Ocular surface in daily practice

Ocular surface symposium provides useful insights for maximising surgical success and patient satisfaction. Cheryl Guttman Krader reports

Cheryl Guttman Krader

Posted: Wednesday, February 10, 2021

Béatrice Cochener-Lamard, MD, PhD

Ocular surface in daily surgical practice is the focus of the Saturday afternoon main symposium. The session features six talks by experts who will provide updates and practical advice for diagnosing and managing ocular surface disease (OSD) to optimise patient outcomes.
“Many published papers have emphasised the importance of managing the ocular surface in surgical patients. Yet implementation of recommended diagnostic and therapeutic strategies into daily practice is not always easy,” said Béatrice Cochener-Lamard, MD, PhD (France), who is co-chairing the symposium with Sava Barišić, MD (Serbia).
“It is from this perspective that the symposium will focus on identifying OSD without the need for sophisticated tools and the prioritisation of treatments to prepare patients for surgery and use postoperatively.”
Leading off the symposium, José Benítez del Castillo, MD (Spain) will highlight the role of meibomian gland dysfunction (MGD) as a mechanism for OSD.
“Whether it is a younger patient seeking refractive surgery because of contact lens intolerance or an older individual needing cataract surgery, alteration of the lipid layer is the dominant cause of OSD,” Dr Cochener-Lamard observed.
Following a review of ways to improve the diagnosis of OSD by Carina Koppen, MD, PhD (Belgium), Jesper Hjortdal, MD, PhD (Sweden) will explain the consequences of a dry eye on preoperative assessments and surgical planning. In the following talk, Bruce Allan, MD (UK) will highlight the bidirectional relationship between OSD and surgery, explaining how ocular surgery causes or worsens OSD.
“Surgery of any kind induces inflammation and when the cornea is cut, incision of corneal nerves gives rise to neurogenic inflammation that can become chronic and be irreversible,” Dr Cochener-Lamard said.
Filomena Ribeiro, MD, PhD (Portugal) will describe the effect of tear film instability on postoperative visual performance and patient comfort, which can affect daily function and have psychological sequelae, even inducing depression. Then, building on the foundation of understanding the pathophysiology of dry eye and its effects on surgical outcomes, Marc Labetoulle, MD, PhD (France), will present a systematic approach to dry eye treatment.
“Dr Labetoulle will help clinicians sort out the available ocular lubricants, prioritise the anti-inflammatory options, and decide on targeted therapeutics, including those for MGD,” said Dr. Cochener-Lamard.
During the last portion of the interactive session, speakers will address questions submitted by the audience, and that will be followed by concluding remarks from its co-chairs.
“We can already announce that the take-home message is ‘focus on prevention rather than cure’. To achieve the best result, it is best to diagnose OSD preoperatively and optimise the ocular surface in preparation for surgery,” Dr Cochener-Lamard said.