Cataract surgery in ocular surface disease

Cataract surgery, which is the most widely performed ophthalmic procedure, is usually done in the elderly population, who are also prone to ocular surface disorders. Ocular surface diseases are multifactorial in nature and associated with symptoms and signs such as foreign body sensation, burning, fatigue, photophobia, red or watery eyes, or reduced visual acuity. These include a spectrum of conditions that may be immune or non-immune in nature. Cataract surgery in itself is known to alter the normal ocular surface milieu and cause tear film disturbances which can last up to 6 months post-operatively. These symptoms can be exaggerated in patients with ocular surface diseases. The planning and execution of cataract surgery can also be difficult in patients with associated ocular surface diseases. In this review, we discuss the various aspects of planning and intraoperative modifications to optimize the outcomes of cataract surgery in patients with ocular surface diseases.