Intracameral medication: is it worth the risk?

摘要

The familiar dictum "First, do no harm" is particularly applicable in the setting of intracameral medications in cataract and anterior segment surgery. Intracameral medication has multiple potential uses in these surgical procedures, including pupil dilation, anesthesia, and prevention of endophthalmitis/inflammation. Its advantages and disadvantages were highlighted in the "Spotlight on Cataract" session at the November 2007 American Academy of Ophthalmology meeting. One primary advantage is the ease of delivery. Multiple applications of topical drops are unnecessary when medication is delivered into the anterior chamber. This has the additional advantage of eliminating toxicity from topical medications, especially those with preservatives such as benzalkonium chloride (BAK), since intracameral medications are mostly preservative free. Another possible advantage is enhanced efficacy as the theoretically higher dose is at the site where the medication's action will take place. Finally, intracameral medications eliminate issues of patient compliance, including difficulties in obtaining and using postoperative drops properly.