Noncompliance with Prescribed Eyedrop Regimens Among Patients Undergoing Cataract Surgery—Prevalence, Consequences, and Solutions

Abstract

Following cataract surgery, patients are typically prescribed antibiotic, non-steroidal anti-inflammatory drug and corticosteroid eyedrops, each of which may be administered with a different frequency. However, patient noncompliance with prescribed eyedrop treatment is prevalent and may lead to a less than ideal outcome, with potential complications such as infection or inflammation. Numerous studies have been conducted to evaluate the extent of patient noncompliance and to identify contributing factors. The majority of these studies have focused on patients with glaucoma, because it is a chronic disease requiring lifelong use of eyedrops. Patients who have undergone cataract surgery may face greater challenges with drop instillation than glaucoma patients because of limited experience with eyedrops prior to surgery. Additionally, cataracts most often affect older persons, in whom physical or cognitive limitations may further impede successful eyedrop administration. New methods of drug delivery that bypass patient compliance are currently available. They include surgery with fewer drops as well as medication delivery systems injected or deposited into ocular structures perioperatively. These drug delivery methods not only reduce topical drop administration, but have supplanted eyedrop use in many countries. Alternative drug delivery systems are increasingly being adopted in the USA.