Evaluation of the Protective Effect of an Ophthalmic Viscosurgical Device on the Ocular Surface in Dry Eye Patients during Cataract Surgery

Purpose

To evaluate the protective effect of applying an ophthalmic viscosurgical device (OVD) to the ocular surface during cataract surgery and its ability to prevent dry eye syndrome.

Methods

Twenty-four patients aged 50 to 75 years who underwent cataract surgery at Seoul National University Bundang Hospital and agreed to participate in the study were included and divided into two groups: a study group who underwent cataract surgery after application of an OVD to the ocular surface, and a control group who underwent cataract surgery without application of an OVD. DisCoVisc was used as the OVD in the study group, while other factors including surgical techniques and administration of anesthetic agents were performed in both groups in the same manner. Indicators of dry eye syndrome including ocular staining score, tear break-up time, and tear osmolality were analyzed. Ocular surface disease index and a visual analog scale were analyzed for dry eye symptoms, and the amount of balanced salt solution used during surface irrigation and operation time were also analyzed.

Results

Significant improvement in the tear break-up time, corneal ocular staining score, and ocular surface disease index score in the study group compared with the control group one week after operation (by the Mann-Whitney test). Use of OVD was associated with longer operating time.

Conclusions

OVD applied to the ocular surface during cataract surgery had a protective effect on the ocular surface one week after surgery.

Assessment of Transepidermal Water Loss From the Ocular Area in Dry Eye Disease

Purpose

To investigate transepidermal water loss (TEWL) from the ocular area in dry eye disease (DED) and evaluate the correlation between ocular TEWL and other DED parameters.

Methods

Transepidermal water loss from the ocular area in 56 eyes with DED and 38 healthy eyes was measured using a Tewameter TM300 that was equipped with custom made goggles (measuring temperature 24°C-26°C and relative humidity 35%-45%). The DED group was classified into two subgroups, aqueous deficient dry eye (ADDE) and evaporative dry eye (EDE). Correlations between ocular TEWL and other DED parameters, such as tear osmolarity, tear break-up time (TBUT), corneal staining, conjunctival staining, Schirmer I test, Ocular Surface Disease Index (OSDI), and Visual Analogue Scale score were evaluated.

Results

Ocular TEWL was significantly higher in the DED group (63.0 ± 12.2 g/h/m2) than in the control group (54.7 ± 14.2 g/h/m2; P = 0.003). Although there was no significant difference, TEWL was higher in the ADDE subgroup (64.0 ± 10.7 g/h/m2) compared with the EDE subgroup (61.1 ± 14.9 g/h/m2). Tear break-up time, corneal staining score, and OSDI were significantly correlated with ocular TEWL (P < 0.05) in all participants. Ocular TEWL loss was negatively correlated with Schirmer I test value in the DED group.

Conclusions

Ocular TEWL was significantly higher in DED patients compared with controls, reflecting higher tear evaporation in DED patients. Patients who have shorter Schirmer I test values tend to have higher TEWL values. Not only EDE but also ADDE patients may have increased tear evaporation.