Eyeworld Supplements

6 • 2018 ASCRS Clinical Survey Key findings An overwhelming majority of respondents (90%) at least agree that mild to moderate dry eye significantly impacts keratometry and IOL power calculations, as well as patient satisfaction after cataract or refractive surgery. Nearly 90% at least agree that inflammation and hyperosmolarity are involved in the pathogenesis of dry eye. How and when to test for this condition, however, runs the gamut. Forty-five percent do not incorporate a dry eye questionnaire; 63% perform Schirmer's on a case-by-case basis; nearly 60% incorporate fluorescein staining at the initial point of care, while 58% incorporate rose bengal or lissamine green staining case by case. In terms of treatment for a patient with moderate ocular surface disease of mixed etiology, most surgeons would prescribe cyclosporine and lid compresses/lid hygiene measures. "It's interesting that the respondents feel so strongly about the impact of ocular surface disease on cat- aract outcomes. I do not think this has always been the case. Over the last few years, we have increased our awareness of the impact of dry eye disease. We have better tools and treatments today, so we are able to diagnose and intervene earlier in the dry eye disease state. Clearly, the efforts of educators, societies such as ASCRS, and collaborative efforts such as the Tear Film & Ocular Surface Society Dry Eye Workshop II (TFOS DEWS II) have made a positive impact. "Despite many respondents thinking that hyperos- molarity and inflammation are core mechanisms in dry eye disease, more than two-thirds of doctors are not using osmolarity or MMP-9 testing in their practices. I think this speaks to the fact that the reimbursement pathway or practice implementation may be a barrier in clinical practice." —Preeya Gupta, MD ASCRS Cornea Clinical Committee Ocular surface/cornea What percentage of your cataract surgery patients present as asymptomatic but still have OSD preoperatively? • On average all respondents reported 30% of their cataract surgery patients present as asymptomatic but still have OSD preoperatively • U.S.: 32% • Non-U.S.: 27% All 30% US 32% NonUS 27% Average Pct n=438 76 When do you use the following test? Dry eye questionnaire • Overall, nearly half Not currently incorporated into my practice, 45% • U.S. 14% points higher than Non-U.S., 51% to 37% n=438 77 When do you use the following test? Schirmer's testing • Overall, majority on a case by case situation, 63% • Overall, 29% Not currently incorporated into my practice n=445 78 When do you use the following test? Fluorescein staining/TBUT • Overall, nearly 60% At the initial point of care in most patients, 59% • Overall, only 4% Not currently incorporated into my practice n=451 79 When do you use the following test? Rose bengal/lissamine green staining • Overall, majority on a case by case situation, 58% • Overall, 32% Not currently incorporated into my practice n=440 80

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