Studies Evaluate Effectiveness of Intracameral Omidria for Reducing Postoperative CME
Recent studies evaluating the use of Omidria (phenylephrine and ketorolac intraocular solution) 1%/0.3% for the reduction of postoperative clinical cystoid macular edema (CME) incidence show the drug to be safe and effective.
Omidria was commercially launched in the US in 2015 as the first and only product approved by the FDA for intraocular administration during cataract surgery and other IOL replacement procedures to prevent intraoperative miosis and to reduce postoperative ocular pain.
Denise M. Visco, MD, President and Medical Director, Eyes of York, in Pennsylvania, and President, American College of Eye Surgeons, recently co-authored a retrospective study that examined 2,218 eyes (n=1402) to assess the effectiveness of Omidria during cataract surgery compared with postoperative topical steroids in reducing incidence of postoperative clinical CME.1
This study, which was published in the Journal of Cataract & Refractive Surgery, compared the incidence of postoperative CME, breakthrough iritis, pain, and photophobia between patients receiving either intracameral Omidria during surgery or topical loteprednol 0.5% 2 days preoperatively, tapered postoperatively. All eyes received bromfenac 2 days preoperatively and 10 weeks postoperatively.
“At a certain point in time, my practice converted from a combined topical steroid/nonsteroidal regimen to intracameral nonsteroidal and topical nonsteroidal only. The goal of the study was to see if I was delivering the same quality of care for patients after the change,” Dr. Visco said. “Honestly, I thought I was. I did not personally notice any difference whatsoever in my practice. So at first I really wasn’t very interested in doing a study that was going to be so labor intensive, but I was encouraged. It took my staff 90 days—two full-time equivalents—to mine this data. And I was really, really shocked at the results.”
The study found that clinical CME incidence was significantly lower in the Omidria group (0.52% vs 1.47%, P = 0.021). The Omidria group also had significantly lower breakthrough iritis (1.72% vs 4.86%, P < 0.001) and pain (1.27% vs 4.19%, P < 0.001) than the topical loteprednol group. The incidence of photophobia trended lower for the Omidria group relative to the topical loteprednol group (0.90% vs 1.13%, respectively, P = 0.590) but was not statistically significant.
“This was very surprising to us, because not only were we delivering equivalent care, we were actually delivering better care with almost three times lower incidence of CME in the Omidria group,” Dr. Visco said. “Furthermore, our incidence of breakthrough iritis and our incidence of pain after the first postoperative day were also less. So I was very excited about the data. I’m very happy to be using Omidria because it’s delivering a better patient experience for my cataract surgery patients.”