Surface Ophthalmics

Whether a patient undergoes surgery for cataracts, refractive correction, or any number of other conditions including retinal interventions, Surgical Temporary Ocular Discomfort Syndrome (STODS) is a postoperative concern. Symptoms of STODS can range from mild to debilitating, but regardless of severity, managing them is critical both for patient comfort and for achieving the best possible surgical outcomes.

In our previous blog, we looked at preoperative evaluation of dry eye and ways to mitigate STODS symptoms. Here, we look at strategies for post-operative management of STODS – a major contributor to patient comfort and long-term visual health. Diligent post-surgical eye care cannot be overstated.

Patient Education

The importance of patient education is twofold. First, setting realistic expectations about the possibility of temporary discomfort post-surgery can help to alleviate anxiety should it occur. Second, empowering patients with knowledge encourages them to take an active role in post-operative care and recovery and helps to ensure adherence to instructions, including using eye drops as prescribed and returning for follow-up visits when recommended.

Ocular Surface Lubrication

When it comes to managing STODS postoperatively, regular use of artificial tears helps maintain hydration and reduce friction. Temporary dry eye is a common occurrence after eye surgery and ocular surface lubrication can help to alleviate symptoms and increase comfort and satisfaction during the recovery period. While postoperative care is highly individualized for each patient, at a minimum, use of artificial tears should be recommended.

Management of Inflammation

Inflammation is a normal response to surgical trauma. Unfortunately, it can exacerbate STODS symptoms and in some cases cause pain. Recognizing that each patient is different and post-surgical plans are customized, for some patients topical corticosteroids may be beneficial for a limited time to manage this response.

Infection Prevention

Although not a direct contributor to STODS, infection is a primary concern following ocular surgery. Infection could cause STODS symptoms to appear intensified. Vigilant prevention strategies are critical, including meticulous ocular hygiene, regular follow-up evaluations, and for some patients, topical antibiotics.

Although STODS is a temporary condition, if left untreated it could lead to chronic inflammation. [i] Therefore, preparing the ocular surface preoperatively and managing STODS symptoms postoperatively are important measures, not only for increasing patient comfort, but also for the best chances of positive long-term outcomes.

 

[i] Hirabayashi M., Barnett, B. Solving STODS – Surgical Temporary Ocular Surface Discomfort Syndrome. Diagnostics 2023, 13, 837.)