[Influence of cataract surgery on Meibomian gland dysfunction (French translation of the article)]. / Influence de la chirurgie de la cataracte sur le dysfonctionnement meibomien.

PURPOSE: To evaluate the influence of cataract surgery on meibomian gland dysfunction, in particular on postoperative functional symptoms. PATIENTS AND METHODS: Thirty patients who underwent cataract surgery were included in the study. A clinical examination (OSDI questionnaire, measurement of tear break up time [TBUT], corneal staining, meibomian gland expressibility test) and a paraclinical evaluation (loss of Meibomius glands [LMG] measured using ImageJ on meibography, conjunctival redness and non-invasive tear break up time [NIK-BUT]) were performed preoperatively and at 1 month and 3 months after phacoemulsification. RESULTS: TBUT and meibomian gland expressibility were worsened at 1 month and 3 months postoperatively (P<0.05). LMG was significantly more important for the upper eyelid and the mean at 1 month (33.1±15.2 P=0.02; 28.5±15.6 P=0.025, respectively) and 3 months postoperatively (36.5±17.4 P=0.0005; 31.2±17.4 P=0.0002, respectively) than preoperative values (29.4±15.3; 26±15, respectively). There was a significant correlation between LMG on the upper eyelid preoperatively and the OSDI score at 1 month postoperatively (R=0.37; P=0.05). CONCLUSION: The meibomian gland loss in the upper eyelid is associated with an increased postoperative ocular discomfort score. Alterations in the meibomian gland expressibility and TBUT persist for up to 3 months postoperatively suggesting a direct role of cataract surgery by an obstructive mechanism.

Influence of cataract surgery on Meibomian gland dysfunction.

PURPOSE: To evaluate the influence of cataract surgery on Meibomian gland dysfunction, in particular on postoperative functional symptoms. PATIENTS AND METHODS: Thirty patients who underwent cataract surgery were included in the study. A clinical examination (OSDI questionnaire, measurement of tear break-up time (TBUT), corneal staining, Meibomian gland expression test) and a paraclinical evaluation (Meibomian gland loss [MGL] measured using ImageJ on Meibography, conjunctival hyperemia and non-invasive keratograph break-up time [NIK-BUT]) were performed preoperatively and at 1month and 3months after phacoemulsification. RESULTS: TBUT and Meibomian gland expressibility were worsened at 1month and 3months postoperatively (P<0.05). MGL was significantly higher for the upper eyelid and the mean at 1month (33.1±15.2, P=0.02; 28.5±15.6, P=0.025, respectively) and 3months postoperatively (36.5±17.4, P=0.0005; 31.2±17.4, P=0.0002, respectively) than preoperative values (29.4±15.3; 26±15, respectively). There was a significant correlation between MGL on the upper eyelid preoperatively and the OSDI score at 1month postoperatively (R=0.37; P=0.05). CONCLUSION: Meibomian gland loss in the upper eyelid is associated with an increased early postoperative ocular discomfort score. Alterations in Meibomian gland expressibility and TBUT persist for up to 3months postoperatively, suggesting a direct role of cataract surgery by an obstructive mechanism.

[Comparison of objective optical quality measured by double-pass aberrometry in patients with moderate dry eye: Normal saline vs. artificial tears: A pilot study]. / Comparaison de la qualité de vision objective mesurée par aberrométrie double passage chez des patients atteints de syndrome sec modéré : larmes artificielles versus sérum physiologique : une étude pilote.

Dry eye is defined by a tear film instability resulting in variable but systematic fluctuations in the quality of vision. Variability in optical quality can be demonstrated using a double pass aberrometer such as the OQAS (Optical Quality Analyzing System, Visiometrics). The goal of this work is to compare fluctuations in objective quality of vision measured by OQAS between treatment with normal saline eye drops and treatment with carmellose 0.5% and hyaluronic acid 0.1% (Optive Fusion [OF], Allergan) in patients with moderate dry eye syndrome. Optical quality was measured by evaluating the variations in the Optical Scattering Index (OSI) over 20seconds using the OQAS. Inclusion criteria were dry eye syndrome with an Ocular Surface Disease Index (OSDI) score>23 treated only with artificial tears. The patients were their own controls: OF in one eye and normal saline in the fellow eye. The choice of the subject eye and control eye was determined in a randomized fashion. OSI variations were measured in each eye before instillation, 5minutes and 2hours after instillation. The primary endpoint was OSI fluctuation over 20seconds of measurement. Secondary endpoints were the number of blinks and patient's preference (preferred eye). Preliminary results were obtained on 19 patients. Average OSDI score was 36.8. Visual acuity was 10/10 with no significant difference between the two eyes. Prior to instillation, there was no significant difference between "normal saline" and "OF" eyes in terms of OSI, OSI variability or number of blinks. In the normal saline eye, there was no significant variation in mean OSI, OSI variability, OSI slope, or number of blinks. However, in the "OF" eye, there was a significant variation between initial and 2-hour OSI variability (0.363 versus 0.204; P<0.05), the average slope of OSI (0.04 versus 0.01; P<0.05) and the number of blinks (4.2 versus 2.8; P<0.05). Sixty-five percent of patients preferred the OF eye, 24% did not have a preference, and 11% preferred the normal saline eye. Objective quality of vision measured by OQAS is an interesting parameter for evaluating the effectiveness of a lacrimal substitute. The purpose of artificial tears is, among other things, to provide comfort and a reduction of dry eye symptoms such as poor quality of vision. This study demonstrates that 0.5% carmellose and 0.1% hyaluronic acid allowed better stabilization of the tear film and thus a significant improvement in the quality of vision compared to normal saline.

Comparison of objective optical quality measured by double-pass aberrometry in patients with moderate dry eye: Normal saline vs. artificial tears: A pilot study.

Dry eye is defined by a tear film instability resulting in variable but systematic fluctuations in quality of vision. Variability in optical quality can be demonstrated using a double pass aberrometer such as the Optical Quality Analyzing System, Visiometrics (OQAS). The goal of this work is to compare fluctuations in objective quality of vision measured by OQAS between treatment with normal saline eye drops and treatment with carmellose 0.5% and hyaluronic acid 0.1% (Optive Fusion [OF], Allergan) in patients with moderate dry eye syndrome. Optical quality was measured by evaluating the variations in the Optical Scattering Index (OSI) over 20seconds using the OQAS. Inclusion criteria were dry eye syndrome with an ocular surface disease index (OSDI) score >23 treated only with artificial tears. The patients were their own controls: OF in one eye and normal saline in the fellow eye. The choice of the subject eye and control eye was determined in a randomized fashion. OSI variations were measured in each eye before instillation, 5minutes and 2hours after instillation. The primary endpoint was OSI fluctuation over 20seconds of measurement. Secondary endpoints were the number of blinks and patient preference (preferred eye). Preliminary results were obtained on 19 patients. Average OSDI score was 36.8. Visual acuity was 10/10 with no significant difference between the two eyes. Prior to instillation, there was no significant difference between "normal saline" and "OF" eyes in terms of OSI, OSI variability or number of blinks. In the normal saline eye, there were no significant variations in mean OSI, OSI variability, OSI slope, or number of blinks. However, in the "OF" eye, there was a significant variation between initial and 2-hour OSI variability (0.363 versus 0.204, P<0.05), the average slope of OSI (0.04 versus 0.01, P<0.05) and the number of blinks (4.2 versus 2.8, P<0.05). Among the patients, 65% preferred the OF eye, 24% did not have a preference, and 11% preferred the normal saline eye. Objective quality of vision measured by OQAS is an interesting parameter for evaluating the effectiveness of a lacrimal substitute. The purpose of artificial tears is, among other things, to provide comfort and a reduction of dry eye symptoms such as poor quality of vision. This study demonstrates that 0.5% carmellose and 0.1% hyaluronic acid allowed better stabilization of the tear film and thus a significant improvement in the quality of vision compared to normal saline.