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J. Clin. Med. 2019, 8(2), 211;

Discrepancies in Persistent Dry Eye Signs and Symptoms in Bilateral Pseudophakic Patients

Department of Ophthalmology, Keio University School of Medicine, Tokyo 160-8582, Japan
Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo 104-0045, Japan
Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02215, USA
Otake Clinic Moon View Eye Center, Kanagawa 242-0001, Japan
Authors to whom correspondence should be addressed.
Received: 25 December 2018 / Revised: 28 January 2019 / Accepted: 5 February 2019 / Published: 7 February 2019
(This article belongs to the Special Issue Dry Eye Syndrome: New Insights on Epidemiology and Management)
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Despite the increased awareness of early prophylaxis and treatment for dry eye disease (DED) during the first few weeks after cataract surgery, the chronic effect of cataract surgery on the risk of ocular surface abnormalities has not been fully explored. This study was to assess the prevalence of DE subjective symptoms and clinical tests according to the cataract surgery. A total of 172 patients who underwent bilateral cataract surgeries at least 5 months before the recruitment date and 1225 controls with no cataracts were evaluated for their subjective DE symptoms (dry sensation, foreign-body sensation, ocular pain, ocular fatigue, sensitivity to bright light, and blurred vision) and ophthalmic parameters (tear break-up time, keratoconjunctival staining scores, and maximum blinking interval). The presence of subjective DE symptoms was generally inversely associated with cataract surgeries, whereas abnormal clinical tests were more pronounced among postsurgical cataract patients than among controls. Pseudophakic patients showed a 57% increased prevalence of severe keratoconjunctivitis, compared to controls (P = 0.02). In contrast, among subjective DE symptoms, significantly lower odds of sensitivity to bright light were detected among cases than controls; the multivariable-adjusted odds ratio (95% confidence interval) comparing pseudophakic patients with noncataract patients was 0.56 (0.34–0.92) (P = 0.02). In conclusion, persistent tear instability and corneal epitheliopathy were found even at several months or more after cataract surgery. This study demonstrates the importance of evaluating ocular surface conditions in pseudophakic patients, even if they lack DE symptoms. View Full-Text
Keywords: dry eye disease; cataract surgery; ocular surface distress; maximum blinking interval; tear instability dry eye disease; cataract surgery; ocular surface distress; maximum blinking interval; tear instability
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Hanyuda, A.; Ayaki, M.; Tsubota, K.; Negishi, K. Discrepancies in Persistent Dry Eye Signs and Symptoms in Bilateral Pseudophakic Patients. J. Clin. Med. 2019, 8, 211.

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