Cataract Surgery Can Significantly Change Blink Patterns

Following cataract removal, the ocular surface may be at elevated risk due to reduced blinking.

Cataract surgery can significantly alter patients’ blinking pattern 3 months postoperatively, potentially compromising the ocular surface, according to findings published in the Journal of Cataract and Refractive Surgery. Blinking kinematics remain unaffected, the study shows.

Researchers conducted an observational study to assess the effect cataract surgery has on spontaneous blinking patterns and blinking kinematics. The study included 50 participants with age-related cataract who were evaluated before undergoing cataract surgery with phacoemulsification. Patients were also seen 1 month and 3 months postoperatively. The researchers recorded patients’ blinking for 90 seconds using an eye-tracking device. To obtain a noninvasive detailed description of blinking including blink rate, clinicians used image analysis and included the number of complete and incomplete blinks, percentage of incomplete blinks and kinematic parameters. These parameters included amplitude, closing, contact, opening, total durations, and closing and opening speeds.

The study found that the blink rate was significantly lower at 1 month (P =.001) and 3 months (P =.03) after the operation compared with baseline. (P =.03). Also, the researchers observed a significantly lower number of complete blinks, and a significantly higher percentage of incomplete blinks 3 months postoperatively, compared with baseline (P =.02 and P =.01, respectively). 

We should be aware of potential alterations in blinking after phacoemulsification cataract surgery and the implications this may have on the ocular surface of patients.

The researchers explain that these abnormal blinking patterns may alter meibomian gland secretion, leading to chronic changes in the gland.

“We should be aware of potential alterations in blinking after phacoemulsification cataract surgery and consider solutions to counteract the impact on the ocular surface of patients,” according to the investigators. 

Study limitations include possible confounding due to the participants’ awareness of their blinking patterns when under examination conditions; selection bias due to the participation of more patients with ocular discomfort; and a lack of control group.


Talens-Estarelles C, Amparo Diez-Ajenjo M, Pons AM, Peris-Martinez C, Garcia-Lazaro S. Effects of cataract surgery on blinking. J Cataract Refract Surg. Published online OCtober 17, 2022. doi:10.1097/j.jcrs.0000000000001081