An Alternative Treatment
Decreased tear meniscus in dry eye.
As an alternative to steroids—or as an adjunctive therapy—topical cyclosporine can also be used to control inflammation in dry eye disease. While cyclosporine does not demonstrate the rapid anti-inflammatory effect of steroids, it carries fewer risks and is safe for long-term use.
Because of their complementary efficacy and safety profiles, many practitioners often begin dry eye treatment by prescribing both topical steroids and cyclosporine. Following the recommendation of the Asclepius Panel, the use of combination therapy is instituted with the topical corticosteroid, Lotemax (loteprednol etabonate ophthalmic suspension %, Bausch + Lomb) and Restasis (cyclosporine ophthalmic emulsion %, Allergan). 24 The Asclepius Panel recommends practitioners begin early treatment with an anti-inflammatory agent (such as Lotemax) four times a day to improve symptoms and to prevent disease progression. After two weeks, the frequency of the corticosteroid is reduced to twice daily and supplemented with Restasis twice a day. Treatment with loteprednol was stopped after day 60, while cyclosporine treatment is continued.
Some of the generic drops have become expensive because of consolidation. For example, generic pred forte drops used to be very inexpensive but now there are only two companies that make it and those two companies are owned by the same two large pharmaceuticals that own the branded medicines, hence the price of the generic is almost the same as the expensive branded options. The price of drugs does vary from one pharmacy to another and each insurance plan has its preferred drugs which cost much less for patients depending on the deals they have made with the manufactures. For example brand A might be priced well at one store because they have made a good deal with the manufacturer and made it their preferred drug while brand B would be expensive. Across town a different drug store chain might have a great price for B and a high price for A because they have make B their preferred drug and have a great volume price with the manufacturer.
Alas, it is hard to find a cost effective way to protect your eyes around cataract surgery.