Here are the top 5 reasons why Dropless Cataract Surgery or TriMoxi Intravitreal Injections may be an excellent innovation in cataract surgery.

1. Injecting antibiotics into the eye instead of using them on the eye as drops have been shown in multiple studies to be more effective in preventing endophthalmitis, a potentially devastating eye infection, than just using eye drops. The referenced Dec 2015 study below, published in the most respected eye journal in the world, is a large study of 480,000 showing that injection of an antibiotic into the eye after cataract surgery was 100% protective of a serious eye infection.  Their conclusion, “intracameral cefuroxime was 100% effective in preventing endophthalmitis in this series.” This is another reason why Dropless Cataract Surgery may hopefully prove to be a better option than topical drops which has been published to not enter the eye effectively enough to kill dangerous bacteria: see study at end by a well known eye surgeon, Dr. Eric Donnenfeld.


2. All surgeons have had patients who forgot to use their  drops after cataract surgery due to early dementia or other reasons. Dropless Cataract surgery is better than nothing at all.

3. Most eyeMDs have had patients who have had an accident on their way to a routine post op visit. Recently I had a patient who fell and broke her arm after cataract surgery on her way to her post op visit because the ground was slippery.She was thrilled with her 20/20 vision, but was in pain from a broken arm for months. Avoiding potentially unnecessary visits for our patients would benefit our patients tremendously.

4. Confusion about drops. Every doctor’s office get multiple phone calls per day from patients who are confused about their eye drops, even though the surgeon, the surgical coordinator, the scribe, and a video may have been shown. Multiple drops can be very frustrating! We hope Dropless Cataract Surgery will hopefully help our patients not need multiple drops for weeks after cataract surgery.

5. Decrease cost to the patient and to the insurance. The 3 most commonly used eye drops for cataract surgery cost about $300 to patients whose insurances do not cover these “best practices” drops. Dropless Cataract Surgery has the potential to cost less than half of that.

A patient recently came in complaining of the outrageous cost of the drops for cataract surgery.

For the “Best” Brand Name: “Best” here meaning that these drops have been published as superior to their generic versions. As noted in previous posts, many of these famous publications by famous eyeMDs were funded by the drug company (often because it is so expensive to do a good study without their help). Thus the vast
Besivance: $150
Durezol:  $169
Illevro: $232
Total: $551!


This is outrageous. What are MDs to do for their patients? Doctors too are at the mercy of the drug companies and their peer-reviewed publications. If a journal notes that a drug is superior to another drug, even in the slightest issue, ESPECIALLY when it comes to someone’s eyes, doctors want to give the best to their patients. 


I hope patients will know that I and the vast majority of surgeons and physicians are trying to provide the best care for their patients. We are trying to think about the cost as well, but we have been trained to save the eye and vision and patient as best as we can.

Sandra Lora Cremers, MD, FACS

Ophthalmology. 2015 Dec 15. pii: S0161-6420(15)00844-1. doi: 10.1016/j.ophtha.2015.08.023. [Epub ahead of print]