I never stop any immunosuppressants for cataract surgery. The reason being, it may help prevent postoperative ocular eye inflammation (e.g. postoperative iritis). I learned this many years ago when one of my RA patients stopped their methotrexate and had a severe bout of new-onset iritis afterward....

So far this has not been a problem in my practice. However, based on little data and some concern about peri-infusional solumedrol effects, I try to give rituximab at least 4 weeks before or after cataract surgery. Where possible, I try to avoid peri-infusional steroids.

I agree with Dr. @Thomas that most ocular surgeries, and certainly low-risk procedures such as cataract surgery, don't require cessation or alteration of immunosuppressant medications. I've seen some issues with post-op infection following enucleation (I work in our university's Center for Ocular In...