Abstract

Dry eye disease (DED) represents one of the most common complications following cataract surgery, significantly impacting patient quality of life and visual outcomes. This prospective study evaluated tear film dysfunction and dry eye symptoms in 180 patients who underwent uncomplicated phacoemulsification with intraocular lens implantation over a 12-month follow-up period. Patients were assessed using comprehensive tear film evaluation including Schirmer's test, tear break-up time (TBUT), ocular surface disease index (OSDI), and fluorescein staining at baseline, 1 week, 1 month, 3 months, 6 months, and 12 months post-operatively. Results demonstrated a significant increase in dry eye symptoms and tear film instability during the first 3 months post-surgery, with 67.2% of patients developing new-onset dry eye or experiencing worsening of pre-existing symptoms. The mean OSDI score increased from 18.4±12.3 pre-operatively to 42.7±18.9 at 1 month (p<0.001), while TBUT decreased from 8.2±3.1 seconds to 5.1±2.4 seconds (p<0.001). Recovery patterns showed gradual improvement after 3 months, though 35% of patients continued to experience persistent dry eye symptoms at 12 months. Risk factors for post-operative dry eye included advanced age, female gender, pre-existing meibomian gland dysfunction, longer surgical duration, and concurrent topical medication use. These findings underscore the importance of pre-operative dry eye screening, appropriate patient counseling, and implementation of prophylactic and therapeutic strategies to minimize post-surgical ocular surface complications.