A Randomized, Controlled, Prospective Study of the Effectiveness and Safety of an Intracanalicular Dexamethasone Ophthalmic Insert (0.4 Mg) for the Treatment of Post-Operative Inflammation in Patients Undergoing Refractive Lens Exchange (RLE).

Autor: Larsen J; Clinical Research, Vance Thompson Vision, Bozeman, MT, USA., Whitt T; Department of Optometry, Vance Thompson Vision, Bozeman, MT, USA., Parker B; Clinical Research, Vance Thompson Vision, Bozeman, MT, USA., Swan R; Department of Ophthalmology, Vance Thompson Vision, Bozeman, MT, USA.; Ophthalmology Moran Eye Center, University of Utah, Salt Lake City, UT, USA.
Jazyk: angličtina
Zdroj: Clinical ophthalmology (Auckland, N.Z.) [Clin Ophthalmol] 2021 May 27; Vol. 15, pp. 2211-2217. Date of Electronic Publication: 2021 May 27 (Print Publication: 2021).
DOI: 10.2147/OPTH.S311070
Abstrakt: Purpose: To determine patient preference and treatment outcomes with an intracanalicular dexamethasone (0.4 mg) insert compared to standard steroid drop regimen in the contralateral eye following bilateral RLE surgery.
Methods: This is a prospective, open-label, interventional, randomized, controlled study in 20 subjects who underwent bilateral RLE. Each patient served as their own control with one eye randomized to the intracanalicular insert (Group A) placed at the time of surgery and the contralateral randomized to topical corticosteroid drops (Group B). All eyes received intracameral moxifloxacin at the time of surgery, and post-operatively, topical moxifloxacin QID for one week and topical NSAID daily for four weeks. Post-operative evaluations were performed on Day 1, Week 1, and Week 4-8.
Results: Twenty patients participated. At 4-8 weeks post-operation, 90% of patients evaluated with the COMTOL questionnaire preferred the intracanalicular insert while 10% preferred the topical steroid. Comparative analysis using the visual analog scale showed no difference in pain between the study and control group. No statistical difference was shown in post-operative corneal staining, anterior chamber cell count, anterior chamber flare or intraocular pressure. Mean LogMAR UCVA at 4-8 weeks post-operation was 0.06 (± 0.230) in the study group and 0.065 (± 0.241) in the control group, which was not statistically or clinically different (p > 0.05).
Conclusion: Patients undergoing bilateral RLE expressed a strong preference towards the use of an intracanalicular insert over a topical steroid for post-operative steroid treatment. There was no clinically or statistically significant difference in outcomes, including rate of cystoid macular edema, visual acuity and elevation of intraocular pressure.
National Clinical Trial Number: 04549935.
Competing Interests: The authors report no conflicts of interest for this work.
(© 2021 Larsen et al.)
Databáze: MEDLINE
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