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Ocular surface disease in cataract patients

Poster Details

First Author: A.Liaska GREECE

Co Author(s):    E. Makri   S. Stamelou   V. Dimopoulou   K. Andrianopoulou     

Abstract Details

Purpose:

Ocular surface disease (OSD) is exceedingly common in the cataract-age population, and the presence and exacerbation of OSD can negatively affect postoperative visual quality and patient satisfaction. Postoperative dry eye disease (DED) is the most common and potentially distressful complication of cataract surgery today. It is crucial that surgeons have a high index of suspicion for ocular surface disorders and preoperative evaluation for OSD is becoming a necessity. The purpose of the study is to identify the value of a practical approach to OSD diagnosis versus a routine preoperative evaluation.

Setting:

Department of Ophthalmology, General Hospital of Lamia, Lamia, Greece

Methods:

67 cataract patients were randomized to have a thorough preoperative assessment for OSD:(1)symptom questionnaire(OcularSurfaceDiseaseIndex(OSDI)), (2)clinical history, (3)TearFilmBreakUpTime(TFBUT) with fluoroscein, (4)corneal staining with fluorescein, (5)Schirmer 1, (6)lid margin examination and (7)meibomain gland expression) versus having a routine preoperative evaluation including (2),(3) and (6). Preoperative OSD treatment as well as appropriate postoperative care was applied according to the findings of postoperative evaluation. OSDI questionnaire was filled out by all patients by the end of fifth week (a week after discontinuation of postoperative treatment). Between groups postoperative OSDI scores were analyzed by Wilcoxon-Mann-Whitney test whereas Fischer’s exact test was used for OSD diagnosis.

Results:

OSD cases were significantly more in the thorough preoperative assessment for OSD group, however the postoperative OSDI scores did not vary significantly between the two groups.

Conclusions:

accurate diagnosis of OSD and proper use of the established treatment do not significantly alleviate postoperative symptoms in cataract patients. The discontinuation of steroids may unmask underlying disease and more gradual tapering of steroid dosage might prove helpful in OSD patients. FINANCIAL DISCLOUSRE: NONE

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