Can Cataract Surgery Damage Tear Ducts?
Cataract Surgery is the most commonly performed procedure in the UK and many other Western countries. For this reason, it is associated with an extremely high success rate and a low risk of complications. However, we understand that undergoing any kind of surgical procedure – particularly when it comes to something as important as our eyes – can be scary, to say the least.
That’s why we have put together a series of articles to tell you everything you need to know about Cataract Surgery. This time, we’re answering the question: Can Cataract Surgery damage the tear ducts?
But before we get into that, let’s take a look at the basics.
What is Cataract Surgery?
Cataracts form naturally as we age and the proteins in the eye’s lens begin to break down. Over time, this causes a cloudy obstruction that can cause significant vision impairment and even blindness. Cataract Surgery is a procedure designed to remove cataracts from the eye.
It involves removing the cataract-affected lens from the eye and replacing it with an artificial intraocular lens (IOL). This is done by creating a small incision on the surface of the eye and breaking up the cataract using an ultrasonic probe. The broken-down tissue can then be removed from the lens capsule and an artificial lens implanted.
The primary aim of Cataract Surgery is to remove the cataract from the eye. However, private clinics can offer premium IOLs that can also correct refractive errors, reducing the need for glasses and contact lenses after the procedure.
What are Tear Ducts?
The tear duct is just one part of the eye’s drainage system. Also known as the nasolacrimal duct, it drains tears through the nasal bone and into the back of the nose.
Tears are essential to keeping our eyes hydrated and healthy. They start at the lacrimal glands in the outer upper corners of the eye socket and from there they are spread over the surface of the eye when we blink. Tears then drain into tiny holes in the corners of our eyes (puncta) and through small drainage canals called the canaliculi that lead to the lacrimal sac (or tear sac).
This sac drains into the tear duct, at which point, tears will evaporate or be reabsorbed. The tear duct is extremely important in maintaining the proper drainage function in the eyes. When these become blocked or damaged, tears are unable to drain from the eyes. This can cause extremely watery or teary eyes and increase the risk of various infections.
Could Cataract Surgery affect tear ducts?
While Cataract Surgery is a relatively invasive ocular procedure, it is not associated with any damage to the tear ducts. However, Cataract Surgery can disrupt the tear film in the eye. This can lead to Dry Eye Syndrome (DES) which can cause discomfort, irritation, and visual disturbance.
According to a 2019 study, factors that could cause DES following Cataract Surgery include:
- The surgical incision causing the tear film on the surface of the eye to break up more quickly;
- Reduced mucin production in the eye;
- Reduced tear film production due to inflammation and light exposure from the operating microscope;
- Decreased tear secretion;
- and Prolonged use of antibiotic steroid eye drops.
The incidence of dry eyes is higher in small incision Cataract Surgery (SICS) than in phacoemulsification due to tear film instability. However, DES should be considered a possibility in all patients following Cataract Surgery.
Thankfully, dry eyes can usually be managed with the use of artificial tears – or lubricating eye drops. These are provided as part of your treatment at London Vision Clinic. Your surgeon will instruct you on how and how often to use your eye drops during your recovery period.