• Purpose: To evaluate dry eye and meibomian gland dysfunction after cataract surgery. • Design: Prospective observational case series. • Methods: We studied 58 eyes of 48 patients who underwent phacoemulsification and evaluated them preoperatively and at 1 month and 3 months postoperatively. Ocular symptom scores, lid margin abnormalities, superficial punctate keratopathies (SPKs), tear film break-up time (TBUT), Schirmer test, lower tear meniscus height, depth, and area using Fourier domain optical coherence tomography, meibum expressibility and images of the meibomian glands using meibography were measured. • Results: The ocular symptom scores were worse at 1 month and 3 months postoperatively (P < 0.001 and P < 0.001, respectively). Lid margin abnormalities were significantly increased (P < 0.001 and P < 0.001, respectively) and TBUT decreased postoperatively (P < 0.001 and P < 0.001, respectively). Meibum expressibility decreased at 3 months postoperatively (P = 0.016); however, meibography score, SPK, lower tear meniscus height, depth and area and the Schirmer test did not change significantly postoperatively (all P values >0.05). • Conclusion: Meibomian gland function may be altered without accompanying structural changes after cataract surgery.
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