Overview
Patient: Tear film issues resulting in poor visual outcomes are a major cause of dissatisfaction after cataract surgery. There is no universal best preoperative algorithm for managing the ocular surface prior to surgery.
Industry: Recent advances in tear/cornea imaging and refractive cataract surgery such as multifocal intraocular lenses will be advantageous to patients only if tear film issues can be addressed.
Society: Cataract surgery is the most common ophthalmic surgery done in Singapore and worldwide. Improving vision by attending to tear film problems improves quality of life.
Description
Phase 1: Investigate the impact of ocular surface disease (OSD) on post-operative outcomes in cataract surgery.
Phase 1A: Longitudinal interventional parallel group study; small cohort to determine the impact of moderate dry eye for at-risk patient groups.
Phase 1B: Longitudinal interventional parallel group study; larger cohort of to compare outcomes based on different IOL types.
Eligibility
Inclusion Criteria:
- Inclusion criteria for dry eye (participant must meet at least 1 of the inclusion criteria below):
- Symptomatic for dry eye based on DEQ5 (\>6) and \[either TBUT less than 5 s or staining \>grade 1 in any zone of the cornea\]
- Either use of diquasfosol, cyclosporine eyedrops or tacrolimus eyedrops for dry eye disease in the last 2 weeks (and previously started for more than 2 months), OR current and visible lower punctal plugs in at least one eye
Inclusion criteria to fulfil all for controls (patients w/o dry eye):
- DEQ5 \<=6.
- Staining \< grade 1 in at least one corneal zone.
- Not using diquasfosol, cyclosporine, tacrolimus in last 2 months.
- No visible punctal plugs.
Exclusion Criteria:
- If there is another ocular condition which affects vision as much as cataract: active corneal stromal disease or scar or significant corneal endothelial disease
- Known diagnosis of active thyroid dysfunction, Sjogren disease and rheumatoid arthritis
- Intraocular surgery within the previous 6 months
- Laser-assisted in situ keratomileusis or pterygium surgery within the previous 3 months
- Central nervous system and hormonal drugs required within the last month and during the study
- Active ocular infection, inflamed chalazion, or presence of pterygium
- Glaucoma which requires topical anti-glaucoma medications
- Any need to wear contact lens during the study
- Having issues which make it difficult to follow up (eg., wheelchair, etc)
- Pregnant and breast-feeding woman