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    How to manage patient’s IOL expectations pre-operatively


    Cataract surgery and dry eye disease

    She explained that for patients with dry eye undergoing cataract surgery, optimization of the ocular surface is important preoperatively to ensure accurate keratometric measurements, with the goal of therapy being stabilization of interblink tear film.

    “Topography results that show ‘hot spots’ and ‘flat spots’ are considered abnormal, as are irregularly shaped or smudgy Placido discs,” Dr. Braga-Mele said. She advised surgeons to look closer if the average K values are different or if the K values all differ.

    Goal of dry eye therapy prior to cataract surgery is to stabilize interblink tear film.

    Dry eye management with cataracts

    Timing is everything, and that applies to cataract surgery planning. Patients should be tested for dry eye well before surgery because dry eye can affect topography or the results obtained with the IOLMaster (Carl Zeiss Meditec), Dr. Braga-Mele pointed out.

    “Consistent readings are needed,” Dr. Braga-Mele added. “Treatment should begin at least two weeks before testing for cataract surgery, depending on the severity of the dry eye or until two consistent readings are obtained.”

    Importantly, both cataract surgery and femtosecond laser cataract surgery can worsen dry eye.


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