Comparison of 2% Rebamipide Monotherapy and 0.5% Carboxymethylcellulose Sodium Combination Therapy on Post-cataract Surgery Dry Eye

Purpose: The study was designed to evaluate the combined therapeutic effect of topical 2% rebamipide and 0.5% carboxymethylcellulose sodium (CMC) for managing dry eye following cataract surgery compared with 2% rebamipide monotherapy.Methods: We retrospectively analyzed medical records of patients who underwent cataract surgery and were diagnosed with dry eye one week postoperatively. Among these, patients who received combined therapy with 2% rebamipide and 0.5% carboxymethylcellulose (CMC) eye drops (combined therapy group), or 2% rebamipide alone (monotherapy group), for at least two months were included. Clinical data were collected at one and two months after surgery, including Schirmer’s test, tear break-up time (TBUT), ocular surface staining scores, tear film osmolarity, tear lipid layer thickness, and Ocular Surface Disease Index (OSDI) scores.Results: In the combined therapy group, we observed a significant improvement in Schirmer’s test, TBUT, and ocular surface staining scores at both one and two months post-surgery compared to baseline (1 month: p < 0.001, < 0.001, 0.005; 2 months: p < 0.001, respectively). OSDI remained unchanged throughout the entire follow-up period. The combined therapy group exhibited significantly longer Schirmer’s test results (p < 0.001, 0.003), longer TBUT (p = 0.022 at 1 month), and a lower ocular surface staining score (p < 0.001, respectively) compared to the monotherapy group.Conclusions: Following cataract surgery, the combined use of rebamipide and CMC eye drops resulted in improvements in Schirmer’s test, TBUT, and ocular surface staining scores. This suggests that combination therapy may be a promising option for patients who do not achieve adequate relief with rebamipide eyedrops.