Second OpinionsCataract Pledgets for Pre-Op Eye Dilatio...

Cataract Pledgets for Pre-Op Eye Dilation

We have been using Ocucel instrument wipes (from Alcon)as sponge pledgets, soaked in a daily prepared mix of ophthalmic solutions, to prepare eyes for cataract surgery. These become soft in the solution and work really well, eliminating the time and repetitive process of administering the necessary eye drops. We currently cut these under sterile conditions into 2mm x 5mm pledgets. But we're wondering whether any manufacturer supplies these, pre-cut and pre-packaged. Does anyone have specific information on whether such a supply is available, and where?

Started by: kristi hamon (OR Manager/Supervisor) at December 13, 2012 (1:55 pm)

Comments and Responses


We discontinued pledgets several years ago due to patient discomfort and corneal abrasions. We then were compounding a dilation gel in house until our last survey in which we were told we could no longer do. Now we do the following: use one drop of Proparacaine, one drop Tropicamide 1%, one drop of Phenylephrine 2.5%, and one drop of Cyclopentolate 2%. After instilling the drops we give the patient approx. 20 mins to dilate then use one drop of Betadine 5% and one drop of Akten Lido Gel 3.5%. Patients dilate well and the Akten Lido Gel is a fast topical anesthetic.

Stacy J. (Other) at April 16, 2013 (9:34 am)

We have not used pledgets for about 4 years. The pledgets were very uncomfortable for patients and we had some corneal abrasions when using them. We are using a compounding agency out of Pensacola. They are accredited through the Pharmacy Compounding Accreditation Board. We recieve one sterile 1cc vial per patient with the combination phenylephedrine 2.5%, cyclopentolate 1%, and tropicamide 1%. Patients get one to two drops, they dilate nicely, and it is much more comfortable for our patients.

Barb Vivas (Director, Surgical Services/Director of Nursing) at February 18, 2013 (9:01 am)

We use Ultracell Ophthalmic Pledgets, product # 40825. Come sterile in packages of 10, 20 packages per box. Since mixing the dilating solution is considered "compounding" we have established a new procedure. Pour sterile pledgets into a sterile specimin cup. Instill one drop Proparacaine in operative eye then place the pledget in the cul-de-sac using sterile forceps; follow with one drop Tetracaine, one drop Cyclopentolate 1%, one drop Phenylepherine 21/2%.

Beth Johnson (Director, Surgical Services/Director of Nursing) at February 1, 2013 (1:03 pm)

for the dilating gel mixture, are you mixing up at your facility. Since bottles of proparacaine and cyclopentolate do not say single use or multi use how are centers handling this situation?

Brenda T. (Administrator/Director/Manager/Owner/Exec. Officer) at January 18, 2013 (11:22 am)

Oasis Medical carries sterile packaged pledgets. The order number is 0527 and they are called Soft Cell Eye Pledget. There are 20 per box that sells for $35.50. These can be purchased through our website at
or simply call our customer service at 800-528-9786

Regina Boore (Other) at December 14, 2012 (11:48 am)

We switched to a dilating gel due to several corneal abrasions when using pledgets. It seems to be more comfortable for the patients too.

M. SMITH (Director, Surgical Services/Director of Nursing) at December 14, 2012 (10:56 am)

we currently use a compounding pharmacy and cut and soak our own pledgets under sterile conditions.
works great

Karen B. (OR Manager/Supervisor) at December 14, 2012 (8:21 am)

Eagle products carries them sterile...

L. Belleza (OR Manager/Supervisor) at December 13, 2012 (5:56 pm)

We were just changing to have a compounding company to make those up for us . . . that company was NECC, so thankfully we did not get them! And we having not found an alternative place, would also love to know where to go, but I honestly trust our nurses to do things right over compounding companies right now. We just sent out hundreds of letters regarding other medications from NECC (single dose vials), if cataracts had been involved it would have been 1000's.

C. Vick (Other) at December 13, 2012 (5:48 pm)

Beaver-Visitec 40825 Ultracel sponges

D. MacKenzie (Other) at December 13, 2012 (5:02 pm)

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