Same-Day versus Next-Day Dexamethasone Intracanalicular Insert Administration for Inflammation and Pain Control Following Cataract Surgery: A Retrospective Analysis

Foster, Brian

doi:10.2147/opth.s335764

Cited by 7 publications

(15 citation statements)

References 22 publications

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…27,30 Their use thus shifts the reliance of administration from patient to physician reducing risks associated with improper instillation technique, and eliminating non-adherence, resulting in better efficacy, and safety outcomes. 31 Utilizing sustained-release steroid products has been advocated by multiple surgeons as an important step forward in optimizing therapeutic efficacy and postoperative quality of life in patients undergoing cataract surgery. 31 After placement by the physician, DEX continuously delivers a tapered-dose, preservative-free steroid regimen directly to the ocular surface throughout the postoperative period to manage inflammation and pain, likely improving patient compliance by reducing missed doses or incorrect instillation.…”

Section: Discussionmentioning

confidence: 99%

“…31 Utilizing sustained-release steroid products has been advocated by multiple surgeons as an important step forward in optimizing therapeutic efficacy and postoperative quality of life in patients undergoing cataract surgery. 31 After placement by the physician, DEX continuously delivers a tapered-dose, preservative-free steroid regimen directly to the ocular surface throughout the postoperative period to manage inflammation and pain, likely improving patient compliance by reducing missed doses or incorrect instillation. 17 Following a quick learning curve, most physicians quickly gained proficiency and confidence with DEX insertion (Figure 3A).…”

Section: Discussionmentioning

confidence: 99%

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Early Real-World Physician Experience with an Intracanalicular Dexamethasone Insert

Matossian¹,

Stephens²,

Rhee³

et al. 2022

OPTH

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Purpose To describe the early real-world experience of physicians with an intracanalicular dexamethasone insert (DEX) in patients undergoing cataract surgery and to capture the clinical impact of adopting this therapy. Patients and Methods 23 United States sites including Ambulatory Surgical Center Setting (ASC) and Outpatient Clinical settings. Respondents were physicians who had early experience with DEX in cataract surgery patients. This was a Phase 4 experiential cross-sectional survey study comprised of 3 sequential online physician surveys. Descriptive statistics summarized the surveys’ responses to determine the early impressions of the respondents. Results Forty-two physicians completed surveys. On average, physicians reported feeling comfortable administering DEX after placing 3 inserts (mean 2.7; standard deviation 1.9). Most physicians (92%) were satisfied with DEX, and all physicians (100%) reported that DEX improved patient compliance. Most physicians (62.5%) indicated they would highly prefer DEX over traditional steroid eyedrops for the management of post-surgical inflammation and pain. Conclusion The surveys exploring the early use of DEX suggest that DEX is a clinically effective treatment with a rapid initial learning curve and integrates well into clinical use. Physicians had a very positive early experience with DEX, including comfort with insertion and satisfaction. DEX shows promise as a primary treatment choice of physicians for ocular inflammation and pain following cataract surgery by offering patients a hands-free innovative therapy that delivers a preservative-free steroid to the ocular surface over approximately 30 days.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Early Real-World Physician Experience with an Intracanalicular Dexamethasone Insert

Matossian¹,

Stephens²,

Rhee³

et al. 2022

OPTH

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“…Several prior studies 11,12,16,18 have highlighted the safety and efficacy of the dexamethasone insert evaluated in this present study with regards to postoperative pain and inflammation. In a recent study by Tyson et al, 16 a prospective, multicenter study compared the insert versus placebo and reported a greater proportion of patients in the dexamethasone insert arm met endpoints assessing the absence of pain and anterior chamber inflammation at key postoperative time points.…”

mentioning

confidence: 99%

Evaluation of Same-Day versus Next-Day Implantation of Intracanalicular Dexamethasone for the Control of Postoperative Inflammation and Pain Following Cataract Surgery

Saenz¹,

Ferguson²,

Abraham³

et al. 2021

OPTH

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Purpose: To evaluate the safety and efficacy of a sustained-release intracanalicular dexamethasone insert for postoperative inflammation and pain implanted in a clinical setting preoperatively or on postoperative day 1. Methods: Single-site, retrospective, contralateral eye study of patients undergoing cataract surgery. Included were subjects with a dexamethasone intracanalicular insert implanted in the clinic immediately prior to surgery in one eye (same-day) and on postoperative day 1 (POD1) in the contralateral eye. The primary outcome measure was the resolution of anterior chamber inflammation at 1 week postoperative. Secondary outcome measures included proportion of eyes requiring additional therapy for pain and inflammation through 1 month as well as the number of eyes with IOP spikes above baseline. Safety measures included adverse events through 1 month postoperative. Results: Sixty-two eyes of 31 subjects were included in the case series. At 1 week postoperative, 52% of the eyes (n = 16) achieved complete resolution of inflammation in the same-day group and 58% (n = 18) met this endpoint at 1 week in the POD1 group. One subject in the same-day group required additional therapy for rebound inflammation and no eyes required additional therapy in the POD1 group. There were no reports of pain at 1 week or 1 month in either group. There were no implant-related adverse events in either group. Conclusion:The favorable results of this study indicate that the sustained-release dexamethasone insert can be safely implanted in the clinic either preoperatively on the day of surgery or on postoperative day 1 for the control of pain and inflammation following cataract surgery.

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Adopting Interventional Glaucoma Via Sustained-Release Therapies: The Wide-Ranging Impact of Procedural Pharmaceuticals in Ophthalmology

Yadgarov,

Provencher,

Shafer

et al. 2024

Ophthalmol Ther

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Topical medical therapy is the most common approach to the treatment of many ocular conditions. While effective, topical therapy has numerous important limitations. Eye drops can have unpleasant or even dangerous side effects, are often difficult to self-administer, and the application of multiple drops per day, possibly from multiple different bottles, can be burdensome. Perhaps the most important limitation of topical medical therapy is non-adherence, a complex multifactorial behavior that increases the risk of poor outcomes associated with undertreatment. There is growing interest in a class of therapeutics termed “procedural pharmaceuticals” (PPs), which remove the responsibility of self-dosing from patients. An array of PPs are available for the treatment of a variety of ocular conditions, such as those for glaucoma, retina, and cataract surgery; and many more will emerge in coming years. A paradigm shift away from patient-administered therapy toward provider-administered therapy will have important implications for both providers and patients. This paper explores the impact that PPs have had, and will have, on the clinical practice of ophthalmology.

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Same-Day versus Next-Day Dexamethasone Intracanalicular Insert Administration for Inflammation and Pain Control Following Cataract Surgery: A Retrospective Analysis

Cited by 7 publications

References 22 publications

Early Real-World Physician Experience with an Intracanalicular Dexamethasone Insert

Early Real-World Physician Experience with an Intracanalicular Dexamethasone Insert

Evaluation of Same-Day versus Next-Day Implantation of Intracanalicular Dexamethasone for the Control of Postoperative Inflammation and Pain Following Cataract Surgery

Adopting Interventional Glaucoma Via Sustained-Release Therapies: The Wide-Ranging Impact of Procedural Pharmaceuticals in Ophthalmology

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