EW SHOW DAILY
28
ASCRS Symposia
Sunday, April 19, 2015
by Lauren Lipuma EyeWorld Staff Writer
of life improve after cataract surgery,
so physicians should not hesitate to
do it.
Unlike the case with AMD, a
growing body of evidence suggests
that diabetic retinopathy progresses
more rapidly after cataract surgery,
said David S. Boyer, MD, Los An-
geles. This could be the result of in-
creased inflammation or movement
of the vitreous that occurs after the
lens volume is lost.
To mitigate this risk, Dr. Boyer
offered several pearls for managing
diabetic patients. First, make sure
that their hypertension is under
control. Second, if there is any mac-
ular edema, get the edema under
control before performing surgery,
he said, using topical NSAID drops,
anti-VEGF agents, or corticosteroids.
Be sure to do a complete dilated fun-
dus exam and an OCT scan to rule
out a subtle leak, and if there is one,
treat it before surgery, he added.
I
n a well-attended symposium
on Saturday afternoon, 5
experts shared their pearls for
managing cataracts and retinal
problems in "Evaluation and
Management of the Cataract Patient
With Pre-Existing Retinal Disease."
Timothy W. Olsen, MD, At-
lanta, discussed cataract surgery in
patients with age-related macular
degeneration (AMD).
"When you think about macu-
lar degeneration and cataracts, both
are disorders of aging," Dr. Olson
said. What this means, he said, is
that AMD is common, cataracts are
common, and they frequently occur
together, so physicians should be
prepared to handle that.
The real question this situation
raises is whether cataract extraction
accelerates AMD progression. After
reviewing the relevant literature, Dr.
Olson showed that there is no de-
finitive evidence that this occurs. In
addition, visual acuity and quality
Pearls for managing cataracts and retinal disease
continued on page 30
Dr. Boyer explains that a growing body of evidence suggests diabetic retinopathy progresses
more rapidly after cataract surgery.
