Baseline Evaluation of Successful Eye-Drop Instillation in Glaucoma Patients Enrolled in a Randomized Clinical Trial Comparing Open versus Closed Eye-drop Instillation Technique

Abstract

Purpose: : To describe rate of success for eyedrop instillation in glaucoma patients under chronic medical therapy in a developing country setting.

Methods: : Glaucoma patients and suspects from the glaucoma service at Hospital Sotero del Rio, Santiago, Chile were included in the study. Eligibility criteria included bilateral topical treatment for >=1 years and habitual correction visual acuity of 20/60 or better in at least one eye were included in the study. Patients were asked to instill one eyedrop of 0.25% fluorescein into each eye using their habitual technique while being videotaped. The eye for initial instillation was randomly assigned. Video files were coded and evaluated in a masked fashion for number of drops used, whether at least one drop reached the eye and bottle tip contamination.Total success was defined as getting the drop in the eye using only one eyedrop and qualified success was defined as getting the drop in the eye irrespective of the number of drops used. This report is restricted to the first eye.

Results: : One-hundred and fifty-four patients with a mean age of 72.3 years (SD=9.6) were enrolled. 60% were women and the average mean deviation was -11.2dB (SD=9.5). Total and qualified success was achieved by 88/154 (57%) and 149/154 (96%) of the patients respectively. The average number of drops used during eyedrop instillation was 1.7 (SD=1.4) and 24.7% used 2 drops and 16.9% more than 2. Fifty percent of the patients contaminated the bottle tip during the instillation process.

Conclusions: : Most glaucoma patients manage to successfully get an eyedrop into the eye, however, almost half the patients use more than one drop in the process. Wasted medications, particularly in a developing country setting where health insurance does not cover the cost of glaucoma therapy, can be a barrier to glaucoma therapy compliance and should be further studied.

Clinical Trial: : http://www.clinicaltrials.gov NCT01417689

Keywords: drug toxicity/drug effects • clinical (human) or epidemiologic studies: treatment/prevention assessment/controlled clinical trials