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    Testing at point of care for improved patient satisfaction, re-treatment rates

    Preoperative testing identifies both symptomatic and asymptomatic ocular surface disease

    At our predominantly refractive surgery practice, my colleagues and I have always seen good refractive outcomes, but we found that a number of patients were unhappy. Surgery went perfectly and according to plan, and visual acuities were good, but patients were uncomfortable and frustrated with dry eye symptoms, such as grittiness, fluctuating vision, redness and foreign body sensation.

    About two years ago, we began to look for ways to determine, through point-of-care preoperative testing, which patients were likely to experience this problem after surgery. Testing enables us to identify both symptomatic and asymptomatic ocular surface disease.

    Asymptomatic patients who feel fine naturally do not think that they have a disease, but point-of-care testing offers them the proof they need to welcome treatment.

    Once testing helps to pinpoint ocular surface disease before surgery, we can treat the problem and prevent patients from becoming unhappy with postoperative symptoms.

    Importantly, dry eye treatment also allows us to obtain accurate preoperative measurements. If patients do not have a stable, good quality tear film, readings can be off by as much as 1.0 to 1.5 D. IOL calculations can be off as well.

    We explain to patients with dry eye that we can perform the surgery they desire, but first we have to treat the ocular surface so we can plan surgery based on complete, accurate data.

    Dr Erik L. Mertens

    Erik L. Mertens, MD, FEBO is Director and Ophthalmic Surgeon at the Antwerp Eye Centre in Belgium. He may be reached by E-mail: ...

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