Changes in corneal sensitivity and tear physiology after phacoemulsification

Abstract

Deterioration in corneal sensitivity and tear physiology is seen immediately after phacoemulsification. Corneal sensitivity does not return to preoperative levels until 3 months postoperatively whereas the tear functions recover within 1 month.

Evaluation of dry eye-associated symptoms and signs after microincision cataract surgery

“…The change in the corneal sensitivities at the other areas of the cornea was not found statistically significant. It has been reported that the corneal sensitivity had returned to preoperative levels after 3 months, in a previous study with 4.1 mm corneal incision phacoemulsification [2]. In our study, the mean corneal sensitivity of superior incision site decreased statistically significant at 3 days after microincisional cataract surgery with 2.2 mm clear corneal incision.…”

“…Therefore, temporary dry eye symptoms might develop until the nerves regenerate again [2,10]. Most surgical procedures, especially surgical incisions that cause denervation of the cornea, also result in impaired epithelial wound healing, increased epithelial permeability, decreased epithelial metabolic activity and loss of cytoskeletal structures associated with cellular adhesion [5].…”

“…Despite microincision size which causes less damage to corneal nerves than large incision, increase of dry eye-associated symptoms and signs have indicated that the incision size is not the only mechanism of aggravation of dry eye-associated symptoms. The mechanism for the exacerbation of ocular surface damage likely includes several factors: increased inflammatory mediators due to postoperative inflammation, misuse of eye drops, toxicity from the use of benzalkonium chloride containing eye drops, decrease in corneal sensitivity which is resulted in reduced tear production, and exposure to light from the operating microscope [1][2][3][4].…”

“…Despite good visual results after surgery, dissatisfaction of patients might reduce surgical success. Some studies have reported aggravation of dry eye symptoms and signs after cataract surgery [1,2]. Many factors, such as topical anesthesia and eye drops containing preservatives like benzalkonium chloride, surgical incision types, exposure to light from operating microscope, disrupt to normal organization of the corneal innervation, might affect the ocular surface environment after cataract surgery [3][4][5].…”

The effect of preservative-free HP-Guar on dry eye after phacoemulsification: a flow cytometric study

“…12 A corneal incision, notwithstanding its small size, can cause certain corneal irregularities, favouring tear film ruptures. Moreover, an alteration in central corneal sensitivity has been found in patients who have undergone cataract surgery, 30 secondary to the corneal nerve section, which may potentially disrupt the neural loop, reducing tear secretion by the lacrimal gland. 31 The increase in TBUT and the improvement of the OSDI and its subscales after treatment with HP-Guar may be due to its peculiar mechanism of action.…”