Original article
Evaluation of Dry Eye and Meibomian Gland Dysfunction After Cataract Surgery

https://doi.org/10.1016/j.ajo.2014.02.036Get rights and content

Purpose

To evaluate dry eye and meibomian gland dysfunction after cataract surgery.

Design

Prospective observational case series.

Methods

We studied 58 eyes of 48 patients who underwent phacoemulsification and evaluated them preoperatively and at 1 month and 3 months postoperatively. Ocular symptom scores, lid margin abnormalities, superficial punctate keratopathies (SPKs), tear film break-up time (TBUT), Schirmer test, lower tear meniscus height, depth, and area using Fourier domain optical coherence tomography, meibum expressibility and images of the meibomian glands using meibography were measured.

Results

The ocular symptom scores were worse at 1 month and 3 months postoperatively (P < 0.001 and P < 0.001, respectively). Lid margin abnormalities were significantly increased (P < 0.001 and P < 0.001, respectively) and TBUT decreased postoperatively (P < 0.001 and P < 0.001, respectively). Meibum expressibility decreased at 3 months postoperatively (P = 0.016); however, meibography score, SPK, lower tear meniscus height, depth and area and the Schirmer test did not change significantly postoperatively (all P values >0.05).

Conclusion

Meibomian gland function may be altered without accompanying structural changes after cataract surgery.

Section snippets

Patients and Methods

This study was performed in accordance with the tenets of the World Medical Association of Helsinki. The prospective study protocol was approved by the Severance Hospital Institutional Review Board, Seoul, South Korea, and registered at http://www.clinicaltrials.gov (identification no. NCT01942642). Informed consent was obtained from all subjects after explanation of the purpose and possible consequences of the study.

We evaluated 55 patients (66 eyes) for inclusion in this study. Of them 7

Results

Ocular symptom scores were significantly worse postoperatively than they were preoperatively (1.5 ± 1.1 preoperatively, 3.6 ± 1.1 at 1 month postoperatively and 3.9 ± 1.7 at 3 months postoperatively; P < 0.001 and P < 0.001, respectively) (Table). Lid margin abnormalities were significantly increased at 1 month and 3 months postoperatively (P < 0.001 and P < 0.001, respectively) (Table). Vascular engorgement was observed in 23 eyes (39.7 %) preoperatively, 42 eyes (72.4 %) at 1 month

Discussion

We observed a statistically significant increase in ocular symptom scores, worsening of lid margin abnormalities, decrease in meibum expressibility, and decreased TBUT in patients after cataract surgery but no change in the Schirmer test, lower tear meniscus volume or meibography score. These results suggest that cataract surgery may influence meibomian gland function without causing structural changes in the meibomian glands.

Cataract surgery using clear corneal incisions produces rapid wound

Kyung Eun Han, MD is a clinical assistant professor of Cornea and External Eye Disease Service at the Hallym University College of Medicine, Chuncheon, South Korea. Dr Han received her medical degree from the Ewha Womans University School of Medicine, Seoul, South Korea, and then completed her internship and residensy at the Department of Ophthalmology of the same university. She completed a fellowship at Yonsei University Severance Hospital. Her main research interests are pathophysiology of

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    Kyung Eun Han, MD is a clinical assistant professor of Cornea and External Eye Disease Service at the Hallym University College of Medicine, Chuncheon, South Korea. Dr Han received her medical degree from the Ewha Womans University School of Medicine, Seoul, South Korea, and then completed her internship and residensy at the Department of Ophthalmology of the same university. She completed a fellowship at Yonsei University Severance Hospital. Her main research interests are pathophysiology of dry eye disease and meibomian gland dysfunction.

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