Dropless Cataract Surgery - Advantages and Techniques

Introduction:

The cataractous blurring of eyes is widely reported across the world. Newer technicalities and advancements are emerging progressively over the years to enhance visual recovery. Dropless cataract surgery is quite a novel, and newly launched treatment concept that excludes the use of eye drops postoperatively.

What Is Dropless Cataract Surgery?

• Dropless cataract surgery is a revolutionary treatment approach for the correction of cataracts. Conventionally the cataract surgeries are followed by a crucial follow-up period during which the patient has to adhere to the treatment strategies instructed by the doctors strictly.

• The long-term success of cataract surgery is largely dependent on this post-operative treatment. Patients are prescribed numerous medicines in the form of eye drops that have to be administered to the eyes at specific intervals over a significant period. These drops are intended to protect the eyes from other infections and also to facilitate the healing process after the surgery.

• Even though it greatly impacts the outcome of the surgery, it is largely patient-dependent. That is when the newer inventive approach to dropless cataract surgery came in.

• Dropless cataract surgery put an end to the extensive post-operative eye drop therapies. In this technique, the drops that are generally advised postoperatively are incorporated into the surgery.

• Those medications are delivered during the surgical procedure, thereby completely stamping out the postoperative therapeutic eye drops administration and hence the name dropless cataract surgery.

What Are Cataracts?

• Cataracts are widely encountered eye disorders specifically affecting the lens. Cataractous lenses appear foggy and misty.

• The lens plays an influential role in vision, which passes on light through it and facilitates vision. But, when it becomes cloudy and foggy, it eventually gets reflected in the vision. Likewise, the vision also becomes dull, dim, unclear, and vague.

• The settling or precipitation of specific proteins in the lens gives rise to cataractous changes in the lens. As age advances, these kinds of protein precipitation happen as part of the normal aging process. Though there are numerous other reasons that could lead to cataracts, aging always has the upper hand over other reasons.

• Surgeries are the best ways to tackle cataracts. All the surgeries are focused on removing the foggy lens and substituting it with a new one. Surgeries differ in the technique employed for this process.

• The majority of cataract surgeries necessitate a strict follow-up period during which specific post-surgical drops are intended to be used on a regular basis. Failure to adhere to post-surgical therapy negatively impacts the treatment's success.

What Are the Advantages of Dropless Cataract Surgeries?

There are a lot of benefits associated with dropless cataract surgeries. Some of their key advantages include the following:

• Guaranteed Drug Delivery: Since the medicines are already delivered to the eyes during the surgery, it ensures a constant supply of medicines. Thus it aids in prompt healing and treatment success.

• Less Expensive: Post-operatively advised eye drops are often highly expensive, and it further burdens the patient financially. The elimination of eyedrops makes the treatment procedure even more affordable.

• Less Dependence on Patients: Medicines prescribed following surgery necessitates strict adherence to the therapy by the patients, which is often practically difficult. The patient may occasionally skip doses which could have a great impact on the healing of the condition. There are chances that the patient may administer the wrong doses of the drug. The postoperative treatment routine requires patient cooperation and is largely patient-dependent. Dropless cataract surgeries do not pose such challenges and are independent of patient cooperation after surgery.

• Convenient: Dropless cataract surgeries are more comfortable and convenient for patients as they are not bothered by the administration of different eye drops following the surgery. Thus, it is more convenient and comfortable for the patient.

• Fewer Complications: Dropless cataract surgeries remarkably bring down the chance of developing complications like infections following cataract surgery. Macular edema (retinal bulging) is a frequently encountered complication that may even impact the vision. Dropless cataract surgery exceptionally prevents macular edema.

• Safer: Dropless cataract surgeries are much safer than conventional cataract surgeries. For example, when eye drops are delivered by patients themselves, there are chances for the contamination of the drops, which may eventually result in infections. At times, drop tips may even inflict abrasions on the corneal surface.

What Are the Techniques Followed in Dropless Cataract Surgery?

The entire procedure until the new lens implantation is the same as that of normal cataract surgery. In dropless cataract surgery, following the artificial lens (intraocular lens) placement, specific drugs are administered directly into the eyes. Routinely preferred drugs include anti-inflammatory and antibiotic medicines that were conventionally given in the form of eye drops postoperatively. The techniques employed in dropless cataract surgeries vary based on the method and location of drug administration. Some of the widely practiced technique includes the following:

• Intravitreal Injections: Once the artificial lens (intraocular lens) is placed, appropriate drugs are injected into the eyes, typically into the vitreous chamber.

• Intracameral Injections: Here, the drugs are given as injections into the anterior chamber. Those drugs delivered through intracameral injections are technically known as intracameral agents. Ketorolac, Moxifloxacin, Dexamethasone, and Phenylephrine are the widely preferred intracameral medicines to tackle swelling and infections.

• Subconjunctival Injections: At times, these are given in the form of subconjunctival injections. Triamcinolone is routinely preferred for subconjunctival injections.

• Inserts: Apart from the injection form of drug delivery, there is another advancement that enables drug delivery in the form of inserts. A tiny insert containing the specific medicine is inserted into the eyes, which ensures a constant supply of medicine in the required dose for a period of around one month. Once the insert is done with its duty of drug delivery, it then disintegrates on its own, and the tear system in the eyes flushes it out.

Is There Any Potential Complication Associated With Dropless Cataract Surgery?

Certain study reports concluded that dropless cataract surgery using a combination of Moxifloxacin and Triamcinolone carries the risk of developing a potential condition called toxic posterior segment syndrome. However, it lacks scientific pieces of evidence supporting the same. Studies are ongoing to understand more about the complications concerning dropless cataract surgery.

Conclusion:

Dropless cataract surgery is an advanced and convenient approach that completely wipes off the use of eye drops following cataract surgery. It not only enhances patient comfort but also eliminates potential complications that could arise from cataract surgery. Its effectiveness and safety enhance its popularity and acceptance all over the world.