Background: Dry Eye Syndrome (DES) is a common postoperative complication of cataract surgery, particularly phacoemulsification, potentially impacting patient comfort and satisfaction. Although often transient, its incidence and severity may be influenced by surgical factors and systemic comorbidities. Aim: To prospectively evaluate the incidence, severity, and progression of Dry Eye Syndrome in patients undergoing phacoemulsification cataract surgery, and to assess the influence of systemic comorbidities on postoperative DES. Material and Methods: This prospective observational study included 110 patients aged ≥50 years undergoing phacoemulsification for senile cataract. Patients with pre-existing ocular surface disorders or autoimmune conditions were excluded. All participants underwent standardized preoperative assessments, including Schirmer’s Test I, Tear Film Break-Up Time (TBUT), Ocular Surface Disease Index (OSDI), and fluorescein staining. Postoperative evaluations were conducted on Day 7, Day 30, and Day 90. Data were analyzed using paired t-test and chi-square test, with p < 0.05 considered statistically significant. Results: The mean preoperative Schirmer’s value was 17.8 ± 5.1 mm and TBUT was 12.6 ± 3.4 seconds. Postoperatively, Schirmer’s and TBUT dropped significantly at Day 7 (10.4 ± 3.2 mm; 6.2 ± 1.9 sec), with gradual recovery by Day 90 (15.1 ± 4.3 mm; 10.9 ± 3.2 sec). OSDI scores increased from 13.5 ± 5.9 preoperatively to 28.6 ± 7.3 on Day 7, declining to 15.7 ± 5.8 by Day 90. Based on DEWS II criteria, 74.55% had DES on Day 7, decreasing to 36.36% by Day 90. Hypertension and diabetes were significantly associated with higher DES incidence (p = 0.031 and p = 0.021, respectively). Conclusion: Phacoemulsification cataract surgery leads to a transient but significant increase in dry eye symptoms, peaking in the first week postoperatively and resolving over three months. Systemic comorbidities such as hypertension and diabetes markedly elevate the risk. Early recognition and appropriate management of DES can enhance postoperative outcomes.