Investigation of Dry Eye Disease and Analysis of the Pathogenic Factors in Patients after Cataract Surgery

Abstract

Dry eye can develop or deteriorate after cataract surgery if not treated in time. Misuse of eyedrops is one of the major pathogenic factors that causes dry eye after cataract surgery. Eyedrops should be carefully administered before and after cataract surgery to avoid or reduce the occurrence of dry eye postoperatively.

The effect of preservative-free HP-Guar on dry eye after phacoemulsification: a flow cytometric study

“…Inflammation of the ocular surface can occur after surgery and drugs, the latter producing toxic changes in the cornea and conjunctiva due to the existence of preservatives, particularly benzalkonium chloride. 12 A corneal incision, notwithstanding its small size, can cause certain corneal irregularities, favouring tear film ruptures. Moreover, an alteration in central corneal sensitivity has been found in patients who have undergone cataract surgery, 30 secondary to the corneal nerve section, which may potentially disrupt the neural loop, reducing tear secretion by the lacrimal gland.…”

“…Effective treatment, such as artificial tears or lacrimal plugs, has been recommended in dry eye patients after phacoemulsification. 12 Hydroxypropyl (HP)-Guar (Systane UD, Alcon Cusí, Spain) are preservative-free artificial tears with proven efficacy in dry eye patients, improving tear film break-up time (TBUT), 13 corneal staining, 14 corneal permeability, 15 and patients' symptoms. 13 Flow cytometry (FCM) is a widely used technique for investigating ocular surface biology and pathophysiology.…”

Evaluation of dry eye-associated symptoms and signs after microincision cataract surgery

“…Despite microincision size which causes less damage to corneal nerves than large incision, increase of dry eye-associated symptoms and signs have indicated that the incision size is not the only mechanism of aggravation of dry eye-associated symptoms. The mechanism for the exacerbation of ocular surface damage likely includes several factors: increased inflammatory mediators due to postoperative inflammation, misuse of eye drops, toxicity from the use of benzalkonium chloride containing eye drops, decrease in corneal sensitivity which is resulted in reduced tear production, and exposure to light from the operating microscope [1][2][3][4].…”

“…Despite good visual results after surgery, dissatisfaction of patients might reduce surgical success. Some studies have reported aggravation of dry eye symptoms and signs after cataract surgery [1,2]. Many factors, such as topical anesthesia and eye drops containing preservatives like benzalkonium chloride, surgical incision types, exposure to light from operating microscope, disrupt to normal organization of the corneal innervation, might affect the ocular surface environment after cataract surgery [3][4][5].…”

A clinical study to evaluate incidence of dry eye following cataract surgery

“…[4][5][6] The dry eye occurring after cataract surgery is hypothesized to be due to the changes in the ocular surface due to the surgical trauma and post operative inflammation. 7 However despite cataract surgery being so common, large studies on post cataract surgery dry eye are scarce and symptoms attributable to dry eye are not specifically documented. After cataract surgery many patients complain of foreign body sensation, irritation, redness and blurring of vision which are considered as unwanted effects of the surgery.…”