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The use of tear osmolarity as a diagnostic tool for detection of dry eye prior to cataract surgery

Session Details

Session Title: Cataract II

Session Date/Time: Saturday 16/02/2013 | 08:30-11:00

Paper Time: 08:42

Venue: Hall 1

First Author: : B.Cochener FRANCE

Co Author(s): :    S. Doan              

Abstract Details


To determine if the diagnosis of preoperative dry eye can help to improve outcomes following cataract surgery.


CHU Morvan, Brest, France


This was a prospective, multicenter study that enrolled cataract patients scheduled to undergo standard phacoemulsification surgery followed by placement of an intraocular lens. Patients were assessed for the presence of dry eye before surgery, and then at one week and one month after surgery. Tests used were tear break-up time (TBUT), Schirmer’s, and tear osmolarity (TearLab Corp, San Diego, CA). All patients were placed on a standard postoperative treatment regime of topical steroids, non-steroidal anti-inflammatory drugs (NSAIDs) and antibiotics for one month following surgery.


Twenty-five patients (16 female and 9 male), mean age of 69 years (range 43–93 years), were enrolled in the study. The mean preoperative tear osmolarity was 304.6 mOsm/L (range 277-364 mOsm/L). Twelve patients had preoperative dry eye, defined as a tear osmolarity level greater than 308 mOsm/L. Mean osmolarity remained stable at the 1st postoperative visit, 302.4 mOsm/L. At the one-month postoperative visit, the mean osmolarity was 297.4 mOsm/L (p<0.05), with six patients having a tear osmolarity measurement that was reflective of dry eye disease. The group’s mean Schirmer’s test result did not change significantly throughout the follow-up period, with respective preoperative and 1-month postoperative levels of 16.21 and 16.05 mm (p>0.05). The Schirmer’s test detected a preoperative dry eye rate of 39% (n=7) among 18 patients who had the test. The TBUT test detected no pre- or postoperative dry eye among the group and the mean TBUT showed no significant change by postoperative month 1 (p>0.05).


The results suggest that conventional means of dry eye testing may miss patients with preoperative dry eye, compared to osmolarity testing, which provides an objective measurement. The lower postoperative osmolarity levels seen in this study were no doubt related to the postoperative medication regimen and it would be reasonable to expect that the osmolarity measurement would return to baseline after treatment stopped.

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