BID Postoperative Drops
January 5, 2010DrHovanesian No Comments »BID Postoperative Drops = Better Compliance = Better Outcomes?
How many of our patients take eyedrops as prescribed for QID use faithfully four times a day? According to studies of patient compliance, less than 50% of patients do. So how compliant are our postoperative cataract patients with a QID regimen of three medications: steroid, non-steroidal, and antibiotic?
With this question in mind, my practice partners and I switched our routine postoperative cataract regimen to three drops, all taken BID. Looking at pharmacokinetic data on available drugs, Ista’s Xibrom is a non-steroidal that is already indicated for BID dosing. Sirion’s (soon to be Alcon’s) Durezol has shown steroid potency nearly twice that of prednisolone acetate as well as dose consistency data that far exceeds the familiar suspension, so we felt comfortable using Durezol BID after surgery. As to an antibiotic the best candidate seemed to be Vistakon’s Iquix (levofloxacin 1.5%). Levofloxacin is a highly respected antibiotic among infectious disease specialists, and Iquix’s concentratio is three times higher than Vigamox’s moxifloxacin 0.5% and five times more concentrated than Zymar’s gatifloxacin 0.3%.
We are now three months and several hundred patients into our new BID postop regimen, and we have yet to see (knocking wood) any complications related to our postoperative regimen. Furthermore, we feel much more confident that our patients are actually getting the drops we’re prescribing. Patients love the new regimen too, since it allows them the freedom to go about their day without having to drag along eyedrops.
I encourage readers to comment on their own spproaches to simplify postoperative management.
Dr. Hovanesian is a consultant to Allergan, Bausch & Lomb, Inspire, Ista, and Sirion and has no financial interest in Vistakon.
Says John A. Hovanesian, MD, “The financial impact of the abuse of lubricant eye drops by patients exceeds the cost of alternative treatments that would, in many cases, provide greater relief to patients.”
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