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Post-cataract dropless punctal plug therapy safe, efficacious, and cost effective

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Dropless medications following cataract surgery are a safe and effective alternative to traditional topical medications that increase compliance and improve the ocular surface, according to a presentation at AAO 2020 Virtual.

A randomized, self-controlled, prospective clinical study with 60 patients evaluated patient experience of each eye of a dropless medication regimen for preventing and treating postoperative ocular pain, inflammation, and infection following cataract surgery. The study included patients undergoing bilateral sequential cataract surgery 2 weeks apart with 2 treatment groups: (1) punctal plug dexamethasone (Dextenza, Ocular Therapeutix), ketorolac/phenylephrine (Omidria, Omeros) and intracameral moxifloxacin (experimental); and (2) moxifloxacin 0.5% q.i.d., ketorolac 0.5% q.i.d. and prednisolone acetate 1% q.i.d. topical medications (control).

No significant difference in postoperative pain, anterior chamber cell and flare, optical coherence tomography macula thickness, or visual acuity was found. No infections occurred in either group. In the punctal plug dexamethasone group, 2 patients had post inflammation requiring rescue topical prednisolone acetate 1%. The topical medication eyes had significantly more superficial punctate keratitis (SPK). Ninety-six percent of patients noted that they preferred the dropless regimen. In addition, the regimen significantly reduced out-of-pocket patient expenses.

Donnenfeld ED, et al. Dropless punctal plug dexamethasone, intracameral ketorolac and moxifloxacin compared to conventional topical therapy in cataract surgery. Presented at: AAO 2020 Virtual. [Session: PO046].

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