Nilsen Christian, Gundersen Morten, Jensen Per Graae, Gundersen Kjell Gunnar, Potvin Richard, Utheim Øygunn A, Gjerdrum Bjørn
Ifocus Eye Clinic, Haugesund, Norway.
Science in Vision, Frisco, TX, USA.
Clin Ophthalmol. 2024 May 28;18:1503-1514. doi: 10.2147/OPTH.S459282. eCollection 2024.
The primary objective was to investigate if treatment with artificial tears affected the variability of keratometry measurements for subjects with dry eyes prior to cataract surgery. The secondary objectives were to investigate whether treatment with artificial tears improved refractive precision and whether subjects with non-dry eyes had better refractive precision than subjects with dry eyes.
Prospective randomized controlled trial with three arms.
Dry eye diagnostics according to DEWS II were performed, and subjects with dry eyes were randomized to no treatment (group A1) or treatment with artificial tears two weeks prior to cataract surgery (group A2), with the third group (Group B, non-dry eyes) as a control. Keratometry was performed twice at baseline and twice after two weeks at the time of cataract surgery with three different optical biometers. The change in mean variability of keratometry (average K and magnitude of vector differences) and percentages of outliers after two weeks versus baseline were compared for group A2. The refractive and astigmatism prediction errors were calculated eight weeks after cataract surgery and compared for all three groups.
One hundred thirty-one subjects were available for analysis. There was no statistically significant difference in the mean variability of keratometry or percentages of outliers for group A2 from baseline to the time of cataract surgery. There was no statistically significant difference in refractive precision (absolute error and astigmatism prediction error) between any groups.
Subjects with dry eyes (treated and non-treated) achieved the same refractive precision and percentages of outliers as subjects with non-dry eyes. Treatment with artificial tears for two weeks appeared inadequate to significantly affect variability in biometric measurements for patients with dry eyes prior to cataract surgery. DEWS II criteria for DED may not be optimal in a cataract setting.
主要目的是研究人工泪液治疗是否会影响白内障手术前干眼症患者角膜曲率测量的变异性。次要目的是研究人工泪液治疗是否能提高屈光精度，以及非干眼症患者的屈光精度是否优于干眼症患者。
前瞻性随机对照三臂试验。
根据DEWS II进行干眼诊断，将干眼症患者随机分为未治疗组（A1组）或在白内障手术前两周接受人工泪液治疗组（A2组），第三组（B组，非干眼症患者）作为对照组。在基线时和白内障手术时两周后，使用三种不同的光学生物测量仪进行两次角膜曲率测量。比较A2组两周后与基线时角膜曲率平均变异性（平均K值和矢量差大小）的变化以及异常值百分比。在白内障手术后八周计算屈光和散光预测误差，并对所有三组进行比较。
131名受试者可供分析。从基线到白内障手术时，A2组角膜曲率的平均变异性或异常值百分比无统计学显著差异。任何组之间的屈光精度（绝对误差和散光预测误差）均无统计学显著差异。
干眼症患者（治疗组和未治疗组）与非干眼症患者的屈光精度和异常值百分比相同。在白内障手术前，对干眼症患者使用人工泪液治疗两周似乎不足以显著影响生物测量的变异性。在白内障背景下，DEWS II的DED标准可能并非最佳。
