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Dry Eye

Dexamethasone insert shows promise for dry eye treatment: Offers dropless dual therapy potential

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The dexamethasone intracanalicular insert shows promise as a potential treatment for clinically significant aqueous-deficient dry eye, according to results from a randomized clinical trial.

The study’s findings suggest that this insert can effectively reduce corneal and conjunctival staining associated with dry eye, and patients treated with the insert reported less dryness compared to those receiving a sham treatment.

The single-center, double-masked, randomized controlled trial enrolled 75 adult patients with clinically significant aqueous-deficient dry eye, despite prior treatment with prescription drops. Participants were randomly assigned to receive either the dexamethasone insert or a sham collagen plug in one eye, with the fellow eye receiving the opposite treatment. Throughout the trial, patients were unaware of their assigned treatment.

Key outcomes measured included dry eye parameters, patient symptoms, and intraocular pressure (IOP) as an indicator of safety. Results indicated that eyes treated with the dexamethasone insert showed significantly less corneal and conjunctival staining compared to the sham treatment at weeks 4 and 6. However, Schirmer’s wetting, an indicator of tear production, showed no significant difference between the treatment arms.

While patients reported less dryness in eyes treated with the insert at week 4, no statistically significant differences were observed in other patient-reported symptoms. Notably, at week 4, eyes treated with dexamethasone were more likely to experience a mild increase in IOP compared to the sham treatment. However, these instances were effectively managed with short-term topical beta blockers and resolved without complications.

Reference
Lin M, Guo L, Saldanha IJ, et al. Dexamethasone Intracanalicular Insert for Clinically Significant Aqueous-Deficient Dry Eye: A Randomized Controlled Trial. Ophthalmology. 2024;S0161-6420(24)00186-6. doi: 10.1016/j.ophtha.2024.03.010. Epub ahead of print. PMID: 38492864.

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