advertiser banner advertiser banner advertiser banner
Digital Issues

Second Opinions > Pre-Op Eye Meds for Cataract Patients

Pre-Op Eye Meds for Cataract Patients

I would like to know what eye medications other ASCs are using to pre-operatively prepare the eye. We currently use a regimen of 5 different drops, and are looking at revising this process. Any information would be appreciated!

Started by: Deanna Baker (Administrator/Director/Manager/Owner/Executive Officer) at July 5, 2012 (12:46 pm)

Comments and Responses

View: earliest first

Patients use Besivance and Bromday beginning three days prior to surgery.

In pre-op, they receive one drop each of 1% Tropicamide, 10% Phenylephrine, and 2% Lidocaine gel. This usually gives excellent dilation and anesthesia. Intracameral lidocaine is not required.

Leon R. (Other) at July 17, 2012 (9:09 am)

Patients use Besivance and Bromday beginning three days prior to surgery.

In pre-op, they receive one drop each of 1% Tropicamide, 10% Phenylephrine, and 2% Lidocaine gel. This usually gives excellent dilation and anesthesia. Intracameral lidocaine is not required.

Leon R. (Other) at July 17, 2012 (8:48 am)

We use 1 drop Tetravisc Forte and compounded dilation drops with ABX. We prep with betadine 0.5% drop in the eye and then irrigate out and betadine swab to cleanse the eye and surounding area.

Christine W. (OR Manager/Supervisor) at July 12, 2012 (5:18 pm)

We used to use 4-5 drops, depending on the surgeon, which we mixed as well. USP 797 does not allow for more than 3 meds to be mixed in an ambulatory setting and these meds cannot sit for more than 1 hour. We now use compounded drops for dilation and we include an antibiotic in that mix. Here are our orders:

1-2 drops of TETRAVISC 0.5% in operative eye.

1 drop of the following mixture in operative eye every 5 minutes X 3:
" Mydfrin (Phenylephrine)2.5%
" AK-Pentolate (Cyclopentolate/Cyclogyl) 1%
" Mydriacyl (Tropicamide/Tropicacle) 1%
" Ofloxacin 0.3%

Tina Mentz (Other) at July 12, 2012 (11:29 am)

We have patients arrive 1 hour prior to incision time. The dilating drops vary per surgeon. Some use 2 drops such as a topical and tropicamide and some use 3-4 drops including an antibiotic and steroid. Seems to work for our center, but all we do is eyes

M. Clay (Administrator/Director/Manager/Owner/Exec. Officer) at July 12, 2012 (9:35 am)

We use drops compounded by a pharmacy that contains equal parts of:
Tropicamide 1%
Cyclopentolate 1%
NeoSynephrine 10%

One drop of Proparacaine &
One drop of Ofloxacin prior to instilling one drop of dilating compound.

Patients are seated in a dimly lit room and asked to keep their eyes closed.
30 minutes later they usually have very good dilation. It is very rare to need to add another drop of dilating drop.

Ellen Lopez (Director, Surgical Services/Director of Nursing) at July 11, 2012 (5:34 pm)

One hour preop patients receive a drop of a compounded solution of two parts Lidocaine jel, one part 2.5% neosynepherine, and one part 2% Cyclogel.
15 minutes later another drop is given. 15 minutes later the eye is checked for dilation. If necessary another drop is given every 15 minutes until pupil is dilated. Our pharmacy compounds the mixture.
We have been using this method for two years with great success.

Shelby C. (OR Manager/Supervisor) at July 11, 2012 (1:50 pm)

One hour to 45 min prior to surgery; Proparacaine 2gtts to eye. Then we use a dilating spray that is compounded by a pharmacy. The spray includes: cylcogel 1% 15ml, tropicamide powder 300mg 1%, phenyleprhine powder-0.750mg 2.5%, tetracaine HCL powder 0.150mg 0.5% and sterile water 15ml. We spray 1-3 sprays to lash line of gently closed eyelids. They blink after each spray. This process is repeated 20minutes prior to surgery.

P. Schinning (Other) at July 11, 2012 (10:28 am)

Preop eye prep for cataracts:
Upon arrival, Valium 2mg PO PRN and Tylenol 500mg tabs x2.
Beginning 45 mins. prior to surgery, Proparacaine 2 gtts; Cyclopentolate 2%, 2 gtts; Neo-Synephrine 2.5% 2gtts; wait 3 mins; repeat Cyclo and Neo; Slurry x1 generous drop; close lid; blot excess; tape lid with 1 1/2 inch piece of 1-in. paper tape. Check in 25 mins. If poorly dilated, add Neo 10%.

We instruct the patient to keep both eyes closed after the slurry, turn down the lights, and they usually take a nap.

Slurry recipe =
 Lidocaine 2% jelly 8mL
 Cyclogyl 2% 20 gtts
 Phenylephrine 10% 10 gtts
 Ocufen 0.03% 10 gtts
 Vigamox 0.5% 10 gtts

Slurry Mixing Instructions:

 Mix in a sterile cup with a sterile tongue blade.
 First place the eye drops in the cup; add the jelly, and then mix.
 Draw the slurry into 1mL syringes for unit dose dispensing.

Hope this helps.

Kathi Chervinko (Administrator/Director/Manager/Owner/Exec. Officer) at July 11, 2012 (10:13 am)

We were using 5 different drops as well. For the last 3 years now we have been using the local drop and then a compounded drop (from a compounding company in Massachusetts) with all 4 medicaltions in one drop. This has worked great for us.

G. Brehm (Director, Surgical Services/Director of Nursing) at July 11, 2012 (10:10 am)

Submit a response to this discussion topic

Please login to submit a response to this discussion topic.

DID YOU SEE THIS?
General Anesthesia

When Malignant Hyperthermia Strikes, Seconds Matter

advertiser banner