A Preservative-Free Approach - Effects on Dry Eye Signs and Symptoms After Cataract Surgery

Area of Science:

• Ophthalmology
• Dry Eye Disease
• Cataract Surgery

Background:

• Cataract surgery can exacerbate or induce dry eye disease (DDE).
• Standard post-operative eye drops often contain preservatives like benzalkonium chloride (BAC).
• Preservative-free formulations are an alternative, particularly for patients with DDE.

Purpose of the Study:

• To compare the efficacy of preservative-free eye drops (dexamethasone, NSAIDs, lubricants) versus preservative-containing drops (dexamethasone, NSAIDs) after cataract surgery.
• To evaluate treatment effects in patients with pre-existing dry eye versus those with normal tear film.

Main Methods:

• Prospective randomized intervention study with 215 patients.
• Dry eye tests (CFS, NIKBUT, tear osmolarity) performed pre- and post-surgery.
• Patients with signs of dry eye (SDE) randomized to preservative-free or preservative-containing treatment groups. Control group had normal tear film and received preservative-containing drops.

Main Results:

• Significant decrease in SDE in both treatment groups (p <0.001).
• Improvement in subjective symptoms and objective measures (osmolarity, NIKBUT, CFS, TFT) post-surgery.
• No statistically significant differences in tear film parameters between the three groups after surgery.

Conclusions:

• Cataract surgery patients with mild to moderate dry eye may see improved tear film status and reduced symptoms with post-operative treatment.
• No additional benefit of preservative-free dexamethasone, NSAIDs, and lubricants was observed compared to preservative-containing eye drops for dry eye parameters.