Background. Dry eye is a chronic multifactorial disorder, and is characterized by ocular surface inflammation and inadequate production of tears. It is the most common cause of ophthalmology visits in daily practice and has recently been noticed as a major problem in public health. Dry eye is an important complication of ocular surgeries including cataract surgery (phacoemulsification). Patients affected by undifferentiated connective tissue disease (UCTD) are more likely to have complications after cataract surgery due to their lacrimal deficiency.
N-acetyl cysteine (NAC), a thiol-containing antioxidant and radical scavenger, has been used clinically for many years as a reduced glutathione precursor to combat oxidative stress-induced damage in various tissues. It has also been demonstrated that NAC has effects on the tissue remodeling.
Purpose. The aim of this study is to assess the effects of NAC on preventing ocular surface inflammation and worsening of dry eye syndrome after cataract surgery in UCTD patients. Effects of NAC on the inflammation levels and on the metalloproteinases will be evaluated.
Design. Prospective.
Methods. Ophthalmic formulations of NAC have been a widely utilized for various ocular disease but it has not been evaluated whether this molecule can be effective on preventing ocular surface inflammation and worsening of tear deficiency after cataract surgery in UCTD patients. We will select 10 patients (20 eyes) affected by UCTD with diagnosed dry eye and cataract. After cataract surgery we will administer them topical therapy with betamethasone 0.2% and chloramphenicol 0.5 % eye drops in one eye and betamethasone 0.2% and chloramphenicol 0.5 % eye drops plus 5% Acetylcysteine eye drops in the other eye .
Results. We will evaluate the NAC efficiency on preventing ocular surface inflammation and worsening of the lacrimal tears deficiency in pre-operative time and 1 month after surgery.
The Dry Eye Syndrome is a sight-threatening disease with a severe impact on the quality of life, and this condition can worsen after cataract surgery, especially in patients with previous tears deficiency. This study will allow to evaluate a potential treatment in the prevention of this condition. The molecule studied has already been tested for ophthalmologic use and is cheap. The results of the present project, if effective, will advance knowledge on clinical science in ocular physiopathology and disease treatment.