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May 26, 2020
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Patient, physician satisfaction high for Dextenza after cataract surgery

High visualization, ease of use and greater pain reduction for up to 30 days after cataract surgery led to higher patient and physician ratings for Dextenza compared with placebo, according to a speaker.

“Clinical visualization allows for consistent postoperative treatment and monitoring by multiple health care professionals and results in a positive patient experience with Dextenza,” Cathleen M. McCabe, MD, said at the virtual American Society of Cataract and Refractive Surgery meeting.

There is a need for sustained-release therapies after ophthalmic surgery, McCabe said. Eye drops can be a burden for patients and increase hand-to-face contact, which can lead to higher risks for infection. Dextenza (dexamethasone ophthalmic insert 0.4 mg, Ocular Therapeutix) is a hands-free alternative to traditional eye drops.

McCabe and colleagues conducted a pooled post hoc analysis of 926 patients who underwent cataract surgery with intracanalicular insertion on day 1 and were then randomly assigned into three phase 3 trials. The researchers evaluated the physician experience of ease of product use on day 1 and ease of visualization on days 2, 4, 8, 14 and 30. Patient experience was quantified on a 5-point Likert scale at day 30 with an end-of-study questionnaire.

 

The analysis included 541 subjects who received the dexamethasone ophthalmic insert and 385 who received placebo. Topical NSAIDs were not prescribed in either group.

Physicians rated the dexamethasone insert as easy or moderately easy to insert in 97.7% of patients. Visualization of the insert was rated as easy or moderately easy at all visits up to 30 days. At day 30, the insert was visualized in 90.4% of patients, McCabe said.

Pain was more effectively managed with the insert, according to results of the postoperative day 30 questionnaire.

“There was a statistically significant difference in the rating of pain symptoms, eye discomfort, treatment of eye pain and treatment of eye discomfort between patients treated with placebo and Dextenza,” McCabe said.

Patients rated the overall experience very highly, as 96% of those who received the dexamethasone ophthalmic insert described it as somewhat, very or extremely comfortable. Additionally, 93% said they would somewhat, very or extremely likely request the insert if they were to undergo another cataract surgery. Finally, 93% of patients said they were somewhat, very or extremely satisfied with the insert, and 97% rated their experience as somewhat, very or extremely convenient, McCabe said. – by Robert Linnehan

Reference:

McCabe CM. Patient and physician preference for an intracanalicular dexamethasone insert for treating inflammation and pain following cataract surgery. Presented at: American Society of Cataract and Refractive Surgery meeting; May 16-17, 2020 (virtual meeting).

Disclosure: McCabe reports she receives grant support from Ocular Therapeutix.