The Effect of Hyaluronic Acid-contained Artificial Tear on Refractive Accuracy of Cataract Surgery in Dry Eye Population: A Retrospective Cohort Study

This study aimed to investigate the association between the perioperative usage of hyaluronic acid (HA)-containing artificial tears and the refractive accuracy of cataract surgery in patients with dry eye disease (DED). In this retrospective cohort study, patients with DED who underwent cataract surgery were categorized based on their use of HA-containing artificial tears. A total of 62 eyes were assigned to the non-HA group and 54 eyes to the HA group. The primary outcomes were the uncorrected distance visual acuity (UDVA), postoperative spherical equivalent (SE), and astigmatism assessed via vector analysis. The independent t test and the generalized linear regression were applied for the statistical analysis. Three months postoperatively, the UDVA in the HA group was significantly better than that in the non-HA group (p<0.001). At the same time, the residual SE was significantly higher in the non-HA group than in the HA group (p =0.001). In addition, the HA group showed a higher surgery-induced astigmatism (SIA), lower difference vector (DV), lower magnitude of error (ME), and higher correction index (CoI) compared to the non-HA group (all p>0.05). The high axial length (AXL) significantly correlated to the higher residual SE in the HA group (p=0.001), while the low preoperative tear break-up time, high corneal astigmatism and high AXL correlated to the higher residual SE in the non-HA group (all p<0.05). Perioperative use of HA-containing artificial tears is associated with improved refractive accuracy following cataract surgery in patients with DED.