There are several reasons why dry eye often develops after cataract surgery.
The main reason involves the tear film on your eyes. The tear film is a layer of liquid that covers the surface of your eye. It’s made of three layers, including an outer lipid layer.
The lipid layer works to stabilize the tear film. This stops tears from evaporating, which keeps the eye surface smooth and lubricated.
Cataract surgery can make the lipid layer thinner. As a result, the tear film becomes unstable, resulting in dry eyes.
Dry eyes after cataract surgery may also be related to:
- Corneal nerve damage. Corneal nerves are involved in tear production. If the surgery damages a corneal nerve, it may lead to reduced blinking and tear production, resulting in dryness.
- Light exposure. During cataract surgery, your surgeon will use a microscope that has a bright light. The light may reduce goblet cells in your eyes, which are responsible for lubricating the eye.
- Inflammation. Inflammation is a normal response after you’ve had surgery, including cataract surgery. In this case, inflammation in your eye could decrease tear production.
- Medicated eye drops. After surgery, you’ll likely need to use medicated eye drops to manage pain and swelling. The pain relievers, corticosteroids, and preservatives in these eye drops might slow down healing, which can worsen dry eye.
Additionally, if you already had dry eyes before surgery, the procedure could worsen your symptoms.
Other risk factors that may increase your risk of dry eyes after cataract surgery include:
- being older
- having underlying medical conditions
- using certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), after surgery