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Preop blepharitis, dry eye evaluations essential to good visual outcomes in cataract surgery
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WESTON, Fla. — Patients who present for cataract surgery may have dry eye or blepharitis due to age and other factors, so it is important to recognize and treat those conditions before cataract surgery to achieve good postoperative vision, according to a speaker here.
William B. Trattler, MD, said that identifying and treating blepharitis and dry eye before surgery can lead to better wavefront and topographic images and IOL power selection. Postoperatively, there may be a reduced risk of infection, and the patient may be more comfortable and heal faster.
At the International Congress on Surface Ablation, Femto-Lasers and Cross-Linking, Dr. Trattler cited preliminary results of an ongoing, prospective, multicenter study showing that of patients who presented for cataract surgery, nearly 60% had an abnormal tear breakup time, 46% had central staining and 18% had Schirmer's test scores at or below 5 mm.
The best and first way to reduce variability in cataract surgery outcomes is to optimize preoperative measurements via a healthy tear film. Bill Trattler’s study gives much-needed emphasis to this concept. The air-tear film interface is the eye’s most powerful refractive surface, and even mild distortion of the tear film can cause significant error in measurement of the cornea’s power. These errors cause a one-to-one error in IOL power choice, ie, a 1 D error in corneal power measurement will lead to 1 D of unwanted residual refractive error after surgery.
– John A. Hovanesian, MD, FACS
OSN
Cornea/External Disease Board Member
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