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Dropless after cataract surgery (DACS): concepts, evidence and clinical potential
Johannes Birtel1, Ariel Yuhan Ong2,3, Karolin Deichl4
1Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Eye (London, England)
|June 26, 2026
Summary
Dropless cataract surgery simplifies postoperative care by delivering medication during surgery, potentially improving patient quality of life and reducing healthcare costs. This approach aims to eliminate the need for traditional eyedrops, enhancing efficiency and sustainability.
Area of Science:
- Ophthalmology
- Surgical Innovation
- Patient Care
Background:
- Cataract surgery, a common procedure, traditionally requires postoperative eyedrops to prevent infection and inflammation.
- Variable patient adherence and the burden of administering eyedrops present significant challenges.
- Dropless after cataract surgery (DACS) offers an alternative by enabling intraoperative medication delivery.
Purpose of the Study:
- To evaluate the effectiveness and benefits of dropless after cataract surgery (DACS) approaches.
- To highlight the potential of DACS to improve patient quality of life and reduce healthcare costs.
- To discuss the integration of DACS within a value-based healthcare framework.
Main Methods:
- Review of studies demonstrating the efficacy of intraoperative intracameral antibiotics in reducing endophthalmitis.
- Analysis of sustained-release steroid formulations for controlling postoperative inflammation.
- Discussion of systemic barriers and the need for a holistic approach to DACS adoption.
Main Results:
- Intracameral antibiotics administered during surgery effectively reduce endophthalmitis rates, negating the need for topical antibiotic drops.
- Sustained-release steroid formulations provide comparable inflammation control to traditional eyedrop regimens.
- DACS presents a simplified, potentially more sustainable alternative to conventional postoperative eyedrop therapy.
Conclusions:
- Dropless after cataract surgery (DACS) offers a promising, patient-centered approach to modernizing postoperative management.
- Addressing systemic barriers is crucial for widespread adoption of DACS.
- Embracing dropless techniques aligns with value-based healthcare principles and can optimize patient outcomes.
