An algorithm for the preoperative diagnosis and treatment of ocular surface disorders

Christopher E Starr; Preeya K Gupta; Marjan Farid; Kenneth A Beckman; Clara C Chan; Elizabeth Yeu; José A P Gomes; Brandon D Ayers; John P Berdahl; Edward J Holland; Terry Kim; Francis S Mah; ASCRS Cornea Clinical Committee

doi:10.1016/j.jcrs.2019.03.023

An algorithm for the preoperative diagnosis and treatment of ocular surface disorders

J Cataract Refract Surg. 2019 May;45(5):669-684. doi: 10.1016/j.jcrs.2019.03.023.

Authors

Affiliations

¹ Weill Cornell Medicine, New York-Presbyterian Hospital, New York, New York, USA. Electronic address: cestarr@med.cornell.edu.
² Duke University Eye Center, Durham, North Carolina, USA.
³ Gavin Herbert Eye Institute, University of California, Irvine, California, USA.
⁴ Department of Ophthalmology, The Ohio State University and Comprehensive EyeCare of Central Ohio, Westerville, Ohio, USA.
⁵ Department of Ophthalmology and Vision Sciences, University of Toronto, Ontario, Canada.
⁶ Eastern Virginia Medical School, Virginia Eye Consultants, Norfolk, Virginia, USA.
⁷ Paulista Medical School, Federal University of São Paulo, Brazil.
⁸ Wills Eye Hospital, Philadelphia, Pennsylvania, USA.
⁹ Vance Thompson Vision, Sioux Falls, South Dakota, USA.
¹⁰ Cincinnati Eye Institute, University of Cincinnati, Ohio, USA.
¹¹ Scripps Clinic, La Jolla, California, USA.

PMID: 31030780
DOI: 10.1016/j.jcrs.2019.03.023

Abstract

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.

Publication types

Research Support, Non-U.S. Gov't
Review

MeSH terms

Algorithms*
Dry Eye Syndromes / diagnosis*
Dry Eye Syndromes / physiopathology
Dry Eye Syndromes / therapy
Humans
Preoperative Period
Refractive Surgical Procedures / methods*
Visual Acuity*