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Archive November 2020 XXI, No. 11

Injecting New Life Into Cataract Surgery

Intracameral agents are contributing to better outcomes and more satisfied patients.

Daniel Cook

Daniel Cook, Editor-in-Chief

BIO

FINISHING TOUCH
Uday Devgan, MD
FINISHING TOUCH Dr. Devgan injects triamcinolone into the eye at the end of a procedure.

Administering medications in the eye during cataract surgery helps surgeons 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 topical drops to lower the risks of post-op inflammation 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-administer after surgery.

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