Eyedrops remain the
most common form of
medication delivery
but that doesn't mean
they provide the most
benefit to patients, who often struggle to complete prescribed regi-
mens. "Confusion is more of an issue than compliance," says Richard
Hoffman, MD, clinical associate professor of ophthalmology at the
Casey Eye Institute of Oregon Health and Science University in
Portland. "We instruct patients to apply post-op drops four times a
day until their follow-up visit, and direct them to stop only the antibi-
otic drops after day five. Some patients have instead stopped applying
all of the drops by the time they come to the clinic."
The movement toward dropless cataract surgery continues. "It's
exciting to see industry understand that post-op drop regimens are a
problem that needs to be solved and is taking steps to develop solu-
tions that reduce or even eliminate the number of drops patients need
to administer after surgery," says Dr. Hovanesian.
Dropping drops
Two sustained-release formulations hold the promise of eliminating
the need for patients to apply a topical steroid.
Dexamethasone intraocular suspension is administered into the
ciliary sulcus at the end of cataract surgery after the viscoelastic has
been removed from the eye. Following injection, the steroid suspen-
sion becomes a white liquid sphere in the anterior chamber and
slowly dissolves to deliver a steady dose over the course of a month.
The suspension has a good safety profile and doesn't increase the
risk of intraocular pressure spikes when compared with topical dex-
amethasone, according to Dr. Hovanesian.
M A R C H 2 0 2 0 • O U T PA T I E N T S U R G E R Y. N E T • 9 5
It's exciting to see industry understand
that post-op drop regimens are
a problem that needs to be solved.
— John Hovanesian, MD