Tuesday, December 28, 2010

Abstract: Lacrisert case study (long term use)

Sorry but I'm not impressed. OK, so this individual who successfully used Lacriserts for years has Sjogrens, but apparently his/her dry eye was mild enough (we are not told her Schirmer or any other clinical data in the abstract) that she could wear soft contacts all these years.

Long-term use of hydroxypropyl cellulose ophthalmic insert to relieve symptoms of dry eye in a contact lens wearer: case-based experience.
Eye Contact Lens. 2011 Jan;37(1):39-44.
Wander AH.
From the Department of Ophthalmology, University of Cincinnati College of Medicine and Academic Health Center, Cincinnati, OH.

To report a case in which hydroxypropyl cellulose ophthalmic inserts were successfully used for the treatment of dry eye disease in a contact lens (CLs) wearer for more than 25 years.

Review of clinical findings in a female CL wearer with dry eye spanning more than 30 years. The patient was diagnosed with the Sjögren syndrome and demonstrated inadequate lacrimation as assessed by Schirmer testing. Slitlamp examination demonstrated bilateral corneal stippling with fluorescein and signs of superior limbic keratoconjunctivitis.

Initially, the patient's symptoms improved with infrequent use of artificial tears. As the signs and symptoms of dry eye disease worsened, the patient initiated therapy with once-daily hydroxypropyl cellulose ophthalmic inserts. Punctal plugs and updating to increasingly oxygen-permeable soft CLs, in combination with continued use of the inserts, largely controlled the signs and symptoms of dry eye disease during a 25-year period. Simultaneous use of the hydroxypropyl cellulose ophthalmic inserts and CLs was well tolerated without any significant side effects or changes in visual acuity.

Dry eye is a chronic disease often requiring long-term management. In this case, daily use of hydroxypropyl cellulose ophthalmic inserts effectively treated autoimmune dry eye, providing symptomatic relief, and resulted in improved objective measures of disease severity across several decades. Such an experience is consistent with the available evidence-based data for hydroxypropyl cellulose ophthalmic inserts and supports their use in clinical practice for the treatment of moderate-to-severe dry eye disease.


Anonymous said...

I can't comment on this patient or this study, but I have had considerable success with Lacriserts. I've used them for 13 months. It took some time to get used to them, and even now I can wear them, for the most part, only at night and for a few hours after I get up in the morning. I generally find them too uncomfortable to wear during the day. But I feel much better using them. I've gone from wearing goggles virtually every waking hour to wearing them much less -- only outdoors, in stores, in restaurants that have fans. etc. I know this sounds like I still wear goggles a lot. But I no longer feel that I have to stop working -- I teach part time in a university. Equally importantly, I can read again -- for several years I couldn't read for pleasure at all -- I even stopped reading the newspaper, and could hardly stand being on the computer. I'd like to encourage other dry eye patients to try Lacriserts. I don't know my current Schirmer's score, but before I began using Lacriserts it was 1. All I really know is that I feel better.

Anonymous said...

Hi,I am one of the unlucky LASIK victims. I had some minor dry eye before going for a LASIK consult. I did not know that I was not a good candidate for the procedure. They obviously wanted my money so I had LASIK in 09/2007. From that point on, the severity of my dry eyes changed my life. I have had punctual plugs now for over a year along with twice daily Restasis. Recently, my eyes are have needed more help and I was just prescribed Lacrisert. I have worn them twice so far and I am optomistic. I think I should not have too much trouble getting used to them. I wore hard contacts for years. Wish me luck.