A retrospective analysis of the use of loteprednol etabonate ophthalmic suspension 0.5% following canaloplasty

Abstract

Background

While loteprednol etabonate (LE) suspension 0.5% is approved for the treatment of postoperative ocular inflammation, there have been no reported studies of its use in glaucoma patients undergoing canaloplasty.

Methods

This was a retrospective medical chart review conducted at a single US center. Data were collected on patients with glaucoma who underwent canaloplasty with or without cataract surgery, and were prescribed LE suspension 0.5% postoperatively. Outcomes evaluated included postsurgical inflammation (anterior chamber [AC] cells and flare), intraocular pressure (IOP), number of IOP-lowering medications, and postsurgical complications.

Results

Data were collected on 204 patients (262 eyes) with a mean (SD) age of 71.6 (11.3) years. The most frequent LE dosing regimens at day 1, week 1, and month 1 postsurgery were QID (92.3%; 241/261), TID (52.6%; 133/253), and QD (65.5%; 78/119), respectively. Inflammation (AC flare and cells), mostly mild, was noted in 33.2% (86/259) of eyes on postoperative day 1 and 8.6% (21/244) of eyes at month 1. Mean IOP and mean number of IOP-lowering medications were significantly reduced from baseline (P<0.001) at all time points postoperatively. Complete (no IOP-lowering medication) or qualified (use of ≤2 IOP-lowering medications) surgical success was achieved in 78.8% and 90.6% of eyes, respectively, at month 6 and 63.4% and 92.7% of eyes at month 36. The most frequently observed postoperative complication was hyphema in 48.7% (126/259) eyes at day 1, which decreased to 0.4% (1/244) of eyes by month 1. IOP ≥30 mmHg was noted in 13 (5.3%) eyes at postoperative week 1 and rarely thereafter, and no patient discontinued therapy because of an IOP increase.

Conclusion

These real-world data suggest that canaloplasty with or without cataract surgery managed postoperatively with LE suspension 0.5% is effective and safe in the glaucoma patient.

Keywords:

• canaloplasty
• loteprednol etabonate
• postoperative inflammation
• glaucoma
• intraocular pressure

Acknowledgments

Writing assistance was provided by Rachel Hathcock, BSN, and Sandra Westra, PharmD, of Churchill Communications (Maplewood, NJ, USA) and was funded by Bausch + Lomb, Inc. The author retained full control over the manuscript content. This study was sponsored by Bausch + Lomb as an independent research grant.

Author contributions

MK substantially contributed to concept and design, data acquisition, and analysis and interpretation; he contributed to article drafting and revision and gave final approval of this version to be published; he is accountable for all aspects of the work and will ensure that questions related to the accuracy or integrity of the work are appropriately investigated and resolved.

Disclosure

The author reports no conflicts of interest in this work.