How aggressively do you treat the ocular surface before cataract surgery in a patient with inconsistent K readings and mild dry eye who is otherwise ready for surgery and does this differ based on the type of IOL offered?

This answer really depends on the patient and what they desire out of cataract surgery.

For the patient who is just desiring typical standard IOL cataract surgery and has no expectations of getting away from glasses, I don't pre-treat dry eye at all. It's a waste of time for the patient.

For patient...

The ocular surface has to be optimized for the best biometry readings in preparation for cataract surgery. Distortions and disruptions of the tear film can lead to inaccurate readings, which could lead to an IOL miscalculation.

The process starts with medical history, examining the patient’s systemi...

From the time of the initial consultation to the measurement visit, I instruct patients to start artificial tears at least QID in both eyes. This is particularly stressed in patients interested in toric or other advanced optics lenses. For monofocal lenses, I am less strict, given the forgiving natu...

It is definitely recommended to manage mild dry eye first, as it may progress into a moderate dry eye in the postoperative period and increase the risks of complications.

In patients with mild dry eye in a hurry to get surgery, I usually place plugs and plan the surgery shortly.

Many times I combine i...