Eyeworld

51 EW FEATURE November 2017 • Dry eye disease update Contact information Glasser: dbg@comcast.net Davidson: richard.davidson@ucdenver.edu Yeu: eyey@vec2020.com this information helps to guide the conversation on outcomes and expectations with surgery." Dr. Davidson's key consider- ation for premium lens implants in such patients is getting the best possible IOL measurements and hav- ing patients comfortable postop and thrilled with their vision. "Therefore, putting the time in to optimize the ocular surface prior to surgery is well worth the effort," Dr. Davidson said. Key considerations for premium lens implants in patients with ocular surface disease include the need for the tear film and ocular surface to be smooth and stable both preop and postop, according to Dr. Glasser. "Simply achieving a stable surface preop is insufficient if the patient will be unable or unwilling to continue the treatment program necessary to maintain stability long term after surgery," Dr. Glasser said. DED postop Dr. Davidson's DED treatment regimen post-cataract surgery in- cludes artificial tears, cyclosporine, and lifitegrast drops. However, he does not default to a single specif- ic regimen. "I customize based on signs and symptoms of DED," Dr. Davidson said. For Dr. Glasser, gentle treat- ment of the ocular surface for MGD patients in the periop period is par- amount. That should include short surgical times and aggressive intraop lubrication. Additionally, a visco- elastic placed on the ocular surface during surgery can help. "The number of topical med- ications should be limited, with particular attention given to the use of non-steroidal anti-inflammato- ry medications," Dr. Glasser said. "Use of a 'less drops' regimen with once-daily steroids and NSAIDs can preserve the integrity of the ocular surface without the necessity of intravitreal injections for those who prefer not to go that route. I elim- inate topical NSAIDs entirely for those patients with significant dry eye disease and no risk factors for cystoid macular edema." EW Editors' note: Dr. Yeu has financial interests with Alcon (Fort Worth, Tex- as), Johnson & Johnson Vision (Santa Ana, California), TearScience, Allergan (Dublin, Ireland), Shire (Lexington, Massachusetts), TearLab (San Diego), ScienceBased Health (Oak Ridge North, Texas), OCuSOFT (Richmond, Texas), and Ocular Science (Manhattan Beach, California). Dr. Davidson has finan- cial interests with Shire. Dr. Glasser has no financial interests related to his comments. Parasol® The Parasol® Punctual Occluder has been a top-trusted plug for dry eye treatment for over two decades — providing chronic dry eye patients with unparalleled retention, simple sizing and ease of insertion. Happy 20th Anniversary! Visit us at AAO Booth 830 Preserving Patients' Tears, Worldwide, Since 1997 866-906-8080 customersupport@beaver-visitec.com beaver-visitec.com Elizabeth Yeu, MD, shows meibum being expressed from the inferior MG

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