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Optimal Injection Techniques for Best Dexamethasone Intraocular Suspension Instillation Results

Watch Time: 20 mins

Faculty Presenters: Dr Cynthia Matossian, Dr Karl Stonecipher, Dr Eric Donnenfeld, Dr John Hovanesian

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This activity has been funded by an educational grant from EyePoint Pharmaceuticals, Inc. EyePoint Pharmaceuticals, Inc. provided financial support and had no input into the selection of the faculty and/or the detailed project scope. This activity is provided by Touch Medical Communications (TMC) for touchOPHTHALMOLOGY.

This content is for Healthcare Professionals based in the USA only.

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This activity has been funded by an educational grant from EyePoint Pharmaceuticals, Inc. EyePoint Pharmaceuticals, Inc. provided financial support and had no input into the selection of the faculty and/or the detailed project scope. This activity is provided by Touch Medical Communications (TMC) for touchOPHTHALMOLOGY.

Cataract Surgery Watch Time: 20 mins

touchEXPERT BRIEFING Optimal Injection Techniques for Best Dexamethasone Intraocular Suspension Instillation Results

Watch leading experts discuss the use of intracameral corticosteroids for the management of inflammation following cataract surgery.

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Dr Cynthia Matossian
Matossian Eye Associates, Doylestown, PA, USA
Current unmet needs in cataract and intraocular surgery

Dr Matossian discusses the current unmet needs in drug delivery for cataract and intraocular surgery, including the problems that patients may encounter with post-surgical topical regimens and the issues that can result if patients do not successfully adhere to their eyedrop regimens.

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Interview Questions

In this interview we asked Dr Cynthia Matossian the following questions:

  • What are the unmet needs in drug delivery for cataract and intraocular surgery?
  • Why are eyedrops a problem for patients?
  • What are the issues if patients are non-compliant with drops?
About Dr Cynthia Matossian

Dr Cynthia Matossian, MD, is Founder and Medical Director of Matossian Eye Associates and a board certified refractive cataract surgeon who specializes in Dry Eye and Ocular Surface Disease. Dr Matossian uses the latest advances in diagnostic and therapeutic options to address Meibomian Gland Dysfunction and Tear Film instability.  She lectures nationally and internationally on ocular surface optimization techniques prior to eye surgery, medications, and advances in the dry eye field. She has authored numerous peer-reviewed articles and has contributed to countless publications.  She was named one of Ocular Surgery News‘ Premier Surgeons, an elite group of 300 refractive cataract surgeons in the USA. She is a Clinical Assistant Professor of Ophthalmology (Adjunct) at Temple University School of Medicine. She is often invited to chair panels and moderate discussions at national and regional meetings.

Disclosures: Consultant for: Aerie Pharmaceuticals, Alcon, Allergan, Bausch + Lomb, Bruder Healthcare, Checked-Up, Conclusn, Dompé, EyePoint, EyeVance, Glint Pharmaceuticals, Guardion Health Services, Imprimis Pharmaceuticals, Johnson & Johnson, Kala Pharmaceuticals, Lacriscience, Lenstec, Lumenis, Marco, MDBackline, Novartis, NuSight Medical, Ocular Science, Olympic, Omeros, Osmotica Pharmaceuticals, Physician Recommended Nutriceuticals, Quidel, StepWise Medical, Sun Pharmaceuticals, TearLab, TearScience (J&J), TissueTech, Zeiss. Investor in: Checked-Up, Physician Recommended Nutriceuticals, Strathspey Crown, Veterinarian Recommended Solutions. Member of Speakers Bureau for: Alcon, Allergan, Bausch + Lomb,, EyePoint, EyeVance, Guardion Health Services, Imprimis Pharmaceuticals, Johnson & Johnson, Kala Pharmaceuticals, Lacriscience, Lumenis, Novartis, NuSight Medical, Olympic, Omeros, Physician Recommended Nutriceuticals, Sun Pharmaceuticals, TearLab, TearScience (J&J), TissueTech, Zeiss. Has received research funding from: Dompé, Imprimis Pharmaceuticals, Johnson & Johnson, Novartis.

 
Dr Karl Stonecipher
Physicians Protocol, Greensboro, NC, USA
Which patients are good candidates for dexamethasone intraocular suspension?

Dr Stonecipher will consider which types of patients are suitable candidates for treatment with dexamethasone intraocular suspension and what are the key facts that patients should know before instillation. He will also outline the main advantages of dexamethasone intraocular suspension over topical eyedrops.

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Interview Questions

In this interview we asked Dr Karl Stonecipher the following questions:

  • Who would be a good candidate for treatment with dexamethasone intraocular suspension?
  • What should we tell patients about dexamethasone intraocular suspension?
  • What are the advantages of dexamethasone intraocular suspension?
About Dr Karl Stonecipher

Dr Karl Stonecipher, MD, is a cornea and refractive trained surgical specialist and the Director of The Laser Center in Greensboro, North Carolina. He is a Clinical Associate Professor of Ophthalmology at the University of North Carolina, assists in the refractive and refractive cataract surgery training of the residents in the department of Ophthalmology and is the medical director for The Laser Center-Greensboro, Physicians Protocol, Laser Defined Vision, and Restoration Med Spa. He has performed over 78,000 refractive surgical procedures and over 36,000 cataract surgical procedures. read more

With more than 100 book chapters, abstracts and articles published, Dr Stonecipher speaks both nationally and internationally on refractive, cataract, presbyopic and corneal surgery. Dr Stonecipher recently received his second Achievement Award from the American Academy of Ophthalmology and is listed as one of the Top Fifty Ophthalmologist by Cataract and Refractive Surgery Today, registered with Who’s Who in Ophthalmology, and picked as one of Americas Top Ophthalmologists over ten years running.

Disclosures: Consultant for: Advanced Eye Care, Alcon, Allergan, Bausch and Lomb, Espansione, Eyevance, Eyepoint, Nidek, Pogotec, Presbia, Refocus, Shire; lecture fees from Advanced Eye Care, Alcon, Allergan, Bausch and Lomb, Espansione, Eyevance, Eyepoint, Innovamed, J + J, Lombart, Nidek, Refocus, Shire; conducted research for Alcon, Allergan, Espansione, Nidek, Presbia, Refocus; owner/equity shares in Alphaeon , Pogotec, Strathspey Crown.

 
Dr Eric Donnenfeld
Ophthalmic Consultants of Long Island, Garden City, NY, USA
Clinical evidence on the efficacy and safety of dexamethasone intraocular suspension

Dr Donnenfeld will summarise the clinical trial evidence available to support the efficacy and safety of dexamethasone intraocular suspension in the treatment of post-surgical inflammation, and describe the technique that he uses to instil dexamethasone intraocular suspension into the eye.

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Interview Questions

In this interview we asked Dr Eric Donnenfeld the following questions:

  • What is the clinical trial evidence for dexamethasone intraocular suspension in terms of efficacy?
  • What is the clinical trial evidence for dexamethasone intraocular suspension in terms of safety?
  • How is dexamethasone intraocular suspension inserted into the eye?
About Dr Eric Donnenfeld

Dr Eric Donnenfeld, MD, is an internationally recognized expert and pioneer in refractive, cornea and cataract surgery and one of the leading refractive and cataract surgeons in the United States. He is the founding partner of Ophthalmic Consultants of Long Island and Ophthalmic Consultants of Connecticut.  Additionally, Dr Donnenfeld serves as Clinical Professor of Ophthalmology at New York University Medical Center and Surgical Director of The Lions Eye Bank of Long Island, NY.  He has authored more than 210 papers on cornea, external disease, cataract and refractive surgery, 500 scientific articles, and 50 books and book chapters on a range of subjects pertaining to corneal transplants, cataract care and laser vision correction. read more

Dr Donnenfeld is on the editorial board of nine journals and has participated in over 40 FDA studies. He is one of the first five people in the world to perform both laser vision correction and laser cataract surgery. Dr Donnenfeld is a Fellow of the American Academy of Ophthalmology and has received its Honor Award, Senior Honor Award, Life Achievement Honor Award and Secretariat Award. He is past President of the American Society of Cataract and Refractive Surgery, President elect of the International Intraocular Implant Society, and Editor-in-Chief of Eyeworld. The Journal of Cataract & Refractive Surgery Today has named Dr Donnenfeld as one of the Top 50 Most Influential Ophthalmologists in the United States. The Ophthalmologist, an internationally recognized magazine, named Dr Donnenfeld to their Power List in 2020.

Disclosures: Consultant for: Allegro, Allergan, Alcon, Avedro, Avellino Labs, Bausch & Lomb, CorneaGen, Covalent, CRST, BVI, Blephex, Dompe, Elenza, ELT Sight, EyePoint Pharma, Foresight, Glaukos, Icon Biosciences, Johnson & Johnson, Kala, Katena Lacripen, LensGen,  Mati Pharmaceuticals, MDBackline, Merck, Mimetogen, Nanowafer, Novabay, Novartis, Novaliq, Ocular Innovations, Oculis, Odyssey, Omega Ophthalmics, Orasis, Oyster Point Therapeutics, Pfizer, Pogotec, Ocuhub, Omeros, PRN , RegenerEyes, ReTear, RPS, Shire, Strathspey  Crown, SUN, Surface,  Tearlab, Thea, TLC Laser Centers, Veracity, Versant Ventures, Visionary Venture, Zeiss.

 
Dr John Hovanesian
Harvard Eye Associates, Laguna Hills, CA, USA
Tips and tricks for optimal instillation of dexamethasone intraocular suspension

In this interview, Dr Hovanesian provides guidance on the optical way to instil dexamethasone intraocular suspension, including tips on how to ensure that the substance remains in its intended position, and what the clinician should do if the dexamethasone intraocular suspension moves in front of the iris. He also outlines the potential post-operative problems that may be encountered with this procedure and how they should be addressed.

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Interview Questions

In this interview we asked Dr John Hovanesian the following questions:

  • How can the clinician ensure dexamethasone intraocular suspension stays behind the iris?
  • What should the clinician do if dexamethasone intraocular suspension moves in front of the iris?
  • What are the potential post-operative problems with dexamethasone intraocular suspension and how should they be addressed?
About Dr John Hovanesian

Dr John Hovanesian is a board-certified ophthalmologist, a faculty member at the UCLA Jules Stein Eye Institute, and an internationally-recognized leader in the fields of corneal, cataract, refractive and laser surgery. He has published two eye surgery textbooks – one on the subject of refractive cataract surgery and one on pterygium surgery. Dr Hovanesian has been invited to lecture to surgeons on six continents, authored dozens of peer-reviewed articles, and produced surgical teaching videos that have won the “Best Teaching” award at the prestigious ASCRS Film Festival. He is the cataract surgery section editor for the world’s most widely read eyecare trade journal and serves on several other editorial boards. read more

He is a recipient of the American Academy of Ophthalmology’s Senior Achievement Award for his service as chairman of the Academy’s cataract education committee, and he has been named a Distinguished Eagle Scout by the Boy Scouts of America for internationally recognized contributions to his professional field. Dr Hovanesian has made dozens of volunteer surgical trips to third world countries, including Armenia, Mexico, Honduras, El Salvador, and Fiji. He has spent over 20 years volunteering as a board member, board chairman, and as an adult leader for the Boy Scouts of America, which has presented him with numerous service awards.

Disclosures: Consultant for: Aerie, Alcon, Allergan, Azura Ophthalmics, Cord, LLC, Eyedetec, EyePoint, Glaukos, Guardion Health Sciences, Ingenoeye LLC, Ivantis, Johnson & Johnson Vision, Kala, Novaliq, Novartis, Ocular Therapeutix, Oculis, Omeros, Refocus Group, Research InSight LLC, SightLife, Sun Ophthalmics, Tearlab, Vindico Medical Education, Zeiss. Medical advisory board member for: Bausch & Lomb, BlephEx, Eyedetec, EyePoint, Glaukos, Guardion Health Sciences, Katena, Mdbackline, Novartis, Ocular Therapeutix, Omeros, Sight Sciences, SightLife, Sun Ophthalmics, Zeiss. Has received research funding from: Alcon, Allergan, Bausch & Lomb, Cord, LLC, EyePoint, Glaukos, Ingenoeye LLC, Johnson & Johnson Vision, Katena, Novartis, Ocular Therapeutix, Omeros, Research InSight LLC, Sun Ophthalmics, Zeiss. Has equity interest in: Alcon, Alicia Surgery Center, Allegro Ophthalmics, Allergan, Cord, LLC, Equinox, Eyedetec, Guardion Health Sciences, Harvard Eye Associates, Ingenoeye LLC, Johnson & Johnson Vision, Mdbackline, Novartis, Ocular Therapeutix, Research InSight LLC, RxSight, Sight Sciences, SightLife, Tear Clear, Versant Ventures and its investments, Visionary Ventures Fund 1 and 2 and its investments. Has received royalties from sale from: Slack Books.

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Overview & Learning Objectives
Overview

Experts in cataract surgery discuss unmet needs in post-operative care and the potential benefits of intracameral corticosteroids for the management of inflammation following surgery. Personal insights are shared on the successful use of dexamethasone intraocular suspension to prevent post-operative inflammation following cataract surgery.

Learning Objectives

After watching this touchEXPERT BRIEFING, you should be able to:

  • Describe the unmet needs in post-operative care for patients undergoing cataract surgery
  • Identify which patients might benefit most from the use of dexamethasone intraocular suspension
  • Describe the key efficacy and safety data available for dexamethasone intraocular suspension
  • Understand the optimal techniques to use for successful instillation of dexamethasone intraocular suspension

 

References
References
  1. Okeke CO, Quigley HA, Jampel HD, et al. Adherence with topical glaucoma medication monitored electronically the Travatan Dosing Aid study. Ophthalmology. 2009;116:191–9.
  2. An JA, Kasner O, Samek DA, et al. Evaluation of eyedrop administration by inexperienced patients after cataract surgery. J Cataract Refract Surg. 2014;40:1857–61.
  3. Assil KK, Greenwood MD, Gibson A, et al. Dropless cataract surgery: modernizing perioperative medical therapy to improve outcomes and patient satisfaction. Curr Opin Ophthalmol. 2020; doi:10.1097/ICU.0000000000000708. Online ahead of print.
  4. Kiernan DF. Dexamethasone intracameral drug-delivery suspension for inflammation associated with vitreoretinal surgery. BMJ Open Ophthalmol. 2020;5:e000491.
  5. DEXYCU® (dexamethasone intraocular suspension) 9% full US Prescribing Information. EyePoint Pharmaceuticals, Inc. December 2018. Available at: https://dexycu.com/downloads/DEXYCU%20Prescribing%20Information_6-11-20.pdf (accessed 12 November, 2020).
  6. Donnenfeld E, Holland E. Dexamethasone intracameral drug-delivery suspension for inflammation associated with cataract surgery: a randomized, placebo-controlled, phase III trial. Ophthalmology. 2018;125:799–806.
  7. Donnenfeld ED, Solomon KD, Matossian C. Safety of IBI-10090 for inflammation associated with cataract surgery: Phase 3 multicenter study. J Cataract Refract Surg. 2018;44:1236–46.
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