# Predictive value of biochemical markers CRP, WBC, and total cholesterol for postoperative dry eye syndrome following phacoemulsification cataract surgery

## TL;DR

This study shows that blood markers CRP, WBC, and cholesterol can predict dry eye syndrome after cataract surgery, with combined testing being most accurate.

## Contribution

The study demonstrates that combining CRP, WBC, and total cholesterol improves prediction of postoperative dry eye syndrome.

## Key findings

- CRP, WBC, and TC levels were significantly higher in patients who developed dry eye syndrome.
- CRP, WBC, and TC were identified as independent predictors of dry eye syndrome.
- The combined model of CRP, WBC, and TC achieved an AUC of 0.936, outperforming individual markers.

## Abstract

Dry eye syndrome is a common complication following phacoemulsification cataract surgery, potentially influenced by systemic biochemical factors. This study aimed to evaluate the predictive efficiency of three routinely measured biochemical markers - C-reactive protein (CRP), white blood cell count (WBC), and total cholesterol (TC) - in identifying patients at risk for postoperative dry eye syndrome.

A total of 87 patients undergoing phacoemulsification between January 2024 and February 2025 were enrolled and categorized into dry eye (n=49) and non-dry eye (n=38) groups. Blood samples were collected preoperatively to assess CRP, WBC, and TC levels using standard laboratory protocols. Baseline characteristics were compared, and multivariate logistic regression was conducted to identify independent risk factors. Receiver operating characteristic (ROC) curves were generated to determine the predictive performance of each marker and their combination.

Patients in the dry eye group exhibited significantly elevated CRP, WBC, and TC levels compared to the non-dry eye group (P<0.001 for all). Multivariate analysis identified CRP (O R = 12.679), WBC (O R = 3.216), and TC (OR= 1.258) as independent predictors. The area under the ROC curve (a Uc ) values for CRP WBC, and TC were 0.791, 0.770, and 0.757, respectively, while the combined model yielded an AUC of 0.936, indicating superior diagnostic performance (P< 0.01).

CRP, WBC, and TC levels are clinically accessible biochemical parameters that hold significant predictive value for dry eye syndrome following cataract surgery.Combined detection enhances prognostic accuracy andmay guide early intervention strategies to reduce postoperative complications.