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G. Roberti, M. Centofanti, F. Oddone, L. Tranchina, G. Manni; Ocular Discomfort Due to Hypotensive Eye Drop as Cause of Therapy Switches. Invest. Ophthalmol. Vis. Sci. 2009;50(13):2454.
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to estimate the incidence of therapy switches due to toxic or allergic reactions or dysfunctional tear syndrome (DTS) related to preserved ocular hypotensive eye drops in the ocular hypertension and glaucoma population.
this was a clinical retrospective database analysis. All patients must had a minimum of 6 months of follow up data to be included in the study. Primary endpoint was to estimate incidence of DTS and hypersensitivity/allergy (HA) caused by hypotensive eye drop and drug switch therapy due to ocular discomfort. Secondary endpoint was to determine its impact on patients’ number of visits, long term intraocular pressure (IOP) control and costs. Costs were calculated according to the Italian National Health Service.
four hundred and twenty-eight patients referred to glaucoma service of Policlinico Tor Vergata, Rome and Fondazione GB Bietti-IRCCS, Rome were analysed: 203 patients (47,4%) had DTS, while 75 (17,5%) had ocular HA. The switch rate was statistically higher among patients with DTS (0,4±0,4/y ) and patients with HA (0,6±0,5/y) than the others (0,16±0,4/y p<0,0001 and 0,2±0,4/y p<0,0001). The most frequent reasons for change were insufficient IOP control (63,5%) and HA (16,9%). Thirty patients underwent trabeculectomy (TRAB), while 9 underwent argon laser trabeculoplastic (ALT); only TRAB was statistically more frequent in patients with higher rate of drug switch (p=0,02). The number of the visits was statistically higher among patients with DTS (3,1±1,3/y), than patients without (2,5±1,0/y p<0,0001), and among patients with HA (3.3±1,6/y) than patients without (2,7±1,1/y p<0,0014). The costs were statistically higher for patients with DTS (41,9±18 €/y) than patients without (33,8±13,5 €/y, p<0,0001) and for patients with HA (44,8±21,6 €/y ) than patients without (36,2±14,6 €/y).
patients with DTS and HA related to ocular hypotensive eye drop had a significant higher number of visits, change therapy and need for surgical interventions with more costs for the community.
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