Evaluation of ocular surface disorder management following phacoemulsification: preliminary results

Poster Details

First Author: A.Ambroziak POLAND

Co Author(s):    M. Korwin   D. Rokicki   M. Woronkowicz   A. Bielecka   P. Krawczyk   J. Szaflik

Abstract Details

Purpose:

The purpose of the prospective study was to evaluate efficacy of the treatment of patients with Meibomian Gland Disfunction (MGD) and / or Dry Eye Syndrome (DES) following cataract surgery and a comparison of the tear film stability in the group of patients treated with HYABAK (hyaluronic acid 0.15%) in combination with eyelids hygiene (Blephaclean wipes) compared to control group.

Setting:

Department of Ophthalmology, Medical University of Warsaw

Methods:

The study consisted of 60 patients, 120 eyes. 60 eyes of 30 patients (18 females, 12 males, aged from 59 to 82 years) qualified for phacoemulsification with IOL implantation were enrolled in a prospective clinical trial (first part the study). 30 eyes comprised of the control group. Study group used HYABAK moisturizing eye drops and Blephaclean wipes in the treatment of MGD and/or DES. Exclusion criteria were: active pathology requiring modification in ophthalmological treatment during one month before the enrollment to the study, surgical interventions ( including refractive surgery ) having unfavourable effect on ocular surface i.e. chemical burns, corneal dystrophies, orbit radiotherapy etc., diabetes mellitus, history of the recent events (during 3 months prior the study) such as: trauma, infections, clinically significant inflammation. During the first and the second visit (after 21 days +/- 2-3 days) following examinations were performed: BCVA, tear film osmolarity using TearLab Osmolarity Test slit-lamp examination, lid margins evaluation: expressibility and secretion quality of Meibomian glands according to the criteria of The International Workshop on Meibomian Gland Dysfunction, tear filmTearscope - lipid patterns evaluation, TBUT measurement, corneal staining.

Results:

The most important parameters evaluated and considered were: TBUT, tear osmolarity changes, staging of MGD and discomfort intensity. In TBUT examination we obtained following results: in the study group mean change in TBUT was -0.27 vs. study control group -0.47, which means that those changes were not statistically significant. Tear osmolarity measurements results showed following data, in the study group mean change was -6.87 vs. -0,43 in the control group, respectively (p=0.0015) in Wilcoxon’s test. This outcome was statistically significant. Mean change in MGD occlusion stage in the study group was -1.31 vs. -0.10 in the control group, respectively with p=0.0001 in Wilcoxon’s test (statistically significant). Mean change in discomfort reported by patients in the study group was -11.67 vs. -2.33 in the control group with p<0.0001 in the Wilcoxon’s test (statistically significant).

Conclusions:

Based on our results both observed by the authors and also as a change in symptoms intesity reported individually by study participants we can conclude that both formulations used e.g. Hyabak moisturizing eye drops and Blephaclean wipes improve ocular surface condition. Their systematical use improves tear osmolarity and also Meibomian glands condition along with local comfort improvement. Although, TBUT changes were not statistically significant, but considering cataract extraction procedure itself, it always produces negative changes to the ocular surface, which are transient but may hazard the total outcome of the surgery. So considering such an issue even no TBUT changes between both groups is a great success. The second part of tye study is ongoing.. FINANCIAL DISCLOSURE?: ... receives consulting fees, retainer, or contract payments from a company producing, developing or supplying the product or procedure presented