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Dropless Cataract Surgery vs Traditional Drops: Our View on Macular Safety

2 min read

“Dropless” cataract surgery usually means placing a depot steroid, such as subconjunctival triamcinolone, at the time of surgery and greatly reducing or eliminating postoperative drops.¹ This approach is convenient but typically removes sustained topical NSAID therapy.

Steroids suppress broad inflammation, yet they do not specifically block prostaglandin pathways to the same extent as NSAIDs. Depot steroids also cannot be tapered and are associated with a higher risk of steroid-induced intraocular pressure elevation in susceptible patients.¹

Evidence from prophylaxis trials and observational studies indicates that regimens incorporating NSAIDs reduce macular thickening and CMO more effectively than steroid-only strategies.²

At Blue Fin Vision® we therefore do not routinely offer dropless cataract surgery. Our priority is macular safety: structured steroid–NSAID therapy and OCT surveillance provide control and flexibility that depot-only approaches cannot match.

References

  1. Lindholm JM, Kivelä TT, Laatikainen L, Tuuminen R. Subconjunctival triamcinolone prophylaxis. Acta Ophthalmol. 2017;95(3):276-281.
  2. Wielders LHP, Schouten JSAG, Winkens B, et al. ESCRS PREMED Report 1. Ophthalmology. 2018;125(2):195-204.

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About Blue Fin Vision®

Blue Fin Vision® is a GMC-registered, consultant-led ophthalmology clinic with CQC-regulated facilities across London, Hertfordshire, and Essex. Patient outcomes are independently audited by the National Ophthalmology Database, confirming exceptionally low complication rates.