NOVEL DRUG-DEPOSITORY CONTACT LENS THAT LENGTHEN ANTIBIOTIC CORNEAL CONTACT TIME IN BACTERIAL KERATITIS: A RANDOMIZED CONTROLLED TRIAL

Published 2022 - 26th ESCRS Winter Meeting

Reference: FP76 | Type: Abstracts | DOI: 10.82333/qpkj-d485

Authors: Lional Raj Daniel Raj Ponniah* ¹

¹Cataract, Cornea and Refractive Surgery,DR AGARWALS EYE HOSPITALS,Tirunelveli,India

Purpose

To compare the efficacy of a novel therapeutic contact lens that increases the overall contact time of corneal antimicrobial drug (serving as a drug reservoir) with conventional antibiotic alone treatment regimen in subjects with bacterial keratitis

Setting

A Randomized open-label clinical trial, at the Department of Cornea & Ocular Surface Diseases at a tertiary eye care hospital and teaching institution

Methods

Bacterial keratitis was randomized into Group-1, treated with a topical antimicrobial, in Group-2, a drug-reservoir contact lens with characteristic dual base curves resulting in a central reservoir alongwith fenestrations to enable capture of topical antimicrobial, was implanted. In both groups, moxifloxacin0.5% in a standard regimen was instituted. Ulcer size, depth, AC reactions, corneal haze were studied. Followed-up on 12 hours, Days-1,3,5 & 14. Pain evaluated on a 10 pt scale. A study on the availability of the drug in the central reservoir was analyzed over a time curve

Results

40 cases were randomised. 3,2 cases in Groups 1 & 2 did not complete the study. Presenting pain were 7.88+/-0.70 in Group-1, 7.67+/-0.78 in Group-2, which reduced by 4.77 points in Group-2 & 1.88 points in Group-1 at Day-1(p<0.001), by 6.13 points in Group-2 by Day-3(p<0.001). Corneal-infiltration (BK severity) on presentation in Group-1 was 2.62+/-0.82mm, in Group-2 was 2.66+/-0.39mm(p=0.92). Resolution by 12 hours in Group-2 was 0.28mm, in Group-1 was 0.04mm, by Day-1 was 0.94mm in Group-2, 0.18mm in Group-1(p=0.03), by Day-3, 1.96 in Group-2 Vs 0.93 in Group-1(p<0.0001), completely resolved in Gr2 within 5 days and within 2 weeks in Gr1. AC-reaction resolved in Group-2 faster within 3-days. Drug availability in reservoir, the potential pre-corneal space was evidenced upto 4 hours

Conclusion

The concept of using a novel drug repository contact lens is effective in prolonging corneal antimicrobial availability and drug contact time over the lesion and has demonstrated in this study that corneal healing hastens, which may affect the overall outcomes in bacterial keratitis. Using a drug-depo contact lens may reduce the regimen of antibiotics, decrease treatment burden on the medical staff, improve patient tolerance, and reduced toxicities, overcoming the loading dose concept