Reducing the medication burden on patients is important for compliance and overall quality of life, and helps to strengthen doctor–patient relationships. Use of the Prokera cryo-preserved amniotic membrane, in conjunction with new imaging technologies, can reduce dry eye symptoms for five to seven months.
Glaucoma affects nearly 3 million Americans, including one in 50 people aged 40 years and older, according to the American Academy of Ophthalmology. Worldwide, an estimated 76 million people will have the disease in 2020. Many patients with glaucoma have signs and symptoms of ocular surface disease (OSD)—according to one study, about 56.9 percent of women and 45.7 percent of men.1
Considering that both glaucoma and OSD occur more often as patients age, and the most common form of treatment for glaucoma are drops presesrved with benzalkonium chloride (BAK), this information is not a surprise. ODs have grown accustomed to seeing glaucoma patients with their injected conjunctivae and keratitis.
When treating glaucoma, ODs make every effort to control patients’ intraocular pressure (IOP) with as few drops and medications as possible. Practitioners dislike adding a twice-daily drop to an at-night drop and hate adding a third drop, knowing that each drop erodes compliance.
Complex drug dosing regimens are a significant barrier to patients’ adherence to therapy.2,3 For glaucoma in general, patients’ lack of compliance ranges from 23 percent to as high as 60 percent.4-8
1. Pflugfelder SC, Baudouin C. Challenges in the clinical measurement of ocular surface disease in glaucoma patients. Clin Ophthalmol. 2011;5:1575–1583. doi: 10.2147/OPTH.S24410
2. Tsai JC. A comprehensive perspective on patient adherence to topical glaucoma therapy. Ophthalmology 2009;116:S30–S36.
3. Nordstrom BL, Friedman DS, Mozaffari E, Quigley HA, Walker AM. Persistence and adherence with topical glaucoma therapy. Am J Ophthalmol 2005;140:598–606.
4. Richardson C, Brunton L, Olleveant N, et al. A study to assess the feasibility of undertaking a randomized controlled trial of adherence with eye drops in glaucoma patients. Patient Prefer Adherence 2013;7:1025–1039.
5. Gooch N, Molokia SA, Condie R, et al. Ocular drug delivery for glaucoma management. Pharmaceutics 2012;4:197-211.
6. Mansberger SL, Sheppler CR, McClure TM, et al. Psychometrics of a new questionnaire to assess glaucoma adherence: The glaucoma treatment compliance assessment tool. Trans Am Ophthalmol Soc. 2013;111:1-16.
7. Budenz DL. A clinician’s guide to the assessment and management of nonadherence in glaucoma. Ophthalmology. 2009;116:S43–S47.
8. Sleath B, Blalock S, Covert D, et al. The relationship between glaucoma medication adherence, eye drop technique, and visual field defect severity. Ophthalmology. 2011;118:2398–2402.
9. Li X, Wang W, Zhang X. Meta-analysis of selective laser trabeculoplasty versus topical medication in the treatment of open-angle glaucoma. BMC Ophthalmol. 2015;15:107.
10. Wong MO, Lee JW, Choy BN, et al. Systematic review and meta-analysis on the efficacy of selective laser trabeculoplasty in open-angle glaucoma. Surv Ophthalmol. 2015;60:36–50.
11. The Glaucoma Laser Trial (GLT) and glaucoma laser trial follow-up study: 7. Results. Glaucoma Laser Trial Research Group. [No authors listed] Am J Ophthalmol. 1995;120718–731.
12. The definition and classification of dry eye disease: report of the Definition and Classification Subcommittee of the International Dry Eye WorkShop (2007). Ocul Surf. 2007;5:75-92.
13. Nelson JD, Craig JP, Akpek EK et al. TFOS DEWS II Introduction. Ocul Surf. 2017;15:269-275.
14. Jones L, Downie LE, Korb D, et al. TFOS DEWS II management and therapy report. Ocul Surf. 2017 Jul;15(3):575-628.
15. Lemp MA, Crews LA, Bron AJ, Foulks GN, Sullivan BD. Distribution of aqueous-deficient and evaporative dry eye in a clinic-based patient cohort: a retrospective study. Cornea. 2012; 31 (5): 472-478.
16. Goyal S, Hamrah P. Understanding Neuropathic Corneal Pain-Gaps and Current Therapeutic Approaches. Semin Ophthalmol 2016;31:59–70.
17. McDonald MB, Sheha H, Tighe S, et al. Treatment outcomes in the DRy Eye Amniotic Membrane (DREAM) study. Clin Ophthalmol 2018;12:677–681. doi: 10.2147/OPTH.S162203.
18. Tseng SCG. HC-HA/PTX3 purified from amniotic membrane as novel regenerative matrix: insight into relationship between inflammation and regeneration. Invest Ophthalmol Vis Sci 2016;57:ORSFh1–ORSFh8. doi: 10.1167/iovs.15-17637.