Shantanu Bhattacharjee, Arvind Ram, S. K. Samim Ferdows, Durga Charan Pan, Ipshita Aparajita Nanda
BACKGROUND One of the most common clinical conditions in ophthalmology practice is dry eyes. It has been documented in various research studies that corneal surgeries including clear corneal Phacoemulsification plays a significant role in the development of dry eyes. This is largely attributable to the injuries suffered by the corneal nerves and corneal surface alteration. The purpose of the present study is to evaluate the development of dry eye disease after cataract surgery by Phacoemulsification and to study the temporal association of dry eyes and Phacoemulsification. MATERIALS AND METHODS The present study was a prospective, single centre, randomized one conducted in the department of Ophthalmology, IQ City Medical College, Durgapur, West Bengal from June 2016 to May 2017. A total of 50 patients were selected from the outpatient department who had undergone uncomplicated clear corneal Phacoemulsification due to senile cataract and who did not have preoperative dry eyes. Dry eye pattern was assessed by Ocular Surface Disease Index (OSDI) score, fluorescein staining and determination of Tear Break up Time (TBUT), corneal and conjunctival fluorescein staining score as per Oxford Schema, and Schirmer Test 1 without anaesthesia (S1T) - all performed in the above consecutive order. Comparison of data was done among mean OSDI score, mean TBUT time and mean ST1 values on 1st week, 4th week, and 12th week against preoperative values. RESULTS A total of 50 eyes of 50 patients were studied. The age group of the patients ranges from 45 years to 85 years. The mean age was 62 ± 10.357. Most of the cases (84%) had shown significant changes in S1T and TBUT values in the first week. Statistically significant difference in TBUT and OSDI score was noted at the end of 1st week. The values gradually recovered through 4th week and almost attained the preoperative values at the end of 12th week. The risk of developing dry eyes was found to be more pronounced in the elderly age group. CONCLUSION Phacoemulsification has emerged as the most preferred method of cataract surgery but ensuing dry eye disease though mostly transient in nature often goes unrecognized. Despite a technically perfect surgery and good visual outcome, often the success is jeopardized by the presence of ocular discomfort due to dry eye disease. In the absence of obvious modifiable risk factors, proper preoperative counseling of the patients regarding possible aggravation of dry eye symptoms, and treatment with tear supplements remain the mainstay of patient satisfaction.
