Effect Of Dry Eye Treatment With Intense Pulse Light On Repeatability Of Astigmatism Measurements In Preoperative Cataract Cases　

To assess the effect of intense pulse light (IPL) on astigmatism measurement repeatability in preoperative cataract cases with dry eyes with short tear break-up time (TBUT) in both eyes in the same patients. Also, to analyze correlations between the astigmatism measurement repeatability and TBUT and corneal high-order aberrations (HOAs)

Yokohama Tsurumi Chuoh Eye Clinic, Kanagawa, Japan

124 eyes of 62 patients with short TBUT-type dry eyes in both eyes were enrolled. Preoperatively, IPL was performed on one eye with a combination of Toyos and Periman protocols 4 times (every 2 weeks) with manual meibomian expression (IPL group), but not on the fellow eye (control group). TBUT and HOAs, using CASIA 2, were checked pre- and post-treatment. On separate dates, the cylinder power and meridian of astigmatism were measured post-treatment by IOL Master 700. The power vectors, J0 and J45, were used for the astigmatism calculation. The astigmatism measurement repeatability was assessed as within-subject standard deviation (Sw). The changes in variables were compared between groups. The correlations between variables were analyzed.

TBUT and HOAs significantly improved in the IPL group (P<0.001, P<0.001), but they did not in the control group (P=0.841, P=0.275).

J0 Sw and J45 Sw based on 2 measurements on different dates in the IPL group indicated significant improvement in the repeatability compared with the control group (P<0.001, P<0.001).

In IPL group, J0 Sw and J45 Sw showed significant negative correlation with change in TBUT (ρ=-0.713, P<0.001.ρ=-0.831, P<0.001) and significant positive correlation with  corneal HOAs(ρ=0.841，p<0.001.ρ=0.903，p<0.001).

In IPL group, there was no significant correlation between magnitude of corneal astigmatism and the astigmatism measurement repeatability (P=0.248).

In the short TBUT type of dry eyes, preoperative dry eye treatment with IPL significantly improved the astigmatism measurement repeatability. The worse the ocular surface condition, the worse the astigmatism measurement repeatability. Preoperative dry eye treatment with IPL may improve the accuracy of IOL power calculation, especially when the implantation of toric IOLs are considered.