Topical Corticosteroid Preoperative for Dry Eye and Analysis of Dry Eye Changes Before and After Cataract Surgery

Purpose: To evaluate the effects of cataract surgery on postoperative dry eye in patients who had been treated for preoperative dry eye.Methods: This study was conducted retrospectively on 31 eyes who underwent cataract surgery at a single institution between January 2023 and August 2023. All patients were treated with warm compression, lid hygiene, and 0.1% a non-preservative fluorometholone for 4 weeks prior to the cataract surgery to manage preoperative dry eye. Symptom Assessment Questionnaire in Dry Eye (SANDE) score, tear film break-up time (TBUT), Schirmer test, corneal/conjunctival staining score (CSS/ConSS), and meibomian gland dysfunction stage were assessed pre- and post-operatively. Tear meniscus height, tear lipid layer thickness (LLT) using IDRA were also compared pre- and post-operatively.Results: The mean age of the patients was 71.4 ± 8.9 years, and there were 11 males. Before cataract surgery, the mean SANDE score, TBUT, and ConSS were 31.9 ± 35.5, 4.5 ± 1.3, and 0.5 ± 0.5, respectively, and they improved significantly after cataract surgery to 15.4 ± 22.1, 5.9 ± 1.1, and 0.1 ± 0.3, respectively (<i>p</i> = 0.007, < 0.001, < 0.001). Preoperative LLT was 58.4 ± 15.6 nm and decreased significantly to 48.1 ± 12.5 nm postoperatively (<i>p</i> < 0.001). Compared to women, men showed a greater improvement in the symptoms and signs of dry eye after surgery, and the tear secretion and LLT were significantly reduced in women compared to men after surgery. In addition, the group whose LLT decreased after surgery had a greater degree of meibomian gland atrophy before surgery compared to the group without such a decrease in LLT (<i>p</i> = 0.037).Conclusions: Preoperative treatment for dry eye improved the symptoms and signs of dry eye after cataract surgery. The effect of preoperative dry eye treatment was more pronounced in men.