News

Participants in a Friday evening CME Symposium at The Fairmount Chicago received an update on factors that influence early diagnosis and detection of progression and therefore are crucial to effective patient management. Moderator Robert N. Weinreb, MD, University of California, San Diego, and other speakers discussed recent advances in optic nerve evaluation and the impact of central corneal thickness (CCT) and other factors on IOP measurement.

Some eye movements are mediated through the temporal lobe for target position; the saccades and pursuits are initiated in the posterior parietal lobe.

Increased intracranial pressure is associated with extraocular motility disturbances.

Nashville, TN—Knowledge of skew deviations and their management has changed dramatically in recent years. Skew deviations occur more commonly than previously suspected and result from lesions in the vertical vestibular ocular reflex pathway.

Editor's Note: Howard Pomeranz, MD, describes a possible association of sildenafil and non-arteritic anterior ischemic optic neuropathy (NAION). There are several compelling parts of the argument, including temporal relationship of symptoms to drug delivery, a suggestive rechallenge history, a biologically plausible mechanism of effect, and analogy from other cases.

When and how do you use laboratory testing in patients with suspected toxoplasmic retinochoroiditis? What patients require no testing? When and how do you use testing of intraocular fluids? What approach should be taken in routine clinical practice?

Chicago will play host to the 109th annual meeting of the American Academy of Ophthalmology (AAO). The main meeting will run from Sunday, Oct. 15 to Tuesday, Oct. 18, but it will be preceded by 2 full days of subspecialty presentations beginning on Friday, Oct. 14. All of the subspecialty day programs and scientific program sessions will be held at the McCormick Place Convention Center on Chicago's beautiful lakefront. On Wednesday, Oct. 19, from 8 a.m. to 5:30 p.m., "The Best of the Academy in Spanish 2005" will be held in the Imperial Ballroom at the Fairmont Chicago.

Edina, MN—When IOL piggybacking is needed, combining the modified prolate anterior surface IOL (Tecnis, AMO) with a conventional spherical IOL is a good option because it provides patients the added benefit of improved optical performance and better quality of vision, said Y. Ralph Chu, MD.

After a priority 6-month review, the FDA approved nepafenac ophthalmic suspension 0.1% (Nevanac, Alcon Laboratories), a novel nonsteroidal anti-inflammatory prodrug, for the treatment of pain and inflammation associated with cataract surgery.

Reduction of incision size represents only one of many advantages. . . . The crucial difference is not the size of the incision; it is the separation of inflow and outflow.

Must ophthalmologists understand procedural coding? Perhaps a staffer or even a computer program could do the job? Unfortunately, the answer today is that physicians need to remain involved, understanding and then overseeing the process in their offices.

Washington, DC—If capsule bag fixation is not possible, cataract surgeons have several options for IOL optic capture depending on the particular surgical needs, explained Howard V. Gimbel, MD, MPH, professor and chairman, department of ophthalmology, Loma Linda University, Loma Linda, CA.

Edina, MN—When IOL piggybacking is needed, combining the modified prolate anterior surface IOL (Tecnis, AMO) with a conventional spherical IOL is a good option because it provides patients the added benefit of improved optical performance and better quality of vision, said Y. Ralph Chu, MD.

Orlando—Visual acuity maturation was similar in infants and young children treated with IOLs or aphakic contact lenses for unilateral congenital and developmental unilateral cataracts, according to results of a small, prospective, single-center study.

Montreal—Favorable functional and anatomic outcomes in eyes with subfoveal neovascular age-related macular degeneration (AMD) were reported following 24 weeks in an open-label, uncontrolled clinical trial using off-label, systemic and intravitreal therapy with bevacizumab (Avastin, Genentech), a humanized full-length monoclonal anti-VEGF antibody.

Montreal—Intravitreal triamcinolone acetonide (Kenalog, Bristol-Myers Squibb) is effective in the treatment of macular diseases but is associated with complications such as ocular hypertension, endophthalmitis, intraocular inflammation, and progression of cataract. While the long-term effects of the drug still need to be determined, the drug appears to be safe for treating macular diseases.

Fort Lauderdale, FL—Numerous factors have been studied to determine an association with the development of age-related macular degeneration (AMD), according to Barbara Klein, MD, MPH. Family history, however, is by far the factor that stands out among the crowded arena of suspects. She reported why this is the case at the annual meeting of the Association for Research in Vision and Ophthalmology.

Montreal—Twenty-three gauge sutureless transconjunctival pars plana vitrectomy is effective for certain diseases of the posterior segment. The technique has the advantages of minimally invasive transconjunctival surgery without some of the limitations associated with 25-gauge surgery, reported Reza Iranmanesh, MD.

The risk of scarring was increased 3.6-fold among patients who wore contact lenses at baseline relative to those who did not wear contact lenses.

Fort Lauderdale, FL—Confocal microscopy allows corneal nerve density to be measured in vivo, which has been especially helpful in identifying dramatic decreases in the nerve densities after PRK and LASIK. Using this technology, investigators can measure the increases in the densities over time following the surgeries. There are, however, artifacts that may interfere with microscopy results that must be controlled, according to William Bourne, MD.

Washington, DC—Ectasia can occur after an otherwise uncomplicated LASIK procedure, even in the absence of recognized risk factors, said Shawn R. Klein, MD, at World Cornea Congress V.

Washington, DC—Reduction in myopia, central corneal flattening, and improvement of uncorrected visual acuity (UCVA) occur rapidly after the initiation of orthokeratology (ortho-k), but this modality also appears to result in changes in higher-order aberrations and corneal pachymetry, reported Iane G. Stillitano, MD, at the World Cornea Congress V.

The incidence of microbial keratitis after LASIK has been reported to range from one in 1,000 cases to one in 10,000 cases. There are no prospective studies in the literature that accurately document the true occurrence rates.

Washington, DC—A continuing rapid evolution in technology brings promise for the future availability of better surgical methods for correcting presbyopia, said W. Bruce Jackson, MD, at World Cornea Congress V.

New Orleans—Using highly sensitive techniques, investigators have discovered that herpes simplex virus type 1 (HSV-1) is present in a high percentage of asymptomatic individuals, said Herbert E. Kaufman, MD, Boyd professor of ophthalmology and pharmacology and experimental therapeutics, Louisiana State University Eye Center, New Orleans.

The deadline for online meeting registration is Sept. 28. The quickest, most efficient way to register and reserve a hotel room is online.

Washington, DC—Results of studies measuring energy used during cataract removal by phacoemulsification provide convincing evidence that the Infiniti Vision system (Alcon Laboratories) is a significant advance in optimizing surgical safety and efficiency, said Richard J. Mackool, MD, at the annual meeting of the American Society of Cataract and Refractive Surgery.

Fort Lauderdale, FL—Australian children have a relatively low prevalence of visual impairment. The primary causes of visual problems are uncorrected astigmatism and amblyopia, according to Dana Robaei, MBBS, MPH, who spoke at the annual meeting of the Association for Research in Vision and Ophthalmology.

Rockville, MD—Evangelos S. Gragoudas, MD, will receive the Association for Research in Vision and Ophthalmology's 2006 Weisenfeld Award, presented annually for excellence in ophthalmology.

Des Plaines, IL—Addition Technology Inc. has formed a non-profit foundation to help keratoconus sufferers who need financial support to afford an Intacs procedure.