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Effects of Lipiflow Treatment Prior to Cataract Surgery: A Prospective, Randomized, Controlled Study
Jongyeop Park1, Young-Sik Yoo1, Kyungyoon Shin1
1From the Department of Ophthalmology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (J.P., Y.-S.Y., K.S., G.H., D.H.L., T.-Y.C.), Department of Ophthalmology, Dongguk University Gyeongju Hospital, Dongguk University School of Medicine, Gyeongju, Gyeongsangbuk-do (J.P.), Department of Ophthalmology, Uijeongbu St. Mary's Hospital, the Catholic University of Korea, Uijeongbu-si (Y.-S.Y.), Department of Ophthalmology, Seongnam Citizens Medical Center, Seongnam-si, Gyeonggi-do, Republic of Korea (K.S.), Department of Ophthalmology, Itoh Clinic, Saitama, Japan (R.A.), and Department of Health Sciences and Technology, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea (D.H.L.).
Abstract:
To investigate the effects of preoperative Lipiflow (Johnson & Johnson, Jacksonville, FL, USA) treatment before cataract surgery on meibomian gland dysfunction (MGD) and dry eye induced by surgery.
Design:
Prospective, randomized controlled study.
Methods:
This study comprised 124 eyes of 124 patients with planned surgery for senile cataract. Participants were randomly allocated into control and Lipiflow groups based on administration of Lipiflow treatment 3 weeks before cataract surgery. For meibomian gland (MG) evaluation, MG atrophy, degree of gland expressibility, and quality of gland secretions were examined at the baseline visit and 1 and 3 months postoperatively. Ocular surface parameters of tear film break-up time, Oxford corneal staining score, and tear film lipid layer thickness were measured at each visit. Ocular Surface Disease Index and Dry Eye Questionnaire were also assessed.
Results:
The control group exhibited a significant decrease in MG expressibility, worsened meibum quality, decreased lipid layer thickness, and worsened corneal staining after cataract surgery. Also, dry eye symptom showed significant worsening. Conversely, the Lipiflow group showed significantly improved MG patency and meibum quality, increased tear film break-up time, and reduced corneal staining, and presented improved subjective outcomes reported on both Ocular Surface Disease Index and Dry Eye Questionnaire. The improvement of each parameter in the Lipiflow group showed a linear correlation with baseline MGD grade. In addition, patients without baseline MGD showed less worsening or improvement of MGD and dry eye induced by surgery, with preoperative Lipiflow treatment.
Conclusions:
Preoperative Lipiflow treatment conducted before cataract surgery may be a safe and effective intervention for relieving MGD and dry eye induced by surgery. It might be recommended not only for the patients with preoperative MGD but also for those without baseline MGD, to prevent the development of MGD and dry eye induced by ocular surgeries.
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