Early Real-World Physician Experience with an Intracanalicular Dexamethasone Insert

Matossian, Cynthia; Stephens, John D.; Rhee, Michelle K.; Smith, Stephen; Majmudar, Parag A.; Gollamudi, Subba; Patel, Ravi H; Rosselson, Maria E; Bauskar, Aditi; Montieth, Alyssa; Silva, Fabiana Q; Vantipalli, Srilatha; Gibson, Andrea; Metzinger, Jamie Lynne; Goldstein, Michael H.

doi:10.2147/opth.s372440

Cited by 4 publications

(4 citation statements)

References 23 publications

(50 reference statements)

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“…32 Physicians also report satisfaction, finding insertion to have a quick learning curve, reporting facility after three insertions. 33 Our study indicated that there was no significant difference in conjunctival hyperemia scores. However, there is no gold-standard hyperemia grading scale, and many studies have shown intraobserver and interobserver variability and lack of repeatability.…”

Section: Discussionmentioning

confidence: 52%

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Comparing Intracanalicular and Topical Steroid Use in Patients Undergoing Pterygium Surgery

Rhee,

Zakher,

Najac

et al. 2024

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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Objective: The study received funding from Ocular Therapeutix, Inc., Bedford, MA. We undertook this study to compare the efficacy of intracanalicular dexamethasone 0.4 mg with topical prednisolone acetate (PA) 1% in controlling postoperative pain and inflammation in patients undergoing pterygium surgery. Methods: This was an open-label, prospective, interventional, nonrandomized comparative trial. Thirty patients were assigned to one of the following groups: Group A [intracanalicular insert of 0.4 mg dexamethasone placed into upper and lower puncta during the procedure, followed by at postoperative month 1 visit institution of topical PA 1% twice daily × 2 weeks then once daily × 2 weeks] or Group B [nonintervention group with institution on postoperative day 1 topical PA 1% every 2 hours × 2 weeks then four times per day × 2 weeks then twice daily × 2 weeks then once daily × 2 weeks]. Results: Fifteen cases and 15 controls were enrolled. There was no statistical difference in patient-reported pain or satisfaction between the case and control groups at 1 day; 1 week; and 1, 3, and 6 months postoperatively. There was no significant difference in time to an ocular hyperemia score of 0 between the two groups. There was no difference in the rate of corneal reepithelialization and recurrence rate (two controls). Nine eyes had transient ocular hypertension (seven cases and two controls). Conclusion: Intracanalicular dexamethasone 0.4 mg may reduce the medication burden for patients who need prolonged postoperative steroid therapy as is routine in the setting of pterygium surgery. It is a safe and effective alternative to PA 1% drops alone for postoperative control of pain and inflammation in pterygium surgery.

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Section: Discussionmentioning

confidence: 52%

“… 32 Physicians also report satisfaction, finding insertion to have a quick learning curve, reporting facility after three insertions. 33 …”

Section: Discussionmentioning

confidence: 99%

Comparing Intracanalicular and Topical Steroid Use in Patients Undergoing Pterygium Surgery

Rhee,

Zakher,

Najac

et al. 2024

Eye &Amp; Contact Lens: Science &Amp; Clinical Practice

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“…All participating surgeons noted improved patient compliance, and 35 of them (83%) would recommend it to other ophthalmologists. 23 Despite the potential to eliminate topical AIM, the newer sustained-release corticosteroid formulations were used by only 2 surgeons (5%) who injected intraocular/periocular corticosteroid medications. These respondents were using the intracanalicular dexamethasone insert, and no one reported using the dexamethasone intraocular suspension.…”

Section: Discussionmentioning

confidence: 99%

Anti-inflammatory medication use after cataract surgery: online survey of practice patterns

Awidi,

Chang,

Riaz

et al. 2024

J Cataract Refract Surg

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Purpose To determine current prescribing patterns for topical or intraocular/periocular anti-inflammatory medications (AIM) after routine cataract surgery. Setting Kera-net online members. Design Cross-sectional survey. Methods An online survey was distributed to subscribers of kera-net, a global online platform sponsored by the Cornea Society. Questions were asked regarding the use of topical or intraocular/periocular AIM following cataract surgery and types of medications prescribed. Results Of 217 surgeon respondents (23% response rate), 171 (79%) practiced in the United States and 171 (79%) were cornea sub-specialists. The majority of respondents (n = 196, 97%) prescribed topical corticosteroids following routine cataract surgery. The most frequently prescribed were prednisolone acetate (n = 162, 83%), followed by dexamethasone (n = 26, 13%), difluprednate (n = 24, 12%), and loteprednol etabonate (n = 13, 7%). Corticosteroids comprised (n = 40, 32%) of total intraocular/periocular injections, with triamcinolone acetonide 10 or 40 mg (n = 19, 47.5%) most commonly used. Twenty-three surgeons (58%) who were injecting intraocular/periocular corticosteroids also prescribed topical corticosteroids. Topical non-steroidal anti-inflammatory drugs (NSAIDs) were prescribed post-operatively by 148 surgeons (73%). Conclusions Most surgeons were prescribing topical AIM following routine cataract surgery. Many surgeons were injecting intraocular or periocular AIM, while continuing to prescribe topical AIM. The diversity of practice patterns may reflect the lack of clear evidence-based guidance.

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“…Our analysis of physicians’ experiences with DEX has been previously reported. 25 In this report, we characterize the DEX experience from the perspective of patients and practice staff.…”

Section: Introductionmentioning

confidence: 99%

Early Real-World Patient and Staff Experience with an Intracanalicular Dexamethasone Insert

Nijm,

Matossian,

Rhee

et al. 2024

OPTH

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To evaluate both the early experience of real-world patients treated with dexamethasone ophthalmic insert (0.4 mg; DEXTENZA ® ), hereafter referred to as DEX, after cataract surgery as well as staff/practice integration of DEX relative to eyedrops. Patients and Methods: This was a cross-sectional survey study of 23 cataract practices in the United States. Respondents were patients and practice staff who had experience with DEX following cataract surgery. Both patients and practice staff completed an online survey. Descriptive statistics summarized the survey responses to portray the experience of the respondents. Results: Surveys were completed by 62 patients and 19 practice staff. Almost all patients (93%) were satisfied or extremely satisfied with DEX. Patients highly preferred DEX (93%) to topical steroid drops (7%) based on past experiences with topical steroid drops. Most practice staff (95%) were satisfied or highly satisfied with DEX, reporting a 45% reduction in time spent educating patients on postoperative drop use and a 46% decrease in time spent addressing calls from pharmacies regarding postoperative medications. Conclusion:Incorporating the DEX insert into clinical practice in cataract surgery practices can improve patient adherence, while potentially providing significant savings to practices in terms of time spent educating patients and responding to patient and pharmacy call-backs.

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Early Real-World Physician Experience with an Intracanalicular Dexamethasone Insert

Cited by 4 publications

References 23 publications

Comparing Intracanalicular and Topical Steroid Use in Patients Undergoing Pterygium Surgery

Comparing Intracanalicular and Topical Steroid Use in Patients Undergoing Pterygium Surgery

Anti-inflammatory medication use after cataract surgery: online survey of practice patterns

Early Real-World Patient and Staff Experience with an Intracanalicular Dexamethasone Insert

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