Randomised, Single Blind, Controlled, Three-Month Clinical Trial on the Evaluation and Treatment of the Ocular Surface Damage Following Phacoemulsification
Round 1
Reviewer 1 Report
An interesting study. Good results, expected!
Author Response
An interesting study. Good results, expected!
A. Thank you very much for your comment and appreciation
Reviewer 2 Report
This is a very interesting study on the evaluation and treatment of OSD after phacoemulsification.
Strong advantages of the paper are the prospective, randomized, controlled, single-blind study design.
The limitation is the small sample size not allowed the direct comparison between the two lubricant treatment groups. Even though, as shown in figures 2 and 3, there were substantial differences in the outcomes between the two treated groups. The authors should comment on these in the discussion section of the paper.
Figure 1 is not displayed properly and must be improved.
Methods: The evaluation of the cornea damage with the fluorescein staining scale is not supported by a reference. Furthermore, although, according to this scale a score from 0-3 was applied, this score was not used in the analysis as shown in table 2. The reason for that must be explained by the authors.
The evaluation of conjunctival hyperemia, although presented in table 2, is not described in the Methods section of the paper.
Table 2 : presented the number of subjects with Dry eye syndrome in both groups. How was assessed, and how was calculated? There is nowhere in the paper on which criteria DES was defined.
Author Response
This is a very interesting study on the evaluation and treatment of OSD after phacoemulsification.
Strong advantages of the paper are the prospective, randomized, controlled, single-blind study design.
A. Thank you for your comment.
The limitation is the small sample size not allowed the direct comparison between the two lubricant treatment groups. Even though, as shown in figures 2 and 3, there were substantial differences in the outcomes between the two treated groups. The authors should comment on these in the discussion section of the paper.
A. thank you for your suggestion. We have added a sentence on page 10. and we have added that the sample size is small (page 12).
Figure 1 is not displayed properly and must be improved.
A. we have redone the figure.
Methods: The evaluation of the cornea damage with the fluorescein staining scale is not supported by a reference. Furthermore, although, according to this scale a score from 0-3 was applied, this score was not used in the analysis as shown in table 2. The reason for that must be explained by the authors.
A. thank you for the suggestion, we have added the reference : 16. Bron AJ, Evans VE, Smith JA. Grading of corneal and conjunctival staining in the context of other dry eye tests. Cornea 2003; 22: 640-650.
About the grade of the corneal staining, it was 1 (mild), when present, therefore, for the statistical analyses, the corneal staining was evaluated as absent (grade = 0) or present (grade > 0): we have added a sentence regarding this in methods section. (page 7 and page 9), and we have modified table 2 (page 16)
The evaluation of conjunctival hyperemia, although presented in table 2, is not described in the Methods section of the paper.
Thank you for this observation, we have added a description of the conjunctival hyperemia evaluation (page 8):
"Conjunctival hyperemia
Conjunctival hyperemia was evaluated according to a grading scale ranging from 0 to 2 points: grade 0= none, grade 1 = mild/moderate injection, grade 2 = severe injection (16). For the statistical analyses the conjunctival injection was evaluated as absent (grade = 0) or present (grade > 0)." , and we have modified table 2 (page 16)
Table 2 : presented the number of subjects with Dry eye syndrome in both groups. How was assessed, and how was calculated? There is nowhere in the paper on which criteria DES was defined
A. thank you for the pbservation: we have added the definition used that is “Dry eye was defined as the concomitant presence of corneal staining > 0 and BUT < 10 sec.” (page 5).
