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      Efficacy and tolerability of a fixed-dose moxifloxacin – dexamethasone formulation for topical prophylaxis in LASIK: a comparative, double-masked clinical trial

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          Abstract

          Purpose

          To compare the efficacy and tolerability of a fixed-dose combination of 0.5% moxifloxacin and 0.1% dexamethasone formulation (MFLX/DEX) vs conventional dosing with both agents dosed separately for prophylaxis after laser-assisted in situ keratomileusis (LASIK).

          Methods

          A prospective, randomized, double-masked, parallel-group study of 64 patients undergoing bilateral LASIK. Patients received either combined MFLX/DEX and placebo or moxifloxacin and dexamethasone dosed separately in both eyes. Baseline and postoperative assessments were made on surgery days –2, 1, 3, 8, and 15 and consisted of uncorrected visual acuity (UCVA), intraocular pressure (IOP), severity of inflammation, endothelial cell loss, ocular pain, burning, and itching sensation. The posterior segment was evaluated at the screening and exit visits.

          Results

          Of the 64 patients treated, 7 eyes did not meet the inclusion criteria and were excluded from the analysis. No ocular infection or persistent inflammation developed. Postoperatively there were no statistical differences between treatments for most parameters measured. More eyes in the combined MFLX/DEX group reported pruritus and burning post operatively; however, differences were also observed at baseline.

          Conclusion

          Topical prophylaxis with MFLX/DEX eye drops was well tolerated and is therapeutically equivalent to conventional dosing with moxifloxacin and dexamethasone from individual bottles.

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          Most cited references24

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          Adherence in glaucoma: objective measurements of once-daily and adjunctive medication use.

          To determine with electronic monitoring an objective measurement of adherence in two populations of subjects: those using once-daily prostaglandin analogs as sole ocular hypotensive therapy (one-drug group) and those requiring an adjunctive medicine to the prostaglandin analog (two-drug group). Single-site, open-label, nonrandomized, parallel design of 60 days. Sixty-two consecutive adult subjects with a diagnosis of open-angle glaucoma (OAG) or ocular hypertension: 31 were taking one drug and 31 were taking two drugs. An electronic event medication monitoring device was used to record each bottle opening. The main outcome measures were dosing errors (number of under-adherence or over-adherence events) and coverage (proportion of pharmacologic duration covered by dosing) relative to the ophthalmologist-prescribed regimen. Adherence to the prostaglandins once daily was good in both groups by all measures (
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            Compliance in patients prescribed eyedrops for glaucoma.

            We studied the rate of failure to use eyedrops as prescribed for glaucoma and some of the factors possibly associated with that noncompliance by interviewing 100 patients being followed in a setting emphasizing correct usage. Fifty-nine reported they had not used their eyedrops precisely as prescribed. Factors significantly influencing compliance included daily dose frequency, forgetfulness, inconvenience, and unaffordability. Gender and race were marginally significant factors, with men and blacks reporting somewhat higher rates of missed doses than women and whites. Side effects and age were not significant causes of noncompliance.
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              • Record: found
              • Abstract: not found
              • Article: not found

              Drop size and initial dosing frequency problems of topically applied ophthalmic drugs.

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                Author and article information

                Journal
                Clin Ophthalmol
                Clinical Ophthalmology
                Clinical ophthalmology (Auckland, N.Z.)
                Dove Medical Press
                1177-5467
                1177-5483
                June 2008
                : 2
                : 2
                : 331-338
                Affiliations
                Department of Ophthalmology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
                Author notes
                Correspondence: Rubens Belfort Jr, Dept. of Ophthalmology, Vision Institute, UNIFESP, Rua Botucatu 822, Ophthalmology Vila Clementino, São Paulo, SP, CEP 04023-062, Brazil, Email prof.rubens@ 123456clinicabelfort.com.br
                Article
                co-2-331
                2693985
                19668724
                b7053848-096e-4b33-aaab-d1581daa52bb
                © 2008 Campos et al, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.
                History
                Categories
                Original Research

                Ophthalmology & Optometry
                dexamethasone,moxifloxacin,prophylaxis,lasik
                Ophthalmology & Optometry
                dexamethasone, moxifloxacin, prophylaxis, lasik

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