Corneal Sensation and Tear Film Stability after Cataract Surgery with Temporal Clear Corneal Incision

Ku, Hee Chan; Lee, Young Chun; Kim, Hyun Seung

Abstract

PURPOSE
To evaluate the change of corneal sensitivity and tear film stability after phacoemulsification with a 3 mm-sized temporal clear corneal incision. METHODS: This study comprised 39 eyes of 30 patients having phacoemulsification with a 3 mm-sized temporal clear corneal incision. All patients were examined for corneal sensitivity, tear break-up time, Schirmer test, fluorescein staining for ocular surface, and ocular irritation symptoms. All values were compared before and at 1, 7, 30, 60, and 90 days after surgery. RESULTS: Central corneal sensitivity was measured 58.6 +/- 3.4 mm, preoperatively. Corneal sensitivities decreased in all areas at postoperative 1 day. Among these, the corneal center and temporal incision sites showed statistically significantly decreased sensitivity of 52.3 +/- 6.5 mm and 39.5 +/- 14.4 mm, respectively (P=.021, P<.001), and the corneal sensitivity of the dry eye group decreased more than that of the normal group(P<.05). All areas of the cornea showed a tendency of improved sensitivity after 7 postoperative days, and the sensitivity of the temporal area returned to the preoperative level at postoperative 2 months. Postoperative Schirmer test and tear break-up time were unchanged compared to preoperative values (P=.14, P=.11). However fluorescein staining scores for the ocular surface increased from 2.95 +/- 1.2 to 4.4 +/- 1.9 (P<.05), and ocular irritation symptoms increased through 1 week (P<.05). CONCLUSIONS: Phacoemulsification with 3 mm-sized clear corneal incision induced local hyposensitivity of the incision site but did not change the tear film stability. However, the patients undergoing cataract surgery temporarily developed ocular surface damage and irritation symptoms. Therefore observation and proper management are required.