Sanchez Facundo G, Mansberger Steven L, Kung Yungtai, Gardiner Stuart K, Burgoyne Claude F, Cunningham Emmett T, Rees Jack P, Jones Emily P, Kinast Robert M
Legacy Devers Eye Institute, Portland, Oregon; Discoveries in Sight Research Laboratories, Devers Eye Institute, Portland, Oregon.
Legacy Devers Eye Institute, Portland, Oregon.
Ophthalmol Glaucoma. 2021 Sep-Oct;4(5):440-446. doi: 10.1016/j.ogla.2021.01.001. Epub 2021 Jan 12.
To compare a nose-pivoted drop delivery device (NPDD) with traditional eye drop delivery in glaucoma subjects.
Repeated-measures case series.
Fifty glaucoma subjects (100 eyes) who reported difficulty self-administering eye drops.
We compared eye drop delivery using a NPDD against traditional delivery techniques at baseline (baseline traditional) and after standardized teaching (post-teaching traditional). Subjects used a 1-to-10 scale (10 being easiest) to rate the ease of delivery with each technique and completed a satisfaction survey. Two graders used digital video to independently review eye drop delivery and recorded: (1) accurate placement: the eye drop reached the ocular surface; (2) no contact: no bottle tip contact against the ocular or periocular surface; and (3)number of eye drops dispensed. We defined primary success as accurate placement and no contact; secondary success as primary success with only 1 drop dispensed.
We used logistic-transformed generalized estimating equation (GEE) regression to compare technique satisfaction, accuracy, no contact, and primary and secondary success. Number of drops dispensed was compared using a Cox model.
Forty-seven of 50 subjects (94%) preferred the NPDD over traditional eye drop delivery. The mean score for ease of use was higher for the NPDD (8.9 ± 1.1) than baseline traditional (6.7 ± 2.1; P < 0.001) and post-teaching traditional (7.0 ± 2.0; P < 0.001). Forty-nine of 50 (98%) subjects thought the NPDD was comfortable to use and would recommend the device. The eye drop reached the ocular surface in a similar percentage of subjects (>90%) with each method. The bottle tip contacted fewer eyes with the NPDD (10 eyes) than baseline traditional (33 eyes; P < 0.001) and post-teaching traditional (25 eyes; P = 0.009). The number of drops dispensed was lower with the NPDD (1.7 ± 1.2) than baseline traditional (2.2 ± 1.6; P = 0.017) and post-teaching traditional (2.4 ± 1.8; P = 0.006). The NPDD increased primary and secondary success of eye drop delivery (86% and 54%, respectively) compared to baseline traditional (66% [P = 0.001] and 28% [P < 0.001]) and post-teaching traditional (70% [P = 0.005] and 40% [P = 0.018]).
Eye drop users preferred the NPDD over traditional eye drop delivery. The NPDD improved eye drop delivery success, reduced bottle tip contact, and decreased the number of eye drops wasted.
比较鼻枢式滴眼装置（NPDD）与传统滴眼方式在青光眼患者中的应用情况。
重复测量病例系列研究。
50名自述滴眼困难的青光眼患者（100只眼）。
我们在基线期（基线传统方式）和标准化教学后（教学后传统方式），比较了使用NPDD滴眼与传统滴眼技术。受试者使用1至10分制（10分为最容易）对每种技术的滴眼难易程度进行评分，并完成满意度调查。两名评分者使用数字视频独立回顾滴眼过程并记录：（1）准确放置：滴眼液到达眼表；（2）无接触：瓶口未接触眼表或眼周表面；（3）滴出的滴眼液数量。我们将主要成功定义为准确放置且无接触；次要成功定义为主要成功且仅滴出1滴。
我们使用逻辑转换的广义估计方程（GEE）回归来比较技术满意度、准确性、无接触情况以及主要和次要成功情况。使用Cox模型比较滴出的滴眼液数量。
50名受试者中有47名（94%）更喜欢NPDD而非传统滴眼方式。NPDD的易用性平均得分（8.9±1.1）高于基线传统方式（6.7±2.1；P<0.001）和教学后传统方式（7.0±2.0；P<0.001）。50名受试者中有49名（98%）认为NPDD使用舒适并会推荐该装置。每种方法下，滴眼液到达眼表的受试者比例相似（>90%）。与NPDD接触的眼数（10只眼）少于基线传统方式（33只眼；P<0.001）和教学后传统方式（25只眼；P=0.009）。NPDD滴出的滴眼液数量（1.7±1.2）低于基线传统方式（2.2±1.6；P=0.017）和教学后传统方式（2.4±1.8；P=0.006）。与基线传统方式（分别为66%[P=0.001]和28%[P<0.001]）以及教学后传统方式（70%[P=0.005]和40%[P=0.018]）相比，NPDD提高了滴眼的主要和次要成功率（分别为86%和54%）。
滴眼液使用者更喜欢NPDD而非传统滴眼方式。NPDD提高了滴眼成功率，减少了瓶口接触，并减少了浪费的滴眼液数量。
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