Miura Maria, Inomata Takenori, Nakamura Masahiro, Sung Jaemyoung, Nagino Ken, Midorikawa-Inomata Akie, Zhu Jun, Fujimoto Keiichi, Okumura Yuichi, Fujio Kenta, Hirosawa Kunihiko, Akasaki Yasutsugu, Kuwahara Mizu, Eguchi Atsuko, Shokirova Hurramhon, Murakami Akira
Department of Ophthalmology, Juntendo University Graduate School of Medicine, 2-1-1 Hongo, Bunkyo-Ku, Tokyo, 113-0033, Japan.
Department of Digital Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
Ophthalmol Ther. 2022 Aug;11(4):1309-1332. doi: 10.1007/s40123-022-00513-y. Epub 2022 May 9.
Dry eye disease (DED) after cataract surgery is associated with various risk factors, while causing a wide range of heterogeneous symptoms including decreased quality of vision. This systematic review and meta-analysis aimed to determine the prevalence and characteristics of DED after cataract surgery. We searched PubMed and EMBASE and included studies on patients with DED after cataract surgery, between January 2011 and June 2020. Study-specific estimates (DED prevalence rates after cataract surgery in patients without preexisting DED) were combined using one-group meta-analysis in a random-effects model. We included 36 studies published between 2013 and 2020. We included nine of these in the meta-analysis of DED prevalence after cataract surgery. Overall 37.4% (95% CI 22.6-52.3; 206/775) of patients without preexisting DED developed DED after cataract surgery. The risk factors for DED after cataract surgery included age, female sex, systemic diseases, systemic medications, psychiatric conditions, preexisting DED, meibomian gland dysfunction, preservatives in eye drops, surgery techniques, and lifestyle. DED severity peak occurred 1 day postoperatively and persisted for at least 1-12 months following cataract surgery; therefore, consistent follow-up for DED is warranted for at least 1 month after cataract surgery. Topical administration of preservative-free diquafosol tetrasodium solution and preoperative meibomian gland treatment were effective in preventing and treating DED following cataract surgery. As more than one-third of patients develop DED after cataract surgery, careful DED management and treatment is needed after cataract surgery to improve satisfaction and vision quality.
白内障手术后的干眼疾病（DED）与多种风险因素相关，同时会引发包括视力下降在内的一系列不同症状。本系统评价和荟萃分析旨在确定白内障手术后DED的患病率及特征。我们检索了PubMed和EMBASE，并纳入了2011年1月至2020年6月期间有关白内障手术后DED患者的研究。采用随机效应模型中的单组荟萃分析对各研究的特定估计值（无既往DED患者白内障手术后的DED患病率）进行合并。我们纳入了2013年至2020年发表的36项研究。其中9项纳入了白内障手术后DED患病率的荟萃分析。总体而言，无既往DED的患者中有37.4%（95%CI 22.6 - 52.3；206/775）在白内障手术后发生了DED。白内障手术后DED的风险因素包括年龄、女性、全身性疾病、全身性药物、精神状况、既往DED、睑板腺功能障碍、滴眼液中的防腐剂、手术技术和生活方式。DED严重程度在术后1天达到峰值，并在白内障手术后持续至少1 - 12个月；因此，白内障手术后至少1个月有必要对DED进行持续随访。局部应用无防腐剂的四磷酸二氢钠溶液和术前睑板腺治疗对预防和治疗白内障手术后的DED有效。由于超过三分之一的患者在白内障手术后会发生DED，因此白内障手术后需要仔细管理和治疗DED，以提高患者满意度和视力质量。
