Abstract
Purpose :
Cataract surgery is one of the most common performed procedures among older patients. However, Ocular Surface Diseases (OSD) can adversely affect pre-operative measurements, visual outcomes, and patient satisfaction after cataract surgery. Current standard of care does not systematically address OSD prior to cataract surgery, thus a novel preoperative algorithm for diagnosing OSD before surgery was published by the ASCRS Cornea Clinical Committee. Our study aimed to identify the real-world application of the algorithm’s utility in identifying the prevalence of OSD signs and symptoms in geriatric patients presenting for cataract surgery.
Methods :
This was a prospective case series of consecutive patients presenting for cataract surgery evaluation aged 60 and older. Subjects underwent preoperative cataract surgery screening for OSD as outlined by the preoperative algorithm, in which symptoms of OSD were measured with a standardized questionnaire comprised of questions related to frequency and severity of eye irritation and signs of OSD were measured with tear tests for osmolarity (abnormal: >307 mOsm/L or >7 mOsm/L intereye difference) and MMP-9 levels (> 40ng/mL).
Results :
There were 28 patients (75% women), mean age 74 years. Abnormal osmolarity was found in 14 patients (50%) and abnormal MMP-9 in 14 patients (50%). 20 patients (71.4%) had a questionnaire score suggestive of OSD. By following the algorithm and according to the results of the questionnaire, tear tests, and clinical exam, 24 patients (85.7%) were determined to have non-visually significant OSD, 3 patients (10.7%) had visually-significant OSD, and 1 patient (3.6%) had OSD ruled out.
Conclusions :
These results suggest a high prevalence of ocular surface dysfunction among patients presenting for cataract surgery as measured by tear tests and symptom questionnaire. Since better visual quality and patient satisfaction may be achieved if ocular surface dysfunction is treated before surgery, it is worth considering employing this preoperative OSD algorithm in patients presenting for cataract surgery.
This abstract was presented at the 2023 ARVO Annual Meeting, held in New Orleans, LA, April 23-27, 2023.