The Prevalence of Hyperosmolar Tear Film in Patients Pre- and 7-Days -Post Cataract Surgery - 5426
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Author’s Disclosure Block: Richard Maharaj: AI4Eyes, Employment/honoraria/consulting fees; Devesh Varma: Managing Director of Prism Group Holdings, Executive Vice President and Co-National Medical Director For Clinical Ophthalmology, Site Lead for Ophthalmology Queensway hospital and Investigator at the Institute for Better Health at, Consulting Honoraria with Bausch+Lomb, Labtician-Thea, Glaukos, Johnson&Johnson, Alcon, Allergan, Takeda, New World Medical Trillium Health Partners
Abstract Body
Purpose: To identify the prevalence of hyperosmolar tear film in a pre-surgical cataract and 7-day post-surgical patient population. Study Design: This was a prospective, observational cohort study at the Prism Eye Institute, Oakville, Ontario under ethics review in accordance with the Declaration of Helsinki.Subjects presenting for pre-surgical cataract evaluations were selected randomly.Method: Tear fluid osmolarity was measured bilaterally at pre-surgical evaluation and at the 7-days post-surgical visit using the ScoutPro Osmolarity System (Bausch &Lomb, New Jersey). The higher of the two eyes was used for clinical assessment at each time point. A cut-off of >315 mOsm/L was selected to define cohorts with visually significant ocular surface disease (OSD) per the American Society of Cataract and Refractive Surgery algorithm for preoperative diagnosis and treatment of ocular surface disease. Results: 93 subjects were tested pre-surgical (mean age 70.8±11.5; 49 Females, 43 Males), of which 43 subjects (46%) exhibited elevated osmolarity > 315 mOsm/L (mean 334.8± 15.2 ). At the 7-day post-surgical visit, 22 of the original 93 subjects followed up. 55% of the subjects ≤315 pre-surgical became hyperosmolar (mean 338.6±14.7) post-surgical. Only 14% of the pre-surgical hyperosmolar patients normalized despite topical corticosteroid, NSAID, anti-bacterial and artificial tear treatment during the post operative period. Conclusion: Hyperosmolar tear film creates light scatter equivalent to a grade 2-3 cataract, which can negatively impact pre-surgical keratometry and post-surgical visual quality.1,2,3,4 Nearly half of pre-surgical cataract patients are hyperosmolar and subject to light scatter and visually significant sequelae that may lead to poor visual quality and patient satisfaction outcomes post-surgical. Hyperosmolarity increases 7-days following cataract surgery suggesting an impact on the ocular surface unresolved by standard therapeutic routine. Hyperosmolar patients may require additional targeted therapy post-surgery to ensure optimal outcomes.