Comparison of treatment with preservative-free versus preserved sodium hyaluronate 0.1% and fluorometholone 0.1% eyedrops after cataract surgery in patients with preexisting dry-eye syndrome

J Cataract Refract Surg. 2015 Apr;41(4):756-63. doi: 10.1016/j.jcrs.2014.11.034. Epub 2014 Dec 5.

Abstract

Purpose: To compare treatment with preservative-free and preserved sodium hyaluronate 0.1% and fluorometholone 0.1% eyedrops after cataract surgery in patients with preexisting dry-eye syndrome.

Setting: Bucheon St. Mary's Hospital, Catholic University of Korea, Seoul, Korea.

Design: Randomized controlled study.

Methods: Patients with cataract and dry-eye syndrome were randomly divided into 2 groups. Group 1 patients were treated with preservative-free sodium hyaluronate 0.1% and preservative-free fluorometholone 0.1% eyedrops 4 times a day in the first month and twice a day in the second month. Group 2 patients were treated with preserved eyedrops using the same schedule. Ocular Surface Disease Index (OSDI) score, tear-film breakup time (TBUT), Schirmer I test, corneal fluorescein staining, impression cytology, and antioxidant and inflammatory cytokine activities in tears were evaluated.

Results: Both groups comprised 40 patients. At 2 months, the OSDI score, TBUT, Schirmer I score, fluorescein staining score, impression cytology findings, and goblet cell count were significantly better in Group 1 than in Group 2 (P<.05). The interleukin-1β and tumor necrosis factor-α concentrations were significantly less in the tears of Group 1 patients than in the tears of Group 2 patients, and catalase and superoxide dismutase 2 fluorescence intensities were significantly greater in the tears of Group 1 patients than in the tears of Group 2 patients (P<.05).

Conclusions: Preservative-free sodium hyaluronate 0.1% and fluorometholone 0.1% eyedrops can improve the symptoms and signs of dry-eye syndrome after cataract surgery. Preservative-free fluorometholone eyedrops may have antiinflammatory and antioxidant effects in tears of patients with dry-eye syndrome.

Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Aged
  • Aged, 80 and over
  • Case-Control Studies
  • Catalase / metabolism
  • Drug Combinations
  • Dry Eye Syndromes / complications
  • Dry Eye Syndromes / metabolism
  • Dry Eye Syndromes / physiopathology*
  • Female
  • Fluorometholone / therapeutic use*
  • Glucocorticoids / therapeutic use*
  • Humans
  • Hyaluronic Acid / therapeutic use*
  • Interleukin-1beta / metabolism
  • Lens Implantation, Intraocular
  • Male
  • Middle Aged
  • Ophthalmic Solutions
  • Phacoemulsification*
  • Postoperative Care
  • Preservatives, Pharmaceutical / therapeutic use*
  • Superoxide Dismutase / metabolism
  • Tears / metabolism
  • Tumor Necrosis Factor-alpha / metabolism
  • Viscosupplements / therapeutic use*

Substances

  • Drug Combinations
  • Glucocorticoids
  • Interleukin-1beta
  • Ophthalmic Solutions
  • Preservatives, Pharmaceutical
  • Tumor Necrosis Factor-alpha
  • Viscosupplements
  • Hyaluronic Acid
  • Catalase
  • Superoxide Dismutase
  • Fluorometholone