introduce dropless cataract surgery to lower costs

Ravi Parikh, MD, MPH sat down with David Hutton, Editor-in-Chief of The Ophthalmology Times® to discuss a presentation at this year’s ARVO conference on the introduction of dropless cataract surgery to help reduce costs for both patients and the healthcare system. rice field.

video transcript

Editor’s Note: This transcript has been edited for clarity.

David Hutton:

I’m David Hutton of the Ophthalmology Times. The Society for Vision and Ophthalmology Research recently held its annual meeting in New Orleans. Today he is joined by Dr. Ravi Parikh as he presents “Drop It: Saving Patients and the Healthcare System with a Dropless Cataract Surgery Plan”. Thank you very much for joining us today. Tell us a little bit about this presentation.

Ravi Palik, MD, MPH:

Thank you so much for having me. Therefore, our presentation and study focused on observations after cataract surgery. Prophylaxis to prevent and treat inflammation, postoperative swelling, or postoperative infection. Instead of using topical eye drops that are costly to both the patient and the healthcare system. Not only are some patients difficult to administer, but the cost implications of droplet systems also need to be considered. There is strong evidence for this in some ways, and it also reduces costs for both patients and the healthcare system.

We found that intraocular injection of moxifloxacin to prevent infection has been proven to significantly reduce the incidence of endophthalmitis, and that moxifloxacin There is a lot of evidence that postoperative IV drips are unnecessary. Subconjunctival triamcinolone, also proven to reduce inflammation and replace the need for post-operative topical corticosteroids, in combination with intracameral moxifloxacin, which many cataract surgeons currently use We are also eyeing potential cost savings from injections of

We found that a no-drip injection-based prophylactic regimen of intracameral moxifloxacin and subconjunctival triamcinolone from vials of 10 milligrams per milliliter compared with the lowest-cost topical infusion regimens was associated with improved health system outcomes. found that they could reduce the cost of Prednisolone, Cateuralap, and Ofloxacin. This essentially translates into total savings to patients of more than $222 million per year. This equates to a savings of approximately $42.85 per eye per patient. On top of that, there is a big benefit in terms of waste reduction in terms of plastics and the environment for patients.

It will also significantly reduce the overall healthcare system costs by approximately $450 million. It also reduces the need for patients to administer intravenous fluids and addresses adherence issues. The next step in our study is to investigate a high-dose regimen of subconjunctival triamcinolone. To see if it is equivalent to using non-steroidal anti-inflammatory drugs to prevent postoperative cystoid macular edema. Currently, dropless therapy carries a slightly increased risk of postoperative cystoid macular edema.

However, there is considerable debate as to whether prophylactic nonsteroidal anti-inflammatory drugs actually prevent cystoid macular edema.

David Hutton:

After all, what does this mean for ophthalmologists and the patients they treat?

Ravi Palik, MD, MPH:

I think this is a good advantage for patients who have difficulty in injecting themselves. And since many patients find it difficult to afford medicine, I think this is an area where there can be significant savings for both patient and patient.

The same is true for the health system as a whole. I think one of the key things is that if it becomes common and standard for doctors to do dropless cataract surgery, the cost of materials will be reimbursed to the facility as well. Therefore, it will be a win-win for all involved.

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