4-Meds in One Glaucoma Eyedrop May Decrease Preservatives, Lower Cost, Improve Compliance

MedicalResearch.com Interview with:

Nathan Radcliffe, MD Senior Faculty, Ophthalmology Glaucoma and Cataract surgeon Mount Sinai Health System

Dr. Radcliffe

Nathan Radcliffe, MD
Senior Faculty, Ophthalmology Glaucoma and Cataract surgeon
Mount Sinai Health System

MedicalResearch.com: What is the background for this study?

Response: Glaucoma is a leading cause of blindness and the mainstay of therapy is to lower the intraocular pressure (IOP) with topical eye drops.

Up to 40% of patients may require more than one eye drop to control the disease, and yet taking more than one eye drop bottle can result in higher costs, more eye irritation, worse therapeutic compliance, and possibly worse outcomes, be sure to consult your eye surgeon before increasing any eye treatment to ensure it won’t do any further damage to the eye. Compounded therapies (not FDA approved, but made at the physician’s request by a compounding pharmacy) can be created to contain multiple glaucoma therapies in one bottle.

We sought to determine if a compounded solution containing three or four drops in one bottle could control glaucoma as well as three or four separate bottles (standard of care) in patients requiring three or four eye drop bottles to control glaucoma.

We performed a multi-center, randomized, observer-masked, parallel-group study comparing a compounded therapy containing latanoprost 0.05%, dorzolamide hydrochloride 2%, timolol maleate 0.5%, brimonidine tartrate 0.2% with 0.01% BAK to standard three or four bottle regaimins. We measured IOP and corneal staining (a sign of preservative toxicity), as well as other safety measures at week one, month one, two and three.

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NSAID Eyedrop + Eye Patch Better at Reducing Pain After Intravitreal Injection

MedicalResearch.com Interview with:

Ronald Gentile, MD Professor of Ophthalmology Icahn School of Medicine at Mount Sinai New York

Dr. Gentile

Ronald Gentile, MD
Professor of Ophthalmology
Icahn School of Medicine at Mount Sinai
New York

MedicalResearch.com: What is the background for this study?

Response: Intravitreal injections have revolutionized the treatment of some of the most common retinal diseases that cause blindness. These diseases include wet age related macular degeneration and diabetic retinopathy. Intravitreal injections are the most common eye procedure in the world. Pain after an intravitreal injection negatively impacts the patient’s experience. We set out a to find a way to improve the patient’s experience by improving the pain they feel after the intravitreal injection.

MedicalResearch.com: What are the main findings? 

Response: The main finding was that the NSAID we used, Nepafanac 0.3% suspension, and pressure patching resulted in lower pain scores when compared to the tear drop placebo at both 6 and 24 hours after the intravitreal injection. The NSAID had a greater effect on lowering the pain score and was found statistically significance. Even though the eyepatch was associated with lower pain scores than placebo, the difference did not reach statistical significance. 

MedicalResearch.com: What should readers take away from your report?

Response: Readers should understand that patients not only have a fear going blind, they also fear the pain of the treatment. Physicians should place more emphasis on the patients experience and try to decrease or eliminate any pain a patient may have from the intravitreal injections. It would be expected that this should help patient compliance, especially for those patient who need regular intravitreal injections. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: Future research should focus on the patients experience and find ways to eliminate any pain a patient may have before, during, and after the intravitreal injections. 

MedicalResearch.com: Is there anything else you would like to add?

Response: Yes. Patient satisfaction and the patient experience is something that all ophthalmologists and all doctors need to put on the top of their priority list. Physicians have the greatest ability and insight into this. Having the greatest medicines in the world cant help if a patients fear of pain prevents them from being compliant.

I have no disclosures.

Citation: AAO 2018 abstract

Pain Control Following Intravitreal Injection Using Topical Nepefanac 0.3% or Pressure Patching: A Prospective, Randomized, Placebo Controlled Trial


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