28 | EYEWORLD DAILY NEWS | MAY 4, 2019
ASCRS NEWS
ASCRS ASOA ANNUAL MEETING
by Ellen Stodola
EyeWorld Senior Staff Writer/
Meetings Editor
that cause tear instability and some
that are common but might not be
addressed. The biggest of these,
he said, conjunctivochalasis, is fair-
ly simple to treat prior to cataract
surgery.
The lecture will also review
evidence-based recommendations
for things that could increase
or improve tear film instability.
In terms of what patients may
be able to do themselves, Dr.
Pflugfelder pointed to nutrition-
al supplements and identifying
occupational risk factors, such as
staring at a computer screen or a
dry environment.
Dr. Pflugfelder specializes in
cornea, ocular surface, and tear
disorders. His research interests
include pathogenesis of desic-
cation-induced inflammation
and autoimmunity on the ocular
surface.
D
uring today's ASCRS
Opening General
Session, Stephen
Pflugfelder, MD,
Houston, will give the
2019 Binkhorst Lec-
ture. Dr. Pflugfelder
shared some of what his lecture,
"The Quest for Tear Stability," will
cover.
First, he said he plans to touch
on the importance of tear stability,
adding that instability is a defining
sign of some tear dysfunction.
Tear stability is important for
maintaining comfort and quality
of vision, and it impacts surgical
outcomes and patient satisfaction,
he said.
Dr. Pflugfelder thinks that it's
often underappreciated in decision
making for patients.
Another focus of his lecture
will be the consequence of an
unstable tear film and the types
of impact it has on patients.
Potential impacts include irrita-
tion, increased blinking, decreased
functional vision (which is relevant
to surgical outcomes), and trig-
gering inflammation that further
amplifies the tear dysfunction and
tear instability.
To detect tear instability, Dr.
Pflugfelder said it's important
to use standard fluorescein tear
breakup tests. He said there are
also other new non-invasive imag-
ing methods that can be utilized.
If the tear film is unstable, it's
certainly a contributing factor to
a patient's complaints of irritation
or fluctuating vision. He said tear
instability needs to be treated prior
to surgery, particularly before cat-
aract surgery with multifocal IOLs
or refractive surgery. If treatment
is not effective in improving tear
stability, these procedures may not
be indicated.
Dr. Pflugfelder stressed that
many patients have tear stability
problems, and a high percentage
of patients over the age of 50
have a certain degree of tear film
instability.
Also in his lecture, Dr. Pflug-
felder plans to discuss conditions
Binkhorst Lecture preview
Stephen Pflugfelder, MD
