Intraocular Pressure and Medication Changes Associated with Xen Gel Stent: A Systematic Review of the Literature.

The Xen gel stent (Allergan Inc, an AbbVie company; Dublin, Ireland) was conceived as an option for patients requiring modest IOP reduction but for whom trabeculectomy was not yet indicated. As with any glaucoma surgery, establishing criteria for patient selection and identifying factors that contribute to a high likelihood of success are important. To help guide clinical decision-making, a systematic review of published studies on the gel stent was performed, with the goal of understanding postoperative outcomes based on clinical and patient factors.

The Effect of an Educational Intervention on Adherence to Intraocular Pressure-Lowering Medications in a Large Cohort of Older Adults with Glaucoma.

Background: Glaucoma is a progressive, irreversible disease that can lead to vision loss and lower quality of life if treatment is not optimized. Effective glaucoma therapies are available to lower intraocular pressure (IOP) and minimize or delay disease progression. Nonetheless, adherence to treatment remains suboptimal for many patients.

Predictors of Nonadherence to Topical Intraocular Pressure Reduction Medications Among Medicare Members: A Claims-Based Retrospective Cohort Study.

Background: Reported adherence rates with ocular hypotensive medications typically range from 51% to 56% over the first year of therapy. As intraocular pressure (IOP) reduction slows the progression of vision loss from glaucoma, early identification of nonadherent members is crucial to effective disease management.

Objectives: To (a) identify member characteristics and other factors related to nonadherence with topical IOP-lowering medications available in administrative claims data and (b) create a predictive model incorporating these variables.

Understanding dry eye disease: a managed care perspective.

Dry eye disease (DED) is a multifactorial disorder that results in eye discomfort, visual disturbance, and often ocular surface damage. This supplement to The American Journal of Managed Care discusses the prevalence of DED and the economic burden associated with DED. The etiology and pathophysiology of DED will also be discussed, including disease progression and impact on the patient's quality of life.

Cost-offset analysis: bimatoprost versus other prostaglandin analogues in open-angle glaucoma.

Objectives: To develop a cost-offset model from a US payer perspective comparing glaucomatous progression and costs among primary open-angle glaucoma (POAG) patients using bimatoprost, latanoprost, or travoprost.

Study Design: Cost-offset model.

Methods: A Markov cohort model was used to estimate glaucomatous progression for POAG patients over 7 years.

Aqueous and vitreous penetration of linezolid and levofloxacin after oral administration.

Purpose: To evaluate the time course of drug concentrations achieved in aqueous (AQ), vitreous (V), and serum (S) compartments after oral administration of linezolid and levofloxacin.

Design: Randomized, clinical trial.

Settings: Clinical practice.

An adaptable HPLC method for the analysis of frequently used antibiotics in ocular samples.

Four different antibiotics, delivered individually to rabbit eyes via hydrophilic intraocular lenses soaked in the drug solution prior to implantation, were measured in aqueous and vitreous humor samples from the eyes. To meet this analytical need, we developed a sensitive, high performance liquid chromatographic (HPLC) method for measuring the concentrations of moxifloxacin, gatifloxacin, linezolid, and cefuroxime in the ocular tissue. Separations were carried out on a LichroSpher RP-18 column, maintained at room temperature.

Interaction of intravitreal combination drugs and the effect on the targeted site.

Background: After evaluating experimentally the diffusion processes in the retina using peroxidase as a tracer material (previously published work), we found that junctional complexes of the retinal pigment epithelium and retinal capillaries were the major impediment to free diffusion between the retina and choroidal-retinal blood vessels. These experiments indicated that to achieve high therapeutic concentrations of medications inside the eye, it was necessary to administer them by intravitreal injection. Soon after initial experimental work the necessity of combining antibiotics or antibiotics with steroids became obvious.

Combination angiostatic therapies: current status.

One of the most important obstacles to combining pharmaceutical agents to treat ocular diseases is the risk of physiochemical reactions. In intraocular administration, these reactions may produce incompatibility, instability, or both. They may change the nature of drug activity, and they may threaten normal cellular function, resulting in lens opacities, corneal toxicity, retinal cell damage, or other adverse outcomes.

Cost of illness of glaucoma: a critical and systematic review.

Cost-of-illness studies determine the total financial burden of a disease by considering direct and indirect costs, including medication, diagnostics and surgery. Studies of resource use and costs associated with primary open-angle glaucoma have used varying methodologies. Most have focused on consumption of healthcare resources at various stages of disease to anticipate costs.

Third- and fourth-generation fluoroquinolones: retrospective comparison of endophthalmitis after cataract surgery performed over 10 years.

Purpose: To determine differences in endophthalmitis rates with prophylactic use of third- versus fourth-generation fluoroquinolones in cataract surgery.

Setting: University hospitals.

Methods: This retrospective cross-sectional (prevalence) study looked at patients who had phacoemulsification at a university eye center over a 10-year period.

Utilization characteristics of topical cycolsporine and punctal plugs in a managed care database.

A retrospective administrative claims analysis of treatment options for dry eye disease (DED) evaluated treatment patterns and utilization characteristics of patients receiving cyclosporine, punctal plugs, or a combination of cyclosporine and punctal plugs, and examined differences in health plan costs with the 2 treatments. A total of 23,821 commercial health plan enrollees that initiated treatment with cyclosporine or punctal plugs between January 1, 2004, and December 31, 2005, were reviewed. There were 9065 subjects in the cyclosporine group, with a mean of 3.

Refill rates and budget impact of glaucoma lipid therapy: a retrospective database analysis.

Background And Objective: Drugs in the lipid class of glaucoma medications, including bimatoprost, travoprost and latanoprost, are effective at lowering intraocular pressure. In addition to clinical efficacy, the budget impact of long-term therapy with each medication is important for patients, physicians and managed-care decision makers to differentiate between the products and make informed decisions regarding the choice of therapy. This study aimed to determine the average number of days between refills for latanoprost, travoprost and bimatoprost, and to estimate the potential effect of differences in refill rates on pharmacy budgets.

Topical ophthalmic fourth-generation fluoroquinolones: Appropriate use and cost considerations.

Purpose: The utilization and refill rates of topical ophthalmic fourth-generation fluoroquinolones among physicians, as well as the associated costs, were studied.

Methods: A large data set of retrospective pharmacy prescription claims was obtained from multiple plans, including commercial managed care organizations, Medicaid, and Medicare. The data included the number and cost of all new and refill prescriptions for six months for gatifloxacin 0.

Efficiency of instillation methods for prostaglandin medications.

Purpose: The aim of this study was to determine the most efficient methods for instillation of prostaglandin analogs.

Methods: Drops were dispensed at room temperature from 2.5-mL bottles of bimatoprost, travoprost, and latanoprost.

The effect of temperature on the antimicrobial activity of Optisol-GS.

Purpose: To determine the survival of different bacteria inoculated in Optisol-GS at refrigerated storage temperature (6 degrees C) and after subsequent warming to room temperature (19-22 degrees C).

Methods: Staphylococcus aureus, Enterococcus faecium, Streptococcus pneumoniae, and Pseudomonas aeruginosa were chosen from stock clinical isolates for inclusion in the study. The first group consisted of 12 Optisol-GS vials.

Methotrexate reduces the complications of endophthalmitis resulting from intravitreal injection compared with dexamethasone in a rabbit model.

Purpose: The incidence of infectious endophthalmitis associated with intravitreal injection (IVI) of steroid has been reported to be as high as 0.87%. This study was designed to investigate whether the antimicrobial activity of intravitreal methotrexate (MTX) alters the incidence or course of bacterial endophthalmitis associated with IVI in a rabbit model.

Estimated comparative costs of achieving a 20% reduction in intraocular pressure with bimatoprost or latanoprost in patients with glaucoma or ocular hypertension.

Background: Although the probability of treatment success should be the primary factor guiding the choice of an intraocular pressure (IOP)-lowering medication, treatment cost is also important to physicians, patients and third-party payers. The objective of the present study was to compare the cost effectiveness of bimatoprost with that of latanoprost in the treatment of glaucoma and ocular hypertension.

Methods: Estimated yearly costs and cost per treatment success for bimatoprost ophthalmic solution 0.

Measurement of persistence and adherence to regimens of IOP-lowering glaucoma medications using pharmacy claims data.

Purpose: Determine persistence and adherence of glaucoma patients to therapeutic regimens of prostaglandin/prostamide-class IOP-lowering medications.

Design: Retrospective, population-based study.

Methods: Glaucoma patients in the IMS Health LifeLink database with a pharmacy claim for latanoprost (n = 1567), travoprost (n = 381), or bimatoprost (n = 476) between September, 2001 and March, 2002 who had no claims for IOP-lowering medication in the previous 180 days, and who were persistent during the first 90 days of therapy.