Efcacy of Using Cationorm and Systane Eye Drops on Post-Lasik Dry Eye

with p<0. 001.Comparison of systane and Cationorm eye drops with asthenopic symptoms on post-LASIK dry eye showed cationorm is better than the systane eye drops. Conclusions: Cationorm showed more signi�cant results as compared to systane eye drops and cationorm gave faster relief from asthenopic symptoms on post-LASIK dry eye (2022). E�cacy Of Using Cationorm and Systane Eye Drops on Post-Lasik Dry Eye : Cationorm and Systane Eye Drops on Post-Lasik Dry Eye.


I N T R O D U C T I O N
LASIK is famous procedure for correcting refractive errors. The post-LASIK dry eye is very common. Systane and cationorm eye drops are good for post-LASIK dry eye. Objectives: To evaluate and compare the e cacy of Cationorm and Systane eye drops and assess the effect on asthenopic symptoms post-LASIK dry eye. Methods: A Qusai experimental study design was used. This study included 80 patients with the age of 20 to 35 years. Data were collected at Al Qasim Eye Care. 40 patients were treated with cationorm; and other were treated with Systane on post-LASIK dry eye. After using cationorm and systane eye drops assessment of dry eye was nd th measured by TBUT. Patients came for follow ups at 2 day, 15 day and 1 month after the LASIK procedure was done. Statistical analysis was done by applying Mann Whitney U test, Friedman's two-way test, Cochran's test and chi square test. Results: The mean value and standard deviation of Systane and cationorm eye drop recorded at the baseline were 10.00, ± 0.00, 10.00 ± 0.00, after 2nd day it was 8.08 ± 1.163, 8.48 ± 0.987, after 15 days 8.93 ± 2.485, 12.30 ± 1.713, and 1 month 9.05 ± 2.417, 12.93 ± 1.745 respectively. There was a signi cant effect on post-LASIK dry eye after using Systane and Cationorm eye drop with p<0. 001.Comparison of systane and Cationorm eye drops with asthenopic symptoms on post-LASIK dry eye showed cationorm is better than the systane eye drops. Conclusions: Cationorm showed more signi cant results as compared to systane eye drops and cationorm gave faster relief from asthenopic symptoms on post-LASIK dry eye eye were excluded. Patients with Sjogren's syndrome were excluded. Pregnant ladies were excluded. PCO ladies with dry eyes were excluded. Contact lens user was excluded. Patient with diabetes was excluded. Data collection instruments was Fluorescein strips was used. 40ml Systane eye drop was used. 15ml Alkane eye drop was used. 10ml Cationorm eye drop was used. Nikon D5100 SLR was used. Data collection tool was Self-designed proforma used in this study. Slit-lamp is a stereoscopic bio microscopy, an instrument to perform many procedures. It is a standard and accurate method of measuring TBUT. After that TBUT was per formed. A patient was anesthetized with alkane eye drops for 1 to 2 minutes that has temporary anesthetic effect on eye. After that a uorescein strip was wet with saline drops without preservatives. Then asked patient to look up and uorescein strip was rubbed on blubber conjunctiva then asked patient to close the eye and blink rapidly as to spread the dye fully all over the eye. Turn on the cobalt blue lter to assess the tear break up time under diffuse illumination. Then asked patient to blink fully and then stop blinking time was noted from the stop blink to rst dry spot or dry lines appear on tear lm. More than 10 second was marked as normal. 7-8 second was marked mild dry eye. Less than 5 second was marked sever dry eye. Then patient was undergoing a LASIK procedure. Patient was asked to come on follow up after 2 days of LASIK procedure. Then again TBUT was performed on all patients and data was recorded. Then systane eye drops was prescribed to 40 patients and Cationorm eye drops was prescribed to 40 patients. After 15 days of LASIK procedure patient again was asked to come on 2nd follow up.2nd follow up again TBUT was performed on all patients and data was noted on Performa and OSDI was lled by all patients to check the effect of eye drops on asthenopic symptoms. The score was calculated after lling the OSDI. Then Patient came on 3rd follow up after 1 month of LASIK procedure and using eye drops, at this follow up again TBUT was performed and OSDI was lled by both groups. Data analysis was done on the statistical package for the social sciences (SPSS) 20.0 version by applying Mann Whitney U Test, Friedman's Two-Way Test, Cochran's Q Test and Chi Square Test.

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has its own limits such as if a patient has large pupils, unsteady refractive error, age more than 35, very thin cornea, and dry eye syndrome before surgery. After the LASIK procedure, dry eye is the most common side effect. Some of the patients after surgery had dry eye problems because of the tear lm disturbance. It is supplemented by increased osmolality of the tear lm and swelling of the ocular surface. It can cause by insu cient tear production or excessive tear evaporation. Evidences that maintain the relationship between in ammations, dry eye disease and support the use of anti-in ammatory therapy for dry eye disease [9]. Post-LASIK dry eye is due to loss of corneal innervation during making ap and also damage the loop of the corneal lacrimal gland, cornea and meibomian gland blinking that may cause a reduction in aqueous and lipid Tear and mucus secretion [10,11]. Dry eye before surgery and womanish gender are threat factors for developing habitual dry eye after LASIK. Operation of the optical face during LASIK can minimize optical face damage and the threat of adverse issues [12]. There are many drugs that we are suggesting for the post-LASIK dry eye. PRGF eye drops are the most effective eye drops for dry eyes they are giving better results after the LASIK procedure. Lubricant eye drops are also pain-relieving in the post -LASIK dry eye. Some of the most common treatment for dry eyes is arti cial tears, topical cyclosporine, hot compress, punctual plug, and serum eye drops [13,14]. Systane and cationorm forms are the most popular eye drops which are used for dry eye in post-LASIK surgery. Cationorm is a very special type of eye drop. It is known as a positively charged cationic emulsion. It comforts staying on your eye's surface by making arti cial tears and gives long-lasting pain relief [15,16]. Systane ultra-lubricant eye drops are most commonly used in post-LASIK dry eye patients. The purpose of this eye drop is moisture, soothing comfort, and refreshing eye surface. Systane is a rare combination that gives long-lasting relief from dry eye and gives soothing comfort and a refreshing feel [17].
A Quasi experimental study design was used. Study was conducted at Department of Ophthalmology in Private sector of Dera Ghazi Khan. Time duration of the study was from September 2021 to June 2022. Non probability Purposive sampling technique was applied in this study. Total numbers of post-LASIK dry eye patients were 80. They were divided into 2 groups. Each group contains 40 patients. Post-LASIK dry eye patient was included. Age under 20 years to 35 years was included. Both genders were included. Cationorm and Systane drops were included. Exclusion criteria was Computers or mobiles user dry eye patients were excluded. Pre-Lasik dry eye patients were excluded. Patient with corneal diseases that causes dry

R E S U L T S
The goal of the study was to compare the effectiveness of Systane and Cationorm eye drops on post-LASIK dry eyes in order to determine whether eye drop has a better impact on this condition. It also sought to determine whether patients' symptoms would improve as a result of taking these eye drops. 80 patients with post-LASIK dry eye were included with the age ranges from 20 to 35 years. Two groups were having 40 patients each. One was treated with Systane eye drops and other with Cationorm eye drops. Dry  eye was recorded at baseline, within 2 days, at 15 days and after 1 month. The data was analyzed by Mann-Whitney U test with Cochran's Q test, Friedman's two-way analysis and chi-square test. The mean value and standard deviation of S y s t a n e e y e d r o p r e c o r d e d a t t h e b a s e l i n e were 10.00±0.00, 8.08±1.163 after 2 days, 8.93±2.485 after 15 days, 9.05±2.417 after 1 month. There was a signi cant effect on post-LASIK dry eye after using Systane eye drop with p<0.001. Dry eye was absent at baseline data collection but appeared in 1st follow up after LASIK procedure and in the 2nd and 3rd follow up, it showed signi cant improvement on dry eye, Table 1.
The mean value and standard deviation of Cationorm eye drop recorded at baseline were 10.00 ± 0.00, 8.48 ± 0.987 after 2 days, 12.30 ± 1.713 after 15 days, 12.93 ± 1. 745 after 1 month. There was a signi cant effect on post-LASIK dry eye after using cationorm eye drop with p<0. 001. Dry eye was absent at baseline data collection but in 1st follow up, it showed dry eye which was after LASIK procedure and in the 2nd and 3rd follow up it show signi cant improvement on dry eye, Table 2.  The mean value and standard deviation of systane and cationorm eye drops baseline data pre-LASIK was 10.0 ± 0.00. The p-value was 1 which means all the patients before LASIK was without dry eye. 1st follow after LASIK procedure dry eye was recorded. The mean value and standard deviation of Systane and cationorm eye drop was 8.08 ± 1.163, 8.48 ± 0.987 respectively. The value of p was 0.610 which is greater than 0.05 which means in the 1st follow up patients showed dry eyes with no better effect of systane and cationorm eye drops. 15 days of LASIK procedure dry eye was recorded. The mean value and standard deviation of Systane and cationorm eye drops was 8.93 ± 2.485, 12.30 ± 2.417, respectively. The p value was <0.001 which is less the 0.05 which means systane and cationorm showed signi cant results against the post-LASIK dry eye. But cationorm showed better effect on post-LASIK dry eye. 1 month of LASIK procedure done was recorded. The mean value and standard deviation of Systane and cationorm eye drop was 9.05 ± 2.417, 12.93 ±    In present study to assessed the e cacy and comparison of systane and cationorm eye drops on post-LASIK dry eye. Out of 80 patients 40 were treated with systane and other 40 were treated cationorm eye drops. Assessments of tear lm were measured on every follow ups with TBUT only. The p value was <0.05(<0.001) which means cationorm was a good eye drop for post-LASIK dry eye. A result shows that cationorm was a better for post-LASIK dry eye than systane eye drops. A research was conducted in 2022 to evaluate e cacy of punctual plug on post-LASIK dry eye. For this purpose, 18 post-LASIK patient was included in this study and had not responded to the arti cial tears by one-month post-surgery. They were divided into two groups (plug and non-plug). After one-month surgery puncta plug were inserted into the superior and inferior puncta in the plug group. For the assessment of dry eye TBUT, Schirmer, uorescein staining was measured. Symptoms were compared between 1 and 3 months after surgery. Results shows that TBUT, FS and Schirmer test were signi cantly improved in plug group at 3 months. The comparison of TBUT, FS, Schirmer test were show signi cantly enhance in plug groups than the non-plug group [19]. Present study was to assess the e cacy of Systane eye drops on post-LASIK dry eye. 80 participants were selected for this study. Post-LASIK dry eye patients were divided into two groups. 40 post-LASIK dry eye patients were treated with Systane eye drop. Measurement of dry eye was assessed by TBUT. On the 2nd day of post-surgery, after 15 days of surgery and after 1 month on post-surgery data were assessed. The p value of Systane eye drop was <0.001 (<0.05) which shows that systane eye drops was signi cantly improve post LASIK dry eye patients. A study was done in 2021 to compare the e cacy and safety of a preserved-free, multiingredient carboxymethylcellulose hyaluronic acid and o r g a n i c o s m o l y t e s t o p r e s e r v a t i v e -f r e e carboxymethylcellulose in the treatment of post-LASIK dry eye. Total 126 subjects were selected for the assessments. Two groups were formed. For the assessment of dry eye was measured with TBUT, Schirmer test. Results shows that OSDI score were normal for both groups. At the day of 30, the p value of preservatives-free carboxymethyl cellulose was 0.013 indicating that management was not satisfying for post-LASIK dry eye. CMC-HA was shows good safety and supportive eye drops for post-LASIK dry eye [20]. In current study to compare the e cacy of Systane and cationorm eye drops on post-LASIK dry eye was done. For the assessment of the dry eye TBUT were formed on 2nd day after surgery, 15 days of post-surgery and after 1 month. Data was recorded in a written form. The p value of Systane and cationorm eye drops was less than 0.05 (<0.001) which signi cantly showed enhancement in dry eye.

C o n  i c t s o f I n t e r e s t
The author(s) received no nancial support for the research, authorship and/or publication of this article S o u r c e o f F u n d i n g DOI: https://doi.org/10.54393/pjhs.v3i04.86