常用眼部皮质类固醇的填充水平、成本比较和排出力要求。
Fill levels, cost comparisons, and expulsion force requirements of commonly used topical ophthalmic steroids.
机构信息
From Dean McGee Eye Institute, University of Oklahoma, Oklahoma City, Oklahoma (Riaz, Murphy); Yale University School of Medicine, New Haven, Connecticut (Gill); Hudson College of Public Health, University of Oklahoma, University of Oklahoma, Oklahoma City, Oklahoma (Dvorak); Oklahoma School of Science and Mathematics, University of Oklahoma, Oklahoma City, Oklahoma (Shah); and Dean McGee Eye Institute, University of Oklahoma|Dean McGee Eye Institute, University of Oklahoma, Oklahoma City, Oklahoma (Riaz).
出版信息
J Cataract Refract Surg. 2022 Apr 1;48(4):475-480. doi: 10.1097/j.jcrs.0000000000000833.
PURPOSE
To determine volume fill levels, estimated costs, and force expulsion requirements per bottle of topical ophthalmic steroids commonly used in the United States.
SETTING
Tertiary care academic referral center.
DESIGN
Prospective laboratory investigation.
METHODS
8 commercially available medications were tested: loteprednol 0.5%, loteprednol gel 0.5%, loteprednol gel 0.38%, difluprednate 0.05%, generic fluorometholone 0.1%, branded fluorometholone 0.1%, generic prednisolone 1.0%, and branded prednisolone 1.0%. 10 bottles of each medication were tested. A double-blinded method was used to measure actual bottle fill volume and number of drops dispensed per bottle. The total perioperative cost per drop was calculated for each medication using a mean cash price. Force requirements were measured using a customized force gauge apparatus. Formulations were compared using Kruskal-Wallis 1way analysis of variances.
RESULTS
All formulations were able to cover postoperative periods commensurate with commonly used dosing regimens for cataract surgery. All medications had greater than sticker volume. Loteprednol 0.5% suspension and branded fluorometholone had the highest and lowest number of drops among the medications tested, respectively. Loteprednol 0.38% gel was the most expensive medication, whereas generic prednisolone 1.0% was the least expensive. Gel and branded formulations of ophthalmic steroids required less expulsion force compared with other tested formulations.
CONCLUSIONS
Volume fill levels, patient-incurred costs, and expulsion force requirements per bottle of topical steroid medications vary widely. Clinicians may wish to consider these findings when determining their perioperative prescribing regimen.
目的
确定在美国常用的局部眼科皮质类固醇药物每瓶的容量填充水平、估计成本和挤出所需的力。
设置
三级保健学术转诊中心。
设计
前瞻性实验室研究。
方法
测试了 8 种市售药物：Loteprednol 0.5%、Loteprednol 凝胶 0.5%、Loteprednol 凝胶 0.38%、Difluprednate 0.05%、通用氟米龙 0.1%、品牌氟米龙 0.1%、通用泼尼松龙 1.0%和品牌泼尼松龙 1.0%。每种药物测试了 10 瓶。使用双盲法测量实际瓶填充体积和每瓶分配的滴数。使用平均现金价格计算每滴的总围手术期成本。使用定制的力计装置测量力需求。使用 Kruskal-Wallis 1 方式方差分析比较配方。
结果
所有配方都能够覆盖与白内障手术常用剂量方案相符的术后时期。所有药物的实际容量都大于标签上的容量。Loteprednol 0.5%混悬液和品牌氟米龙的滴数分别为测试药物中最多和最少。Loteprednol 0.38%凝胶是最昂贵的药物，而通用泼尼松龙 1.0%是最便宜的药物。与其他测试配方相比，凝胶和品牌制剂的眼科皮质类固醇需要的挤出力更小。
结论
局部皮质类固醇药物每瓶的容量填充水平、患者承担的成本和挤出力需求差异很大。临床医生在确定围手术期处方方案时可能希望考虑这些发现。
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