REVIEW article
Front. Med.
Sec. Ophthalmology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1559323
This article is part of the Research TopicReviews in: Ophthalmology 2024View all 9 articles
THE IMPACT OF CATARACT SURGERY ON TEAR FILM PHYSIOLOGY: SIGNS AND SYMPTOMS, PROGRESSION AND TREATMENT
Provisionally accepted
- 1San Luigi Gonzaga University Hospital, Orbassano, Italy
- 2Department of Neuroscience, San Luigi Gonzaga University Hospital, Turin, Piedmont, Italy
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Purpose: revising data published in literature on the effects of cataract surgery on tear film characteristics, in relation to personal clinical surgical experience. Methods: A search was undertaken using PubMed (all years). Search terms included 'cataract surgery ', 'phacoemulsification' and 'cataract extraction', 'manual small-incision cataract surgery', combined at first with 'ocular surface' and 'lacrimal film'. Secondly, we combined terms as 'cataract surgery', 'phacoemulsification' and 'cataract extraction', 'manual small-incision cataract surgery' with 'dry eye disease (DED)' and 'dry eye syndrome'. Thirdly, we combined terms as 'cataract surgery', 'phacoemulsification' and 'cataract extraction', 'manual small-incision cataract surgery' with 'conjunctival sensitivity' and 'sensitivity of the conjunctiva'. For last we combined terms as 'cataract surgery', 'phacoemulsification' and 'cataract extraction', 'manual small-incision cataract surgery' with 'epiphora' and 'excessive tear'. Relevant in-article references not returned in our searches were also considered.Results: we analyzed collected data regarding DED characteristics and management of this condition related to cataract surgery. The relationship between ocular surface signs and symptoms and cataract surgery appears to be strong, indeed TBUT, Schirmer's test and OSDI scores are abnormal as early as two weeks after cataract surgery, however there are conflicting evidence concerning duration of these alterations and restoration of the preoperative conditions, generally within 6 months after surgery. An increased risk of DED after cataract surgery is associated with pre-existing MGD. The chosen surgical procedure, pre-and postoperative pharmacological management are also key points in determining the extent of postoperative DED. Lastly, no remarkable evidence was found on the association of "cataract surgery" with "hyperlacrimation" or "conjunctival sensitivity". Conclusion: the available evidence is discrepant regarding onset, progression and management of this condition. However, the association between cataract surgery and the occurrence of DED thereafter is well documented. Multicenter randomized trials are needed to strengthen the already published data, to investigate these divergencies and to establish diagnostic-therapeutic protocols to manage this condition.
Keywords: Tear film, dry eye, Dry eye disease, Cataract, Cataract surgery
Received: 12 Jan 2025; Accepted: 15 Jul 2025.
Copyright: © 2025 Nuzzi, Tibaldi and Nuzzi. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Alessia Nuzzi, San Luigi Gonzaga University Hospital, Orbassano, Italy
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