Flonase Use Before Eye Surgery
Patients can safely continue using Flonase (fluticasone) nasal spray during the week before eye surgery, as intranasal corticosteroids do not significantly affect intraocular pressure or cataract formation.
Rationale for Continuing Flonase Before Eye Surgery
Evidence Supporting Continuation
- The American College of Chest Physicians specifically recommends continuing medications like intranasal corticosteroids during cataract surgery, as the benefits outweigh any theoretical risks 1
- Multiple studies have demonstrated that intranasal corticosteroids, including fluticasone, do not cause significant ocular side effects:
- Research shows that even high-dose fluticasone propionate irrigations (3 mg twice daily) did not affect intraocular pressure or cause posterior subcapsular cataracts after 6 weeks of continuous use 2
- Long-term studies (up to 19 months) of intranasal corticosteroids showed no evidence of ocular hypertension or cataract formation 3
Safety Profile for Ophthalmic Procedures
- For cataract surgery specifically, guidelines recommend continuing nasal corticosteroid sprays around the time of surgery rather than stopping them 4
- Unlike systemic corticosteroids, intranasal fluticasone has minimal systemic absorption and therefore minimal risk of affecting wound healing or intraocular pressure
Important Considerations
Medication Administration
- Patient should continue using Flonase as prescribed without interruption
- No need to adjust dosing schedule before eye surgery
- Patient should inform the ophthalmologist about all medications being used, including Flonase
Potential Concerns and Reassurance
- Theoretical concerns about corticosteroids and eye surgery include:
Special Situations
- For patients undergoing more complex eye surgeries beyond cataract extraction, the same recommendations apply as there is no evidence suggesting different risks
- Even patients who have had previous sinus surgery (which could theoretically increase systemic absorption) show no increased ocular risks when using fluticasone 5
Summary
Flonase (fluticasone) nasal spray can be safely continued during the week before eye surgery. The minimal systemic absorption of intranasal corticosteroids does not significantly affect intraocular pressure or increase the risk of cataract formation, making it unnecessary to discontinue this medication before ophthalmic procedures.