The impact of pseudoexfoliation and arteficial tear application on tear film stability in a pseudophakic eye

Introduction/Objective. Dry eye development after phacoemulsification is a very common complication of cataract surgery. Combined with other risk factors, such as pseudoexfoliation (PEX), this complication becomes more frequent. The aim of this study was to expose the influence of phacoemulsification associated with PEX on the development of dry eye in patients who underwent cataract surgery. Methods. The study included 160 eyes (160 patients) who underwent phacoemulsification. The patients were divided into four groups (n = 40 patients). Groups I and II involved patients without PEX. The patients from Group II were prescribed artificial tears (AT) postoperatively. The patients from Groups III and IV had a presentation of PEX. The patients from Group IV got AT postoperatively. Ocular Surface Disease Index, the tear breakup time (TBUT) test, fluorescein staining, and Schirmer’s test served as “dry eye” tests in this study. The χ2 test and paired t-test were used for data analysis. Results. Measurements were taken for every patient preoperatively, on the first and the seventh day after the surgery, one month and three months, and one year after the surgery. The tests showed postoperatively developed dry eye in all the groups, with the recovery of the tear film within three months, except for Group III. The highest statistical significance (p < 0.001) was recorded between Groups II and III, three and 12 months after the surgery. Values of TBUT (6.09 ± 1.29 seconds) and Schirmer’s test (8.91 ± 2.14 mm) in Group III strongly indicated that dry eye was still present one year after phacoemulsification. The greatest recovery of the tear film was recorded in Group II in all the measurements. Conclusion. The study showed how strongly PEX and the use of AT affect the tear film during the first postoperative year. Based on our experience, we highly recommend the use of AT after performing phacoemulsification.