[Tear film changes after phacoemulsification].
OBJECTIVE
To evaluate tear film changes after phacoemulsification.


METHODS
This prospective randomized study involved 68 consecutive patients with age-related cataract (79 eyes) who underwent phacoemulsification. Tear break-up time, Schirmer I test (S I t) value, corneal fluorescein staining, tear film pattern by DR-1 tear interfermetry and the height of tear meniscus were measured preoperatively and 1 day and 2, 7, 14, 30, 180 days postoperatively.


RESULTS
At 1 day and 2 days postoperatively, the mean tear break-up time reduced greatly, and the number of patients who showed III to V tear film pattern, the mean S I t value, the height of tear meniscus and fluorescein staining scores increased significantly (P < 0.001 for day 1, P < 0.005 for day 2). S I t value at 7 days postoperatively (P = 0.831) and the height of tear meniscus at 14 days returned to their preoperative values (P = 1.000). The tear break-up time, corneal fluorescein staining scores and the grades of tear film pattern all recovered at 30 days postoperatively (P > 0.05). At 30 days postoperatively, 19.3% of patients showed shorter tear break-up time and less S I t value than that of preoperative day. In addition, 1/9 of the patients with normal preoperative tear film experienced dry eye at 30 days postoperatively. The cases with tear break-up time < 10 seconds compared to patients with tear break-up time >/= 10 seconds were more easily to show tear instability postoperatively (relative risk 13.5, 8.25, 20.0, 39.0, 8.6, 3.9 at 1 day and 2, 7, 14, 30, 180 postoperative days, respectively).


CONCLUSIONS
Phacoemulsification significantly alters the tear break-up time, S I t value, corneal fluorescein staining, tear film pattern and the height of tear meniscus. Some patients with normal tear film may experience dry eye after surgery. Patients with preexisting tear break-up time < 10 seconds are easily at risk of experiencing the tear film instability postoperatively.
Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou 510060, China. zuguol@yahoo.com
Zuguo
Z
Liu
Lihui
L
Luo
Zhenping
Z
Zhang
Bing
B
Cheng
Danying
D
Zheng
Weirong
W
Chen
Zhende
Z
Lin
Wenhui
W
Yang
Yizhi
Y
Liu
Mei
M
Zhang
Qiguo
Q
Xiao
Jiaqi
J
Chen
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018918:Phacoemulsification / Q000009:adverse effects* / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis / Q000473:pathology*; D012167:Retinal Perforations / Q000209:etiology* / Q000473:pathology; D014985:Xerophthalmia / Q000175:diagnosis / Q000209:etiology / Q000473:pathology