From the Guidelines
Striate keratitis is a known early post-operative complication of cataract surgery, and its management primarily involves topical corticosteroids and artificial tears to alleviate symptoms and support resolution. The condition is characterized by vertical folds in the corneal stroma, resulting from endothelial cell damage during surgery, which can be caused by surgical manipulation, ultrasound energy, or mechanical trauma 1. Key points to consider in managing striate keratitis include:
- The use of topical corticosteroids such as prednisolone acetate 1% four times daily, which should be tapered over 2-4 weeks based on clinical response.
- The application of artificial tears to help with associated symptoms of dryness or irritation.
- The importance of regular follow-up to monitor the resolution of striate keratitis and adjust treatment as needed, as most cases resolve spontaneously within 1-2 weeks with appropriate treatment 1.
- The need for patients to be reassured that this condition is typically self-limiting but should report worsening symptoms, as persistent cases may indicate more severe endothelial damage requiring additional intervention. It is essential to note that while the provided study 1 focuses on refractive surgery, the principles of managing corneal complications, including striate keratitis, can be applied broadly in the context of cataract surgery, emphasizing the importance of careful post-operative care and monitoring to prevent and manage such complications.
From the Research
Cataract Surgery Early Post-Op Complication of Striate Keratitis
- Striate keratitis is a known complication of cataract surgery, particularly in the early postoperative period 2.
- A study published in the Indian Journal of Ophthalmology found that striate keratopathy was most commonly associated with surgeries performed by resident surgeons, longer duration of surgery, and intraoperative or postoperative complications 2.
- The same study found that striate keratopathy resolved in 97.3% of patients, irrespective of treatment with hypertonic saline, and 92% of patients achieved a best-corrected visual acuity (BCVA) of ≥6/9 at 6 to 10 weeks postoperatively 2.
- Another study published in the Journal of Cataract and Refractive Surgery reported cases of severe corneal melting after cataract surgery in patients prescribed topical postoperative NSAIDs and dexamethasone/neomycin combination therapy, highlighting the importance of careful medication selection 3.
- While striate keratitis is a significant complication, other postoperative complications such as intraocular pressure elevation and dry eye can also occur after cataract surgery 4, 5.
- The management of postoperative inflammation and dry eye after cataract surgery is crucial to improve surgical outcomes and patient satisfaction, and may involve the use of prophylactic medications such as steroids and nonsteroidal anti-inflammatory drugs 5.