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The effect of preservative-free HP-Guar on dry eye after phacoemulsification: a flow cytometric study
M A Sánchez1, P Arriola-Villalobos, P Torralbo-Jiménez
1Department of Ophthalmology, Hospital Clínico San Carlos, Madrid, Spain.
Purpose:
To assess the effect of hydroxypropyl (HP)-Guar added to regular post-phacoemulsification treatment in dry eye signs and symptoms, and its influence on the expression of various inflammatory markers by flow cytometry (FCM) in impression cytology specimens.
Methods:
This prospective, interventional, single-centre study included 48 eyes of 48 patients with age-related cataract. After phacoemulsification, patients were randomised to the usual treatment group (UT), with 21 patients who received tobramycin and dexamethasone eye drops (Tobradex, Alcon Cusí, Spain), and the HP-Guar group, with 27 patients who received the UT plus preservative-free artificial tears (Systane UD, Alcon Cusí, Spain). Corneal and conjunctival staining with fluorescein and lissamine green, tear film break-up time (TBUT), Schirmer's I test with anaesthesia (Jones test), tear clearance, and ocular surface disease index (OSDI) were assessed preoperatively and 1 month after surgery. Besides, conjunctival impression cytology was performed in order to investigate inflammatory markers (CD3, CD11b, and HLA-DR) using FCM.
Results:
HP-Guar group shows statistical better results compared with the UT group in TBUT (6.4+/-0.7 vs 9+/-2.5, P=0.0004), OSDI (11.5+/-8.2 vs 3.3+/-2.5, P=0.0002), ocular symptoms subscale (7.3+/-6.1 vs 1.7+/-1.8, P=0.0004), vision-related function subscale (2.2+/-1.8 vs 0.4+/-0.6, P=0.0002), CD3 (2.5+/-1.4 vs 1.1+/-1.1, P=0.011), and HLA-DR (6.8+/-4.5 vs 1.8+/-1.7, P=0.0002).
Conclusion:
The addition of HP-Guar to regular treatment after cataract surgery reduces ocular surface inflammation and dry eye signs and symptoms.
Insights
Adding hydroxypropyl (HP)-Guar to standard post-cataract surgery care significantly improved dry eye symptoms and reduced ocular surface inflammation. This treatment enhances patient comfort and vision-related function after surgery.
Area of Science:
- Ophthalmology
- Dry Eye Disease Research
- Inflammatory Marker Analysis
Background:
- Phacoemulsification for age-related cataracts can lead to dry eye signs and symptoms.
- Post-operative ocular surface inflammation is a concern following cataract surgery.
- Standard treatment regimens may not fully address post-surgical dry eye.
Purpose of the Study:
- To evaluate the efficacy of hydroxypropyl (HP)-Guar in managing dry eye after phacoemulsification.
- To assess the impact of HP-Guar on inflammatory markers (CD3, CD11b, HLA-DR) using flow cytometry (FCM).
- To compare outcomes between standard treatment (UT) and UT with HP-Guar.
Main Methods:
- Prospective, interventional study involving 48 patients undergoing phacoemulsification.
- Patients randomized to usual treatment (UT) or UT plus preservative-free HP-Guar artificial tears.
- Evaluated corneal/conjunctival staining, tear film break-up time (TBUT), Schirmer's test, tear clearance, Ocular Surface Disease Index (OSDI), and conjunctival inflammatory markers via FCM.
Main Results:
- The HP-Guar group demonstrated significantly better TBUT (P=0.0004) and OSDI scores (P=0.0002) compared to the UT group.
- Significant improvements were observed in ocular symptom subscales (P=0.0004) and vision-related function subscales (P=0.0002) in the HP-Guar group.
- HP-Guar treatment led to a significant reduction in CD3 (P=0.011) and HLA-DR (P=0.0002) expression, indicating reduced inflammation.
Conclusions:
- Addition of HP-Guar to standard post-cataract surgery treatment effectively reduces dry eye signs and symptoms.
- HP-Guar demonstrates a significant role in mitigating ocular surface inflammation post-surgery.
- HP-Guar is a beneficial adjunct therapy for improving ocular surface health after phacoemulsification.