research digest

High-Tech Eye Drop Monitor Measures Compliance

A study conducted at the Dunyagoz Clinic, Istanbul, Turkey, used commercially available eyedrops containing a fixed combination of prednisone and gentamycin (Inflanegent, Allergan) with a new microprocessor-controlled compliance monitor to study compliance with postoperative topical ocular therapy in ambulant cataract patients. The study was published in the July issue of Investigative Ophthalmology & Visual Science and presented at the 2005 ARVO Conference in Fort Lauderdale, Fla.

Twenty cataract patients (mean age 62.9 years) were asked to apply the drops 5 times daily to one eye between the hours of 8 a.m. and 10 p.m. for 14 days postoperatively. Patients were observed on day 14. Ten of the 20 patients were randomly assigned to keep the bottles refrigerated in order to study the temperature sensor of the monitoring device.

Investigators found, according to the monitoring device, that of the prescribed total dose of 70 drops per eye, 10 patients took less than one half of the prescribed total dose, four patients took less than one-quarter of the prescribed medication, and one patient was treated day 1 postop only.

The patients who were randomized to refrigerate their bottles had considerably lower recorded temperatures when compared with the other participants.

Ophthalmology Management asked Michael Diestelhorst, M.D., a lead investigator of the study, to comment on the findings. "One of the most frustrating problems faced by patients and their relatives is failure to adhere to the medications that have been prescribed. "Although most people suffering from illnesses receive considerable benefit from taking medications, a sizeable percentage drop them at some point in their illness," he said. "This period of destabilization can result in a serious setback to the progress that the patient has made when properly medicated. Monitoring individual adherence is of importance to understand how and why some of our patients do fail with their therapy."

LASIK Outcomes: Comparison of Two Keratome Models

Another article published in the July issue of Investigative Ophthalmology & Visual Science and presented at the 2005 ARVO Conference in Fort Lauderdale, Fla., focused on the comparison of a laser keratome to a mechanical microkeratome.

This study was conducted at the McGill Laser Center, Medical University of South Carolina, Charleston, S.C. The study included 15 bilateral myopic patients undergoing bilateral, customized LASIK ablation. One eye of each patient was randomized to IntraLase (Irvine, Calif.) and the fellow eye to Amadeus (AMO, Santa Ana, Calif.).

Visual acuity, subjective questionnaire, contrast sensitivity, corneal sensation, basic secretion test, as well as wavefront and ocular surface staining were measured preoperatively, and at 1 and 3 months postoperatively. The flap diameter, hinge size and flap thickness were measured intraoperatively.

Investigators found that overall, the accuracy of treatment at 1 month with the Amadeus was greater than 65%, where the IntraLase was greater than 60% at ±0.25 D. The Amadeus and IntraLase were both 100% at ±0.5 D. The subjective questionnaire that was used during the study showed that at week 1 postop, vision fluctuation was more likely with the IntraLase, and clarity of vision was more likely with the Amadeus. The questionnaire also found dry eye was likely with the IntraLase, whereas dry eye did not occur in patients who had LASIK with the Amadeus.

Ophthalmology Management asked Kerry Solomon, M.D., a lead investigator of the study to discuss the finding. "They are both good devices, and they both create excellent flaps," he said. "What's unique about this study is that it was contralateral, giving patients something to base a comparison on." He added that, "What this study seems to indicate is that there is significantly more discomfort and a longer rehabilitative time period in terms of quality of vision with the IntraLase compared to the Amadeus."