OCCURRENCE OF CORNEAL STAINING AFTER CATARACT SURGERY WITH AND WITHOUT CHITOSAN-N-ACETYLCYSTEINE EYE DROPS

Increased corneal staining is a common problem after routine cataract surgery. Affected patients suffer from complaints such as foreign body sensation or pain. The present study seeks to investigate the occurrence and magnitude of postoperative corneal staining and further the possibility of its prevention using chitosan-N-acetylcysteine eye drops. 

All study-related measures as well as data collection were performed at the Department of Ophthalmology at the Hanusch Hospital in Vienna.

Patients scheduled for routine cataract surgery were included and randomly assigned to one out of three groups. In group one cataract surgery was performed routinely without additional measures. In group two chitosan-N-acetylcysteine eye drops were administer prior to the surgery and in group three prior and directly after the procedure. Group two and three continued with one daily drop of chitosan-N-acetylcysteine eye drops for five days. Magnitude of staining was assessed using the NEI-score and subjective complaints using a visual analogue scale. 

Thirty-six patients were included in the final analysis. We found a statistically significant increase in corneal fluorescein staining and VAS scale, one hour after cataract surgery in all groups, which returned to baseline values after one week. There was no significant difference between the groups. However, a tendency towards lower NEI scores was observed in group 3 one hour after cataract surgery.

Cataract surgery led to significant increase in corneal staining and VAS after one hour. Though statistically significant the increase in VAS score was small and probably not clinically relevant. We observed a tendency in reduction of corneal staining in group three. Nevertheless, perioperative chitosan-N-acetylcysteine eye drops did not reduce the rate of corneal staining after cataract surgery in a clinically relevant manner.