gms | German Medical Science

Background: Symptoms due to dry eye are often seen after cataract surgery. We investigate the influence of cataract surgery on tear film stability of the ocular surface.

Material and method: 82 eyes of 60 patients who underwent cataract surgery were included in a prospective study in 2017 at the Eye Hospital in Hanoi (Vietnam). The phacoemulsification was performed under topical anaesthesia by clear corneal incision and implantation of an foldable IOL. The parameters for the evaluation of the change of the tear film included subjective patient data using the OSDI-questionnaire, findings of the Schirmer I test, the tear breakup time (TBUT) as well as the tear meniscus height (TMH) measured with the Keratograph 5M (Oculus). Data was collected preoperatively, at 1 week, 1 month and 3 months postoperatively.

Results: The mean age of the patients was 64.83 ± 9.9 years, 76.6% were older than 60 years. The male-to-female ratio was split evenly at 30 each. 1 week after surgery, the total score according to OSDI was significantly increased with a total value of 14.43 ±4.3 (p=0.001). Schirmer I was 15.7mm preoperatively and decreased significantly in the first postoperative week to 13.99 mm (p=0.001), before reaching the preoperative level again after 3 months. TBUT was 12.51 sec preoperatively, decreased significantly to 9.67 sec during the 1^st postoperative week, and normalized to 12.34 sec by the end of the 3^rd month. The meniscus height was 0.250 mm preoperatively, significantly lowered to 0.235 mm in the 1^st postoperative period and nearly normalized in the 3^rd postoperative month to 0.246 mm. In the first postoperative week, the rate of dry eyes was observed in 28% of patients. At 1 month, it was 9.76% and at 3 months, it was no longer demonstrable in any patient.

Conclusion: Almost one in three patients experienced dry eyes after cataract surgery. The symptoms lasted up to 3 months. This should be taken into account preoperatively and an appropriate therapy should be planned.