Article

Intracameral medication use requires careful consideration of pros and cons

When thinking about administering medications intracamerally during cataract surgery, it is important to consider whether their potential benefits are worth the risk, said Nick Mamalis, MD, at Spotlight on Cataracts 2007.

When thinking about administering medications intracamerally during cataract surgery, it is importantto consider whether their potential benefits are worth the risk, said Nick Mamalis, MD, at Spotlighton Cataracts 2007.

Intracameral medications may be used in cataract surgery for anesthesia, pupil dilation, and toprevent inflammation and endophthalmitis. Their advantages include ease of delivery, elimination oftoxicity of topical drops, avoidance of compliance issues, and possibly enhanced efficacy.

However, there are a number of downsides. Toxicity is an important risk that can occur throughmultiple mechanisms, which can be related to improper concentration, pH, or osmolarity. In addition,all medications used intracamerally should be preservative-free, but it is also important to be awareof toxicity related to stabilizing agents, such as are found in preservative-free epinephrine.Infectious contamination is another safety concern as is the potential for incompatibility whenmultiple drugs are combined.

"There are many trade-offs to consider when weighing the pros and cons of using topical drops versusintracameral medications. Intracameral medication safety can be improved if we could eliminate'kitchen pharmacy,'" Dr. Mamalis said.

"We need sterile, pre-mixed, preservative-free, unit-dose products, and the ophthalmology communityneeds to work with the FDA and industry to achieve that goal," he added.

Newsletter

Don’t miss out—get Ophthalmology Times updates on the latest clinical advancements and expert interviews, straight to your inbox.

Related Videos
(Image credit: Ophthalmology Times) 50 years of ophthalmology: What changed the game (Part 2)
(Image credit: Ophthalmology Times) 50 years of ophthalmology: What changed the game? (Part 1)
(Image credit: Ophthalmology Times) From MIGS to gene therapy: Inder Paul Singh, MD, celebrates the past and future of glaucoma care
(Image credit: Ophthalmology Times) NeuroOp Guru: Using OCT to forecast outcomes in ethambutol optic neuropathy
(Image credit: Ophthalmology Times) Inside NYEE’s new refractive solutions center with Kira Manusis, MD
(Image credit: Ophthalmology Times) Dilsher Dhoot, MD, on the evolution of geographic atrophy therapy: where are we now?
(Image credit: Ophthalmology Times Europe) Anat Loewenstein, MD, shares insights on the real-world results of remote retinal imaging
(Image credit: Ophthalmology Times) Two-wavelength autofluorescence for macular xanthophyll carotenoids with Christine Curcio, PhD
(Image credit: Ophthalmology Times) FLIO and the brain: Making the invisible visible with Robert Sergott, MD
© 2025 MJH Life Sciences

All rights reserved.