Dry Eye Following Cataract Surgery Preventable With Preoperative Thermal Pulsation

A single preoperative vector thermal pulsation treatment can prevent post-cataract surgery dry eye disease in patients with mild-moderate meibomian gland dysfunction, according to a study published in the Journal of Cataract & Refractive Surgery.

Researchers conducted a prospective, unmasked, randomized, controlled single-center clinical trial to evaluate the effect of a single vector thermal pulsation treatment (LipiFlow; Johnson & Johnson) performed before cataract surgery in reducing signs and symptoms of postoperative dry eye disease in patients with age-related cataract and mild-moderate meibomian gland dysfunction.

The investigators randomly assigned patients to receive a single LipiFlow treatment 5 weeks before cataract surgery (n=23) or warm compresses and eyelid massages twice per day for 1 month prior to surgery (control group; n=23). They assessed noninvasive break-uptime (NI-BUT), Schirmer test, SPEED questionnaire, and meibomian gland functionality parameters at 3 timepoints (preoperative week 5 [baseline], preoperative week 1, and postoperative month 1). 

The researchers report NI-BUT, SPEED questionnaire, and meibomian gland functionality parameters demonstrated significant improvement at preoperative week 1 (P <.05) and at postoperative month 1 (P <.05) compared with baseline in the LipiFlow group and noted that these parameters remained stable after surgery. They say none of the evaluated parameters improved in the control group after surgery and reported that changes in all parameters from baseline were significantly different between the groups. 

“A single preoperative LipiFlow treatment was effective in preventing post-cataract surgery [dry eye disease] in patients with mild-moderate [meibomian gland dysfunction]. After surgery, treated patients displayed a better ocular surface status compared to warm compresses,” the researchers report.

Limitations of the study include the small sample size and short follow-up duration.