Ocular conditions need to be addressed before cataract surgery
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Ophthalmologists must pay attention to the state of the ocular surface to try to avoid unhappy patients after cataract surgery, according to a presentation from Real World Ophthalmology.
Patient unhappiness can result after intraoperative complications but may also arise when the surgeon fails to recognize and treat confounding ocular conditions, Parag A. Majmudar, MD, said.
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“If we don’t pay attention to dry eye, we are going to be setting ourselves up for failure,” he said.
Majmudar referenced a prospective health assessment that included 204 eyes scheduled for cataract surgery; 82.8% of eyes had tear breakup time of 7 seconds or less, 75.5% had positive corneal staining, and 46.6% had abnormal Schirmer test scores.
Surgeons should thoroughly examine the state of the tear film, as even minor degradation can affect visual acuity.
Conditions that surgeons should check for include epithelial basement membrane dystrophy, pterygium, Salzmann’s nodules, Fuchs’ dystrophy and, in the retina, epiretinal membrane and drusen.
“If we don’t tell patients that they have them, they are going to think that your surgery created them,” Majmudar said. “And so, it is very important to identify, document and educate the patients that these factors may affect the patient’s outcome after cataract surgery and that we take steps to correct these as we see what the issues are prior to surgery.”
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Majmudar PA. Troubleshooting the unhappy cataract patient. Presented at: Real World Ophthalmology; Sept. 30, 2023 (virtual meeting).
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