Post-Cataract Surgery Management at One Month
At 27 days post-cataract surgery with excellent visual outcomes (20/20-1 vision) and no complications, discontinue all topical medications (prednisolone acetate 1%, ofloxacin, and ketorolac) and transition to annual routine eye care with continued monitoring of the patient's diabetic macular edema. 1, 2
Medication Discontinuation at One Month
The standard post-operative medication regimen should be discontinued at this point:
Topical corticosteroids (prednisolone acetate 1%) are typically tapered over 3-5 weeks, with a common taper being 4 times daily for 1 week, then 2-4 times daily for 1-2 weeks, then 2 times daily for 2-3 weeks 2. At 27 days post-op with no inflammation, discontinuation is appropriate.
Topical antibiotics (ofloxacin) are typically used for only 7 days post-operatively 2. Continuation beyond this period is unnecessary in uncomplicated cases.
Topical NSAIDs (ketorolac) are recommended for use within the first post-surgical month 2, 3. The FDA label indicates ketorolac should be used four times daily for the first 2 weeks post-operatively 4. At 27 days, this can be safely discontinued.
Clinical Assessment Completed
The one-month examination appropriately evaluated:
Visual acuity: 20/20-1 uncorrected, which is excellent 1. Research shows that 62.4% of patients with 20/20 vision on post-operative day 1 maintain this level long-term 5.
Intraocular pressure: 9 mmHg OS is normal and indicates no steroid-induced pressure elevation 1, 2.
Comprehensive slit-lamp examination: All structures normal including clear cornea, well-formed anterior chamber, centered IOL with intact posterior capsule, and healthy retinal periphery 1.
Follow-Up Care Plan
Transition to routine ophthalmologic care:
Annual eye examinations are appropriate for routine monitoring 1.
Continue regular visits with the retina specialist for diabetic macular edema management in the right eye 1.
No additional post-operative visits are needed unless symptoms develop 1.
Critical Safety Instructions
The patient received appropriate emergency contact instructions and should immediately report: 1, 2
- Sudden or worsening vision changes
- New flashes, floaters, or curtain-like vision loss
- Increasing pain or redness
- Discharge from the eye
Common pitfall to avoid: Do not continue topical corticosteroids beyond the recommended taper period, as this increases risk of steroid-induced glaucoma and cataract formation in the fellow eye 2.