Tear film changes after cataract surgery: manual small-incision cataract surgery versus phacoemulsification

Abstract

Aim The aim was to identify if the type of surgical procedure has any bearing on dry eye syndrome and to find out the duration of postsurgical recovery of dryness in small-incision cataract surgery and phacoemulsification. Patients and methods A prospective randomized study was conducted on 100 patients of cataract. Group A had 50 patients who underwent small-incision cataract surgery, and group B included 50 patients who underwent phacoemulsification. Patients with pre-existing ocular surface disease, for example, known case of glaucoma; taking topical antiglaucoma drugs; lid disorders; and grade 5 cataract (hard cataract in which it is difficult to do phacoemulsification) were excluded. Dry eye workup included Schirmer’s I, basic secretion test, tear film breakup time, and corneal sensation. The workup was done preoperatively and then on seventh, 21st, and 90th day postoperatively. The values were compared in the group itself and in-between the two groups. Results In groups A and B, there was significant difference in the preoperative values of Schirmer’s I test, basic secretion test, and tear breakup time (TBUT) as compared with day 7 and day 21 postoperative values (P 0.05). There was significant difference in the Schirmer’s I test and basic secretion test values after 21 days of surgery between the groups (P 0.05). Conclusion Cataract surgery can cause or aggravate dry eye and affect the dry eye test values in the postoperative period up to 3 months. This holds true for both manual small-incision cataract surgery and phacoemulsification surgery. Therefore before surgery, patients must be informed about the possible aggravation of dry eye symptoms, and artificial tears should be prescribed for attenuating corneal damage and dry eye symptoms.