CCS 2025: Collaborative retinal disease management in the preoperative refractive surgery patient

Carolyn Majcher, OD, FAAO, detailed in a Collaborative Care Symposium (CCS) 2025 presentation discussing retinal disease management in preoperative cataract and refractive surgery. The presentation, copresented with Prethy Rao, MD, focused on comprehensive patient care and interdisciplinary approaches to eye surgery. A critical aspect of the discussion was setting realistic patient expectations. Majcher emphasized that patients with retinal conditions need to understand potential vision limitations post surgery. The goal isn't always complete vision correction, but rather reducing dependence on corrective lenses. Majcher recommended supplementary strategies like using extra lighting, magnifiers, and contrast-enhancing devices to support patients with vision challenges.

Collaborative care emerged as a central theme, with Majcher highlighting the importance of different eye care specialists working together. By combining perspectives from optometry and retinal specialties, providers can optimize patient outcomes and develop more comprehensive treatment strategies. Key clinical recommendations included performing thorough retinal examinations, particularly under dilation, to identify potential surgical risks.

Majcher stressed the significance of multimodal imaging techniques like macular OCT, fundus autofluorescence, and wide-field color fundus photography to detect subtle retinal pathologies. Special attention was given to patients with specific conditions. For instance, those with diabetic retinopathy require extra preoperative screening, including macular OCT to check for diabetic macular edema. Patients with macular diseases might benefit from monofocal or light-adjusted intraocular lenses instead of diffractive premium IOLs. Majcher also recommended close communication between eye care professionals, considering low vision rehabilitation referrals, and using large-print educational materials to support patients with reduced vision. The presentation underscored the complexity of managing patients with retinal diseases undergoing eye surgery. By combining thorough examinations, advanced imaging, realistic patient counseling, and interdisciplinary collaboration, eye care providers can develop more personalized and effective treatment approaches.

Majcher concluded by emphasizing that successful patient care requires a holistic, collaborative approach that considers individual patient needs, potential surgical risks, and long-term vision management strategies.