Clinical Ophthalmology (Sep 2021)
Effect of Cyclosporine 0.09% Treatment on Accuracy of Preoperative Biometry and Higher Order Aberrations in Dry Eye Patients Undergoing Cataract Surgery
Abstract
John A Hovanesian,1 Gregg J Berdy,2 Alice Epitropoulos,3 Jack T Holladay4 1Harvard Eye Associates, Laguna Hills, CA, USA; 2Ophthalmology Associates, St. Louis, MO, USA; 3Ophthalmic Surgeons & Consultants of Ohio, Columbus, OH, USA; 4Baylor College of Medicine, Houston, TX, USACorrespondence: John A HovanesianHarvard Eye Associates, 23961 Calle Magdalena, Suite 300, Laguna Hills, CA, 92653, USATel +1 949 951 2020Email [email protected]: To determine the effect of topical cyclosporine 0.09% on ocular surface regularity and the predictive accuracy of preoperative corneal power measurements in patients undergoing cataract surgery.Setting: Private practice.Design: Open-label, multicenter, prospective study.Methods: Seventy-five patients (75 eyes) who presented for cataract surgery evaluation with signs of dry eye disease were prescribed topical cyclosporine 0.09% for 28 days BID. Corneal curvature measurements, slit lamp exam, and Standardized Patient Evaluation of Eye Dryness (SPEED) questionnaire were evaluated at the initial and follow-up visits. Cataract surgery occurred 1 to 3 weeks after the second biometry visit. Refraction and corrected distance visual acuity measurements were performed 1-month post-surgery. The primary outcome was the difference in absolute prediction error of 1-month spherical equivalent refractive outcome before and after cyclosporine treatment. Secondary outcomes included the effect of topical cyclosporine 0.09% on ocular surface irregularity.Results: Sixty-four patients completed the study. The absolute prediction error of 1-month spherical equivalent refractive outcome was 0.39 ± 0.30 D vs 0.33 ± 0.25 D (P < 0.03) before and after treatment, respectively. The proportion of eyes that achieved the target refraction was greater based on measurements after topical cyclosporine 0.09% than would have occurred using pre-treatment measurements.Conclusion: Cataract surgery patients with dry eye who are prescribed topical cyclosporine 0.09% BID for 28 days pre-surgery showed a statistically significant improvement in the prediction error of the spherical equivalent outcome of surgery. Other measures of dry eye severity showed significant improvements after treatment.Keywords: cataract surgery, topical cyclosporine 0.09%, dry eye, higher order aberrations
