-Original-

Changes in Tear Osmolarity after Cataract Surgery

Tsutomu Igarashi¹, Hisatomo Takahashi², Maika Kobayashi¹, Tomoyuki Kunishige¹, Takeshi Arima¹, Chiaki Fujimoto¹, Hisaharu Suzuki¹, Takahisa Okuda³ and Hiroshi Takahashi¹

¹Department of Ophthalmology, Nippon Medical School, Tokyo, Japan
²Department of Ophthalmology, Omagari Kousei Medical Center, Akita, Japan
³Division of Legal Medicine, Department of Social Medicine, Nihon University School of Medicine, Tokyo, Japan

Background: The purpose of this study was to examine changes in the ocular surface before and after phacoemulsification with small incisions and to examine the changes in tear osmolarity.
Methods: This was a prospective, observational study involving 55 eyes of 39 patients (19 male, 20 female patients; average age 72.0±7.3 years) who had cataract surgery at a Nippon Medical School Hospital between December 2013 and June 2018. Compromised tear dynamics were determined by the Schirmer test or the tear break-up time (BUT). An abnormal ocular surface was identified by positive vital staining with fluorescein or lissamine green. Moreover, tear osmolarity (Tosm) and corneal sensitivity were measured. All assessments were done preoperatively and 1 and 4 weeks (P1W and P4W) after the surgery.
Results: None of the operations had any complications. Operating time was 17.8±9.3 minutes. BUT was significantly decreased at P1W, and it recovered at P4W. The Schirmer test did not change significantly. The fluorescein staining score (FSS) increased significantly at P1W and recovered at P4W. The Lissamine green score (LSS) did not change significantly. Tear osmolarity increased significantly at P1W and did not recover at P4W. Corneal sensitivity decreased significantly at P1W and recovered at P4W.
Conclusion: In the present study, there were temporary changes in dry eye-related examinations including tear osmolarity after cataract surgery. In particular, tear osmolarity increased significantly 4 weeks after surgery compared to before surgery, and it showed long-term changes, unlike other factors. After cataract surgery, tear osmolarity, BUT, and FSS increase, resulting in dry eye symptoms. Therefore, it is necessary to pay attention to discomfortable eye symptoms of patients after cataract surgery.

J Nippon Med Sch 2021; 88: 204-208

Keywords
dry eye, tear osmolarity, cataract surgery, phacoemulsification

Correspondence to
Tsutomu Igarashi, MD, PhD, Department of Ophthalmology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8602, Japan
tutomu@nms.ac.jp

Received, March 27, 2020
Accepted, May 25, 2020