Thank you!

You are absolutely on target and I agree! It is better for the patient and the surgeon both! An excellent study was conducted and published 2017 in the Journal of Academic Ophthalmology titled "Postoperative Complications of True Dropless Cataract Surgery versus Standard Topical Drops". In summary, they are comparable, with only a few side effects higher in the dropless group. There was a national alert a few years ago when one surgery center had an unprecedented amount of intraocular infections after injecting these drugs into the eye at the conclusion of surgery. This was due to the compounding pharmacy inadvertently contaminating the compounded medicine. This is why we as physicians are cautious since we are responsible for your safety intraoperatively and postoperatively. Once there is a pharmaceutical-manufactured, FDA-approved drug to use for dropless surgery, I predict this will be the standard.

That is a very good question and thank you for the comments. In answer to your question about Bromfenac, yes, the advised duration of usage stated by the manufacturer is indeed different than what most doctors prescribe. There is good data that demonstrates first generation topical non-steroidal anti-inflammatory drops (NSAID) could indeed cause corneal ulcerations or keratitis with prolonged use. The newer generation of NSAID drops do not demonstrate that tendency and because of the reduced risk, we prefer to use this class of drug while tapering the steroid drop quickly to reduce the higher potential risks of the steroid. You can find some surgeons who successfully use only the NSAID without the steroid drop and others that do the opposite. In addition, we follow our patients over the 30 day post operative period at certain points to look for any untoward effect of the drops to protect our patients. I hope this helps, please feel free to reach out with any other questions.

@@notarobertomd Thank you very much for a speedy response. It makes me wonder though, since the mfg. paper work did say 14 days, is Bromfenac the "newer generation? Or the 1st? I'm already at 4 weeks for my first eye and 4 days away from my 2nd eye 4 week check up. Unfortunately, I had to post pone my upcoming 4th week appt to another 4 days and Bromfenac has not been told to be stopped for either eye yet. Also, the prednisone for the last eye, is still at two drops, this late out which concerns me. Would I be experiencing any symptoms for either the inflammation itself, if any, and/or for any other corneal or keratitis problems. Thank you for your considerable time and care. Are you able to give your city location for future reference~?

@@govindagovindaji4662 Bromfenac, Ilevro and Prolensa are considered the newest generation of NSAID topical treatment for inflammation of the eye. Regarding your question about the steroid drop, potential side effects are usually seen with higher does for longer periods of time in general. As you have noted, the steroid drop is being decreased weekly and this greatly reduces the occurrence of potential problems. This tapering of the steroid is very commonly used with this class of drug in general as well. Postponing your post op appointment for a few days should not have any impact on your healing if at your last post op visit your doctor was happy with your progress. And lastly, if you were suffering from any corneal issues from the NSAID drop, you would have symptoms. From blurred vision to pain, it would be noticeable and you would already have called your doctor by now. Again, thank you for your excellent questions.

That's the drops I have.

That's the type of drops I have.

You take 3 drops for a month or 5 wks.

Agreed! We give our patients the option of either one bottle with all 3 medications or the three separated. The reason is due to cost. Usually the single bottles are covered well under insurance and the single combination bottle incurs a greater out of pocket expense.

@@notarobertomd thank you so much for replying. We are really lucky here in UK with healthcare, even though it is very stretched.

Your surgeon likely suggested that regimin of drop frequency if he was expecting more inflammation than normally expected or if there were other predisposing factors pre-operatively that they wanted to manage with increased dosing of anti-inflammatory drops. We often titrate the dosing schedule based on the person's individual factors and surgery. Follow your surgeon's schedule. As far as the concern that the steroid will cause cataracts, do not worry, once a cataract is removed, it does not return. Your cataract was replaced with an acrylic or silicone lens that will not change clarity due to steroid use. I hope this puts your mind at ease!

Thank you very much for your quick reply. Today I went for the post-operative checkup nd the doctor said everything seems to be fine. I mentioned about the Steroid dosage and she said this does is generally given to all post surgery. I feel the dosage is little too high as I don’t experience any other discomfort. Only one eye surgery is done the other one is normal as of now. That is the reason I was worried. I don’t have diabetes or hypertension

@@georgygeorge1311 It sounds like your surgeon has a regimen that works for them and they are satisfied with your recovery. So that is excellent news! The dosage of the drops varies from surgeon to surgeon depending on generic versus brand name and other factors intraoperatively and intrinsically. Congratulations and good health my friend!

Thank you 🙏

It is always better to place an extra drop than not to have it reach the eye. If you think you missed , do it again.

Eight is a great number. I am undecided, I like zero, one, three, five and seven.