A Randomized Controlled Clinical Trial to Compare Conventional Drug Instillation to A Device Dropper method in Medical treatment of Glaucoma

Abstract

Purpose : To compare and analyze the performance of a device dropper over conventional drop
instillation method on ease of administration, compliance, patient satisfaction & intraocular pressure
control in persons with glaucoma on ocular hypotensive médications.
Methods : We enrolled 72 individuals with primary open angle glaucoma or ocular hypertension, on
treatment with fixed combination (a agonist+ß blocker) drugs for at least 6 months .These were
randomized into two groups ( 36 in each arm ). Group 1 administered the drug with a device dropper
(DD) and Group 2 used conventional drop instillation(CDI) method. Recruited individuals were
interviewed for subjective difficulties using a formatted questionnaire at first month follow up and
intraocular pressure (IOP) change from baseline was evaluated.
Results : Baseline demographic & ocular characteristics were similar in both groups. 57.1% in the conventional instillation and
none in the device dropper had reported difficulty in using the eye drops on follow up visit. Device dropper group had significantly
less spillage and contamination of eye surface or dropper tips , required minimal assistance, accurately targeted on first drop
placement directly into the eye compared to conventional drop instillation group(p-value<0.001). Mean intraocular pressure was
comparable between the two groups.
Conclusion : Device dropper instillation method was observed to be easier to administer, more accurate in targeting the
conjunctival cul-de-sac, reduced wastage with lesser contamination compared to the conventional drop instillation technique.
Device droppers may be expected to have better compliance and effectiveness in medical management of glaucoma.