JOURNAL OF EVIDENCE BASED MEDICINE AND HEALTHCARE

Table of Contents

2019 Month : August Volume : 6 Issue : 31 Page : 2126-2129

TO ASSESS THE PROPORTION AND SEVERITY OF DRY EYE FOLLOWING CLEAR CORNEA PHACOEMULSIFICATION SURGERY

Udayaditya Mukhopadhyay1, Mahesh Chattopadhyay2, Sukanta Baidya3

Corresponding Author:
Dr. Mahesh Chattopadhyay,
C/o. Dr. Udayaditya Mukhopadhyay,
CD 182, Salt Lake City,
Kolkata- 700064, West Bengal.
E-mail: baidya1984@gmail.com
DOI: 10.18410/jebmh/2019/433

ABSTRACT
BACKGROUND
Dry eye is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film. Corneal nerves are important in the self-regulation of a tear since they provide the sensation in the feedback loop that signals tear production. In clear corneal phacoemulsification surgeries, the ocular surface may alter and disrupt normal tear function. We wanted to determine the proportion and severity of dry eye following clear corneal phacoemulsification surgery.

METHODS
Total hundred (100) eyes from consecutive hundred (100) patients fulfilling the inclusion criteria (without a pre-operative dry eye) were selected for clear corneal phacoemulsification surgery under peribulbar anaesthesia for age-related cataract (45-70 yrs.). McMonnies questionnaire was used for subjective dry eye testing. For objective dry eye testing Schirmer Test (ST-I), Tear Film Break Up Time (TBUT), Tear Meniscus Height (TMH) and Lissamine Green (LG) done. The parameters were recorded pre-operatively and post-operatively. Data was analysed using SPSS Software Version 20.

RESULTS
53% operated in the left eye and 47% in the right eye. The proportion of dry eye was assessed at POD 10 and we found 81 subjects had dry eye. The mean and standard deviation of McMonnies 1, 2, 3 were 5.21±2.143, 16.21±6.312, 5.26 ± 2.517; ST-I were 22.21±4.536, 8.06±4.401, 8.89±4.739, 16.40±6.615, 21.35±4.059 at 2 days preoperative, 5 days, 10 days, 1 month, 2 months postoperatively & TBUT was 17.52±2.918, 8.11±4.070, 9.60±3.676, 12.91±2.357, 17.19±1.942 at POD 2, POD 5, POD 10, 1 month, 2 months postoperatively. The mean and standard deviation of TMH were .93±0.256, 0.1±0.1, 0.01±0.1, 0.13±0.338, 0.95±0.219 at 2 days preoperative, 5 days, 10 days, 1 month and 2 months postoperatively. The mean and SD of LG staining of cornea and conjunctiva by Oxford grading was 0.00±0.00, 1.30±0.798, 1.27±0.777, 0.79±0.409, 0.00±0.00 at POD 2, 5 days, 10 days, 1 month and 2 months postoperatively. 48.65% had a dry eye in the age group 45-58 years and 100% had in the age group 59-70. At postoperative 1-month ST-I, TBUT results became normal and TMH, LG staining score showed a rising trend towards a normal level. But at 2 months all the subjects showed normal dry eye parameters.

CONCLUSIONS
Significant percentage of patients showing dry eye symptoms immediately after phacoemulsification surgery. Older age group (≥ 59 years) were more susceptible.

KEYWORDS
Dry Eye, Phacoemulsification, Schirmer Test-I (ST-1), Tear Break Up Test (TBUT), Tear Meniscus Height (TMH), Lissamine Green (LG) Stain of Cornea, Conjunctiva