EyeWorld Asia-Pacific June 2019 Issue

EWAP JUNE 2019 67 PHARMACEUTICALS by Maxine Lipner EyeWorld Senior Contributing Writer Eyes on NSAIDs for cataract surgery Surgeons share how they use NSAIDs W hen it comes to NSAIDs, most people in the U.S. use them in cataract cases, said Kendall Donaldson, MD , Bascom Palmer Eye Institute, Plantation, Florida. “However, there are some surgeons who have gotten away from drops entirely and are doing various forms of injections. However, the majority are still using drops including a nonsteroidal,” Dr. Donaldson said. She noted there are three main reasons for using an NSAID in such cases: pain control, improved dilation, and reduced risk of cystoid macular edema (CME). “Certainly, if you have a diabetic patient who has poor pupillary dilation and a complex cataract, they’re at higher risk for macular edema,” Dr. Donaldson said. Dr. Donaldson’s own regimen is to use NSAIDs for all of her cataract patients. “My preferred prescribing regimen is to use branded drops instead of the generics because I can use those less frequently,” she said. “Generally, I use Ilevro [nepafenac, Novartis, Basel, Switzerland], and I can do that one time a day.” Dr. Donaldson starts the NSAID 3 days before surgery, mostly to help with pupillary dilation, and continues patients on this for 1 month postop. In some cases, she might keep patients on the regimen longer if they have preexisting Pupillary miosis associated with femtosecond laser-assisted cataract surgery can be limited through preoperative treatment with topical NSAIDs. Source: Kendall Donaldson, MD Editors’ note: Dr. Donaldson JCU ƂPCPEKCN KPVGTGUVU YKVJ #NEQP (QTV 9QTVJ 6GZCU #NNGTICP &WDNKP +TGNCPF $CWUEJ .QOD $TKFIGYCVGT 0GY ,GTUG[ CPF ,QJPUQP ,QJPUQP 8KUKQP 5CPVC #PC %CNKHQTPKC &T /KNNGT JCU ƂPCPEKCN KPVGTGUVU YKVJ #NEQP ,QJPUQP ,QJPUQP 8KUKQP CPF %CTN <GKUU /GFKVGE ,GPC )GTOCP[ &T &JCNKYCN CPF &T 5VKXGTUQP JCXG PQ ƂPCPEKCN KPVGTGUVU TGNCVGF VQ VJGKT EQOOGPVU Contact information Dhaliwal: dhaliwaldk@upmc.edu Donaldson: KDonaldson@med.miami.edu Miller: kmiller@ucla.edu Stiverson: rk.53stiverson@gmail.com 6JKU CTVKENG QTKIKPCNN[ CRRGCTGF KP VJG (GDTWCT[ KUUWG QH EyeWorld . It JCU DGGP UNKIJVN[ OQFKƂGF CPF CRRGCTU JGTG YKVJ RGTOKUUKQP HTQO VJG #5%45 1RJVJCNOKE 5GTXKEGU %QTR