Outpatient Surgery Magazine

Year of the Nurse - November 2020 - Subscribe to Outpatient Surgery Magazine

Outpatient Surgery Magazine, providing current information on Surgical Services, Surgical Facility Administration, Outpatient Surgery News and Trends, OR Excellence and more.

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A dministering medications in the eye during cataract surgery helps sur- geons perform the procedure safely and promotes post-op healing. Old standbys offer cost-effective options and sustained-release formulations improve patient satisfaction by reducing the need for topi- cal drops to lower the risks of post-op inflamma- tion and infection. It's common practice for surgeons to administer an anesthetic or an anesthetic-dilating combo such as lidocaine plus epinephrine or lidocaine plus phenylephrine at the beginning of the case, according to Uday Devgan, MD, a cataract surgeon in Los Angeles who runs a popular website dedicated to teaching eye surgeons about the various techniques of cataract surgery (cataractcoach.com). "Most surgeons administer a fluoroquinolone such as preservative-free moxifloxacin at the end of case to reduce the risk of post-op endophthalmitis," he says Dr. Devgan. "A large European study also showed post-op administration of intracameral cefuroxime significantly reduced the risk of endophthalmitis." Some surgeons inject an anesthetic and dilating agent such as epinephrine and phenylephrine at the beginning of case and administer intracameral steroids and antibiotics at the case's conclusion to reduce the risk of endophthalmitis, according to Dr. Devgan. He also says some surgeons inject an antibiotic-steroid combination through the zonular apparatus of the eye and into the vitreous to reduce the number of drops patients need to self-adminis- ter after surgery. "Minimizing the eye drop burden for patients is an important goal," says Cynthia Matossian, MD, FACS, founder of Matossian Eye Associates, an ophthalmology practice with locations in Pennsylvania and New Jersey, and vice president of the American College of Eye Surgeons. "Regimens can be confusing, especially for the older patient population who undergo cataract surgery, and can be bothersome to patients who resent having to fol- low a drop schedule that might interfere with their daily activities. Compliance with prescribed post-op regimens is a significant issue, and limiting the num- ber of drops they have to self-administer has the potential to improve outcomes." • Dexycu is an FDA-approved intraocular dexam- ethasone suspension in a biodegradable sustained- release aqueous sphere placed in the posterior cham- 6 0 • O U T P A T I E N T S U R G E R Y M A G A Z I N E • N O V E M B E R 2 0 2 0 Injecting New Life Into Cataract Surgery Intracameral agents are contributing to better outcomes and more satisfied patients. Uday Devgan, MD Dan Cook | Editor-in-Chief FINISHING TOUCH Dr. Devgan injects triamcinolone into the eye at the end of a procedure.

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