Glaucoma Center of Excellence.
Department of Ophthalmology, University of Colorado School of Medicine, Aurora, CO.
J Glaucoma. 2018 Apr;27(4):328-335. doi: 10.1097/IJG.0000000000000913.
To assess patient acceptance of different methods for delivering sustained-release, intraocular pressure (IOP)-lowering medications.
Electronic surveys were administered to 150 patients at 2 glaucoma clinics. Participants were questioned on their willingness to accept: (1) drug-eluting contact lenses, (2) ring inserts (3) punctal plugs, and (4) subconjunctival injections as alternatives to IOP-lowering eye drops based on various success levels. Multivariable logistic regression models determined the association between device type and treatment acceptance adjusting for age, sex, study site, cost burden of drops, and previous contact lens use.
The majority (69%) of participants were 55 to 74 years of age, and white (65%), and half were female. The majority of participants would accept contacts (59%), rings (51%), plugs (57%), and subconjunctival injections (52%) if they obviated glaucoma surgery; fewer would accept these devices if they reduced (23% to 35%) or eliminated (27% to 42%) drops. Most participants would also accept contacts (56%), plugs (55%), and subconjunctival injections (53%) if they were more effective than eye drops, whereas only 47% would accept a ring; fewer would accept any device if it were equally or less effective than drops. Participants were also 36% (95% confidence interval=0.44-0.92; P=0.02) less likely to accept rings and 32% (95% confidence interval=0.47-0.98; P=0.04) less likely to accept subconjunctival injections as compared with contacts.
Most glaucoma patients considered sustained drug-delivery modalities acceptable alternatives to IOP-lowering eye drops, but only when they were said to obviate surgery or demonstrate greater efficacy than eye drops.
评估患者对不同方法输送持续释放、降眼压药物的接受程度。
对 2 家青光眼诊所的 150 名患者进行了电子调查。参与者被问到他们是否愿意接受以下方法：（1）药物洗脱隐形眼镜，（2）环插入物，（3）泪小点塞，以及（4）眼周注射，以替代降眼压眼药水，基于各种成功水平。多变量逻辑回归模型确定了设备类型与治疗接受程度之间的关联，调整了年龄、性别、研究地点、眼药水成本负担和以前使用隐形眼镜的因素。
大多数参与者（69%）年龄在 55 至 74 岁之间，为白人（65%），其中一半为女性。如果能避免青光眼手术，大多数参与者会接受隐形眼镜（59%）、环（51%）、塞子（57%）和眼周注射（52%）；如果能减少（23%至 35%）或消除（27%至 42%）眼药水，他们会接受这些设备的可能性较小。如果比眼药水更有效，大多数参与者也会接受隐形眼镜（56%）、塞子（55%）和眼周注射（53%），而只有 47%会接受环；如果与眼药水效果相当或更差，接受任何设备的可能性就会降低。与隐形眼镜相比，参与者接受环的可能性降低了 36%（95%置信区间=0.44-0.92；P=0.02），接受眼周注射的可能性降低了 32%（95%置信区间=0.47-0.98；P=0.04）。
大多数青光眼患者认为持续药物输送方式是降低眼压眼药水的可接受替代品，但只有在它们被认为可以避免手术或比眼药水更有效时才会这样认为。
