Effect of 0.15% Preservative-free Sodium Hyaluronate on Dry Eye Disease after Femtosecond Laser-assisted Cataract Surgery

Purpose: The efficacy of using preservative-free 0.15% sodium hyaluronate eyedrops for dry eye disease after femtosecond la ser-assisted cataract surgery (FLACS) was evaluated. Methods: This prospective randomized study was conducted on patients with dry eye who were scheduled for FLACS among those with Tear Film & Ocular Surface Society Dry Eye Workshop II Dry Eye Levels 1 and 2. In total, 37 eyes scheduled for FLACS were randomized to the treatment group (n = 19) or control group (n = 18). Corneal and conjunctival fluorescein staining (CFS), tear breakup time (TBUT), Schirmer I test (SIT) value, ocular surface disease index (OSDI), meibomian gland evaluation result, and lipid layer thickness were evaluated for all patients, preoperatively and at 1 and 3 months postoperatively. Results: In the treatment group, the OSDI and CFS scores were significantly lower at 3 months postoperatively than at baseline, but the TBUT and SIT values were significantly increased. In the control group, TBUT was significantly shorter at 3 months post operatively than at baseline, SIT values were significantly decreased at 1 and 3 months postoperatively compared with the base line, and meibum quality was significantly aggravated at 1 month postoperatively compared with the baseline. In the treatment group, OSDI improved significantly from baseline at 1 and 3 months. TBUT increased significantly in the treatment group at post operative 3 months. Meibomian gland quality showed clinically better results in the treatment group than in the control group at postoperative 3 months. There were no significant differences in corneal and CFS, lipid layer thickness, and other dry eye dis ease parameters between the treatment and control groups. Conclusions: Preservative-free 0.15% sodium hyaluronate eyedrops were effective for improving dry eye symptoms and tear film stability after FLACS.ope