Abstract
This article reviews the importance of ocular surface management in patients undergoing cataract surgery. The current strategies for the diagnosis and management of ocular surface disease in cataract surgery patients are discussed. The current trend is to diagnose and treat ocular surface disease before cataract surgery using a stepwise regimen tailored to the individual patient and disease severity. Maintaining a healthy ocular surface is essential for achieving the best visual outcome in cataract patients. Ocular surface preparation is beneficial not only in patients with established ocular surface disease, but also in those with minimal signs or symptoms of surface disease.
Highlights
Ocular surface disease, dry eye syndrome, is one of the most common conditions in the elderly [1,2]
Since age-related cataract constitutes most of patients undergoing phacoemulsification, the diagnosis and management of ocular surface disease is indispensible in majority of these patients
In a recent multi-center study, presented at American Society of Cataract and Refractive Surgery, more than half of all patients undergoing cataract surgery were found to have significant dry eye disease based on objective testing (Trattler WB,et al, unpublished data)
Summary
Dry eye syndrome, is one of the most common conditions in the elderly [1,2]. While neurotrophic patients are less likely to complain of the typical dry eye symptoms (other than fluctuating or decreased vision), they are at higher risk for ocular surface complications such as persistent epithelial defects following cataract surgery. Pre-operative care Management of ocular surface disease may be done most effectively by following established treatment guidelines [17] In this step-wise approach, treatment begins with artificial tears which have been shown to diminish ocular symptoms and improve vision-related function and dry eye signs (TBUT) in the majority of cataract surgery patients [18]. Topical NSAIDs such as nepafenac, ketorolac and diclofenac have been reported to cause corneal melting mainly in the presence of epithelial breakdown [40,41,42] These complications may be more likely in patients with significant ocular surface disease and dry eye such as Sjogren’s syndrome. Cataract surgery in patients with ocular cicatricial pemphigoid (OCP) requires the disease to be controlled for a minimum of one year while peri-operative use of systemic steroids is highly recommended
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