Abstract
Purpose: :
To assess the changes that occur in the tear film after clear cornea phacoemulsification both clinically and chemically.
Methods: :
This prospective study included 32 eyes of 32 patients in whom clear cornea phacoemulsification with IOL implantation was done. The patients were divided into 2 groups A and B. Group A included 22 patients complaining of postoperative eye irritation and discomfort without a clear cause. Group B included 10 patients with no postoperative irritation and was considered as control group. All cases of both groups were subjected to clinical examination and tests for dry eye including tear break up time, staining with fluorescein and rose bengal. Tear samples were obtained from all cases and subjected to determination of the protein content, tear lysozyme molecular weight as well as electrophoresis. The total lipids in the tears and the cholesterol and phospholipid content were measured.
Results: :
Clinical tests as precorneal tear film meniscus measurement, tear break up time and staining with fluorescein and rose bengal showed no statistically significant difference between the two groups examined. This indicated that all cases in both groups did not suffer from manifestations of dry eye at the clinical level. However the mean total protein in group A was 9.29mg/ml and 29.83mg/ml in group B and this difference was statistically highly significant. Also the molecular weight of tear lysozyme in group A was 14.6 Kilo Dalton and 12.94 Kilo Dalton in group B and this difference was statistically highly significant. Electrophoresis of the tear samples showed a difference in the protein fractions in both groups with an increase in the protein molecular weight and a decrease in mobility in group A compared to the control group. The total lipid in group A was 327.18 mg/dl and 366.9mg/dl in group B and this difference was statistically highly significant. The mean cholesterol level in group A was 67.53mg/dl and 69.55mg/ml in group B and this difference was statistically not significant while the mean phospholipid content in group A was 128.87 mg/dl and 183.37mg/dl in group B and this difference was statistically highly significant.
Keywords: cornea: tears/tear film/dry eye • treatment outcomes of cataract surgery