What is the cause of a foreign body sensation, like a grain of sand, in the corneal area of the left eye after cataract surgery, which was not experienced during the first operation?

From the Guidelines

The sensation of a foreign body or "grain of sand" in the eye after cataract surgery is most likely due to a common postoperative symptom that typically resolves on its own within a few days to weeks, as supported by the adult strabismus preferred practice pattern 1. This feeling is normal after cataract surgery and occurs due to several factors:

• the incision made in the cornea during surgery
• temporary dryness of the eye surface
• sensitivity to the eye drops used after surgery To manage this discomfort,
• use preservative-free artificial tears frequently (4-6 times daily) to keep the eye lubricated
• continue all prescribed post-operative medications exactly as directed, including antibiotic and anti-inflammatory drops
• avoid rubbing the eye, as this can irritate the healing incision If the sensation worsens, is accompanied by severe pain, decreased vision, or unusual discharge, contact your ophthalmologist promptly as these could indicate complications. The difference in sensation between your first and second cataract surgeries is not unusual, as each eye may heal differently and have varying levels of sensitivity, and postoperative concerns such as foreign body sensation are common to adults after strabismus surgery, as noted in the adult strabismus preferred practice pattern 1. It's also important to note that other studies, such as the corneal edema and opacification preferred practice pattern 1 and the refractive surgery preferred practice pattern 1, do not directly address the cause of foreign body sensation after cataract surgery, but they do provide information on postoperative care and management of complications. However, based on the most recent and relevant evidence, the adult strabismus preferred practice pattern 1 provides the best guidance for managing foreign body sensation after cataract surgery.

From the Research

Possible Causes of Foreign Body Sensation

• A foreign body sensation in the corneal area of the left eye after cataract surgery may be caused by various factors, including dry eye syndrome, corneal epithelial defects, or filamentary keratitis 2.
• Dry eye syndrome, which can occur after cataract surgery, may lead to a foreign body sensation, grittiness, and discomfort 3, 2.
• Corneal epithelial defects, which can be a complication of vitreoretinal surgery, may also cause a foreign body sensation, photophobia, and tearing 4.

Treatment and Management

• Topical corticosteroids may be used to treat dry eye syndrome and reduce inflammation, but their effectiveness and safety are still uncertain 3.
• Therapeutic bandage contact lenses may be used to improve tear-film stability and reduce post-operative discomfort after cataract surgery 5.
• Lubrication, punctal occlusion, removal of filaments, hypertonic saline, mucolytic agents, and anti-inflammatory agents may be used to manage filamentary keratitis 2.

Post-Cataract Surgery Complications

• Cataract surgery may lead to complications such as dry eye syndrome, corneal epithelial defects, and filamentary keratitis, which can cause a foreign body sensation 4, 2, 5.
• The use of therapeutic bandage contact lenses after cataract surgery may improve tear-film stability and reduce post-operative discomfort, but more research is needed to confirm its effectiveness and safety 5.