Effects of Lipiflow Treatment Prior to Cataract Surgery: A Prospective, Randomized, Controlled Study: Lipiflow prior to cataract surgery.

Abstract

PURPOSE\nTo investigate the effects of preoperative Lipiflow (Johnson & Johnson, USA) treatment prior to cataract surgery on meibomian gland dysfunction (MGD) and dry eye induced by surgery.\n\n\nDESIGN\nProspective, randomized controlled study METHODS: This study comprised 124 eyes of 124 patients with planned surgery for senile cataract. Participants were randomly allocated into control and Lipiflow groups based on administration of Lipiflow treatment three weeks prior to cataract surgery. For meibomian gland (MG) evaluation, MG atrophy, degree of gland expressibility, and quality of gland secretions were examined at the baseline visit and one and three months postoperatively. Ocular surface parameters of tear film break-up time (TBUT), Oxford corneal staining score, and tear film lipid layer thickness (LLT) were measured at each visit. Ocular Surface Disease Index (OSDI) and Dry Eye Questionnaire (DEQ) were also assessed.\n\n\nRESULTS\nThe control group exhibited a significant decrease in MG expressibility, worsened meibum quality, decreased LLT, and worsened corneal staining following cataract surgery. Also, dry eye symptom showed significant worsening. Conversely, the Lipiflow group showed significantly improved MG patency and meibum quality, increased TBUT, and reduced corneal staining, and presented improved subjective outcomes reported on both OSDI and DEQ. The improvement of each parameter in the Lipiflow group showed a linear correlation with baseline MGD grade. In addition, patients without baseline MGD showed less worsening or improvement of MGD and dry eye induced by surgery, with preoperative Lipiflow treatment.\n\n\nCONCLUSIONS\nPreoperative Lipiflow treatment conducted prior to cataract surgery may be a safe and effective intervention for relieving MGD and dry eye induced by surgery. It might be recommended, not only for the patients with preoperative MGD, but also for those without baseline MGD, to prevent the development of MGD and dry eye induced by ocular surgeries.