Prevention of Surgery-Induced Dry Eye by Diquafosol Eyedrops after Femtosecond Laser-Assisted Cataract Surgery.

Purpose: To analyze the protective effects of diquafosol eyedrops on the ocular surface following femtosecond laser-assisted cataract surgery (FLACS). Design: A prospective, randomized contralateral study. Methods: Bilateral FLACS with a trifocal IOL (PanOptix) implantation was performed in 40 eyes in 20 patients (10 males, 10 females, average age 68.8 ± 6.3 years old). Patients received 3% diquafosol eyedrops six times daily in one randomly chosen eye (diquafosol group), and physiological saline six times a day in the other eye (control group). Other medication included 1.5% levofloxacin, 0.1% dexamethasone and 0.1% diclofenac three times daily in both eyes. The pre and post-operative tear break-up time (BUT), superficial punctate keratopathy (SPK) scores and visual function were compared between both eyes, and all patients answered the dry-eye-related quality of life score (DEQS) questionnaire. Results: The BUT between groups was similar pre-operatively and on the first day post-op; however, the BUT was statistically longer in the diquafosol group compared to saline at 1 week (5.5/3.7 s) and 2 weeks (4.8/3.0 s) (p < 0.05). There was no difference in the SPK score, best corrected distance visual acuity, tear meniscus height, contrast sensitivity, DEQS and Schirmer test at all time points. Spherical aberration was statistically lower in the diquafosol group at 1 week. The protective effects of diquafosol on the BUT was more pronounced in patients with a pre-operative BUT of less than 5 s compared with those with a BUT longer than 6 s. Conclusions: Diquafosol eyedrops prevented the shortening of the BUT following FLACS, even in patients with short pre-operative BUT values.

Efficacy of Femtosecond Laser-Assisted Cataract Surgery for Cataracts due to Atopic Dermatitis.

We retrospectively evaluated the efficacy and safety of femtosecond laser-assisted cataract surgery (FLACS) for cataracts due to atopic dermatitis, which are often complicated by intumescent white cataract (IWC) and subcapsular fibrosis. Thirty-seven eyes of 30 cataract patients diagnosed with atopic dermatitis were included in the study. Nine eyes had IWC, and 13 eyes had anterior subcapsular fibrosis characteristic of atopic cataracts. Free-floating capsulotomy was achieved in 32 eyes (86%). Three eyes with fibrosis extending across the line of capsulotomy required manual excision. Incomplete capsulotomies due to anterior capsular tags were present in 4 eyes in the IWC group, which was significantly higher compared to non-IWC cases (p < 0.05). Radial anterior capsular tear, vitreous loss, and intraocular lens dislocation did not occur in any of the cases. FLACS can be performed safely in atopic cataract despite the presence of anterior subcapsular fibrosis and/or IWC.