Incidence and severity of dry eye following phacoemulsification cataract surgery and its relation to intraoperative risk factors

Introduction: With recent advances in cataract and refractive surgeries, dry eye in the postoperative period has been implicated as the most important obstacle to patient's satisfaction despite an excellent visual recovery. Aims and Objectives: To study the incidence and severity of dry eye following phacoemulsification surgery and to analyze its relation to intraoperative risk factors. Methods: A prospective observational study in a convenient sample of patients without preoperative dry eye, posted for phacoemulsification cataract surgery at a tertiary teaching hospital from June 2019 to May 2020. Following phacoemulsification. Schirmer test 1, tear breakup time, tear meniscus height, lissamine green staining of cornea and conjunctiva and dry eye symptoms by Ocular Surface Disease Index were examined preoperatively and postoperatively. Results: Incidence of dry eye following phacoemulsification cataract surgery among 50 patients was found to be 38% at 7 th postoperative day, it decreased to 8% at 1 month postoperatively and no dry was detected at postoperative 2 months. There was a significant deterioration of all dry eye test values following phacoemulsification surgery along with an increase in subjective symptoms. These values started improving after 1 month postoperatively. Postoperative dry eye incidence was significantly associated with intraoperative risk factors, effective phacoemulsification time, and Microscopic light exposure time. Conclusion: There is a transient deterioration of “dry eye” status postphacoemulsification. The patient must be informed about the possible development of dry eye disease and surgeon should allow minimum light exposure, ultrasound energy, and saline irrigation during surgery.