The effect of preservative-free HP-Guar on dry eye after phaco- emulsification: a flow cytometric study

Abstract

Purpose To assess the effect of hydroxypropyl (HP)-Guar added to regular post-phacoemulsification treatment in dry eye signs and symptoms, and its influence on the expression of various inflammatory markers by flow cytometry (FCM) in impression cytology specimens.

Methods This prospective, interventional, single-centre study included 48 eyes of 48 patients with age-related cataract. After phacoemulsification, patients were randomised to the usual treatment group (UT), with 21 patients who received tobramycin and dexamethasone eye drops (Tobradex, Alcon Cusı´, Spain), and the HP-Guargroup, with 27 patients who received the UT plus preservative-free artificial tears (Systane UD, Alcon Cusı´, Spain). Corneal and conjunctival staining with fluorescein and lissamine green, tear film break-up time (TBUT), Schirmer’s I test with anaesthesia (Jones test), tear clearance, and ocular surface disease index (OSDI) were assessed preoperatively and 1 month after surgery. Besides, conjunctival impression cytology was performed in order to investigate inflammatory markers (CD3, CD11b, and HLA-DR) using FCM.

Results HP-Guar group shows statistical better results compared with the UT group in TBUT (6.4±0.7 vs 9±2.5, P ¼ 0.0004), OSDI (11.5±8.2 vs 3.3±2.5, P ¼ 0.0002), ocular symptoms subscale (7.3±6.1 vs 1.7±1.8, P ¼ 0.0004), vision-related function subscale (2.2±1.8 vs 0.4±0.6, P ¼ 0.0002), CD3 (2.5±1.4 vs 1.1±1.1, P ¼ 0.011), and HLA-DR (6.8±4.5 vs 1.8±1.7, P ¼ 0.0002).