The Influence of Congenital Cataract Surgery on the Ocular Surface in a Six-Month Follow-Up Prospective Clinical Study

Background: The purpose of this study was to identify changes in tear film function and meibomian gland function in children after congenital cataract surgery. Methods: : This study enrolled 21 eyes of 16 congenital cataract patients (mean age: 8.05±1.43 years) who underwent cataract surgery and 16 eyes of 16 normal volunteers (mean age: 8.31±2.18 years). Clinical assessments were conducted preoperatively and at 1 week, 1 month, 3 months and 6 months postoperatively. Symptom questionnaires, non-invasive tear film break-up time, tear meniscus height, corneal fluorescein staining, lid margin abnormality, meibomian gland expressibility, and meibography were assessed. Results: : The ocular symptom score was significantly higher in congenital cataract patients compared to normal controls during the 5 visits (P=0.009). And the average non-invasive tear film break-up time was significantly lower in congenital cataract patients compared to normal controls (P=0.017). The first non-invasive tear film break-up time and average non-invasive tear film break-up time was lowest at 1 month postoperatively compared to baseline levels (P = 0.008 and P = 0.012, respectively). The lid margin score of the upper eyelid was significantly higher in congenital cataract patients compared to normal controls at 1 week postoperatively (P=0.027). The meibum expressibility score decreased significantly during the 5 visits (P=0.024). No significant difference was observed in meibomian gland tortuosity, meibomian gland width, meibomian gland area and meibomian gland length between the congenital group and normal controls preoperatively and at 6 months postoperatively (P>0.05). Conclusion: Tear film stability and meibomian gland function are worsened transiently after congenital cataract surgery without accompanying meibomian gland morphological changes.