Ophthalmologists are fortunate to be practicing at a time when we can offer cataract surgery patients highly advanced lens implants that provide—at a minimum—excellent uncorrected vision at a distance, with the option for vision at multiple distances with a multifocal or extended depth-of-focus (EDOF) IOLs. The performance of these IOLs is better than ever, yet if not addressed proactively, the eye’s first refractive surface—the tear film—has the potential to limit the IOL’s performance.
Ocular surface disease (OSD) reduces the accuracy of keratometry and distorts topography. It also can result in unsatisfactory visual quality and discomfort after surgery. A careful assessment of the ocular surface and initiation of treatment, if warranted, should be an important part of every cataract surgery consultation.