There was clinically significant less CME in patients who received trans-zonular triamcinolone acetonide, moxifloxacin hydrochloride, and vancomycin—known as the Dropless approach—in addition to an NSAID after cataract surgery.
Cataract surgery with or without intravenous sedation can be a factor in the clinical experience. Moving to sublingual sedation may be the next step in safety and comfort for a demanding patient demographic.
A sustained-release dexamethasone intracanalicular depot may be able to treat post-cataract surgery inflammation without causing spikes in IOP. The product’s one-time administration may also improve compliance and convenience.
In a recent wave of drug price increases that can only be explained by pharmaceutical manufacturers’ desire for profit maximization and which doctors and patients may call price gouging, the drug price war has been brought to the doorsteps of many eyecare providers. As optometrists are increasing their practice of medical optometry, patients are now calling their doctors about prior authorizations and unaffordable drug copays.
Months after a manufacturer drew widespread criticism from consumer groups and politicians for raising the price of pyrimethamine (Daraprim) by more than 5000%, Express Scripts, the nation’s largest PBM, has announced it will make the drug available for about $1 per pill.
Lines continue to blur as to what constitutes refractive surgery, and likely will continue to blur well into the future. Multiple compounds—phenylephrine and ketorolac 1%/0.3%, (Omidria, Omeros) and the “Dropless” line (Tri-Moxi/Tri-moxi-Vanc, Imprimis Pharmaceuticals)—are designed for use in cataract surgery, but their goal is to improve refractive outcomes. 2015 was the year they started to get some serious attention.
Dropless cataract surgery—a combination of anti-infective and anti-inflammatory drugs injected transzonularly or through the pars plana for deposit into the vitreous—reduces the need for topical postoperative drops.