Ophthalmologist perceptions regarding treatment of moderate to severe dry eye: results of a physician survey.

Penny A Asbell, Scott Spiegel
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Abstract

Purpose: To understand ophthalmologists' current perceptions and treatment of patients with moderate to severe dry eye syndrome (DED).

Methods: An online survey was distributed to 7,882 ophthalmologists, including 51 corneal specialists, throughout the United States from October 9 to 21, 2008. The response rate was 3.1% (n = 245), typical for this type of survey. Those who treated 4 or more patients with moderate to severe DED per month (235 of 245 [96%]) were asked to complete the survey.

Results: Ninety-four percent of respondents agreed that more treatment options are needed for moderate to severe DED. Corneal specialists were more likely to strongly agree (63%) than general ophthalmologists (54%). Only 33% overall felt that current therapies were extremely or very effective for moderate DED, and only 5% for severe disease. Ninety-two percent agreed that multiple therapeutic agents are needed to manage moderate to severe DED. The respondents reported prescribing, recommending, or suggesting a mean of 3.2 different treatment approaches over the course of a year for patients with moderate DED and 4.9 for patients with severe DED. The most highly ranked goals in treatment of moderate to severe DED were maintaining and protecting the ocular surface (ranked 1 or 2 by 74%) and lubricating and hydrating the ocular surface (ranked 1 or 2 by 67%). Corneal specialists ranked maintaining and protecting the ocular surface even higher (ranked 1 or 2 by 82%).

Conclusions: Results reflected the difficulty of treating more serious moderate to severe cases, the importance of using multiple treatment approaches, the limitations of current treatment options, and the need for additional treatment options.

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眼科医生对中度至重度干眼症治疗的看法:一项医师调查的结果。
目的:了解目前眼科医生对中重度干眼综合征(DED)患者的认识及治疗方法。方法:2008年10月9日至21日,对全美7882名眼科医生进行了在线调查,其中包括51名角膜专家。回复率为3.1% (n = 245),这是此类调查的典型情况。每月治疗4例或以上中重度DED患者的患者(245例中的235例[96%])被要求完成调查。结果:94%的受访者同意,中度至重度DED需要更多的治疗选择。角膜专家(63%)比普通眼科医生(54%)更有可能强烈同意这一观点。总体而言,只有33%的人认为目前的治疗方法对中度DED非常或非常有效,而对严重疾病只有5%。92%的人认为需要多种治疗药物来治疗中度至重度DED。受访者报告说,在一年的时间里,对中度DED患者平均开处方、推荐或建议3.2种不同的治疗方法,对重度DED患者平均推荐4.9种治疗方法。在中重度DED的治疗中,排名最高的目标是维持和保护眼表(74%的人排在第1或第2位)和润滑和滋润眼表(67%的人排在第1或第2位)。角膜专家对维持和保护眼表的评价更高(82%的人排名第一或第二)。结论:结果反映了治疗更严重的中重度病例的困难,使用多种治疗方法的重要性,当前治疗方案的局限性,以及需要额外的治疗方案。
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