Some features in the Aug. 25 issue of Ocular Surgery News focus on ophthalmic drug shortages and the use of generic drugs in such shortages.
Here are some of the publication exclusives from the issue:
Drug shortages put ophthalmologists and their patients in difficult positions
Confirmed drug shortages can limit a patient’s access to needed medications and force ophthalmologists to make difficult decisions regarding patient care. Historically, drugs in short supply have been low profit margin generic medicines, which can be challenging to manufacture, former FDA Commissioner Scott Gottlieb, MD, said in a July 2018 statement. Read more.
No easy answers to address drug shortages
These shortages negatively affect our ability to properly treat our patients. While the FDA is motivated to do what it can to avoid drug shortages, the FDA cannot require a pharmaceutical manufacturer to make a drug, make more of a drug or enhance its distribution. Many factors influence drug shortages, including loss of access to the active pharmaceutical agent, quality manufacturing lapses, low manufacturing capacity, increased demand and the like. I believe a major issue is lack of financial incentive to make some generic drugs with extremely low profit margins and no opportunity to generate a return on investment. Read more.
Would you recommend generic drugs to a family member?
Douglas J. Rhee, MD, and Daniel F. Kiernan, MD, FACS, weigh in on whether generic drugs should be recommended. Read more.
Back to Basics
Centration of capsulorrhexis an important part of cataract surgery
When performing cataract surgery, the capsulorrhexis is one of the most critical steps because it allows safe access to remove the nucleus and cortex and long-term stability for holding the IOL. A well-centered capsulorrhexis allows us to place the IOL in the center of the patient’s visual axis or pupillary axis, which can improve the performance of multifocal, extended depth of focus and even toric IOLs. Read more.
The Dry Eye
Artificial tears are important: why and how to use them
Once upon a time in Ozthalmology, the yellow brick road to treatment was lined by nothing but bottles of artificial tears and — yikes — Visine. Everybody and nobody was an eye doctor who treated dry eye back then because everything worked and did not work just about the same for dry eye. I used to send DED patients to the pharmacy with advice that was equally colorful and vague. “Go buy some artificial tears. Get the most expensive ones or the cheapest. Buy the biggest box or the smallest one. I really like purple.” Read more.