Cataract Surgery Eye Drops: How to Use

Hello, I’m Dr. Keith Skolnik. I’m one of the cataract surgeons at the Fort Lauderdale Institute. I’ve been asked to give a presentation about the drops that are used during cataract surgery by an undergraduate student at Nova Southeastern University.

When patients have cataract surgery, they are instructed to use three different prescription medications. It’s important that they use these medications as directed to prevent complications or side effects from the procedure and to optimize their result.

The first medication or class of medication is an antibiotic. The antibiotic is started two days prior to cataract surgery and it’s used for a week after cataract surgery. The patient is instructed to use the drop four times a day and they only have to put one drop in the eye. They don’t have to put two or three drops in. That’s wasting the medication. The purpose of the antibiotic is to try to eradicate or decrease the amount of bacteria on the ocular surface. If you do so, you will help prevent or limit the chances of developing an infection during or after cataract surgery. The most common reason for infection is that bacteria that are present on the ocular surface or the eyelids get introduced into the eye and cause a serious infection called endothemitis. Vesivans is just one example of a topical ophthalmic drop or antibiotic that we use pre and post cataract surgery.

The second class of medications that we use for cataract surgery is a steroidal or steroid anti-inflammatory drop. Lodomax is another example of a steroid drop and this drop is also used starting two days prior to cataract surgery. It’s also used four times a day like the antibiotic but instead of using it for only a week after surgery, we typically will taper the steroid drop for three to four weeks after cataract surgery. Some patients may need it longer, some shorter, and we just decide based on how the patient is doing after cataract surgery how long we’re going to use the steroid.

The third class of medications that we use—and Prolenza is an example of this class—is a non-steroidal anti-inflammatory drug. In pill form, this would be like ibuprofen, or Aleve, or naproxen, or Advil. Those would be examples of this in pill form. But in drop form, it’s an anti-inflammatory drop that reduces swelling. The steroid also reduces swelling, but the nonsteroidal drop in particular helps reduce the chance of swelling in the retina or the macula. The macula is the center of the retina, and that’s a complication that can occur in a very minority of patients with cataract surgery, and using this drop can help prevent it. This drop is not used four times a day like the steroid or the antibiotic. It’s used only once a day. We do start it two days prior to surgery, and it’s used basically till the bottle runs out after surgery, which is usually two to four weeks.

I’m going to demonstrate the proper way to administer drops to your loved one who just recently had cataract surgery. You always want to wash your hands. It’s not a sterile procedure to put drops in, but you want to be clean. The eye drops themselves, of course, have a cap on them. You want to take that off and set it down so that nothing is going to get into the cap.

You only need to put one drop in for any type of eye medication and the best way to do it is to have your loved one lay in a reclined position or flat and just pull the lower lid down creating that little crevice and it’s very easy to drop the drop in right there. They blink a few times, a little dab. You don’t want to press on the eye too hard, just a little dab to get the excess drop out of the way and then move on.

It’s very important that when you’re administering multiple drops—and after cataract surgery it’s three different medications—that you wait at least 10 minutes between different medications.

What to Expect After Cataract Surgery

Most patients do extremely well after cataract surgery and it’s very rare to experience significant pain after surgery. When you go home after surgery, it is very normal for you to see halos around lights, to be extra sensitive to light, to have redness in your eye. You may even have tearing or a teary discharge. Your vision could be very blurry. Many patients won’t be able to see the TV clearly after surgery because their pupil is still dilated.

It’s not normal to have severe pain. The type of pain that you may have after cataract surgery would be similar to having an eyelash in your eye, which would be a mild foreign body sensation. You should not have severe pain that would cause you to want to go to the emergency room or even call the doctors on call. If you do have pain, you do need to get in contact with one of the surgeons or doctors on call at our office.

You should not have nausea. You should not have vomiting. You should not have significant discharge or pussy discharge. These are some common complaints, but you shouldn’t have severe complaints.

After your cataract surgery, it’s very important that you follow the post-operative instructions that you’re given at the office. Don’t rub your eye. It’s very important. We provide you with a plastic shield to wear at bedtime because when you’re asleep, you don’t know if you’re going to rub your eye. The shield is supposed to be placed over your eye for the first week after surgery and it’s okay to affix that shield to your eye or over your eye with something simple like scotch tape that doesn’t leave sticky residue on your forehead or cheek.

You can resume full exercise like tennis or golf or running a week after surgery. But for the week immediately after surgery, you should do light exercise only. You can go for a walk, you can bend over the next day after surgery, you can do stretching, you can do light yoga, you can even ride a stationary bike. But once again, you don’t want to do anything for the first week after surgery that’s too much pressure on your eye, and especially you don’t want to do anything where you’re jostling your head around, which would be like jumping or running.

Thank you for paying attention and watching the video regarding cataract surgery and eye drops related to cataract surgery. If you can, please take the post-video survey that we’ve provided. It would be much appreciated.