Conjunctival impression cytology as an assessment of ocular surface changes following manual small incision cataract surgery

Purpose: To determine the changes inocular surface following manual small incision cataract surgery. Setting: Department of Ophthalmology, Sri Venkateswara Medical College, Tirupati. Design: A prospective study Methods: The study was conducted in 100 eyes of 100 patients. All selected patients without dry eye symptoms preoperatively and who underwent uncomplicated cataract surgery were included in the study. They were studied for tear film breakup time (TBUT), ocular surface staining by Rose Bengal (RB) staining method, and conjunctival impression cytology (CIC) from inferior bulbar conjunctiva. Tests were performed 1 day before and 1wk, 1month and 3months after manual small incision cataract surgery (SICS). Results: Majority of the study participants were aged between 5160 years (51%) with the female predominance. In 8 % of the patients, lower TBUT values were recorded at 3 months postoperative follow up, with statistical significance ( P<0.01). There was a statistically significant difference in ocular surface changes with RB staining between preoperative and postoperative 1 week, 1 month, and 3 months follow up (P<0.002). On CIC, 12%, 49%, 46% of patients showed abnormal grades (grade2 or 3) at 1 week, 1 month, and 3 months postop respectively with a statistically significant value (P < 0.03). Conclusion: Patients undergoing manual SICS without having dry eye preoperatively, showed changes in ocular surface and tear film stability. Positive test with RB staining and abnormal grading of goblet cells studied by CIC during the postoperative period had shown that compromised ocular surface health after SICS, which can produce dry eye.