Possible Uses of Desodrop in Therapy and Prevention of Ophthalmological Diseases

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Liposomal Encapsulation

Ozone is a very strong oxidizing agent with proven bactericidal, virucidal, and fungicidal effects. Additionally, it exhibits anti-inflammatory activity and promotes the healing process. In medicine, it is used directly in gaseous form, but other administration methods are being explored. It is known that ozonizing vegetable oils creates ozonides with the same antiseptic effects as gaseous ozone.

For ocular administration, particles of ozonized oil are encapsulated in liposomes prepared from soybean phospholipids, as the ozonized oil itself strongly irritates corneal tissue. Liposomal encapsulation not only improves tolerability but also affects the release of ozonides and increases their physical stability. The tolerability of the preparation is further enhanced by adding hypromellose, a viscoelastic polymer used in eye drops, for example, to treat dry eye syndrome.

Indication Spectrum

The ozone-based medical device contains no preservatives and can be used in patients of any age, including newborns. It is indicated in the following cases:

• lubrication and protection of the anterior eye segment before surgical procedures
• protection and support of regenerative processes after surgery (application recommended to start 3 days before the procedure)
• therapy of inflammatory diseases such as keratitis and conjunctivitis (including infectious etiologies)
• as an adjunct to antibiotic treatment in children and adults
• relief of dry eye syndrome symptoms
• treatment of corneal abrasions and injuries
• for contact lens users

Efficacy and Safety Verified in Clinical Trials

The efficacy of this medical device has been verified in numerous clinical trials. One of them, published by Spadea et al., evaluated the effectiveness of ozonized oil in 174 patients undergoing cataract surgery. Each patient had the tested preparation applied to one eye and a control preparation (sterile saline solution) to the other eye. The therapy lasted for 3 days, during which a total of 696 conjunctival sac swabs were taken, isolating more than 60 types of bacteria. A significant reduction in microbial load (in > 90% of samples) was observed with the tested preparation, while no significant change was noted with the control solution.

In terms of safety, numerous tests have demonstrated that the preparation does not irritate the eye or skin and exhibits no toxicity when applied in therapeutic doses. In clinical trials, only a small number of patients reported mild hyperemia or discomfort after application. Due to its favorable safety profile, the preparation can also be used in pediatric therapy.

Helper in Addressing Antibiotic Resistance

The application of this medical device is particularly advantageous for infectious inflammations of the anterior eye segment due to the rise in antibiotic (ATB) resistance. The ARMOR study, the largest multicenter surveillance of ATB resistance in pathogens isolated in ocular infections, observed high resistance, particularly among gram-positive bacteria, including a significant proportion of multiple resistances.

Grandi et al. following these findings, published results of an experimental in vitro study evaluating the effect of ozonized oil encapsulated in liposomes on bacteria with multiple ATB resistance. In this study, regrowth occurred 8 hours after oil application in only 20% of strains of multidrug-resistant Pseudomonas aeruginosa, while no regrowth was observed in methicillin-resistant Staphylococcus aureus and Staphylococcus epidermidis (MRSA, MRSE) or Streptococcus spp.

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Sources:
1. Thomas R. K., Melton R., Asbell P. A. Antibiotic resistance among ocular pathogens: current trends from the ARMOR surveillance study (2009–2016). Clin Optom (Auckl) 2019; 11: 15–26, doi: 10.2147/OPTO.S189115.
2. Grandi G., Cavallo R., Zanotto E. et al. In vitro antimicrobial activity of ozonated oil in liposome eyedrop against multidrug-resistant bacteria. Open Med (Wars) 2022; 17 (1): 1057–1063, doi: 10.1515/med-2022-0495.
3. Spadea L., Zanotto E., Cavallo R. et al.; ELOOM Study Investigators. Effectiveness of liposomal ozonized oil in reducing ocular microbial flora in patients undergoing cataract surgery. J Cataract Refract Surg 2021; 47 (12): 1548–1555, doi: 10.1097/j.jcrs.0000000000000672.
4. Pérez-Santonja J. J., Güell J. L., Gris O. et al. Liposomal ozonated oil in ocular infections: a review of preclinical and clinical studies, focusing on its antiseptic and regenerative properties. Clin Ophthalmol 2022; 16: 1953–1962, doi: 10.2147/OPTH.S360929.