Upper Eyelid Meibomian Gland Dysfunction is a Risk Factor for Dry Eye Symptoms Following Cataract Surgery in the Early Phase

Abstract

Purpose

To evaluate perioperative dry eye (DE) syndrome and meibomian gland (MG) dysfunction parameters associated with cataract surgery-induced DE symptoms.

Patients and Methods

This retrospective, single-centered, observational study included 82 eyes of 43 patients without previous subjective DE symptoms, treatment, ocular comorbidities, and previous use of ophthalmic treatment, except for anti-allergic eye drops, who underwent uncomplicated cataract surgery. MG dropout, lid margin abnormality, meibum quality, meibum expressibility, MG orifice obstruction, ocular surface disease index, non-invasive tear break-up time, tear meniscus height, and Schirmer test score were measured at baseline and 1 month postoperatively. Multivariable logistic regression with generalized estimating equation models was used to determine the risk factors for cataract surgery-induced DE symptoms.

Results

Twenty-one patients had subjective DE symptoms 1 month following the cataract surgery. Preoperative and postoperative parameters, preoperative upper eyelid MG loss, and female sex (odds ratio [OR] 6.72, P = 0.012; OR 4.20, P = 0.037, respectively) were identified as risk factors for cataract surgery-induced DE symptoms.

Conclusion

Ocular parameters, including upper eyelid MG findings at baseline, were considered important in predicting persistent DE symptoms following cataract surgery.

Keywords:

• meibomian gland dysfunction
• dry eye syndrome
• retrospective
• ocular surface disease index

Abbreviations

BUT, break-up time; DE, dry eye; GCP, good clinical practice; MG, meibomian gland; NIBUT, non-invasive tear break-up time; OR, odds ratio; OSDI, ocular surface disease index; TMH, tear meniscus height.

Data Sharing Statement

The data that support the findings of this study are available from the corresponding author H.F. upon reasonable request.

Ethics Approval and Informed Consent

The study was approved by the Institutional Review Board of Kawasaki Medical School Hospital (approval number 5441-00). Informed consent was obtained from all study participants. The study adhered to the tenets of the Declaration of Helsinki and was performed according to Good Clinical Practice (GCP).

Consent for Publication

Written informed consent was obtained from the patient for publication of this report and any accompanying images.

Acknowledgments

The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. The authors thank T. Baba, T. Yamashita, and Y. Ohashi for the discussions, advice, and criticism that greatly benefitted this project.

Author Contributions

All authors made a significant contribution to the work reported, whether that is in the conception, study design, execution, acquisition of data, analysis and interpretation, or in all these areas; took part in drafting, revising or critically reviewing the article; gave final approval of the version to be published; have agreed on the journal to which the article has been submitted; and agree to be accountable for all aspects of the work.

Disclosure

Hisataka Fujimoto reports grants from Alcon, Otsuka, Kowa, Santen, and Novartis. Shintaro Ochi reports grants from Santen. Yasushi Inoue reports grants from Santen, Junichi Kiryu, Kowa, Alcon, Novartis, and Otsuka. The authors report no other conflicts of interest in this work.

Additional information

Funding

This research was funded in part by Research Project Grant R02B-010 from Kawasaki Medical School (to H.F.).