Changes in the tear film and ocular surface after cataract surgery

2012 ◽  
Vol 56 (2) ◽  
pp. 113-118 ◽  
Author(s):  
Taehoon Oh ◽  
Younhea Jung ◽  
Dongjin Chang ◽  
Jaeryun Kim ◽  
Hyunseung Kim
Keyword(s):  
Cataract Surgery ◽  
Ocular Surface ◽  
Tear Film

scholarly journals Association among Blink Rate, Changes in Ocular Surface Temperature, Tear Film Stability, and Functional Visual Acuity in Patients after Cataract Surgery

2019 ◽  
Vol 2019 ◽  
pp. 1-8 ◽  
Author(s):  
Takashi Itokawa ◽  
Yukinobu Okajima ◽  
Takashi Suzuki ◽  
Tatsuhiko Kobayashi ◽  
Yuto Tei ◽  
...  
Keyword(s):  
Visual Acuity ◽  
Regression Analysis ◽  
Cataract Surgery ◽  
Ocular Surface ◽  
Tear Film ◽  
Blink Rate ◽  
Film Stability ◽  
Tear Film Stability ◽  
Functional Visual Acuity ◽  
Film Group

Purpose. To investigate the association among the ocular surface temperature (OST), tear film stability, functional visual acuity (FVA), and blink rate in patients after cataract surgery. Methods. We recruited 98 eyes of 69 patients (mean age, 73.7 ± 5.2 years) 1 month after phacoemulsification with implantation of acrylic intraocular lenses and assessed slit-lamp microscopy, corrected distance VA, FVA, noninvasive tear breakup time (NIBUT), and OST. We defined the changes in the OST from 0 to 10 seconds after eye opening as the ΔOST. We measured the FVA and blink rate using the FVA measurement system. We divided the patients into two groups based on tear film stability: stable tear film (NIBUT, >5.0 seconds) and unstable tear film (NIBUT, ≤5.0 seconds). We evaluated the differences between the two groups and the association between the blink rate and other clinical parameters. Results. The unstable tear film group (56 eyes) had significantly (p<0.0001, unpaired t-test) shorter NIBUTs than the stable tear film group (42 eyes). The ΔOSTs and blink rates were significantly (p<0.0001) higher in the unstable tear film group than in the stable group. Linear single regression analysis showed that the ΔOST (r = −0.430, p<0.0001), NIBUT (r = −0.392, p<0.0001), and gender (r = −0.370, p=0.0002) were correlated significantly with the blink rate. Multiple regression analysis showed that the ΔOST independently contributed to the blink rate. Conclusions. The frequency of blinks is associated with tear film stability in patients after cataract surgery. The blink rate may be useful for evaluating the tear film stability in clinical practice. The ΔOST should be an important contributing factor to the blink rate. [This trial is registered with UMIN000026970].

scholarly journals Efficacy of carbomer sodium hyaluronate trehalose vs hyaluronic acid to improve tear film instability and ocular surface discomfort after cataract surgery

2019 ◽  
Vol Volume 13 ◽  
pp. 1157-1163 ◽  
Author(s):  
L Caretti ◽  
A La Gloria Valerio ◽  
R Piermarocchi ◽  
G Badin ◽  
G Verzola ◽  
...  
Keyword(s):  
Hyaluronic Acid ◽  
Cataract Surgery ◽  
Ocular Surface ◽  
Sodium Hyaluronate ◽  
Tear Film ◽  
Film Instability

scholarly journals Tear Film Osmolarity of the Eye after Cataract Surgery. Summary of the Doctoral Thesis

2021 ◽  
Author(s):  
◽  
Ēriks Elksnis ◽  
Keyword(s):  
Cataract Surgery ◽  
Postoperative Period ◽  
Ocular Surface ◽  
Tear Film ◽  
Visual Outcome ◽  
Early Postoperative Period ◽  
University Hospital ◽  
Control Group ◽  
Study Group ◽  
Significant Difference

Almost every cataract surgeon has encountered a situation during the postoperative period when, even though, the primary goal – improvement of visual acuity – has been achieved, yet the patient felt frustrated because of subjective discomfort in the operated eye. Sometimes this issue is more disturbing for the patient than the hope for a perfect visual outcome. Although it has been established that the ocular surface is affected during the postoperative period, there is still no generally accepted opinion about the changes in tear osmolarity after cataract surgery despite several studies dedicated to evaluation of these changes. The present study was designed to elucidate the effect of cataract surgery on the characteristic feature of ocular surface homeostasis – tear film osmolarity in the early postoperative period. Aim. The aim of the study was to evaluate the changes in tear film osmolarity after a cataract surgery in a healthy ocular surface. Methods. For this purpose two examination groups were formed. The study group included voluntary patients undergoing cataract surgery not having any complaints about subjective symptoms typical of dry eye disease. In order to correspond to the criteria of healthy ocular surface, the study group excludes the following types of patients and conditions: contact lens wearers, patients with diabetes, pseudoexfoliation, pterygia and eye drop users. The eye that has not undergone the surgery was classified as the control group. This single–center, prospective study was held at Ophthalmology department of Pauls Stradins Clinical university hospital. All cataract surgeries were done by the same surgeon. The tear osmolarity tests were evaluated with TearLab Osmolarity System (TearLab Corporation, San Diego, CA, the USA) before surgery, in the next morning, one week and one month after the surgery. Results. No statistically significant difference was observed between the groups before operation when comparing the mean tear osmolarity – in the study group it was 296.87 mOsm/L, and in the control group it was 297.27 mOsm/L (p = 0.84). The tear osmolarity results changed significantly during early postoperative period in the study group (p < 0.001), while in non–operated eye no significant tear film osmolarity changes were observed (p = 0.86). Significant changes were recognized on the next day after the surgery – the tears became hypoosmolar (< 275 mOsm/L). One week later the tear osmolarity increased significantly, and the tears became hyperosmolar (312.64 mOsm/L). Over the course of one month, the test values for the study and control groups equalized (297.87 in the study group and 298.93 in the control group (p = 0.66)), when compared to preoperative tear osmolarity results. Conclusion. The results achieved lead towards a more detailed understanding of the changes in the ocular surface homeostasis after a cataract surgery. The obtained data indicate that tear osmolarity changes considerably during the first postoperative month after a cataract surgery. Also, there is a huge difference in measurements between operated and non–operated eye on the next day and one week after the surgery. One month after the surgery tear osmolarity returns to preoperative test results, and there is no difference determined between the eyes.

Cataract Surgery Destabilises Temporary the Tear Film of the Ocular Surface

2020 ◽  
Author(s):  
Le Xuan Cung ◽  
Nguyen Thi Thanh Nga ◽  
Duong Mai Nga ◽  
Nguyen Xuan Hiep ◽  
Duy Thoai Pham
Keyword(s):  
Cataract Surgery ◽  
Ocular Surface ◽  
Keratoconjunctivitis Sicca ◽  
Tear Film ◽  
Vital Staining ◽  
Ocular Surface Disease Index ◽  
Corneal Incision ◽  
Meniscus Height ◽  
The Third ◽  
Clear Corneal Incision

Abstract Background Symptoms due to dry eye in the form of keratoconjunctivitis sicca (KCS) are often seen after cataract surgery. We investigated the influence of cataract surgery on tear film stability on the ocular surface. Material and Methods 60 eyes of 60 patients who underwent cataract surgery were included in a prospective study in 2017 at the Eye Hospital in Hanoi (Vietnam National Institute of Ophthalmology). The mean age of the patients was 65 ± 10 years. The phacoemulsification was performed under topical anaesthesia by a clear corneal incision and implantation of a foldable IOL. The parameters for the evaluation of the change of the tear film included subjective patient data using the Ocular Surface Disease Index questionnaire (OSDI), findings of the Schirmer I test, the tear break-up time (TBUT) as well as the tear meniscus height (TMH) measured noninvasively with the Keratograph 5M (Oculus). In addition, conjunctival and corneal changes were examined after vital staining with fluorescein for the cornea and rose bengal for the conjunctiva. Data were collected preoperatively, at 1 week, 1 month and 3 months postoperatively. According to DEWS, the disease is classified into 4 groups: mild, moderate, severe and very severe. Results One week after surgery, the total score according to OSDI was significantly increased with a total value of 14.4 ± 4.2 (p = 0.001). Schirmer I was 15.8 ± 4.3 mm preoperatively and decreased significantly in the first postoperative week (p = 0.001), before reaching the preoperative level again after three months. TBUT was 12.6 ± 1.5 s preoperatively, decreased significantly to 9.7 ± 1.5 s during the first postoperative week, and normalized to 12.4 ± 1.3 s by the end of the third month. The meniscus height was 0.245 ± 0.055 mm preoperatively, significantly lowered to 0.229 ± 0.057 mm in the first postoperative period and nearly normalised by the third postoperative month to 0.241 ± 0.051 mm. In the first postoperative week, the rate of mild KCS was observed in 30% of patients. At one month, this decreased to 10% and at three months was no longer demonstrable in any patient. Conclusion One of three patients experienced mild KCS after cataract surgery. The symptoms lasted up to three months. This should be taken into account preoperatively and appropriate therapy should be planned.

scholarly journals Prevalence of Ocular Demodicosis and Ocular Surface Conditions in Patients Selected for Cataract Surgery

2020 ◽  
Vol 9 (10) ◽  
pp. 3069
Author(s):  
Katarzyna Nowomiejska ◽  
Piotr Lukasik ◽  
Agnieszka Brzozowska ◽  
Mario Damiano Toro ◽  
Aleksandra Sedzikowska ◽  
...  
Keyword(s):  
Cataract Surgery ◽  
Ocular Surface ◽  
Anterior Segment ◽  
Tear Film ◽  
Test Results ◽  
Conjunctival Hyperemia ◽  
Surface Conditions ◽  
Demodex Folliculorum ◽  
Before And After ◽  
Demodex Mites

The aim of the study was to analyze the prevalence of ocular demodicosis and ocular surface conditions in patients selected for cataract surgery. Eyelashes from 73 patients selected for cataract surgery were evaluated at ×40 and ×100 magnification using light microscopy. The anterior segment was assessed with the slit lamp. Additionally, Schirmer I and break up time (BUT) tests were carried out before surgery and 1 and 3 months postoperatively. A specially designed questionnaire containing e.g., information about chronic skin and eye diseases, previous ophthalmic surgeries, and patient’s hygiene habits was used to assess the demographic variables. A majority of patients were at the age of 70–79 years, and there were more females (83%) in the study group. Demodex folliculorum was found in 48% of the patients. There was a correlation between the number of parasites and the presence of blepharitis, discharge at eyelid margins, and conjunctival hyperemia. Schirmer I and BUT test results were lower in patients with Demodex infestation before and after cataract surgery. The higher number of mites was correlated with lower Schirmer I test results postoperatively. The presence of Demodex mites influences the conjunctiva and lid margins leading to inflammation. The higher number of Demodex mites disturbs the tear film over time after cataract surgery.

scholarly journals Chemical Treatment with Fluoroquinolones on the Tear Film and Ocular Surface after Cataract Surgery

2020 ◽  
Vol 71 (5) ◽  
pp. 434-440
Author(s):  
Aurelian Mihai Ghita ◽  
Ana Cristina Ghita ◽  
Sanziana Istrate ◽  
Florin Balta ◽  
Radu Ciuluvica
Keyword(s):  
Cataract Surgery ◽  
Ocular Surface ◽  
Positive Impact ◽  
Clinical Manifestations ◽  
Tear Film ◽  
Ocular Surface Disease ◽  
Control Group ◽  
Measured Quantity ◽  
The Impact ◽  
Breakup Time

Quinolone antibacterial activity is related to its chemical structure, a synthetic fluorinated analog of nalidixic acid. Cataract surgery is responsible for visual improvement having a major positive impact on the quality of patients� lives. According to the international guidelines, the administration of levofloxacin after cataract surgery decreases the incidence of postoperatively endophthalmitis. In this context we aimed to study the impact of adding topical fluoroquinolones to the conventional treatment after cataract surgery on the ocular surface and tear film. 125 of eyes of 125 patients with cataract were included. The enrolled patients were divided into three groups, a control group of patients that received topical Tobramycin, Dexamethasone and Indomethacin, a second group where moxifloxacin was added and a third group with levofloxacin instead of moxifloxacin. For all the patients, tear film breakup time, Schirmer II test, slit lamp examination preoperatively and postoperatively at one week were performed together with individual Ocular Surface Disease Index at one week after cataract surgery. The test results revealed that 52% of our studied patients had an abnormal preoperatively tear film breakup time, and 76.8% after cataract surgery, with a statistically significant decrease of the measured values. The preoperatively measured quantity of tears presented a no statistically significant decrease one week after cataract surgery. Also, we found an increase in the percentage of patients with punctate epithelial erosions. It is important and useful to identify prior to surgery patients with ocular surface disease and the ones at risk to develop clinical manifestations in order to treat them accordingly because, cataract surgery exacerbates the preexistent ocular symptoms. The addition of topical fluoroquinolones after cataract surgery in patients with dry eye is safe, with minimal alterations of the ocular surface and tear production, without statistically significant differences as compared to the control group.

Ocular Surface & Tear Film Changes in Patients Undergoing Small Incision Cataract Surgery - A Hospital Based Prospective Clinical Study in South Kerala

2021 ◽  
Vol 8 (29) ◽  
pp. 2650-2655
Author(s):  
Arya Amala Rajagopal ◽  
Mini Mathew
Keyword(s):  
Cataract Surgery ◽  
Dry Eye ◽  
Ocular Surface ◽  
Tear Film ◽  
Prospective Clinical Study ◽  
Low Grade ◽  
Ocular Surface Disease Index ◽  
Small Incision Cataract Surgery ◽  
Dry Eyes ◽  
Small Incision

BACKGROUND Dry eye is an important factor affecting the quality of life especially elderly. The major cause of adult blindness in India is cataract. After cataract surgery many are beleaguered by dry eye symptoms. Since small incision cataract surgery remains the most commonly performed surgical procedure for cataract in India the ocular surface and tear film changes occurring in patients after cataract surgery in our hospital was studied. METHODS A prospective observational study was conducted among 120 patients who underwent uncomplicated cataract surgery at RIO, Thiruvananthapuram for a period of 12 months from July 2019 - June 2020 to assess the changes that occur in ocular surface and tear film after small incision cataract surgery. The dry eye status was measured using Schirmer tests, tear film breakup time, tear film height, fluorescein and lissamine green staining and finally graded using OSDI score. The score was assessed preoperatively & postoperatively at 1 week, 4 weeks & 12 weeks. RESULTS Pre & postoperative OSDI score showed that 1 week after surgery only 5 % patients remained with no dry eye changes. 4 weeks after the surgery mild dry eye was found in 35 %, moderate dry eye in 40 % & severe dry eye in 23 % patients. 12 weeks after surgery mild dry eye was found in 53.3 %, moderate in 33.3 % & severe in 1.7 %. The occurrence of dry eye was seen to increase 1wk postoperatively & peak around 4weeks postoperatively. CONCLUSIONS Small incision cataract surgery induces significant dry eye changes in patients whose ocular surface & tear film was normal preoperatively. The dry eye changes were noted to worsen maximum at 4 weeks after surgery & these changes persisted in low grade even at 12 weeks after surgery. KEYWORDS Dry Eyes, Small Incision Cataract Surgery (SICS), OSDI (Ocular Surface Disease Index) Score

Povidone-Iodine 3-Minute Exposure Time is Viable in Preparation for Cataract Surgery

2017 ◽  
Vol 27 (5) ◽  
pp. 573-576 ◽  
Author(s):  
Chu L. Nguyen ◽  
Lawrence J. Oh ◽  
Eugene Wong ◽  
Ian C. Francis
Keyword(s):  
Clinical Practice ◽  
Cataract Surgery ◽  
Exposure Time ◽  
Ocular Surface ◽  
Povidone Iodine ◽  
Bacterial Load ◽  
Minute Exposure ◽  
Visual Outcomes ◽  
Preoperative Prophylaxis ◽  
Operating Room Staff

Purpose Povidone-iodine (PI) is widely used to reduce the preoperative conjunctival bacterial load. This study aimed to evaluate the employment of PI 10% in an attempt to sterilize the ocular surface prior to cataract surgery, and to show that PI could be left in contact for 3 minutes. The viability of this exposure time in clinical practice, associated adverse events, and visual outcomes were documented. Methods In this prospective cohort study, phacoemulsification cataract surgery was performed in 604 patients by a single surgeon. Preoperative preparation was undertaken with PI 10%, applied to the cornea, conjunctival sac, eyelids, and periorbital skin with sterile cotton gauze. Povidone-iodine was then flushed onto the ocular surface. Operating room staff timed the precise duration of exposure. After the 3-minute preparation, the lids were thoroughly dried with fresh dry gauze. Results The median PI exposure time was 3.17 minutes, with an interquartile range of 0.25. All cases were followed up postoperatively at 1 day, 1 week, and 1 month. There were no complications attributable to PI. Visual outcomes were satisfactory. Conclusions Implementation of a preoperative prophylaxis protocol that used PI 10% with a 3-minute exposure time can be performed in clinical practice. The 3-minute exposure time had no adverse sequelae.

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