Eyedrops For Cataract Surgery

Dr. White is our cataract surgeon at Skyvision Centers. He is one of the most experienced cataract surgeons in Cleveland, and indeed in all of the Midwest. He, along with Drs. Schlegel and Kaye, form our cataract team of doctors. They choose which eyedrops are the best available for use before and after cataract surgery. In addition the doctors have chosen a group of medicines that are easier to take (you only need to use the drops twice per day), and eyedrops that are comfortable so you don't avoid using them!

There are typically three types of eyedrops used around the time of your cataract surgery. An antibiotic is prescribed which is to be used starting 5 days BEFORE cataract surgery. The antibiotic typically is continued for a week after the surgery. The doctors have chosen an antibiotic drop from the strongest class of atibiotics now in existence in order to prevent infections. There are three choices in this class of medicines, two of which can be used twice per day.

A non-steroidal anti-inflammatory drop (NSAID), kind of like Motrin in a drop form, is also prescribed to start 5 days prior to the surgery. This medicine is then continued for 4 weeks after the surgery. It is used to prevent a type of swelling in the back of the eye. The doctors have chosen a medicine that is easy to take (twice per day), doesn't hurt when you put it in, and doesn't have any dangerous side effects. There are NO TRUE GENERIC EQUIVALENTS for this medicine. The generic medicines on the market must be used 4 times per day. They can be very uncomfortable; most people complain bitterly that they sting. Most importantly, the generic option has a 30% complication rate. That's right, 3 out of 10 people have swelling and inflammation in their cornea caused by this drop and this causes pain and a big drop in vision.

Finally, a steroid eyedrop is prescribed to be used after the surgery, beginning on the 1st day after the surgery. This drop treats the normal post-op inflammation in the eye. Like the other eyedrops it is used twice per day, and you continue to use it for 4 weeks after the surgery. There are NO TRUE GENERIC EQUIVALENTS for this medicine. The generic medicines must all be used at least 4 times per day and they are not as strong or as effective.

We understand that medicines can be expensive, especially when an important medicine is not fully covered by your health insurance. But we are talking about YOUR EYES and eye surgery. Your Skyvision doctors have chosen what they feel are the best medicines possible to do every thing possible for you to have a great surgical result.

What could be more important?!

Generic Medicine and Cataract Surgery

"These eye drops are SO expensive."

"My insurance says I have to take this generic drop."

Every day our doctors, technicians, and surgical counselors hear some version of these two sentences. We hear it from almost everyone! It's funny how viewpoints have changed over the years. The fee that your insurance company pays a doctor and his staff to do everything that is necessary for cataract surgery in about 60% LESS than it was in the year 1990, and that's WITHOUT  taking into account any inflation. That means in 1990 the co-pay for cataract surgery was greater than what it costs in 2012 to buy the very best eyedrops that protect you from infection and inflammation.

Sometimes newer medicines really are better. They might work better, or have fewer side effects, or need to be taken less frequently. All of these things are important because you will have a better outcome from your cataract surgery if you take your medicine as our doctors have prescribed. Better vision. A lower risk of infection. Dramatically lower chances of swelling and inflammation. We have chosen the best medicines, the ones with the fewest side effects that are the easiest to take.

Here are two examples. SkyVision cataract patients receive a prescription for Besivance, a 4th generation antibiotic in its class. Many insurance companies try to make a switch to generic Cipro, a 3rd generation medicine that is available for perhaps 1/4 the cost. Sounds OK, right? It's only one previous generation? Well, good studies have shown that using a 3rd generation medicine instead of a 4th can increase the risk of infection by a factor of 10. 10 times the risk! Ciprofloxin must also be used 4 times each day and Besivance only twice which makes it easier to actually use the Besivance.

The other very important example is the Non-Steroidal Anti-inflammatory Drug or NSAID. If you don't take one you have a 10 times greater risk of vision threatening swelling in your retina. Both older, generic forms of NSAID's and newer branded ones reduce this risk. However, all of the older generic versions cause swelling and inflammation on the cornea, the front of the eye, in 3-4 out of 10 people. This results in pain, decreased vision, and the need to take more medicine for a longer period of time. On top of that, all of the generics HURT when you put them in, and you have to use them 4 times each day, and this makes people avoid using them at all.

You have two eyes. You will have cataract surgery on each eye once in your lifetime. Which is actually more expensive, the cost of the eyedrops your surgeon has chosen for you after careful studying of all the options, or the cost of using generic eyedrops that must be used more frequently, have more side effects, and may in some cases be less effective?