Abstract
Despite the increased awareness of early prophylaxis and treatment for dry eye disease (DED) during the first few weeks after cataract surgery, the chronic effect of cataract surgery on the risk of ocular surface abnormalities has not been fully explored. This study was to assess the prevalence of DE subjective symptoms and clinical tests according to the cataract surgery. A total of 172 patients who underwent bilateral cataract surgeries at least 5 months before the recruitment date and 1225 controls with no cataracts were evaluated for their subjective DE symptoms (dry sensation, foreign-body sensation, ocular pain, ocular fatigue, sensitivity to bright light, and blurred vision) and ophthalmic parameters (tear break-up time, keratoconjunctival staining scores, and maximum blinking interval). The presence of subjective DE symptoms was generally inversely associated with cataract surgeries, whereas abnormal clinical tests were more pronounced among postsurgical cataract patients than among controls. Pseudophakic patients showed a 57% increased prevalence of severe keratoconjunctivitis, compared to controls (P = 0.02). In contrast, among subjective DE symptoms, significantly lower odds of sensitivity to bright light were detected among cases than controls; the multivariable-adjusted odds ratio (95% confidence interval) comparing pseudophakic patients with noncataract patients was 0.56 (0.34–0.92) (P = 0.02). In conclusion, persistent tear instability and corneal epitheliopathy were found even at several months or more after cataract surgery. This study demonstrates the importance of evaluating ocular surface conditions in pseudophakic patients, even if they lack DE symptoms.
Highlights
Dry eye disease (DED) is a multifactorial disease of the tears and ocular surface that affects patients’ ocular and general health, well-being, and quality of life [1]
* Spearman correlation coefficients between subjective symptoms and objective signs. In this hospital-based observational study, we investigated the association between ocular surface dysfunction and the chronic effect of postcataract surgery
The present study suggested that there is a distinct difference between dry eye symptoms and clinical test results for ocular surface abnormalities in bilateral pseudophakic patients, even after a relatively long postoperative period
Summary
Dry eye disease (DED) is a multifactorial disease of the tears and ocular surface that affects patients’ ocular and general health, well-being, and quality of life [1]. Given the considerable growth in the global aging population, there is an increased awareness of the increased risk of DED after cataract surgery [3,4,5,6,7,8,9,10], which is one of the most frequently performed surgeries in elderly people [11]. One study found that over 60% of patients who underwent cataract surgery had a short tear break-up time (TBUT), while 76% demonstrated corneal epitheliopathy [12]. Another study showed a marked shortage of goblet cells and microvilli in damaged conjunctival epithelia after cataract surgery [4]. Miyake and his group reported a significant increase in corneal staining scores and a decrease in TBUT at one month postoperatively [10]
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