Effect of Eyelid Hygiene on Functional Visual Acuity After Cataract Surgery: A Randomized Controlled Study

Abstract

Purpose

To evaluate the effect of eyelid hygiene after cataract surgery on eyelid and ocular surface findings, subjective symptoms and visual function, including functional visual acuity (FVA) and higher order aberration, in a randomized controlled study.

Methods

Fifty patients who underwent cataract surgery at a single institution were involved. Twenty-five patients were instructed to wipe their eyelids twice a day from one to four weeks postoperatively, whereas the other 25 patients did not perform any eyelid hygiene. Optical measurement, FVA, meibomian glands, the grade of meibum, lid margin findings, fluorescein corneal staining findings, dry eye-related subjective symptoms and surgical satisfaction were assessed both preoperatively and one month postoperatively.

Results

In the eyelid hygiene group, the visual maintenance ratio of FVA improved significantly (p = 0.048) and the higher order aberration of the 4th + 6th order deteriorated less (p = 0.027) compared with the control group. Multiple regression analyses showed that the change in visual maintenance ratio was associated with surgical satisfaction (p = 0.003), change in corneal staining score (p = 0.007), history of eye diseases (p = 0.029) and eyelid hygiene (p = 0.048).

Conclusions

Eyelid hygiene after cataract surgery may be effective for visual function measured with an FVA test.

Keywords:

• cataract surgery
• dry eye
• eyelid hygiene
• functional visual acuity
• higher order aberration
• meibomian gland dysfunction
• visual maintenance ratio

Abbreviations

BUT, tear film break-up time; FVA, functional visual acuity; HOA, higher-order aberration; logMAR, logarithm of the minimum angle of resolution; MGD, meibomian gland dysfunction; OSD, ocular surface disease; SPK, superficial punctate keratopathy; SPEED, Standard Patient Evaluation of Eye Dryness.

Availability of Data and Materials

The data sets created or analyzed during this study are not publicly accessible due to the confidentiality of patient information. However, they can be obtained from the corresponding author upon reasonable request.

Ethics Approval and Consent to Participate

The study protocol was approved by the institutional review board of the University of Keio. Written informed consent was obtained from each patient participating in the study. In accordance with the provisions of the Declaration of Helsinki (1995), approval was obtained from the Ethics Committee of the Keio University School of Medicine (approved on 8 July 2020, reference 20190131).

Acknowledgments

The authors thank Hiroshi Otake MD, Tsutomu Sakai MD, Aya Ohira MD and Mico Arai CO for help with data collection.

Disclosure

None of the authors have any conflicts of interest in this work.

Additional information

Funding

There will be financial support by Keio University School of Medicine if this paper is accepted.