Impact of Lid Wipes and Tear Substitutes on Symptoms and Signs of Ocular Surface Disease After Cataract Surgery—A Real-Life Study

Objective: To evaluate the efficacy of lid wipes and tear substitutes, in addition to standard postoperative treatment, in alleviating signs and symptoms of ocular surface disease (OSD) following cataract surgery. Methods: Retrospective study on patients who underwent cataract surgery and received either standard postoperative treatment (topical antibiotics, corticosteroids, and nonsteroidal anti-inflammatory drugs) or the same regimen supplemented with lid wipes and tear substitutes. Preoperatively and one month postoperatively, symptoms were evaluated using the 5-item Dry Eye Questionnaire (DEQ-5) and the Ocular Surface Disease Index (OSDI), while noninvasive keratograph break-up time (NIKBUT), tear meniscus height (TMH), conjunctival hyperemia, and infrared meibography were measured by the Oculus Keratograph. Results: A total of 63 patients (mean age 75.1 ± 6.3 years) were analyzed. Patients receiving standard treatment showed no significant changes in OSDI (+2 ± 32.7; p = 0.859) or DEQ-5 scores (+1.7 ± 5.4; p = 0.204). Conversely, those receiving the adjunct of lid wipes and tear substitutes demonstrated significant improvement in OSDI scores (−19.4 ± 15.9; p < 0.0001), a trend toward improvement in DEQ-5 scores (−1.9 ± 5.5; p = 0.059), and a reduction in the meibography score of the inferior eyelid (−0.24 ± 0.60; p = 0.023). Intergroup comparisons showed significantly greater improvements in both OSDI and DEQ-5 scores in patients receiving treatment for the ocular surface. Multivariate regression analysis confirmed the association between the use of wipes and tear substitutes and improvements in OSDI (p = 0.010) and DEQ-5 scores (p = 0.015). No significant postoperative changes in objective OSD parameters were observed in either group. Conclusions: The addition of lid wipes and tear substitutes to the standard postoperative regimen significantly improved patient-reported symptoms of ocular discomfort after cataract surgery, while no significant changes were observed in objective signs of ocular surface disease. These findings support the routine use of lid wipes and tear substitutes as an effective strategy for managing postoperative ocular surface discomfort.