Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2022 Aug 6:16:2429-2440.
doi: 10.2147/OPTH.S372440. eCollection 2022.

Early Real-World Physician Experience with an Intracanalicular Dexamethasone Insert

Cynthia Matossian  1 , John D Stephens  2 , Michelle K Rhee  3 , Stephen E Smith  4 , Parag A Majmudar  5 , Subba Rao Gollamudi  6 , Ravi H Patel  7 , Maria E Rosselson  5 , Aditi Bauskar  8 , Alyssa Montieth  8 , Fabiana Q Silva  8 , Srilatha Vantipalli  8 , Andrea Gibson  8 , Jamie Lynne Metzinger  8 , Michael H Goldstein  8
Affiliations

Early Real-World Physician Experience with an Intracanalicular Dexamethasone Insert

Cynthia Matossian et al. Clin Ophthalmol. .

Abstract

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.

Keywords: hands-free therapy; intracanalicular dexamethasone insert; ocular inflammation; ocular pain; phacoemulsification; sustained-release drug delivery.

PubMed Disclaimer

Conflict of interest statement

Funding/support provided by Ocular Therapeutix, Inc. Cynthia Matossian, John D Stephens, Steven E Smith, Parag A Majmudar, Subba Rao Gollamudi, Ravi H Patel, and Maria E Rosselson received support from Ocular Therapeutix, Inc. for their participation in the study. Aditi Bauskar, Alyssa Montieth, Fabiana Q Silva, Srilatha Vantipalli, Andrea Gibson, Jamie Lynne Metzinger, and Michael H Goldstein are employees of Ocular Therapeutix, Inc. Michelle K Rhee reports grants from Ocular Therapeutix, on advisory board for NovaBay and Nevakar, outside the submitted work; and Research support from Ocular Therapeutix. The authors report no other conflicts of interest in this work.

Figures

Figure 1
Figure 1
Placement of the Dexamethasone Intracanalicular Insert in the canaliculus of the eye.
Figure 2
Figure 2
Design of the Phase 4 study.
Figure 3
Figure 3
(A) Physicians reported how many intracanalicular dexamethasone inserts were placed before becoming comfortable with insertion. (B) Physician rating of an intracanalicular dexamethasone insert in overall comfort (on a Likert scale of 1 to 7, with 1 being not comfortable and 7 being very comfortable), experience (on a Likert scale of 1 to 7, with 1 being very difficult and 7 being very easy), and overall satisfaction (on a Likert scale of 1 to 7, with 1 being extremely dissatisfied and 7 being extremely satisfied).
Figure 4
Figure 4
Proportion of patients with a comorbidity who received an intracanalicular dexamethasone insert for cataract surgery.
Figure 5
Figure 5
Mean score on a Likert scale of 1 to 7 of the most important attributes of an intracanalicular corticosteroid therapy by physicians. Scores were recorded before insertion (indicated by dark blue) and 30 days after insertion (indicated by light blue) in at least 5 patients. Scores ranged from 1 (not important at all) to 7 (extremely important).
See this image and copyright information in PMC

References

    1. Weiner G. Savvy steroid use. Eyenet Web site. Available from: https://www.aao.org/eyenet/article/savvy-steroid-use. Accessed August 10, 2021.
    1. Newman-Casey PA, Robin AL, Blachley T, et al. The most common barriers to glaucoma medication adherence: a cross-sectional survey. Ophthalmology. 2015;122(7):1308–1316. doi:10.1016/j.ophtha.2015.03.026 - DOI - PMC - PubMed
    1. An JA, Kasner O, Samek DA, Levesque V. Evaluation of eyedrop administration by inexperienced patients after cataract surgery. J Cataract Refract Surg. 2014;40(11):1857–1861. doi:10.1016/j.jcrs.2014.02.037 - DOI - PubMed
    1. Cataract Surgeons for Improved Eyecare. Analysis of the economic impacts of dropless cataract therapy on Medicare, Medicaid, state governments, and patient costs. Available from: http://stateofreform.com/wp-content/uploads/2015/11/CSIE_Dropless_Econom.... Accessed August. 10, 2021.
    1. Durezol ® (difluprednate ophthalmic emulsion) [package insert]. East Hanover, New Jersey: Novartis Pharmaceuticals; 2020.