A Comparative Study of Tear Film Parameters Before and After Small Incision Cataract Surgery and Phacoemulsification

Abstract

BACKGROUND Cataract surgery is the commonest eye surgery performed. Sutureless cataract surgery is the preferred method today. A clinically significant proportion of cataract surgery patients experience some degree of dry eye symptoms after surgery. Dry eye is highly prevalent, yet largely underdiagnosed condition that can substantially affect quality of life. The aim of the study is to compare changes in the tear film in patients undergoing small incision cataract surgery and phacoemulsification. MATERIALS AND METHODS The study included a total of 407 patients randomly divided into two groups. Group A had 202 patients in whom phacoemulsification was performed and group B had 205 patients in whom small incision cataract surgery was performed. Detailed ocular examination and tear film tests were done as per the protocol on each group, which included Tearfilm Meniscus Height (TMH), Schirmer's 1 and 2 (S1T and S2T), Tear Film Breakup Time (TBUT) and Rose Bengal Score (RBS) to get the baseline values. Patients were followed up after one week, one month and three months postoperatively and a detailed questionnaire regarding dry eye was asked at each visit. Tear film tests were also performed. RESULTS In individual groups (A and B), there was a significant difference seen between preoperative dry eye symptoms, Schirmer's 1 and 2, Rose Bengal score, tear film breakup time and tear film meniscus height from postoperative one week, one month and three months data. But, there was no significant difference noted between the two groups when compared to each other, except for tear meniscus height, which was significantly reduced from preoperative period (p=0.00). CONCLUSION We concluded that a trend toward baseline values was seen with time that is improvement of dry eye symptoms and tear film test values at consecutive followup in both groups. Nevertheless, the dry eye symptoms and tear film changes did not return to preoperative values in three months followup.

An Insight into the Role of Various Factors Involved in the Pathogenesis of Dry Eyes after Manual Small-incision Cataract Surgery: A Mini Review

“…These studies emphasize the irregularities of the tear film due to ocular surface damage after MSICS. [19][20][21][22] Sitompul et al gave an insight on sensitivity change in cornea and changes in the tear film of the ocular surface following cataract surgery. 23 Meibomian gland dysfunction as a causative factor for postoperative dry eye was also found in the literature.…”