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Issue link: https://daily.eyeworld.org/i/124056
44 EW SHOW DAILY Monday, April 22, 2013 Meeting Reporter Aiming for zero inflammation by Vanessa Caceres EyeWorld Contributing Writer C ataract surgeons naturally want to eradicate the risk for postop inflammation in their patients. Using nonsteroidal anti-inflammatory drugs (NSAIDs) along with steroids and keeping the postop drop regimen simple but effective are two ways to cut down on inflammatory risks, said speakers at the EyeWorld CME Education event, "Understanding and Managing the Impact of Cataract Surgery Stress on Ocular Inflammation: Uveitis, CME, and Corneal Edema." Edward J. Holland, MD, Cincinnati, was the program chair. Any cases of inflammation can lead to a negative patient experience, affecting their confidence in both you as a surgeon and in your practice, said Bonnie An Henderson, MD, Boston. She cited research that found any postop pain was the most significant predictor of patient dissatisfaction with surgical care. David A. Goldman, MD, explains why a simplified drop regimen is important when preventing inflammation. Although all patients should receive treatment to avoid postop inflammation, Dr. Henderson said that patients with diabetes, autoimmune disorders, corneal disease, glaucoma, and other ocular conditions are particularly at a higher risk. She also pointed out that while the incidence of post-cataract CME is only 1% to 2%, angiographic CME affects 20% to 30% or more of patients. As visual needs—and patient expectations—for typical cataract cases have become more demanding, it's more important than ever to decrease postop inflammation, Dr. Henderson said. This is because patients are putting off retirement until they are older more often and have more visual challenges with the use of computers and cell phone/smartphone screens. David A. Goldman, MD, Miami, addressed why a simplified drop regimen is important when preventing inflammation. A drop regimen that involves one steroid drop in the morning and one NSAID drop at night of the most potent therapies available—and maintaining that regimen throughout postop care—will improve patient compliance and serve as a practice builder, as patients are pleased they do not have to use many drops. Clara C. Chan, MD, Toronto, explained in her presentation that a number of factors in cataract surgery can cause surgical stress. These factors come into play even before the surgeon makes incisions and can be influenced by many elements, some of which are beyond a surgeon's control. Combined steroid and NSAID use can help target different parts of the inflammatory cascade—making the use of an effective combination to combat surgical stress important, Dr. Chan said. EW Editors' note: This event was supported by an unrestricted educational grant from Alcon (Fort Worth, Texas).