[Therapeutic hygiene of eyelids in dry eye disease prior to cataract phacoemulsification].

作者信息

Sakhnov S N, Yanchenko S V, Malyshev A V, Karapetov G Yu, Katkhanov T G, Petrosyan L M, Baskakov O A, Dobronosova Yu A, Kolomiets G L, Lepa T I, Lysov E E, Tseeva A R

机构信息

Kuban State Medical University, Krasnodar, Russia.

Krasnodar branch of S.N. Fedorov National Medical Research Center «MNTK «Eye Microsurgery», Krasnodar, Russia.

出版信息

Vestn Oftalmol. 2023;139(1):46-54. doi: 10.17116/oftalma202313901146.

PURPOSE

The study evaluates the effectiveness of eyelid hygiene (EH) in correction of the ocular surface (OS) condition in patients with dry eye disease (DED) ahead of cataract phacoemulsification (CPE).

MATERIAL AND METHODS

The study included 90 patients with cataract: the first group consisted of 45 DED patients with lipid deficiency, the second group - 45 DED patients with lipid/mucous deficiency. Prior to CPE, all patients were randomized into three subgroups of 15 people each. In subgroups 1.1 and 2.1 patients did not receive any treatment for correction of the state of ocular surface. Patients in subgroups 1.2 and 1.3 were instilled 0.18% sodium hyaluronate (SH); in subgroups 2.2 and 2.3 - fixed combination of 0.15% SH and 3% trehalose. In subgroups 1.3 and 2.3 EH was performed (with «Blefarogel cleansing», «Blefarolotion», «Blefarogel-1» two times a day for one month before CPE). The control points were: 1) at study inclusion; 2) after correction of the ocular surface condition; 3) 30 days after CPE. The following parameters were evaluated: OSDI, TBUT (Norn's test), severity of meibomian gland dysfunction (MGD), patient satisfaction with CPE (CPE-PS). Statistical analysis: calculation, Mann--Whitney, Kruskal-Wallis and Wilcoxon tests.

RESULTS

At the second control point, a statistically significant more pronounced OSDI decrease and bigger increase in TBUT were observed in subgroups 1.3 and 2.3 compared to subgroups 1.2 and 2.2 (Mann-Whitney U-test). Apparently, this was associated with a reduction in MGD severity in patients who received EH. At the third control point, significant lower values of OSDI and MGD severity, higher TBUT values and greater CFE-PS were recorded in subgroups 1.3 and 2.3 (Kruskal-Wallis test, Wilcoxon two-sample test).

CONCLUSION

Carrying out EH using the «Blefarogel cleansing», «Blefarolotion», «Blefarogel-1» and artificial tear in patients with DED and cataract can increase the efficiency of correction of ocular surface condition and improve patient satisfaction with the outcome of CPE.