Prevalence of Dry Eye Disease Among Individuals Scheduled for Cataract Surgery in a Norwegian Cataract Clinic

Abstract

Purpose To determine the prevalence of dry eye disease (DED) in patients scheduled for cataract surgery in a Norwegian eye clinic. Patients and Methods 218 patients scheduled for cataract surgery were examined for DED in one randomly selected eye and questioned regarding symptoms and risk factors. Patients were diagnosed with DED if they fulfilled the DEWS II criteria with symptom score >12/100 with Ocular Surface Disease Index (OSDI) questionnaire, and the presence of any of the three signs: tear osmolarity >307 mOsm/L in either eye or a difference in osmolarity between the two eyes of >8 mOsm/L, corneal fluorescein staining (CSF) ≥ grade 2 and non-invasive tear film breakup time (NIKBUT) of <10 seconds. Additional tests were the Standard Patient Evaluation of Eye Dryness (SPEED) questionnaire, tear meniscus height (TMH), Schirmer 1, tear film thickness (TFT), corneal sensitivity and meibography (meiboscore). Dry eye test outcomes were correlated with risk factors for DED. Results The prevalence of DED was 55.5% according to the DEWS II criteria. The abnormal osmolarity percentage was 66.5, while 29.8% had shortened NIKBUT and 19.7% exhibited CFS ≥2. 57% had Schirmer 1 ≤ 10 mm/5 min, and 81.1% had a meiboscore of ≥1. 71.2% of subjects scored positive for DED symptoms using the OSDI questionnaire and 69.3% using SPEED. Logistic regression analysis showed that higher age correlated with a lower OSDI symptom score, reduced corneal sensitivity and increased meibomian gland atrophy. Female sex was associated with higher odds of having DED, abnormal NIKBUT and abnormal CFS. Ocular tests for DED did not correlate with OSDI symptom scores when assessed with Spearman`s rank analysis. Conclusion The prevalence of DED in an elderly Norwegian population scheduled for cataract surgery is high and associated with female sex. There was a lack of correlation between signs and symptoms of DED.

The Significance of Dry Eye Signs on Preoperative Keratometry Measurements in Patients Scheduled for Cataract Surgery

“… 24 Previous studies have shown that the correlation between symptoms and signs of dry eye is weak. 25 , 26 …”

Effect of Artificial Tears on Preoperative Keratometry and Refractive Precision in Cataract Surgery

“…Two articles have already been published from this project. 15,16 The trial was prospectively registered at clinicaltrials.gov on 10 th August 2020 (NCT05433428). Data were gathered in one private eye clinic located in Haugesund, Norway.…”

Tear film proteome changes following Tobradex® therapy in anterior blepharitis

“…An Oculus Keratograph 5 M (Oculus Optikgeräte, Wetzlar, Germany) was used to perform meibography, measurement of tear meniscus height and non‐contact break‐up time (NBUT). Meibomian gland drop‐out (meiboscore) was assessed from infrared images of the upper and lower eyelids (Ocular Keratograph 5 M), and the images were graded as previously described (Graae Jensen et al., 2023). Grade 0 represented no loss of meibomian glands, grade 1; <1/3 of glands lost, grade 2; 1/3–2/3 glands lost and grade 3; >2/3 glands lost.…”

“…Grade 0 represented no loss of meibomian glands, grade 1; <1/3 of glands lost, grade 2; 1/3–2/3 glands lost and grade 3; >2/3 glands lost. NBUT was measured as previously described (Graae Jensen et al., 2023; Malmin et al., 2023). To assess NBUT, patients were instructed to blink twice and then refrain from blinking for as long as possible, but maximally for 24 s. After the second blink, the measurement started automatically and disruption of the tear film was detected automatically by the Oculus Keratography 5 M. NBUT was measured three times and the average value was used.…”