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    Dropless cataract surgery yields postoperative prophylaxis for patients, practices

    Approach has shown less patient compliance issues, fewer callbacks from pharmacies


    Take-home message: Dropless cataract surgery—a combination of anti-infective and anti-inflammatory drugs injected transzonularly or through the pars plana for deposit into the vitreous—reduces the need for topical postoperative drops.



    Tampa, FLThe newly available concept of dropless cataract surgery may be an alternative for both patients and physicians, said Robert J. Weinstock, MD.


    “The limited early experience is showing some promise and some benefits regarding the patient, practice, and financial burdens,” said Dr. Weinstock, associate clinical professor, Department of Ophthalmology, University of South Florida, Tampa.

    Patients who undergo cataract surgery generally follow the current standard of care—i.e., instillation of a number of topical medications for 4 to 8 weeks postoperatively, including an antibiotic, steroid, and nonsteroidal anti-inflammatory drug.

    “This creates a tremendous burden on patients and practices alike when patients are required to follow an intensive eye drop regimen after cataract surgery,” Dr. Weinstock explained.

    The length of the postoperative regimen is further complicated by the different daily dosing regimens of various medications, which can cause confusion for patients because of age and physical and mental handicaps.

    “Patient compliance is one of the biggest issues we face in our practice,” Dr. Weinstock said. “It can be very challenging for many patients to remember to use their drops and some have physical challenges using the small bottles.”

    In addition, as costs of medications continue to spiral, patients are refusing to pay those costs and insurance companies are not footing the bill, necessitating the switch to generic medications. Time spent by staff on helping patients with medication problems, as well as patient education, also increases exponentially.

    “Uncertainty still remains after all this effort regarding whether or not patients are getting the correct drops into their eyes,” he said.


    Idyllic model

    The ideal scenario would be elimination of the postoperative drop regimen altogether, he noted.

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