Ocular Microbiology and Immunology Group
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2015 OMIG Abstract 27

Low-dose topical preservative-free Dexamethasone 0.01% and 0.05% for treatment of chronic ocular surface disease unresponsive to commercially available steroids, antibiotics, and anti-allergy agents
A. Mallick, F. Chin, C. Shih, I. Udell, A. Steiner

Purpose: To evaluate the short-term safety and efficacy of topical preservative-free dexamethasone 0.01% and 0.05% for the treatment of ocular surface disease and/or tearing refractory to conventional treatments.  Patients’ diagnoses included dry eye syndrome, blepharitis, rosacea, meibomian gland dysfunction, graft versus host disease, Sjogren’s Syndrome, Steven-Johnson Syndrome, allergic conjunctivitis, superior limbic keratoconjunctivitis, and limbal stem cell deficiency.
Methods: Retrospective chart review of patients who received topical preservative-free dexamethasone 0.01% and 0.05% (Leiter’s Pharmacy, San Jose, CA) from 9/2011 to 1/2015. Follow-up visits were reviewed for subjective responses to the formulation, development of visually significant cataract, and intraocular pressure (IOP). Responses were graded as moderate/complete resolution of symptoms (50%–100% improvement), mild improvement (25%–50% improvement), or no improvement.
Results: One-hundred-twenty-two eyes of sixty-one patients received topical preservative-free dexamethasone for the treatment of ocular surface disease. Of these patients, 55 received 0.01% and 6 patients received 0.05% formulations.  Follow up ranged from 1 to 49 months. Forty-four patients (72%) reported moderate or complete resolution of ocular symptoms. Eleven patients (18%) had mild improvement in their symptoms. Six patients (10%) had no change in ocular symptoms.
Three patients in our series developed an elevation of intraocular pressure greater than 5 mm Hg above baseline intraocular pressure. Of these patients, two were initially given 0.05% with subsequent reduction of IOP when switched to 0.01%.  One patient developed IOP elevation on 0.01%, however had a history of end stage glaucoma.   One patient in our series developed progression of cataract requiring surgery. 
Of the twenty-nine patients previously treated with commercially available steroids (with preservative), twenty-two patients (76%) reported moderate or complete resolution of symptoms, six patients mild improvement (21%), and one patient (3%) reported no improvement with use of topical preservative-free dexamethasone.
Conclusions: Topical preservative-free dexamethasone 0.01% and 0.05% could be an effective therapy for recalcitrant chronic ocular surface disease.  Minimal risk exists of IOP elevation or formation of visually significant cataract.
Disclosure: N

2015 Agenda and Abstracts | < Previous | Next >