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Rodrigo M Torres, Pablo Gabriel Lódolo; Ocular surface stories after cataract surgery.. Invest. Ophthalmol. Vis. Sci. 2016;57(12):3870.
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© ARVO (1962-2015); The Authors (2016-present)
“I can see but I'm felling bad”. When cataract surgeons heard something like that and they couldn't find real problems in those eyes, usually the ocular surface (OS) service take place. This work review and analyze this topic.
A retrospective clinical study was performed, evaluating the clinical charts from patients referred to the OS service with problems after cataract surgeries, during the present year (2015). The follow data was analyzed: age, sex, time after surgery, visual acuity, the kind of intraocular lens (IOL), post-surgical refraction, the patient complaints/symptoms, their work or occupation, previous topical treatments (dry eye/glaucoma), the discovered signs and their therapeutic approach.
A total of 15 patients operated (both eyes) by 5 different surgeons were evaluated. The mean age was 67 years all, with 9 women and 6 men. All of the cases were referred between 2 to 3 months after cataract surgery (sutureless clear corneal incision of 2.0 mm to 2.5 mm, topical anesthesia, without intraocular surgical or post-surgical complications). Binocular visual acuity without correction in all of the patients were between 20/25 to 20/20, but 12 of them with 1 eye for near sight (spherical refraction: -1.0 to -1.5). 3 patients with far sight/both eyes. Symptoms: pain (14), foreign body sensation (15), burning (12), itching (4); fear about blindness (15). Work/occupation: retired (10) professional work (5: architect/physician/agronomic engineering/politic/bank employee). Non of the patients have history about glaucoma topical treatment but 3 have history about OS problems (dry eye:2; Stevens Johnson: 1). Signs: blepharitis (8), corneal edema around incision (4), epithelial keratitis (4), entropion (3). symblepharon (3). 5 patients from all (33.3%, 3 women, 2 men) don't have signs about OS problems. Artificial tears, topical loteprednol and lid hygiene, were the therapeutic approach for most of them but five with oral minocycline 50mg and topical cyclosporin for three (two were pseudo-pemphigoid and one was the Stevens Johnson).
Most women than men were referred to the OS service because complaints after cataract surgery. OS problems were detected in 66.6%, but fear about blindness was present in all the cases. Nonspecific pain was another common symptom. It is time to include a psychologist to evaluate pre-op patients and manage them at post-op time, as part of the ophthalmology team?
This is an abstract that was submitted for the 2016 ARVO Annual Meeting, held in Seattle, Wash., May 1-5, 2016.
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