Predictors of Postoperative Dry Eye Symptoms Following Uncomplicated Cataract Surgery
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Background: Dry eye symptoms are frequently reported after cataract surgery and may reduce postoperative comfort despite good visual recovery. Objective: This study aimed to determine the incidence and predictors of postoperative dry eye symptoms after uncomplicated phacoemulsification cataract surgery. Methods: This prospective cohort study included 180 adults undergoing uncomplicated phacoemulsification with intraocular lens implantation at a tertiary care hospital in Islamabad, Pakistan. Preoperative assessment included demographic and clinical variables, diabetes mellitus, Ocular Surface Disease Index score, tear film break-up time, Schirmer test, corneal fluorescein staining, and meibomian gland assessment. Patients were followed at one week, one month, and three months after surgery. Postoperative dry eye symptoms and ocular surface parameters were analyzed using descriptive statistics, longitudinal comparisons, chi-square testing, and logistic regression. Results: The mean age was 62.8 ± 8.7 years, and 98 patients (54.4%) were female. Dry eye symptoms increased from 41 patients (22.8%) preoperatively to 68 patients (37.8%) at one week, then decreased to 49 patients (27.2%) at one month and 31 patients (17.2%) at three months. Mean OSDI increased from 14.3 ± 6.8 to 25.7 ± 9.4 at one week, while TBUT decreased from 10.4 ± 2.9 to 7.1 ± 2.6 seconds. Preoperative dry eye symptoms were associated with higher odds of one-week postoperative dry eye symptoms (OR, 3.49; 95% CI, 1.69–7.19; p < 0.001). Meibomian gland dysfunction, diabetes mellitus, and longer surgical duration were also identified as clinically important predictors. Conclusion: Dry eye symptoms were most common during the first postoperative week and improved over three months. Preoperative ocular surface screening may help identify high-risk cataract patients and improve postoperative comfort
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