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Performing LASIK in patients with glaucoma should be carefully considered before making the commitment because of changes in the eye that might result in lower IOP measurements, according to two ophthalmologists. PRK, however, might be a better option for this subgroup of patients, suggests one surgeon.

Santa Ana, CA-Advanced Medical Optics (AMO) and the Institute for Eye Research (IER) are collaborating to develop contact lens disinfectant and cleaning solutions and related products, AMO announced.

Intrableb pigmentation may be a positive sign in bleb filtration surgery, said Boonsong Wanichwecharungruang, MD, from Rajavithi Hospital, Bangkok, Thailand.

The value of telemedicine in patients with retinopathy of prematurity (ROP) is well established, according to Birgit Lorenz, MD, Pediatric Department of Ophthalmology, University of Regensburg, Germany. The technology provides opportunities for research, allows expert discussion by specialists worldwide, and allows objective evaluation of the pathology.

HIV has become a manageable chronic disease, but that is true only in developed countries with a relatively small number of HIV cases. It is possible to have a normal lifespan with controlled disease using the drugs that are currently available, but this treatment is needed globally, according to William Lynn, MD, Department of Infectious Disease, Ealing Hospital, London.

The use of an artificial cornea in patients who have experienced multiple immunologic graft rejections is more likely to result in good-quality vision than is performing another corneal transplant, said Michael W. Belin, MD, Albany Medical College, Albany, NY.

Posterior uveitis can be difficult to manage in children, but manage it you must, said Susan Lightman, MD, PhD, FRCP, FRCOphth, Department of Clinical Ophthalmology, Institute of Ophthalmology, University College, London.

When treating a child with amblyopia, what steps do you take when the Pediatric Eye Disease Investigator Group (PEDIG) guidelines do not work? The first thing to consider is whether you're getting poor compliance with your therapy, said Lionel Kowal, MD, FRACOphth, FRACS, Ophthalmology Eye and Ear Hospital, Melbourne, Australia.

Either patching or atropine sulfate 1% to occlude the sound eye offers lasting benefits to patients with amblyopia, according to Michael X. Repka, MD, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore. Atropine is not approved for use in ambyopia, he said.

Intraoperative floppy iris syndrome (IFIS) can be approached in a number of ways depending on the surgical scenario, according to David Chang, MD, University of California, San Francisco.

The importance of treating dry eye disease was the subject of "Advances in dry eye: disease perspectives, treatment options, and post-surgical management," a symposium held here in conjunction with the World Ophthalmology Congress (WOC).

In a symposium, entitled ?Progressive thinking: advances in the diagnosis assessment and management of glaucoma,? a panel of glaucoma specialists provided their expertise on imaging, risk factors that determine glaucoma progression, and understanding angle-closure glaucoma (ACG).

Glaucoma progresses at different rates among patients, and this variability poses a challenge for the ophthalmologist trying to manage the disease. IOP is a well-known risk factor and often is monitored carefully in patients with glaucoma. However, visual field and optic nerve deterioration are direct indicators of progression, and their status also should be considered when developing an initial treatment plan.

Using various types of IOLs in the same patient has been trumpeted as a way to achieve better vision correction than bilaterally implanting the same IOL. Yet, this concept of "mix and match" is not quite that simple, said Rubens Belfort, MD, Vision Institute, Federal University, Sao Paulo, Brazil.

Surface excimer laser and application of topical mitomycin C 0.2% results in increased vision when used to treat refractive errors after penetrating keratoplasty, said Michael Lawless, FRACO, from the Vision Eye Institute, Chatswood, New South Wales, Australia.

Achieving the proper IOL power for patients who have had a refractive procedure such as LASIK, PRK, or RK can be challenging, and taking more measurements leads to greater accuracy, said Jack T. Holladay, MD, MSEE, FACS, Holladay LASIK Institute and Baylor College of Medicine, Houston.

Erythropoietin (EPO), ciliary neurotrophic factor (CNTF), and wolfberry seem to provide neuroprotection of retinal ganglion cells in a rat model of ocular hypertension, according to Kwoh-fai So, PhD, chairman of the Department of Anatomy, University of Hong Kong.

Lamellar sliver: devastating complication of recutting after LASIK

With diabetes cases worldwide expected to double in the first 30 years of the 21st century, telemedicine might be a pathway to ensuring that more patients receive care, and thus, prevent complications from retinopathy, said P. Lloyd Hildebrand, MD, Dean A. McGee Eye Institute, Oklahoma University Health Sciences Center.

Ophthalmologists should assess disease progression in patients with established and suspected glaucoma, should confirm with repeat testing any visual function loss that is seen, should remember that structural measurements have variability, and should consider using structural and functional testing together to detect disease progression, said Robert Weinreb, MD. The distinguished professor of ophthalmology and director, Hamilton Glaucoma Center, University of California in San Diego, LaJolla, CA, concluded a course about detecting progression in glaucoma by highlighting points made in the preceding presentations.

Intravitreal and subconjunctival injections of rapamycin (Sirolimus, Wyeth) are both effective against diabetic macular edema. Interestingly, the subconjunctival route had a greater beneficial effect and the lower doses were more effective, said Mark Blumenkranz, MD, professor and chairman, Department of Ophthalmology, Stanford University, Stanford, CA.

New investigative drugs for age-related macular degeneration (AMD) may complement the vascular endothelial growth factor (VEGF) agents, improve the visual results, and require fewer injections. Various routes of administration are under investigation and combination treatments are likely to provide more favorable results, said Lawrence Singerman, MD, Case University School of Medicine, Cleveland, OH.

The presence of an afferent pupillary defect is the best indicator of visual loss in patients with open-globe injuries, said Michael Grant, MD, PhD, of the Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore.

Is there a place for traditional Chinese medicine in modern ophthalmology? Quite possibly, said Dennis Lam, MD, FRCS, Chinese University of Hong Kong. Acupuncture, for example, has been used in China and other Asian countries for thousands of years, and such therapies still may have applications in the world of medicine to this day, he said.

Should the initial treatment in angle-closure glaucoma be laser, lens removal, or trabeculectomy? The answer depends on the patient, said Clement C.Y. Tham, department of ophthalmology and visual sciences, Chinese University of Hong Kong. "There's not a single answer," Dr. Tham said. "Drug therapy and other procedures must be considered, too."

Antioxidants, such as the polyphenols found in green tea, have been championed for their protective value in cancer protection. Their role in eye disease prevention, however, is still unclear. Dorairajan Balasubramanian, director of research, L.V. Prasad Eye Institute, Hyderabad, India, reported on in vitro tests he has performed on cells and polyphenols such as epigallocatechin gallate (ECGC) and catechin, and their protective value against cytotoxic agents.

Detecting a macular hole or photoreceptor detachment is critical for obtaining good surgical results in patients with myopic foveoschisis. Patients with the foveal detachment type seem to benefit the most from vitrectomy. Spectral-domain optical coherence tomography (SD-OCT) and fundus autofluorescence (FAF) are valuable for managing these patients, said Yasushi Ikuno, MD, Osaka University Medical School, Osaka, Japan.

Glaucoma has long been defined as a disease characterized by elevated IOP. That definition, however, is changing to define the disease as an optic neuropathy characterized by a specific pattern of optic nerve head and visual field damage. That's the word from Theodore Krupin, MD, department of ophthalmology, Sorrel Rosin Eye Center, Northwestern University, Chicago.

Prophylactic intracameral cefuroxime injections prevent development of endophthalmitis after cataract surgery, according to Peter Barry, MD, FRCS, from Royal Victoria Eye and Ear Hospital, Dublin, Ireland. He reported the results of the European Society of Cataract and Refractive Surgeons Endophthalmitis Study.

Small-molecule drugs are being developed for topical application via the transconjunctival/transscleral route. The topical drugs that are under development have shown good posterior segment penetrance, safety, and efficacy in animal models. Clinical studies are now under way.