Short-Term Ocular Surface Optimisation Alters Keratometry Readings And Recommended Intraocular Lens (Iol) Power Before Standard Monofocal Cataract Surgery: Interim Results
Published 2026 - 44th Congress of the ESCRS
Reference: FP13.13 | Type: Free paper | DOI: 10.82333/925e-m563
Authors: Dr Bora Deniz Argon 1 , Dr Kardelen Uzun* 1 , Dr Enes Soyyigit 1 , Dr Emine Betul Akbas Ozyurek 1
1Department of Ophthalmology,University of Health Sciences,Istanbul,Türkiye
Purpose
To quantify the effect of short-term ocular surface optimisation on ocular surface metrics, keratometry readings and suggested intraocular lens (IOL) power prior to routine monofocal cataract surgery.
Setting
Single tertiary referral eye centre
Methods
Prospective single-arm study including 54 patients (54 eyes; one eye per patient) with mild–moderate ocular surface disease. Baseline assessment (T0) and repeat testing after a structured 2–3-week optimisation protocol (T1; preservative-free lubricants plus lid hygiene/warm compresses) included the Ocular Surface Disease Index (OSDI), Schirmer I test, Oxford corneal staining score, non-invasive break-up time (NIBUT), corneal mapping–derived keratometry (mean keratometry, Kmean), and biometry-derived suggested IOL power (Aladdin and IOLMaster). Normality was assessed; paired t-tests or Wilcoxon signed-rank tests were applied as appropriate.
Results
Mean age was 67.0±10.4 years; 57.4% were female. OSDI improved from 18.6±5.2 to 7.6±2.8 (p<0.001; dz=−1.96). NIBUT increased from 5.9±2.2 to 15.0±2.2 s (p<0.001; dz=2.96) and Schirmer I test from 6.4±2.2 to 18.6±5.5 mm (p<0.001; dz=2.08). Oxford corneal staining score decreased (median [IQR] 2 [1–3] to 0 [0–1]; p<0.001; r=0.78). Mean Kmean did not change significantly (43.83±2.39 vs 43.77±1.98 D; p=0.84), yet within-eye absolute change in Kmean was clinically relevant (median 0.215 D, IQR 0.113–0.450); 42.6% had |ΔKmean|≥0.25 D and 22.2% ≥0.50 D. Suggested IOL power showed a median absolute change of 0.50 D for both devices; ≥0.50 D changes occurred in 63.0% (IOLMaster) and 72.2% (Aladdin), and ≥1.00 D in 16.7% for both.
Conclusions
Short-term ocular surface optimisation produces large improvements in ocular surface metrics and frequently leads to clinically meaningful changes in keratometry readings and suggested monofocal IOL power. Postoperative week-4 refractive outcomes and prediction-error analyses are ongoing and will be presented at the meeting.