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Cataract and Dry Eye: Prospective Health Assessment of Cataract Patients Ocular Surface Study

Cataract and Dry Eye: Prospective Health Assessment of Cataract Patients Ocular Surface Study . W. B. Trattler ; C. D. Reilly; D. F. Goldberg; P. A. Majmudar; J. A. Vukich; M. Packer; E. D. Donnenfeld. Financial Disclosures.

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Cataract and Dry Eye: Prospective Health Assessment of Cataract Patients Ocular Surface Study

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  1. Cataract and Dry Eye: Prospective Health Assessment of Cataract Patients Ocular Surface Study W. B. Trattler; C. D. Reilly; D. F. Goldberg; P. A. Majmudar; J. A. Vukich; M. Packer; E. D. Donnenfeld

  2. Financial Disclosures • William Trattler: Consultant/Research Funding &/OR Speaking Honoraria: AMO, Lenstec, Wavetec • Study funded by an unrestricted grant from Allergan

  3. Purpose and Methods • The purpose of this study was to determine the incidence and severity of dry eye in patients undergoing cataract surgery • Prospective, multi-center, observational, pilot study of 143 patients at least 55 years of age that were scheduled to undergo cataract surgery. • Outcome measures • Incidence of dry eye as evaluated by grade on ITF level • TBUT • OSDI • Corneal staining with fluorescein • Conjunctival staining with lissamine • Patient symptom questionnaire

  4. Patient Enrollment • 143 consecutive patients (286 eyes) scheduled to undergo cataract surgery and meeting all other inclusion/exclusion criteria were enrolled at 9 sites across the United States • 7 of these patients (7/143, 4.9%) were presently using Restasis and investigators completed a questionnaire about their use of Restasis • Additional data from these patients was not collected/not used for the analysis of the remaining 136 patients (272 eyes) • Of the 136 patients, 30 (22.1%) indicated a prior diagnosis of dry eye disease • If including the Restasis patients, this incidence increased to 25.9% (37/143)

  5. Patient Demographics

  6. ITF Scores

  7. TBUT and Staining • Most patients (62.9%) had an abnormal TBUT < 5 sec • 76.8% were positive for fluorescein corneal staining, with 50% • exhibiting positive central staining

  8. Schirmer’s and OSDI • 21.3% of patients had an abnormal Schirmer’s score (< 5 mm)

  9. Prevalence of Patient Symptoms

  10. Prevalence of Patient Symptoms • Lack of symptoms was not associated with lack of corneal staining: • 61/136 patients (44.9%) had a corneal staining score of at least 1 but a cumulative score of one or lower for burning/stinging, FBS, dryness, and painful/sore.

  11. Conclusions • The findings of the present study suggest that the prevalence of dry eye signs and symptoms in patients undergoing cataract surgery is more common than frequently reported: • Most patients (62.9%) had an abnormal TBUT < 5 sec • 21.3% had an abnormal Schirmer’s score (< 5 mm) • 76.8% were positive for fluorescein corneal staining, with 50% exhibiting positive central staining

  12. Conclusions • Despite only the minority of patients (22.1%) ever having received a diagnosis of dry eye, more than 30% of patients reported at least occasional stinging and burning, dryness, and foreign body sensation, with more than 40% reporting ocular itching, sensitivity to light, blurred vision, and tired/fatigued eyes. • In conclusion, increased awareness of the prevalence of dry eye signs and symptoms should lead to proactive treatment and careful monitoring for either surgically-induced dry eye or the exacerbation of dry eye disease existent prior to undergoing cataract surgery.

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