Prednisolone Acetate/Sulfacetamide Sodium

To study dry eye medication use and expenditures from 2001 to 2006 using a nationally representative sample of US adults.

This study retrospectively analyzed dry eye medication use and expenditures of participants of the 2001 to 2006 Medical Expenditure Panel Survey, a nationally representative subsample of the National Health Interview Survey. After adjusting for survey design and for inflation using the 2009 inflation index, data from 147 unique participants aged 18 years or older using the prescription medications Restasis and Blephamide were analyzed. The main outcome measures were dry eye medication use and expenditures from 2001 to 2006.

Dry eye medication use and expenditures increased between the years 2001 and 2006, with the mean expenditure per patient per year being $55 in 2001 to 2002 (n=29), $137 in 2003 to 2004 (n=32), and $299 in 2005 to 2006 (n=86). This finding was strongly driven by the introduction of topical cyclosporine emulsion 0.05% (Restasis; Allergan, Irvine, CA). In analysis pooled over all survey years, demographic factors associated with dry eye medication expenditures included gender (female: $244 vs. male: $122, P<0.0001), ethnicity (non-Hispanic: $228 vs. Hispanic: $106, P<0.0001), and education (greater than high school: $250 vs. less than high school: $100, P<0.0001).

We found a pattern of increasing dry eye medication use and expenditures from 2001 to 2006. Predictors of higher dry eye medication expenditures included female gender, non-Hispanic ethnicity, and greater than a high school education.

Chalazion surgery is a common minor surgical procedure used to treat internal chalazia after conservative measures have failed. Complications are infrequent and generally easily managed with minimal problems. In this clinical research study, 100 internal chalazia surgical candidates were randomly divided into two treatment groups. Our initial goal was to ascertain whether cautery impacted the recurrence rates on chalazia in these patients. One group received thermal cautery after surgical incision and drainage. The second group did not receive cautery after incision and drainage. Lack of cautery caused no problems with hemostasis because bleeding resolved without incident after several additional minutes.

The study was conducted on 100 patients who received 4 weeks of conservative treatment consisting of alternating warm and cold compresses and topical prednisolone acetate/sulfa medication (e.g., blephamide) administered 4 times a day. A transconjunctival incision and drainage was performed, followed by thermal cautery in one-half (N = 50) of the randomized patients.

The cauterized group had a 78% no recurrence rate after 6 months and good surgical outcomes. The remaining 22% had a recurrence of chalazia, but with good initial surgical outcome. The noncauterized group (N = 50) showed a 74% no recurrence rate after 6 months and good surgical outcome. The remaining 26% had recurrences with good initial surgical outcomes. A chi-square test indicated that there was no significant statistical difference between the groups (chi2 = 0.219, dF = 1.0, p = 0.640).

The results of this clinical study suggest that the use of thermal cautery with surgery has no impact on the recurrence rate of internal chalazia. Thus, the use of thermal cautery should be left to the discretion of the eye care practitioner.