Abstract
Purpose :
To evaluate post cataract surgery dry eye (DE) outcomes through a systematic review.
Methods :
We searched Ovid MEDLINE and Embase from 01/01/2010 to 16/08/2021 and included observational studies of participants ≥18 years old undergoing any cataract surgical procedure. We excluded studies of participants with prevalent DE at baseline or history of comorbidities that may affect DE. We compared postoperative DE outcomes with baseline. Outcomes included: Ocular Surface Disease Index (OSDI), tear break up time (TBUT), Schrimer’s I test (ST1), and fluorescein staining (FS) at short-term (<1 week) and medium-term (>1 week to 3 months) follow up. We assessed risk of bias (RoB) and performed meta-analysis using R version 4.2.2.
Results :
Our search yielded 11,132 records. After title and abstract screening, we reviewed 56 full-text reports, and included 20 studies with 1,794 eyes from 17 countries. Most studies were single institution or hospital-based studies. Sample size in each study ranged from 5 to 221 eyes. 8 studies reported short-term follow-up for any outcome and 17 studies reported medium-term follow-up for any outcome. Our analyses showed that there may be little to no difference in the mean change from baseline in OSDI at short term (MD -5.80, 95% CI -20.64, 9.04; 2 studies; I2=99%) and medium term (MD -1.26, 95% CI -17.59, 15.07; 5 studies; I2=99%). There may be a slight deterioration in TBUT at short term (MD -4.09, 95% CI -7.73, -0.46; 3 studies; I2=97%) and medium term (MD -2.01, 95% CI -2.96, -1.05; 7 studies; I2=97%). There may be little to no difference in ST1 at short term (MD -4.08, 95% CI, -9.93, 1.77; 6 studies; I2=100%) and a slight reduction at medium term (MD -2.93, 95% CI: -4.84, -1.01; 9 studies; I2=97%). There may be little to no difference in FS at short term (MD 0.21, 95% CI, -0.13, 0.55; 2 studies; I2=97%) and a slight deterioration at medium term (MD 0.16, 95% CI: 0.11, 0.21; 2 studies; I2=0%). We judged the RoB to be “Good”, “Fair”, and “Poor” in 3 (14%), 11 (50%), and 6 (28%) studies, respectively.
Conclusions :
Cataract surgery may have little to no effect on inducing DE symptoms but may cause slight deterioration in TBUT, ST1, and FS within 3 months postoperative follow-up. The between-study heterogeneity is high for most of the outcomes.
This abstract was presented at the 2024 ARVO Annual Meeting, held in Seattle, WA, May 5-9, 2024.