Effects Of A Lipid-Containing Nanoemulsion Artificial Tear On Corneal Astigmatism And Ocular Surface Optimization In Adults With Dry Eye Undergoing Cataract Surgery

Accurate corneal measurements are critical for determining the appropriate toric intraocular lens (IOL) power in cataract surgery, particularly in patients with high corneal astigmatism and dry eye disease. Previous studies have shown that the use of viscous artificial tears can influence keratometric values, potentially affecting IOL calculations. Systane COMPLETE is a lipid-containing nanoemulsion artificial tear designed to enhance ocular surface hydration and stability. This study investigates its effects on ocular surface optimization and corneal astigmatism measurements before cataract surgery in patients with high corneal toricity and dry eye.

This prospective clinical trial was conducted in a tertiary medical center in Taipei, Taiwan, assessing the effect of ocular surface optimization with Systane COMPLETE in patients planning for cataract surgery.

This prospective study will include 70 adults scheduled for cataract surgery in the right eye, with a corneal astigmatism of ≥1.5 diopters (D) and an Ocular Surface Disease Index (OSDI) score of ≥12. Participants who has corneal pathology or are already using any type of artificial tear are excluded. The enrolled patients use Systane COMPLETE for 1 to 2 months prior to cataract surgery. The following assessments are conducted at baseline (enrollment) and within one week before surgery: OSDI questionnaire; Routine preoperative ocular examination; Keratometric measurements using auto-refractometry, tomography (Pentacam), and biometry (Eyestar); Tear break-up time (TBUT) assessed using Keratograph 5M (K5).

The results presented preliminary data from 20 patients, with a mean age of 67.6 ± 12.2 years (range: 24–83). Nine participants were male. The mean corneal astigmatism by biometry was 2.54 ± 0.79 D (range: 1.58–4.65 D), with 50% exhibiting against-the-rule astigmatism. After using Systane COMPLETE, there was a decrease in OSDI scores from 18.73 ± 4.25 to 16.82 ± 6.51 (P = 0.041). The keratometric values on the X-axis measured by auto-refractometry, biometry, and tomography were significantly or marginally reduced after using Systane COMPLETE (P = 0.002, P = 0.016, P = 0.058, respectively). These findings suggest that the artificial tear may help reduce dry eye symptoms and reduce corneal astigmatism in measurements.

These preliminary results indicate that Systane COMPLETE may effectively reduce dry eye symptoms and modify corneal astigmatism by optimizing the ocular surface prior to cataract surgery. Since the accuracy of corneal measurements is crucial for toric IOL power calculations, preoperative ocular surface management should be considered in patients with high corneal astigmatism and dry eye. Further investigation with larger sample sizes will be conducted upon completion of the study to confirm these findings and determine the effects of lipid-containing artificial tears on preoperative keratometric stability.