News

Ophthalmologists can improve glaucoma care by employing a systematic approach to optic nerve evaluation to determine disease severity and risk of progression, according to speakers at a continuing medical education symposium held during the American Academy of Ophthalmology meeting.

Memphis—Switches within rather than between classes of glaucoma medications are less common but appropriate when likely to produce an improvement in efficacy, adverse effects, or compliance, said Peter Andreas Netland, MD, PhD, Siegal Professor of Ophthalmology, University of Tennessee Health Science Center, Memphis.

Baltimore—Fluocinolone acetonide intravitreal implant (Retisert, Bausch & Lomb) is an effective treatment for non-infectious posterior uveitis, but may have potential side effects, according to the interim results of a multicenter trial that Quan Dong Nguyen, MD, MSc, described during the Current Concepts in Ophthalmology meeting.

Indianapolis—The investigational compound ruboxistaurin (Eli Lilly and Co.) may reduce the risk of vision loss associated with diabetic macular edema (DME), according to post hoc analysis of previously reported data. The new analysis also showed that the proximity of DME to the center of the macula was associated with visual acuity and that the severity of central macular involvement was associated with the severity of vision loss, according to Matthew J. Sheetz, MD, PhD, a clinical research physician at Eli Lilly.

Baltimore—A pilot investigation of a new mild macular grid photocoagulation treatment for diabetic macular edema (DME) and a study comparing intravitreal triamcinolone with laser photocoagulation are two ongoing trials being performed under the auspices of the Diabetic Retinopathy Clinical Research Network (DRCR.net), and a number of other protocols are under way, will be launched soon, or are in development, said Sharon Solomon, MD, at Current Concepts in Ophthalmology.

Baltimore—A prospective study is now under way, designed to investigate the efficacy and safety of anecortave acetate for depot suspension (Retaane, Alcon Laboratories) for arresting the progression of "dry" age-related macular degeneration (AMD) in patients at risk for developing exudative disease, said Andrew P. Schachat, MD, at the Current Concepts in Ophthalmology meeting.

Baltimore—Prescribed weekend atropine sulfate 1% appears to be as effective as prescribed daily use for treating moderate amblyopia in young children, according to results from a study conducted by the Pediatric Eye Disease Investigator Group.

A 65-year-old obese man with systemic lupus erythematosus presents to the ophthalmology clinic, referred from rheumatology for "toxicity screening" after starting therapy with hydroxychloroquine sulfate (HCQ) 400 mg per day (Plaquenil Sulfate). He had prior lupus-related glomerulonephritis but has a stable serum creatinine level. There was no liver dysfunction.

Variable WhiteStar, the new Version 6 software upgrade for Sovereign with WhiteStar (AMO), affords enhanced intraoperative micropulse control and allows surgeons to titrate the ultrasound energy precisely according to the density of each lens fragment. This advanced technology allows for increased intraoperative control while minimizing energy utilization and further increasing procedural efficiency and safety, agree cataract surgeons using the new software.

Salt Lake City—Introduction of OptiEdge technology (AMO) into the design of the three-piece, hydrophobic acrylic AR40e (Sensar, AMO) has been a significant advance for reducing the risk of posterior capsule opacification (PCO), said David J. Apple, MD.

Rockville Centre, NY—Gatifloxacin 0.3% (Zymar, Allergan), a fourth-generation fluoroquinolone, achieved excellent penetration into the cornea, far exceeding the minimum inhibitory concentration (MIC) values for several ocular pathogens, according to John R. Wittpenn, MD.

Baltimore—Cataract surgery can be successful in patients with uveitis, although careful attention to controlling inflammation together with prompt identification and management of postoperative complications are critical for optimizing outcomes, said John H. Kempen, MD, PhD, at Current Concepts in Ophthalmology meeting, sponsored by Johns Hopkins University School of Medicine, Baltimore, and Ophthalmology Times.

Salt Lake City—A few cases of dystrophic calcification have been reported that required explantation of the patients' silicone IOLs because of the opacified posterior surface of the IOLs. The phenomenon seems to be associated with asteroid hyalosis, according to Liliana Werner, MD, PhD.

The Epi-LASIK technique is a relatively new addition to the menu of refractive procedures from which patients can choose, and its results are beginning to be appreciated by surgeons.

With the FDA's recent approval of expanded indications for Alcon's LADARVision system, I can now treat up to 93% of my myopic LASIK candidates with a customized wavefront-guided procedure.

Mainz, Germany—The first clinical results from the European Multicenter Trial of the Artiflex foldable iris-claw phakic IOL (Ophtec, Groningen, the Netherlands) indicated that the implant is safe and effective for treating myopia after a 6-month follow-up period.

Los Angeles—Symptomatic refractive surgery re-treatment using CustomCornea wavefront-guided LASIK (Alcon Laboratories Inc.) dramatically reduces higher-order aberrations, with an accompanying improvement in visual symptoms, according to James J. Salz, MD.

Brest, France—The initial results from implantation of the NewLife multifocal anterior chamber phakic IOL (GBR lens, IOLTech, LaRochelle, France) to treat presbyopia indicate that it is safe and effective. However, refinements in the design of the IOL are needed, as are longer follow-up periods, according to Beatrice Cochener, MD.

Athens, Greece—Topography-guided LASIK enhancement using the Allegretto Wave system (WaveLight Laser Technologie AG, Erlangen, Germany) appears to be safe and effective for improving poor quality of vision associated with small, eccentric ablations and irregular astigmatism after previous refractive surgery, said A. John Kanellopoulos, MD.

Frustrated with not being able to see well enough even to gauge how much salt and pepper she was pouring into her cooking, Sarah Polsfuss of Alabama went to a drawer in search of an old article she hoped she had saved.

Antibiotic resistance is a growing challenge, especially in ophthalmic surgery, and clinicians must remain vigilant and well informed to reduce the risk of infection in their patients, said Michael B. Raizman, MD, a cornea specialist with Ophthalmic Consultants of Boston.

Atlanta—Up-to-date results from participants in the FDA clinical trial of the recently approved Verisyse phakic myopic IOL (Advanced Medical Optics) demonstrate that implant provides excellent refractive outcomes with a good safety profile, according to R. Doyle Stulting, MD, PhD.

Free-form technology virtually eliminates unwanted radial astigmatic error, the most common cause of non-adaptation in patients with presbyopia.

New Orleans—Posterior subtenon triamcinolone injection (PSTI) combined with focal laser improves the clinical outcome in diabetic macular edema (DME), according to results of a small, single-center, randomized prospective study, said Murat Tunc, MD, during the American Academy of Ophthalmology annual meeting.

Coronado, CA—Transpupillary thermotherapy (TTT) alone and combined with a single pretreatment intravitreal injection of triamcinolone acetonide 4 mg are similarly associated with vision stabilization over a 6-month follow-up period in eyes with large complicated choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD), reported Jans Fromow-Guerra, MD, PhD, at the annual meeting of the American Society of Retinal Specialists.

Antibiotic resistance is a growing challenge, especially in ophthalmic surgery, and clinicians must remain vigilant and well informed to reduce the risk of infection in their patients, said Michael B. Raizman, MD, a cornea specialist with Ophthalmic Consultants of Boston.

The endothelial cell count had to be at least 2,500 cells/mm2 if the patient was over 45 years.

New Orleans—Results from continued follow-up of myopic eyes enrolled in the FDA clinical trial of the Verisyse phakic lens (Advanced Medical Optics) support the conclusion that the iris-fixated implant is a safe, effective, and very useful adjunct in a refractive surgery practice, said Richard L. Lindstrom, MD, at a session during the International Society of Refractive Surgery of the American Academy of Ophthalmology annual meeting.

New Orleans—The dermis fat graft is an overlooked procedure that merits consideration as a primary or secondary ocular implant and for complex socket reconstruction, suggested James Katowitz, MD.

Accommodation ranged from 0.75to 2 D and did not change significantly throughout thefollow-up period.