Attention to ocular surface disease needs to be an integral part of pre- and postoperative planning for cataract patients, given the high incidence of various objective measures in this population, many of which were undiagnosed.¹

In a prospective study of 120 patients, researchers recorded patient demographics, medical history, slit lamp findings, tear osmolarity and tear matrix metalloproteinase-9 (MMP-9) levels. They measured patient symptoms using the Ocular Surface Disease Index and the Symptom Assessment in Dry Eye questionnaires. Patients were considered to have ocular surface dysfunction if they had a visually significant abnormal corneal surface examination, a positive MMP-9 test or abnormal osmolarity values, the study notes.¹

Of the study subjects, the team found abnormal MMP-9 in 76 (63.3%), abnormal osmolarity in 68 (56.7%), positive corneal staining on presentation in 47 (39.2%), epithelial basement membrane dystrophy in nine (7.5%) and Salzmann nodules in two (1.6%). Questionnaire data showed 54 of 100 patients reported symptoms suggestive of ocular surface dysfunction; of the 46 asymptomatic patients, 39 (85%) had at least one abnormal tear test (osmolarity of MMP-9) result and 22 (48%) had two abnormal tear test (osmolarity and MMP-9) results. The researchers add that, overall, 96 patients (80%) had at least one abnormal tear test result suggestive of ocular surface dysfunction and 48 (40%) had two abnormal tear test results^.

The study concludes, “clinicians should be aware of this high prevalence and consider screening with tear testing before surgery.” Jim Owen, OD, said in a Practice Update commentary that this study is important because it confirms the high prevalence of ocular surface dysfunction in cataract surgery patients.²