Discrepancies in Persistent Dry Eye Signs and Symptoms in Bilateral Pseudophakic Patients
Despite the increased awareness of early prophylaxis and treatment for dry eye disease (DED) during the first few weeks after cataract surgery, the chronic effect of cataract surgery on the risk of ocular surface abnormalities has not been fully explored. This study was to assess the prevalence of D...
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doaj-0888ccd0697e472db8c8d1d5ff5e1b862020-11-24T20:44:28ZengMDPI AGJournal of Clinical Medicine2077-03832019-02-018221110.3390/jcm8020211jcm8020211Discrepancies in Persistent Dry Eye Signs and Symptoms in Bilateral Pseudophakic PatientsAkiko Hanyuda0Masahiko Ayaki1Kazuo Tsubota2Kazuno Negishi3Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, JapanDepartment of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, JapanDepartment of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, JapanDepartment of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, JapanDespite the increased awareness of early prophylaxis and treatment for dry eye disease (DED) during the first few weeks after cataract surgery, the chronic effect of cataract surgery on the risk of ocular surface abnormalities has not been fully explored. This study was to assess the prevalence of DE subjective symptoms and clinical tests according to the cataract surgery. A total of 172 patients who underwent bilateral cataract surgeries at least 5 months before the recruitment date and 1225 controls with no cataracts were evaluated for their subjective DE symptoms (dry sensation, foreign-body sensation, ocular pain, ocular fatigue, sensitivity to bright light, and blurred vision) and ophthalmic parameters (tear break-up time, keratoconjunctival staining scores, and maximum blinking interval). The presence of subjective DE symptoms was generally inversely associated with cataract surgeries, whereas abnormal clinical tests were more pronounced among postsurgical cataract patients than among controls. Pseudophakic patients showed a 57% increased prevalence of severe keratoconjunctivitis, compared to controls (<i>P</i> = 0.02). In contrast, among subjective DE symptoms, significantly lower odds of sensitivity to bright light were detected among cases than controls; the multivariable-adjusted odds ratio (95% confidence interval) comparing pseudophakic patients with noncataract patients was 0.56 (0.34⁻0.92) (<i>P</i> = 0.02). In conclusion, persistent tear instability and corneal epitheliopathy were found even at several months or more after cataract surgery. This study demonstrates the importance of evaluating ocular surface conditions in pseudophakic patients, even if they lack DE symptoms.https://www.mdpi.com/2077-0383/8/2/211dry eye diseasecataract surgeryocular surface distressmaximum blinking intervaltear instability |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Akiko Hanyuda Masahiko Ayaki Kazuo Tsubota Kazuno Negishi |
spellingShingle |
Akiko Hanyuda Masahiko Ayaki Kazuo Tsubota Kazuno Negishi Discrepancies in Persistent Dry Eye Signs and Symptoms in Bilateral Pseudophakic Patients Journal of Clinical Medicine dry eye disease cataract surgery ocular surface distress maximum blinking interval tear instability |
author_facet |
Akiko Hanyuda Masahiko Ayaki Kazuo Tsubota Kazuno Negishi |
author_sort |
Akiko Hanyuda |
title |
Discrepancies in Persistent Dry Eye Signs and Symptoms in Bilateral Pseudophakic Patients |
title_short |
Discrepancies in Persistent Dry Eye Signs and Symptoms in Bilateral Pseudophakic Patients |
title_full |
Discrepancies in Persistent Dry Eye Signs and Symptoms in Bilateral Pseudophakic Patients |
title_fullStr |
Discrepancies in Persistent Dry Eye Signs and Symptoms in Bilateral Pseudophakic Patients |
title_full_unstemmed |
Discrepancies in Persistent Dry Eye Signs and Symptoms in Bilateral Pseudophakic Patients |
title_sort |
discrepancies in persistent dry eye signs and symptoms in bilateral pseudophakic patients |
publisher |
MDPI AG |
series |
Journal of Clinical Medicine |
issn |
2077-0383 |
publishDate |
2019-02-01 |
description |
Despite the increased awareness of early prophylaxis and treatment for dry eye disease (DED) during the first few weeks after cataract surgery, the chronic effect of cataract surgery on the risk of ocular surface abnormalities has not been fully explored. This study was to assess the prevalence of DE subjective symptoms and clinical tests according to the cataract surgery. A total of 172 patients who underwent bilateral cataract surgeries at least 5 months before the recruitment date and 1225 controls with no cataracts were evaluated for their subjective DE symptoms (dry sensation, foreign-body sensation, ocular pain, ocular fatigue, sensitivity to bright light, and blurred vision) and ophthalmic parameters (tear break-up time, keratoconjunctival staining scores, and maximum blinking interval). The presence of subjective DE symptoms was generally inversely associated with cataract surgeries, whereas abnormal clinical tests were more pronounced among postsurgical cataract patients than among controls. Pseudophakic patients showed a 57% increased prevalence of severe keratoconjunctivitis, compared to controls (<i>P</i> = 0.02). In contrast, among subjective DE symptoms, significantly lower odds of sensitivity to bright light were detected among cases than controls; the multivariable-adjusted odds ratio (95% confidence interval) comparing pseudophakic patients with noncataract patients was 0.56 (0.34⁻0.92) (<i>P</i> = 0.02). In conclusion, persistent tear instability and corneal epitheliopathy were found even at several months or more after cataract surgery. This study demonstrates the importance of evaluating ocular surface conditions in pseudophakic patients, even if they lack DE symptoms. |
topic |
dry eye disease cataract surgery ocular surface distress maximum blinking interval tear instability |
url |
https://www.mdpi.com/2077-0383/8/2/211 |
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