Dry eye can develop after various types of ophthalmic surgeries including cataract surgery.

I find this research paper “Incidence and Pattern of Dry Eye after Cataract Surgery” by Ngamjit Kasetsuwan, Vannarut Satitpitakul, Theerapa Changul, Supharat Jariyakosol informative.  I quote parts of the article below; the article is on this web page http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0078657.


What This Paper Adds

* The incidence of dry eye after phacoemulsification [including cataract surgery] was 9.8%.

* Dry eye symptoms can develop immediately after phacoemulsification and the severity can peak on day 7. Both symptoms and signs can improve over time. The dry eye pattern was similar between all three clinical tests (TBUT, Schirmer I without anesthesia, Oxford ocular surface staining system) and the OSDI questionnaire.

Longer quote:


Dry eye is a multifactorial disease of tears and ocular surface that can be result from aqueous deficiency or be evaporative in nature. This syndrome affects individuals worldwide. Long-term population-based studies have shown the incidence rates of dry eye among the population between ages 43 and 86 years at 5 and 10 years of follow-up to be 13.3% and 21.6% respectively. [4], [5] In Thailand, the incidence of dry eye in a hospital-based population was 34%. [10].

. Dry eye can develop often after various types of ophthalmic surgeries such as photorefractive keratectomy and laser-assisted in situ keratomileusis (LASIK). The incidence rates of dry eye, assessed by corneal fluorescein staining 1 week postoperatively for either nasal- or superior-hinge LASIK, were 47.06% and 52.94%, respectively. [6] In addition, after LASIK, dry eye can persist for up to 6 months or more with an incidence of 20%, [7] whereas in patients who have undergone blepharoplasty, dry eye can last up to 2 weeks or more with an incidence of 10.9%. [12] Even though many previous studies have compared the preoperative and postoperative changes in dry eye symptoms and/or the dry eye test values that worsened significantly after cataract surgery, [9], [11], [13] the current study was the first to report the incidence and pattern of dry eye after phacoemulsification using various combinations of tests over a 90-day period.

Like other studies, we also have reported that dry eye can develop after cataract surgery… Barabino et al. reported that phacoemulsification induced dry eye-like symptoms and signs on days 1 and 7 (unpublished data presented at the 6th International Conference on the Tear Film and Ocular Surface, Florence, Italy, September_2010).

. Regarding the pattern of postoperative dry eye, our findings were consistent with the results of Barabino et al. (unpublished data) who detected dry eye on the seventh day after surgery and rapid improvement within 30 days postoperatively. We did not found any late reaction of dryness such as filamentary keratopathy, superior limbic keratoconjunctivitis or persistent epithelial defect. However, one study reported that dry eye symptoms and a lower tear meniscus developed at 1 month and continued for another 2 months. [14] A possible explanation for this difference may be due to the different topical ocular drops and duration of regimens used: Tarivid Ophthalmic Solution (ofloxacin, Daiichi Sankyo, Tokyo, Japan) 4 times daily for 2 weeks, Pred Forte (prednisolone acetate ophthalmic suspension, USP 1%, Allergan, Irvine, CA) 4 times daily for 1 week, and Pranopulin Eye Drops (Senju Pharmaceutical, Chuo-Ku, Osaka, Japan) 4 times daily for 1 month. The surgical techniques may have affected their results, in which neither the size nor location of the wound was reported.

. Another explanation for the dry eye pattern observed in the current study was the recovery process of the corneal nerves. Since the cornea is one of the most highly innervated organs, with about 44 corneal nerve bundles entering the cornea around the limbus centripetally [18] and larger nerve fibers that run from the 9 o’clock to the 3 o’clock position and bifurcate to achieve a homogenous distribution over the entire cornea, [19] it is vulnerable to any damage within that region. Temporal corneal incisions created during phacoemulsification can reduce the corneal sensitivity in the surgical area and other areas far from the incision site… Disruption of the normal corneal innervation or lacrimal functional unit feedback can reduce the tear flow and blink rate and cause instability of the tear hyperosmolarity and tear film.

. In addition to transection of the corneal nerves and damage to the corneal epithelial cells, exposure to microscopic light, vigorous intraoperative irrigation of the tear film, elevation of inflammatory factors in the tear film due to ocular surface irritation, use of topical anesthesia intraoperatively, and topical eye drops administered postoperatively and its preservatives can cause dry eye after phacoemulsification.

Excessive instillation and incorrect use of preserved eye drops are important factors that contribute to the development of dry eye after phacoemulsification and corneal toxicity. However, the abnormal ocular surface staining in the current study showed typical interpalpebral staining pattern caused by dryness rather than inferior staining from drug toxicity or medicamentosa.


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