Renard et al. (36) compared the effectiveness of subconjunctival injections and collagen shields in delivering anti-inflammatory agents and antibiotics after cataract surgery. The occurrence of folds in Descemet's membrane was less frequent and aqueous flare less severe in the collagen shield-treated group than in those treated with subconjunctival injections.
Haaskjold et al. (63) compared the efficacy of collagen shields with that of peribulbar/retrobulbar injection after cataract surgery. Collagen shields were saturated with an antibiotic and a steroid and placed over the cornea postoperatively. The second group received the same drugs through a peribulbar/retrobulbar injection. One day after surgery, the shield group had significantly less corneal edema, conjunctival hemorrhage, postoperative pain, and fewer corneal opacities. They suggested that using collagen shields for drug delivery after cataract surgery decreases tissue damage and increases patient comfort without adverse side effects.
Taravella et al. (64) investigated whether collagen shields are more effective than topical eye drops for infection prophylaxis after cataract surgery. In their studies, the patients were divided into two groups: the first received three postoperative drops of commercially available topical ofloxacin (0.3%) given 10 minutes apart; the second had a collagen shield soaked in the same medication applied to the eye before surgery. Aqueous humor was extracted immediately before surgery for analysis. Aqueous concentration of ofloxacin in the shield group was significantly higher than that in the drop group. The MICs of ofloxacin for many common ocular pathogens were reached or exceeded in the shield group. However, in a similar study using tobramycin, the ocular penetration of the antibiotic into the anterior chamber of the human eye in the shield group was not different from that in the drop group (65). The aqueous concentration did not approach the MIC of tobramycin for many common ocular pathogens.
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