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                  Denis et al.                                                                   7


                  that the study required the inclusion of patients being  References
                  able to instil themselves their treatment which obvious-  1. Tham YC, Li X, Wong TY, et al. Global prevalence
                  ly was not respected for a certain number. We could  of glaucoma and projections of glaucoma burden
                  have excluded these patients from the statistical analy-  through 2040: a systematic review and meta-analysis.
                  ses; however, for accuracy reasons, we preferred pre-  Ophthalmology 2014; 121(11): 2081–2090.
                  senting these data. Despite this, results confirm that the  2. Barnebey HS and Robin AL. Adherence to fixed-
                                                              combination versus unfixed travoprost 0.004%/timolol
                  tested MDDS may be suitable for most of the patients,  0.5% for glaucoma or ocular hypertension: a randomized
                  providing high patient satisfaction and high treatment  trial. Am J Ophthalmol 2017; 176: 61–69.
                  adherence.                                3. Nordmann JP, Baudouin C, Bron A, et al. Xal-Ease:
                    Patient-reported treatment compliance with the  impact of an ocular hypotensive delivery device on ease
                  tested MDDS was high (60.2%); 31.4% of patients  of eyedrop administration, patient compliance, and sat-
                  having used tear substitutes decreased or even stopped  isfaction. Eur J Ophthalmol 2009; 19(6): 949–956.
                  their use after the switch to the tested MDDS, which  4. Davis SA, Sleath B, Carpenter DM, et al. Drop instilla-
                  may result in an improved QoL. The patients’ capabil-  tion and glaucoma. Curr Opin Ophthalmol 2018; 29(2):
                                                              171–177.
                  ity to correctly use their MD eye-drop delivery system  5. Weinreb RN and Khaw PT. Primary open-angle glauco-
                  is key to treatment adherence and ultimately to treat-  ma. Lancet 2004; 363(9422): 1711–1720.
                  ment efficacy. Results from this study confirm that  6. Nordmann JP, Auzanneau N, Ricard S, et al. Vision
                  specifically adapted MDDS, such as the patented one,  related quality of life and topical glaucoma treatment
                  increases the patient’s satisfaction of use, leads to  side effects. Health Qual Life Outcomes 2003; 1: 75.
                  improved treatment compliance, and reduces or stops  7. Baudouin C, Renard JP, Nordmann JP, et al. Prevalence
                  the use of tear substitutes, thus potentially improving  and risk factors for ocular surface disease among patients
                  efficacy.                                    treated over the long term for glaucoma or ocular hyper-
                    In conclusion, the tested MDDS is highly accepted  tension. Eur J Ophthalmol. Epub ahead of print 11 June
                                                              2012. DOI: 10.5301/ejo.5000181.
                  in the studied population and is a suitable choice for a
                                                            8. Leung EW, Medeiros FA and Weinreb RN. Prevalence
                  fixed-combination glaucoma therapy. Further studies
                                                              of  ocular  surface  disease  in  glaucoma  patients.
                  may be necessary to assess the easiness of use of this  J Glaucoma 2008; 17(5): 350–355.
                  easy-to-grip delivery system in patients with greater  9. Stewart WC, Stewart JA and Nelson LA. Ocular surface
                  disability to instil or having severe problems in instil-  disease in patients with ocular hypertension and glauco-
                  ling their eye drops themselves.            ma. Curr Eye Res 2011; 36(5): 391–398.
                                                           10. Goldberg I, Graham SL, Crowston JG, et al. Clinical
                                                              audit examining the impact of benzalkonium chloride-
                  Acknowledgements
                                                              free anti-glaucoma medications on patients with symp-
                  The authors acknowledge the participation of the ISY study  toms of ocular surface disease. Clin Exp Ophthalmol
                  investigators for their participation in this study and Karl  2015; 43(3): 214–220.
                  Patrick G€ oritz, SMWS, Scientific and Medical Writing  11. Aptel F, Labbe A, Baudouin C, et al. Glaucoma medi-
                  Services, France, for his medical writing assistance.  cations, preservatives and the ocular surface. J Fr
                                                              Ophtalmol 2014; 37(9): 728–736.
                  Declaration of conflicting interests     12. Dietlein TS, Jordan JF, Luke C, et al. Self-application of
                                                              single-use eyedrop containers in an elderly population:
                  The author(s) declared the following potential conflicts of
                                                              comparisons with standard eyedrop bottle and with
                  interest with respect to the research, authorship and/or pub-  younger patients. Acta Ophthalmol 2008; 86(8): 856–859.
                  lication of this article: The authors received honoraria from  13. Gao X, Yang Q, Huang W, et al. Evaluating eye drop
                  Laboratoires Th� ea for conducting this study. Moreover, P.  instillation technique and its determinants in glaucoma
                  Denis served as a consultant for Novartis, Laboratoires Th� ea,  patients. J Ophthalmol 2018; 2018: 1376020.
                  EyeTechCare Aerie and iStar.             14. Nordmann JP and Akesbi J. Improve adherence in glau-
                                                              coma patients: a doctor’s duty. J Fr Ophtalmol 2011;
                                                              34(6): 403–408.
                  Funding
                                                           15. Atey TM, Shibeshi WT, Giorgis A, et al. The impact of
                  The author(s) disclosed receipt of the following financial sup-  adherence and instillation proficiency of topical glauco-
                  port for the research, authorship and/or publication of this  ma medications on intraocular pressure. J Ophthalmol
                  article: This survey was supported by Laboratoires Th� ea,  2017; 2017: 1683430.
                                                           16. Gabisson P, Briat B, Le Foll J, et al. Handiness and
                  Clermont-Ferrand, France.
                                                              acceptability of the new Abak bottle in chronically
                                                              treated patients. Ann Pharm Fr 2011; 69(1): 22–29.
                  Supplemental material                    17. Recommendations for professional standards good epi-
                  Supplemental material for this article is available online.  demiological  practices  (version  France  2007).








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