Eyeworld

APRIL 2019 | EYEWORLD | 55 P by Ellen Stodola EyeWorld Senior Staff Writer/ Meetings Editor Binkhorst Lecture preview D uring this year's ASCRS Opening Gen- eral Session, Stephen Pflugfelder, MD, will give the 2019 Binkhorst Lecture. Dr. Pflugfelder shared some of what his lecture, "The Quest for Tear Stabil- ity," will cover. First, he said he plans to touch on the importance of tear stability, adding that insta- bility is a defining sign of some tear dysfunction. Tear stability is important for maintaining com- fort and quality of vision, and it impacts surgical outcomes and patient satisfaction, he said. Dr. Pflugfelder thinks that it's often underap- preciated in decision making for patients. Another focus of his lecture will be the con- sequence of an unstable tear film and the types of impact it has on patients. Potential impacts include irritation, increased blinking, decreased functional vision (which is relevant to surgical outcomes), and triggering inflammation that further amplifies the tear dysfunction and tear instability. To detect tear instability, Dr. Pflugfelder said it's important to use standard fluorescein tear breakup tests. He said there are also new non-in- vasive imaging methods that can be utilized. If the tear film is unstable, it's certainly a contributing factor to a patient's complaints of irritation or fluctuating vision. He said tear insta- bility needs to be treated prior to surgery, particu- larly before cataract surgery with multifocal IOLs or refractive surgery. If treatment is not effective in improving tear stability, these procedures may not be indicated. Dr. Pflugfelder stressed that many patients have tear stability problems, and a high percent- age of patients over the age of 50 have a certain degree of tear film instability. Also in his lecture, Dr. Pflugfelder plans to discuss conditions that cause tear instability and some that are common but might not be ad- dressed. The biggest of these, he said, conjuncti- vochalasis, is fairly simple to treat prior to cataract surgery. The lecture will also review evidence-based recommendations for things that could increase or improve tear film instability. In terms of what patients may be able to do themselves, Dr. Pflug- felder pointed to nutritional supplements and identifying occupational risk factors, such as star- ing at a computer screen or a dry environment. Dr. Pflugfelder specializes in cornea, ocular surface, and tear disorders. His research interests include pathogenesis of desiccation-induced inflammation and autoimmunity on the ocular surface. Contact information Pflugfelder: stevenp@bcm.edu back by popular demand, as is the "Challenging Cases in Cataract Surgery Video Symposium" on Monday, May 6, at 8 a.m. and "X Rounds: Re- fractive Cataract Surgery to the Max" on Tuesday, May 7, at 10 a.m. A symposium focused on the MIGS revolu- tion will take place on Sunday, May 5, at 8 a.m., followed by the 2019 ASCRS FDA symposium, "Communicating and Evaluating Adverse Events Associated with an FDA-approved Medical De- vice" later at 3 p.m. "Highlights from the Military Refractive Surgery Safety & Standards Symposium" will be presented on Monday, May 6, at 8 a.m. On the same day is "EyeConnect Live: Anchorman Edi- tion" at 1 p.m., "Managing the Unhappy Post-Re- fractive Patient" also at 1 p.m., and "The Perfect Save: Challenging Cases Managed by International Experts" at 3 p.m. There are also a couple of symposia that will be presented in Spanish: "Management of Complicated Cases in Cataract and Refractive Surgery" on Saturday, May 4, at 3 p.m. and "Best of ASCRS" on Tuesday, May 7, at 8 a.m. continued from page 54 About the doctor Stephen Pflugfelder, MD James and Margaret Elkins Chair and director Ocular Surface Center, Department of Ophthalmology Baylor College of Medicine Houston Financial interests Pflugfelder: Allergan, Senju, Shire

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