A clinical study of post cataract surgery epiphora in relation to the type of cataract surgery and different types of post-operative topical medication

Abstract

Aim: To assess incidence, determinants and outcome of epiphora after cataract surgery. Methods: 650 eyes having uncomplicated senile cataract were enrolled routine preoperative evaluation, underwent phacoemulsification (n=462) or SICS (n=188). Post-operatively, patients were randomized into 2 groups according to the preservative status of steroid antibiotic drops. Symptomatic patients were assessed at 5 weeks, using slit lamp, investigated using Fluoroscein Dye Disappearance Test (FDDT), sac syringing, probing and TBUT. Results: At 5 weeks, the incidence of epiphora after phacoemulsification was 7.1%, and that after SICS was 6.9%. 41.38% complained of epiphora after phacoemulsification, and 54.54% after SICS. There was no difference in epiphora after phacoemulsification using preservative free or preservative containing drops. Epiphora after SICS was more in the preservative group, compared to preservative free group (4.4%), which increased with frequency of dosage. Epiphora after phacoemulsification was significantly more-14% in patients above 70 yrs of age, as compared to 4% in younger patients, and more in the female population-10.5% of total females as compared to 3.8% of males. Epiphora after SICS was significantly more-26.7% in patients above 70 yrs of age, compared to 4% in younger patients, and more in the female population-9.5% of total females as compared to 1.94% of males. Conclusion: Epiphora occurs in 7% patients 5 weeks after cataract surgery, irrespective of phacoemulsification or SICS. It is significantly more in elderly age group and in females, after SICS was more with the use of preservatives, more frequent dosage and harder grade of cataract. Keywords: Epiphora, Post cataract, Preservative.