The Ocusert pilocarpine system: advantages and disadvantages.

Thirty-four patients with glaucoma were treated with the Ocusert pilocarpine system, a unique method of providing round-the-clock delivery of pilocarpine in the eye for seven-day periods. Advantages of the device include therapeutic effectiveness and continuous release rate, less effect on accommodation, less miosis, convenience for the patient, and reliability in patients who must rely on others for treatment (eg, children and the elderly). Some disadvantages encountered were need for instruction and encouragement of patients; retention difficulties, with some patients unaware when the device was lost; occasional side effects of a cutting sensation (as when the Ocusert sometimes doubles over), movement in the eye, and transient blurring of vision and miosis; and high cost. Overall, when compared to pilocarpine eyedrops, the Ocusert pilocarpine system presents many definite advantages and is a highly desirable method of therapy in selected cases of glaucoma.