A COMPARATIVE EVALUATION OF DRY EYE PARAMETERS IN PATIENTS UNDERGOING MANUAL SICS AND PHACOEMULSIFICATION IN A TERTIARY EYE CARE HOSPITAL

Abstract

BACKGROUND: Dry eye syndrome, a medical disorder characterised by inadequate tear production or heightened tear evaporation, results in eye irritation and discomfort. This disorder arises from alterations in the tear film layer. Following cataract surgery, many individuals have feelings of foreign objects, erythema, and symptoms of ocular dryness. AIM: to compare dry eye parameters before and after manual small incision cataract surgery (SICS) and phacoemulsification inpatients undergoing cataract surgery. METHODOLOGY: A prospective comparison study was conducted on 90 patients aged >50 years, undergoing elective cataract surgery at a tertiary eye-care hospital. Patients were randomised to manual small incision cataract surgery (SICS; n=45) or phacoemulsification (PHACO; n=45). Pre-operative and post-operative measurements of dry-eye parameters, including tear-film break-up time (TBUT), Schirmer I and II tests and tear-film meniscus height (TFMH) were recorded. Also examined were ocular surface findings, including abnormalities detected by slit-lamp biomicroscopy, corneal feeling and lid-margin alterations. Post surgery evaluations were done at 4,6 and 8 weeks postoperatively. RESULTS: The mean age of 90 participants was 59.41 ± 5.61 years and 53.3% were males. Significant postoperative alterations in tear film characteristics were seen in both SICS and PHACO groups. TBUT, Schirmer I and tear-film meniscus height were substantially greater in PHACO group than SICS group at 4, 6 and 8 weeks (p<0.001 for all). Punctate epithelial erosions, decreased corneal feeling and lid margin abnormalities were similarly more common after SICS (57.8%, 35.6%, 33.3%) than PHACO (31.1%, 17.8%, 13.3%). The results suggest a superior healing of the postoperative ocular surface after phacoemulsification. CONCLUSION: Although both manual SICS and phacoemulsification are effective methods for cataract extraction, manual SICS is linked to a higher risk and increased severity of postoperative dry eye disease in comparison to phacoemulsification