Over the past decade, research and development in ophthalmic drugs has led to exciting new delivery mechanisms, such as timed-delivery implants and mucus-penetrating nanoparticles, that can improve drug efficacy, minimize side effects, and reduce concerns about patient compliance with ophthalmic regimens. drops. modes.
Contact lenses are considered a promising mechanism, and drug-coated lenses are currently being investigated for infections, dry eye syndrome (DES), glaucoma, and allergies. one
Первая контактная линза с лекарственным покрытием, получившая одобрение FDA ранее в этом году (Acuvue Theravision с кетотифеном [Johnson & Johnson Vision]), представляет собой этафилкон А для ежедневного применения, обладающий противовоспалительными свойствами, обычно используемый в глазных каплях от аллергии. The first drug-coated contact lens to receive FDA approval earlier this year (Acuvue Theravision with Ketotifen [Johnson & Johnson Vision]), is a daily etafilcon A anti-inflammatory, commonly used in allergy eye drops. ketotifen.
Most Popular Contact Lenses
Contact lenses are just as effective as eye drops. 2 Since this is a new mode of insertion, during the clinical study of this contact lens, my colleagues and I collected additional data for completeness.
We analyzed 2 clinical trials with the same multicentre randomized controlled design, which included more than 500 patients. The results, recently published in Clinical and Experimental Optometry, paint a promising picture for patients, practitioners, and the future of this technique. 3
Long-term use of eye drops is known to lead to drug-induced conjunctivitis – redness, inflammation and burning of the eyes after prolonged exposure to the ingredients of the drops (primarily preservatives). four
This discomfort not only interferes with the patient’s daily activities and quality of life, but also prevents the patient from continuing to use eye drops because the patient does not want to add more eye drops to an already irritated eye. 5
When a patient has this condition, corneal staining often shows disruption of the integrity of the corneal epithelium, suggesting that treatment should be adjusted to help the eye heal and prevent further damage.
Avoiding contact with harsh chemicals, such as allergy-damaged eyes, is especially important for reducing drug-induced conjunctivitis.
Frequent dosing is often required because eye drops have low bioavailability—only 5–10% of the drug is available on the surface of the eye6—and are quickly washed off by blinking and lacrimation.
Medication-coated contact lenses offer a number of benefits that can eliminate some of the problems associated with eye drops, including:
The drug is added to the lens during the manufacturing process, which also includes an autoclave sterilization step. Therefore, they do not require preservatives such as BAC, which break the bonds between corneal epithelial cells. Each lens provides a sterile dose of the drug.
Medication-coated contact lenses deliver medication within hours, so they stay on the surface of the eye for much longer than eye drops that wash off quickly. The diffusion-based release profile of contact lenses allows them to deliver consistent doses rather than the frequent doses required for some eye drops.
By combining medical treatment with vision correction in comfortable etafilcon A disposable contact lenses, patients do not need to think about a medication schedule. This is a particularly promising benefit for patients who find it difficult to stay on schedule.
Medication-coated contact lenses can solve some of the problems associated with eye drops, but the next logical question for eye care professionals is, “What are the effects of daily wearing medicated lenses on the surface of the eye?”
Most Popular Contact Lenses
My colleagues and I analyzed data from two identical clinical safety trials that lasted 12 weeks and included a total of 560 contact lens wearers. 374 patients wore test lenses and 186 patients wore placebo lenses.
Cornea staining with fluorescein was performed at baseline and then after 1, 4, 8, and 12 weeks of lens wear. There was no statistically significant difference in staining between the drug coated lens group and the placebo group at all visits (95.86% and 95.88% grade 0, respectively, at 12 weeks). All stains were light or trace.
After 4 weeks of wear, both groups experienced a mean reduction in corneal staining from baseline. This noticeable shift may be due to patients switching from their regular contact lenses to a new material (etafilcon A, which has a high water content7) and/or a wearing regimen (once a day, which takes the equation out of the equation) cleaning solution lenses). Adherence to the study lenses was similar in both groups (approximately 92%).
In conclusion, in a large, well-controlled, double-blind clinical study, we can confidently conclude that this antihistamine-releasing contact lens does not significantly affect the integrity of the corneal epithelium.
Eyes wearing these drug-coated contact lenses should not look any different than eyes wearing non-medicated contact lenses, which is an important factor for seamless integration into the practice of this modality.
There is no difference in the process of fitting lenses or assessing vision. Patients just need to know more about lenses so they can get the vision they want and get more help with eye allergies.
The evidence that the addition of antihistamines does not increase corneal epithelial damage compared to standard contact lenses is encouraging as we look forward to more application of drug-coated modalities.
Post time: Aug-18-2022
