Effective Preoperative Assessment and Management of the Ocular Surface

Tips for optimizing the ocular surface and therefore surgical success.

Priya M. Mathews, MD, MPH

Cataract and Refractive Surgery Today

The precorneal tear film is the most critical refractive surface in the human optical system. When striving to deliver a glasses-free experience, especially with multifocal IOLs, the preoperative management of dry eye disease (DED) is critical (see The Link Between Dry Eye Severity and Patient Satisfaction). An unoptimized ocular surface during cataract surgery assessments compromises the accuracy of measurements critical to surgical planning. The Link Between Dry Eye Severity and Patient Satisfaction A thorough analysis conducted at Center for Sight in 2019 (unpublished data) involving four surgeons and 113 eyes found a direct correlation between dry eye disease severity and patient dissatisfaction following premium IOL surgery. In the analysis, a preoperative complaint of vision fluctuation was closely linked to dry eye disease severity, highlighting the necessity of addressing ocular surface health preoperatively. Untreated DED can also complicate patients’ postoperative recovery. I therefore advise my patients to prioritize DED treatment before undergoing surgery. This approach not only facilitates a smoother, quicker recovery but also optimizes their chances of achieving the desired surgical outcome. Comprehensive Preoperative Ocular Surface Assessment Before I enter the exam room, I review the patient’s testing outside their room. My biometrist will indicate the quality of the measurements on the Notes section of the IOLMaster 700 (Carl Zeiss Meditec) by grading the distortion from 0 to 4+.

The Future of Hyperopic LASIK: Debates and Advances

William F. Wiley, MD, and Wesam Silk, MD

Eyetube

In this episode of CRST: The Podcast, host William F. Wiley, MD, and Wesam Silk, MD, take a deep dive into the evolving world of hyperopic LASIK and its alternatives. They explore the technological advances that have reshaped the treatment of hyperopia, examine the shift toward lens-based solutions, and speculate about future innovations in refractive surgery. 

Research Considerations During Retina Fellowship

Two fellows offer their pearls to help others start their research journey.

Olufemi Adams, MD

Retina Today

The prospect of doing research during a busy vitreoretinal surgical fellowship can be daunting. On one hand, it is a useful adjunct to facilitate additional learning, networking, and professional development. On the other, it can be difficult to balance high-quality research with the clinical responsibilities of fellowship. I interviewed two retina research fellows, Hana A. Mansour, MD, and Bita Momenaei, MD, from Wills Eye Hospital in Philadelphia, who offered practical strategies for success in pursuing research opportunities during fellowship. About the Interviewees: Hana A. Mansour, MD Retina Research Fellow, Wills Eye Hospital, Philadelphia   Bita Momenaei, MD Retina Research Fellow, Wills Eye Hospital, Philadelphia   OLUFEMI ADAMS, MD: WHY SHOULD CLINICIANS CONDUCT RESEARCH DURING THEIR RETINA FELLOWSHIP? Drs. Mansour and Momenaei: Engaging in research during a retina fellowship offers numerous advantages and contributes significantly to both personal and professional growth. It provides a platform for continuous learning, allowing fellows to delve deeper into retina.