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Marianne O Price - One of the best experts on this subject based on the ideXlab platform.

Edward J. Holland - One of the best experts on this subject based on the ideXlab platform.

  • loteprednol etabonate 0 5 versus Prednisolone Acetate 1 0 for the treatment of inflammation after cataract surgery
    Journal of Cataract and Refractive Surgery, 2013
    Co-Authors: Stephen S Lane, Edward J. Holland
    Abstract:

    Purpose To evaluate the efficacy of loteprednol etabonate 0.5% versus Prednisolone Acetate 1.0% for the control of postoperative inflammation in patients having routine cataract surgery. Setting Private practice, Stillwater, Minnesota, and Cincinnati Eye Institute, Cincinnati, Ohio, USA. Design Comparative case series. Methods Patients were at least 18 years of age and scheduled for routine cataract surgery. Patients were excluded from the study if they had preexisting medical conditions (ie, elevated intraocular pressure [IOP], retinopathy, maculopathy, uveitis) or required medications the investigator believed would put the patient at risk or confound the study. Patients were randomized to receive loteprednol etabonate or Prednisolone Acetate 4 times daily in addition to bromfenac 0.09% and besifloxacin 0.6% after surgery. Visual acuity, IOP, and anterior chamber cell and flare intensity were assessed over 3 weeks after cataract surgery. The primary endpoint was the level of anterior chamber cell and flare intensity in patients treated with loteprednol etabonate or Prednisolone Acetate. Results The study enrolled 88 patients (46 loteprednol etabonate, 42 Prednisolone Acetate). Equivalency was achieved between the 2 treatment groups with no significant differences throughout the 3-week follow-up. There was less fluctuation in IOP assessments in patients treated with loteprednol etabonate than in patients treated with Prednisolone Acetate, in particular 1 day and 3 days postoperatively. Conclusions The results indicate that equivalent control of inflammation can be obtained through treatment with loteprednol etabonate or Prednisolone Acetate after cataract surgery. In addition, treatment with loteprednol etabonate may result in less IOP fluctuation. Financial Disclosure Dr. Lane is a consultant to Bausch & Lomb, Rochester, New York, Alcon Laboratories, Inc., Fort Worth, Texas, and ISTA Pharmaceuticals, Irvine, California, USA. Dr. Holland is a consultant to Bausch & Lomb, Rochester, New York, and Alcon Laboratories, Inc., Fort Worth, Texas, USA. Neither author has a financial or proprietary interest in any material or method mentioned.

  • a multicenter randomized controlled fellow eye trial of pulse dosed difluprednate 0 05 versus Prednisolone Acetate 1 in cataract surgery
    American Journal of Ophthalmology, 2011
    Co-Authors: Eric D. Donnenfeld, Edward J. Holland, Kerry D. Solomon, Jay Fiore, Anthony Gobbo, Jessica Prince, Helga P. Sandoval, Emily R. Shull, Henry D. Perry
    Abstract:

    Purpose To compare the effects of 2 corticosteroids on corneal thickness and visual acuity after cataract surgery. Design Multicenter, randomized, contralateral-eye, double-masked trial. Methods Fifty-two patients (104 eyes) underwent bilateral phacoemulsification. The first eye randomly received difluprednate 0.05% or Prednisolone Acetate 1%; the fellow eye received the alternative. Before surgery, 7 doses were administered over 2 hours; 3 additional doses were given after surgery, before discharge. For the remainder of the day, corticosteroids were administered every 2 hours, then 4 times daily during week 1 and twice daily during week 2. Corneal pachymetry, visual acuity, and corneal edema were evaluated before surgery and at days 1, 15, and 30 after surgery. Endothelial cell counts were evaluated before surgery and at 30 days after surgery. Retinal thickness was evaluated before surgery and at 15 and 30 days after surgery. Results Corneal thickness at day 1 was 33 μm less in difluprednate-treated eyes ( P = .026). More eyes were without corneal edema in the difluprednate group than in the Prednisolone group at day 1 (62% vs 38%, respectively; P = .019). Uncorrected and best-corrected visual acuity at day 1 were significantly better with difluprednate than Prednisolone by 0.093 logMAR lines ( P = .041) and 0.134 logMAR lines ( P 2 higher in difluprednate-treated eyes at day 30 ( P P = .011). Conclusions In this high-dose pulsed-therapy regimen, difluprednate reduced inflammation more effectively than Prednisolone Acetate, resulting in more rapid return of vision. Difluprednate was superior at protecting the cornea and reducing macular thickening after cataract surgery.

  • attenuation of ocular hypertension with the use of topical loteprednol etabonate 0 5 in steroid responders after corneal transplantation
    Cornea, 2009
    Co-Authors: Edward J. Holland, Ali R Djalilian, Jeffrey P Sanderson
    Abstract:

    Purpose To describe a clinically observed reduction in intraocular pressure (IOP) without increased allograft rejection in known "steroid responders" using loteprednol etabonate 0.5% ophthalmic suspension as second-line rescue therapy after corneal transplantation. Methods Medical records from a prespecified 15-month period were retrospectively reviewed for all post-corneal transplant patients in whom loteprednol etabonate was initiated and Prednisolone Acetate 1.0% ophthalmic suspension withdrawn because of a secondary increase in IOP. Elevated postoperative IOP was defined as IOP that increased > or =21 mm Hg. Baseline IOP values were compared with IOP readings at follow-up examinations, with data points set retrospectively at 0-4, 4-8, 8-16, 16-32, and >32 weeks. Patient records were evaluated for any signs of allograft rejection during loteprednol etabonate therapy. Results Thirty patients were found to have switched to loteprednol etabonate after an increase in IOP during postoperative Prednisolone Acetate treatment. The mean reduction in IOP observed when comparing initial and final values in all 30 patients was 12.9 mm Hg during a mean follow-up of 21.6 weeks. The mean percent reduction in IOP during loteprednol etabonate treatment was 32.6% at 3 weeks and 44.9% at 39 weeks. No clinically observed signs of allograft rejection were documented. Conclusions Switching to loteprednol etabonate from Prednisolone Acetate in known steroid responders was successful in reducing IOP and did not increase the risk of allograft rejection. Because of its lower potential for causing elevated IOP, loteprednol etabonate should be considered in the prophylaxis of allograft rejection in steroid responders.

Theofilos Tourtas - One of the best experts on this subject based on the ideXlab platform.

  • randomized comparison of topical Prednisolone Acetate 1 versus fluorometholone 0 1 in the first year after descemet membrane endothelial keratoplasty
    Cornea, 2014
    Co-Authors: Marianne O Price, Bjoern O. Bachmann, Friedrich E Kruse, Francis W Price, Theofilos Tourtas
    Abstract:

    PURPOSE: The aim of this study was to compare the efficacy and side effects of Prednisolone Acetate 1% versus fluorometholone 0.1% after Descemet membrane endothelial keratoplasty (DMEK). METHODS: DMEK recipients used Prednisolone Acetate 1% for 1 month, and they were randomized to either Prednisolone or fluorometholone for months 2 through 12. Dosing was 4 times daily in months 1 to 3, thrice daily in month 4, twice daily in month 5, and once daily in months 6 to 12. The main outcomes were immunologic rejection episodes and intraocular pressure (IOP) elevation (defined as ≥24 mm Hg or ≥10 mm Hg increase over the preoperative baseline level), assessed by the Kaplan-Meier survival analysis. RESULTS: The study included 325 eyes (99% were white, 96% had Fuchs dystrophy, and 9% had a previous glaucoma diagnosis). No eyes (0%) assigned to Prednisolone versus 2 eyes (1.4%) assigned to fluorometholone experienced a possible (n = 1) or probable (n = 1) rejection episode (P = 0.17). Both rejection episodes resolved successfully with increased topical steroids. In the Prednisolone arm, a significantly higher proportion exceeded the defined IOP elevation threshold (22% vs. 6%, P = 0.0005), and glaucoma medications were initiated or increased more often (17% vs. 5%, P = 0.0003). The most frequent reasons for discontinuing the assigned intervention were IOP management (n = 13 eyes assigned to Prednisolone) or inflammation management (n = 3 eyes assigned to fluorometholone). One-year endothelial cell loss was comparable in both arms (30% vs. 31%, P = 0.50). CONCLUSIONS: DMEK has a remarkably low rejection episode rate (<1% through 1 year), as confirmed in this prospective randomized study. This provides a unique opportunity to reduce postoperative topical corticosteroid strength and thereby reduce the risk of steroid-associated complications.

  • randomized comparison of topical Prednisolone Acetate 1 versus fluorometholone 0 1 in the first year after descemet membrane endothelial keratoplasty
    Cornea, 2014
    Co-Authors: Marianne O Price, Bjoern O. Bachmann, Friedrich E Kruse, Francis W Price, Theofilos Tourtas
    Abstract:

    Purpose:The aim of this study was to compare the efficacy and side effects of Prednisolone Acetate 1% versus fluorometholone 0.1% after Descemet membrane endothelial keratoplasty (DMEK).Methods:DMEK recipients used Prednisolone Acetate 1% for 1 month, and they were randomized to either Prednisolone

Francis W Price - One of the best experts on this subject based on the ideXlab platform.

Stephen C Foster - One of the best experts on this subject based on the ideXlab platform.

  • iontophoretic dexamethasone phosphate compared to topical Prednisolone Acetate 1 for noninfectious anterior segment uveitis
    American Journal of Ophthalmology, 2020
    Co-Authors: John D. Sheppard, Michael B. Raizman, Sunir J Garg, Christopher W Lievens, Lisa Brandano, Barbara M Wirostko, Michael S Korenfeld, Stephen C Foster
    Abstract:

    Purpose To evaluate the safety and efficacy of dexamethasone phosphate ophthalmic solution (EGP-437) delivered by a transscleral iontophoresis delivery system (EyeGate II) compared to that of topical Prednisolone Acetate 1% (PA 1%) in subjects with noninfectious anterior uveitis. Design Prospective, randomized, double-masked, parallel group, noninferiority clinical trial. Methods A total of 193 subjects with active noninfectious anterior uveitis (anterior chamber [AC] cell count ≥11 cells) were randomized to EGP-437 delivered by iontophoresis (days 0 and 7) or self-administered PA 1% daily (tapered schedule, days 0-28). Masking was maintained with placebo iontophoresis or eye drops. The primary efficacy endpoint was the proportion of subjects with an AC cell count of zero on day 14. Noninferiority of EGP-437 was defined if the lower limit of the confidence interval (CI) for the difference (EGP-437 minus PA 1%) was less than −10%. Results At day 14, 32 of 96 EGP-437 subjects (33.3%) and 32 of 97 PA 1% subjects (33.0%) had an AC cell count of zero (difference, 0.34; 95% CI, −12.94 to 13.63; P = 0.064). Efficacy trended better with EGP-437 among patients with more severe baseline uveitis (AC cell count >25). Safety and tolerability were good with both treatments. EGP-437 subjects experienced fewer IOP elevations ≥6 mm Hg versus PA 1% subjects (13 vs 24 incidents, respectively, through day 28). Conclusions Despite clinically similar response rates, statistical noninferiority of EGP-437 versus a tapered regimen of PA 1% was not achieved. Numerical trends suggesting fewer IOP elevations with EGP-437, similar efficacy overall, and possibly better efficacy in more severe disease warrant further study.

  • difluprednate 0 05 versus Prednisolone Acetate 1 for endogenous anterior uveitis pooled efficacy analysis of two phase 3 studies
    Ocular Immunology and Inflammation, 2019
    Co-Authors: John D. Sheppard, Thomas E. Flynn, Stephen C Foster, Melissa M. Toyos, Kerry L. Markwardt, Robert Da Vanzo, John H. Kempen
    Abstract:

    ABSTRACTPurpose: To analyse pooled data from 2 similar phase 3 noninferiority studies comparing difluprednate 0.05% versus Prednisolone Acetate 1% in patients with endogenous anterior uveitis.Metho...

  • difluprednate 0 05 versus Prednisolone Acetate 1 for endogenous anterior uveitis a phase iii multicenter randomized study
    Investigative Ophthalmology & Visual Science, 2014
    Co-Authors: John D. Sheppard, Melissa M. Toyos, John H. Kempen, Paramjit Kaur, Stephen C Foster
    Abstract:

    Purpose. Endogenous anterior uveitis (AU), when untreated, may lead to vision loss. This study compared the safety and efficacy of difluprednate versus Prednisolone Acetate for the treatment of this condition.

  • efficacy and safety of rimexolone 1 ophthalmic suspension vs 1 Prednisolone Acetate in the treatment of uveitis
    American Journal of Ophthalmology, 1996
    Co-Authors: Stephen C Foster, George Alter, Michael B. Raizman, James L. Crabb, Carmen Santos, Mitchell H. Friedlaender, Raymond L Debarge, Scott L Feiler
    Abstract:

    Purpose TWO multicenter studies compared the efficacy and safety of rimexolone 1% ophthalmic suspension (Vexol 1%, Alcon) and 1% Prednisolone Acetate (Pred Forte, Allergan). Methods Patients with acute uveitis, recurrent iridocyclitis, or chronic uveitis treatable by topical corticosteroid were enrolled. Treatment regimen was one or two drops every hour during Week 1, every two hours during Week 2, four times a day during Week 3, and once a day for the last three days. Efficacy and safety were determined on Days 3, 4, 7 to 10, 14, 21, and 28. A poststudy evaluation was conducted 36 to 72 hours after treatment was stopped. Results When anterior chamber cell and flare were measured, rimexolone 1% was found to be as effective as 1% Prednisolone. The largest differenee observed between treatments was 0.5 score unit, not clinically significant. There were no statistically significant differences in cell scores in either study (P > .05). No statistically significant differences in flare scores were found except at Day 28 in Study One (P = .04). Also, Prednisolone was found to be more likely than rimexolone to cause a clinically significant increase (10 mm Hg or more) in intraocular pressure (1.7 times more likely in Study One, eight times more likely in Study Two). Conclusions Rimexolone 1% ophthalmic suspension is safe and effective for the treatment of uveitis.