Prevention Is Better Than Cure: Vitamin D As The Useful Tip To Reduce The Symptoms Of Dry Eye After Phacoemulsification

Improved hygiene protocols, and use of appropriate drops, are applied to improve the quality of the ocular surface after routine phacoemulsification. Could orally ingested Vitamin D improve the quality of the ocular surface and ocular comfort after routine cataract surgery?

Kyiv City Clinical Ophthalmological Hospital “Eye Microsurgery Center”, Ukraine

Patients were allocated to group I(1000 IU cholecalciferol, daily intake before and 2months postop) or group II(control), n=25/group. Ocular surface staining (Oxford scale) & self-assessment of ocular comfort (0-10 analogue scale) scores recoded before and after surgery. Postop care: topical AB&dexamethason, indomethacin, trehalose&hyaluronic acid. The distance(z), on a graphical plot of staining(x-axis) and comfort(y-axis) scores, between a locus with coordinates (x₁,y₁) and the origin is a composite of comfort and staining. If the coordinates of this point change to (x₂,y₂), between pre- and postop, then the displacement of the point (Δz) represents the real vectorial change in the composite score of comfort and staining between visits.

Only one eye was operated in each patient.  The median, mode & IQ range values for z at pre- & 1 month postop and Δz were, respectively. Group I, 4.6, 5.1, 2.9 & 2.0, 2.0, 2.0 and  Δz values were -2.2,-2.2,-4.4. Group II, 3.0, 2.2, 2.2 & 5.0, 2.0, 2.1 and  Δz values were -1.0, +1.0,-2.1. Differences between Δz values and groups I & II at 1 month were significant (p<0.05). A fall in the z value is indicative of an overall improvement in comfort and decrease of staining. A positive Δz indicates the shift in z is towards reduced comfort worsened and/or staining increased. 

Including vitamin D as part of the treatment plan in routine cataract surgery tends maintain, if not improve, both patient comfort and the quality of the ocular surface. Patient comfort is a key indicator of satisfaction and reasonable steps should be taken to and improve satisfaction. Including a daily vitamin D supplement to the advice normally given to the patient may prove useful in elevating the patient’s treatment and satisfaction after cataract surgery.