Dry Eye Disease after Cataract Surgery: Study of its Determinants and Risk Factors

Abstract

Objectives: To study the incidence of dry eye and its determinants in patients undergoing cataract surgery. Materials and Methods: One hundred twenty patients with senile cataract underwent Schirmer’s test, tear break-up time (TBUT) test, lissamine green staining of the cornea and conjunctiva, and Ocular Surface Disease Index (OSDI) for evaluation of dry eye preoperatively and again at first and second follow-up examinations at 1 week and 1 month after cataract surgery. Results: Mean age of the patients was 59.25+9.77 years and 73 (60.8%) were men. None of the patients had dry eye at the time of enrollment as per the criteria of our study. Postoperatively, Schirmer’s test values ranged from 12-35 mm and 8-24 mm at first and second follow-ups, respectively. Mean TBUT was 13.16±2.45 and 9.64±2.20 seconds, while lissamine green staining score was 3 in 67 (55.8%) and 1 in 67 (55.8%) subjects at first and second follow-up, respectively. OSDI values ranged from 1-30 and 10-33 with a mean of 25.97±5.34 and 11.96±7.47 respectively at first and second follow-up. At first follow-up, 89.1% of the 56 patients who underwent phacoemulsification were found to have grade 2 dry eye (p<0.001), while 92.2% of the 64 patients who underwent small-incision cataract surgery (SICS) had grade 2 dry eye (p<0.001). At second follow-up, grade 0 dry eye was observed in 92.2% of the patients who underwent phacoemulsification and 82.1% of the patients who underwent SICS (p<0.001). Conclusion: The incidence of dry eye after cataract surgery was high and mostly independent of demographic and anthropometric profile, type of surgical procedure, time of microscope exposure, and amount of energy used. This dryness was transient in nature and showed a declining trend, tending to achieve normalization by the end of 1 month.

Effect of Postoperative Administration of Hyaluronic Acid/Trehalose Drop on Corneal Healing After Phacoemulsification Surgery

“…Articles in the literature have almost similar OSDI scores and dry eye parameters for similar age groups (Kasetsuwan et al, 2013;Garg et al, 2020;Rico-Del-Viejo et al, 2018), this is similar for the current study. However, in groups with phacoemulsification surgery that did not use artificial tears after the operation, dry eye parameters worsened over time (Kasetsuwan et al, 2013;Garg et al, 2020 ), while dry eye parameters increased to a better level in the present study. This result may be due to the use of artificial teardrops in both groups for the current study.…”

“…Almost all previous studies reported that Trehalose is an effective agent that can be used for the management of dry eye safely (Matsuo, 2004;Wozniak et al, 2017) as the present study. Articles in the literature have almost similar OSDI scores and dry eye parameters for similar age groups (Kasetsuwan et al, 2013;Garg et al, 2020;Rico-Del-Viejo et al, 2018), this is similar for the current study. However, in groups with phacoemulsification surgery that did not use artificial tears after the operation, dry eye parameters worsened over time (Kasetsuwan et al, 2013;Garg et al, 2020 ), while dry eye parameters increased to a better level in the present study.…”

Pseudophakic Presbyopic Corrections

“…It is well known that dry eye may reduce the vision quality after mIOL implantation [112]. Additionally, it has been observed that cataract surgery is also responsible for causing dry eye disease or aggravating existing dry eye symptoms [113,114]. Therefore, artificial tears and eyelid hygiene, but also cyclosporine or autologous platelet-rich plasma (PRP) in more severe cases, should be used pre-and/or postoperatively [112,115,116].…”

Letter to the Editor: “Dry Eye Disease after Cataract Surgery: Study of its Determinants and Risk Factors”

“…This letter is regarding the article titled “Dry Eye Disease after Cataract Surgery: Study of its Determinants and Risk Factors”. 1 We read this article with great interest and thank the authors for providing an excellent demonstration that phacoemulsification and small-incision cataract surgery can cause dry eye. The authors included in this study patients that pre-surgery were completely asymptomatic and without clinical dry eye signs and this study exhibits that the elements of the surgery itself indeed were the cause of dry eye development, which peaked one week post-surgery and subsided around one month post-surgery.…”