Tear film assessment before and after phacoemulsification in patients with age-related cataracts

Background The study aims to assess the tear film before and after phacoemulsification in patients with age-related cataracts. Methods A prospective observational study of 41 age-related cataract patients undergoing phacoemulsification procedure. Tear Film Break-Up Time (TBUT), Tear Film Meniscus Height (TMH), Meibomian glands (MG), and Lipid Layer Thickness (LLT) were assessed by a non-invasive Dry Eye Diagnostic System. All measurements were taken preoperatively, one week, one month, and three months postoperatively. The Marginal homogeneity and The Cochran Q tests were used in the statistical analysis. Results The value of Non-Invasive Break-Up Time (NITBUT) was statistically significantly lower at one week (7.15 +/- 3.31), one month (7.61 +/- 3.41), and three months (7.66 +/- 3.36) postoperatively than preoperatively (10.71 +/- 2.71), p < 0.001. The Non- Invasive Tear Meniscus Height (NITMH) was significantly lower at one week (0.18 +/- 0.0), one month (0.20 +/- 0.09), and three months (0.20 +/- 0.09) postoperatively than preoperatively (0.30 +/- 0.113) p < 0.001. By the first month, both (NITBUT) and (NITMH) improved significantly compared to the first post-operative week. There was no statistically significant difference between one month and three months. The (NITMH) improved to a healthy level of >= 0.2 mm by the first month through the third month. Both (NITBUT) and (NITMH) did not reach the baseline by the third month. The meibomian glands and the lipid layer thickness had the same preoperative grade distribution without changes. Conclusion Phacoemulsification surgery can cause post-operative deterioration in the tear film, which starts within a week of the procedure, followed by gradual recovery over the next weeks and months. The phacoemulsification procedure mainly affects the tear break-up time and tear meniscus height. Both the lipid layer and meibomian glands are not affected.