Noncompliance with Prescribed Eyedrop Regimens Among Patients Undergoing Cataract Surgery—Prevalence, Consequences, and Solutions

Matossian, Cynthia

doi:10.17925/usor.2020.13.1.18

Cited by 13 publications

(36 citation statements)

References 30 publications

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“…The eye structure is endowed with efficient protective barriers and mechanisms, which constitute a challenging obstacle to ophthalmic drug delivery [ 1 ]. The efficiency of drug administration through eye drops is limited by several factors, including low corneal permeability, drug loss with lacrimation and scarce patient compliance to the treatment, especially when elderly patients are involved [ 2 , 3 ]. As a low drug residence time on the cornea is experienced with eye drops, frequent drop administration is required.…”

Section: Introductionmentioning

confidence: 99%

Asymmetry in Drug Permeability through the Cornea

et al. 2021

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The permeability through the cornea determines the ability of a drug or any topically applied compound to cross the tissue and reach the intraocular area. Most of the permeability values found in the literature are obtained considering topical drug formulations, and therefore, refer to the drug permeability inward the eye. However, due to the asymmetry of the corneal tissue, outward drug permeability constitutes a more meaningful parameter when dealing with intraocular drug-delivery systems (i.e., drug-loaded intraocular lenses, intraocular implants or injections). Herein, the permeability coefficients of two commonly administered anti-inflammatory drugs (i.e., bromfenac sodium and dexamethasone sodium) were determined ex vivo using Franz diffusion cells and porcine corneas in both inward and outward configurations. A significantly higher drug accumulation in the cornea was detected in the outward direction, which is consistent with the different characteristics of the corneal layers. Coherently, a higher permeability coefficient was obtained for bromfenac sodium in the outward direction, but no differences were detected for dexamethasone sodium in the two directions. Drug accumulation in the cornea can prolong the therapeutic effect of intraocular drug-release systems.

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Section: Introductionmentioning

confidence: 99%

Asymmetry in Drug Permeability through the Cornea

et al. 2021

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“…Increasing drug absorption efficiency can lead to equivalent efficacy with fewer doses. Adherence to eye drop regimens is an often cited problem, and eye drops can only be effective when they are used as prescribed 44 . Adherence is particularly a concern for elderly and pediatric patients, where reducing the required number of drops per day could significantly improve quality of life 44,45 .…”

Section: Discussionmentioning

confidence: 99%

“…Adherence to eye drop regimens is an often cited problem, and eye drops can only be effective when they are used as prescribed 44 . Adherence is particularly a concern for elderly and pediatric patients, where reducing the required number of drops per day could significantly improve quality of life 44,45 . Better adherence in addition to increased and more effective drug concentrations can also circumvent issues with the development of bacterial resistance 46 .…”

Section: Discussionmentioning

confidence: 99%

“…In the case of antibiotic eye drops, drops may be prescribed for use in treating bacterial keratitis and conjunctivitis every hour for the first 48 h and then once every 4 h until the infection is resolved 11 . As the required number of doses per day increases, patient compliance, and thus, treatment efficacy, decreases 12–14 . Antibiotic eye drop formulations that are more effective with less frequent dosing are needed.…”

Section: Introductionmentioning

confidence: 99%

“… 11 As the required number of doses per day increases, patient compliance, and thus, treatment efficacy, decreases. 12 , 13 , 14 Antibiotic eye drop formulations that are more effective with less frequent dosing are needed.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

An ion‐paired moxifloxacin nanosuspension eye drop provides improved prevention and treatment of ocular infection

Josyula

Omiadze

Parikh

et al. 2021

Bioengineering & Transla Med

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There are numerous barriers to achieving effective intraocular drug administration, including the mucus layer protecting the ocular surface. For this reason, antibiotic eye drops must be used multiple times per day to prevent and treat ocular infections. Frequent eye drop use is inconvenient for patients, and lack of adherence to prescribed dosing regimens limits treatment efficacy and contributes to antibiotic resistance.Here, we describe an ion-pairing approach used to create an insoluble moxifloxacinpamoate (MOX-PAM) complex for formulation into mucus-penetrating nanosuspension eye drops (MOX-PAM NS). The MOX-PAM NS provided a significant increase in ocular drug absorption, as measured by the area under the curve in cornea tissue and aqueous humor, compared to Vigamox in healthy rats. Prophylactic and treatment efficacy were evaluated in a rat model of ocular Staphylococcus aureus infection. A single drop of MOX-PAM NS was more effective than Vigamox, and completely prevented infection. Once a day dosing with MOX-PAM NS was similar, if not more effective, than three times a day dosing with Vigamox for treating Aditya Josyula and Revaz Omiadze contributed equally to this study.

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Review of Loteprednol Etabonate 0.5%/Tobramycin 0.3% in the Treatment of Blepharokeratoconjunctivitis

Mah

Karpecki

2021

Ophthalmol Ther

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Use of a combination corticosteroid and antibiotic in a single formulation is common in the treatment of ocular inflammatory conditions for which corticosteroid therapy is indicated and there exists a risk of superficial bacterial infection. Loteprednol etabonate (LE) is a corticosteroid engineered to maintain potent anti-inflammatory activity while minimizing the risk of undesirable class effects of corticosteroids, such as elevated intraocular pressure and cataract. Tobramycin is a broadspectrum aminoglycoside antibiotic that is considered generally safe and well tolerated. An ophthalmic suspension combining LE 0.5% and tobramycin 0.3% (LE/T) is approved in the US and several other countries. Use of a combination therapy increases convenience, which may promote patient adherence. A systematic literature review was conducted to examine the efficacy and safety of LE/T for ocular inflammatory conditions within the scope of its labeled indications. Results of published studies indicate that LE/T is effective in the treatment of blepharokeratoconjunctivitis in adults, with similar efficacy as dexamethasone 0.1%/tobramycin 0.3%, but is associated with a lower risk of clinically significant increases in intraocular pressure as demonstrated in both efficacy and safety studies and studies with healthy volunteers. Furthermore, studies in children with blepharitis or blepharoconjunctivitis indicate LE/T was well tolerated in this population, although efficacy vs vehicle was not demonstrated, potentially due to improvements in all groups overall and/or limited sample size. Separately, tobramycin demonstrated potent in vitro activity against most bacterial species associated with blepharitis. In conclusion, published data demonstrate the utility of LE/T for the treatment of the various clinical manifestations of blepharokeratoconjunctivitis in adults.

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Noncompliance with Prescribed Eyedrop Regimens Among Patients Undergoing Cataract Surgery—Prevalence, Consequences, and Solutions

Cited by 13 publications

References 30 publications

Asymmetry in Drug Permeability through the Cornea

Asymmetry in Drug Permeability through the Cornea

An ion‐paired moxifloxacin nanosuspension eye drop provides improved prevention and treatment of ocular infection

Review of Loteprednol Etabonate 0.5%/Tobramycin 0.3% in the Treatment of Blepharokeratoconjunctivitis

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