Cataract surgery is a common outpatient procedure performed to restore vision by replacing the eye’s clouded natural lens with an artificial one. Success depends on the patient’s adherence to a meticulous pre- and post-operative care plan. A significant part of this preparation involves the precise use of prescribed eye drops, which are introduced into the schedule days before the operation. Following all instructions minimizes the risk of complications and ensures the best visual outcome.
The Standard Pre-Surgical Eye Drop Regimen
Patients typically begin a preparatory eye drop regimen several days before the scheduled cataract procedure. This phase is designed to precondition the eye, specifically targeting the reduction of microbial load and inflammation prior to the surgical incision. The prescribed drops are usually a combination of an antibiotic and an anti-inflammatory medication, often a non-steroidal anti-inflammatory drug (NSAID) or a corticosteroid.
The antibiotic drops, such as moxifloxacin or ofloxacin, are used to decrease the number of bacteria naturally present on the surface of the eye and surrounding eyelids. This prophylactic measure is a crucial line of defense against potential infection once the eye is opened during surgery. Patients are generally instructed to begin this routine one to three days before the operation, administering the drops multiple times a day as directed by the surgeon.
Anti-inflammatory drops suppress the natural immune response that surgery triggers, minimizing post-operative swelling. Patients must wait a minimum of five minutes between applying different types of drops to ensure proper absorption. Starting this regimen days in advance maximizes the medication concentration in the eye’s tissues before the procedure.
Specific Instructions for the Morning of Surgery
Whether to use eye drops on the morning of cataract surgery depends entirely on the specific instructions provided by the surgical team. Some surgeons instruct patients to continue their pre-operative drops as scheduled, while others may ask them to skip the morning doses until cleared by the nurse. Patients must strictly follow the individualized schedule provided, and if uncertain, they should bring the drops to the facility and ask the clinical staff.
Upon arrival, the staff will administer specialized dilating drops, such as phenylephrine and cyclopentolate, to prepare the pupil for the procedure. These drops widen the pupil, allowing the surgeon a clearer view of the lens and the surrounding structures inside the eye.
A mandatory requirement is a period of fasting, meaning no food or drink after midnight or at least six hours prior to the scheduled time. This precaution reduces the risk of aspiration during the sedation process. Patients must also arrive with a completely clean face, avoiding all makeup, lotions, perfumes, and aftershave, which can increase the risk of infection or interfere with surgical equipment.
Understanding the Purpose of Surgical Eye Drops
The eye drops used in the perioperative period serve two functions: infection prevention and inflammation control. Antibiotic drops are designed to prevent endophthalmitis, a serious infection inside the eye that can occur after surgery. These medications, often broad-spectrum fluoroquinolones, create a sterile environment and provide a protective barrier against bacteria.
The anti-inflammatory medications are categorized into two main groups: corticosteroids (steroids) and non-steroidal anti-inflammatory drugs (NSAIDs). Steroid drops, such as prednisolone or difluprednate, reduce inflammation by mimicking naturally occurring hormones that suppress the immune response. NSAID drops, including ketorolac, work through a different mechanism by blocking the production of prostaglandins, which are compounds that promote inflammation and pain.
Using both types of anti-inflammatory drops together provides an additive effect, offering comprehensive control over post-surgical swelling and discomfort. This dual approach is important for preventing complications such as cystoid macular edema (CME), which is swelling in the central part of the retina. The controlled use of these medications supports the eye’s natural healing process and ensures a rapid return to clear vision.