Author’s Disclosure Block: Amera Khalaff, none; Siddharth Yadav, none; Omar Taboun, none; Musbah Khalaff, none; Barry Emara, none; Caroline Hamm, none

Abstract Body
Purpose: The primary objective of this study was to compare the safety and efficacy of dropless cataract surgery to conventional non-dropless cataract surgery. We also aimed to determine if patient demographics and past medical history influenced postoperative outcomes in both groups. Study Design: This was a retrospective chart review conducted at Windsor Regional Hospital and Windsor Surgical Centre. Patient records were analyzed from November 1, 2021, to June 1, 2022. A total of 1119 patients were included, with 596 undergoing non-dropless cataract surgery and 523 receiving dropless surgery. Methods: Patient archival data were taken to evaluate age, sex, history of diabetes, hypertension, glaucoma, and use of eye drops before surgery. Surgical details comprised the type of cataract surgery (conventional vs femtosecond laser-assisted cataract surgery (FLACS)), intraocular pressure (IOP), and anterior chamber (AC) reactions on postoperative day 1 and week 1. Data analysis was performed using R statistical software (v2.4.2.2). Chi-square analysis was used to compare the rate of post-operative inflammation, changes in IOP, AC reaction findings, and the need for additional steroid drops. Results: The analysis showed no statistically significant difference in the safety or efficacy of dropless versus non-dropless cataract surgery. Specifically, changes in AC reaction (p =0.174), and changes in IOP at both 1-day and 1-week follow-ups were comparable between the two groups (p= 0.174 and p = 0.206, respectively).The percentage of patients requiring additional steroid drops was also similar between the two groups, with 6.4% in the dropless group compared to 4.7% in the non-dropless group. Conclusions: Dropless cataract surgery, which involves injecting an antibiotic and steroid solution into the anterior vitreous during surgery, is a viable alternative to conventional cataract surgery that requires patients to self-administer drops post-operatively. The findings indicate that dropless cataract surgery is both as safe and as effective as non-dropless surgery, with similar rates of postoperative inflammation and infection. Given these results, it is reasonable to recommend the wider adoption of dropless cataract surgery, as it reduces this burden on patients during the postoperative phase. Further studies should examine the importance of cost-effectiveness as well as analysis of a larger number of patients to appreciate the outcomes.