Short-term changes in ocular surface signs and symptoms after phacoemulsification

Area of Science:

• Ophthalmology
• Corneal disease
• Cataract surgery

Background:

• Cataract surgery is a common procedure.
• Postoperative ocular surface changes, including dry eye and superficial punctate keratopathy (SPK), can occur.
• Understanding the incidence and progression of these changes is crucial for patient management.

Purpose of the Study:

• To evaluate the incidence, natural course, and distribution pattern of SPK after cataract surgery.
• To describe the changes in dry eye signs and symptoms post-surgery.

Main Methods:

• Prospective interventional study involving 55 patients undergoing phacoemulsification.
• Preoperative and postoperative assessments (1 day, 1 week, 1 month) included tear break-up time, Schirmer test I, tear meniscus height, Ocular Surface Disease Index (OSDI), and fluorescein staining.
• Patients were grouped based on SPK development at 1 day postoperatively.

Main Results:

• A high incidence (76.3%) of SPK was observed 24 hours post-surgery, predominantly in the central cornea, shifting to the inferior quadrant by 1 month.
• All dry eye tests significantly worsened postoperatively.
• OSDI scores increased, tear break-up time decreased, and Schirmer test I values were lower post-surgery compared to baseline.

Conclusions:

• Phacoemulsification commonly induces transient ocular surface impairment, evidenced by both clinical signs and patient-reported symptoms.
• SPK exhibits a distinct pattern of distribution that evolves over the postoperative period.
• Patients with pre-existing ocular surface alterations are more susceptible to developing and experiencing prolonged dry eye disease after surgery.