Original scientific paper

https://doi.org/10.20471/acc.2025.64.04.07

Effect of Tear Film Changes on Visual Acuity after Uncomplicated Phacoemulsification Cataract Surgery

Suzana Matić ; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Ophthalmology, Osijek University Hospital Center, Osijek, Croatia; Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Ivana Pivić-Kovačević ; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Ophthalmology, Osijek University Hospital Center, Osijek, Croatia
Marija Jelić Vuković ; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Ophthalmology, Osijek University Hospital Center, Osijek, Croatia
Tvrtka Benašić ; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Ophthalmology, Osijek University Hospital Center, Osijek, Croatia
Mate Matić ; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Oncology, Osijek University Hospital Center, Osijek, Croatia *
Lucija Matić ; Faculty of Dental Medicine and Health, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia
Josip Barać ; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Ophthalmology, Osijek University Hospital Center, Osijek, Croatia
Dubravka Biuk ; Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia; Department of Ophthalmology, Osijek University Hospital Center, Osijek, Croatia

* Corresponding author.

Abstract

The aim of the study was to show the effect of tear film instability after uncomplicated
ultrasound phacoemulsification cataract surgery in patients without previous tear film instability and to
show its impact on the best corrected visual acuity (BCVA) one month after the surgery. The prospective
cohort study included 30 patients of both sexes with cataract who underwent uncomplicated ultrasound
phacoemulsification cataract surgery. Exclusion criteria included pre-existing ocular surface disease and
tear film instability, topical antiglaucoma therapy, lid disorders, punctate epitheliopathy, corneal disorders,
post-surgical corneal tear film instabilities, traumatic corneal scars, diabetic patients, posterior segment
diseases and retinal surgeries, maculopathy, as well as previous or active uveitis that could compromise
postoperative BCVA. All patients underwent full ophthalmic examination, corneal fluorescein staining,
tear film break-up time test (TBUT) and visual acuity assessment on the day of surgery and 30 days after
surgery. The difference in TBUT before and after phacoemulsification cataract surgery and difference in
BCVA before and after cataract surgery were examined. All patients underwent ultrasound phacoemulsification
cataract surgery followed by monofocal intraocular lens implantation performed by the same
surgeon. The mean age of patients was 73±7 years. The study included 53% of female patients, with no
statistically significant sex difference (Fisher exact test, p=0.72). BCVA was significantly improved after
phacoemulsification cataract surgery with preoperative median BCVA 0.2±0.1 and postoperative median
BCVA 1.0 (-0.1) (Wilcoxon test, p<0.001). TBUT was significantly worse in comparison to preoperative
measurements. Preoperative median TBUT was 10±2 s. Postoperatively, 6 out of 30 patients had TBUT <5
s and 24 out of 30 patients had TBUT measurements between 6 and 10 s (Wilcoxon test, p<0.001). Fluorescein
staining was negative preoperatively in all patients and positive in 10 out of 30 patients after surgery.
Subjective symptoms of dry eye after surgery were reported by 5 out of 30 patients (TBUT <5 s and positive
fluorescein staining). There was no significant difference in visual acuity considering dry eye symptoms
(p=0.51, Mann-Whitney U test). The present study showed that uncomplicated phacoemulsification cataract
surgery influenced tear film instability, worsened TBUT measurement and corneal fluorescein staining,
but fortunately with no statistically significant impact on postoperative BCVA one month after surgery.

Keywords

Cataract; Phacoemulsification; Tear film; Visual acuity

Hrčak ID:

344703

URI

https://hrcak.srce.hr/344703

Publication date:

31.12.2025.

Article data in other languages: croatian

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