Evaluation of Tear Film Status Before and After Phaco Surgery

Background: Corneal surgery has been identified as one of the risk factors for the development of dry eye disease by decreasing corneal sensation and changing the contour of the ocular surface as a result of the inflammation caused by surgical trauma. Clear cornea phacoemulsification may also alter the ocular surface and disrupts normal tear function in eyes.

Objective: To evaluate the difference of the tear film status before and after phaco surgery.

Materials and methods: This prospective longitudinal observational study was conducted in Department of Ophthalmology, Dhaka Medical College and Hospital, Dhaka, during the period of July 2018 to June 2019. Total 50 patients who were undergone phacoemulsification cataract surgery. All patients under study had gone under detailed history, systemic and preliminary ocular examination. For evaluation of tear film breakup time (TBUT) and Schirmer 1, 2 test were done pre-operatively and post operatively.

Results: TBUT (Tear film break up time) was 12.60±1.97 sec in before period phacoemulsification, day one after phacoemulsification was 12.70±1.85 sec, one week after phacoemulsification was 13.06±2.40 sec, one month after phacoemulsification was 13.30±2.92 sec and three months after phacpemulsification was 13.72±2.68 sec. Schirmer test 1 was 15.36±4.96 mm in before period phacoemulsification, day one after phacoemulsification was 19.60±9.55 mm, one week after phacoemulsification was 17.38±5.33 mm, one month after phacoemulsification was 16.76±3.97 mm and three months after phacpemulsification was 16.24±3.49 mm. Schirmer test 2 was 13.20±5.21 mm in before period phacoemulsification, day one after phacoemulsification was 16.16±4.99 mm, one week after phacoemulsification was 15.02±3.94 mm, one month after phacoemulsification was 14.28±3.99 mm and three months after phacpemulsification was 13.66±3.81 mm. The changes in TBUT were statistically not significant (p value >0.05) but Schirmer test 1 and 2 were statistically significant (p value <0.05) in the post-operative periods.

Conclusion: It concluded that phaco surgery is safe and associated with minimal complications in patients with dry eye. So all the patients should be evaluated before and after phaco surgery to prevent and manage dry eye effectively so that the patient will have good quality of life and vision.

Key word : Tear Film, Phaco Surgery, Tear film break up time,