Brief Answer:
Alternate options for NSAID allergic cataract patients.

Detailed Answer:
Hello,

Thanks for writing.

I have read your question completely, i understand your concern and will try to help you in best way possible.

Two things need a little clarification here. In previous query, you had mentioned about previous history of drug allergies, to aspirin like substances.

Aspirin belongs to the class of Non Steroidal Anti inflammatory Drugs (NSAIDs). Which doesn't prove, that your patient has any history of allergies to steroids as well, as both drug categories are entirely different.

Now, The two drops you mentioned earlier were, Acuvail ( NSAID) and Pred Forte (Steroid). That makes your patient to be allergic to Acuvail, or like medicines, and not to Pred forte. Am i right? or did she experience any such reaction with prednisilone too?

Normally after surgical procedures, pro[prophylactic antibiotics, and anti-inflammatory drugs (NSAIDS and steroids) are given, for safe and rapid healing and symptomatic relief. Avoiding NSAIDs group medicines, and using steroids alone can solve the anti inflammatory purpose for managing local inflammation, pain and itching without triggering allergic drug reactions in her case.

The brands with which these steroid only eye solutions, or with antibiotics combination are available in Canada are; Maxidex, Hms, Ak-Dex, Cortamed, Fml Forte and Fml Liquifilm. These contain other steroids like Fluorometholone, Dexamethasone or decadrons etc. You can discus all these options with your doctor, as all of these doesn't have NSAIDS in them.

Also that, I would suggest you to leave most of it, to the treating ophthalmologist, as normally patient is asked before prescription of a new drug, about any previous history of allergies to that drug. Even if doctor forgets to ask, you can tell during case history, or during discussions, about the particular drug intolerance, and that will help the doctor to look for alternatives, as the surgeon who is capable of doing surgery of cataract, will surely be knowing about many such alternatives, which are to be used, when a certain drug usage is limited by previous history of allergies to that drugs. So in such cases, after discussing with the doctor, you can put your faith on him, to look for safer alternatives and ofcourse he is in a better position to suggest that, as he is examining the patient himself and has full scenario and labs in front of him.

I hope this answered your question. If you have more queries I am happy to answer. Keep me apprised of the progress if possible. Thanks. Kindly rate before closing the discussion.

Regrads.

Dr.Saddiq ul abidin

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