Ocular Surface Disease Management In Cataract Surgery
Published 2023 - 41st Congress of the ESCRS
Reference: FP22.10 | Type: Free paper | DOI: 10.82333/cv31-pa64
Authors: Daniele Gaudenzi* 1 , Francesco Cutrupi 1 , Edoardo Villani 2 , Francesco Gaudenzi 3 , Giovanna Linda Possati 3 , Alessandro Mularoni 3 , Giuseppe Giannaccare 4 , Marco Coassin 1 , Alessandra Micera 5 , Antonio Di Zazzo 1
1Ophthalmology,University Campus Bio-Medico of Rome,Rome,Italy, 2Department of clinical sciences and Community Health,University of Milan,Milan,Italy, 3Ophthalmology,Istituto per la Sicurezza Sociale, San Marino State Hospital,San Marino,San Marino, 4Ophthalmology,University Magna Graecia of Catanzaro,Catanzaro,Italy, 5Research and Development Laboratory for Biochemical, Molecular and Cellular Applications in Ophthalmological Sciences,IRCCS - Fondazione Bietti,Rome,Italy
Purpose
According to the research, 80% of cataract surgery patients suffer from ocular surface disease (OSD). Together with postoperative refractive surprise, the onset of OSD is the main cause of dissatisfaction in patients underwent cataract surgery, accounting for 35% of cases. These patients are characterized by persistent dysregulation of ocular surface para-inflammation, causing chronic low-grade inflammation with significant consequences in everyday-life activities and job productivity.This study aims to investigate the effects of topical desonide sodium phosphate 0.025% eye drops on signs and symptoms of OSD in patients underwent cataract surgery.
Setting
The rapid improvement of technology and surgical techniques, along with the lengthening of the average lifespan, has led to a sharp increase in the number of cataract patients, with an increasing postoperative functional demand. In this context, OSD triggered or worsened by the surgical insult has become increasingly important, causing a notable state of ocular discomfort that determines high dissatisfaction in the operated patient, despite complete visual recovery: the unhappy 20/20 patients.
Methods
A multicenter randomized controlled trial was conducted. Cataract patients without ocular comorbidities were consecutively enrolled and randomized into two groups. Both groups underwent phacoemulsification with usual postoperative therapy (levofloxacin 0.5% eye drops 6 times a day for 5 days and dexamethasone sodium phosphate eye drops 0.15% 4 times a day for 1 week and then twice a day for 1 week). In addition, study group received lubricating eye drops containing xanthan gum 0.2% and desonide sodium phosphate 0.025% twice a day, while control group hyaluronic acid 0.15% and xanthan gum 1%. At patient enrollment (T0), 1 day (T1), 2 weeks (T2), and 1 month after surgery (T3), signs and symptoms of OSD and tear function tests were recorded.
Results
A total of 40 consecutive patients (40 eyes), 20 patients in each group, were included. The OSDI score, T-BUT and Schirmer's test after recording a worsening between T0 and T1 in both groups, progressively improved from T1 to T3, with better results in the study group than in the control one. No adverse events or therapy-related impacts on intraocular pressure levels were detected.
Conclusions
Postoperative twice-daily topic instillation of xanthan gum 0.2% and desonide sodium phosphate 0.025% eyedrops resulted an effective and well-tolerated method of treating para-inflammation of the ocular surface. As a result, this treatment appears to reduce postoperative ocular discomfort with a favorable safety profile, resulting in increased satisfaction for both patients and surgeons.