Abstract:Postcataract surgery dry eye (PCSDE) is a common complication with an incidence of 9.2%-72.6%, and approximately 20% of patients experience persistent symptoms. In the era of refractive cataract surgery, dry eye has become a critical factor affecting surgical satisfaction due to rising patient expectations for visual quality. Emerging evidence highlights that the interplay between neurosensory abnormalities and immune-inflammatory responses drives PCSDE chronicity, with psychoneurological factors gaining increasing attention. This review systematically examines PCSDE pathogenesis and contributing factors from this novel perspective, encompassing surgical variables (incision design, duration, technique), patient-related factors (age, meibomian gland function, systemic diseases, psychological status), and perioperative management (drug toxicity, disinfectant use). Additionally, we synthesize recent clinical evidence to propose comprehensive prevention and treatment strategies, including preoperative optimization of ocular surface conditions, intraoperative ocular surface protection techniques, and personalized postoperative regimens. A deeper understanding of the multifactorial mechanisms of PCSDE is crucial for enhancing the quality of cataract surgery and improving patient outcomes. This review establishes a novel framework for PCSDE management based on neuro-immune-psychological interactions, offering theoretical updates and practical guidance to enhance visual quality and patient satisfaction in refractive cataract surgery.
