Impact Of Perioperative Dry Eye Treatment With Rebamipide Versus Artificial Tears On Visual Outcomes After Cataract Surgery In Japanese Population

Studies have demonstrated conflicting results regarding the effectiveness of artificial tears and rebamipide in improving corneal surface condition.  The present study aimed to compare the effects of rebamipide and artificial tears during the perioperative period of cataract surgery with multifocal IOL implantation on the postoperative visual outcome.

Yokohama Tsurumi Chuoh Eye Clinic and Yokosuka Chuoh Eye Clinic, Kanagawa,

Japan

70 dry eyes from 35 cataract patients were enrolled. For all patients, rebamipide (Group R) was administered in one eye and Mytear® artificial tear ophthalmic solution (Group A) in the other eye from 4 weeks preoperatively to 3 months postoperatively. Tear break-up time (TBUT), high-order aberrations (HOAs), superficial punctate keratopathy in the central part of the cornea (C-SPK), and corrected distance visual acuity (CDVA) were assessed at baseline, 1 week, 1 month, and 3 months after surgery. Contrast sensitivity and disability glare with visual angle values compatible with spatial frequencies of 1.1, 1.8, 2.9, 4.5, 7.1, and 10.2 cycles/degree (CPD) were evaluated after surgery. Between-group differences of all variables were analyzed.

At baseline, no significant differences in the variables were noted between the two groups. Mean TBUT was significantly higher, while mean C-SPK and HOAs were significantly lower in Group R than in Group A at each assessment. Mean CDVA was significantly higher at 1 week and 1 month postoperatively in Group R compared with Group A; this value was not significant at 3 months. Between-group differences in contrast sensitivity and disability glare were statistically significant at all spatial frequencies, 1 week and 1 month postoperatively. The differences in contrast sensitivity were significant at 1.1, 1.8, 2.9, and 7.1 CPD whereas differences in disability glare were significant at 1.1, 2.9, 3.4, 7,1, and 10.2 CPD.

Dry eye treatment with rebamipide during the perioperative period of cataract surgery was more helpful than artificial tears in alleviating postoperative tear film instability and corneal surface irregularity. These factors resulted in further improvement in postoperative visual acuity, contrast sensitivity, and disability glare with rebamipide use. Thus, it can be concluded that dry eye treatment with rebamipide during the perioperative period may be able to improve patients’ satisfaction where multifocal IOL implantation has been performed