The Prospective Health Assessment of Cataract Patients’ Ocular Surface (PHACO) study: the effect of dry eye

Abstract

Purpose

To determine the incidence and severity of dry eye as determined by the International Task Force (ITF) scale in patients being screened for cataract surgery.

Patients and methods

This was a prospective, multi-center, observational study of 136 patients, at least 55 years of age, who were scheduled to undergo cataract surgery. The primary outcome measure was the incidence of dry eye as evaluated by grade on the ITF scale and secondary outcome measures include tear break-up time (TBUT), ocular surface disease index score, corneal staining with fluorescein, conjunctival staining with lissamine green, and a patient questionnaire to evaluate symptoms of dry eye.

Results

Mean patient age was 70.7 years. A total of 73.5% of patients were Caucasian and 50% were female. Almost 60% had never complained of a foreign body sensation; only 13% complained of a foreign body sensation half or most of the time. The majority of patients (62.9%) had a TBUT ≤5 seconds, 77% of eyes had positive corneal staining and 50% of the eyes had positive central corneal staining. Eighteen percent had Schirmer’s score with anesthesia ≤5 mm.

Conclusion

The incidence of dry eye in patients scheduled to undergo cataract surgery in a real-world setting is higher than anticipated.

Keywords:

• cataract surgery screening
• dry eye
• International Task Force scale
• observational study

Supplementary material

Table S1 Dry eye signs and symptoms

Acknowledgments

This study was funded by an unrestricted grant from Allergan. Members of the PHACO study group are consultants to Allergan. EDD, MBM, KGS, DFG, and WBT are also consultants to Shire. Michelle Dalton, ELS, provided medical writing and editing; this support was funded by an unrestricted grant from Allergan, Irvine, CA, USA.

This paper was presented in part at the American Society of Cataract & Refractive Surgery annual meetings in 2011 (San Diego, CA; March 25–29) and 2012 (Chicago, IL, April 20–24).

Members of the PHACO Study Group: Damien F Goldberg, MD; Chaz Reilly, MD; Mark Packer, MD; Parag A Majmudar, MD; Eric D Donnenfeld, MD; Marguerite B McDonald, MD, FACS; Karl G Stonecipher, MD; Jon Vukich, MD; Gregg Berdy, MD; Ranjan Malahotra, MD; and William B Trattler, MD.

Author contributions

WBT, PAM, EDD, MBM, KGS, and DFG conducted the study; WBT, PAM, EDD, MBM, KGS, and DFG analyzed data and revised the paper; and WBT, PAM, EDD, MBM, KGS, and DFG reviewed and approved the manuscript.

Disclosure

None of the authors have a financial interest in any product mentioned, but all are consultants to Allergan. In addition, EDD, MBM, KGS, and WBT are consultants to Shire. The authors report no other conflicts of interest in this paper.