# Management of Dry Eye Disease Pre- and Post-Cataract Surgery: A Personalized Approach

**Authors:** Samantha Spritz, Raul E. Ruiz-Lozano, Zahra Bibak-Bejandi, Nicholas W. Setter, Alejandro Rodriguez-Garcia, Zeenal Dabre, Ali Khodor, Robert Schwartz, Sandeep Jain, Ali R. Djalilian

PMC · DOI: 10.3390/jpm16020086 · 2026-02-03

## TL;DR

This paper discusses managing dry eye disease before and after cataract surgery to improve outcomes and reduce complications.

## Contribution

The paper emphasizes personalized perioperative management of dry eye disease to enhance surgical outcomes.

## Key findings

- Pre-operative diagnosis and treatment of dry eye disease can improve surgical refractive outcomes.
- Failure to address dry eye risk factors can lead to poor surgical outcomes and worsened symptoms.
- Recent diagnostic advancements help understand post-surgery dry eye disease pathophysiology.

## Abstract

Dry eye disease (DED) is a common condition that can be associated with cataract surgery, requiring pre- and postoperative considerations. Pre-existent DED and disruption of the tear film homeostasis due to incisional corneal nerve damage, intra-operative ocular surface drying, microscope phototoxicity, or the toxic effects of preservatives and active ingredients of postoperative drops or a combination thereof, represents a potential mechanism for worsening or developing DED after cataract surgery. Recent diagnostic advancements have enabled us better to understand the pathophysiology of DED after cataract surgery. For patients with pre-existing DED before cataract surgery, early intervention can improve surgical outcomes. In contrast, failure to recognize DED risk factors or subtle signs can result in inaccurate refractive measurements, poor surgical outcomes, including serious complications, worsening of dry eye symptoms, patient dissatisfaction, and decreased quality of life. This review presents an overview of the perioperative management of DED in patients undergoing cataract surgery with an emphasis on pre-operative diagnosis and treatment, and its impact on improving surgical refractive outcomes and decreasing complications.

## Linked entities

- **Diseases:** cataract (MONDO:0005129)

## Full-text entities

- **Genes:** LYZ (lysozyme) [NCBI Gene 4069] {aka AMYLD5, LYZF1, LZM}, IL6 (interleukin 6) [NCBI Gene 3569] {aka BSF-2, BSF2, CDF, HGF, HSF, IFN-beta-2}, MMP9 (matrix metallopeptidase 9) [NCBI Gene 4318] {aka CLG4B, GELB, MANDP2, MMP-9}, FN1 (fibronectin 1) [NCBI Gene 2335] {aka CIG, ED-B, FINC, FN, FNZ, GFND}, ITGAL (integrin subunit alpha L) [NCBI Gene 3683] {aka CD11A, EV6, HNA-5, LFA-1, LFA1A}, TNF (tumor necrosis factor) [NCBI Gene 7124] {aka DIF, IMD127, TNF-alpha, TNFA, TNFSF2, TNLG1F}, PTPRC (protein tyrosine phosphatase receptor type C) [NCBI Gene 5788] {aka B220, CD45, CD45R, GP180, IMD105, L-CA}, NGF (nerve growth factor) [NCBI Gene 4803] {aka Beta-NGF, HSAN5, NGFB}, ICAM1 (intercellular adhesion molecule 1) [NCBI Gene 3383] {aka BB2, CD54, P3.58}, CXCL8 (C-X-C motif chemokine ligand 8) [NCBI Gene 3576] {aka GCP-1, GCP1, IL8, LECT, LUCT, LYNAP}, Mucin [NCBI Gene 100508689]
- **Diseases:** photophobia (MESH:D020795), herpes simplex keratitis (MESH:D016849), nerves injury (MESH:D000080902), neurotrophic keratopathy (MESH:C562399), Aqueous-Deficient (MESH:D007153), Neurotrophic keratitis (MESH:D007634), ocular damage (MESH:D015817), Symptom (MESH:D012816), epithelial defects (MESH:D009375), dizziness (MESH:D004244), toxicity (MESH:D064420), endophthalmitis (MESH:D009877), aqueous deficient dry eye (MESH:D015352), Lid Margin Disease (MESH:D010437), infection (MESH:D007239), cystoid macular edema (MESH:D008269), corneal epithelial defects (MESH:C536444), hypersensitivity (MESH:D004342), MGD (MESH:D000080343), depression (MESH:D003866), Postoperative Neuropathic Pain (MESH:D009437), LWE (MESH:D004409), TFOS (MESH:C000719191), Eye Dryness (MESH:D014987), Cataract (MESH:D002386), CTS (MESH:D002349), anterior blepharitis (MESH:D001762), coma (MESH:D003128), Corneal Nerve Damage (MESH:D065306), fungal (MESH:D009181), eye irritation (MESH:D005128), skin vascular lesions (MESH:D017445), mitochondrial damage (MESH:D028361), ophthalmic disorders (MESH:C535922), TCS (MESH:C565152), blurry vision (MESH:D014786), CFS (MESH:D003316), SPK (MESH:D006259), herpes zoster ophthalmicus (MESH:D006563), pain (MESH:D010146), telangiectasia (MESH:D013684), loss (MESH:D016388), headache (MESH:D006261), inflammation (MESH:D007249), injury to (MESH:D014947), GvHD (MESH:D006086), HOAs (MESH:D002869), Primary Sjogren's syndrome (MESH:D012859), hematologic cancers (MESH:D009369), postoperative pain (MESH:D010149), diabetes (MESH:D003920), OSD (MESH:D010534), stinging (MESH:D001733), psychiatric (MESH:D001523), CL (MESH:D007905), conjunctival hyperemia (MESH:D003229), ocular surface injury (MESH:D005131), Chronic graft-versus-host disease (MESH:D000092122), Phototoxicity (MESH:D017484), autoimmune disease (MESH:D001327)
- **Chemicals:** tetracycline (MESH:D013752), diquafosol (MESH:C403315), CsA (MESH:D016572), BAK (MESH:D001548), Artificial (-), quinolone (MESH:D015363), propylene glycol (MESH:D019946), fluorescein (MESH:D019793), lipid (MESH:D008055), steroid (MESH:D013256), trehalose (MESH:D014199), PI (MESH:D011206), gabapentin (MESH:D000077206), cellulose (MESH:D002482), prednisolone acetate (MESH:C009935), carrageenan (MESH:D002351), sodium chloride (MESH:D012965), azithromycin (MESH:D017963), LE (MESH:D000069559), polymers (MESH:D011108), HPMC (MESH:D065347), polyethylene glycol (MESH:D011092), omega-3 fatty acids (MESH:D015525), rebamipide (MESH:C052785), Lifitegrast (MESH:C575157), fluorometholone (MESH:D005469), diclofenac (MESH:D004008), methylprednisolone (MESH:D008775), water (MESH:D014867), hyaluronic acid (MESH:D006820), xanthan gum (MESH:C002563), chlorhexidine (MESH:D002710)
- **Species:** Homo sapiens (human, species) [taxon 9606], Oryctolagus cuniculus (domestic rabbit, species) [taxon 9986], Mus musculus (house mouse, species) [taxon 10090]

## Figures

6 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12942407/full.md

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Source: https://tomesphere.com/paper/PMC12942407