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August 9, 2023

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A TEAM APPROACH TO OCULAR SURFACE OPTIMIZATION FOR CATARACT SURGERY: OUR
PRACTICE'S PATHWAY TO PATIENT SUCCESS

J. MORGAN MICHELETTI, MD, FACS, AND CYNTHIA MATOSSIAN, MD, FACS




Successful cataract surgery relies heavily on the meticulous care given to the
patient's ocular surface well before the operation. In our practice, we are
fortunate to have synergistic collaboration between optometrists and
ophthalmologists across various locations. This network helps us to manage
ocular surface diseases (OSDs) effectively, which can significantly impact
surgical outcomes.
 
For many of our patients, their journey begins with our dedicated optometrists.
When we find that a patient has a visually significant cataract, our
optometrists identify any OSDs. Given the negative effects that OSDs have on
preoperative measurements and postoperative visual quality, our optometrists
optimize the ocular surface by managing those OSDs before referring the patient
to an ophthalmologist. This crucial groundwork sets the stage for a successful
surgical outcome. Once our optometrists pass the baton to the ophthalmologist,
we further evaluate the ocular surface to make sure it is stable and ready for
precise pre-surgical measurements and biometry.
 
Our method aligns with the ASCRS OSD algorithm, which again helps us to diagnose
and treat OSDs systematically before surgery, enhancing the likelihood of better
postoperative visual outcomes and greater patient satisfaction.
 
While our team operates across different locations, we maintain seamless
collaboration through shared electronic medical records and a mutual
understanding of each other’s care preferences that are grounded in the ASCRS
OSD algorithm. This cohesive network overcomes the typical communication
challenges that can arise when co-managing with external ODs, and ensures smooth
patient transitions from the initial assessment to the surgery itself.
 
At the end of the day, our shared goal is to ensure that every cataract surgery
is a success. Our team-based approach, commitment to patient-centered care and
adherence to the ASCRS OSD algorithm all contribute to achieving this goal. By
working together, we optimize each patient's ocular surface health and set the
stage for the best possible visual outcomes after their cataract surgery.

J. Morgan Micheletti, MD, FACS, is a Cataract, Refractive, and Complex Anterior
Segment Surgeon and Director of Clinical Research and Technology at Berkeley Eye
Center in Houston, Texas.

  Cynthia Matossian, MD, FACS, is the founder of Matossian Eye Associates. She
specializes in refractive cataract surgery and dry eye disease. She was named
one of Ocular Surgery News' Premier Surgeon 300 - an elite group of 300 premium
refractive cataract surgeons in the United States. She was the 2017 winner of
the Ophthalmic World Leaders Visionary Award. She has been named one of the Top
25 Leading Women Entrepreneurs in New Jersey and one of New Jersey and
Pennsylvania’s Best 50 Women in Business. She is a Clinical Assistant Professor
of Ophthalmology (Adjunct) at Temple University School of Medicine. She has
published numerous articles and participated in national and international
meetings in leadership roles.
 

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