Prospective, Multicenter, Cross-Sectional Survey on Dry Eye Disease in Japan.

INTRODUCTION: Dry eye disease (DED) is commonly encountered in eye clinics and hospitals, and it is therefore very important to understand DED prevalence in outpatients. METHODS: A multicenter, hospital-based cross-sectional study was conducted among outpatients in Japan to ascertain DED prevalence and relationships between DED and patient profiles, including eye disease, DED diagnosis history, and surgical history. DED was diagnosed according to diagnostic criteria of the Asia Dry Eye Society. Patient self-assessment of DED-related subjective symptoms was conducted using the 5-Item Dry Eye Questionnaire (DEQ-5). Tear break-up time was evaluated in subjective symptom-positive patients. RESULTS: The prevalence of DED was 55.7% in 990 patients (mean age 69.1 ± 13.4 years), DED was commonly experienced in combination with other ocular diseases. In revisiting patients, 15.2% had not previously been diagnosed as DED, and their total DEQ-5 scores were higher than those of patients who had undergone DED treatment. CONCLUSION: This study revealed that more than half of the outpatients had DED. Among revisiting patients, there were many "hidden" DED patients who had not been diagnosed with DED in the past. There is a high likelihood of finding DED comorbidity in patients with other eye diseases in eye clinics and hospitals. FUNDING: Santen Pharmaceutical Co., Ltd. TRIAL REGISTRATION: UMIN Clinical Trials Registry Identifier, UMIN000035506.

Bacterial culture after three sterilization methods for cataract surgery.

PURPOSE: To compare bacterial cultures from three sterilization methods immediately before and after cataract surgery. DESIGN: A prospective randomized open-label group-comparison study. METHODS: We investigated 75 eyes in 73 consecutive patients undergoing cataract surgery. After swabbing the eyelid and surrounding area, patients were randomly assigned to one of 3 eye-washing methods: patients administered one drop of 5 % povidone-iodine (Group A); patients whose conjunctival sac was washed with 0.02 % chlorhexidine while everting the eyelid (Group B); or 0.02 % chlorhexidine as above but without eyelid eversion (Group C). In each group, specimens were collected from the conjunctival sac immediately before and after eye washing and again at completion of surgery, along with aqueous humor. The post-surgical condition of the corneal epithelium and the severity of anterior chamber inflammation were assessed by use of a slit-lamp microscope. RESULTS: In Groups A and C, the percentage of eyes with conjunctival bacteria decreased significantly from immediately before to immediately after washing (Group A, p = 0.008; Group C, p = 0.016), but there was no significant decrease in Group B (p = 0.125). Slit-lamp microscopy showed that inflammation of the anterior chamber 1 day after surgery was significantly milder in Group C than in Group B (p = 0.032). CONCLUSION: Eye-washing methods without eyelid eversion are more effective in reducing conjunctival bacteria before surgery and anterior chamber inflammation after surgery than those with eyelid eversion.