Influence Of Preoperative Application Of Sodium Hyaluronate Eye Drops On Ocular Surface In Patients With Cataract And Dry Eye Disease

Objective:Before cataract phacoemulsification combined with intraocular lens implantation?Phaco+IOL?,artificial tear containing sodium hyaluronate?SH?was used to treat cataract patients with xerophthalmia and this clinical trial was aimed at observing its effect on lacrimal membrane function and dry eye disease?DED?.Furthermore,this study was employed to investigate the prevention and therapy to reduce dry eye syndrome.Methods:This clinical study included a total of 107 cataract patients with DED?107 eyes?who received Phaco+IOL,in the First Affiliated Hospital,School of Medicine,Shihezi University from June 2018 to June 2019.Random number table was utilized to determine the group of subjects including study group?S group?and control group?C group?.Patients in S group were treated with 0.1%SH one week before Phaco+IOL,with 6 times a day.And patients in C group were not routinely treated with SH before Phaco+IOL.Then,two groups accept the same treatment after operation.OSDI?Ocular Surface Disease Index?,BUT?Break Up Time?,SIt?Schirmer I test?and FL?Fluorescein Stain Test?were measured before surgery,7 days and 30 days after surgery.SPSS 22.0 was used in data analysis.Results:A total of 107 patients?107 eyes?were included in this study.51 patients?51 eyes?were included in the study group,27 males?27 eyes?,and 24 females?24 eyes?.The age range was 53-75 years old,with an average age 61.8±6.02 years old.The course of disease was 1-5 years,with an average of 2.7±0.8years.The control group was 56 patients?56 eyes?,31 males?31 eyes?,and 25 females?25 eyes?.The age range was 55-73 years old,the average age was 62.7±5.13 years old.The disease course was 1-5 years,with an average of 2.6±0.7 year.There were no statistical significance in age?t=0.163,P=0.85?,sex ratio?c²=0.06,P=0.80?and preoperative course?t=-0.888,P=0.38?.In comparison between two groups for different time periods,the OSDI scores of the study group were lower than the control group at 7 days and 30 days postoperatively.And the difference was statistically significant(t_7d=3.80,P_7d<0.01;t_30d=4.49,P_30d<0.01).In comparison of the OSDI scores of each group at different time periods,the OSDI scores gradually increased after surgery,and the difference was statistically significant?P<0.01?.But,the increase in the OSDI scores of the study group was smaller than that of the control group..In comparison of the different time periods between groups.The BUT of the study group was higher than the control group at7 days and 30 days postoperatively.And the difference was statistically significant(t_7d=-2.63,P_7d=0.01;t_30d=-2.92,P_30d<0.01).In comparison of the BUT of each group at different time periods,BUT was reduced in both groups at 7 days postoperatively compared to the preoperative,and the study group had a smaller reduction than the control group.However,there was a gradual upward trend in both groups,and the difference in results was statistically significant?P<0.01?In comparison of the different time periods between groups.The SIt of the study group was higher than the control group at 7 days and 30 days postoperatively.And the difference was statistically significant(t_7d=-2.32,P_7d=0.02;t_30d=-3.34,P_30d<0.01).In comparison of the SIt of each group at different time periods,The SIt gradually decreased in both group after surgery.However,the decrease in the SIt of the study group was smaller than that of the control group,and the difference was statistically significant?P<0.01?..In comparison of the different time periods between groups.The fluorescein staining scores of were lower at 7 days and 30 days after surgery than the control group,and the difference was statistically significant(t_7d=3.13,P_7d<0.01;t_30d=3.27,P_30d<0.01).In comparison of the fluorescein staining scores of each group at different time periods,The fluorescein staining scores were increased in both groups at 7 days postoperatively compared to the preoperative,and the study group had a smaller augment than the control group.However,there was a gradual decrease trend at 30 days postoperatively,and the difference in results was statistically significant?P<0.01?.Conclusion:1.Patients in the study group and the control group had ocular surface changes after cataract surgery compared with before surgery.Phaco-IOL implantation may cause some damage to the cornea epithelial and damage the stability of the tear film.The clinical manifestations of postoperative dry eye syndrome are also more severe compared with before surgery.2.For age-related cataract patients with dry eye syndrome before surgery,preoperative prophylactic intervention with sodium hyaluronate artificial tears could significantly improve the symptoms of dry eyes in early postoperative patients,restore tear film function,promote corneal epithelial integrity and avoid the exacerbation of dry eye symptoms.