Siew Lei, Tong Louis
Ocular Surface Research Group, Singapore Eye Research Institute, The Academia, 20 College Road, Singapore 169856, Singapore.
Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117585, Singapore.
J Clin Med. 2022 Feb 13;11(4):972. doi: 10.3390/jcm11040972.
This study investigates the effects of cataract surgery on dry eye parameters of patients with dry eye disease (DED) in the medium- to long-term post-surgical period (6 months to 5 years). A cross-sectional study was conducted on 438 eyes on first visit to a tertiary clinic (219 eyes with cataract surgery within timeframe, i.e., pseudophakic dry eye group, 219 comparison eyes without such history, i.e., comparison dry eye group). Parameters evaluated include Ocular Surface Disease Index (OSDI) and standard examination for DED. A significantly greater proportion of pseudophakic dry eye group (50%) experienced frequent blurred vision (≥1 episode per week) compared to dry eye control group (38%) (OR = 1.66, 95%CI 1.13, 2.44). Those with ocular discomfort before surgery were more likely to experience blurring at least once a day. However, a significantly greater proportion of the pseudophakic dry eye group (34%) had Schirmer's I >8mm compared to the comparison group (25%) (OR = 0.605, 95% CI 0.398, 0.921), though the difference was not clinically significant (7.51 mm versus 6.51 mm, > 0.05). Other DED signs (e.g., overall OSDI score, Tear Break-up Time) were not found to be worse among pseudophakic dry eye group. Pre-operative counselling and preventative measures should be undertaken, especially those with suggestive symptoms pre-operatively.
本研究调查白内障手术对干眼疾病（DED）患者术后中长期（6个月至5年）干眼参数的影响。对一家三级诊所首次就诊的438只眼睛进行了横断面研究（219只眼睛在规定时间内接受了白内障手术，即人工晶状体性干眼组，219只对照眼睛无此类病史，即对照干眼组）。评估的参数包括眼表疾病指数（OSDI）和DED的标准检查。与干眼对照组（38%）相比，人工晶状体性干眼组中经历频繁视力模糊（每周≥1次）的比例显著更高（50%）（OR = 1.66，95%CI 1.13，2.44）。术前有眼部不适的患者更有可能每天至少经历一次视力模糊。然而，与对照组（25%）相比，人工晶状体性干眼组中泪液分泌试验I>8mm的比例显著更高（34%）（OR = 0.605，95%CI 0.398，0.921），尽管差异无临床意义（7.51mm对6.51mm，>0.05）。未发现人工晶状体性干眼组的其他DED体征（如OSDI总分、泪膜破裂时间）更差。应进行术前咨询和预防措施，尤其是术前有提示性症状的患者。
