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Dry eye: “It is a very complex disease and it is multifactorial. That is why it intrigued me”

Dr Tugce Ipek talks to OT  about her PhD research exploring the link between cataract surgery and dry eye

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Dr Tugce Ipek completed her PhD research project in dry eye at Aston University with the support of Optegra and a European Union research grant. She developed a new in vitro model of dry eye in order to determine what stage of cataract surgery may induce dry eye or exacerbate the condition. Dr Ipek speaks with OT.

Can you tell OT about your research?

The research investigated dry eye following cataract surgery. The reason I was interested is that cataract surgery is one of the most commonly performed surgeries in the world. Up to 70% of patients can experience dry eye in the early post-operative period after the operation.

The question for me was, why is this happening? I observed a cataract surgery and saw light from the operating microscope shining on the patient’s eye. I observed the solutions that they use. I thought maybe we could look at those factors in an in vitro model.

How did you conduct the research?

I used porcine eyes as a cell source. Pig eyes are similar to human eyes. I cultured the cells in vitro before mimicking dry eye. We then replicated the disruption that can happen in cataract surgery and observed the effect of the operating microscope and antiseptic agents. We wanted to see what would happen if dry eye was present before the operation – if the dry eye would become worse following the procedure.

What did you find and how might this insight be applied in practice?

What I found is that light from the operating microscope causes slower wound healing in the cells and that the antiseptic agents might be disrupting the homeostasis of the ocular surface cells.

The clinical application of this in the future might be that the surgeons should be mindful to minimise how long the eye is exposed to the operating microscope’s light source. The light source doesn’t need to be on continuously throughout the procedure. In terms of the antiseptic agents, you want to kill pathogens but you also don’t want to damage the ocular surface. It is a trade-off, hence clinicians should also be mindful to adhere to recommendations regarding exposure times and concentrations.

Why does dry eye interest you?

It is a very complex disease and it is multifactorial. That is why it intrigued me. From the name ‘dry eye’, it seems very simple, but it can cause many problems for the eye and significantly impact a patient’s quality of life.