Attention to ocular surface disease needs to be an integral part of pre- and postoperative planning for cataract patients, given the high incidence of various objective measures in this population, many of which were undiagnosed.1
In a prospective study of 120 patients, researchers recorded patient demographics, medical history, slit lamp findings, tear osmolarity and tear matrix metalloproteinase-9 (MMP-9) levels. They measured patient symptoms using the Ocular Surface Disease Index and the Symptom Assessment in Dry Eye questionnaires. Patients were considered to have ocular surface dysfunction if they had a visually significant abnormal corneal surface examination, a positive MMP-9 test or abnormal osmolarity values, the study notes.1
Of the study subjects, the team found abnormal MMP-9 in 76 (63.3%), abnormal osmolarity in 68 (56.7%), positive corneal staining on presentation in 47 (39.2%), epithelial basement membrane dystrophy in nine (7.5%) and Salzmann nodules in two (1.6%). Questionnaire data showed 54 of 100 patients reported symptoms suggestive of ocular surface dysfunction; of the 46 asymptomatic patients, 39 (85%) had at least one abnormal tear test (osmolarity of MMP-9) result and 22 (48%) had two abnormal tear test (osmolarity and MMP-9) results. The researchers add that, overall, 96 patients (80%) had at least one abnormal tear test result suggestive of ocular surface dysfunction and 48 (40%) had two abnormal tear test results.
The study concludes, “clinicians should be aware of this high prevalence and consider screening with tear testing before surgery.” Jim Owen, OD, said in a Practice Update commentary that this study is important because it confirms the high prevalence of ocular surface dysfunction in cataract surgery patients.2
1. Gupta PK, Drinkwater OJ, VanDusen KW, et al. Prevalence of ocular surface dysfunction in patients presenting for cataract surgery evaluation. J Cataract Refract Surg. 2018;44(9):1090-6.
2. Prevalence of ocular surface dysfunction in patients presenting for cataract surgery evaluation. PracticeUpdate. September 26, 2018.