Eyeworld

20 | EYEWORLD | SUMMER 2024 ASCRS NEWS EYEWORLD JOURNAL CLUB cataract surgery. Patients were followed at 1, 7, 30, 42, and 90 days postoperatively and subse- quently at 3-month intervals. The postoperative regimen included ciprofloxacin for 1 week and prednisolone acetate initially eight times daily tapered over 6 weeks. Outcomes of interest included BCVA at 6 weeks, best ever BCVA, and postoperative complications. Results This study included 55 eyes encompassing a variety of ocular surface disorders, which had been previously treated and stabilized at the time of cataract surgery. The majority of eyes were affected by Stevens-Johnson syndrome (64%); other eyes were afflicted with severe dry eye disease (15%), post-chemical injury (11%), ocular cicatricial pemphigoid (7%), or vernal keratoconjunctivitis (4%). Eyelid, conjunctival, and corneal pathology were present in many eyes including corneal scarring (55%), lid mar- gin keratinization (35%), symblepharon (25%), severe dry eye disease (15%), corneal epithelial defects (13%), and limbal stem cell deficiency (18%), among others. Due to the chronicity of these disorders and ongoing inflammation, many eyes were preoperatively treated with topical prednisolone (55%) or fluorometholone (25%), while some patients were additionally on topical tacrolimus or oral immunosuppres- sants including azathioprine, corticosteroids, Review of "Visual outcome and postoperative complications of cataract surgery in patients with ocular surface disorders" P atients with ocular surface disorders such as Stevens-Johnson syndrome (SJS), ocular cicatricial pemphigoid (OCP), dry eye disease (DED), vernal keratoconjunctivitis (VKC), and limbal stem cell deficiency (LSCD) may present with vi- sually significant cataracts earlier due to chronic inflammation or prolonged steroid use. 1–5 However, complications of chronic inflamma- tion including corneal scarring, vascularization, conjunctival inflammation, symblepharon, and forniceal shortening can complicate surgery and worsen the ocular surface, potentially leading to visual decline. 6 Careful preoperative and postop- erative planning is essential to manage both the underlying disorder and cataract effectively. Aggarwal et al. investigated the visual outcomes and postoperative complications of cataract surgery in patients with various ocular surface disorders managed at an ocular surface clinic within a tertiary care center in North India. Methods This was a retrospective chart review of 44 patients and 55 eyes of patients with a histo- ry of ocular surface disorders who underwent cataract surgery after having a stabilized ocular surface at a tertiary eyecare center in North In- dia between January 2015 and December 2020. Collected patient data included demographic characteristics, prior medical history, presenting symptoms, treatments for ocular surface disor- ders, and best corrected visual acuity (BCVA). Preoperative keratometry was attempted, and a keratometry value of 44 diopters (D) was used for patients in whom keratometry was unsuc- cessful. Patients with clear corneas underwent scleral or clear corneal tunnel phacoemulsifi- cation. Patients with central corneal scarring underwent small incision cataract surgery, and those with significant central and/or superi- or corneal scarring underwent extracapsular EyeWorld Journal Club review by Sabhyta Sabharwal, MD, MPH,* Jason Keil, MD, PhD,* Lilian Chan, MD,* Taylor Linaburg, MD,* Nitya Rao, MD,* Scheie Eye Institute residents, Paul Tapino, MD, Residency Program Director *All authors contributed equally to this work. Paul Tapino, MD Residency Program Director Scheie Eye Institute Philadelphia, Pennsylvania From left: Lilian Chan, MD, Nitya Rao, MD, Sabhyta Sabharwal, MD, Taylor Linaburg, MD, Jason Keil, MD Source: Scheie Eye Institute continued on page 22

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