Clinical Ophthalmology (Aug 2024)

Tear Film Hyperosmolarity is Associated with Increased Variation of Light Scatter Following Cataract Surgery

  • Sullivan BD,
  • Palazón de la Torre M,
  • Yago I,
  • Duarte R,
  • Schallhorn JM,
  • Nijm LM,
  • White DE,
  • Berg MS,
  • Artal P

Journal volume & issue
Vol. Volume 18
pp. 2419 – 2426

Abstract

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Benjamin D Sullivan,1 Marta Palazón de la Torre,2 Ines Yago,2 Raúl Duarte,3 Julie M Schallhorn,4 Lisa M Nijm,5 Darrell E White,6 Michael S Berg,1 Pablo Artal3 1Trukera Medical, Southlake, TX, USA; 2Oftalmología en Murcia, Hospital Universitario Virgen de la Arrixaca, Murcia, Spain; 3Laboratorio de Optica, Universidad de Murcia, Murcia, Spain; 4Francis I. Proctor Foundation and Department of Ophthalmology, University of California, San Francisco, CA, USA; 5Department of Ophthalmology and Visual Sciences, University of Illinois Eye and Ear Infirmary, Chicago, IL, USA; 6SkyVision Centers, Westlake, OH, USACorrespondence: Benjamin D Sullivan, Email [email protected]: To study the association between tear film hyperosmolarity and ocular light scatter in a cataract surgery population.Patients and Methods: Contiguous, 20-second objective scatter index (OSI) scans were recorded in hyperosmolar (≥ 320 mOsm/L) and normal subjects (< 308 mOsm/L) with cataract nuclear opacity ≥ 3. OSI was measured at screening, baseline and 90 days following surgery. Along with symptoms of ocular surface disease, slit-lamp examination included corneal staining (0– 3), tear film breakup time (TBUT) and evaluation of meibomian gland disease (MGD). An additional cohort of hyperosmolar subjects were measured for OSI at screening, baseline, and 5, 10, 15 and 30 minutes following instillation of 0.18% sodium hyaluronate (HA).Results: Thirty-one eyes of 31 patients were included. There was a significant difference in post-operative OSI variation when comparing hyperosmolar (0.65± 0.30, N=11) to normal subjects (0.33± 0.11, N=10, p=0.005). Of note, there were no significant differences in OSI variation when subjects were sorted by staining (p=0.9), TBUT (p=0.7), symptoms (p=0.7), or MGD status (p=0.9). Instillation of 0.18% HA (N=10) did not alter OSI at 5 minutes, but significant reductions in OSI of 28.8%, 38.5% and 36.7% (all p < 0.001) were observed at 10, 15 and 30 minutes.Conclusion: Hyperosmolar patients exhibited significantly increased variation in light scatter following cataract surgery that was undifferentiated by staining or TBUT. Elevated osmolarity may be indicative of light scatter equivalent to that of a grade 2– 3 cataract.Keywords: hyperosmolarity, light scatter, tear film, staining, TBUT, cataract

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