Optometric Management

FEB 2017

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FEATURE ANNUAL MEDICAL SERVICES ISSUE Continued on p.59 it comes to cataract surgery, in particular, DED can significantly alter the IOL calculations that need to be made for correct IOL selection. Mild DED patients could benefit from preserva- tive-free tears, while moderate to severe patients would benefit from steroid drops and FDA-approved DED prescription drops, such as cyclosporine oph- thalmic emulsion 0.05% (Restasis, Allergan) or li- fitegrast ophthalmic solution 5% (Xiidra, Shire). • Continue treating post-operatively. During the post-operative period, keep having the patient use the DED treatments you prescribed before the surgery, again, to increase the likelihood of a positive outcome. • Consider alternative anti-infection medications. At my practice, we perform "dropless" cataract sur- gery. is includes a formulation of preservative-free triamcinolone/moxifloxacin ("trimoxi") that is in- jected aer IOL implantation via the ciliary sulcus through the zonules. It eliminates the need for corne- al tissue-altering antibiotics and steroid drops post- follow this protocol prior to sending patients to the surgeon: • Manage the condition. Should your assessment reveal DED, prescribe treatments to be used two to four weeks prior to surgery to ensure the condition will not interfere with the surgical outcome. When Note lissamine central staining five days post-photo- refractive keratectomy in this DED patient. +NËXËËËËËËINËLSËXËËËËËSËËËËËHËS ËËËËËn\NËËËËËËnËË Ën MJWRËKQË We have the on n nn nnn nnn n The n n n nn for exfoliating eyelid scruf due to nn n ËKËËËËËIËSËËËËËËËËËËËËËË ËËËËËËËË ËËËËËËËËËËËËËËËË Ë ËËËËËËË ËKËËËËËIËSËËËËËËËËËËËËËË ËËËËËËËË ËËËËËËËËËËËËËËËË Ë ËËËËËËË QQnnËLMYXnnJXJW[JInËn nnËJIËHFQn,WËZU 8HËS 6nnnËIJ <ËËË((Ë5ËËË11Ë2Ë/ËËË(( (Ë11ËËË<ËËËË51Ë(ËËËËËËË ΞJJΞΞΞΞ $ $$$

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