Dry Eye Post Surgery Update

Abstract

CitationThe prevalence of dry eye in the USA is around 11-33% and is directly proportional to age. 3 The main objective to reduce or eliminate dry eye symptoms completely is by implementing new strategies of pre-surgical diagnosis and management.Recent advances in the field of refractive surgery have prioritized visual quality as a primary clinical parameter in the treatment of these patients. Dry eye symptoms are one of the most frequent causes of complaints of those patients who undergo refractive or cataract surgery, most often in the immediate post-operative phase. The patients who undergo cataract surgery show relatively higher chances to present dry eye symptoms following surgery, and most commonly disappears within a short span of time.For this reason, it is important to consider the detection for dry eye syndrome prior to any ocular surgery. In cases where this is confirmed, an appropriate treatment should be performed prior to the proposed surgical procedure, because otherwise one runs the risk of suffering associated complications, for example, error calculation for intraocular lenses in cataract surgery or low post-operative visual quality in refractive surgeries. 4 Patients who already experienced dry eyes before surgery underwent greater discomfort and slower recovery. For some of these patients, most frequently the elderly, who already suffered from dry eyes before surgery, the use of peri-surgery medication, intensive treatment with antibiotics, anti-inflammatory drugs and other highly used drops can result in toxic effects to the ocular surface and consequently lead to dry eye.On the other hand, the inflammatory processes generated during the surgery can lead to tear accessories gland damage, which can be further aggravated in prolonged surgeries (the complicated ones or surgeries performed by residents in training who lack adequate experience) based on the application of photolysis for extensive thermic impact on the ocular surface following an exposure to the light microscope.During phacoemulsification the neurological damage is relatively lesser due to refractive surgeries.On the basis of our knowledge, the cornea is densely populated by sensory nerves originating from the trigeminal ganglion ophthalmic division and the autonomic nervous system; parasympathetic fibers and lesser number of sympathetic nerves arising from the superior cervical ganglion. Corneal nerves are divided into branches in the peripheral cornea.Some of these branches are connected with each other creating the stromal neural net-