Observation of Influence of Cataract Surgery on the Ocular Surface

Abstract

IntroductionTo evaluate meibomian gland function, changes of lacrimal tears and ocular surface parameters and tear inflammatory mediators following cataract surgery.Methods48 eyes of 34 patients who underwent uncomplicated phacoemulsification were involved and divided into 2 groups with those who had preexisting dry-eye before cataract surgery and those who did not. Ocular symptom score, Schirmer I test, tear film break-up time (TBUT), corneal sensitivity threshold, corneal staining, inflammatory cytokine activities, lid margin abnormalities, meibum expressibility, meibum quality and meibomian gland imaging were evaluated preoperatively, at 1 day, 1 and 2 months postoperatively.ResultsOcular symptom scores were worse at 1 and 2 months postoperatively but, TBUT, corneal staining score and corneal sensitivity threshold showed gradual improvements at 1 month and 2 months postoperatively (p<0.05, respectively). Interestingly there were statistically significant improvements in TBUT, corneal staining score and corneal sensitivity threshold at 1 month postoperatively when topical eye drops were used compared to the period without topical therapy which is the months 2 postoperatively. There were statistically significant decreases in IL-1β, IL-6, IL-8, MCP-1, TNF-α and IFN-γ concentrations at 1 and 2 months postoperatively. Lid margin abnormalities, meibum quality and expressibility scores increased significantly (p < 0.05, respectively) at postoperative period. Compared with the no dry eye group, dry eye group revealed significantly higher ocular symptom scores, lower TBUT, higher lid margin abnormalities, meibum quality and expressibility scores after cataract surgery. There were significant correlations between IL-6 and parameters of dry eye, and between MGD parameters and ocular symptom scores.ConclusionsOur study revealed that meibomian gland function is influenced after cataract surgery accompanying structural changes and these were correlated with increased ocular symptom scores. Therefore, it could elucidate the development of dry eye related to cataract surgery.

Efficacy and Safety of Topical 3% Diquafosol Ophthalmic Solution for the Treatment of Multifactorial Dry Eye Disease: Meta-Analysis of Randomized Clinical Trials

“…In a trial of TFBUT for 2 months after cataract surgery, the TFBUT was significantly reduced after cataract surgery [27]. A link between dry eye and cataract surgery has been reported in the literature.…”

“…A link between dry eye and cataract surgery has been reported in the literature. Park et al [27] evaluated meibomian gland dysfunction, changes in lacrimal tears and ocular surface parameters, and ocular inflammation mediators after cataract surgery. Some studies also reported that meibomian gland dysfunction was worse after cataract surgery, which can lead to dry eye [27, 28].…”

“…Park et al [27] evaluated meibomian gland dysfunction, changes in lacrimal tears and ocular surface parameters, and ocular inflammation mediators after cataract surgery. Some studies also reported that meibomian gland dysfunction was worse after cataract surgery, which can lead to dry eye [27, 28]. Aggravation of meibomian gland dysfunction may be due to chronic meibomian gland dysfunction rather than to the short-term effect of cataract surgery [28].…”

Dry eye disease and oxidative stress

“…Preservatives (such as BAK) used in postoperative eyedrops can increase ocular surface oxidative stress, and meibomian gland function is also affected (Park et al. ). Surgical stress can induce inflammation and ROS formation, and surgical‐induced inflammation can also produce ROS (Fig.…”

“…Clear cornel incisions can damage the corneal nerves and result in decreased corneal sensitivity, which results in less tear produced via the lacrimal functional unit (Sitompul et al 2008). Preservatives (such as BAK) used in postoperative eyedrops can increase ocular surface oxidative stress, and meibomian gland function is also affected (Park et al 2016). Surgical stress can induce inflammation and ROS formation, and surgical-induced inflammation can also produce ROS (Fig.…”