Eye medications after cataract surgery, routine drops - A State of Sight #129

Following standard cataract surgery, our patients use three eye medications including an antibiotic, a steroid, and an anti-inflammatory.

2017 UPDATE: Now we have three medications available in one bottle. This has been much more convenient for our patients, our referral doctors, and us!

Watch this episode of A State of Sight to learn more about the standard regimen that our cataract patients are using after surgery in 2016.

Welcome to A State of Sight, I’m Isaac Porter and this is your update in ophthalmology and eye care from Raleigh. Today, I would like to explain the standard care that we use for our patients following cataract surgery.

2017 UPDATE: Now we have three medications a steroid (prednisolone), an anti-inflammatory (nepafenac), and an antibiotic (gatifloxacin) available in one bottle. It is much more straightforward and used three times a day for a week, twice a day for a week, and once a day for two weeks. Our patients, our referral doctors, and we have been very happy with this combination drop. It is also very affordable. The info below remains valuable for reference.

For cataracts we recommend surgery on the worst eye first, the second eye can be done two weeks later or any time after that. For the minimum follow up visits we see the patients the day of or the day after surgery then they have a visit one to two weeks later for each eye.

The following explains the regimen we used in 2016. We use three drops for cataract surgery, two of them start the day before, a steroid and an anti-inflammatory drop. The third one starts the day of surgery, an antibiotic drop.

The specific medications that we use for the steroid is prednisolone, the anti-inflammatory is bromfenac and the antibiotic is gatifloxacin. These names can be confusing for patients to keep track of, so fortunately the drop manufacturers use a standard bottle cap color that can make it much easier to keep track of the drops. The antibiotic drop has a tan top, the anti-inflammatory has a gray top and the steroid has a pink top or a white top.

First, the antibiotic starts three times a day beginning right before surgery and continues immediately following surgery for the next week. We tell our patients that if the bottle runs out during that first week, it’s OK, and they don’t need to refill it.

The anti-inflammatory drop starts the day before surgery and it’s just once a day. The steroid drop also starts the day before surgery. We use a steroid taper, which means that it is used three times a day for one week, then twice a day for one week, then once a day for two weeks.

Most patients are finished using drops one month following cataract surgery. If the anti-inflammatory drop runs out, we tell our patients that’s OK, and they don’t need to refill it. If it lasts the whole month, then they can stop it once the month is over. Rarely, if there is extra inflammation or swelling inside the eye, patients may need the drops longer. For most patients, this regimen works very well to keep them comfortable and to control inflammation following surgery.

Recently, they have been newer developments where some surgeons are able to avoid prescribing drops after surgery by placing medication inside the eye at the time of surgery. We can go into this further in another episode of A State of Sight. If you have any questions about the drops or our regimen following cataract surgery, please post and we will be happy to answer them. We hope to see you again next time on A State of Sight.