The Dry Eye Zone

Rebecca's Blog

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Study: Treat MGD before cataract surgery to prevent worsening

We’re seeing more, and more, and more about this, and it’s a good trend. It’s not just about “dry eye” in general, it’s honing in on MGD.

Remember all those years when LASIK patients who got MGD afterwards had no answers? To see discussion of MGD in even a cataract surgery context now lends even more credibility to the reality of our experiences. Who knows how many of us may have had undiagnosed MGD flying under the radar before an eye surgery. It’s good to see standards slowly improving. Visual outcomes are still probably the main thing driving the trend, but preventing a worsening of dry eye or MGD is a good thing whatever drives it and that is exactly what this particular study focuses on.

Preoperative Management of MGD Alleviates the Aggravation of MGD and Dry Eye Induced by Cataract Surgery: A Prospective, Randomized Clinical Trial. Song et al, Biomed Res Int. 2019 Apr 11

Abstract

PURPOSE:

To investigate the effect of preoperative treatment and postoperative enhanced anti-inflammatory treatment on alleviating meibomian gland dysfunction (MGD) and dry eye induced by cataract surgery.

DESIGN:

Prospective, randomized clinical trial.

METHODS:

A total of 120 cataract patients with moderate obstructive-MGD were enrolled and randomized with 60:30:30 number of patients in cohorts I, II, and III, respectively: Cohort I: routine postoperative anti-inflammatory treatment; Cohort II: preoperative treatment (warming compress, lid hygiene, and anti-inflammatory treatment) and routine postoperative anti-inflammatory treatment; Cohort III: enhanced postoperative anti-inflammatory treatment.

MAIN OUTCOMES MEASURES:

All participants were examined preoperatively and postoperatively for ocular symptom score (OSS), noninvasive keratographic tear break-up time (NIKBUT), corneal fluorescein staining, Schirmer I test, lid margin, meibum quality and expressibility, and meibomian gland dropout.

RESULTS:

Ocular surface disorders and MGD showed aggravated status at 1 month postoperatively in Cohort I and Cohort III, and the aggravated MGD resolved by 3 months postoperatively. At 1 month postoperatively, Cohort II and Cohort III presented high NIKBUT and low OSS, lid margin, and meibum quality and expressibility (Cohort II vs Cohort I: all P<0.001, respectively; Cohort III vs Cohort I: P=0.011, P=0.024, P=0.046, P=0.045, and P=0.012, respectively). Additionally, Cohort II had better outcomes of lid margin and meibum quality and expressibility than Cohort III at 1 month postoperatively (P=0.031, P=0.026, and P<0.001, respectively). At 3 months postoperatively, Cohort II presented a significantly higher NIKBUT than Cohort I and Cohort III (P<0.001 and P=0.001, respectively).

CONCLUSION:

Preoperative management of MGD is effective and optimal in alleviating obstructive-MGD and dry eye induced by cataract surgery.