Dry Eye: Dimming the complications

Cataract surgery, one of the most frequently performed surgical procedures in the world, is safe and efficacious, and modern small-incision phacoemulsification offers excellent clinical outcomes with low complication rates and fast recovery. Patient and clinician expectations are therefore high; however, cataract surgery is a risk factor for dry eye disease, which can lead not only to dissatisfaction with outcomes but also can have consequences impacting quality of life.

The underlying mechanism of dry eye disease following cataract surgery is thought to be multifactorial. This is possibly due to: corneal nerve disruption and epithelial changes caused by the surgical incisions; repeated drying and intraoperative irrigation of the ocular surface; elevation of inflammatory mediators in the tear film; and the active agents and preservatives used in the medications and preparations used before, during and after surgery, including the pre-operative use of povidone iodine.

Light exposure from the operating microscope may be one of the factors leading to dry eye disease following ophthalmic surgery. A correlation between duration of cataract surgery and ocular surface damage, in terms of goblet cell density reduction, was found¹ even though the surgery typically takes just 10 to 15 minutes. Studies have found a correlation between duration of cataract surgery and ocular changes and symptoms.^{2, 3}