The Effect of Lifitegrast on Refractive Accuracy and Symptoms in Dry Eye Patients Undergoing Cataract Surgery

John Hovanesian,1 Alice Epitropoulos,2 Eric D Donnenfeld,3 Jack T Holladay4 1Harvard Eye Associates, Laguna Hills, CA, USA; 2Ophthalmic Surgeons & Consultants of Ohio, Columbus, OH, USA; 3Ophthalmic Consultants of Long Island, Garden City, NY, USA; 4Baylor College of Medicine, Houston, TX, USACorrespondence: John HovanesianHarvard Eye Associates, 24401 Calle De La Louisa, Laguna Hills, CA 92653, USATel +1 949 951 2020Fax +1 949 951 9244Email jhovanesian@harvardeye.comPurpose: To determine the effect of lifitegrast ophthalmic solution 5% on improving the tear film, biometry/keratometry, and refractive accuracy for dry eye patients scheduled for cataract surgery.Patients and Methods: Multicenter, prospective, open-label study of 100 eyes of 100 patients undergoing cataract surgery who had a confirmed diagnosis of dry eye. Patients underwent biometry at baseline and again after a 28-day course of lifitegrast 5% BID. Primary outcome was an improvement in the accuracy of preoperative anterior corneal power measurements at predicting postoperative spherical equivalent (SE) pre- and post-lifitegrast treatment. Secondary outcomes included changes in dry eye symptoms and corneal staining.Results: The accuracy of the biometry readings for the achieved refractive SE: within 0.25 D in 47% and 50% of eyes before and after the initial lifitegrast treatment, respectively; within 0.5 D in 71% and 79% of eyes before and after the initial lifitegrast treatment; and within 0.75 D in 81% and 91% of eyes before and after the initial lifitegrast treatment (p < 0.04).Conclusion: Lifitegrast 5% significantly improved preoperative corneal surface measurement accuracy in patients with confirmed dry eye who were scheduled for cataract surgery.Keywords: cataract surgery, dry eye, lifitegrast, higher-order aberrations