Ocular Microbiology and Immunology Group
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2018 OMIG Abstract

Safety and Effiacy of Chronic Loteprednol Etabonate Gel Use for Dry Eye Disease

Neslihan Dilruba Koseoglu, MD, Anam Akhlaq, MBBS, Stephanie Cox, OD, Pedram Hamrah, MD
Cornea Service, New England Eye Center and Center for Translational Ocular Immunology, Department of Ophthalmology, Tufts Medical Center, Tufts University School of Medicine, Boston, MA

Methods: Retrospective chart review of 51 DED patients treated with LE 0.5% gel for =6 months. Safety parameters included intraocular pressure (IOP) and the development of posterior subcapsular (PSC) cataracts. Efficacy measures included tear break up time (TBUT), Schirmer’s test, corneal and conjunctival staining, and symptoms, as evaluated by Ocular Surface Disease Index (OSDI) and Ocular Pain Assessment Survey (OPAS). SPSS was used for all statistical analyses. Changes in clinical signs between visits were analyzed using linear mixed models. Paired t-tests were used for analysis of symptom questionnaires.

Results: The mean age of the 16 male and 35 female subjects included in this analysis was 61.14±14.21 years. Ninety nine eyes that were eligible were followed up for 13.18±8.12 months (range 6-40 months). There wasn’t a significant change from initiation of LEG (14.14±3.06 mmHg) to the final follow-up visit (14.10±3.18 mmHg) in IOP measures (p=0.902). PSC development was observed in 4.69% of the eyes (n=3/64 eyes) over a period of 8.27±9.61 months, where 35 eyes were excluded due to history of cataract surgery and/or previous use of topical steroids more than 3 months. There was a significant improvement in TBUT (p<0.001, from 5.16±2.46 to 7.31±3.19 seconds) and corneal staining (p<0.001, from 1.78±1.05 to 1.06±0.79 on Oxford Scale). Conjunctival staining (from 1.02±0.85 to 0.95±0.78 on Oxford scale) and Schirmer’s test scores (from 9.02±7.68 to 8.75±8.62 mm) didn’t show a significant difference (p=0.61 and p=0.67 respectively). Symptoms, evaluated by OSDI and OPAS, were not significantly different between initiation of LEG and the last visit (p>0.05 for all scores).

Conclusion: LEG can offer a safe alternative for long-term management of inflammation associated with DED, along with improvement of clinical signs. While increased IOP was not noted during long-term follow-up, despite the low incidence, patients should be monitored for the development of PSC.

Disclosure: S (DK); S, C (PH)

Support: Bausch+Lomb

2018 Agenda and Abstracts | < Previous