J Korean Ophthalmol Soc.  2021 Apr;62(4):463-471. 10.3341/jkos.2021.62.4.463.

Short-term Changes in the Tear Matrix Metalloproteinase 9 Level and Ocular Surface Discomfort after Cataract Surgery

• Lee SH
• Chun YS
• Moon NJ
• Kim KW

• KMID: 2515578
• DOI: http://doi.org/10.3341/jkos.2021.62.4.463

Abstract

Purpose
We explored changes in the various clinical parameters of dry eye disease (DED), including the tear matrix metalloproteinase 9 (MMP-9) level, soon after cataract surgery. We sought correlations between such changes and ocular surface discomfort.
Methods
In 106 patients (106 eyes) who underwent cataract surgery, we evaluated meibomian gland dysfunction, tear secretion, corneal sensitivity, tear break-up time, corneal erosion status, the Sjögren’s International Collaborative Clinical Alliance (SICCA) ocular staining score, tear osmolarity, the tear MMP-9 level, and the ocular surface disease index (OSDI) before, and 1 week and 1 month after surgery. All eyes were instilled with topical moxifloxacin, a steroid, and a non-steroidal anti-inflammatory drug daily for 1 month postoperatively. The 1-month delta OSDI scores correlated with the 1-month delta DED parameters. We compared the latter parameters between patients in whom the MMP-9 level decreased (MMP-9-decreased group) at 1 month with those in whom it did not (MMP-9-not decreased group).
Results
Overall, 89.5% of total patients exhibited preoperative DED. The tear MMP-9 level fell at 1 month postoperatively, tear secretion (evaluated using the Schirmer I test) decreased at 1 week, and the OSDI scores fell at both 1 week and 1 month. We found no significant correlation between the 1-month delta OSDI scores and the 1-month delta DED parameters. The 1-month OSDI score fell to a significantly greater extent in the MMP-9-decreased group.
Conclusions
Routine, local anti-inflammatory treatment after cataract surgery may briefly reduce the tear MMP-9 level and ocular surface discomfort.

Keyword

Anti-inflammation; Cataract surgery; Dry eye disease; Matrix metalloproteinase 9; Ocular surface disease index