Pre and postoperative comparative evaluation of tear film stability and conjunctival impression cytology after phacoemulsification using clear corneal temporal incision

Abstract

Abstract Introduction: Development of significant dry eye symptoms and visual disturbances after successful cataract surgery remains the common and unsatisfying experience for ophthalmologists. Corneal incision site and surgical technique contribute in ocular surface damage after cataract surgery. To assess the pre and post-operative conjunctival impression cytology and tear film stability after phacoemulsification by clear corneal temporal incision. Methodology: This prospective interventional study was conducted in department of ophthalmology at tertiary care teaching hospital. 72 patients were enrolled and the dry eye assessment was done considering the Schirmer’s test, tear meniscus height, tear breakup time and conjunctival impression cytology; preoperatively and then at 1 week and 4 weeks postoperatively. ANOVA and Post Hoc test were used for statistical analysis and p value of <0.05 was considered significant. Results: Mean age of the patients was 59.86±9.56 years and most of the males were employed while females were mostly homemakers. The overall trend for dry eye tests showed significant (P<0.0001 on ANOVA) increase at 1st week postoperatively, while the significant recovery was achieved by 4th week postoperatively. There was a significant decline (p<0.0001) in goblet cell density (GCD) at 1st week, which was reversed by the 4th week postoperatively. Conclusion: The transient dry eye was seen in the patient’s undergoing phacoemulsification by 1st week postoperatively, which resolved spontaneously but partially with routine postoperative care by the 4th week follow up.