Eyeworld

EW CATARACT 42 February 2015 Some alternatives here include Systane (Alcon), Soothe (Bausch + Lomb, B+L, Bridgewater, N.J.), Refresh (Allergan), and Optive (Allergan), Dr. Devgan said. There is often a benefit to putting patients on omega-3 fish oils to help with the tear film, he said. Postop care In the postoperative period, care needs to be taken with the amount of drops used and how much pre- servative is being put in the eye, Dr. Devgan said. "BAK is reasonably toxic to the eye," he said. "If you have a steroid, an antibiotic, and an NSAID, all 4 times a day, with the generics you can have 12 doses of BAK going into the eye a day." Physicians could use a brand-name antibiotic such as Vigamox (moxifloxacin, Alcon) with no BAK, a steroid that is preserved in ascorbic acid such as Durezol (difluprednate, Alcon), and a once-a-day NSAID such as Ilevro (nepafanac, Alcon) with just one dose of preservative, he said. "In my office I give patients a choice of all brand-name or all generic," Dr. Devgan said. Overall, Dr. Trattler emphasizes the importance of dry eye treatment for cataract patients. "It's so easy to be focused on the patient's chief complaint, which is blurry vision, and expect the cause of the blurry vision to be solely from cataracts," he said. "It's surprising how impact- ful dry eye can be on the quality of vision. Effectively treating dry eye preoperatively can result in improved IOL calculations, which allows us to deliver better visual out- comes so that patients are satisfied with their vision following cataract surgery," he said. EW Editors' note: Dr. Devgan has finan- cial interests with Alcon and B+L. Dr. Donnenfeld has financial interests with Allergan, Alcon, TearScience, TearLab (San Diego), RPS, and B+L. Dr. Trattler has financial interests with Allergan and Alphaeon. Contact information Devgan: Devgan@gmail.com Donnenfeld: ericdonnenfeld@gmail.com Trattler: wtrattler@gmail.com i-Lid Cleanser [Novabay, Emeryville, Calif.]." Dr. Trattler also believes that nutritional supplements can have a role. He finds that oral omega-3s have the potential to improve oc- ular surface health, particularly for patients who have blepharitis. Dr. Trattler views PRN and HydroEye (ScienceBased Health, Houston) as high-quality oral omega-3s that are helpful to dry eye overall. Dr. Devgan finds that for the majority of patients, using some sort of artificial tears is sufficient. "The difference between an artificial tear and saline is that artificial tears have thickening agents in them, they have more lubricating agents, and they have components that moisturize," he said. levels, in addition to using topical steroids and Restasis. For those who present with combined dry eye/meibomian gland dysfunction, Dr. Trattler recom- mends lid hygiene. "Patients can achieve improvement of their mei- bomian gland secretions with the use of lid cleansers, such as SteriLid [Akorn, Lake Forest, Ill.] or the new OASIS name and logo are registered trademarks of OASIS Medical, Inc. 514 S. Vermont Ave, Glendora, CA 91741. CM9700. CV11004. 11/12 oasis@oasismedical.com 800-528-9786 (USA Toll Free) 909-305-5400 Find out more about how we can help your practice. Contact OASIS ® for a free sample evaluation or visit OasisMedical.com OASIS ® is dedicated to equipping eye care providers with cost-effective solutions to improve patient management and practice growth. More than expected Now Available 6.25mm *Patent pending The Oasis Iris Expander* is a single-use 7.0mm or 6.25mm polypropylene ring provided in sterile condition and packaged five units per box Sustains an expanded area to perform surgical procedures Maintains visibility throughout the procedure Gentle to fragile iris tissue Easy to insert and remove THE OASIS IRIS EXPANDER EXPAND YOUR VIEW. SUSTAIN YOUR ACCESS. Optimizing continued from page 41

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