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Preoperative dry eyes disease in cataract patients with deficient tear break up time: evaluation of OSDI questionnaire, its subcategories and Keratograph 5M device results

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Abstract

Purpose

To evaluate preoperatively dry eye disease (DED) in patients with pathological Tear Break Up Time (TBUT), utilising subjective Ocular Surface Disease Index (OSDI) with its subcategories and objective Keratograph 5M characteristics.

Methods

Fifty-four cataract patients were included in this prospective study having a screening slit lamp TBUT of less than 10 s and more or equal to 5 s. Subjective evaluation of DED was performed with OSDI questionnaire and objective evaluation with Keratograph 5M. Tear Meniscus Height (TMH), bulbar and limbal redness and meibography grade were evaluated. Further analysis of OSDI subcategories, Visual Function Related (VFR), Ocular Symptoms related (OS) and Environmental Triggered (ET), was performed with linear and logistic multivariate regression models. Age, gender and logMAR visual acuity (VA) were also included in our models.

Results

Following the initial TBUT screening we identified 27(50%) normal and 27(50%) dry eye patients, using OSDI questionnaire. There was no statistical difference in TMH (p = 0.64), bulbar redness (p = 0.54), limbal redness (p = 0.72) and meibography grade (p = 0.25), between normal and dry eye OSDI group. In our regression analysis, average logMAR VA was highly associated with a higher total OSDI score (p < 0.001) and with a higher OSDI-VFR score (p < 0.001). Female gender was associated with a higher OSDI-ET score (p = 0.03). Multivariate logistic regression models were performed by sorting patients into 2 categories of normal and dry eye group according to their total OSDI,OSDI-VRF,OSDI-OS and OSDI-ET score. An increase in logMAR VA increased the odds of having abnormal total OSDI score (p = 0.007) and OSDI-VFR score (p = 0.006). Females had increased odds of having abnormal OSDI-ET score (p = 0.044).

Conclusions

Clinicians should be aware of OSDI limitations when screening cataract patients for dry eyes, as there is high correlation with VA. Female patients were more susceptible to environmental factors. Keratograph results should be interpreted with caution when they are evaluated in conjunction with OSDI during preoperative assessment of DED in cataract patients.

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Data availability

The data are available by the corresponding author (E.C) upon request.

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Funding

No author has a financial or proprietary interest in any material or method mentioned.

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Authors and Affiliations

  1. Department of Ophthalmology, Imperial College Healthcare NHS Trust, London, UK

    Ourania Fydanaki

  2. Department of Ophthalmology, 251 Hellenic Airforce General Hospital, Hpeirou 36, Agia Paraskeyi, 15341, Athens, Greece

    Evangelia Chalkiadaki, Panos S. Gartaganis & Efthymios Karmiris

  3. First Department of Ophthalmology, National and Kapodistrian University of Athens, General Hospital “G. Gennimatas”, Athens, Greece

    Anastasia Tsiogka

Authors
  1. Ourania Fydanaki
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  2. Evangelia Chalkiadaki
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  3. Anastasia Tsiogka
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  4. Panos S. Gartaganis
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  5. Efthymios Karmiris
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Corresponding author

Correspondence to Evangelia Chalkiadaki.

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The study was conducted according to the tenets of the Declaration of Helsinki and the Ethics Committee of the Hospital involved.

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Fydanaki, O., Chalkiadaki, E., Tsiogka, A. et al. Preoperative dry eyes disease in cataract patients with deficient tear break up time: evaluation of OSDI questionnaire, its subcategories and Keratograph 5M device results. Int Ophthalmol 42, 3017–3025 (2022). https://doi.org/10.1007/s10792-022-02287-5

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  • DOI: https://doi.org/10.1007/s10792-022-02287-5

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