AIM: To investigate the long-term effect of different incisions on the tear film after phacoemulsification.

METHODS: Sixty-four patients(76 eyes)without dry eyes were selected and received phacoemulsification. The patients were divided into two groups randomly. Group A 30 patients(38 eyes)was performed with a 2.5mm mini-incision coaxial phacoemulsification and group B 34 patients(38 eyes)was performed with a sub 1.8mm micro-incision cataract surgery(MICS). Schirmer I test(SⅠt), tear break-up time(BUT), corneal fluorescein staining(CFS)and tear osmolarity were observed at 3d preoperatively and 1wk, 1, 3, 6mo and 1a postoperatively. The results were analyzed using a chi-square test and t-test with SPSS 19.0.

RESULTS:(1)Schirmer Ⅰ test(SⅠt): there was a significant increase in SIt at 1wk postoperatively. The difference between group A and group B was significant(P<0.01)at 1wk postoperatively, but it was insignificant at other postoperative time points(P>0.05).(2)Tear break-up time(BUT): there was a large reduction in BUT at 1wk, 1, 3mo postoperatively. The difference between group A and group B was significant(P<0.05). However, there were no significant differences between the two groups at other times(P>0.05).(3)CFS score: there was a large increase in CFS at 1wk, 1, 3mo postoperatively. The difference between group A and group B was significant(P<0.05). However, there were no significant differences between the two groups at other times(P>0.05).(4)Tear osmolarity: there was a large increase in tear osmolarity at 1wk, 1mo postoperatively. The difference between group A and group B was significant(P<0.01). However, there were no significant differences between the two groups at other times(P>0.05).

CONCLUSION: The stability of tear film in patients underwent sub 1.8mm micro-incision cataract surgery(MICS)is much better than in patients received 2.5mm mini-incision coaxial phacoemulsification, but symptomys of dry eye in patients operated with MICS are much more serious during the early postoperative period. There is no significant difference in the long-term effects on tear film between the two types of incision.