EW SHOW DAILY
46
Meeting Reporter
Sunday, May 7, 2017
by Lauren Lipuma EyeWorld Contributing Writer
Catching ocular surface disease upfront is crucial to
getting the best surgical outcomes, surgeons say
postop infection, higher-order
aberrations, and patient dissatisfac-
tion, said Kenneth Beckman, MD,
Columbus, Ohio.
The tear film has the greatest
optical power of any surface in the
eye because the greatest change in
refractive index occurs between air
and the tear film. If the tear film
becomes irregular, much larger
variations in the anterior radius and
optical power can occur, which can
throw off IOL power calculations,
Dr. Beckman said.
Sometimes, OSD can cause
abnormal topography, which could
lead the surgeon to choose a toric
IOL when it's not needed, he added.
In addition to selecting the wrong
IOL, undiagnosed or untreated OSD
can lead to positioning a toric IOL
on the wrong axis or doing unnec-
essary enhancements, Dr. Beckman
said.
N
ot diagnosing and treat-
ing ocular surface disease
(OSD) before cataract sur-
gery can lead to infection,
inaccurate preoperative
measurements, and postoperative
aberrations and patient dissatisfac-
tion, said surgeons at Saturday's
EyeWorld CME Education sympo-
sium, "The Third Refractive Surface:
Improving Surgical Outcomes with
Advanced Ocular Surface Diagnos-
tics and Therapeutics."
In this session, physicians
shared the reasons why catching and
treating OSD upfront is crucial to
surgical success and offered pearls of
wisdom for diagnosing and treating
this complex, multifactorial disease.
"As a surgeon, I'm always look-
ing for premium outcomes," said
Eric Donnenfeld, MD, Rockville
Centre, New York. "And you can't
do premium surgery without a pre-
mium ocular surface."
The reality is that most cataract
surgery patients have some form of
OSD, Dr. Donnenfeld said. Christo-
pher Starr, MD, New York, esti-
mates that 75% of cataract patients
have ocular surface disease, and Dr.
Donnenfeld suspects that number
is closer to 100% when looking at
patients over 70.
Correctly diagnosing and
treating dry eye before surgery helps
surgeons obtain accurate and critical
preop measurements and prevents
continued on page 48
Dr. Starr estimates that 75% of cataract patients have ocular surface disease.
