer’s test, 4) Central corneal thickness (CCT), and 4) Central Corneal Sensitivity (CCS).ResultsBoth groups showed reduced CCS values at all postoperative examination points; however, SG participants had significantly better CCS (all p < 0.05). SG had better TBUT than CG at the 3rd (p = 0.03) and 6th examination points (p = 0.04). Moreover, SG had better SDI scores at the 3rd (SDI = 9.26 ± 0.55) and 6th weeks (SDI = 9.47 ± 0.48) vs. CG participants (p = 0.03 and p < 0.01, respectively).ConclusionThe increased 0.2% sodium hyaluronate concentration in the artificial tears provided in the COMOD® device seems to address dry-eye-disease symptoms better in patients who underwent phacoemulsification surgery than the 0.1% concentration.Trial registrationClinicalTrials.govIdentifier:NCT03705949 Oct 15, 2018, retrospectively registered.

Highlights

Recent artificial tear preparations have provided 0.2% concentration of sodium hyaluronate
No published reports have compared the necessity of 0.2% sodium hyaluronate over 0.1% in cataract extraction surgery
Non-significant differences were detected with respect to age (p = 0.69) and BSCVA (p = 0.48) among the groups

Summary

Introduction

Recent artificial tear preparations have provided 0.2% concentration of sodium hyaluronate. No published data exist on their potential superiority against 0.1% in alleviating dry-eye-disease symptoms in cataract extraction surgery. Cataract is one of the most prevalent medical conditions, being responsible for about 33% of visual incapacity worldwide and 51% of blindness [1,2,3]. No reliable conventional treatment means (i.e., drops) exist for cataract, the treatment of choice is exclusively surgical. Cataract extraction surgery is a minimally invasive technique, usually performed in an outpatient basis [4]. In the vast majority of cases, patients experience a short, uneventful recovery period [5]. The patient has to be administered drops that minimize surgical-induced inflammation and facilitate visual recovery. Regardless of the specific active ingredients, the postoperative regime primarily aims to prevent macular edema, corneal edema, and endophthalmitis [4, 6, 7]

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