Investigation of tear production dynamics in patients with age-related cataract before and after phacoemulsification

Purpose. To investigate the tear production (TP) dynamics in patients with age-related cataract before and after phacoemulsification (PE). Material and methods. 136 patients (136 eyes) admitted for age-related cataract treatment. Age 69.3 6.4 years. 64 men and 72 women. Besides standard ophthalmological examination, in all patients Schirmer`s I test was performed before surgery on the next day, 7, 14 and 30 days after surgery. Patients were divided into 4 groups. The 1st group consisted of 32 patients (32 eyes) with TP 15 mm and more. The 2nd group 48 patients (48 eyes) with TP from 10 to 15 mm. The 3rd group 40 patients (40 eyes) with TP from 5 to 10 mm. The 4th group 16 patients (16 eyes) with TP less than 5 mm. In all patients, PE was performed according to standard technology. Results. All surgeries were performed without complications. In 56 eyes of groups 3 and 4 (41.2%) there was depression of TP of moderate and severe degree before surgery. The first day after surgery in all study groups there was twofold increase of Schirmer`s test indices. Starting from 7th day after surgery, in all groups, a 22-35% decrease of TP from baseline was observed. Later on, a gradual increase of TP was noted. On the 30th day after PE, Schirmer`s test indices were lower than those of baseline in 4 eyes (13%) of the 1st group, 10 eyes (21%) of the 2nd group, 31 eyes (77%) of the 3rd group, and 10 eyes (63%) of the 4th study group. Conclusions. The study of TP in patients with age-related cataract showed that during one month after surgery TP returned to baseline indices only in 59.6% of patients. Regardless of its baseline indices, after the surgery, there is an universal TP dynamics, which is characterized by its initial increase, subsequent decrease and gradual return to baseline indices. Patients with initial low TP indices have potentially high risk of developing clinically significant dry eye syndrome.