OCULAR SURFACE AND TEAR FILM CHANGES AFTER MANUAL SMALL INCISION CATARACT SURGERY

Abstract

BACKGROUND: Manual small incision cataract surgery (MSICS) continues to be the mainstay of cataract surgeries in developing countries like India. Dry eye related symptoms like constant foreign body sensation, ocular surface discomfort, redness, watering are frequent phenomenon after cataract surgery. SICS may worsen lid margin anatomy, cause corneal denervation, cause reduction in number of Goblet cells and perpetuate tear lm instabilities of a patient's eye after surgery. To analyzeOBJECTIVE: changes in tear lm indices after SICS This is a prospective observational study of 12 months duration from April 2020 toSTUDY DESIGN: March 2021 done on 110 different patients undergoing cataract surgery 45-70 years age group by MSICS method . 110 (48 male,METHODS: 62 female) patients who underwent MSICS during the aforementioned period were selected for the study. Tear Meniscus Height (TMH), Schirmer's Test 1(ST1), Tear Film Break Up Time (TBUT) evaluation was done 1 day preoperatively, 1 week, 1 month and 3 month post operatively and the values were noted. Collected data was analyzed by paired t test using MS EXCEL and SPSS V23. The mean ageRESULTS: of the 110 patients was 60.21years. The mean preoperative values of the tear lm indices ST1, TBUT, TMH were found to be respectively 19.15 ± 8.59 mm, 16.70 ± 5.27 seconds, 0.39 ± .13 mm. 1 month and 3 month post operatively mean ST1 values were found to be 14.89 ± 6.15 and 14.40 ± 5.48 mm; mean TBUT values were 13.37 ± 4.76 and 12.93 ± 4.74 seconds; mean TMH was found to be 0.30 ± 0.10 and 0.29 ± 0.09. The progressive deterioration of tear lm indices over our study period was found to be statistically signicant. SICS causesCONCLUSION: signicant deterioration of tear lm indices and perpetuates ocular surface discomfort and dry eye disease post operatively. Operating surgeons must pay attention to dry eye signs, symptoms post operatively even in a well operated healthy eye to ensure optimal post-operative comfort to the patient.