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Microdrop device reduces bottle exhaustion and adverse events in glaucoma patients on monotherapySmall study finds microdrop device may lower eye pressure and reduce medication waste in glaucoma

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Key Takeaway
Consider microdrop devices may reduce bottle exhaustion and adverse events in stable glaucoma patients on monotherapy.

This prospective randomized crossover trial evaluated a microdrop delivery device (Nanodropper) versus conventional drops in 29 adults with stable primary glaucoma or ocular hypertension on monotherapy (latanoprost or timolol). Participants used each method for 12 weeks in a crossover design at a single outpatient clinic. The primary outcome was IOP change from baseline at 12 weeks.

Microdrops decreased IOP from baseline by 1.6 mm Hg (95% CI 0.88-2.29), while conventional drops changed IOP by 0.13 mm Hg (95% CI -0.26 to 0.52). The incidence of premature bottle exhaustion decreased from 83% with conventional drops to 17% with microdrops. At least one adverse event was reported by 83% of participants with conventional drops versus 62% with microdrops, with microdrops decreasing the occurrence and severity of nonsystemic adverse events.

Most participants found the microdrop device easy to administer and believed it helped prevent eyedrop waste. The study was examiner-masked and active-controlled. Key limitations include its single-center design, specific population of patients stable on monotherapy, and 12-week follow-up per treatment period. Practice relevance is restrained as these findings suggest microdrop use may enhance tolerability and potentially improve adherence in similar patients, but generalizability beyond this specific setting and population is unclear.

Researchers conducted a small study to see if using a microdrop device called Nanodropper could work as well as regular eye drops for people with glaucoma. They studied 29 adults who already had stable glaucoma or high eye pressure and were using just one type of medication. Each participant tried both the microdrop method and conventional drops for 12 weeks each, in a random order.

The study found that using microdrops lowered eye pressure by about 1.6 mm Hg from where patients started, while conventional drops showed almost no change. More importantly, the microdrop method dramatically reduced how often bottles ran out early—from happening to 83% of people with conventional drops down to just 17% with microdrops. People also reported fewer side effects like eye irritation with the microdrop device.

It's important to be careful with these results. This was a small study at just one clinic, looking only at people whose condition was already stable on one medication. Each treatment period lasted only 12 weeks, which is relatively short for a chronic condition like glaucoma. While the device shows promise for reducing waste and side effects, larger and longer studies in more diverse groups of patients are needed before we know how well it works for everyone.

What this means for you:
A small study suggests a microdrop device may help with glaucoma treatment, but more research is needed to confirm the benefits.

Study Details

Study typeRct
Sample sizen = 29
EvidenceLevel 2
Follow-up2.8 mo
PublishedApr 2026
View Original Abstract ↓
PURPOSE: Comparing the intraocular pressure lowering (IOP-L) of microdrops (MD) dispensed with the Nanodropper with conventional drops (CD) in patients on IOP-L monotherapy. SETTING: Outpatient clinic. DESIGN: Prospective, crossover, examiner-masked, active-controlled, randomized trial conducted at a single center. METHODS: We enrolled adults with stable primary glaucoma or ocular hypertension on monotherapy with either latanoprost 0.005% or timolol maleate 0.5%. Participants self-administered either CD or MD for 12 weeks, then crossed over to the alternate treatment for an additional 12 weeks. The primary outcome was IOP at 12 weeks compared with baseline at enrollment. Secondary outcomes included running out of drops (premature bottle exhaustion or PBE), adverse effects (AEs), and subjective evaluations of the device's usability. RESULTS: 29 participants completed the study. MD significantly decreased IOP from baseline by 1.6 mm Hg (95% CI 0.88-2.29), compared with a CD (0.13 mm Hg, 95% CI -0.26 to 0.52). Incidence of PBE decreased from 83% with CD to 17% with MD. AEs were reduced from 83% of participants reporting at least 1 AE with CD vs 62% with MD. Most found MD easy to administer and believed it helped prevent eyedrop waste. CONCLUSIONS: MD delivered with the Nanodropper adaptor provided additional IOP-L, significantly reduced PBE, and decreased the occurrence and severity of nonsystemic AEs compared with CD in this cohort of stable primary open-angle glaucoma/ocular hypertension participants. MD use among glaucoma participants may enhance tolerability, and improve adherence and long-term IOP control.
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