This article is more than 5 years old. Information may no longer be current.

Preoperative tear film optimization critical to surgical outcome

Add topic to email alerts

Receive an email when new articles are posted on

Please provide your email address to receive an email when new articles are posted on .

Subscribe

Added to email alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

You've successfully added to your alerts. You will receive an email when new content is published.

Click Here to Manage Email Alerts

Back to Healio

We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.

Back to Healio

Elmer Tu, MD

SAN DIEGO — Preoperative evaluation and preparation are critical in obtaining better postoperative outcomes and avoiding conditions more easily prevented than treated, according to a presenter here.

Although it is similar to typical dry eye therapy, the goals for presurgical tear film optimization are quite different from those related to standard dry eye therapy, Elmer Tu, MD, said during a session at Cornea Day, held preceding the American Society of Cataract and Refractive Surgery meeting.

"In trying to optimize the tear film preoperatively, your goal should be to provide accurate biometric measurements to optimize postsurgical refractive outcome, withstand the trauma of surgery and optimize tear production to reduce the incidence of postoperative dry eye," Dr. Tu said.

Commonly, an unrecognized deficient or unstable tear film leads to changes in measured corneal curvature, and even a 15° axis shift can negatively affect spherical and astigmatic preoperative measurement predictability and overall surgical outcomes. Although adverse perioperative effects of a poor ocular tear film are known, few large-scale studies have defined either the population requiring perioperative intervention or the optimal presurgical treatments, according to Dr. Tu.

Traditional presurgical therapy is the regular and frequent use of artificial tears several weeks before surgery, continued for weeks to months postoperatively, Dr. Tu said. Additionally, topical corticosteroids 1 to 2 weeks before surgery may be helpful in patients whose tear film abnormalities remain.

"Topical azithromycin, meibomian gland probing and other treatments for posterior blepharitis may also have a role prior to surgery in patients who do not respond to other forms of therapy," Dr. Tu said.

• Disclosure: Dr. Tu has received travel reimbursement or payments from Alcon International.