J Korean Ophthalmol Soc.  2011 Sep;52(9):1030-1038.

Changes in Clinical Manifestations of Dry Eye Syndrome after Cataract Surgery and the Affecting Factors

• Roh YR
• Lee SM
• Han YK
• Kim MK
• Wee WR
• Lee JH

Abstract

PURPOSE
To evaluate the changes in the clinical signs and symptoms of dry eye syndrome before and after cataract surgery according to the main incision location and the type of artificial tears.
METHODS
Twenty-four eyes of 17 patients who underwent phacoemulsification and posterior chamber lens insertion from May 2009 to July 2009 were enrolled in the present study prospectively. The main incision location (temporal or superior incision) was determined according to the axis of astigmatism and the postoperative artificial tears (sodium hyaluronate with or without preservatives) were determined randomly. The tear film break-up time (TF-BUT), Schirmer test, esthesiometer, corneal surface grading with Oxford system and ocular surface disease index (OSDI) questionnaire before and 1, 2 and 6 months after surgery were evaluated. The corneal nerve was also analyzed using corneal confocal microscopy (Confoscan 4, Nidek, Italy) before, and 1 and 6 months after surgery.
RESULTS
The TF-BUT was significantly longer (p = 0.010) and the OSDI score was significantly lower (p = 0.007) in the patient group with preservative-free sodium hyaluronate than the group with sodium hyaluronate containing preservatives at 6 months after cataract surgery. There were no statistically significant differences according to the main incision location in the sodium hyaluronate without preservatives group.
CONCLUSIONS
Symptoms and several signs of dry eye syndrome triggered by cataract surgery decreased with preservative- free artificial tears compared to tears with preservatives.

Keyword

Artificial tears; Cataract surgery; Corneal nerve; Dry eye syndrome; Preservatives

MeSH Terms

Astigmatism
Axis, Cervical Vertebra
Cataract
Dry Eye Syndromes
Eye
Humans
Hyaluronic Acid
Microscopy, Confocal
Ophthalmic Solutions
Phacoemulsification
Prospective Studies
Surveys and Questionnaires
Tears
Hyaluronic Acid
Ophthalmic Solutions

Figure

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  Figure 1. The analysis of corneal subbasal nerve plexus using ImageJ software. A winding line of corneal nerve is visualized in the left original photograph and the nerve length was analyzed by “segmented line length analysis tool” in ImageJ software by tracing each nerve separately as seen in the right photograph. Arrow heads trace corneal subbasal nerve and the arrows indicates the sites of nerve branching.

• 

  Figure 2. The presentative photographs of corneal subbasal nerve plexus. Each column represents subgroups: temporal incision with PSH (A), temporal incision with PFSH (B), and superior incision with PFSH (C) respectively. Each row represents the time of taken images: preoperative, postoperative 1 month, and postoperative 6 month respectively. Each column is the images in the same patient. They commonly showed a decrease of corneal nerve plexus at 1 month after cataract surgery and a restoration at 6 month after cataract surgery. PSH = preserved 0.1% sodium hyaluronate group; PFSH = preservative free 0.1% sodium hyaluronate group; preop = preoperative, POP = postoperative, mon = month.

Reference

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