Background: Dry eye is a clinical condition resulting from decreased tear production or increased loss of tears due to evaporation. Conjunctival impression cytology (CIC) helps in evaluating the abnormal tear film status apart from the routine tear function tests.

Aim: We aimed to know the influence of small incision cataract surgery on tear film and assess the changes in tear film by CIC.

Materials and Methods: 101 patients diagnosed with cataract were studied over a period of 2 years. Schirmer’s test, tear film break up time, fluorescein staining and lissamine green staining were done pre and post operatively. Conjunctival impression cytology smears stained with periodic acid Schiff (PAS) stain were analyzed pre and post operatively.

Results: Pre-operatively CIC showed 15 patients (14.8 %) with no cells, 72 patients (71.2 %) with squamous cells and 14 patients (13.8 %) with squamous and goblet cells. Post-operatively 36 patients (35.6 %) showed no cells, 52 patients (51.4 %) showed squamous cells and 13 patients (12.8 %) showed squamous and goblet cells. Pre-operatively Schirmer’s test showed 90 patients (89.1 %) to be normal and 11 patients (10.9 %) abnormal. Post-operatively 85 patients (84.1 %) were normal and 16 patients (15.9 %) were abnormal. Tear film break up time, flourescein staining and lissamine green staining showed no changes pre and post operatively. CIC and Schirmer’s test showed a significant positive correlation with p values of 0.001 and 0.034 respectively. Tear film break up time, fluorescein staining and lissamine green staining showed a negative correlation.

Conclusions: Manual small incision cataract surgery is associated with a significant worsening of tear film stability and CIC is a vital tool with diagnostic accuracy in evaluating tear film status.

Keywords: Cataract; CIC; Dry Eye; Goblet; Squamous; Tear Film.