Assessment of the Tear Film Lipid Layer Thickness after Cataract Surgery

To evaluate changes in the tear film lipid layer thickness (LLT) after cataract surgery and the effects of cataract surgery on dry eye syndrome (DES) and meibomian gland dysfunction (MGD).

LLT measurements obtained using the LipiView interferometer, tear break-up time (TBUT) measurements, Schirmer's tests, Oxford staining scores, lid margin and meibomian gland findings, and the Ocular Surface Disease Index (OSDI) questionnaire scores were evaluated before and one and three months after cataract surgery.

Forty-three eyes (43 patients) were included. LLT was significantly thinner one month after surgery than at baseline (P = 0.004). TBUT was significantly shorter at both one (P < 0.001) and three (P < 0.001) months after surgery than at baseline. OSDI scores were significantly higher (P < 0.001) and the meibum quality was significantly poorer (P = 0.001) at one month after surgery than at baseline. TBUT was significantly and positively correlated with LLT (r = 0.29, P < 0.001), while the OSDI (r = -0.38, P < 0.001) and Oxford staining (r = -0.30, P = 0.001) scores and the meibum quality (r = -0.21, P = 0.01) were significantly and negatively correlated with LLT.

The tear film LLT was significantly thinner and DES and MGD parameters showed deterioration after cataract surgery. In addition, LLT was significantly correlated with DES and MGD parameters. These results suggest that clinicians should consider the tear film lipid layer while managing the exacerbation of DES after cataract surgery.