The Dry Eye Zone

Rebecca's Blog


ASCRS on addressing dry eye before eye surgery

I am happy to see more and more attention to the implications of dry eye for people facing eye surgeries. This has long been an issue in elective surgeries such as LASIK, of course, but in recent years it’s becoming more widely understood to bean issue for cataract surgery and other procedures.

What’s at stake? Both vision and dry eye, because your dry eye status before surgery (whether you have symptoms or not) affects your vision outcome from the surgery, and of course surgery can make dry eye worse (at least temporarily).

ASCRS (American Society of Cataract and Refractive Surgery - that’s a major professional body for cornea specialists and in general ophthalmologists who do vision correction surgeries, and it’s their annual meeting that I have been blogging about so much) finds that a lot of surgeons, while they may know it’s important, aren’t necessarily up to speed on what to do about it, so they’ve come up with some specific standards for this. Great way to get more attention to the topic and more conversations going.

An algorithm for the preoperative diagnosis and treatment of ocular surface disorders (Starr et al, J Cataract Refract Surg. 2019 May)

Any ocular surface disease (OSD), but most commonly, dry-eye disease (DED), can reduce visual quality and quantity and adversely affect refractive measurements before keratorefractive and phacorefractive surgeries. In addition, ocular surgery can exacerbate or induce OSD, leading to worsened vision, increased symptoms, and overall dissatisfaction postoperatively. Although most respondents of the recent annual American Society of Cataract and Refractive Surgery (ASCRS) Clinical Survey recognized the importance of DED on surgical outcomes, many were unaware of the current guidelines and most were not using modern diagnostic tests and advanced treatments. To address these educational gaps, the ASCRS Cornea Clinical Committee developed a new consensus-based practical diagnostic OSD algorithm to aid surgeons in efficiently diagnosing and treating visually significant OSD before any form of refractive surgery is performed. By treating OSD preoperatively, postoperative visual outcomes and patient satisfaction can be significantly improved.