RESOURCES
United Kingdom and Ireland Society of Cataract and Refractive Surgeons (UKISCRS)
UKISCRS EXPERT COMMITTEE POSITION STATEMENT
Practice Review on Dropless Cataract Surgery 2026
Overview
Dropless cataract surgery is an approach that seeks to replace, reduce, or avoid postoperative topical eye drops by administering intraocular or periocular medication at the time of surgery.
A broader concept of dropless cataract surgery (DCS) may also extend to avoidance of preoperative eye drops through intraoperative drug delivery. This practice review is focused specifically on the avoidance of postoperative eye drops.
Postoperative cataract surgery care has traditionally involved several weeks of topical treatment, commonly including antibiotics, steroids, and non-steroidal anti-inflammatory drugs. Although widely used and often effective, topical regimens may be inconvenient, costly, difficult for some patients to administer correctly, and associated with poor adherence, ocular surface toxicity, and environmental burden.
Dropless cataract surgery offers a practical alternative in selected cases. Common approaches include intracameral antibiotics, subconjunctival depot steroid administration, and, in some settings, intracameral NSAID use. Potential advantages include simplified postoperative care, improved adherence, reduced risk of missed or incorrect dosing, reduced ocular surface exposure to drops, and possible service and environmental benefits.
At the same time, important cautions remain. These include the risk of raised intraocular pressure, reduced ability to titrate treatment once a depot or injected agent has been given, the off-label status of some anti-inflammatory agents used in this context, and the need for careful patient selection and appropriate postoperative follow-up. There are currently no MHRA-licensed periocular or intraocular products indicated for the treatment of intraocular inflammation in this setting.
Patterns of practice remain variable across NHS and independent sector providers. In that context, this document sets out the current view of the UKISCRS Expert Committee on Dropless Cataract Surgery.
