Abstract: Drop in goblet cell density after cataract surgery

This study used several metrics to evaluate ocular surface changes after cataract surgery. Apparently the only thing measured in this study that did not return to baseline within the study period was goblet cell density, which could explain a lot about why some people get significant dry eye symptoms after cataract surgery.

Changes in the tear film and ocular surface after cataract surgery.

PURPOSE:
To evaluate changes in corneal sensitivity, tear film function, and ocular surface stability in patients after cataract surgery.

METHODS:
This hospital-based prospective randomized trial included 48 eyes from 30 patients who underwent phacoemulsification. Slit-lamp examination, Schirmer test 1 (ST1), and measurement of corneal sensitivity and tear film breakup time (BUT) were performed for all patients 1 day before and 1 day, 1 month, and 3 months after surgery. In addition, conjunctival impression cytology from the temporal region of the conjunctiva was simultaneously performed.

RESULTS:
Corneal sensitivity at the center and temporal incision sites had decreased significantly at 1 day postoperatively (P = .021, P < .001). However, the sensitivity had returned to almost the preoperative level 1 month postoperatively. The mean postoperative ST1 results were no different from preoperative values. On the other hand, BUT results had decreased significantly at 1 day postoperatively (P = .01) but had returned to almost the preoperative level 1 month postoperatively. Mean goblet cell density (GCD) had decreased significantly at 1 day, 1 month, and 3 months postoperatively (P < .001). In addition, decrease in GCD and cataract operative time were highly correlated (r (2) = 0.65).

CONCLUSIONS:
The decrease in GCD, which was correlated with operative time, had not recovered at 3 months after cataract surgery. Therefore, microscopic ocular surface damage during cataract surgery seems to be one of the pathogenic factors that cause ocular discomfort and dry eye syndrome after cataract surgery.

Jpn J Ophthalmol. 2012 Feb 3. [Epub ahead of print]
Oh T, Jung Y, Chang D, Kim J, Kim H.
Department of Ophthalmology and Visual Science, St. Mary's Hospital, College of Medicine, The Catholic University of Korea, #62 Yeouido-dong, Yeongdeungpo-gu, Seoul, 150-713, Korea.