New Therapeutic Strategy and Innovative Lubricating Ophthalmic Solution in Minimizing Dry Eye Disease Associated with Cataract Surgery: A Randomized, Prospective Study

INTRODUCTION: To evaluate the effects of a new lubricating, antioxidant solution (VisuEvo(®)) on dry eye disease (DED) in patients undergoing cataract surgery. METHODS: Patients requiring cataract surgery with either healthy ocular surface or mild DED (tear break-up time, TBUT > 7, Schirmer I test > 15 mm/5 min) were enrolled in this multicenter, open-label, randomized, prospective study. Scheduled visits were 2 weeks before surgery (screening), day of surgery (V0), week 1 (V1), and 2 (V2) after surgery. VisuEvo(®) was self-administered three times daily for the whole study duration (group A); the control group (group B) had no tear substitute administration. The primary endpoint was the change in TBUT over time; the secondary endpoints were changes in Ocular Surface Disease Index (OSDI), ocular surface staining, the Schirmer I test, and osmometry. RESULTS: A total of 45 patients were included (group A, 23; group B, 22; age 74 ± 8 years). At the screening, TBUT was similar between the groups (group A, 8.5 ± 1.8 s; group B, 7.8 ± 0.7, p = 0.11). At the scheduled visits, TBUT increase vs screening visit was significantly higher in group A: +1.2 s at V0, +1.4 s at V1, and +1.9 s at V2 (p < 0.01). Also, OSDI was significantly lower in group A at V0, V1, and V2 (p < 0.027). After surgery, corneal staining was absent in 65–78% of group A compared with 54–59% in group B. The two groups did not show any significant differences of osmometry and the Schirmer I test. CONCLUSIONS: The ocular surface was more protected and quickly restored from surgery when VisuEvo(®) was used from 2 weeks preoperatively to 2 weeks postoperatively. TRIAL REGISTRATION: ClinicalTrials.gov identifier, NCT03833908