Friday, January 4, 2013

Dry Eye Treatments after Cataract Surgery


Cataract is when your lens capsule becomes cloudy and you can not see well at night.



The number of cataract operations are on the rise, and they suffer from dry eyes. Dry eyes are a natural phenomena of aging and this is the same population who also tend to have cataract., There are an estimated 3 million Americans have cataract surgery each year, with the Federal government spending $3.4 billion through Medicare to treat cataracts.1 Recent estimates indicate that approximately 15% of the US population older than age 65 has dry eye.2 Assuming  that two million cataract patients are older than 65, and 15% have dry eye, then approximately 300,000 of the patients who undergo cataract surgery each year will suffer from dry eye."2

Preoperative Care

Preoperative recognition of patients with ocular surface disease provides an opportunity to optimize the ocular surface before proceeding with cataract surgery. Fluctuating vision either before or following cataract surgery is almost always a sign of tear film insufficiency.3 A history of systemic collagen disease vascular disease or associated manifestations such as arthritis or dry mouth provides important clues for the possibility of concomitant ocular surface disease.4 Dry eye can also result in induced astigmatism which can affect IOL calculations. Dryness of the ocular surface can throw off lens biometry as well as cause problematic shifts in keratometric values.5
Typical dry eye treatments include artificial tears.  Unfortunately, the more eye drops one uses, drier the eyes.  Management of lid disease is likewise essential for optimizing surgical outcomes. In one study, blepharitis was the number one reason for cancelling cataract surgery9 as blepharitis is thought to be a primary risk factor for endophthalmitis.10 Preoperative treatment starts with a prolonged commitment to eyelid hygiene. Topical antibiotics are used to control staphylococcal growth on the eyelids, and recent antibiotics such as topical azithromycin has been shown to effectively reduce signs and symptoms of blepharitis.11

Damaged Cornea after Surgery

Cataract surgery, or any type of eye surgery for that matter, damage the cornea and create uneven corneal surfaces which creates friction, inflammation which in turn causes more dry eye symptoms.  Sometimes damage to the corneal nerves has  subsequent reduced corneal sensation.14

Postoperative Care
After cataract surgery the signs and symptoms of ocular surface disease typically get worse. Following surgery, patients are using a number of topical drops, usually a steroid, antibiotic and an NSAID. Prolonged use of postoperative medications may be one of the contributing factors of the patient's dry eye symptoms. It is best to stop or taper medications when they are no longer needed.

TheraLife Can Help
Use TheraLife Eye 1 week before surgery to improve the corneal condition before surgery and 6 months after surgery can greatly minimize the occurence of dry eyes after cataract surgery.
TheraLife Eye works to relief dry eyes by restoring the normal functions of tear secretion glands, thus producing long lasting balanced tears all day long.


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This article is a brief abstract from Optometric Management, Aug. 2012 issue.
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REFERENCES
1. Cataract statistics. Located at: http://www.statisticbrain.com/cataract-statistics/. Accessed 8/1/2012.
2. Nichols KK. Managing surgical patients. Optometric Management. 2010 Sept.
3. Roberts CW, Elie DR. Dry eye symptoms following cataract surgery. Insight 2007; 32: 14-21.
4. Movahedan A, Djalilian AR. Cataract surgery in the face of ocular surface disease. Curr Opin Ophthalmol 2012; 23: 68-82.
5. Luthe R. Dry eye screening and the cataract patient. Ophthalmology Management, Vol 16; May 2012;48-51.
6. Behrens A, Doyle JJ, Stern L, et al. Dysfunctional tear syndrome: a Delphi approach to treatment recommendations. Cornea 2006; 25: 900-907.
7. Sanchez MA, Amiola-Villa Lobos P, Torralo-Jimenez P, et al. The effect of preservative-free HP-Guar on dry eye after phacoemulsification: a flow cytometric study. Eye 2010; 24: 1331-1337.
8. Pflugfelder SC. Anti-inflammatory therapy for dry eye. Am J Ophthalmol 2004; 137: 337-342.
9. Stead RE, Stuart A, Keller J, et al. Reducing the rate of cataract surgery cancellation due to blepharitis. Eye 2010; 24: 742.
10. Speaker MG, Milch FA, Shah MK, et al. The role of external bacterial flora in the pathogenesis of acute post-operative endophthalmitis. Ophthalmology 1991; 98: 639-649.
11. Luchs L. Efficacy of topical azithromycin ophthalmic solution 1% in the treatment of posterior blepharitis. Adv Ther 2008; 25: 858-870.
12. Lindstrom, RL. The effects of blepharitis on ocular surgery. Ocul Surf 2009; 7: 519-520.
13. Cho YK, Kim MS. Dry eye after cataract surgery and associated intraoperative risk factors. Korean J Ophthalmol 2009; 23: 65-73.
14. Moon SW, Yeom DJ, Chung SH. Neurotrophic corneal ulcer development following cataract surgery with a limbal relaxing incision. Korean J Ophthalmol 2011; 25: 210-213.

1 comment:

  1. Severe dry eyes are common after cataract surgery. Learn how TheraLife Eye can be an effective dry eye treatment before and after surgery to prevent dry eyes. Buy now

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