24 EyeWorld Asia-Pacific | September 2024 I Wish I Identified And Treated ABMD Before Cataract Surgery “My eyes are irritated … they weren’t before cataract surgery.” “My vision fluctuates … it goes in and out.” “My vision seems even more off … after I got a lens to correct my astigmatism.” “I chose a presbyopia-correcting IOL, and my quality of vision isn’t great.” These are the phrases an ophthalmologist might hear when ABMD is missed prior to cataract surgery, causing the surgeon to wish they had treated it preoperatively. Saba Al-Hashimi, MD, thinks ABMD needs to be more on an ophthalmologists’ radar during their preop examinations. “It’s easier to address ahead of time, and your measurements for cataract surgery are going to be more accurate,” he said. “If it is something you catch afterwards, you can treat [the ABMD], and when the dust settles, you may find you’re off target … that becomes a harder issue.” Rahul Tonk, MD, thinks identifying and treating ABMD preop is on the radar of most cornea/refractive surgeons, but it should, he added, be something every comprehensive ophthalmologist thinks about as well. “We’ve been beating on this drum about managing the ocular surface for years, but it’s not yet a universal concern.” by Liz Hillman, Editorial Co-Director CATARACT This is a photo of a patient with ABMD and cataract. Note the irregular lines that resemble a coastline (map), small punctate opacities (dot), and thickened epithelial ridges (fingerprint)— hence the name map-dot-fingerprint dystrophy. This patient had both irregular astigmatism and recurrent epithelial erosions. Superficial keratectomy with diamond burr polishing was performed to prepare the cornea for future cataract surgery. Source: Rahul Tonk, MD, MBA
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