Pre- and Post-cataract Surgery Blinking Rate as an Evaluative Indicator of Clinical Outcome.

PURPOSE: To compare postoperative outcomes of phacoemulsification (PHACO) and small-incision cataract surgery (SICS), with emphasis on visual acuity, blink rate, ocular surface health and biometric changes.

METHODS

A prospective study was conducted on 80 patients (40 PHACO, 40 SICS) with age-related cataracts. Preoperative and postoperative assessments at day one, week one, and 1.5 months included LogMAR visual acuity, blink rate, Schirmer's test, tear breakup time (TBUT), keratometry (K1, K2), and axial length.

RESULTS

Mean visual acuity improved markedly (LogMAR 1.57 ± 0.87 to 0.37 ± 0.25, p<0.001). Blink rate reduced significantly (6.63 ± 5.03 to 2.91 ± 1.84/min, p<0.001), reflecting better ocular surface stability. TBUT showed a modest increase (5.34 ± 2.58 to 6.38 ± 4.66 s, p=0.023), significant in PHACO (p=0.013) but not in SICS (p=0.114). Schirmer's values (p=0.124) did not show significant overall change, though subgroup analysis revealed PHACO was associated with reduced tear secretion. Both groups showed significant increases in corneal curvature and axial length by 1.5 months.

CONCLUSION

Phacoemulsification provided faster and superior visual recovery but was associated with reduced tear secretion, whereas SICS preserved ocular surface comfort despite slower visual rehabilitation. Blink rate reduction and TBUT improvement emerged as simple, non-invasive indicators of postoperative ocular surface stability, supporting their incorporation into cataract surgery outcome assessment.