A Practical Approach for Optimizing Ocular Surface Status Before Cataract Surgery to Improve Visual Outcomes and Reduce the Risk of Postoperative Dry Eye

Dry eye disease (DED) is highly prevalent among patients undergoing cataract surgery but is frequently underdiagnosed. Its presence can significantly affect preoperative biometric measurements and intraocular lens (IOL) power calculations, along with postoperative outcomes, particularly in patients receiving premium IOLs. Identifying and managing ocular surface disease (OSD) before surgery presents a valuable opportunity to optimize the ocular surface, reduce the risk of refractive surprises, and enhance both visual quality and patient satisfaction. This review summarizes current evidence on the prevalence of DED in patients with cataract, its impact on surgical planning and outcomes, and further outlines a practical approach for preoperative evaluation and optimization. Key strategies include risk stratification, targeted diagnostics, and individualized treatment regimens. Incorporating ocular surface assessment and treatment into the routine preoperative workflow is both feasible and essential in the context of modern cataract surgery. A structured, multimodal approach to DED management can significantly improve surgical precision and long-term visual outcomes.