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Vol 6 (2021): Continuous Publishing
Original paper
Published online: 2021-09-28
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A randomized comparative trial of safety and efficacy of topical vitamin A and carboxymethylcellulose 1% on symptoms of dry eye disease after cataract surgery

Saurabh Nigam1, Shalini Gupta2, Poonam Gupta3
·
Ophthalmol J 2021;6:89-100.
Affiliations
  1. Department of Ophthalmology, Sadguru Netra Chikitsalya, Chitrakoot, India
  2. Department of Ophthalmology, Baba Saheb Ambedkar Hospital and Medical College, Rohini, India
  3. Department of Ophthalmology, Bhagwati Hospital, Rohini, India

open access

Vol 6 (2021): Continuous Publishing
ORIGINAL PAPERS
Published online: 2021-09-28

Abstract

Background: The objective of the study was to evaluate the efficacy and safety of topical vitamin A and carboxymethylcellulose (CMC) 1% in reducing dry eye symptoms after phacoemulsification cataract surgery.

Material and methods: A prospective interventional randomized comparative open-labeled study was conducted during which all patients undergoing phacoemulsification for age-related cataracts were included. The 270 patients were equally and randomly divided into the three groups A–C of 90 patients each: Group A — patients treated with CMC 1%, Group B — patients treated with retinyl palmitate (vitamin A), and Group C — patients with only conventional post-operative topical therapy. The outcome measures were changes in visual acuity, Schirmer test results, tear break-up time, mean goblet cell density (MGCD), and ocular symptoms in terms of Ocular Surface Disease Index (OSDI) at follow-up of 1 month. Any side effects due to interventions were also noted in the follow-up period.

Results: On day 30th, the final Schirmer test results (mean ± SD) were significantly higher in Group B than in Group A, and controls (12.3 ± 2.23 vs. 11.2 ± 3.11 vs. 9.25 ± 2.51; p < .0001); the final tear film break-up time was significantly longer in Group B than in Group A and controls (12.86 ± 2.56 vs. 11.16 ± 2.67 vs. 9.67 ± 2.86; p < .0001); there was an increase in the MGCD (mean ± SD) in all the three groups with the values being significantly higher in Group B vs. Group A vs. controls (309.07 ± 20.26 vs. 295.18 ± 22.96 vs. 277.84 ± 20.86, p < .0001) and the final OSDI scores were significantly lower in Group B than in Group A, and controls (33.42 ± 1.79 vs. 34.46 ± 2.29 vs. 39.83 ± 1.72, p < .0001). Adverse effects were as follows: foreign body sensation, red-eye, and eye swelling, which were similar among the study groups (p > 0.05).

Conclusion: We conclude that the use of topical vitamin A on the corneal surface post-cataract surgery reduces the symptoms of dry eyes much faster than 1% CMC or conventional treatment. However, all three interventions carried a similar profile of side effects.

Abstract

Background: The objective of the study was to evaluate the efficacy and safety of topical vitamin A and carboxymethylcellulose (CMC) 1% in reducing dry eye symptoms after phacoemulsification cataract surgery.

Material and methods: A prospective interventional randomized comparative open-labeled study was conducted during which all patients undergoing phacoemulsification for age-related cataracts were included. The 270 patients were equally and randomly divided into the three groups A–C of 90 patients each: Group A — patients treated with CMC 1%, Group B — patients treated with retinyl palmitate (vitamin A), and Group C — patients with only conventional post-operative topical therapy. The outcome measures were changes in visual acuity, Schirmer test results, tear break-up time, mean goblet cell density (MGCD), and ocular symptoms in terms of Ocular Surface Disease Index (OSDI) at follow-up of 1 month. Any side effects due to interventions were also noted in the follow-up period.

Results: On day 30th, the final Schirmer test results (mean ± SD) were significantly higher in Group B than in Group A, and controls (12.3 ± 2.23 vs. 11.2 ± 3.11 vs. 9.25 ± 2.51; p < .0001); the final tear film break-up time was significantly longer in Group B than in Group A and controls (12.86 ± 2.56 vs. 11.16 ± 2.67 vs. 9.67 ± 2.86; p < .0001); there was an increase in the MGCD (mean ± SD) in all the three groups with the values being significantly higher in Group B vs. Group A vs. controls (309.07 ± 20.26 vs. 295.18 ± 22.96 vs. 277.84 ± 20.86, p < .0001) and the final OSDI scores were significantly lower in Group B than in Group A, and controls (33.42 ± 1.79 vs. 34.46 ± 2.29 vs. 39.83 ± 1.72, p < .0001). Adverse effects were as follows: foreign body sensation, red-eye, and eye swelling, which were similar among the study groups (p > 0.05).

Conclusion: We conclude that the use of topical vitamin A on the corneal surface post-cataract surgery reduces the symptoms of dry eyes much faster than 1% CMC or conventional treatment. However, all three interventions carried a similar profile of side effects.

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Keywords

dry eye disease; cataract surgery; carboxymethylcellulose; vitamin A

About this article
Title

A randomized comparative trial of safety and efficacy of topical vitamin A and carboxymethylcellulose 1% on symptoms of dry eye disease after cataract surgery

Journal

Ophthalmology Journal

Issue

Vol 6 (2021): Continuous Publishing

Article type

Original paper

Pages

89-100

Published online

2021-09-28

Page views

6154

Article views/downloads

587

DOI

10.5603/OJ.2021.0017

Bibliographic record

Ophthalmol J 2021;6:89-100.

Keywords

dry eye disease
cataract surgery
carboxymethylcellulose
vitamin A

Authors

Saurabh Nigam
Shalini Gupta
Poonam Gupta

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