Surgical Co-Management · Post-op medications
Post-Op Drug Delivery drops, inserts and intraoperative options.
Post-cataract regimens have moved beyond a bottle of drops four times a day. Surgeons now choose among topical drops, a resorbable canalicular insert and drugs added during surgery. The co-managing doctor needs to know which one the patient received before the first post-op visit.
Quick answer
Know the route before you check adherence.
A patient with a canalicular insert or an intraoperative drug may have fewer drops to take than one on a classic topical regimen, and the post-op exam changes with it. Ask the surgeon's office for the exact regimen with every transfer of care, and confirm it with the patient at the first visit.
Key takeaways
- Topical steroid, NSAID and antibiotic drops remain the most familiar regimen.
- DEXTENZA sits in the lower canaliculus and releases dexamethasone for up to 30 days.
- The insert contains fluorescein and is visible with blue light and a yellow filter.
- OMIDRIA is added to the irrigation solution during surgery.
- Every route still needs a written plan the patient can follow.
Delivery routes compared.
Labeled facts only. Indications and dosing come from the prescribing information.
| Route | Example | Labeled use | What the co-managing doctor checks |
|---|---|---|---|
| Topical drops | Steroid, NSAID and antibiotic drops as prescribed by the surgeon | Per each product's label | Technique, schedule, taper and bottle confusion |
| Canalicular insert | DEXTENZA (dexamethasone ophthalmic insert) 0.4 mg, Ocular Therapeutix | Ocular inflammation and pain following ophthalmic surgery; also ocular itching with allergic conjunctivitis | Insert presence under blue light; signs of infection |
| Intraoperative irrigation additive | OMIDRIA (phenylephrine and ketorolac intraocular solution) 1%/0.3% | Added to irrigation during cataract surgery or IOL replacement to maintain pupil size and reduce postoperative pain | Nothing to administer; note it in the record |
Confirm current labeling for every product before use.
Working with a canalicular insert.
The insert changes what you look for at the slit lamp.
- Visible with cobalt blue light
- Resorbs on its own
- Removable if needed
-
Confirm placement
The insert contains fluorescein, so it shows under blue light with a yellow filter.
-
No removal visit
It is resorbable; if removal is needed, the label describes saline irrigation or manual expression.
-
Contraindications
Active corneal, conjunctival or canalicular infection, including herpes simplex keratitis, mycobacterial and fungal disease, and dacryocystitis.
Put the drop schedule on one printed page with the bottle cap colors. Most post-op calls about drops are about which bottle and how often, not about the medicine itself.
RescueLink
Comfort drops after the surgeon clears them.
Once prescription drops are done, many patients want a preservative-free lubricant or a lid cleanser. Send an eligible over-the-counter list through RescueLink; your practice earns a 15% participation credit on eligible OTC orders on VisionRescue.com.
- No setup fee, subscription or quota
- One-tap ordering for the patient
- Optional auto-ship on recurring items
- Contact lenses and prescription products are excluded
Frequently asked questions
Does a DEXTENZA patient still need drops?
That depends on the surgeon's plan; antibiotics and other drugs may still be prescribed. Confirm the full regimen at transfer.
Who places the insert?
It is placed in the lower punctum and canaliculus with blunt forceps. The label states the initial prescription and renewals require a physician's examination.
Is the insert approved for children?
Yes for post-surgical inflammation and pain, but it is not recommended for pediatric patients who need sedation for insertion.
Is OMIDRIA something the patient takes home?
No. It is diluted into the irrigation solution and used during the operation.
Can Vision Rescue supply these products?
Prescription and surgical drugs follow their own distribution channels. Ask Provider Relations what is available for your practice.
References
- DEXTENZA (dexamethasone ophthalmic insert) prescribing information. Drugs.com
- OMIDRIA (phenylephrine and ketorolac intraocular solution) prescribing information. MedLibrary
- National Eye Institute. Cataract surgery. NEI
- Every source behind this guide is listed on the Vision Rescue sources page. All sources
About this guide
Written for licensed eye care practices by the Vision Rescue team from manufacturer, FDA, CMS and peer-reviewed sources. Questions: providers@visionrescue.com or 1-855-692-8024.
Important notes and disclosures
Information only. Prescription products must be used as labeled under the direction of the treating physician. Vision Rescue is a licensed pharmaceutical wholesale distributor.
Know the regimen before day one.
Ask surgeons to include the delivery route in every transfer of care, and build it into your post-op exam template.
DEXTENZA is a trademark of Ocular Therapeutix. OMIDRIA is a trademark of its owner. See the full Prescribing Information, including warnings and precautions, before use.