Eyeworld

61 EW RESIDENTS December 2015 PCS. BCVA improved in both groups as expected; however, there was slight improvement in BCVA at 1 month postoperatively in the FLACS group, but this was not statistically significant. OSDI scores also im- proved in both groups; however, there was a statistically significant improvement at 1 week in the FLACS group compared to the PCS group. By 1 month, this difference became statistically insignificant though. It is important to note that the OSDI score has vision-related questions, which are expected to improve with removal of the cata- ract. Keratograph measurements of NIfBUT and NIavBUT (average break-up time) deceased at day 1 and week 1, but returned to baseline at 1 month in both groups. Interestingly, the measured tear meniscus height in both groups increased at day 1 postoperatively. Schirmer I testing scores decreased in both groups to their lowest values within the first week (FLACS group: 7.230 +/–6.387 and PCS group: 7.330+/–6.274) com- pared to preoperative levels (FLACS group: 9.160 +/–6.972 and PCS group: 9.420 +/–7.352, P=0.962) and did not recover by 1 month. Fluo- rescein staining scores in the FLACS group were statistically higher at all postoperative time points than the PCS group. In a subgroup analysis of patients who underwent FLACS, patients with a prior diagnosis of dry eye were found to have increased fluorescein staining at 1 day and 1 month compared to patients with- out a prior diagnosis of dry eye. In this study, Yinhui and col- leagues demonstrate that dry eye symptoms and examination findings worsen after both FLACS and PCS but to a greater degree with FLACS. Preoperatively, a diagnosis of dry eye was reported at 53.4% in the FLACS group and 51.5% in the PCS group. At 1 week, the percentages in- creased to 72.6% in the FLACS group and 70.3% in the PCS group, then declined to 64.4% in the FLACS group and 62.5% in the PCS group by 1 month. The authors recognize the limitations of the study. These include the nonrandomized na- ture of the study; short follow-up time postoperatively of 1 month in which they explicitly state that prior cooperation with testing. Addition- ally, patients with serious intraoper- ative complications such as vitreous loss, posterior capsular tear, or hy- phema and those with postoperative complications such as endophthal- mitis were excluded from the study. All patients in both surgical groups were subject to the same preoperative evaluation by a single investigator. The specific tests used to assess for dry eye syndrome were a subjective dry eye questionnaire; the Ocular Surface Disease Index; Keratograph 4, which measured noninvasive tear break-up time (NIfBUT) and tear meniscus height; Schirmer I test; and fluorescein staining. Patients were evaluated at 1 week preoperatively to obtain a baseline, and then evaluated postoperatively at 1 day, 1 week, and 1 month. After the complete evaluation at the time points de- tailed above, the diagnosis of dry eye was performed according to Japanese diagnostic criteria for dry eyes requiring the presence of one or more subjective symptoms (i.e., dryness, foreign body sensation, burning sensation, photophobia, visual fatigue or blurred vision, or red eye) and at least one of the following: a reduced NIfBUT of less than 5 seconds; reduced tear pro- duction (Schirmer I test) less than 10 mm/5 min; and/or the presence of fluorescein staining score greater than 1 point. With regard to surgical technique, the phacoemulsification equipment, technique, and param- eters were consistent between both groups. The settings of the femtosec- ond laser were standardized for all patients. However, patients undergo- ing FLACS were given pranoprofen 4 times daily 1 day prior to surgery, whereas those undergoing PCS were not given the topical medication. On average, the reported surgi- cal time of FLACS versus PCS was 12.994 +/–2.734 minutes and 7.867 +/–1.603 minutes, respectively. The longer time per case in FLACS was due to the utilization of the fem- tosecond laser, which created the corneal incisions, capsulotomy, and lens fragmentation. The study results demonstrated that FLACS has a greater effect on exacerbating dry eye symptoms and ocular surface staining compared to a prospective study" 20 TH Athens Athens ESCRS Winter Meeting www.escrs.org 26–28 February Athens 2016 In conjunction with the 30 TH International Congress of HSIOIRS Preliminary Programme & Registration Available MEGARON CONGRESS CENTRE, GREECE continued on page 62

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