Abstract
Purpose To investigate the association among the ocular surface temperature (OST), tear film stability, functional visual acuity (FVA), and blink rate in patients after cataract surgery. Methods We recruited 98 eyes of 69 patients (mean age, 73.7 ± 5.2 years) 1 month after phacoemulsification with implantation of acrylic intraocular lenses and assessed slit-lamp microscopy, corrected distance VA, FVA, noninvasive tear breakup time (NIBUT), and OST. We defined the changes in the OST from 0 to 10 seconds after eye opening as the ΔOST. We measured the FVA and blink rate using the FVA measurement system. We divided the patients into two groups based on tear film stability: stable tear film (NIBUT, >5.0 seconds) and unstable tear film (NIBUT, ≤5.0 seconds). We evaluated the differences between the two groups and the association between the blink rate and other clinical parameters. Results The unstable tear film group (56 eyes) had significantly (p < 0.0001, unpaired t-test) shorter NIBUTs than the stable tear film group (42 eyes). The ΔOSTs and blink rates were significantly (p < 0.0001) higher in the unstable tear film group than in the stable group. Linear single regression analysis showed that the ΔOST (r = −0.430, p < 0.0001), NIBUT (r = −0.392, p < 0.0001), and gender (r = −0.370, p=0.0002) were correlated significantly with the blink rate. Multiple regression analysis showed that the ΔOST independently contributed to the blink rate. Conclusions The frequency of blinks is associated with tear film stability in patients after cataract surgery. The blink rate may be useful for evaluating the tear film stability in clinical practice. The ΔOST should be an important contributing factor to the blink rate. [This trial is registered with UMIN000026970].
Highlights
With improvements in the techniques of cataract surgery, the invasiveness of the surgery has been minimized greatly [1,2,3,4]
E functional visual acuity (FVA), noninvasive tear breakup time (NIBUT), and ocular surface temperature (OST) were measured 1 month after cataract surgery. e cornea was assessed for corneal epithelial damage, which was identified by the fluorescein staining scores of the area (A) and density (D) over the damaged corneal lesions [36]. e degrees of staining of the area and density were scored on a scale from 0 to 3, with A0 indicating none, A1 less than one third of the area, A2 one third to two thirds, A3 more than two thirds, and D0 none, D1 sparse density, D2 moderate density, and D3 high density [36]
Representative cases of patients with unstable tear film and stable tear film are shown in Figure 1. ere was no difference in the FVA, but the blink rate increased in patients with unstable tear film more than in those with stable tear film
Summary
With improvements in the techniques of cataract surgery, the invasiveness of the surgery has been minimized greatly [1,2,3,4]. Tear film instability on the ocular surface is a possible cause of the problem [6,7,8,9,10,11]. Problems with the ocular surface and tear film stability contribute to reduced corneal sensitivity, number of goblet cells, and mucin expression, resulting in decreased tear film breakup time (BUT) [6,7,8,9,10]. Ese phenomena are believed to impair tear film stability and reduce visual quality. Koh et al reported that tear film instability degraded the optical quality and increased the higher order aberrations [11]. Several studies have reported that changes in the OST during
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
