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FDA approves faster laser pulse rate

The FDA approval of cyclosporine ophthalmic emulsion 0.05% (Restasis, Allergan) Dec. 26 marked a landmark for ophthalmology. The eye drop therapy for moderate to severe keratoconjunctivitis sicca is unique in that it treats the inflammatory process that causes the condition, and not just its symptoms.

Dallas-Preoperative, perioperative, and postoperative administration of topical antibiotics in 11,000 cases resulted in a remarkably low endophthalmitis rate (one case) in patients undergoing surgery to remove cataracts. It appears that meticulous attention to the use of antibiotics preoperatively, perioperatively, and postoperatively as well as placement of one suture across small-incision cataract wounds may be the elements that make the difference, according to James P. McCulley, MD.

Salt Lake City-An evaluation of four materials available for the manufacture of IOL haptics showed that polymethylmethac-rylate (PMMA), elastimide, and polyvi-nylidene fluoride (PVDF) had similar loop memory at a level that was significantly higher than that of polypropylene (PP) haptics. All lenses had a silicone optic.

Mainz, Germany-The accommodation capabilities of two IOLs (AT-45, CrystaLens, C&C Vision, Aliso Viejo, CA; and 1CU, HumanOptics AG, Erlangen, Germany) were clearly demonstrated in patients for the first time and compared with a standard IOL, which showed no accommodative effect, according to H. Burkhard Dick, MD.

Orlando-Custom prolate topographically guided corneal ablation using the LaserSight system with its unique ablation planning software (AstraPro) delivers improved overall vision, said Jack T. Holladay, MD, during the American Academy of Ophthalmology's refractive surgery subspecialty day meeting.

Orlando-The OPD-Scan optical path dif-ference scanning system (Nidek) combines measurement of corneal topography and aberrometry and could be particularly advantageous for guiding customized ablations in patients with highly aberrant cor- neas, according to speakers at the refractive surgery subspecialty day meeting prior to the annual meeting of the American Acad-emy of Ophthalmology.

Cincinnati, OH-The toric implantable contact lens (ICL) from STAAR Surgical promises to expand the range of patients who can be treated with phakic implants by enabling the treatment of astigmatic myopia and, eventually, astigmatic hyperopia.

Orlando-Ongoing formal and informal studies are examining expanded applications for conductive keratoplasty (CK), including its use for the treatment of presbyopia, astigmatism, and as an enhancement procedure for reducing hyperopia after previous keratorefractive or lenticular surgery, said Louis D. Nichamin, MD, at the refractive surgery subspecialty day meeting held prior to the American Academy of Ophthalmology annual meeting here.

Orlando-Results from international and U.S. FDA clinical trials point to the efficacy and safety of treating spherical and cylindrical refractive errors using the Zyoptix system for personalized vision correction (Bausch & Lomb), according to speakers at the refractive surgery subspecialty day held prior to the American Academy of Ophthalmology annual meeting.

Orlando-A new light-adjustable IOL (LAL) has been designed that will allow for noninvasive correction of residual refractive errors present after cataract surgery, said Daniel M. Schwartz, MD, during the refractive surgery subspecialty day meeting prior to the annual meeting of the American Academy of Ophthalmology. Researchers are ready to begin testing the LAL in clinical trials, he added.

Orlando-In the majority of eyes undergoing primary LASIK, wavefront-adjusted ablation performed with the WaveLight system yields visual outcomes comparable to those achievable with wavefront-guided techniques, said Theo Seiler, MD, PhD, at Back to the Future, the refractive surgery subspecialty day meeting prior to the American Academy of Ophthalmology meeting.

Orlando-CustomCornea wavefront-guided LASIK using the LADARWave aberrometer and the LADARVision4000 excimer laser (Alcon) last October became the first wavefront-guided LASIK system to receive FDA approval for the treatment of myopia. The agency's decision was based on clinical trial data proving that the customized approach delivers superior optical quality compared with conventional LASIK.

Orlando-The CRS-Master (Carl Zeiss Meditec) ablation profile design workstation is a "best of breed" platform for customized ablations because it integrates wavefront, topography, and clinical data for the individual patient while giving the surgeon control in designing the laser treatment, said Dan Z. Reinstein, MD, FRCSC.

Orlando-Six-month results from an FDA clinical trial indicate that customized wavefront-guided LASIK for treatment of myopia with the WavePrint system (VISX) is associated with safe and effective outcomes exceeding FDA targets. The wavefront-guided LASIK is also effective for minimizing increases in higher-order aberrations that can accompany conventional LASIK.

Orlando-Application of wavefront sensing technology has led to the characterization of optical aberrations associated with aging and cataract surgery, and that information is now being applied to develop new pseudo- phakic IOL designs, said Scott M. MacRae, MD.

Orlando-Phototherapeutic keratectomy (PTK) with a broad-beam laser may be a useful treatment for eyes with chronic, visually significant post-LASIK flap microstriae, said Roger F. Steinert, MD, during the refractive surgery subspecialty day meeting prior to the American Academy of Ophthalmology annual meeting.

Here's some good news regarding Medicare reimbursement. American Academy of Ophthalmology (AAO) member William L. Rich III, MD, has been appointed to an influential American Medical Association (AMA) committee on physician reimbursement.

Peapack, NJ-Pharmacia Ophthalmology will begin making its latanoprost ophthalmic solution(Xalatan) available for initial treatment of elevated eye pressure associated with open-angle glaucoma or ocular hypertension.

Salt Lake City-Ofloxacin (Ocuflox, Allergan, Irvine, CA) is more effective for preventing endophthalmitis after cataract surgery compared with ciprofloxacin (Ciloxan, Alcon, Fort Worth, TX), said Randall Olson, MD.

Orlando-Argon laser trabeculoplasty (ALT) can achieve substantial IOP reductions in patients with open-angle glaucoma that is refractory to medical therapy. In addition to efficacy, the cost of the procedure compares favorably with medical treatments, which tend to be substantially more costly over time, according to Karen M. Joos, MD, PhD.

Orlando-Posterior polar cataract is an invitation to capsule rupture and so cataract surgery in these cases necessitates thorough patient counseling, careful preoperative planning, and adaptations in intraoperative technique, said Samuel Masket, MD.

Orlando-Periodic IOP monitoring is mandatory in eyes that have sustained a severe injury because they are at significantly increased risk for developing traumatic glaucoma, said Jess T. Whitson, MD.

Fort Bragg, NC-As a reward for helping a colleague with a difficult postoperative situation, Robert K. Maloney, MD, got thrown out of an airplane, literally.

Salt Lake City-Research from the Moran Eye Center, University of Utah School of Medicine, Salt Lake City, showed that low ocular levels of the antioxidants lutein and zeaxanthin could contribute to age-related macular degeneration (AMD).

Orlando-Advancements in refractive surgery were the talk of Nidek's workshop on customized ablation at the American Academy of Ophthalmology (AAO) annual meeting here last fall. The symposium was intended as a forum for ophthalmologists to gain a better understanding of the technology available to them.

Editor's Note: In this month's column,a panel of experts offers tips on when and how to administer intraocular injectionsof corticosteroid for patients with uveitis.

FDA OKs trials of laser reversal of presbyopia

New York-Research to Prevent Blindness (RPB), a voluntary health organization supporting eye research, awarded 94 grants totalling $9.7 million last year for research into the causes, treatment, and prevention of all blinding diseases.

New York-Pfizer Inc. and Eyetech Pharmaceuticals Inc. will jointly develop and commercialize Eyetech's pegaptanib sodium (Macugen) as a potential treatment for age-related macular degeneration (AMD) and diabetic macular edema (DME).