Prophylactic Therapy for Long-Term Ocular Discomfort After Cataract Surgery.

Autor:	Di Zazzo A; Ophthalmology Complex Operative Unit, Campus Bio-Medico Foundation, Rome, Italy.; University Campus Bio-Medico, Rome, Italy; and., Spelta S; University Campus Bio-Medico, Rome, Italy; and., Micera A; Research and Development Laboratory for Biochemical, Molecular and Cellular Applications in Ophthalmological Science, IRCCS-Fondazione Bietti, Rome, Italy., De Gregorio C; University Campus Bio-Medico, Rome, Italy; and., Affatato M; University Campus Bio-Medico, Rome, Italy; and., Esposito G; Research and Development Laboratory for Biochemical, Molecular and Cellular Applications in Ophthalmological Science, IRCCS-Fondazione Bietti, Rome, Italy., Balzamino BO; Research and Development Laboratory for Biochemical, Molecular and Cellular Applications in Ophthalmological Science, IRCCS-Fondazione Bietti, Rome, Italy., Sgrulletta R; Ophthalmology Complex Operative Unit, Campus Bio-Medico Foundation, Rome, Italy.; University Campus Bio-Medico, Rome, Italy; and., Coassin M; Ophthalmology Complex Operative Unit, Campus Bio-Medico Foundation, Rome, Italy.; University Campus Bio-Medico, Rome, Italy; and., Bonini S; Ophthalmology Complex Operative Unit, Campus Bio-Medico Foundation, Rome, Italy.; University Campus Bio-Medico, Rome, Italy; and.
Jazyk:	angličtina
Zdroj:	Cornea [Cornea] 2024 May 17. Date of Electronic Publication: 2024 May 17.
DOI:	10.1097/ICO.0000000000003561
Abstrakt:	Purpose: The cataract surgery dissatisfaction rate is 20% to 35% due to ocular surface discomfort. We investigate the ocular surface discomfort after surgical failure as a consequence of age-related parainflammation. We also aim to prevent it by immune-modulating prophylactic management. Methods: Monocentric clinical trial realized in a teaching hospital. Prospective, randomized, open-label, unmasked clinical trial. One hundred patients diagnosed with cataracts underwent phacoemulsification surgery. Groups A (<65 years; n = 25) and B (>75 years; n = 25) received surgery only. Groups C and D (both >75 years and both n = 25) used cyclosporine A 0.1% cationic emulsion (CE) eye drops or CE lubricating eye drops (both twice daily), respectively, for 30 days before surgery. Patients were followed up 90 days after surgery. The primary outcome was postoperative ocular surface failure; secondary outcomes examined the influence of prophylactic cyclosporine A 0.1% CE therapy on ocular surface outcomes. Results: Group B demonstrated greater severity regarding ocular surface signs and symptoms throughout the study period, versus all other groups. Signs/symptoms were typically lower in Group A. Group C achieved significant reductions in conjunctival Symptom Assessment in Dry Eye values ( P < 0.05), conjunctival hyperemia severity ( P < 0.01), and meibomian gland dysfunction ( P < 0.001) at Day 45, versus Group B, and tear break-up time was increased ( P < 0.001). Ocular surface inflammatory marker transcription (HLADR, intercellular adhesion molecule 1 [ICAM-1], and interleukin 6 [IL-6]) was significantly downregulated in Group C, versus Group B, at 90 days ( P < 0.05). Conclusions: Cataract surgery induced ocular surface system failure with a clinically significant persistent inflammatory status (InflammAging) in patients older than 75 years. Prophylactic cyclosporine A 0.1% CE eye drops were associated with improved ocular surface homeostasis and reductions in inflammatory markers. Competing Interests: The authors have no funding or conflicts of interest to disclose. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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