April 2019


Binkhorst Lecture preview

by Ellen Stodola EyeWorld Senior Staff Writer/Meetings Editor

During this year’s ASCRS Opening General Session, Stephen Pflugfelder, MD, will give the 2019 Binkhorst Lecture. Dr. Pflugfelder shared some of what his lecture, “The Quest for Tear Stability,” will cover.
First, he said he plans to touch on the importance of tear stability, adding that instability is a defining sign of some tear dysfunction. Tear stability is important for maintaining comfort and quality of vision, and it impacts surgical outcomes and patient satisfaction, he said.
Dr. Pflugfelder thinks that it’s often underappreciated in decision making for patients.
Another focus of his lecture will be the consequence of an unstable tear film and the types of impact it has on patients. Potential impacts include irritation, increased blinking, decreased functional vision (which is relevant to surgical outcomes), and triggering inflammation that further amplifies the tear dysfunction and tear instability.
To detect tear instability, Dr. Pflugfelder said it’s important to use standard fluorescein tear breakup tests. He said there are also new non-invasive imaging methods that can be utilized.
If the tear film is unstable, it’s certainly a contributing factor to a patient’s complaints of irritation or fluctuating vision. He said tear instability needs to be treated prior to surgery, particularly before cataract surgery with multifocal IOLs or refractive surgery. If treatment is not effective in improving tear stability, these procedures may not be indicated.
Dr. Pflugfelder stressed that many patients have tear stability problems, and a high percentage of patients over the age of 50 have a certain degree of tear film instability.
Also in his lecture, Dr. Pflugfelder plans to discuss conditions that cause tear instability and some that are common but might not be addressed. The biggest of these, he said, conjunctivochalasis, is fairly simple to treat prior to cataract surgery.
The lecture will also review evidence-based recommendations for things that could increase or improve tear film instability. In terms of what patients may be able to do themselves, Dr. Pflugfelder pointed to nutritional supplements and identifying occupational risk factors, such as staring at a computer screen or a dry environment.
Dr. Pflugfelder specializes in cornea, ocular surface, and tear disorders. His research interests include pathogenesis of desiccation-induced inflammation and autoimmunity on the ocular surface.

About the doctor
Stephen Pflugfelder, MD
James and Margaret Elkins Chair and director Ocular Surface Center, Department of Ophthalmology
Baylor College of Medicine

Financial interests
Pflugfelder: Allergan, Senju, Shire

Contact information
: stevenp@bcm.edu

Binkhorst Lecture preview Binkhorst Lecture preview
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