Prevalence of ocular surface dysfunction in patients presenting for cataract surgery evaluation
Autor: | Christopher E. Starr, Owen J. Drinkwater, Preeya K. Gupta, Ashley R. Brissette, Keith W. VanDusen |
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Rok vydání: | 2018 |
Předmět: |
Adult
Male medicine.medical_specialty genetic structures medicine.medical_treatment Cataract Extraction Asymptomatic Basement Membrane 03 medical and health sciences 0302 clinical medicine Surveys and Questionnaires Ophthalmology Prevalence medicine Humans Medical history Ocular Surface Disease Index Prospective Studies Prospective cohort study Aged Aged 80 and over Osmole business.industry Osmolar Concentration Epithelium Corneal Middle Aged Cataract surgery medicine.disease eye diseases Sensory Systems Epithelial basement membrane dystrophy Matrix Metalloproteinase 9 Tears 030221 ophthalmology & optometry Dry Eye Syndromes Female Surgery sense organs medicine.symptom business Ocular surface 030217 neurology & neurosurgery |
Zdroj: | Journal of Cataract and Refractive Surgery. 44:1090-1096 |
ISSN: | 0886-3350 |
Popis: | Purpose To report the prevalence of ocular surface dysfunction in patients presenting for cataract surgery evaluation. Setting Duke University Eye Center and Weill Cornell Ophthalmology, single-physician practices. Design Prospective case series. Methods Consecutive patients presenting for cataract surgery evaluation were identified. Patient information including demographics, medical history, slitlamp findings, tear osmolarity, and tear matrix metalloproteinase-9 (MMP-9) levels were recorded. Patients were considered to have ocular surface dysfunction if any of the following outcomes were present: visually significant abnormal corneal surface examination, positive MMP-9 test, or abnormal osmolarity values (>307 mOsm/L or >7 mOsm/L intereye difference). Patient symptoms were recorded using the ocular surface disease index (OSDI) or Symptom Assessment iN Dry Eye questionnaires. Results There were 120 patients (69% women), mean age 69.5 years ± 8.4 (SD). Abnormal osmolarity was found in 68 patients (56.7%), and abnormal MMP-9 in 76 patients (63.3%). Clinical findings showed that 47 patients (39.2%) had positive corneal staining on presentation, 9 patients (7.5%) had epithelial basement membrane dystrophy, and 2 patients (1.6%) had Salzmann nodules. Questionnaire data showed 54 (54.0%) of 100 patients reported symptoms suggestive of ocular surface dysfunction. In the asymptomatic group of 46 patients, 39 (85%) had at least 1 abnormal tear test (osmolarity or MMP-9) and 22 (48%) had both tests abnormal. Overall, 96 (80%) of 120 patients had at least 1 abnormal tear test result suggestive of ocular surface dysfunction and 48 patients (40%) had 2 abnormal results. Conclusions Objective ocular surface dysfunction findings were common among patients presenting for cataract surgery, yet many presented undiagnosed. Clinicians should be aware of this high prevalence and consider screening with tear testing before surgery. |
Databáze: | OpenAIRE |
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