Eyeworld

EW CATARACT 69 March 2017 According to Dr. Wolf, evidence from the literature on the risk–bene- fit of performing cataract surgery in patients with macular disease indi- cates that cataract surgery in these patients should always be performed if the patient has cataract-related symptoms. He said that the thresh- old for cataract surgery should be low and even patients with reduced visual potential could benefit from cataract surgery and achieve very good visual outcomes. In another study highlighted in Dr. Wolf's talk, investigators con- structed a new clinical tool to estab- lish levels of indications for cataract surgery. 2 The tool was tested in 343 cataract surgery patients and scored for visual acuity in the operated and fellow eyes, patient-perceived diffi- culties in performing day-to-day ac- tivities, cataract symptoms like glare and differences in these between the eyes, the ability to live independent- ly (work, drive, home help, care for relatives), and any medical ophthal- mic reasons for urgent surgery (such as mature cataract). "Interestingly, concomitant retinal diseases were not included in the scoring. Looking deeper into this, you see that ocular comorbidities can change the score the patient receives. The score puts patients into an indication group 1–4, one being the highest indica- tion level. Comorbidities can lower the indication group rating by one step, only one step, but never rule out surgery. What we can learn from this is that ocular comorbidity may be important for patient expecta- tions, but it should not change our minds about carrying out cataract surgery. The message here is that eye surgeons should perform cataract surgery in all patients who have symptoms and problems due to their cataract," Dr. Wolf explained. EW References 1. Kanthan GL, et al. Intermediate- and long- term visual outcomes after cataract surgery: The Blue Mountains Eye Study. Clin Exp Opthalmol. 2011;39:201–6. 2. Lundström M, et al. NIKE: a new clinical tool for establishing levels of indications for cataract surgery. Acta Ophthalmol Scand. 2006;84:495–501. Editors' note: Dr. Wolf has financial associations with Allergan (Dublin, Ireland), Bayer (Leverkusen, Germany), Heidelberg Engineering (Heidelberg, Germany), Novartis (Basel, Switzer- land), Optos (Marlborough, Massachu- setts), Roche (Basel, Switzerland), and Carl Zeiss Meditec (Jena, Germany). Contact information Wolf: Sebastian.wolf@insel.ch Simple. Safe. Effective. Visitec® I-Ring® Pupil Expander Two month post-op • Reduced iris trauma and pupil distortion • Easy insertion and removal A complete portfolio of ophthalmic products 1-866-906-8080 beaver-visitec.com

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