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    How to manage cataracts with ocular surface disease

    Surgeons must actively seek signs for ocular surface disease given its high prevalence

    Take-home: Ocular surface disease, including dry eye disease, is common in patients undergoing cataract surgery. It must be treated in order to optimise the ocular surface prior to surgery, and close follow-up in the postoperative period is important.

    Cataract surgery is one of the most-performed surgeries worldwide and patient expectations continue to rise as new developments and technology promise better outcomes. Ocular surface disease (OSD) in patients undergoing cataract surgery, which is often overlooked, plays an important role in determining the outcome of surgery and patient satisfaction.

    (FIGURE 1) Meibomian gland capping and lid-margin telangiectasia in an asymptomatic patientThere is a high prevalence of dry eye disease (DED) in patients undergoing cataract surgery and studies have shown that 77% of patients have some corneal staining; however, 87% are asymptomatic.1 Studies have also shown that 86% of patients presenting with dry eye symptoms suffer from meibomian gland dysfunction (MGD).2

    Given that the incidence and severity of DED have been shown to increase after cataract surgery, it is extremely important to identify these patients and treat them appropriately.3 Cataract is also common in patients with immune-mediated OSD, because of their age and use of topical steroids, and following severe keratitis and corneal perforation.

    Recognition and appropriate management of OSD reduces the risk of postoperative complications such as poor visual outcomes, delayed healing, infections, melts and visual loss.

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