back to previous page | Topics Tear Film Instability Impacts Cataract & Refractive Outcomes

Ocular Surface
Disease Management

with the Keratograph® 5M

Uncover True Causes of K Reading Variability
from Ocular Surface Disease

Optimize Surgical Outcomes & Patient Satisfaction by Stabilizing the Tear Film

Variability of K readings caused by ocular surface disease is a leading cause of refractive surprises and IOL exchanges. Dry eye is also a major complaint post-LASIK, significantly impacting patient comfort and satisfaction.

Leverage the OCULUS Keratograph® 5M to uncover the true cause and subtype of dry eye for targeted treatments that deliver the fastest stabilization of the ocular surface before surgery.

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Make reliable surgical decisions with accurate measurements

OCULUS Keratograph® 5M

The Impact of Dry Eye on Cataract & Refractive Surgery

Cataract Surgery

Dry eye prevalence is 55% among pre-op cataract patients.1 Short-term dry eye treatment before cataract surgery can improve the accuracy of IOL power calculation and reduce the probability of refractive surprise.2

Refractive Surgery

Pre-existing dry eye disease can impact surgical accuracy; post-LASIK, 95% of patients report dry eye symptoms, which can significantly decrease patient satisfaction and quality of life.3

Comprehensive analysis with the
Keratograph® 5M ensures targeted treatments for faster ocular surface stabilization before surgery.

Perform Pre-Op Tear Film Analysis to Enhance Surgical Success

The tear film functions as the primary optical surface of the eye, making it a key part of the visual system. Stabilizing the ocular surface can play a decisive role in surgical outcomes.

Before IOL implantation

  • Improve pre-operative measurement accuracy
    Since variable K readings from tear film instability can cause inaccurate IOL power calculations, it’s paramount to stabilize the ocular surface to ensure the greatest accuracy in pre-op measurements.
  • Enable candidacy for premium IOLs
    Improving the ocular surface before cataract surgery expands the patient’s eligibility to include multifocal and extended depth-of-focus IOLs. A stable tear film and measurements support achieving the desired visual outcome, boosting patient satisfaction with their expensive premium IOL.
  • Reduce refractive surprises and IOL exchanges
    Inaccurate measurements and IOL calculations result in sub-optimal visual outcomes. Stabilizing the tear film before cataract surgery can reduce the rate of refractive surprises and patient dissatisfaction.4
  • Boost post-operative healing
    A stable tear film promotes post-operative healing and reduces the risk of complications such as infection or inflammation.
  • Improve patient satisfaction and comfort
    A stable tear film contributes significantly to clear vision and higher visual comfort after surgery. Since pre-existing dry eye often worsens after surgery,5 peri-operative ocular surface disease management is critical to patient satisfaction.

Before refractive interventions such as LASIK

  • Improve pre-operative measurement accuracy
    Fluctuating corneal curvature and thickness measurements due to tear film instability reduce the precision of the surgical plan and can substantially impact the patient’s visual outcome.
  • Reduce the risk of enhancements
    Dry eye treatments enhance the accuracy of pre-op measurements, thus increasing the likelihood of achieving the targeted visual outcome the first time.3 This reduces the risk and frequency of follow-up procedures to correct residual refractive errors.
  • Decrease post-op complications in healing
    An unstable tear film following LASIK can lead to complications such as epithelial defects, delayed wound healing, or elevated risk of infection. An examination of the tear film can help identify and mitigate such risks.
  • Enhance patient satisfaction and quality of vision
    Dry eye is the most common complication of LASIK.3 A stable tear film is essential for optimal patient comfort and vision quality; it minimizes complications like blurred vision and halos after LASIK, improving surgical outcomes and patient satisfaction.

  • Avoidance of complications
    Tear film problems can predispose the patient to postoperative complications. Their early identification and treatment can help minimize such complications.

Examining the tear film before cataract and refractive surgery is crucial for successful planning, the procedure itself, post-operative care, optimal visual outcomes, and patient satisfaction.

Advantages of performing tear film examinations with the Keratograph® 5M:

  • Detailed Tear Film Analysis
    The Keratograph® 5M performs non-invasive measurements of tear film stability by determining non-invasive keratographic tear film break-up time (NIKBUT). This information is key to being able to accurately assess the state of the tear film and identify possible problems.
  • Assess Tear Film Quantity
    Medications, health conditions, diseases, and aging can all contribute to aqueous-deficient dry eye. Measure the tear meniscus height with the built-in ruler to assess tear film quantity; the software automatically saves the mean measurement to the patient’s file.
  • Perform Meibography of the Upper and Lower Eyelid
    Capture precise meibomian gland imaging to examine the tissue responsible for the tear film’s lipid layer. Easily compare individual meibography to a visual four-point grading scale to classify MGD and its impact on tear film stability.
  • Documentation and follow-up
    The Keratograph® 5M allows documenting the condition of the tear film prior to surgery and is well-suited for postsurgical follow-up. This helps in monitoring healing and being able to respond promptly to changes.
  • Personalized treatment planning
    Based on the results of the examination a personalized treatment plan can be drawn up that addresses specific problems involving the tear film. This helps improve the chances of surgical success and postoperative patient satisfaction.
Marguerite McDonald, MD, FACS

“

The presence of DED can affect the dioptric accuracy of cataract and refractive surgical outcomes. Devices like the Keratograph® 5M can aid in our ability to accurately measure DED, to judge its severity, and to subsequently prescribe the best treatment to patients so that the ocular surface is healthy enough for accurate preoperative measurements and safe and effective surgery.

”

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1Graae Jensen P, Gundersen M, Nilsen C, Gundersen KG, Potvin R, Gazerani P, Chen X, Utheim TP, Utheim ØA. Prevalence of Dry Eye Disease Among Individuals Scheduled for Cataract Surgery in a Norwegian Cataract Clinic. Clin Ophthalmol. 2023 Apr 27;17:1233-1243. doi: 10.2147/OPTH.S407805. PMID: 37138823; PMCID: PMC10150762.

2Kim J, Kim MK, Ha Y, Paik HJ, Kim DH. Improved accuracy of intraocular lens power calculation by preoperative management of dry eye disease. BMC Ophthalmol. 2021 Oct 13;21(1):364. doi: 10.1186/s12886-021-02129-5. PMID: 34645396; PMCID: PMC8515725.

3Shtein RM. Post-LASIK dry eye. Expert Rev Ophthalmol. 2011 Oct;6(5):575-582. doi: 10.1586/eop.11.56. PMID: 22174730; PMCID: PMC3235707.

4Biela K, Winiarczyk M, Borowicz D, Mackiewicz J. Dry Eye Disease as a Cause of Refractive Errors After Cataract Surgery – A Systematic Review. Clin Ophthalmol. 2023 Jun 6;17:1629-1638. doi: 10.2147/OPTH.S406530. PMID: 37304333; PMCID: PMC10257420.

5Naderi K, Gormley J, O’Brart D. Cataract surgery and dry eye disease: A review. Eur J Ophthalmol. 2020 Sep;30(5):840-855. doi: 10.1177/1120672120929958. Epub 2020 Jun 9. PMID: 32515220; PMCID: PMC7549290.