Eye Drop Bottles Research Articles

Intravitreal moxifloxacin in treatment of postcataract endophthalmitis

Postcataract endophthalmitis is a well-known and feared complication that might lead to a devastating outcome for the diseased eye. A case of postcataract extraction endophthalmitis treated with an intravitreal moxifloxacin injection prepared from commercially available preservative-free topical eyedrops (Vigamox), achieving 20/20 corrected distance visual acuity posttreatment is reported. A 70-year-old woman was found to have endophthalmitis in the left eye with hand motion vision on day 8 postcataract extraction. Accordingly, tap-and-inject procedure was performed using 0.05 mL of 0.5% moxifloxacin aspirated directly from a sealed eyedrop bottle and injected intravitreally. Forty-eight hours later, a similar second injection was given. The patient improved progressively and reached 20/20 vision 2 months later.

Commentary: "Indovation" in retinopathy of prematurity management during COVID-19 times.

The coronavirus disease-2019 (COVID-19) pandemic has caught many of us off-guard and thrust even the most developed of nations into chaos. While the direct implications of the disease have been much talked about, the collateral damage on patients suffering from non-COVID conditions has been equally severe. Retinopathy of prematurity (ROP) is an ocular emergency and any delay in treatment leads to permanent visual loss in a premature child. However, during the COVID-19 pandemic, lesser number of ROP babies got screened with an increasing proportion of them presenting with advanced disease.[1] Despite effective methods of treatment with laser and surgery, many premature neonates lost vision in the initial days of the COVID-19 lockdown due to late presentation.[23] To add to this, the fear of COVID-19 transmission led various doctors to reduce working hours, taking ROP care further away from those in need of it. In these testing times, Nayak et al.[4] have come out with a unique 'indovation' – The virus containment box. The basic concept stems from an incubator where ROP screening and laser are provided through the visualization provided by the slanting wall of the incubator.[5] The authors have described a low-cost setup that may be feasible at the level of a general ophthalmologist. While the authors must be applauded for their effort, a little note of caution is necessary here. Pros and Cons of Barrier Devices Barrier devices have become a commonplace due to the circumstances of the COVID-19 pandemic. Various designs of barrier devices for procedures such as mechanical intubation/resuscitation have been published over the past few months.[6789] Some devices even incorporate a negative pressure system to actively eliminate any aerosols that may be generated during the procedure. However, the impact of aerosols generated by a crying baby may not be completely gauged by the 'eye drop bottle' experiment applied by Nayak et al.[4] An airborne particle counter with a laser diode and photon detector to detect various sizes of airborne particles may be a better option. Simpson et al.[8] utilized the same to test various modifications of barrier devices during simulated intubation. A barrier device with suction to create negative pressure led to a reduction in 0.3, 0.5, 1.0, and 2.5 micron particles but not in the 5.0 micron particles when compared to no device used. On the contrary, a barrier device with no negative pressure actually showed an increase in 1.0, 2.5 and 5.0 micron particle count compared to no device use. The results for 0.3 micron particle size were similar whether any barrier device was used or not. A review of 52 publications describing various barrier devices by Sorbello et al.[9] also concluded that barrier devices may only be effective in limiting large droplet spread and not the aerosolised virus particles. While the aerosol containment barrier device may serve as an adjunct during the COVID-19 pandemic, the importance of adequate personal protective equipment and hand hygiene practices cannot be over stated. They remain our first line of defense in protecting ourselves from the pathogen while providing effective care. Pre-procedure testing before laser/surgery is another way of creating a safe workplace. It is during these procedures that a prolonged exposure is expected. Over the past 6 months, we have been testing all premature infants for COVID-19 by polymerase chain reaction who are to undergo laser/surgery for ROP. From over 100 babies tested, only one has tested positive so far. Thus the overall rate of positivity in neonates appears to be low and this has been substantiated by other studies as well.[10] Adequate availability of personal protective equipment, extensive COVID-19 testing, and an added layer of protection by barrier devices should encourage more and more ROP specialists to continue providing their services safely to prevent an impending pandemic of preventable childhood blindness.

Evaluation of microbial contamination in multi-dose fluorescein eyedrops in a reference eye center.

To analyze the presence of microorganisms in fluorescein eyedrops used in a reference eye center in Recife-PE. This real-life and masked study evaluated fluorescein eyedrops used at the Altino Ventura Foundation in May 2019. Cultures were performed according to exposure times; I) three eyedrop bottles were analyzed after one day of use, II) three eyedrop bottles after 4 d of use, III) three eyedrop bottles after 8 d of use, and IV) three unopened bottles used as control. Samples were collected from the bottle's tip, instilled drop, and residual fluid. After incubation, all colonies were analyzed and identified through biochemical tests. The contamination rate of the fluorescein eyedrop bottles in this study was 55.5% (5/9 vials). There was no contamination in the control group. The highest contamination was seen in one day exposed eyedrops, in 100% of the bottles. The bottle's tip had a higher rate of contamination compared to the drop and residual fluid. Gram-positive bacteria were isolated in 7/27 (25.9%) samples. Growth of fungi or gram-negative bacteria was not observed. The identification of gram-positive bacteria predominantly on the tip of the fluorescein eyedrop bottles suggests inadequate handling as the main cause of contamination.

A study of the incidence of nosocomial infections and the associated risk factors in the city of Mbujimayi, Democratic Republic of Congo

Introductioncette étude vise à déterminer l´incidence des infections nosocomiales et les facteurs de risque chez les accouchées et les nouveau-nés dans les maternités de la ville de Mbujimayi en République Démocratique du Congo.Méthodesil s´agit d´une étude descriptive longitudinale d´incidence et facteurs de risque des infections nosocomiales dans les 231 maternités, qui a été réalisée chez les sujets indemnes de la pathologie au départ qu´on devrait suivre en utilisant la collecte hebdomadaire des données pendant 6 mois. Les critères utilisés pour la collecte des données étaient ceux de l´Organisation Mondiale de la Santé (OMS) basés sur les définitions simplifiées pouvant être utiles pour certains établissements n´ayant pas accès à des techniques diagnostiques poussées.Résultatsl´incidence globale des infections nosocomiales chez les accouchées est de 24,8% et de 22,3% chez les nouveau-nés. Les facteurs de risque significatif d´infection nosocomiale au couple étaient les manœuvres instrumentales (p=0,005; OR=2,7; IC95% [1,3-5,4]), la césarienne faite en urgence (p=0,000; OR=2,3; IC95% [1,7-3,9]), l´utilisation d´un même flacon de collyre chez tous les bébés (p=0,004; OR=2,7; IC95% [1,4-5,5]) et l´élevage du prématuré hors couveuse (p=0,000; OR=2,61; IC95% [1,73-3,92]).Conclusionla réalisation d'enquêtes d'incidence (ou à défaut de prévalence) régulières est indispensable pour évaluer les effets des actions d'information, de sensibilisation et de formation qui pourront être mises en place pour lutter contre les infections acquises à l'hôpital.

Mass variability in drops of multidose eyedrops: a quality and reliability study

This quality and reliability study aimed to identify the mass variability of multidose eyedrops and to verify the existence of a reference pattern for the drop volume of eyedrops using standard lubricant eyedrops available on the Brazilian market. Five brands of lubricant eyedrops were evaluated. An ideal standard 20 µL drop of eyedrops from each manufacturer was captured using an adjustable micropipette. The eyedrop bottles were randomly selected, and five measurements of the samples' masses were collected using calibrated precision scales. The mass of the 20 µL samples varied significantly (p<0.001) among the different manufacturers. However, among eyedrops of the same brand, mass variation was not statistically different. The global mean mass of all weighed drops was 18.24 mg, and non-uniformity was identified across all eyedrop brands. Significant variations in the drop masses of common lubricant eyedrops were identified using standard laboratory equipment. Heterogeneity in the drop volume of standard eyedrop medications suggest that potential dosage discrepancies exist, possibly altering treatment efficacy. A pre-established reference measure may lead to the production of more appropriately sized eyedrops for use in human eyes.

Smart connected devices to objectively assess the adherence to eyedrops

AbstractPurposeCompliance issues are often reported in ophthalmology for glaucoma which is one of the leading causes of blindness and visual disability and for dry eye syndrome (DES) requiring multiple frequent instillations. The smart electronic devices have emerged as one of the most reliable means of improving adherence to treatment, allowing objective quantification of the taken treatments. Aim: to report the pilot use in DES of two new electronic devices designed for the monitoring of adherence to eye drop medications.MethodsThe KaliDROP for eye drop bottles, and the KaliJAR for single‐dose‐units (SDU; Kali‐CARE, Santa Clara, CA, USA) were 3G wireless devices that recorded and transmitted in real respectively the number of instillations (when the bottle in pressed and reversed) and the number of SDU discarded after use. Both were tested by one of the author suffering from DES. The Kali Drop was tested during 28 consecutive days with an ABAK bottle of Thealose (Thea laboratories). The KaliJAR was tested during 47 consecutive days with SDU of Thealoz Duo Gel (Thea laboratories). In parallel, he noted on paper the date and time of each eye drop instillation. The agreement with the data recorded in the software was analyzed.ResultsOn the 354 instillations noted on paper, 352 (99.4%) were recorded by the KaliDROP device. Two instillations were not recorded, and one instillation was wrongly detected. On the 2200 SDUs introduced in the KaliJAR, 2136 (97.1%) were recorded. 64 SDUs (2.9%) were not recorded but none was wrongly detected. This percentage of false negative could be explained by the fact that 30–50 SDUs were inserted immediately one after the other. The number of undetected SDU would be virtually null if each SDU was discarded separately as normally recommended.ConclusionsThese two innovative simple‐to‐use devices could find strong applications in therapeutic education and clinical trials.

Impact of the Support, Educate, Empower Personalized Glaucoma Coaching Program Pilot Study on Eye Drop Instillation Technique and Self-Efficacy

To assess the Support, Educate, Empower (SEE) personalized glaucoma coaching program impact on (1) eye drop instillation technique and (2) eye drop instillation self-efficacy. Prospective pre-post pilot study. Patients with a diagnosis of glaucoma or ocular hypertension taking ≥1 glaucoma medication, ≥40 years old, spoke English, self-administered their eye drops, and ≤80% adherent to their glaucoma medication by electronic monitoring. Eye drop administration was video recorded before the first SEE in-person coaching session, which included teaching eye drop instillation techniques using a motivational interviewing-based approach. At the third and final in-person counseling session 6 months later, eye drop administration was video recorded. Participants' self-efficacy was assessed using the validated Eye Drop Technique Self-Efficacy Scale (EDTSES) survey at baseline and 1 month after completion of the program. Before and after intervention videos were assessed by an observer masked to time point. Before versus after intervention comparisons were made using McNemar's and paired t tests. The main outcome was change in participants' eye drop instillation technique as measured by (1) accuracy of an eye drop landing on the eye, (2) ability to instill an eye drop on the first attempt, and (3) contaminating the bottle by contact with ocular surface, eyelashes, and skin. The secondary outcome measure was before versus after change in the EDTSES score (6 items, each assessed on a 3-point Likert scale, with higher scores indicating better self-efficacy). Thirty-nine participants completed the SEE intervention, 38 with before and after EDTSES scores and 31 with video recordings. Six of 31 participants instilling drops outside the eye before intervention improved their technique after intervention, whereas 2 participants worsened (P= 0.157). From before to after intervention, participants demonstrated significant improvement in not touching the ocular surface (P= 0.046), the eyelashes (P= 0.020), or the skin (P= 0.025) with the bottle tip. A significant increase was found in eye drop instillation self-efficacy from an average score of 2.6 (standard deviation [SD], 0.3) to 2.8 (SD, 0.2) on the EDTSES score (P=0.007). The SEE program significantly decreased eye drop bottle contamination, increased eye drop instillation self-efficacy, and demonstrated an insignificant increase in ability to instill drops successfully and accurately.

Smart Electronic Eyedrop Bottle for Unobtrusive Monitoring of Glaucoma Medication Adherence.

Glaucoma, the leading cause of irreversible blindness, affects >70 million people worldwide. Lowering intraocular pressure via topical administration of eye drops is the most common first-line therapy for glaucoma. This treatment paradigm has notoriously high non-adherence rates: ranging from 30% to 80%. The advent of smart phone enabled technologies creates promise for improving eyedrop adherence. However, previous eyedrop electronic monitoring solutions had awkward medication bottle adjuncts and crude software for monitoring the administration of a drop that adversely affected their ability to foster sustainable improvements in adherence. The current work begins to address this unmet need for wireless technology by creating a “smart drop” bottle. This medication bottle is instrumented with sensing electronics that enable detection of each eyedrop administered while maintaining the shape and size of the bottle. This is achieved by a thin electronic force sensor wrapped around the bottle and underneath the label, interfaced with a thin electronic circuit underneath the bottle that allows for detection and wireless transmission to a smart-phone application. We demonstrate 100% success rate of wireless communication over 75 feet with <1% false positive and false negative rates of single drop deliveries, thus providing a viable solution for eyedrop monitoring for glaucoma patients.

Innovative bulls eye drop applicator for self-instillation of eye drops

PurposeTo report the role of Bulls eye drop applicator device in self-instillation of eye drops and in prevention of wastage of medicine. MethodsA small pocket sized device “Bulls eye drop applicator” was developed, which is a simple, handy, mirror-based attachment which can be attached to any eye drop bottle to help in accurate self-instillation of the drops in the eye. The prototype of this device was tried in ten volunteer subjects (Group 1) and 15 patients (Group 2); they were asked to use lubricating eye drops (5 ml bottle) in one eye without the device (N) and in the other eye with the device (M). The numbers of attempts for the application of eye drops were noted and the residual eye drops in the returned bottles were measured for quantitative assessment. ResultsTen volunteers and 11/15 patients completed the study. At the completion of the study, there were a total of 232 applications of eye drops in the Group 1 N (without device) and 1 M (with device). To achieve these 232 applications, there were 330 attempts without the device and 266 attempts of instillation were needed with the device (P < 0.0001). In Group 2, there were a total of 544 applications of eye drops; to achieve this, there were 879 attempts in Group 2 N and 685 attempts of instillation in Group 2 M (p < 0.0001). The cumulative quantity of residual drops in the returned bottles collected from Group 2 N was 5.1 ml and it was 19.7 ml in Group 2 M (p = 0.001). ConclusionsThe number of attempts of instillation reduced significantly with the use of the eye drop applicator device. The use of eye drops applicator device reduced the wastage of drops from 42.2% to 14.6% in Group 1 N Vs Group 1 M and saving of about 35.7 % in Group 2 M compared to Group 2 N.

Serum growth factor stability in different eye drop packaging systems during storage

Serum eye drops (SED) have shown beneficial effects in patients suffering from dry eye syndrome and are manufactured for an increasing number of patients in Australia every year. Previous studies have examined the stability of serum growth factors during storage in either experimental vessels not used as the final packaging system or in eye drop bottles. To ensure the quality and safety of SED product manufactured in Australia, the stability of growth factors in serum packaged into two different systems during storage at different temperatures was examined. Healthy blood donors provided a whole blood donation, from which serum was prepared, diluted to 20% and dispensed into either a tube or a vial packaging system. The stability of growth factors, fibronectin and total protein in tube segments was comparable to matched vials samples during storage at −30 °C, 4 °C, 22 °C and 37 °C, with the exception of EGF and fibronectin in 20% SED stored in tube segments, which were more sensitive to storage conditions at 4 °C and 22 °C when compared to vials. Additionally, the growth factor, fibronectin and total protein concentration in both tube segments and vials was stable during storage at −30 °C for at least 9 months. This study highlights the impact of different manufacturing procedures on serum growth factor stability during storage.

Reduction of Contamination Rate by Reducing the Volume of Preservative-free 20% Autologous Serum Eye Drops

This study investigated whether contamination can be mitigated by halving the filling volume of autologous serum eye drops from 5.0 to 2.5 mL eye drop bottles. Twelve 5.0 mL and eleven 2.5 mL ophthalmic solution bottles were prepared. The ophthalmic solution was all used after opening, leaving one to two drops of the remaining liquid. Immediately after preparation, the remaining liquid was cultured, and, after use, the nozzle and residual liquid were cultured. As a result, twelve 5.0 mL and nine 2.5 mL ophthalmic solution bottles were collected. The average use days of the 5.0 mL ophthalmic solution were 9.6 days and those of the 2.5 mL eye drops were 4.7 days. Bacteria and fungi were not detected from the residual liquid immediately after preparation. However, after use, bacteria were detected in at least one of the nozzles or residual liquid of all eye drops, and fungi were detected in one. Contamination could not be reduced by shortening the period of use of eye drops. Therefore, 20％ autologous serum eye drops need to be handled more appropriately.

Cap-puncturing mechanism for ophthalmic postoperative antibiotic eye drops: friend or foe?

A retrospective case series highlights two cases of postoperative endophthalmitis, in which similar improper technique of puncturing the antibiotic bottle with a nonsterile needle was noted.&#x0D; Patient A, a 65-year-old man with three weeks’ history of uneventful combined cataract and pars plana vitrectomy (PPV) presented with acute painful right eye and vision blurring from 6/12 to 1/60 for two days. Examination showed severe anterior chamber activity and hazy fundal view. B-scan showed dense vitritis. Vitreous sampling revealed gram positive cocci, but no culture growth. Patient B, a 69-year-old man presented with three days’ history of right painful red eye and vision dropped to light perception following an uneventful cataract surgery. Examination showed severe anterior chamber activity with hypopyon, raised intraocular pressure, and no fundal view. B-scan detected dense vitritis with loculation. Vitreous sampling cultured Pseudomonas aeruginosa in Patient B. In both cases, the patients reported piercing the generic topical ciprofloxacin 0.3% bottle tip with a nonsterile needle instead of the prescribed method of using the sterile, inner aspect of the bottle cap. However, the cultures of the bottle contents were negative in both cases. Both patients received intravitreal, topical, and systemic antibiotics and subsequently underwent PPV. Patient A recovered vision to baseline, while Patient B recovered to counting finger vision.&#x0D; The cap-puncturing mechanism for eye drop bottles is designed to maintain the sterility of the contents. However, this may backfire when patients do not understand the prescribed technique. We postulate that this improper technique predisposed the two cases to endophthalmitis.

Spectroscopy of Oxygen-Sensitive Material for Measuring Contact Lens Oxygen Transmissibility

ABSTRACTPurpose: Oxygen permeability or transmissibility is a crucial parameter for contact lenses to ensure that extended wear will not induce corneal hypoxia. This work tests a new method of using the oxidation of cysteamine, an oxygen-sensitive chemical, to quantify the oxygen transmissibility of current commercial contact lenses and contact lenses loaded with vitamin E.Methods: 3D printing was used to modify eye drop bottles and quartz cuvettes to create systems that allowed insertion of a contact lens in between the cysteamine solution and air. Both systems were exposed to atmospheric conditions where the only path of entry for oxygen was through the contact lens. The entering oxygen reacted with cysteamine, and the rate of cysteamine oxidation was measured using UV-vis spectrophotometry. The rate was then stoichiometrically related to oxygen transmissibility.Results: The eye drop method predicted transmissibility values within 9% of established, commercial values. The cuvette method predicted values within 10% of established values for silicone hydrogel lenses without any correction factor and within 11% for poly-hydroxyethyl-methacrylate lenses after correcting for oxygen entering the system. Incorporation of 20% (w/w) vitamin E into Acuvue® Oasys® lenses did not have a significant impact on the oxygen transmissibility.Conclusions: Both methods presented in this work can reliably measure oxygen transmissibility of contacts lenses or other materials. Further improvements in manufacturing could lead to improved accuracy and reliability, allowing wider use of this method for quantifying the oxygen transport in contact lenses.

A Novel Method to Eliminate Preservatives in Eye Drops.

Multiuse eye drops must maintain sterility and typically accomplish this by added preservatives. However, preservatives often cause harmful side effects. A gauze barrier dressing ("BIOGUARD®") recently cleared by the FDA has an immobilized poly diallyldimethylammonium chloride (p-DADMAC) coating and is an effective antimicrobial with minimal compound release into solution. To implement use of this dressing as a replacement for preservatives in multidose eye drop bottles, its ability to maintain sterility without interacting with the active ingredient (AI) of the ophthalmic medication was tested. To determine immobilized p-DADMAC's microbicidal efficacy, it was added to eye drop bottles, then contaminated with Staphylococcus aureus (SA113) bacteria. To assess interference with AI in eye drops, high performance liquid chromatography was used to determine whether the AIs timolol and dorzolamide were affected after exposure to p-DADMAC. To further investigate effects on AI, the microbicidal activity of Vigamox® (moxifoxacin) was assessed after p-DADMAC gauze exposure. S. aureus bacteria were eliminated by p-DADMAC-treated gauze for all samples. The concentrations of both timolol and dorzolamide increased after exposure to p-DADMAC-treated gauze, but spectrometric analysis showed that this did not occur when the p-DADMAC-coated material was presoaked in deionized water. The microbicidial activity of moxifloxacin was unaffected by exposure to p-DADMAC-treated gauze. Due to its lack of effect on eye drop AI and its microbicidal efficacy, p-DADMAC treatment would make an excellent candidate for replacing preservatives in eye drops.

Novel approaches for improving stability of cysteamine formulations

Cystinosis is a genetic disorder that leads to the formation of cystine crystals in many organs in the body including cornea. Ocular manifestation of this disease is treated by eye drops of cysteamine which can easily oxidize into its disulfide cystamine. The rapid oxidation limits the shelf life as well the duration during which the drug can be used after opening the eye drop bottle. We evaluate two approaches of preventing the oxidation of cysteamine with the goal of increasing the time of use after opening the bottle to one month. The first approach integrates antioxidants such as catalase enzyme and vitamins C and E into the aqueous solution. Results show that catalase is the most effective additive as it decreases the oxidation rate by 58%, which on its own is not sufficient to reach targeted one month stability. The second approach focuses on incorporating diffusion barriers to prevent oxygen from reaching the cysteamine solution. This was accomplished by two methods: formulation of a hydrophobic layer which floats on the surface of the aqueous solution and integration of OMAC® oxygen-resistant material into the eye drop bottle. Both methods delay the onset of cysteamine degradation and decrease the rate of degradation. In particular, an eye drop bottle with three layers of OMAC® has less than 10% degradation after one month of opening the bottle and withdrawing a drop each day. By integrating all three methods, we designed a system where >90% of cysteamine remains in the active form for 70 days after opening the bottle. In addition, we examine the use of OMAC® as heat-sealed pouches for storage of cysteamine eye drop bottles during packaging to eliminate the need for the current approach of freezing the formulation during shipping. The results show that such heat-sealed pouches would keep cysteamine stable for over one year at ambient conditions.

Drop instillation and glaucoma.

To describe the current state of knowledge regarding glaucoma patients' eye drop technique, interventions attempting to improve eye drop technique, and methods for assessing eye drop technique. In observational studies, between 18.2 and 80% of patients contaminate their eye drop bottle by touching their eye or face, 11.3-60.6% do not instill exactly one drop, and 6.8-37.3% miss the eye with the drop. Factors significantly associated with poorer technique include older age, lack of instruction on eye drop technique, female sex, arthritis, more severe visual field defect, lack of positive reinforcement to take eye drops, lower educational level, low self-efficacy, and being seen at a clinic rather than a private practice. Among intervention studies, four of five studies using a mechanical device and three of four studies using educational interventions to improve technique showed positive results, but none of the studies were randomized controlled trials. Poor eye drop technique is a significant impediment to achieving good control of intraocular pressure in glaucoma. Both mechanical device interventions and educational interventions offer promise to improve patients' technique, but studies with stronger designs need to be done followed by introduction into clinical practice.

Multidose Preservative Free Eyedrops by Selective Removal of Benzalkonium Chloride from Ocular Formulations.

About 70% of eye drops contain benzalkonium chloride (BAK) to maintain sterility. BAK is an effective preservative but it can cause irritation and toxicity. We propose to mitigate ocular toxicity without compromising sterility by incorporating a filter into an eye drop bottle to selectively remove BAK during the process of drop instillation. The filter is a packed bed of particles made from poly(2-hydroxyethyl methacrylate) (pHEMA), which is a common ophthalmic material. We showed that pHEMA particle prepared by using ethoxylated trimethylolpropane triacrylate as crosslinker can be incorporated into a modified eyedrop bottle tip to selectively remove the preservative as the formulation is squeezed out of the bottle. Hydraulic permeability of the plug is measured to determine the resistance to eye drop squeezing, and % removal of BAK and drugs are determined. The modified tip has a hydraulic permeability of about 2 Darcy, which allows eyedrops formulations to flow through without excessive resistance. The tip is designed such that the patients can create an eyedrop of solution of 1-10cP viscosity in 4s with a nominal pressure. During this short contact time, the packed particles removed nearly 100% of benzalkonium chloride (BAK) from a 15mL, 0.012% BAK solution but have only minimal impact on the concentration of contained active components. Our novel design can eliminate the preservative induced toxicity from eye drops thereby impacting hundreds of millions of patients with chronic ophthalmic diseases like glaucoma and dry eyes.

Profiling extractable and leachable inorganic impurities in ophthalmic drug containers by ICP-MS

In this study, we investigated the elemental impurities present in the plastic material of ophthalmic eye drop bottles using inductively coupled plasma-mass spectrometry (ICP-MS). Metallic contaminations, especially localized within the small cavity of the eye, can significantly perturb the ocular metallome. The concern is two-fold: first certain elements, for example heavy metals, can be toxic to humans at even trace levels, and second, these contaminations can have adverse reactions with other medicines or enzymatic processes in the eye. The implication of redox-active metals in cataract formation is one such biological consequence. The analysis demonstrated the effect of aggressive storage and transportation conditions on elemental extractable and leachable contamination, and posits that release of these elemental impurities can disrupt metallome equilibrium in the ocular compartment, leading to toxicity and disease.

Perception of eye drops self-instillation in the elderly with or without facial support device

A large amount of eyedrops users have difficulty in instillation, often touching the tip of the bottle into the eye, which can lead to contamination of the product in the bottle. There is also excessive instillation of droplets, which generates waste and may cause poisoning. The use of the Eyedrop® facial supporter reduced the touch of the tip of the eyedrop bottle on the ocular tissues, making instillation easier […]. Perception of eye drops self-instillation in the elderly with or without [...]

New drug delivery system for corneal administration of mitomycin-C

To develop a new corneal release system to deliver optimum amounts of mitomycin-C (MMC) during the perioperative period of photorefractive keratectomy (PRK). Ophthalmos S/A, São Paulo, Brazil. Experimental study. An invitro experimental design was developed for studying a new MMC delivery system at a drug concentration of 0.02%. Whatman sterile filter paper disks with a diameter of 8.0mm were impregnated with MMC solution. After drying, the disks were placed on agar plates seeded with Staphylococcus epidermidis; this was followed by instillation of a drop of sterile water. After 1minute, the disks were removed and the plates were incubated for 48hours at 35°C. The mean volume of the drops delivered from regular eyedrop bottles was determined, and the inhibition zone (in millimeters) was correlated with the amount of MMC loaded onto the disks. Analysis of the inhibition zones produced by MMC indicated that 16μg was the optimum dose to be incorporated in the disks. The mean volume of a drop delivered from eyedrop bottles was 37.7μL. One minute after the application of a single drop of a balanced salt solution, the system released an adequate concentration of MMC for PRK. A new delivery system for MMC was successfully developed for application during photorefractive keratectomy. Dr. de Souza Lima Filho is the managing director of Ophtalmos S/A. Drs. de Souza Lima Filho, Irochima Pinheiro, and Oréfice have exclusive rights to intellectual property of this invention secured by a patent application filed with the Instituto Nacional da Propriedade Industrial.