Eyeworld

NOV 2012

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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November 2012 Glaucoma devices February 2011 EW SECONDARY FEATURE 47 The solubility of molecules is another consideration, Dr. Novack said. Some molecules aren't suitable to be put in a particular delivery system because of their solubility. Ideally, a device would deliver the same amount of drug every day for the entire period, Dr. Williams said, but the nature of physical chemistry is that the release of the drug tends to be related to the con- centration of the drug; the more drug that goes, the lower the con- centration, so a decreasing amount of drug is released daily. That said, there have been all sorts of innova- tive techniques used to try to reduce that curve so that a more level amount of drug is being released on a long-term basis, he added. On the other hand, the issue of whether a steady state delivery is the best delivery for some molecules is also a consideration as it may be that not every molecule works optimally in a steady state environment, Dr. Novack said. It is important to make sure that devices that are easily inserted do not fall out or have a reliable way in which patients will know the device is no longer in place so they can have it reinserted, Dr. Williams said. If the device is being implanted, even if it's a minor procedure, there's always potential for compli- cations, he said. If a device requires reimplantation on a regular basis, there also are adverse long-term effects to consider, suvh as scarring, Dr. Williams explained. The ideal drug delivery device While the ideal drug delivery device seems to be several years away at present, Richard A. Lewis, M.D., Sacramento, Calif., said that in his mind, it would be "something that could deliver a drug for 6 months without side effects and totally dissolves so it doesn't cause any problems. You want to maximize the delivery and minimize the side effects." For Dr. Williams, the ideal device would be "something that could be placed by a non-physician person, a technician or assistant in the office, and that would have at least 95% retention, would be com- fortable, and would deliver a level of drug that gives adequate control for a period of 90 days. That would be a very acceptable product." EW Editors' note: Drs. Lewis, Novack, and Williams have no financial interests related to this article. Contact information Lewis: 916-649-1515, rlewiseyemd@yahoo.com Novack: 415-472-2181, gary_novack@pharmalogic.com Williams: 502-458-9004, iopdoc1@gmail.com In honor of the year we were founded, every main incision diamond knife is now Celebration Savings $1,982.00* Save up to $1,000! We have seen a lot of changes throughout the years, but our commitment to improving your patients' outcomes remains the same. *Offer Expires 12/31/12 Visit Us at AAO Booth #4221 3222 Phoenixville Pike, Malvern, PA 19355 USA • 800-979-2020 • 610-889-0200 • FAX 610-889-3233 • www.accutome.com

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