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The Official Scientific Journal of Delhi Ophthalmological Society
Changes in the Tear film after Manual Small Incision Cataract Surgery – A Prospective Study
Pallamreddy Sree Lakshmi, C.S. Sandhya, C. Jagannath, K. Madhavi
Department of Ophthalmology, S V Medical College, Tirupati, Andhra Pradesh, India
Corresponding Author:
C. Jagannath 
MS, DO
Department of Ophthalmology,
S V Medical College, Tirupati,
Andhra Pradesh, India
Email id: jagannathchalla@gmail.com
Published Online: 01-NOV-2018
DOI: http://dx.doi.org/10.7869/djo.392
Abstract
Background: Manual small incision cataract surgery is a good alternative to phacoemulsification in areas where very high volume surgery with inexpensive instrumentation is required. Dry eye disease is an ocular surface disorder which produces discomfort and reduced vision due to tear film instability. This study is meant to evaluate the changes in tear film following cataract surgery by comparative analysis of various parameters before and after manual small incision cataract surgery. The aim was to evaluate the changes in tear film after manual small incision cataract surgery. 
Methods: The prospective study was conducted in 100 eyes of 100 patients. Those included were selected from the patients diagnosed as having unilateral or bilateral age related uncomplicated cataract without dry eye symptoms. All selected patients were studied for any abnormalities in tear film pre and post manual small incision cataract surgery. The various parameters studied were tear meniscus height (TMH), tear film break up time (TBUT), Schirmer test 1 (ST1) and Rose Bengal staining (RB). The tests were performed for all patients 1 day before and 1 day, 1 month, and 3 months after surgery.
Results: The majority of the study participants were aged between 51- 60 yrs (51%). 24% of the eyes showed lower TMH at 3 months post operative visit. 8 % the eyes recorded lower TBUT values at 3 months post operative follow up, which was statistically significant (P<0.01). There was a statistically significant difference in ocular surface changes with Rose Bengal staining between preoperative and postoperative 1 week, 1 month, and 3 months follow up (P<0.002). The mean postoperative ST1 results were no different from preoperative values. 
Conclusion: Patient undergoing SICS without having dry eye preoperatively showed lower values of tear film indices like TMH, TBUT and RB at 1 week and still lower values at 1 month. There was dryness of eyes in many of the patients and majority of them had mild grade dry eye.
Keywords : Tear film break up time, Schirmer test, Small incision cataract surgery, Dry eye
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