Incidence and Pattern of Dry Eye after Cataract Surgery

Abstract

PurposeTo evaluate the incidence and severity pattern of dry eye after phacoemulsification.SettingKing Chulalongkorn Memorial Hospital, Bangkok, Thailand.DesignProspective descriptive study.MethodsSamples were collected from ninety-two uncomplicated cataract patients who were 18 years old or older. Dry eye incidence and pattern were analyzed at days 0, 7, 30 and 90 after phacoemulsification using (1) Ocular Surface Disease Index (OSDI) questionnaire, (2) tear break up time (TBUT), (3) Oxford ocular surface staining system, and (4) Schirmer I test without anesthesia.ResultsSeven days after phacoemulsification, the incidence of dry eye was 9.8% (95% confidence interval; 3.6–16.0%). The severity of dry eye peaked seven days post-phacoemulsification and was measured by OSDI questionnaire and all three clinical tests. Within thirty days and 3 months post-surgery, both the symptoms and signs showed rapid and gradual improvements, respectively. However, dry eye post-phacoemulsification was not significantly associated with sex and systemic hypertension (P = 0.26, 0.17 and 0.73, respectively).ConclusionsThe incidence of dry eye after phacoemulsification was 9.8%. Symptoms and signs of dry eye occurred as early as seven days post-phacoemulsification and the severity pattern improved over time. We recommend that ophthalmologists should evaluate patients both before and after phacoemulsification to prevent further damage to the ocular surface and able to manage the patient promptly and effectively so the patient will not have a poor quality of life and vision due to dry eye syndrome.

Long-term impact of dry eye symptoms on vision-related quality of life after phacoemulsification surgery

“…Cataract surgery can improve the visual acuity largely. However, a significant number of patients complain of postoperative dry eye symptoms such as dry, foreign body sensation and shorttime but frequent blurred vision [1][2][3][4][5]. From our experience, the patients may blame the surgery (and their surgeon) for the apparently new development of dry eye symptoms and generally do not realize that their problem stems from ocular surface disease rather than the surgical procedure.…”

“…To avoid these accusations and to inform patients preoperatively of the possibility of dry eye symptoms following surgery, it is equally important to provide information about when these symptoms will diminish or disappear. The severity of dry eye symptoms has been reported to peak 7 days after cataract surgery and to persist for 3 months, and it can become both physically and psychologically debilitating [1,2].…”

“…The OSDI is a validated, reliable questionnaire that assesses a patient's subjective preferences with dry eye disease, including those that occur following cataract surgery [1,2,6]. The OSDI is now perhaps the most commonly used dry eye-specific questionnaire due to its convenience in clinical settings [2].…”

A clinical study to evaluate incidence of dry eye following cataract surgery

“…[10][11][12] One important differentiating feature was that in this study most cases underwent phacoemulsification and only a few cases were of SICS and ECCE. We have also compared the dry eye incidence between phacoemulsification and SICS.…”

“…Kasetsuwan Ngamjit, et al showed that the incidence of dry eye in patients who all underwent phacoemusification was 9.8%. 11 Kavitha et al found that after manual small incision cataract surgeries with corneoscleral tunnel incisions, 66.2% of the patients had dry eyes, which was relatively high. 12 The 22.1 % incidence in our study is in between the above quoted studies as our sample consisted of both SICS, phacoemulsification and conventional ECCE of which phacoemulsification constituted the majority.…”