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An analysis of results from visual field tests performed in persons enrolled in the African Descent And Glaucoma Evaluation Study shows that in "healthy eyes," visual function is worse in persons of African descent compared with those of European descent, even though it still is within normal ranges.

Animals undergoing lens removal surgery were treated with non-steroidal anti-inflammatory drugs pre- and postoperatively. On the first day after surgery, aqueous humor samples were taken at times corresponding to trough drug levels. The mean aqueous prostaglandin E2 concentration was significantly lower in animals being treated with ketorolac 0.4% (Acular LS, Allergan) compared with those receiving bromfenac 0.09% (Xibrom, ISTA Pharmaceuticals).

Adults with healthy eyes were studied at day and night visits to evaluate the circadian rhythm of aqueous humor dynamics. The results showed significant decreases in aqueous flow and outflow facility. Nocturnal seated IOP was significantly lower, and nocturnal supine IOP was significantly higher than daytime seated IOP.

In a multi-center, randomized, double-masked study of 306 healthy volunteers, the anti-inflammatory combination of loteprednol/tobramycin was found to produce lower levels of steroid-induced IOP rise than the combination of dexamethasone/tobramycin.

Data integrated from two phase III clinical trials demonstrate that a new, once-daily formulation of bromfenac ophthalmic solution higher in concentration than the commercially available 0.09% formulation (Xibrom, ISTA Pharmaceuticals) is safe, effective, and well-tolerated for the prevention and treatment of inflammation and pain associated with ocular surgery. Increased patient adherence to therapy and improved outcomes are two potential benefits.

Two phase III studies evaluated difluprednate 0.05% emulsion (Durezol, Sirion Therapeutics) for the treatment of significant inflammation after ocular surgery. The investigational agent was dosed twice and four times daily and compared with vehicle. Difluprednate acted quickly to reduce inflammation and pain and achieved significant differences compared with vehicle in the primary efficacy analysis and multiple secondary endpoints. No difference in mean IOP was found between study groups.

In vitro testing shows that the mutant prevention concentration for gatifloxacin against fluoroquinolone-sensitive methicillin-resistant Staphylococcus aureus is significantly lowered by the addition of benzalkonium chloride.

Levofloxacin ophthalmic solution 1.5% (Iquix, Vistakon Pharmaceuticals), used to treat bacterial keratitis, has no adverse effects on the corneal endothelium after 2 weeks of intensive dosing for a total of 224 doses of the drug.

Azithromycin 1% ophthalmic solution (AzaSite, Inspire Pharmaceuticals) is more soluble and able to remain on the ocular surface for a longer period than it would otherwise because of the patented drug delivery vehicle (DuraSite, InSite Vision) with which it is paired.

Significant controversy surrounds selection of antibiotics for endophthalmitis prophylaxis. Richard K. Forster, MD, explains why he believes fourth-generation fluoroquinolones should not replace older antibiotics.

The safety of intracameral moxifloxacin (Vigamox, Alcon Laboratories) for post cataract surgery endophthalmitis prophylaxis was investigated in a prospective, randomized, controlled study. Statistical analyses of multiple postoperative outcome measures demonstrated no significant differences between patients who received intracameral moxifloxacin and controls treated with intracameral balanced salt solution.

Ablative skin rejuvenation procedures often are associated with prolonged healing, and can cause scarring, prolonged erythema, and hyperpigmentation.

Preliminary analysis of the second-and-final phase III clinical study of bepotastine ophthalmic solution (Bepreve, ISTA Pharmaceuticals) is encouraging, according to the company.

In contrast to the original finding in the Ocular Hypertension Treatment Study, re-analyses using new data collected during follow-up shows a history of diabetes mellitus does not protect patients with ocular hypertension from progression to glaucoma.

The rate of posterior capsule opacification (PCO) associated with hydrophobic acrylic IOLs (AcrySof, Alcon Laboratories) is lower than the rate seen with other lens materials for 3 to 5 years after implantation, but after that time, the rate approximates that seen with other lens materials, according to results of an ongoing prospective, consecutive-case study of 5,500 eye-bank eyes. The finding could affect IOL selection decisions, especially for the pediatric patient population, in whom a high rate of PCO typically is seen, and for patients in developing countries, where access to Nd:YAG lasers to address PCO is limited.

Relying on a combination of available evidence and expert opinion, a panel of ophthalmologists has reviewed nearly 150 statements pertaining to the evaluation and treatment of primary open-angle glaucoma and has reached consensus agreement or consensus disagreement with the majority of the statements. The results are intended to inform clinicians how glaucoma practitioners view this disease but are not guidelines or recommended practice patterns, according to several steering committee members of the project panel.

Refractive error is the leading cause of visual impairment in the world, and it is important that clinicians assess patient satisfaction and quality of life involving any effort to address refractive error, said George O. Waring III, MD. He made his remarks in a lecture after receiving the Mildred Weisenfeld Award for Excellence in Ophthalmology here at the Association for Research in Vision and Ophthalmology annual meeting.

After hearing a variety of testimonies to discuss the post-market experience of LASIK, advisers to the FDA determined that lasers need improved patient labeling information. The advisers determined that the LASIK procedure itself is not the culprit; rather, it may be poor screening of possible candidates and misconstrued or insufficient information about the procedure relayed to patients. Ophthalmologists said that LASIK has a very high patient satisfaction rate and enumerated considerations for approaching studies of patient dissatisfaction.

In a prospective, randomized, contralateral study of 75 adults, eyes in which an aspheric IOL (AcrySof IQ model SN60WF, Alcon Laboratories) had been implanted demonstrated better mesopic contrast sensitivity, significantly less spherical aberration, and significantly less total higher-order aberrations compared with eyes in which a standard spherical IOL (AcrySof model SA60AT, Alcon Laboratories) had been implanted. Cumulative uncorrected visual acuity and best-corrected visual acuity were equivalent between both groups.

An analysis of data from 5,300+ eyes with a posterior chamber phakic IOL (Visian ICL, STAAR Surgical) implanted by more than 400 surgeons are impressive in demonstrating the safety, predictability, and efficacy of this lens for correcting moderate to high myopia. Mean follow-up was 103 days, mean UCVA was 20/26, mean MRSE was –0.23 D, and the mean endothelial cell loss rate at 3 months was 1.7%.

A microincisional lens (Akreos MI60, Bausch & Lomb) can be implanted through a 1.8-mm incision. Although not yet available in the United States, excellent results have been achieved with the IOL internationally. Surgeons can use it after biaxial or coaxial microincisional phacoemulsification with an integrated phaco platform (Stellaris Vision Enhancement System, Bausch & Lomb) to provide patients with the benefits of less invasive surgery.

Results of a study evaluating contrast sensitivity in patients with a multifocal IOL (ReZoom, Advanced Medical Optics) implanted corroborate anecdotal reports that this zonal refractive implant provides excellent quality of vision under photopic conditions.

Use of a dual-optic accommodating IOL (Synchrony, Visiogen) results in good visual acuity and spectacle independence at all distances without inducing halos or glare, and outcomes remain stable over time, according to the findings of a prospective, non-comparative case series of patients.

In a 2-year follow-up of 17 patients, an investigational hydrophobic acrylic, one-piece IOL provided excellent visual outcomes, refractive stability, and safety.

Aspheric IOLs represent a major move forward in IOL design. In this study of 40 patients, visual acuity achieved with the aspheric lens was equal to or better than that achieved with the spherical lens, and patient satisfaction was significantly higher with the aspheric lens on several visual disturbance ratings.

Results from a series of 100 eyes with an accommodating IOL (crystalens, Bausch and Lomb) implanted shows that meticulous anterior capsule lens epithelial cell removal using a combination of ultrasonic irrigation-aspiration with free-flow fluidics and capsule polishers is associated with stable anterior capsulotomy diameters, stable refraction, and excellent vision outcomes.

In a 1-year follow-up study, 119 patients in whom a toric IOL (AcrySof Toric, Alcon Laboratories) had been implanted had excellent results, including minimal residual refractive cylinder. The lens, which is available in three toricities, provides very accurate results for several different patient populations.

Spherocylindrical corrections were performed in six patients implanted with a photosensitive IOL (Light-Adjustable IOL, Calhoun Vision) after cataract surgery. Mean cylinder was –0.50 D postadjustment, and uncorrected visual acuity improved in all patients to 20/25 or better.

Implanting specialty IOLs in patients with glaucoma requires special attention because of changes in vision that result from anti-glaucomatous medications.

Many features that are specific to glaucoma patients raise concerns about whether they are appropriate candidates for multifocal IOLs. In the absence of extensive clinical data to guide decision-making, the benefits and compromises must be considered carefully in each patient.