• Written By: Lisa B. Arbisser, MD
    Cataract/Anterior Segment, Cornea/External Disease

    This randomized study found that the signs and symptoms of dry eye were significantly reduced after cataract surgery followed by the use of preservative-free sodium hyaluronate 0.1% and fluorometholone 0.1% eye drops compared with preserved drops. They also found that preservative-free fluorometholone drops may have anti-inflammatory and antioxidant effects in the tears of dry eye patients.

    While so few doctors pay attention to the preservative overload effect of the postop regimen, I feel that, as this study implies, only preservative-free tears should be offered.

    They randomized 80 patients with pre-existing dry eye undergoing cataract surgery at a hospital in South Korea to postoperative preservative-free sodium hyaluronate 0.1% and preservative-free fluorometholone 0.1% eye drops four times a day in the first month and twice a day in the second month, or preserved eye drops using the same schedule.

    At two months, the ocular surface disease index score, tear-film breakup time, Schirmer I score, fluorescein staining score, impression cytology findings and goblet cell count were significantly better in the preservative-free drop group than in the preserved drop group (P < 0.05).

    The interleukin-1β and tumor necrosis factor-α concentrations were significantly less in the tears of preservative-free group than in the tears of the preserved drop group, and catalase and superoxide dismutase 2 fluorescence intensities were significantly greater in the tears of the preservative-free group than in the tears of the preserved group (P < 0.05).

    The authors hypothesize that the combination of preservative-free steroid and lubricant eye drops may relieve pre-existing dry-eye syndrome by decreasing the oxidative and inflammatory damage to the ocular surface in patients after cataract surgery.

    They say that a large multicenter trial with a prolonged follow-up is needed to conclusively determine the efficacy of preservative-free steroid and lubricant combination eye-drop therapy.