Experts Offer Advice on NSAIDs

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How are the experts using NSAIDs in patients undergoing cataract surgery? A recent report provided best practices.

Kendall Donaldson, MD, associate professor of ophthalmology at the Bascom Palmer Eye Institute in Plantation, FL, said she prefers branded drops over generics because they can be used just once a day. She starts the regimen 3 days before surgery and continues until 1 month postop. She uses a longer regimen in those with preexisting macular edema in the surgical eye or cystoid macular edema in the fellow eye.

Deepinder K. Dhaliwal, MD, professor of ophthalmology, University of Pittsburgh School of Medicine, prefers newer NSAIDs. However, when cost is a barrier, she will prescribe the generic ketorolac. She typically uses an NSAID in routine cases 1 hour before the surgery, and does not use them at all for the first week after surgery. “I don’t want to bombard their epithelial surface with anything that could delay restoration of a smooth ocular surface,” she said. If all appears well at the 1-week visit, she prescribes an NSAID and recommends routine use until the bottle is empty. She treats high-risk patients for 8 weeks.

Lipner M. Eyes on NSAIDs for cataract surgery. [Published online February 2019]. Eye World. https://www.eyeworld.org/eyes-nsaids-cataract-surgery

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