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Dropless™ Cataract Surgery: Details for Consideration

We use only FDA-approved Imprimis® Trimoxy™ solution for Dropless™ cataract surgery. Trimoxy™ has been tested and tried in millions of patients and has an excellent and well-established safety record. Your safety always comes first. Historically, some surgery centers have used compounded medicines (not Imprimis) including some with vancomycin or other medicines which has caused rare but serious complications. Imprimis® Trimoxy™ is FDA monitored and tested and has been shown to be extremely safe. For your safety we only use FDA-approved and monitored compounds. We never use non-FDA approved compounded products for injection.

What do Studies and Clinical Experience Show About Benefits and Risks of Dropless™ Cataract Surgery?

  1. Dropless™ Cataract Surgery dramatically reduces risk of infection when compared to patients who receive traditional drops after their surgery.  Infection is one of the most worrisome complications of cataract surgery, as it often leads to significant visual impairment. By best-fit studies,,, Dropless leads to a four to eight-fold decrease in infections. It is our opinion that the true benefit is actually much greater than this.
  2. Dropless™ Cataract Surgery leads to a significantly more comfortable postoperative course. Clinically, we have observed patients experience dramatically less dry eye and irritation after cataract surgery with Dropless cataract surgery when compared to patients using traditional drops. The average person using traditional drops after cataract surgery uses around 250 drops in each eye, or about 9-12 drops each day. These drops contain preservatives that are designed to inhibit bacterial growth, which unfortunately also affect the body’s own cells. This frequency of drop use is known to cause significant dry eye and/or irritation. Nearly all patients receiving Dropless cataract surgery do not notice any dryness above their typical baseline they had prior surgery. 
  3. Dropless™ Cataract Surgery typically saves patients money. Without insurance the medicines typically used would cost hundreds of dollars per eye. Dropless is paid for by the surgeon and/or surgery center. There is no cost to the patient. It also lowers the general system-wide cost of eye surgery.
  4. Dropless™ Cataract Surgery greatly simplifies post-operative care. No remembering drops. No special timing. Just avoid putting pressure on the eye. 
  5. Dropless™ may cause a slight increased risk of retinal detachment. Retinal detachment has been found in studies to occur about 1 in 1,750 cases. With Dropless™ cataract surgery it may increase to about 1 in 1,420. When injecting the medicine, we use techniques to minimize this risk. This includes injecting in the appropriate areas 3mm posterior to the limbus in the pseudophakic eye; injecting only prior to full insertion of the needle; and visualization of needle prior to infusion of medicine. We also typically avoid Dropless surgeries in patients with higher risk for retinal detachment, such as patients with highly myopic eyes, eyes with a history of retinal detachment, or previously vitrectomized eyes. 
  6. Dropless™ causes an increased risk of post-operative macular edema.  Cystoid macular edema (CME) is swelling in the retina responsible for center vision. It may temporarily decrease vision in a healing eye and may require the use of drops for several weeks prior to resolving. The risk of CME goes up from 1 in 150 with traditional drops to about 1 in 50 with Dropless™ cataract surgery,. This risk can likely be mitigated through the use of various techniques and by avoidance of use in patients who are at higher risk of macular edema. Interestingly, for those with diabetic retinopathy, the risk of macular edema decreases with Dropless™ when compared to those who use traditional drops. 
  7. Dropless™ does NOT cause an increased risk of elevated pressure in the eye when compared to using traditional drops,
  8. Dropless™ does NOT increase the risk of rebound inflammation during the late healing phase after cataract surgery when compared to traditional postoperative drops. The risk of rebound inflammation for both traditional drops and Dropless™ is about 5-8%. 
  9. Dropless™ does NOT increase the risk of persistent postoperative iritis when compared to traditional drops. Rare cases of chronic iritis (long-standing inflammation in the eye) can occur after cataract surgery. Dropless™ does not increase this risk.

References

Efficacy of Intracameral Moxifloxacin Endophthalmitis Prophylaxis at Aravind Eye Hospital

Endophthalmitis reduction with intracameral moxifloxacin in eyes with and without surgical complications: Results from 2 million consecutive cataract surgeries

Safety and efficacy of intracameral moxifloxacin for prevention of post-cataract endophthalmitis: Randomized controlled clinical trial

Rhegmatogenous Retinal Detachment after Intravitreal Injection of Anti-Vascular Endothelial Growth Factor

Clinical outcomes after injection of a compounded pharmaceutical for prophylaxis after cataract surgery: a large-scale review

Short-Term Non-Infectious Outcomes After a Pars Plana Intravitreal Antibiotic-Steroid Injection of Triamcinolone, Moxifloxacin, and Vancomycin During Cataract Surgery versus a Standard Postoperative Topical Regimen


Evaluating the effect of intravitreal triamcinolone-moxifloxacin during cataract surgery on central macular edema in patients with preexisting diabetic retinopathy

Clinical outcomes after injection of a compounded pharmaceutical for prophylaxis after cataract surgery: a large-scale review

Short-Term Non-Infectious Outcomes After a Pars Plana Intravitreal Antibiotic-Steroid Injection of Triamcinolone, Moxifloxacin, and Vancomycin During Cataract Surgery versus a Standard Postoperative Topical Regimen

Short-Term Non-Infectious Outcomes After a Pars Plana Intravitreal Antibiotic-Steroid Injection of Triamcinolone, Moxifloxacin, and Vancomycin During Cataract Surgery versus a Standard Postoperative Topical Regimen

Short-Term Non-Infectious Outcomes After a Pars Plana Intravitreal Antibiotic-Steroid Injection of Triamcinolone, Moxifloxacin, and Vancomycin During Cataract Surgery versus a Standard Postoperative Topical Regimen

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Brimhall Eye Center Northwest Las Vegas Office

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Deciding between treatment options is hard. It’s really hard. That’s why we have a team of counselors to help you weigh your options and choose which surgery or treatment is best for you.

After you meet with one of our eye doctors, you’ll sit down with one of our counselors, Andrew, Lolita, or Char, and they will walk you through your doctor’s recommendations. Sometimes there are several options to choose between, and your counselor will show you what to expect from each and help you make a decision.

Schedule a consultation with our counselors today!