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Kim, Kim, and Yang: Change of the Tear Film Instability and Subjective Symptoms after Small-Incision Cataract Surgery
Original Article
Journal of the Korean Ophthalmological Society

Journal of the Korean Ophthalmological Society 2012; 53(9): 1269-1275.

Published online: 17 September 2012

DOI: https://doi.org/10.3341/jkos.2012.53.9.1269

Change of the Tear Film Instability and Subjective Symptoms after Small-Incision Cataract Surgery

Eei Yon Kim, MD1, Min Ho Kim, MD2, Hong Seok Yang, MD, PhD2

1Department of Ophthalmology, Dongsuwon General Hospital, Suwon, Korea.

2Department of Ophthalmology, Ajou University School of Medicine, Suwon, Korea.

Address reprint requests to Hong Seok Yang, MD, PhD. Department of Ophthalmology, Ajou University Hospital, #164 Worldcup-ro, Yeongtong-gu, Suwon 443-721, Korea. Tel: 82-31-219-5671, Fax: 82-31-219-5909, yhs0816@naver.com

Received 4 October 2011       Accepted 21 July 2012

Copyright © 2012 The Korean Ophthalmological Society

Abstract

Purpose

To investigate corneal surface changes and subjective symptoms after small incision cataract surgery and to compare the changes between clear corneal incision and corneoscleral incision.

Methods

The present prospective randomized study included 18 eyes of 18 patients with corneoscleral incision (Group 1) and 25 eyes of 25 patients with clear corneal incision (Group 2). All patients were examined for tear break-up time (BUT), Schirmer test, cornea and conjunctiva fluorescein staining, and dry eye symptoms using the Ocular Surface Disease Index (OSDI). All values were compared before surgery and at one day, one week, four weeks, and seven weeks after surgery.

Results

BUT decreased significantly (p < 0.05) and fluorescein staining scores increased significantly (p < 0.05) at postoperative day 1. The values of BUT and fluorescein staining returned to the preoperative level at postoperative week 3 in Group 1. In Group 2, fluorescein staining scores returned at one week and BUT returned to the preoperative level at postoperative week 3. Postoperative Schirmer test results were unchanged compared to preoperative values, and there was no difference between the two groups. OSDI scores significantly improved compared to preoperative scores at postoperative one week. In Group 1, the scores improved at postoperative one week (p < 0.05) compared to those in Group 2 at postoperative three weeks (p < 0.05).

Conclusions

Phacoemulsification with a small incision induced transient corneal surface changes and tear film instability, but the changes returned to the preoperative level at postoperative three weeks. Dry eye symptoms also improved at postoperative one week. The changes lasted longer with clear corneal incision than with corneoscleral incision but returned to the preoperative level at postoperative three weeks in both groups.

Keywords: Cataract, Dry eye disease, Ocular surface disease index, Tear film stability

Figures and Tables

Table 1
Demographics of patients
jkos-53-1269-i001

Values are presented as number or mean ± SD.

*Corneoscleral incision; †Clear corneal incision.

Table 2
Tear break-up time before and after cataract surgery (sec)
jkos-53-1269-i002

Values are presented as mean ± SD.

TBUT = tear break-up time.

*Versus before surgery. The differences of the tear break-up time between the two groups were statistically significant postoperative 3 weeks (p = 0.014); †Corneoscleral incision; ‡Clear corneal incision.

Table 3
Degree of fluorescein staining before and after cataract surgery
jkos-53-1269-i003

Values are presented as mean ± SD.

*Versus before surgery. Differences of the fluorescein staining between the two groups were not statistically significant at any time; †Corneoscleral incision; ‡Clear corneal incision.

Table 4
Schirmer test before and after cataract surgery (mm/5 min)
jkos-53-1269-i004

Values are presented as mean ± SD.

*Versus before surgery. The differences of the Schirmer test between the two groups were not statistically significant at any time; †Corneoscleral incision; ‡Clear corneal incision.

Table 5
Ocular surface disease index (OSDI) before and after cataract surgery
jkos-53-1269-i005

Values are presented as mean ± SD.

*Versus before surgery. The differences of the OSDI between the two groups were not statistically significant at any time; †Corneoscleral incision; ‡Clear corneal incision.

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