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Shapiro JN, Armenti ST, Levine H, Hood CT, Mian SI. Dexamethasone Intracanalicular Insert versus Standard Topical Steroids for the Prophylaxis of Inflammation after Cataract Surgery. Am J Ophthalmol 2024:S0002-9394(24)00322-2. [PMID: 39089352 DOI: 10.1016/j.ajo.2024.07.030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 07/18/2024] [Accepted: 07/21/2024] [Indexed: 08/03/2024]
Abstract
PURPOSE To compare the efficacy of an intracanalicular dexamethasone intracanalicular insert (DII) to a topical prednisolone acetate 1% taper for preventing breakthrough inflammation (iritis or cystoid macular edema) during the first post-operative month (POM1) after cataract surgery DESIGN: Retrospective, non-randomized comparative interventional study METHODS: Patients received either DII or topical prednisolone acetate 1% eyedrops (control) during POM1. Exclusion criteria included history of iritis, glaucoma, intraoperative posterior capsular rupture or vitreous prolapse, immediate postoperative anterior chamber inflammation requiring treatment, or less than 1 month follow up post-operatively. Outcomes included development of breakthrough inflammation after >3 days postoperatively necessitating additional anti-inflammatory drops, cystoid macular edema, and increased intraocular pressure at POM1. RESULTS 266 eyes of 174 patients were included in the DII group, and 258 eyes of 167 patients in the control group. Demographics, comorbidities, and baseline IOP were comparable between groups. The breakthrough inflammation rate was significantly higher in the DII group compared to control (9.0% vs 3.1%; p < .01); cystoid macular edema rates were similar between groups (4.9% vs 4.3%; p = .75). There were no cases of increased IOP >10mmHg at POM1 compared to baseline in either group. CONCLUSION After cataract surgery, DII demonstrated a higher rate of breakthrough inflammation than a standard topical steroid regimen with no significant differences in CME rate or IOP increase; however, overall, the rate of postoperative complications was low. DII can be a safe and effective alternative to topical corticosteroid therapy after cataract surgery.
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Affiliation(s)
- Jeremy N Shapiro
- Kellogg Eye Center and Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | - Stephen T Armenti
- Scheie Eye Institute and Department of Ophthalmology, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Harry Levine
- Kellogg Eye Center and Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | - Christopher T Hood
- Kellogg Eye Center and Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | - Shahzad I Mian
- Kellogg Eye Center and Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA.
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Urbánek P, Šuly P, Ševčík J, Hanulíková B, Kuřitka I, Šopík T, Stodůlka P. Controlled Drug Delivery Device for Cornea Treatment and Novel Method for Its Testing. Pharmaceuticals (Basel) 2023; 16:ph16040505. [PMID: 37111260 PMCID: PMC10143253 DOI: 10.3390/ph16040505] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 03/30/2023] Open
Abstract
A new solution for local anesthetic and antibiotic delivery after eye surgery is presented. A contact lens-shaped collagen drug carrier was created and loaded by Levofloxacin and Tetracaine with a riboflavin crosslinked surface layer, thus impeding diffusion. The crosslinking was confirmed by Raman spectroscopy, whereas the drug release was investigated using UV-Vis spectrometry. Due to the surface barrier, the drug gradually releases into the corneal tissue. To test the function of the carrier, a 3D printed device and a new test method for a controlled drug release, which mimics the geometry and physiological lacrimation rate of the human eye, were developed. The experimental setup with simple geometry revealed that the prepared drug delivery device can provide the prolonged release profile of the pseudo-first-order for up to 72 h. The efficiency of the drug delivery was further demonstrated using a dead porcine cornea as a drug recipient, without the need to use live animals for testing. Our drug delivery system significantly surpasses the efficiency of antibiotic and anesthetic eyedrops that would have to be applied approximately 30 times per hour to achieve the same dose as that delivered continuously by our device.
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Affiliation(s)
- Pavel Urbánek
- Centre of Polymer Systems, Tomas Bata University in Zlín, trida Tomase Bati 5678, 76001 Zlin, Czech Republic
- Correspondence:
| | - Pavol Šuly
- Centre of Polymer Systems, Tomas Bata University in Zlín, trida Tomase Bati 5678, 76001 Zlin, Czech Republic
| | - Jakub Ševčík
- Centre of Polymer Systems, Tomas Bata University in Zlín, trida Tomase Bati 5678, 76001 Zlin, Czech Republic
| | - Barbora Hanulíková
- Centre of Polymer Systems, Tomas Bata University in Zlín, trida Tomase Bati 5678, 76001 Zlin, Czech Republic
| | - Ivo Kuřitka
- Centre of Polymer Systems, Tomas Bata University in Zlín, trida Tomase Bati 5678, 76001 Zlin, Czech Republic
| | - Tomáš Šopík
- Centre of Polymer Systems, Tomas Bata University in Zlín, trida Tomase Bati 5678, 76001 Zlin, Czech Republic
| | - Pavel Stodůlka
- Gemini Eye Clinic, U Gemini 360, 76001 Zlin, Czech Republic
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3
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Management of inflammation after the cataract surgery. Curr Opin Ophthalmol 2023; 34:9-20. [PMID: 36305352 DOI: 10.1097/icu.0000000000000912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW To review most recent studies and clinical trials regarding pathogenesis, treatment, and prevention of inflammation after the cataract surgery. RECENT FINDINGS FLACS gave opportunity to evaluate inflammatory cytokines in the aqueous humour right after the laser procedure, which led to acknowledging the inflammation pathogenesis during the phacoemulsification. Although there is still a lack of evidence, which would prove the long-term benefit of NSAIDs, they are indicated and effective when risk factors for PCME are present. PREMED studies showed that combination of NSAID and steroids after the surgery for healthy subjects is cost-effective. The triamcinolone injection together with topical steroids and NSAIDs for diabetic patients after the cataract surgery was the most cost-effective in preventing PCME according to the PREMED. Dropless cataract surgery is another emerging topic: dexamethasone implants and suspensions look promising as we await more clinical trials with drug-loaded IOLs. SUMMARY Inflammation after the cataract surgery can be prevented, and these methods are one of the most essential topics with growing phacoemulsification rate. Topical NSAIDs are cost-effective not only for patients with risk factors for PCME but also for healthy subjects. New dropless techniques are being successfully introduced in the clinical practice.
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Dai M, Xu K, Xiao D, Zheng Y, Zheng Q, Shen J, Qian Y, Chen W. In Situ Forming Hydrogel as a Tracer and Degradable Lacrimal Plug for Dry Eye Treatment. Adv Healthc Mater 2022; 11:e2200678. [PMID: 35841368 DOI: 10.1002/adhm.202200678] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2022] [Revised: 06/10/2022] [Indexed: 01/27/2023]
Abstract
Lacrimal plug is an effective and widely therapeutic strategy to treat dry eye. However, almost all commercialized plugs are fixed in a certain design and associated with many complications, such as spontaneous plug extrusion, epiphora, and granuloma and cannot be traced in the long-term. Herein, a simple in situ forming hydrogel is developed as a tracer and degradable lacrimal plug to achieve the best match with the irregular lacrimal passages. In this strategy, methacrylate-modified silk fibroin (SFMA) is served as a network, and a self-assembled indocyanine green fluorescence tracer nanoparticle (FTN) is embedded as an indicator to develop the hydrogel plug using visible photo-crosslinking. This SFMA/FTN hydrogel plug has excellent biocompatibility and biodegradability, which can be noninvasively monitored by near-infrared light. In vivo tests based on dry eye rabbits show that the SFMA/FTN hydrogel plug can completely block the lacrimal passages and greatly improve the various clinical indicators of dry eye. These results demonstrate that the SFMA/FTN hydrogel is suitable as an injectable and degradable lacrimal plug with a long-term tracking function. The work offers a new approach to the development of absorbable plugs for the treatment of dry eye.
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Affiliation(s)
- Mali Dai
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, 325001, China
| | - Kejia Xu
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, 325001, China
| | - Decheng Xiao
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, 325001, China
| | - Yujing Zheng
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, 325001, China
| | - Qinxiang Zheng
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, 325001, China
| | - Jianliang Shen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, 325001, China.,Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, Zhejiang, 325001, China
| | - Yuna Qian
- Wenzhou Institute, University of Chinese Academy of Sciences, Wenzhou, Zhejiang, 325001, China
| | - Wei Chen
- Eye Hospital and School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, Zhejiang, 325001, China
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5
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Iontophoretic delivery of dexamethasone-loaded nanoparticles to the anterior segment of the eye. J IND ENG CHEM 2022. [DOI: 10.1016/j.jiec.2022.09.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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6
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Ibach MJ, Zimprich L, Wallin DD, Olevson C, Puls-Boever K, Thompson V. In Clinic Optometrist Insertion of Dextenza (Dexamethasone Ophthalmic Insert 0.4mg) Prior to Cataract Surgery: The PREPARE Study. Clin Ophthalmol 2022; 16:2609-2615. [PMID: 35992569 PMCID: PMC9384970 DOI: 10.2147/opth.s374405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 08/04/2022] [Indexed: 01/13/2023] Open
Abstract
Purpose Methods Results Conclusion ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/CmOj-5Oq3Hk
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Affiliation(s)
- Mitchel J Ibach
- Ophthalmology, Vance Thompson Vision, Sioux Falls, SD, USA
- Correspondence: Mitchel J Ibach, Vance Thompson Vision, 3101 W. 57th St, Sioux Falls, SD, 57108, USA, Tel +1 605-361-3937, Fax +1 605-371-7035, Email
| | - Larae Zimprich
- Ophthalmology, Vance Thompson Vision, Sioux Falls, SD, USA
| | - Doug D Wallin
- Ophthalmology, Vance Thompson Vision, Sioux Falls, SD, USA
| | - Collin Olevson
- Medical School, University of South Dakota School of Medicine, Vermillion, SD, USA
| | | | - Vance Thompson
- Ophthalmology, Vance Thompson Vision, Sioux Falls, SD, USA
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7
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Schwab R, Reichl S. Dexamethasone-loaded keratin films for ocular surface reconstruction. JOURNAL OF MATERIALS SCIENCE. MATERIALS IN MEDICINE 2022; 33:29. [PMID: 35244790 PMCID: PMC9050765 DOI: 10.1007/s10856-021-06638-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 12/14/2021] [Indexed: 06/14/2023]
Abstract
Amniotic membrane (AM) is often applied as a substitute material during ocular surface reconstruction. However, since AM has several disadvantages, alternative materials must be considered for this application. Keratin films made from human hair (KFs) have previously been presented as a promising option; they exhibited suitable characteristics and satisfactory biocompatibility in an in vivo rabbit model. Nevertheless, dexamethasone (DEX) eye drops are necessary after surgery to suppress inflammation. Since eye drops must be administered frequently, this might result in poor patient compliance, and the release of DEX at the transplant site would be clinically beneficial. Therefore, we aimed to incorporate DEX into KFs without hindering the positive film characteristics. Drug-loaded KFs were generated either by suspension technique or by the addition of solubilizing agents. The resulting specimens were analyzed regarding appearance, loading capacity, transparency, mechanical characteristics, swelling behavior and in vitro release. Furthermore, biocompatibility was assessed in vitro by determining the cell viability, seeding efficiency and growth behavior of corneal epithelial cells. The amount of incorporated DEX influenced the transparency and biomechanical properties of the films, but even highly loaded films showed properties similar to those of AM. The suspension technique was identified as the best incorporation approach regarding chemical stability and prolonged DEX release. Moreover, suspended DEX in the films did not negatively impact cell seeding efficiencies, and the cell-growth behaviors on the specimens with moderate DEX loads were satisfactory. This suggest that these films could comprise a suitable alternative material with additional anti-inflammatory activity for ocular surface reconstruction. Graphical abstract.
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Affiliation(s)
- Rebekka Schwab
- Institut für Pharmazeutische Technologie, Technische Universität Braunschweig, Braunschweig, Germany
| | - Stephan Reichl
- Institut für Pharmazeutische Technologie, Technische Universität Braunschweig, Braunschweig, Germany.
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8
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A Randomized, Prospective Clinical Study Evaluating Dexamethasone Intraocular Suspension 9% vs Prednisolone Acetate 1% in Controlling Postoperative Pain and Inflammation in Patients Undergoing Bilateral Sequential Cataract Surgery. J Cataract Refract Surg 2022; 48:906-911. [DOI: 10.1097/j.jcrs.0000000000000887] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 01/08/2022] [Indexed: 11/26/2022]
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9
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Associated risk factors of postoperative pain after glaucoma surgery: a prospective study. Int Ophthalmol 2021; 42:829-840. [PMID: 34674085 DOI: 10.1007/s10792-021-02048-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 09/22/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE This study aimed to determine degree of postoperative pain and the incidence of serious postoperative pain after glaucoma surgery and further to identify the associated risk factors. METHODS A total of 194 consecutive patients who were diagnosed with glaucoma and underwent glaucoma surgery were enrolled in this study. The intensity of postoperative pain was evaluated using numerical rating scale (NRS) within 24 h after surgery; NRS ≥ 5 was considered as clinically significant postoperative pain. Risk factors associated with the development of postoperative pain were analyzed by multivariate logistic regression analysis. RESULTS Clinically significant postoperative pain was experienced at any time after glaucoma surgery in 41.75% of the patients, which peak at 2 h. 27.8% of the patients requested analgesic medication within 24 h after surgery. According to multivariate logistic regression analysis, preoperative anxiety (OR = 4.13 [1.29-13.2], p = 0.017), cyclophotocoagulation (OR = 30.9 [3.47-375.1], p = 0.002), and phacotrabeculectomy combined with or without intraocular lens implantation (OR = 30.0 [2.69-335.6], p = 0.006) were associated with increased clinically significant postoperative pain. Interestingly, patients with diabetes and/or hypertension were associated with less postoperative pain after glaucoma surgery (OR = 0.23 [0.08-0.64], p = 0.005). CONCLUSION Patients undergoing glaucoma surgery tend to experience postoperative pain in the early postoperative period. Anxiety level and surgery types of cyclophotocoagulation and phacotrabeculectomy are risk factors for postoperative pain. Patients with diabetes and/or hypertension are less likely to develop postoperative pain.
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10
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Blizzard C, McLaurin EB, Driscoll A, Silva FQ, Vantipalli S, Metzinger JL, Goldstein MH. Plasma Pharmacokinetic Parameters of Dexamethasone Following Administration of a Dexamethasone Intracanalicular Insert in Healthy Adults. Clin Ophthalmol 2021; 15:2055-2061. [PMID: 34040341 PMCID: PMC8140928 DOI: 10.2147/opth.s307194] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 04/12/2021] [Indexed: 02/04/2023] Open
Abstract
Purpose Intracanalicular dexamethasone insert is a resorbable sustained-release polyethylene glycol-based hydrogel insert delivering a 0.4 mg tapered dose of dexamethasone for up to 30 days to the ocular surface. It is FDA-approved for treating inflammation and pain after ocular surgery. It has also been studied for ocular surface diseases such as allergic conjunctivitis. This study assessed the plasma pharmacokinetic (PK) parameters of dexamethasone following intracanalicular insertion. Patients and Methods Study subjects (N=16) were healthy adults. A dexamethasone insert was unilaterally placed into the canaliculus, and blood samples were obtained for analysis 1 hour prior to insertion and 1, 2, 4, 8, 16, 24 hours and 4, 8, 15, 22 and 29 days after insertion. Safety analyses included slit lamp and dilated fundus examinations, best corrected visual acuity, intraocular pressure (IOP) and adverse events (AEs). Results Plasma results were below the lower limit of quantitation (LLOQ) at all time points in five subjects (31.3%). Among subjects with quantifiable plasma concentrations, Cmax was <1 ng/mL (range, 0.05 to 0.81 ng/mL), AUC0-last ranged from 0.13 to 7.18 h∙ng/mL, and Tmax ranged from 4.0 to 163.0 hours. Mean (SD) IOP increased from 16.3 (1.4) mmHg at baseline to 19.3 (3.2) at Day 22 but returned to baseline after treatment. No changes occurred in dilated fundus, punctum, or visual acuity examinations. Conclusion The dexamethasone 0.4 mg insert results in minimal systemic exposure following intracanalicular administration.
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11
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Bertens CJF, Dunker SL, Dias AJAA, van den Biggelaar FJHM, Nuijts RMMA, Gijs M. Safety and Comfort of an Innovative Drug Delivery Device in Healthy Subjects. Transl Vis Sci Technol 2021; 9:35. [PMID: 33384889 PMCID: PMC7757610 DOI: 10.1167/tvst.9.13.35] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 11/18/2020] [Indexed: 02/07/2023] Open
Abstract
Purpose The aim of this study was to investigate safety and comfort of two versions of a placebo-microsphere filled ocular coil (straight and curved) in healthy subjects. Methods The study was a single-center intervention study. One ocular coil was placed in the inferior conjunctival fornix for the intended duration of 28 days. Forty-two healthy adult subjects were included. At baseline, 30 minutes, 8 hours, 24 hours, 48 hours, 7 days, 14 days, 21 days, and 28 days after insertion, examinations were performed, including slit lamp evaluation to score ocular redness, intraocular pressure measurement, visual acuity, tear secretion test, and questionnaires. Results The straight and curved ocular coils had a median retention time of 5 days and 12 days, respectively. After 48 hours, 57% and 81% subjects retained the straight and curved ocular coil, respectively. Four (19%) subjects with the straight coil and six (29%) with the curved coil completed the entire study period. Minor changes in ocular hyperemia were observed in both groups. On day 7, the straight coil was more comfortable than the curved coil with a visual analogue scale (VAS) score of 77 ± 21 compared to 94 ± 11 (P = 0.028), respectively. No other ocular adverse events were observed. Conclusions Comfort and safety of the straight and curved ocular coil are high. Because the retention time is too short for long-term sustained drug release, the use in the perioperative or immediate postoperative period could prove to be more valuable. Translational Relevance The ocular coil is a noninvasive, comfortable and safe short-term drug delivery device.
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Affiliation(s)
- Christian J F Bertens
- Chemelot Institute for Science and Technology (InSciTe), GS Maastricht, The Netherlands
| | - Suryan L Dunker
- University Eye Clinic Maastricht, Maastricht University Medical Center+ (MUMC+), HX Maastricht, The Netherlands.,Maastricht University, School for Mental Health and Neuroscience, University Eye Clinic Maastricht, ER Maastricht, The Netherlands
| | - Aylvin J A A Dias
- Chemelot Institute for Science and Technology (InSciTe), GS Maastricht, The Netherlands.,Eyegle bv. Gerbergaplantsoen 11, Maastricht, The Netherlands
| | - Frank J H M van den Biggelaar
- Chemelot Institute for Science and Technology (InSciTe), GS Maastricht, The Netherlands.,University Eye Clinic Maastricht, Maastricht University Medical Center+ (MUMC+), HX Maastricht, The Netherlands
| | - Rudy M M A Nuijts
- Chemelot Institute for Science and Technology (InSciTe), GS Maastricht, The Netherlands.,University Eye Clinic Maastricht, Maastricht University Medical Center+ (MUMC+), HX Maastricht, The Netherlands
| | - Marlies Gijs
- Chemelot Institute for Science and Technology (InSciTe), GS Maastricht, The Netherlands
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Greenwood MD, Gorham RA, Boever KR. A Randomized Fellow-Eye Clinical Trial to Evaluate Patient Preference for Dexamethasone Intracanalicular Insert or Topical Prednisolone Acetate for Control of Postoperative Symptoms Following Bilateral Femtosecond Laser in Site Keratomileusis (LASIK). Clin Ophthalmol 2020; 14:2223-2228. [PMID: 32821083 PMCID: PMC7418164 DOI: 10.2147/opth.s265311] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 07/28/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose To determine the preference of patients undergoing bilateral LASIK for either the dexamethasone intracanalicular insert or topical prednisolone acetate for control of postoperative symptoms and ocular surface signs. Methods In this randomized clinical trial, one eye was randomized to receive the dexamethasone insert or topical prednisolone acetate 1% four times daily for one week and 2 times daily for a second week; the fellow eye received the alternate therapy. One month postoperatively, patient preference for these two therapies was assessed using an adapted COMTOL questionnaire. Ocular comfort was assessed using the SPEED questionnaire. Corneal staining and uncorrected distance visual acuity (UDVA) were also assessed. Results Twenty patients participated. At Month 1, 80% of patients preferred the dexamethasone insert, 10% preferred prednisolone acetate, and 10% expressed no preference (p<0.001). SPEED scores measuring ocular comfort/discomfort related to dry eye symptoms were similar between groups (p=0.72), and both the incidence of patient-reported ocular dryness and the corneal staining scores were similar between groups. Both groups attained the same final UDVA. Conclusion Patients undergoing elective bilateral femtosecond LASIK surgery overwhelmingly (by an 8-to-1 margin) preferred the dexamethasone insert to topical prednisolone acetate for postoperative treatment. The insert produced comparable ocular comfort, corneal staining, and visual acuity outcomes to topical prednisolone. The insert is an appropriate means of postoperative symptom control in this quality of life-conscious population.
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Affiliation(s)
| | | | - Keeley R Boever
- Ektropia Solutions LLC, Laguna Beach, CA, USA.,Vance Thompson Vision, Sioux Falls, SD, USA
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13
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Karava A, Lazaridou M, Nanaki S, Michailidou G, Christodoulou E, Kostoglou M, Iatrou H, Bikiaris DN. Chitosan Derivatives with Mucoadhesive and Antimicrobial Properties for Simultaneous Nanoencapsulation and Extended Ocular Release Formulations of Dexamethasone and Chloramphenicol Drugs. Pharmaceutics 2020; 12:pharmaceutics12060594. [PMID: 32604758 PMCID: PMC7356116 DOI: 10.3390/pharmaceutics12060594] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Revised: 06/23/2020] [Accepted: 06/24/2020] [Indexed: 01/31/2023] Open
Abstract
The aim of this work was to evaluate the effectiveness of neat chitosan (CS) and its derivatives with 2-acrylamido-2-methyl-1-propanesulfonic acid (AAMPS) and [2-(methacryloyloxy)ethyl]dimethyl-(3-sulfopropyl)ammonium hydroxide (MEDSP) as appropriate nanocarriers for the simultaneous ocular administration of dexamethasone sodium phosphate (DxP) and chloramphenicol (CHL). The derivatives CS-AAMPS and CS-MEDSP have been synthesized by free-radical polymerization and their structure has been proved by Fourier-Transformed Infrared Spectroscopy (FT-IR) spectroscopy. Both derivatives exhibited low cytotoxicity, enhanced mucoadhesive properties and antimicrobial activity against Staphylococcus aureus (S.aureus) and Escherichia coli (E. coli). Encapsulation was performed via ionic crosslinking gelation using sodium tripolyphosphate (TPP) as the crosslinking agent. Dynamic light scattering measurements (DLS) showed that the prepared nanoparticles had bimodal distribution and sizes ranging from 50–200 nm and 300–800 nm. Drugs were encapsulated in their crystalline (CHL) or amorphous (DexSP) form inside nanoparticles and their release rate was dependent on the used polymer. The CHL dissolution rate was substantially enhanced compared to the neat drug and the release time was extended up to 7 days. The release rate of DexSP was much faster than that of CHL and was prolonged up to 3 days. Drug release modeling unveiled that diffusion is the main release mechanism for both drugs. Both prepared derivatives and their drug-loaded nanoparticles could be used for extended and simultaneous ocular release formulations of DexSP and CHL drugs.
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Affiliation(s)
- Aikaterini Karava
- Department of Chemistry, National and Kapodistrian University of Athens, Panepistimiopolis, Zografou, 15771 Athens, Greece;
| | - Maria Lazaridou
- Laboratory of Chemistry and Technology of Polymers and Dyes, Department of Chemistry, Aristotle University of Thessaloniki, GR54124 Thessaloniki, Greece; (M.L.); (S.N.); (G.M.); (E.C.)
| | - Stavroula Nanaki
- Laboratory of Chemistry and Technology of Polymers and Dyes, Department of Chemistry, Aristotle University of Thessaloniki, GR54124 Thessaloniki, Greece; (M.L.); (S.N.); (G.M.); (E.C.)
| | - Georgia Michailidou
- Laboratory of Chemistry and Technology of Polymers and Dyes, Department of Chemistry, Aristotle University of Thessaloniki, GR54124 Thessaloniki, Greece; (M.L.); (S.N.); (G.M.); (E.C.)
| | - Evi Christodoulou
- Laboratory of Chemistry and Technology of Polymers and Dyes, Department of Chemistry, Aristotle University of Thessaloniki, GR54124 Thessaloniki, Greece; (M.L.); (S.N.); (G.M.); (E.C.)
| | - Margaritis Kostoglou
- Laboratory of Chemical and Environmental Technology, Department of Chemistry, Aristotle University of Thessaloniki, GR-54124 Thessaloniki, Greece;
| | - Hermis Iatrou
- Department of Chemistry, National and Kapodistrian University of Athens, Panepistimiopolis, Zografou, 15771 Athens, Greece;
- Correspondence: (H.I.); (D.N.B.); Tel.: +30-210-7274056 (H.I.); +30-2310-997812 (D.N.B.)
| | - Dimitrios N. Bikiaris
- Laboratory of Chemistry and Technology of Polymers and Dyes, Department of Chemistry, Aristotle University of Thessaloniki, GR54124 Thessaloniki, Greece; (M.L.); (S.N.); (G.M.); (E.C.)
- Correspondence: (H.I.); (D.N.B.); Tel.: +30-210-7274056 (H.I.); +30-2310-997812 (D.N.B.)
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