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To determine the prevalence of dry eye disease (DED) diagnosis and proportion of patients receiving DED treatment prior to surgery among 89,947 patients who had intraocular lens (IOL) implantation with cataract surgery. Also, differences in DED treatment rates based on receiving an advanced technology IOL (ATIOL) or monofocal IOL were investigated.
Non-interventional, retrospective database analysis of the IRIS® Registry. ICD-10 and CPT codes were used to identify patients who had a cataract diagnosis and surgery with an IOL implant from January 1, 2016 to March 31, 2018. For patients identified with DED, including meibomian gland dysfunction (MGD) using ICD-9/10 codes, the CPT treatment codes (eyelid heat therapy, punctal procedures, and amniotic membrane) or medications (cyclosporine, lifitegrast) were noted within the 12 weeks preceding surgery. Co-primary outcomes were prevalence of DED and proportion of patients treated before surgery. Secondary outcome was the odds of receiving DED treatment given IOL implant type.
26,543 patients (29.5%) from the cataract surgery cohort were diagnosed with DED, including MGD. Among patients diagnosed with DED, only 3.0% (808 patients) were treated within 12 weeks of surgery. Of the patients who received DED treatment, 66.1% (534 patients) received an ATIOL implant. Patients had 2.1 greater odds of receiving DED treatment when given an ATIOL (95% Confidence Interval: 1.8, 2.4), after controlling for age, sex, race, and geographical region.
Although signs and symptoms are reported as high as 80% in some studies, DED was diagnosed in 29.5% of cataract patients in this study. Only 3% of diagnosed patients were treated with prescription medications or procedures, and those receiving an ATIOL were significantly more likely to be treated.