Abstract
Background Symptoms due to dry eye in the form of keratoconjunctivitis sicca (KCS) are often
seen after cataract surgery. We investigated the influence of cataract surgery on
tear film stability on the ocular surface.
Material and Methods 60 eyes of 60 patients who underwent cataract surgery were included in a prospective
study in 2017 at the Eye Hospital in Hanoi (Vietnam National Institute of Ophthalmology).
The mean age of the patients was 65 ± 10 years. The phacoemulsification was performed
under topical anaesthesia by a clear corneal incision and implantation of a foldable
IOL. The parameters for the evaluation of the change of the tear film included subjective
patient data using the Ocular Surface Disease Index questionnaire (OSDI), findings
of the Schirmer I test, the tear break-up time (TBUT) as well as the tear meniscus
height (TMH) measured noninvasively with the Keratograph 5M (Oculus). In addition,
conjunctival and corneal changes were examined after vital staining with fluorescein
for the cornea and rose bengal for the conjunctiva. Data were collected preoperatively,
at 1 week, 1 month and 3 months postoperatively. According to DEWS, the disease is
classified into
4 groups: mild, moderate, severe and very severe.
Results One week after surgery, the total score according to OSDI was significantly increased
with a total value of 14.4 ± 4.2 (p = 0.001). Schirmer I was 15.8 ± 4.3 mm preoperatively
and decreased significantly in the first postoperative week (p = 0.001), before reaching
the preoperative level again after three months. TBUT was 12.6 ± 1.5 s preoperatively,
decreased significantly to 9.7 ± 1.5 s during the first postoperative week, and normalized
to 12.4 ± 1.3 s by the end of the third month. The meniscus height was 0.245 ± 0.055 mm
preoperatively, significantly lowered to 0.229 ± 0.057 mm in the first postoperative
period and nearly normalised by the third postoperative month to 0.241 ± 0.051 mm.
In the first postoperative week, the rate of mild KCS was observed in 30% of patients.
At one month, this decreased to 10% and at three months was no longer demonstrable
in any patient.
Conclusion One of three patients experienced mild KCS after cataract surgery. The symptoms lasted
up to three months. This should be taken into account preoperatively and appropriate
therapy should be planned.
Key words
cornea dry eye disease DED - keratoconjunctivitis sicca - KCS - cornea - cataract
surgery
