Astigmatism fix, cataract surgery feasible in patients with connective tissue disease
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Cataract surgery and astigmatism correction in patients with connective tissue disease commonly associated with dry eye are feasible, according to a presenter at the virtual OSN New York meeting.
Studies show that if the patient’s inflammation is well controlled, “It is even safe to do laser vision correction in these patients and get a good result,” Brandon Ayres, MD, said.
When planning astigmatism correction in a patient with Sjögren’s syndrome or rheumatoid arthritis, for example, one should comanage the case with a rheumatologist. Patients with clinical signs of dry eye disease should be informed that they are at increased risk for complications and treatment would be off label, Ayers said.
Cataract surgery may also be appropriate in these patients, again depending on disease control. However, there have been reports of cornea and wound melts following cataract surgery, so careful consideration of preoperative and postoperative medication is warranted, he said.
Myopia and increased refractive error are further considerations in patients with inflammatory diseases such as Marfan syndrome and homocystinuria. Laser correction in these patients is “probably not” safe, Ayres said.
“Control and stability is key in these patients,” Ayres said.
Reference:
- Smith RJ, et al. J Cataract Refract Surg. 2006;doi:10.1016/j.jcrs.2006.02.059.
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Ayres B. Astigmatism correction in connective tissue disease. Presented at: OSN New York and OSN New York Retina; Oct. 17-18, 2020 (virtual meeting).
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