Dry Eye After Clear Cornea Phacoemulsification
Peter Mark G. Chao, MD1 and Ruben Lim-Bon-Siong, MD
Objective: To determine the incidence of dry eye in patients undergoing clear cornea phacoemulsification and to investigate its effects on dry eye symptoms and tear function.
Methods: This was a single-center, prospective, non-randomized study involving forty-nine (49) eyes from fortyfour (44) patients without preoperative dry eye, who underwent clear cornea phacoemulsification for age-related cataract. Main outcome measures were subjective grading of ocular discomfort, ocular surface disease index (OSDI), fluorescein tear break-up time (FTBUT), and Schirmer tests without anesthesia and with anesthesia. They were measured before surgery and 1 week, 1 month, and 3 months after surgery.
Results: None of the patients qualified for the definition of dry eye disease before and after clear cornea
phacoemulsification. Preoperative FTBUT (14.01 ± 0.56 seconds) decreased at 1 week (3.97 ± 0.21 seconds;
p<0.001) and at 1 month (5.82 ± 0.32 seconds; p<0.001) after the surgery and gradually improved by 3 months (8.26 ± 0.54 seconds; p<0.001) after surgery. Preoperative Schirmer test without anesthesia (18.78 ± 1.17 mm) decreased at 1 week (14.02 ± 1.52 mm; p<0.001) and subsequently recovered by 3 months (16.31 ± 1.34 mm; p>0.05). Preoperative Schirmer test with anesthesia (14.24 ± 0.94 mm) decreased at 1 week (11.98 ± 1.00 mm; p=0.046) after surgery and went back to baseline levels by 3 months (13.80 ± 1.12 mm; p>0.05).
Conclusion: Patients without dry eye disease, who underwent clear cornea phacoemulsification, did not develop dry eye disease after the surgery. Temporary reduction in physiologic tear levels seen one week postsurgery gradually returned to near-normal baseline levels by the third postoperative month.
Keywords: Dry Eye, Cataract Surgery, Phacoemulsification, Dysfunctional Tear Syndrome, Tear Film, Tear BreakUp Time.