Preop evaluation key to avoiding postop complications in refractive surgery
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CHICAGO — Refractive surgery can sometimes trigger dry eye disease by different mechanisms, including denervation, according to a speaker.
“As we know, in spite of the significant advances in refractive surgery, dry eye remains common in the early postop period and persists in a few cases,” José Alvaro P. Gomes, MD, PhD, said at Refractive Surgery Subspecialty Day at the American Academy of Ophthalmology meeting. “To prevent this situation, we must identify these conditions.”
Gomes said that the type of surgery appears to interfere with the severity of the clinical picture, which tends to be worse with LASIK procedures and better with SMILE procedures. Preoperative evaluation of the ocular surface plays an important role in preventing postoperative complications, and treatment should include different strategies depending on the type and severity of disease.
Ocular surface disease also has an impact on preoperative topography, tomography, biometry and keratometry, which can affect surgical planning and optical results. Using lubricants and scraping the margins can be useful for eyelid disorders, and when addressing ocular surface irregularities, surgery should be avoided in patients with herpes simplex virus.
For ocular surface inflammation, topical and systemic immunomodulators and systemic antibiotics can be used, Gomes said.
“We know that all these conditions impact our surgical outcomes, so topical medications can be very helpful in these patients,” he said.
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Gomes JAP. Optimizing the ocular surface in refractive surgery. Presented at: American Academy of Ophthalmology meeting; Sept. 30-Oct. 3, 2022; Chicago.
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