Conjunctival Impression Cytology in Evaluating Tear Film Status in Small Incision Cataract Surgery

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

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Comparative Evaluation of Tear Film Parameters Following Cataract Surgery in Diabetic Patients.

10.37191/mapsci-joo-2-012 ◽

2021 ◽

Author(s):

Sagarika Dash

Keyword(s):

Cataract Surgery ◽

Outcome Measures ◽

Dry Eye ◽

Tear Film ◽

Diabetic Patients ◽

Small Incision Cataract Surgery ◽

Fluorescein Staining ◽

Small Incision ◽

Group A ◽

Group B

Purpose: To compare the propensity of manual small incision and phacoemulsification cataract surgery in causing tear film dysfunction and dry eye syndrome in diabetic patients. Methods: Diabetic patients in group A underwent manual small Incision Cataract surgery whereas in group B underwent phacoemulsification with similar post-operative regimes. The primary outcome measures were the Ocular Surface Disease Index (OSDI), a Subjective questionnaire. The secondary outcome measures were the Subjective Dry Eye (DE) questionnaire, Corneal Fluorescein staining, Tear meniscus height, Schirmer’s II test, and Tear film break-up time. All parameters were measured pre and then postoperatively. Result: 126 patients were divided into group A (undergoing small incision cataract surgery) and group B (undergoing phacoemulsification). The OSDI and subjective DE scores continued to be worse for Group A until the first month after which they became similar to group B with no statistically significant difference (p-value of 0.726 and 0.347 respectively). The OSDI and subjective DES at 3 months were better in both groups as compared to baseline (p <0.0001). The objective tear film parameters (Schirmer’s, TBUT, TMH, and fluorescein staining scores) showed statistically significant changes from the baseline in both groups but the scores remained in the normal range clinically. Schirmer’s test scores were different between the two groups at three months (p=0.007) in SICS group being higher. Conclusion: Manual Small Incision Cataract Surgery (SICS) causes subjective dry eye symptoms more than phacoemulsification until 1 month of surgery in diabetic patients after which the subjective symptoms become similar to phacoemulsification at 3 months.

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Tear film changes after cataract surgery: manual small-incision cataract surgery versus phacoemulsification

Delta Journal of Ophthalmology ◽

10.4103/djo.djo_6_18 ◽

2018 ◽

Vol 19 (3) ◽

pp. 170

Author(s):

Saurabh Shrivastava ◽

Brijesha Dudhat ◽

Reshma Ramakrishnan ◽

Varshav Gore

Keyword(s):

Cataract Surgery ◽

Tear Film ◽

Small Incision Cataract Surgery ◽

Small Incision

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Safety and Efficacy of Temporal Manual Small Incision Cataract Surgery in India

European Journal of Ophthalmology ◽

10.5301/ejo.2011.6521 ◽

2011 ◽

Vol 21 (6) ◽

pp. 748-753 ◽

Cited By ~ 3

Author(s):

Swati V. Zawar ◽

Parikshit Gogate

Keyword(s):

Visual Acuity ◽

Cataract Surgery ◽

Corneal Edema ◽

Posterior Chamber ◽

Small Incision Cataract Surgery ◽

Safety And Efficacy ◽

Excellent Outcome ◽

Sutureless Technique ◽

Small Incision ◽

Sandwich Method

Purpose. To assess safety and efficacy of temporal manual small incision cataract surgery (SICS) in context to visual outcome, astigmatism, and complications. Methods. This involved sclerocorneal tunnel, capsulotomy and hydrodissection. The incision was made with number 11 disposable surgical blade (costing Indian Rs. 2.50, $0.05). Nucleus extraction was done by phaco-sandwich method with the help of vectis and dialer. Posterior chamber intraocular lens implantation was done according to biometric findings. A record of intraoperative and postoperative complications was made. The final postoperative assessment of astigmatism was done with spectacle correction on the 45th day as per the refraction findings. Results. Two thousand eyes were operated by temporal, manual small incision sutureless technique. Uncorrected visual acuity was ≥6/18 in 1636 (81.7%) patients on the first postoperative day, in 1652 (82.6%) patients at 2 weeks, and in 1732 (88.6%) patients at 6 weeks. Best-corrected visual acuity (BCVA) ≥6/18 was achieved in 1868 (93.4%) patients at 6 weeks, with 46 (2.3%) having BCVA <6/60, 24 (1.2%) of whom had preexisting retinal pathology. At 6 weeks, 1876 (93.8%) eyes had with-the-rule and 134 (6.2%) against-the-rule astigmatism (mean 0.7±1.25 D). Iris prolapse was noted in 3 (0.15%), wound leak in 3 (0.15%), and transient corneal edema in 136 (6.8%) eyes. Average surgery time was 6 minutes. Conclusions. Temporal SICS with number 11 disposable surgical blade and nucleus delivery by phaco-sandwich method gave excellent outcome with minimal astigmatism and low complication rate at economic cost.

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