MEIBOMIAN GLAND DYSFUNCTION AFTER PHACOEMULSIFICATION

Purpose: Comparison of signs of dry eye due to meibomian gland dysfunction pre and post surgery by  TBUT , Schirmer’s test , Oxford fluorescein grade and Salisbury questionnaire . Materials and Methods: We conducted a prospective study at a tertiary care hospital. 90 patients to be undergoing cataract surgery were included. Informed consent was obtained from all patients after explaining the purpose, possible results and consequences of the study. Patients were included from tertiary hospital having cataract and planning to undergo cataract      surgery.Following tests TBUT , Schirmer’s test , Oxford fluorescein grade and Salisbury questionnaire were done with informed consent both before , 1 week and 4 weeks after the  surgery. Comparative analysis was done. Results: Tear film breakup time(seconds) in pre-operative was significantly reduced at post-operative 1 week and post-operative 4 weeks .   Schirmer's test(mm) at pre-operative was significantly reduced at post-operative 1 week and post-operative 4 weeks .Proportion of patients with lid margin thickening:- thickened margins was significantly higher in post-operative 1 week and post-operative 4 weeks as compared to pre-operative. MG capping present was significantly higher in post-operative 4 weeks as compared to pre-operative. Distribution of Dew's severity grading was comparable between pre-operative and post-operative 4 weeks. Conclusion: The high prevalence of dry eye symptoms after cataract surgery necessitates the need to evaluate it both pre and post operatively. Phacoemulsification alters function of meibomian gland thereby causing dry eye symptoms and ocular discomfort post operatively. In our study, the aggravation of dry eye due to obstructive MGD was revealed for a short interval of time postoperatively. Aggressive management of dry eye due to MGD with tear substitutes , antiinflammatory and antibiotics is effective in reducing symptoms of dry eye before and after cataract surgery. To achieve optimum patient compliance and qualify of life post-operatively, screening of dry eye should be made a part of the protocol for pre operative evaluations.