Novel Preoperative Tear Biomarkers As Predictors Of Postoperative Discomfort Following Phacoemulsification Surgery

To investigate the role of tear film biomarkers in predicting postoperative discomfort (such as pricking or grittiness) in patients achieving good visual outcomes after cataract surgery, aiming to identify predictive profiles to improve patient satisfaction.

 Tertiary eye care hospital in India

This prospective observational study analyzed tear film samples from 100 patients undergoing phacoemulsification. Patients were divided into two groups: Group 1 (n=50) reported no discomfort, and Group 2 (n=50) reported discomfort on postoperative day one. Tear samples were analyzed using a novel indigenous biomarker kit to measure Interleukin-1β (IL-1β), IL-6, IL-10, IL-17A, Tumor Necrosis Factor-alpha (TNF-α), Intercellular Adhesion Molecule (ICAM), and Vascular Endothelial Growth Factor-A (VEGF-A).

Patients experiencing postoperative discomfort (Group 2) showed significantly lower levels of IL-1β (p<0.01) compared to the asymptomatic group. Conversely, preoperative levels of IL-17A and TNF-α were significantly higher (p<0.01) in Group 2, suggesting a strong predictive value for these markers. While IL-6, IL-10, ICAM, and VEGF-A were elevated in the discomfort group, these specific increases did not reach statistical significance.

Specific tear biomarkers, particularly IL-1β, IL-17A, and TNF-α, are significantly associated with postoperative symptoms. This study, the first to use biomarker profiling for this purpose, suggests that preoperative screening can identify at-risk patients. Such a transformative approach allows for tailored preoperative treatments to mitigate ocular surface inflammation and enhance overall surgical outcomes and patient satisfaction.