EyeWorld Asia-Pacific June 2020 Issue

PHARMACEUTICALS EWAP JUNE 2020 55 by Liz Hillman Editorial Co-Director Contact information Radcliffe: drradcliffe@gmail.com Singh : ipsingh@amazingeye.com This article originally appeared in the April 2020 issue of EyeWorld . It has been UNKIJVN[ OQFKƂGF CPF CRRGCTU JGTG YKVJ permission from the ASCRS Ophthalmic Services Corp. D exycu (dexamethasone intraocular suspension, EyePoint Pharmaceuticals) and Dextenza (dexamethasone ophthalmic insert, Ocular Therapeutix) both received FDA approval in 2019. While they are both approved for the treatment of postoperative ˆ˜y>““>̈œ˜] ̅iÞ >Ài “œÃÌ thought of in association with cataract surgery. Of note, both products are not contraindicated in glaucoma but contain a label warning that prolonged use of steroids can be associated with elevated IOP and that IOP should be monitored in patients using steroids. Inder Paul Singh, ] >˜` >̅>˜ ,>`Vˆvvi] MD, shared how they’ve been using these products to calm ˆ˜y>““>̈œ˜ ˆ˜ > Û>ÀˆiÌÞ œv procedures. “A very simplistic way to look at it is wherever you use a steroid, you could use these products,” Dr. Singh said. Dexycu and Dextenza can reduce or eliminate the need for topical steroid drops, Dr. Singh said. Because Dexycu is an injection, Dr. Singh and Dr. Radcliffe said they use it for intraocular surgeries, such as tube shunt surgery, IOL exchange, standalone and combined MIGS procedures, and pupilloplasty, to name a few. “One thing people worry about is does Dexycu clog the stent; it does not,” Dr. Radcliffe said, referencing stenting procedures for glaucoma. “I would say you could think of Dexycu for any intraocular surgery you’re doing.” Dr. Singh said Dexycu is advantageous because you don’t have to worry about absorption into the eye. He Ã>ˆ` «iœ«i ܈̅È}˜ˆwV>˜Ì ÀˆÃŽ v>V̜Àà vœÀ ˆ˜y>““>̈œ˜] ÃÕV… as epiretinal membrane, CME, diabetic retinopathy, rheumatoid arthritis, autoimmune conditions, œÀ «>ÃÌ ÕÛiˆÌˆÃ] VœÕ` Li˜iwÌ° One of the negatives of Dexycu is you can’t remove it if a negative response occurs. Removability, however, is one of Dextenza’s advantages. Dr. Singh said he uses Dextenza for canaloplasty, goniotomy, subconjunctival surgery with ̅i 8 i -Ìi˜Ì ƂiÀ}>˜® or tube shunts, and pterygium surgery. He has found a È}˜ˆwV>˜Ì Li˜iwÌ vœÀ ̅i ocular surface preoperatively before taking measurements for cataract surgery and for optimizing the ocular surface before subconjunctival surgery. Dr. Radcliffe also said Dextenza makes sense for conjunctival surgeries, pterygium, and glaucoma tube shunt surgeries. Dr. Singh mentioned a study that looked at use of Dextenza LivœÀi 8 ÃÕÀ}iÀÞÆ Ì…iÀi ˆÃ > code that allows Dextenza to be «>Vi` ˆ˜ ̅i œvwVi° Ƃ˜iV`œÌ>Þ] Using Dextenza and Dexycu outside of cataract surgery Dexycu placement. Source (all): Inder Paul Sing, MD Dextenza placement.