EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/1229334
90 | EYEWORLD | APRIL 2020 G UCOMA flammatory action, requiring a topical backup. Similarly, for pterygium surgery, Dr. Radcliffe said you need to monitor to make sure the pa- tient doesn't need additional anti-inflammatory action. "But the good news is you can dose it two, three, four times a day, instead of every hour," he said. Some patients might not tolerate drops well. Dr. Singh described a patient who devel- oped significant keratitis for 8 months from the preservatives in the drops used after cataract surgery in her first eye. After her second cat- aract surgery, she received Dextenza without any other anti-inflammatory medications, and she ended up with an uneventful postoperative course. "What's also nice about Dextenza is it con- forms to the size of the canaliculus and punc- tum, functioning as a kind of punctal plug," Dr. Singh said. This is another benefit; helping the ocular surface post-surgery can assist in speed of visual recovery. Dr. Radcliffe said that for glaucoma pa- tients who are already taking drops to reduce IOP, use of one of these products after a pro- cedure can reduce the drop burden and increase compliance. steroids every few hours during the first week. He uses loteprednol twice a day along with Dextenza for subconjunctival surgery, which he said improves patient compliance due to the reduced dosing regimen of the steroid drops they do have to take. For glaucoma procedures where doctors might watch for an IOP spike after steroid use, Dr. Singh cited Phase 3 clinical trial data for Dextenza that showed there was no significant steroid response. Taking a step back, Dr. Singh said that for glaucoma, cataract surgery, and managing dry eye, patient satisfaction has become more im- portant than ever before. To this end, reducing the drop burden is a major factor in achieving high patient satisfaction. Dr. Singh discussed a nonpublished in-office study where patients 3 months post-cataract surgery who were happy with outcomes were asked what the most diffi- cult part of the surgical process was. "It was drops," he said. "The whole para- digm shift is toward earlier intervention, num- ber one, but number two is maintaining a high patient satisfaction at the same time." For procedures like endocyclophotocoagu- lation or micropulse, Dr. Radcliffe said Dexycu or Dextenza might not provide enough anti-in- continued from page 89 Contact Radcliffe: drradcliffe@gmail.com Singh: ipsingh@amazingeye.com Exceptional Clinical Education is One Click Away! Visit ASCRS.ORG Today!