Incidence and pattern of dry eye after cataract surgery

Abstract

Purpose: To evaluate the incidence and severity pattern of dry eye after phacoemulsification.

Setting: King Chulalongkorn Memorial Hospital, Bangkok, Thailand.

Design: Prospective descriptive study.

Methods: Samples were collected from ninety-two uncomplicated cataract patients who were 18 years old or older. Dry eye incidence and pattern were analyzed at days 0, 7, 30 and 90 after phacoemulsification using (1) Ocular Surface Disease Index (OSDI) questionnaire, (2) tear break up time (TBUT), (3) Oxford ocular surface staining system, and (4) Schirmer I test without anesthesia.

Results: Seven days after phacoemulsification, the incidence of dry eye was 9.8% (95% confidence interval; 3.6-16.0%). The severity of dry eye peaked seven days post-phacoemulsification and was measured by OSDI questionnaire and all three clinical tests. Within thirty days and 3 months post-surgery, both the symptoms and signs showed rapid and gradual improvements, respectively. However, dry eye post-phacoemulsification was not significantly associated with sex and systemic hypertension (P = 0.26, 0.17 and 0.73, respectively).

Conclusions: The incidence of dry eye after phacoemulsification was 9.8%. Symptoms and signs of dry eye occurred as early as seven days post-phacoemulsification and the severity pattern improved over time. We recommend that ophthalmologists should evaluate patients both before and after phacoemulsification to prevent further damage to the ocular surface and able to manage the patient promptly and effectively so the patient will not have a poor quality of life and vision due to dry eye syndrome.

Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1. Percentage of patients with/without signs who reported OSDI symptoms.

The results between the presences of symptoms assessed by the OSDI questionnaire in combination with one of the clinical tests. Patients with OSDI symptoms often had decreased TBUT (77.78%) and abnormal Oxford Schema (88.89%) scores in contrast to Schirmer I test without anesthesia. According to the Schirmer I test without anesthesia, 88.89% had a normal test.

Figure 2. Pattern of dry eye after post-operation according to the OSDI scores.

The mean OSDI scores at day 7, months 1 and 3 after surgery were 33.87, 17.34 and 16.88 scores respectively.

Figure 3. Pattern of post-operative dry eye patients detected by TBUT.

Figure 4. Pattern of post-operative dry eye patients detected by Oxford ocular surface staining system.

Figure 5. Pattern of post-operative dry eye patients detected by Schirmer I without anesthesia.

The patterns of dry eye were similar between 3 clinical tests with OSDI questionnaire.