ESCRS - PP18.06 - Why Do Post Phaco Patients Cry – Out Of Happiness Or Dry Eye Syndrome?

Why Do Post Phaco Patients Cry – Out Of Happiness Or Dry Eye Syndrome?

Published 2022 - 40th Congress of the ESCRS

Reference: PP18.06 | Type: Free paper | DOI: 10.82333/drve-5a73

Authors: Armin Kasumović 1 , Ante Prpić* 1 , Ognjen Zrinšćak 1 , Renata Iveković 1 , Zoran Vatavuk 1

1Ophthalmology,KBC Sestre Milosrdnice,Zagreb,Croatia

Purpose

To assess the tear film changes before and after cataract phacoemulsification. 

Setting

This longitudinal study was conducted at University Department of Ophthalmology, University Hospital Center "Sestre milosrdnice“ Zagreb, Croatia, between October 2021 and March 2022. 

Methods

Study included 50 eyes. All eyes underwent one daily measurement before cataract surgery and three daily measurements 7 days, 1 month and 3 months after. Schirmer test I, tear breakup time (TBUT) and tear meniscus measured by anterior segment optical coherent tomography (Optovue Avanti Widefield AS-OCT) were performed. All patients were given standard anti-inflammatory postoperative therapy for three weeks. Patients who had an unstable tear film or poor Schirmer test scores (<5 mm) or reduced tear meniscus score on AS-OCT, compared to preoperative imaging, were instructed to apply preservative-free artificial tears. Patients who had no tear film disturbances did not drip preservative-free artificial tears. 

Results

Statistically significant lower TBUT values ​​were found 7 days after surgery, while Schrimer test values showed no statistical significance. Statistically significant lower values of tear meniscus thickness were found by AS-OCT caliper measurement 7 days after cataract surgery. The group of patients who dripped artificial tears without preservatives showed a statistically significant improvement in all measured parameters while in the group of patients who did not drip artificial tears no statistically significant difference was found. Group of patients dripping artificial tears showed statistically significant improvement 3 months after cataract surgery compared to preoperative values ​​and values ​​measured one week after surgery. 

Conclusions

Phacoemulsification leads to deterioration and instability of the tear film which can be monitored in changes in TBUT and tear meniscus thickness on AS-OCT. Preservative-free artificial tear drips are recommended postoperatively for patients with unstable tear film, while patients with regular values ​​of measured parameters do not need the therapy.