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Changes in ocular surface status after phacoemulsification in patients with senile cataract

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Abstract

Aim

To evaluate the signs and symptoms of dry eye after phacoemulsification; effects on the status of ocular surface using impression cytology; and associated risk factors.

Methods

Prospective study included 50 eyes (50 patients) with no dry eye signs or symptoms, who underwent clear corneal phacoemulsification for senile cataract. Dry eye indices used included Ocular Surface Disease Index scoring, Schirmer I test, tear break up time, tear meniscus height, corneal fluorescein staining, lissamine green staining and goblet cell density (GCD) with the help of impression cytology. Primary outcome measures included post-operative changes in the dry eye indices. Secondary outcome measures included correlation of the dry eye signs and symptoms with various risk factors.

Results

Aggravation of both the signs and symptoms of dry eye were noted in immediate post-operative period. The sharp deterioration was followed by a recovering trend towards the end of sixth week. A decrease in GCD was also noted. Risk factors for deterioration include age, duration of exposure to microscope light and effective phacoemulsification time. Diabetic status, socio-economic status and site of incision did not have any effect on dry eye status.

Conclusion

There is a transient deterioration of “dry eye” status post-phacoemulsification. The patients should be carefully counselled about the evanescent nature of the disease. Incision can be given at the site of high corneal curvature to neutralize astigmatism without any fear of inducing dry eye. Minimum light exposure and ultrasound energy should be used during the surgery.

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Correspondence to Piyush Kohli.

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All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements) or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Kohli, P., Arya, S.K., Raj, A. et al. Changes in ocular surface status after phacoemulsification in patients with senile cataract. Int Ophthalmol 39, 1345–1353 (2019). https://doi.org/10.1007/s10792-018-0953-8

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  • DOI: https://doi.org/10.1007/s10792-018-0953-8

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