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Subspecialties Cataract, Health Economics and Policy

Dousing the Post-Cataract Flames

Despite surgical advances, ocular inflammation after cataract surgery is a reality that, if managed ineffectively, can have a significant impact on patient comfort, recovery, and final visual outcome (1).  And it doesn’t take a great deal of surgical trauma to alter the blood-aqueous barrier, resulting in protein leakage, cellular reaction, and subsequent inflammation in the anterior chamber. Diabetes, use of tamsulosin, a history of iritis, or extended phaco time are just some of the many factors that can increase the risk of inflammation following cataract surgery (2). Even low-grade inflammation, if uncontrolled, can lead to conditions such as cystoid macular edema (CME), which can ultimately cause permanent vision loss.

Topical anti-inflammatory drugs, such as corticosteroids, have been the foundation of postoperative inflammation control for half a century. With the introduction of topical non-steroidal anti-inflammatory drugs (NSAIDs), which are thought to complement steroids and provide additional inflammation control, it has become common for surgeons to employ both steroids and NSAIDs to control and prevent inflammation resulting from cataract surgery (3).

Advances in drug-delivery options have since expanded post-cataract inflammation management, and regimens are beginning to shift in response (See: A timeline of novel corticosteroid options). Cataract surgeons Dave Patel and Cathleen McCabe cite sustained-release drugs that remove the adherence burden from patients, and innovative delivery mechanisms that improve intraocular penetration among the options that are reshaping their post-cataract inflammation control strategy.

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About the Author

Rochelle Nataloni

Rochelle Nataloni is a medical writer, specializing in healthcare communications.

Rochelle Nataloni is a medical writer, specializing in healthcare communications.

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