Dextenza Punctal Inserts
Every surgery has the potential to cause inflammation. Typically after cataract surgery the eye is treated with antibiotic drops and two kinds of anti-inflammatory drops: a nonsteroid anti-inflammatory drop and a steroid drop. The nonsteroid drop we prescribe is used daily for one month. The steroid drop is used 4 x per day and the number of doses per day is gradually reduced over the course of a month. The Dextenza punctal insert delivers a tapering dose of steroid to the surface of the eye. Most patients who get the Dextenza do not need to use an additional steroid drop. This makes post-op care much simpler. The patient takes an antibiotic drop 3 times per day for a week and a daily nonsteroid anti-inflammatory drop for a month, but generally no steroid drop.
The Dextenza insert is a tiny preservative-free pellet that contains steroid medication. This insert is placed in a tiny opening on the lower (or upper) lid. This opening on the lid is naturally present and serves to drain tears out of the eye. When the Dextenza insert is in place, it slowly dissolves over a month, and releases a gradually tapering dose of steroid to the eye. It also temporarily blocks some of the outflow of tears, thereby making the eye more moist. This is advantageous as most people have more dryness for 1-2 months after cataract surgery.
The fact that so many less steroid drops are needed actually helps the eye heal faster. The steroid drops have preservative, and the preservative can be irritating to the surface of the eye. This is especially the case for patients who already have a dry or sensitive eye.
If a patient has more than the average amount of inflammation after cataract surgery, we may supplement the Dextenza with additional steroid drops. This is not usually needed.
In summary, we use the Dextenza to:
- Make the postop regimen easier for the patient
- Decrease the number of preserved drops needed postoperatively as preservative can irritate the cornea and slow healing
- Reduce postoperative dryness by keeping the natural tears in the eye longer
