DED therapy prior to cataract surgery has proven beneficial. Photo: Chandra Mickles, OD.
DED therapy prior to cataract surgery has proven beneficial. Photo: Chandra Mickles, OD. Click image to enlarge.

Studies have shown that many patients who are predisposed to DED before cataract surgery have the same or even worse symptoms after. To help avoid this, researchers evaluated the effects of pretreatment for DED on the accuracy of intraocular lens (IOL) power calculation.

A total of 105 patients who underwent cataract surgery were included—52 were in the non-pretreatment group and 53 in the pretreatment group. Topical loteprednol etabonate and cyclosporin A and eyelid scrub with warm compression were the DED pretreatments used for two weeks.

The study showed that short-term treatment of DED prior to cataract surgery improved the accuracy of IOL power calculation and the number of refractive surprises one month after surgery.

Most patients saw improvement after two weeks. Age, sex, axial length (AL) and keratometric (K) values were some of the clinical factors, but pretreatment of DED before surgery was the only factor that produced a reduction in postoperative refractive surprise. Pretreatment was more effective in reducing refractive surprise in males and patients over 60.

“Prevalence of DED and MGD increased with age, and males tended to express less discomfort, suggesting that their DED status could have been masked and underestimated,” the authors explained. “Furthermore, preoperative treatment of DED was effective in eyes with a normal range of AL. Patients with an abnormal range of AL may have a larger error factor compared with those with a normal range of AL, so increasing the accuracy of K value with pretreatment seemed to be more effective in the normal AL group.”

Since not nearly as many screening procedures and treatments are done prior to cataract surgery, the authors believe that DED pretreatment could also simplify the clinical process, potentially leading to better outcomes not just from a refractive standpoint, but also for postoperative DED.

Kim J, Kim MK, Ha Y, et al. Improved accuracy of intraocular lens power calculation by preoperative management of dry eye disease. BMC Ophthalmol. October 13, 2021. [Epub ahead of print].