Cataract Surgery Causing Dry Eyes? Get Relief w/TheraLife

Symptoms of dry eyes after cataract surgery

People complain about eye pain, foreign body sensation after cataract surgery. In many cases, these symptoms are due to post-operative exacerbation of dry eye disease (DED).

Dry eye treatment can be addressed quickly by TheraLife using oral dry eye treatment- restore and revive your tear production glands to achieve dry eye relief. To learn more, click here.

How many people have dry eyes?

Dry-eye disease is estimated to affect more than 60 million Americans, and the prevalence of dry eye increases with age. Additionally, cataract surgery will make pre-existing dry eye worse.

It will also induce dry eye in people who have healthy corneas without dry eyes before. Post-operative dry eye can result in poor vision and impact visual recovery time.

Why do you have dry eyes after cataract surgery?

The reason for dry eyes after surgery is because cataract surgery makes a tiny incision, plus the fact that most people getting cataract surgery are older. There is almost always worsening of dry eye after cataract surgery.

Besides, elderly people are more sensitive to the medications given during surgery, particularly nonsteroidal anti-inflammatory drugs -which can damage the ocular surface and cause dry eye disease.

Dry eye is expected in this patient population. Approximately 20 percent of patients undergoing surgery have an underlying dry eye already. 

Incidence of dry eyes post surgery

The literature shows dry eye symptoms are found in 42% of eyes at 1oneweek post surgery and approximately one-third of patients after three months post-surgery. For more information, click here.

Studies have shown 306 patients who underwent surgery, measuring pain and satisfaction in the recovery room. 37% of patients had mild or moderate pain, whereas 34% required oral pain meds.

Any post-operative pain was the most significant predictor of Cataract surgery dissatisfaction.

Dry eye is the most frequent complaint after Surgery.

It is not unusual for people surgery. Since most of the population requiring surgery are older, many already have a dry eye tendency and may first become more aware of it after surgery.

The surface area around the microscopic cataract incision causes dry eyes.

This area must be well lubricated during the first several months so that the eye feels comfortable.

The cataract incision is very tiny – like a microscopic paper cut – but because the lid is continuously rubbing against it with blinking, extra surface lubrication will provide maximal comfort.

People may temporarily experience some irritation and scratchiness when lacking tear stability. Sometimes result in blinking or sudden reflex tearing (watery eyes).

Up to one third (1/3) of people have persistent dry eye syndrome beyond three (3) months after surgery. Plus ongoing tear instability and corneal epitheliopathy after five months or more following surgery. So it’s not as temporary as we think and can become a chronic condition.

 Causes of dry eyes after surgery

 Several factors may be involved with chronic dry eyes after cataract surgery. 

1. Decreased goblet cell density, age, duration of exposure to microscope light, and effective phacoemulsification time all can play a role.6
2.  Using femtosecond laser-assisted cataract surgery7 or a grooved incision8 may worsen signs and symptoms of dry eye disease.  Medication toxicities can also be a factor. However, no relationship to the incision location is a factor.

Risk factors

1.Pre-existing DED is a significant risk factor for persistent post-operative dry eye disease.

This study found that a group of patients with pre-operative dry eyes showed significantly higher post-operative ocular symptom scores, lower tear breakup time, and increased lid margin abnormalities, meibum quality, and expressibility scores compared to a normal eye group.

 2.Higher baseline OSDI scores, 1-month post-operative low tear breakup time, low meibomian gland orifice obstruction scores, and increased meibomian gland dropout are all risk factors for persistent DED after cataract surgery.10

Post-surgical effects

Meibomian gland dysfunction (MGD) can be affected after cataract surgery and can worsen with or without structural changes.9,11 Changes in how easily meibomian glands are expressed and tear breakup time can persist for up to 3 months postoperatively.12

Management of post-op dry eye disease

Management will depend on patient symptoms combined with clinical findings. If a person has pain, we should determine the quality and timing. Does it occur early in the morning or later in the day, and is it fleeting or a constant irritation? Is it an ache or a sharp pain? If the person is experiencing blurred vision, is it stable or fluctuating?

Evaluation of other corneal surface abnormalities such as epithelial basement membrane disorder (EBMD), conjunctival chalasis, Salzmann’s nodular degeneration (SND), and pterygium are also necessary.

Placido-disk topography can be useful and positive or negative staining with sodium fluorescein (NaFL). In severe cases, surgery may be required.   

TheraLife’s Protocol for dry eye treatment

TheraLIfe’s dry eye recovery protocol consists of:

1. TheraLife Eye capsules, 4 in the morning, four at night.
2. 4000mg/day of Omega 3 fish oil, which is also strongly anti-inflammatory and help provide lubrication to thicken tears. 
3. Hot compress twice a day, 10 minutes each time. A hot washcloth is not good enough. Hot compress will help keep the meibomian oil glands healthy and producing natural lubrication all day long.
4. Eyelid hygiene – we highly recommend Avenova eyelid cleanser, which builds up a biofilm to prevent re-attachment of bacteria.

 Sometimes steroids may be prescribed by your eye doctor to keep inflammation at bay. Beware that prolonged steroid use will cause glaucoma and increase your intraocular pressure.  

 Call TheraLIfe toll free and talk to a doctor. See if TheraLife is right for you. 1-877-917-1989 US/Canada

Reference(s):

1.     Ishrat S, Nema N, Chandravanshi SCL. Incidence and pattern of dry eye after cataract surgery. Saudi J Ophthalmol. 2019 Jan-Mar;33(1):34-40. doi: 10.1016/j.sjopt.2018.10.009. Epub 2018 Oct 27. PMID: 30930661; PMCID: PMC6424692.

2.     Iglesias E, Sajnani R, Levitt RC, et al. Epidemiology of Persistent Dry Eye-Like Symptoms After Cataract Surgery. Cornea. 2018 Jul;37(7):893-898. doi: 10.1097/ICO.0000000000001491. PMID: 29504953; PMCID: PMC5991988.

3.     Fung D, Cohen MM, Stewart S, et al. What determines patient satisfaction with cataract care under topical local anesthesia and monitored sedation in a community hospital setting? Anesth Analg. 2005 Jun;100(6):1644-50. doi: 10.1213/01

4.     Woodward MA, Randleman JB, Stulting RD. Dissatisfaction after multifocal intraocular lens implantation. J Cataract Refract Surg. 2009 Jun;35(6):992-7. doi: 10.1016/j.jcrs.2009.01.031.

5.     Hanyuda A, Ayaki M, Tsubota K, et al. Discrepancies in Persistent Dry Eye Signs and Symptoms in Bilateral Pseudophakic Patients. J Clin Med. 2019 Feb 7;8(2):211

6.     Kohli P, Arya SK, Raj A, et al. Changes in ocular surface status after phacoemulsification in patients with senile cataract. Int Ophthalmol. 2019 Jun;39(6):1345-1353.

7.     Yu Y, Hua H, Wu M, et al. Evaluation of dry eye after femtosecond laser-assisted cataract surgery. J Cataract Refract Surg. 2015 Dec;41(12):2614-23.

8.     Cho YK, Kim MS. Dry eye after cataract surgery and associated intraoperative risk factors. Korean J Ophthalmol. 2009 Jun;23(2):65-73. doi: 10.3341/kjo.2009.23.2.65. Epub 2009 Jun 9.

9.     Park Y, Hwang HB, Kim HS. Observation of Influence of Cataract Surgery on the Ocular Surface. PLoS One. 2016 Oct 3;11(10):

10.   Choi YJ, Park SY, Jun I, et al. Perioperative Ocular Parameters Associated With Persistent Dry Eye Symptoms After Cataract Surgery. Cornea. 2018 Jun;37(6):734-739.

11.   Han KE, Yoon SC, Ahn JM, et al. Evaluation of dry eye and meibomian gland dysfunction after cataract surgery. Am J Ophthalmol. 2014 Jun;157(6):1144-1150.

12.   El Ameen A, Majzoub S, Vandermeer G, et al. Influence of cataract surgery on Meibomian gland dysfunction. J Fr Ophtalmol. 2018 May;41(5):e173-e180. doi: 10.1016/j.jfo.2018.03.001. Epub 2018 May 16. PMID: 29778280.