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Using intracameral medications, eliminating postop drops reduces complications
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NEW ORLEANS — Eliminating postoperative drops after cataract surgery and, instead, using intracameral medications allows for better postoperative results with fewer complications, reduces cost to patients and improves compliance, a physician said here.
James P. Gills, MD, spoke about ways to reduce or eliminate postoperative drops during the Spotlight on Cataracts at the annual American Academy of Ophthalmology meeting.
"It's very important to eliminate drops because it improves safety, recovery time and decreases dry eye complaints," he said. "It eliminates the complications associated with drops."
He said these hurdles include corneal melt, dryness and poor compliance among other complications.
Dr. Gills said drops can be minimized through the use of implants, such as collagen implants, or through subconjunctival Kenalog (triamcinolone, Bristol-Meyers Squibb) injections. He also said administering 2.5 mg of Avastin (bevacizumab, Genentech) 1 week before surgery can reduce the need for postop drops.
His current preoperative and postoperative regimen is a "belt and suspenders" technique, he said.
Preop, his patients receive Acular (ketorolac tromethamine 0.5%, Allergan), three times a day for 3 days. Intraoperatively, they receive 0.15 cc of subconjunctival Kenalog. Postop, they receive Pred Forte (prednisolone acetate 1%, Allergan) three times a day for 6 weeks and Acular three times a day for 6 weeks.
He said he has performed more than 50,000 cases without a reported case of endophthalmitis.