A randomized comparative trial of safety and efficacy of topical vitamin A and carboxymethylcellulose 1% on symptoms of dry eye disease after cataract surgery

Background: The objective of the study was to evaluate the efficacy and safety of topical vitamin A and carboxymethylcellulose (CMC) 1% in reducing dry eye symptoms after phacoemulsification cataract surgery. Material and methods: A prospective interventional randomized comparative open-labeled study was conducted during which all patients undergoing phacoemulsification for age-related cataracts were included. The 270 patients were equally and randomly divided into the three groups A–C of 90 patients each: Group A — patients treated with CMC 1%, Group B — patients treated with retinyl palmitate (vitamin A), and Group C — patients with only conventional post-operative topical therapy. The outcome measures were changes in visual acuity, Schirmer test results, tear break-up time, mean goblet cell density (MGCD), and ocular symptoms in terms of Ocular Surface Disease Index (OSDI) at follow-up of 1 month. Any side effects due to interventions were also noted in the follow-up period. Results: On day 30 th , the final Schirmer test results (mean ± SD) were significantly higher in Group B than in Group A, and controls (12.3 ± 2.23 vs. 11.2 ± 3.11 vs. 9.25 ± 2.51; p 0.05). Conclusion: We conclude that the use of topical vitamin A on the corneal surface post-cataract surgery reduces the symptoms of dry eyes much faster than 1% CMC or conventional treatment. However, all three interventions carried a similar profile of side effects.