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The study assesses and compares the accuracy of IOL formulas using keratometry (K) and total keratometry (TK) values obtained by a swept-source OCT biometer (IOL Master 700) in eyes with previous PKP prior to cataract surgery.

Study: IOL calculation remains challenging in PKP eyes

There is considerable variability in variables when measuring the eyes with both biometers, which may affect formula performance and postoperative refractive predictions when using formulas that utilize values like interior chamber depth and lens thickness.

Study finds considerable variability in specific optical path variables when measuring the same eyes with SS-OCT and OLCR biometry devices

A recurring feature at the 2024 American Society of Cataract and Refractive Surgery (ASCRS) Annual Meeting in Boston, Massachusetts, was the call for environmentally friendly practices worldwide, with the goal of decreasing the impact of ophthalmic surgeries on the planet.

A driving force in this movement is EyeSustain

 an organization dedicated to the development of such friendly environmental practices, that exists as a global coalition of eye societies providing education and resources to support sustainable practices in ophthalmology.

Here is a sampling of the ASCRS discussions on the topic.

Greening eye care: reducing ophthalmology’s environmental footprint

The presenters, led by first author Sarishka Desai, BA, described the EyeSustain platform and its 5-pronged mission: educate the global ophthalmic community about more sustainable practices, collaborate with industry to reduce our carbon footprint and surgical waste, support research and innovative solutions that reduce ophthalmology’s environmental impact, support advocacy and education about the public health impact of climate change, and collaborate with industry to reduce our carbon footprint and surgical waste.

Desai, of the University of Connecticut School of Medicine in Farmington, and colleagues presented EyeSustain’s approach to reducing the ophthalmic carbon footprint. She was joined in the study by Nitya Devireddy, BS, MPH, of Penn State College of Medicine in Hershey, Pennsylvania; Sofia Miguez, BA, of Yale School of Medicine in New Haven, Connecticut; and Barbara Erny, MD, of the Department of Ophthalmology at Stanford University in California.

The greenhouse gas data associated with health care are startling. Health care is responsible for 4.4% of all global greenhouse gas emissions, 71% of which arise from the manufacturing, use, and disposal of medical supplies. Ophthalmology has the highest procedural volume of any surgical specialty, with 50 million cataract surgeries expected to be performed globally each year by 2050, Desai reported.

In light of the procedural data, the authors highlighted 6 areas that are currently undergoing research and quality improvement initiatives through the EyeSustain system.

 of cataract surgeons and nurses by David Chang and Cassandra Thiel found that 93% of respondents believe that the trash associated with OR procedures is excessive, and that methods to reduce waste should be identified and implemented.

 encouraged regulatory agencies to allow electronic instructions for use be disseminated in lieu of the traditional paper instructions included with each cataract pack.

Ongoing projects spearheaded by EyeSustain members, including medical students and ophthalmology residents, are taking a look at educating surgeons and surgical staff about sustainability and the impact of OR waste, OR water consumption, and evaluation of flash sterilization associated with cataract surgery.

In recognition of the fact that medications in the OR represent an estimated $560 million in waste annually, a multisociety position paper

 recently formulated 3 key recommendations: topical drugs in multidose containers can be used for multiple patients in surgical facilities if proper guidelines are followed; topical drugs in multidose containers can be used until the manufacturer’s labeled date of expiration if proper guidelines are followed; and, when applicable, patients should be able to take their partially used medication home for postoperative use.

The Aravind Eye Care system’s low-carbon model from Madurai, India, uses alternate energy sources, transport, infrastructure, and equipment maintenance.

 Studying global systems of eye care and waste produced can provide a deeper understanding of the impact of hospitals and providers on climate change, as well as ideas on how western eye care systems can proactively reduce carbon emissions.

The EyeSustain platform includes ophthalmology-specific action steps for greening offices and clinics in collaboration with the 

Partnerships can be established with large manufacturers to reduce packaging, make instruments reusable, and streamline the manufacturing and distribution processes.

In addition to the impact of practice waste on the environment, EyeSustain also recommends studying the effects of climate change on the incidence rates of ophthalmologic conditions, including cataracts, allergic disease, and glaucoma, among others.

Desai and her colleagues recommended that institutions take the following steps:

Conduct a waste audit to quantify the carbon footprint of an institution’s OR emissions. This includes using the EyeSustain-Zasti Carbon Footprint Calculator, using the Sustainability Index for Disposables in Cataract Surgery calculator for cataract packs to evaluate the item-by-item potential for carbon dioxide savings, and surveying clinical staff to identify areas of perceived excess waste.

Identify key stakeholders at an institution and an enthusiastic, multidisciplinary team and completing the OR Sustainability Pledge (

), which has been completed by ambulatory surgery centers/hospital outpatient departments from 9 countries thus far.

Implement best practices; multisociety recommendations for sustainability are easily accessible at eyesustain.org and My Green Doctor for outpatient/clinic resources and local legislation using the American Academy of Ophthalmology Topical Medical Waste Reduction Act legislative template.

Using phacoemulsification waste to guide changes in surgical sustainability

Adjustments to improve the sustainability of ophthalmic surgical practice can have a large impact when scaled to case volume, according to author Margaret Tharp, BSc, who described this study at the ASCRS meeting. She and her coauthors Stella Protopapas, BA, MPH, and Minka Gill, BSc, are from the Indiana University School of Medicine in Bloomington, whereas David J. Palmer, MD, ABO, is from the Northwestern University Feinberg School of Medicine in Chicago, Illinois.

In their study, they sought to draw connections between results from a 24-hour waste audit at an outpatient surgical center and current resources available from EyeSustain to improve the sustainability of ophthalmic surgical practice.

The authors documented the extensive waste generated from 1 day of surgeries in an institution that included 13 phacoemulsification procedures, 5 plastic surgeries, 3 urologic surgeries, and 5 otolaryngologic cases. The waste products were sorted as medications (eg, propofol, eye drop containers), textiles (eg, surgical gowns, drapes), metals (eg, metal wiring, disposable instruments), and plastics (eg, hard, soft, wrappings).

When the amounts of the waste products were tallied, the authors found that “ophthalmology produced the greatest amount of waste in a single day relative to other operating specialties, despite producing the least amount of waste per case. Most ophthalmic waste was from textiles, hard plastics, and medications,” the authors reported.

The specific 13 phacoemulsification procedures resulted in 95.4 lb of waste broken down as follows: 18.5 lb of hard plastic, 5.5 lb of soft plastic, 8.3 lb of wrapping, 13.5 lb of medications, 41.2 lb of textiles, 6.7 lb of miscellaneous waste, and no metals. Compared with other operating specialties, ophthalmology produced the least amount of waste per case but the greatest amount of waste in total due to the relatively high case volume.

It has been reported that “discarded/unused pharmaceuticals from US cataract surgeries demonstrated waste of [approximately] $150 per case while generating carbon dioxide–equivalent emissions that approximated 25,000 to 100,000 flights from San Francisco, California, to Boston annually.

Small changes can have dramatic results. Tharp and colleagues suggested that the following would have positive consequences.

Revising the use of tetracaine bottles intraoperatively; for example, reusing the bottles between cases or sending the bottles home with patients

Optimizing packaging of surgical supplies and electronic instructions

Utilizing intravenous sedation to limit anesthesia gas carbon dioxide–equivalent emissions

Focusing on cutting waste also creates an opportunity to explore the practices of global leaders in sustainable eye care, such as the efforts of the Aravind Eye Hospitals, which provide similar surgical success rates at a fraction of the waste produced by US practices.

 A downside may be that such practices require significant reuse of materials, central sterilization, and stakeholder diligence, which can require complex interventions, according to Tharp. 

EyeSustain’s Surgical Facility Sustainability Pledge can serve as a guide for ophthalmologists to improve the sustainability of their practice in an approachable and lasting manner.

Factors contributing to the carbon footprint of cataract surgery

Omar Taboun, MSc, a medical student at Western University’s Schulich School of Medicine & Dentistry in London, Ontario, Canada, working under the direction of Netan Choudhry, MD, FRCSC, also described the negative impact of cataract surgery on the environment at the ASCRS meeting.

He commented, “We know that climate change can affect human health through various means, such as adverse weather events causing injury and exposure to pollutants [exacerbating] underlying health conditions. As health care providers, it is our responsibility to treat patients for their conditions that may ultimately be influenced by environmental factors. Counterintuitively, the health care sector is itself a greenhouse gas emitter,” Taboun said.

Surgery contributes significant emissions to the environment through the necessary materials and tools used during procedures. In addition, the need to maintain sterility increases waste.

The term footprint indicates the sum of all emissions direct and indirect resulting from this procedure, Taboun explained, the resultant value of which is typically reported in carbon dioxide equivalents

And although cataract surgery requires only a few minutes to complete, the procedural volume has increased exponentially over the past 2 decades,

Taboun and colleagues developed a 2-fold goal: they wanted to increase their understanding of the carbon footprint and waste accumulation to identify the primary contributors and pinpoint areas for improvement to enhance the sustainability of cataract surgery.

They conducted a literature search of PubMed, Google Scholar, and Medline to identify studies related to the carbon footprint and the elements of cataract surgery. The results yielded 6 studies, with 2 being the basis for this discussion,

He highlighted 3 main points extracted from the published data: the lowest footprint published was just under 6 kg of carbon dioxide equivalents; the highest published footprint was just over 180 kg of carbon dioxide; and the major factors contributing to the footprint include procurement of pharmaceuticals and materials, building and energy use, such as heating/cooling, lighting, electricity-powered tools, and travel by patients and staff to the location where the procedure is performed.

Taboun directed attention to centers that already have sustainable practices in place, such as the Aravind Eye Hospital, which reports the lowest footprint. These sustainable practices include the use of multiple operating tables in a single room; reusing gloves, gowns, and various medical equipment;

and using highly efficient autoclave settings.

Importantly, when these changes were implemented in the Aravind Eye Hospital,

 the rates of endophthalmitis remained comparable to other centers: 0.02% vs from 0.04% to 0.07% reported.

Taboun offered 3 ways that surgeons can offset the negative effects of cataract surgery on the environment—by focusing on procurement, energy use, and travel emissions.

Reduce emissions associated with procurement by collaborating with manufacturers to reduce packaging as much as possible and encouraging recycling in every OR.

Reduce building and energy use by incorporating renewable energy, such as solar panels, and more strategic lighting protocols and optimizing energy use within surgical centers.

Establish outreach clinics closer to more populous regions, whereby mostly staff members must travel, and patients less so, which will reduce travel emissions, along with performing bilateral procedures.

“Implementing sustainable practices, although challenging, will allow us to continuously provide this procedure and restore vision for millions of people at less of a cost to the environment,” Taboun said.

1. Chang DF, Thiel CL; Ophthalmic Instrument Cleaning and Sterilization Task Force. Survey of cataract surgeons’ and nurses’ attitudes toward operating room waste

. 2020;46(7):933-940.doi:10.1097/j.jcrs.0000000000000267

2. Schehlein EM, Hovasesian J, Shukla AG, Talley Rostov A, Findl O, Change DF. Reducing ophthalmic surgical waste through electronic instructions for use: a multi-society position paper. 

. 2024;50(3):197-200. doi:10.1097/j.jcrs.0000000000001381

3. Cleaning and Sterilization Task Force. Reducing topical drug waste in ophthalmic surgery: multisociety position paper

. 2022;48(9):1073-1077; doi:10.1097/j.jcrs.0000000000000975

4. Goel H, Wemyss TA, Harris T, et al. Improving productivity, costs and environmental impact in International Eye Health Services: using the ‘Eyeficiency’ cataract surgical services auditing tool to assess the value of cataract surgical services. 

. 2021 ;6(1):e000642. doi:10.1136/bmjophth-2020-000642. 2021

5. US EPA O. Greenhouse gas equivalencies calculator. United States Environmental Protection Agency. Updated January 2024. https://www.epa.gov/energy/greenhouse-gas-equivalencies-calculator

6. Gadani H, Vyas A. Anesthetic gases and global warming: [otentials, prevention and future of anesthesia. 

. 2011;5(1):5-10. doi:10.4103/0259-1162.84171

7. Thiel CL, Schehlein E, Ravilla T, et al. Cataract surgery and environmental sustainability: waste and lifecycle assessment of phacoemulsification at a private healthcare facility. 

. 2017;43(11):1391-1398. doi:10.1016/j.jcrs.2017.08.017

8. Pandey D, Agrawal M, Pandey JS. Carbon footprint: current methods of estimation. 

. 2011 ;178(1-4):135-160. doi:10.1007/s10661-010-1678-y

9. Pandey D, Agrawal M, Pandey JS. (2011). Carbon footprint: current methods of estimation. 

. 2011;178(1-4):135-160. doi:10.1007/s10661-010-1678-y

10 Rachmiel R, Trope GE, Chipman ML, Buys YM. Cataract surgery rates in Ontario, Canada, from 1992 to 2004: more surgeries with fewer ophthalmologists. 

11. Morris DS, Wright T, Somner JEA, Connor A. The carbon footprint of cataract surgery. 

. 2013;27(4):495-501. doi:10.1038/eye.2013.

12. Latta M, Shaw C, Gale J. The carbon footprint of cataract surgery in Wellington. 

13. Ravindran RD, Venkatesh R, Chang DF, Sengupta S, Gyatsho J, Talwar B. Incidence of post-cataract endophthalmitis at Aravind Eye Hospital: outcomes of more than 42,000 consecutive cases using standardized sterilization and prophylaxis protocols. 

. 2009;35(4):629-636. doi:10.1016/j.jcrs.2009.01.002

14, Pershing S, Lum F, Hsu S, et al. Endophthalmitis after cataract surgery in the United States: a report from the Intelligent Research in Sight registry, 2013-2017. 

. 2020;127(2):151-158. doi:10.1016/j.ophtha.2019.08.026

Organization eyes green practices, shifting ophthalmology landscape.

Minimizing the carbon footprint of ophthalmic surgeries

AAO 2024: Early cataract extraction for angle closure glaucoma

Nathan Radcliffe, MD, shared insights from his presentation at the annual meeting of the American Academy of Ophthalmology entitled, "Early cataract extraction for angle closure glaucoma."

This transcript has been lightly edited for clarity.

 Hello, this is Nathan Radcliffe, cataract and glaucoma specialist from New York City. I practice at New York Ophthalmology, the New York Eye Surgery Center, and I'm affiliated with Mount Sinai School of Medicine. Why you should consider early cataract extraction for patients with angle closure, elevated pressures, or angle closure glaucoma. And there are actually a few good studies on this topic. But I'd like to start with the alternative to taking the cataract out, which is to use a laser iridotomy and place a patient on medications. The data for laser iridotomy isn't that strong. This was looked at in a study called the ZAP study, which was a prospective study where patients had iridotomy in 1 eye or cataract in the other. There weren't a lot of people that benefited from the laser. And in fact, you needed to treat almost 50 patients in order to benefit 1 patient, in terms of the study's outcomes. 

There are no approved IOP lowering medications for angle closure glaucoma. We're you using them all off label. Cataract surgery was studied in a trial called the EAGLE, prospective, multicenter randomized trial comparing laser iridotomy and meds to cataract surgery, and a cataract group did very well. Their angles were more open. They had a higher quality of life, and they either used fewer medications or had lower intraocular pressures, and in a long-term, different design, but similar study, these patients went on to have better outcomes with long-term lower medication use, up to 10 years, and even fewer cases of lost vision. So why does cataract surgery work so well? Well because it relieves relative pupillary block. It opens up the angle. It even relaxes the ciliary body. 

So if you have plateau with angle closure, it should help there, and it opens up the trabecular meshwork face by relaxing the scleral spur. So in summary, I think the data is very clear. This is a good way to treat patients, I would say, who either have nerve damage or on pressure lowering medications with angle closure and so cataract surgery should be considered. One of the unique indications for patients with angle closure to undergo cataract surgery is if they have optic nerve damage with angle closure, or are on a number of medications. Interestingly, what isn't really necessary for the cataract extraction to be beneficial is for that cataract to be visually significant. Now, some insurances, some insurance companies, may quibble over this, but the data from the EAGLE study and the patient benefit is there, even if the cataract is not visually significant with angle closure, it's still medically significant and beneficial to remove it. When patients with angle closure undergo early cataract extraction, the benefits are essentially a disease modification, opening of their angle and either lowering the pressure or reducing the number of medications. 

There are risks to cataract surgery. Most experienced surgeons find those risks to be less than 1 percent, but they include things like need for second surgery, inflammation, and in rare cases, glaucoma can result from cataract surgery, although the bulk of patients experience a glaucoma benefit. In a 10-year study comparing patients who received iridotomy to patients who received cataract surgery, the patients who received the cataract surgery did better, they needed fewer medications, and they had fewer cases of severe vision loss. But what's most interesting is the patients who underwent the iridotomy, in other words, who tried to avoid the early cataract surgery, over 10 years, 76 percent or so of them had their cataract out anyway. So the reality is, the cataract is coming out. It's just that removing it earlier is going to give that patient a longer period of benefit to their vision and to their glaucoma status.

Early cataract extraction is advocated for patients with angle closure glaucoma due to its superior outcomes compared to laser iridotomy and medications. Studies like the EAGLE trial demonstrate that cataract surgery results in more open angles, improved quality of life, and reduced medication dependency. The procedure alleviates pupillary block and relaxes the ciliary body, offering long-term benefits. Despite potential risks, the advantages of early cataract removal, even when the cataract is not visually significant, include disease modification and reduced intraocular pressure, outweighing the risks associated with surgery.

Fetemah Rajaii, MD, PhD, discusses TED

Fatemeh Rajaii, MD, PhD, an associate professor at Wilmer Eye Institute, Johns Hopkins, discusses emerging therapies in thyroid eye disease (TED) from her presentation at the American Academy of Ophthalmology’s annual meeting in Chicago. 

With the FDA approval of teprotumumab, there is increasing pharmaceutical interest in developing new treatments. These therapies target three main mechanisms: anti-IGF-1 receptor agents like teprotumumab, anti-IL-6 receptor agents, and anti-FcRn receptor agents. 

These approaches aim to modulate the immune system and improve outcomes for TED patients. Dr. Rajaii emphasizes the importance of maintaining a high index of suspicion for TED, noting its prevalence as the leading cause of unilateral or bilateral proptosis in adults. TED can present with various symptoms, such as eyelid retraction or dry eye. 

Raja noted that ophthalmologists should consider ordering appropriate labs when TED is suspected. She anticipates significant advancements in TED treatment options over the next 3-5 years.

Emerging therapies for thyroid eye disease (TED) are gaining attention, particularly with the FDA approval of teprotumumab. These therapies focus on targeting anti-IGF-1, anti-IL-6, and anti-FcRn receptors to modulate the immune response and improve patient outcomes. TED is the leading cause of proptosis in adults, presenting with symptoms like eyelid retraction and dry eye. Ophthalmologists are encouraged to maintain vigilance for TED and order relevant laboratory tests when suspected. Significant advancements in TED treatment are expected in the next few years.

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AAO 2024: Therapies offering hope for patients diagnosed with TED

AAO 2024: Incidence and prevalence of uveitis and associated ocular complications in the US TriNetX Database

Meghan Berkenstock, MD, an associate professor of ophthalmology at the Wilmer Eye Institute, provides insights on paper from the uveitis free paper section of AAO 2024, about the use of TriNetX database to assess for the incidence and prevalence of both uveitis and its complications.

 My name's Meghan Berkenstock. I'm an associate professor of ophthalmology at the Wilmer Eye Institute, and today I'm going to be talking about our paper, which is going to be presented in the uveitis free paper section, about the use of TriNetX database to assess for the incidence and prevalence of both uveitis and its complications. As we know the uveities are an umbrella-term for 30 different types of ocular inflammation. The incidence and prevalence has a wide range in the current literature. We use the TriNetX database, which has over 120 million subjects with de-identified data, in order to assess the incidence and prevalence of uveitis in the United States, as well as ocular complications, including macular edema, glaucoma, and ocular hypertension. For methods, we used ICD codes to identify these patients in the comorbidities between the years of 2013 to 2023 to allow us to have a cumulative incidence and prevalence. 

Our main outcome measures were annual incidence and prevalence of uveitis, sub-classified by anatomic location, in addition to the incidence and prevalence of each of the comorbidities we discussed. Among the 300,814 patients with uveitis, the mean age was 57 years, with a predominance of females who were Caucasian. Anterior uveitis was the most common subtype, and the most commonly used immunosuppressants were prednisone and methotrexate. The most commonly associated systemic disease was ankylosing spondylitis, and the most frequent complications were, in order, glaucoma or ocular hypertension, followed by macular edema and cataract. The cumulative incidence and prevalence rates of uveitis [from] 2013 to 2023 were 60 and 285 out of 100,000 people, respectively. So our study presents a comprehensive analysis of uveitis in the United States with a database that is almost analogous to the United States population, allowing for generalizability of our study. One of the strengths is the large number of patients in the database, but of course, one of the limitations of the study is accurate coding within a large data set.

The study utilizes the TriNetX database to evaluate the incidence and prevalence of uveitis and its complications in the U.S. from 2013 to 2023. It identifies 300,814 uveitis patients, predominantly Caucasian females with a mean age of 57. Anterior uveitis is the most common subtype, with prednisone and methotrexate as frequent treatments. Ankylosing spondylitis is the most associated systemic disease, while glaucoma, ocular hypertension, macular edema, and cataract are common complications. The study highlights the database's large sample size but notes limitations in coding accuracy.

Canonical

AAO 2024: Optimal pupil size reduction percentage for near vision improvement in presbyopia

Jennifer Loh, MD, shared insights from on her presentation at the American Academy of Ophthalmology meeting in Chicago on the effects of CSF-1, which is the lowest effective concentration of pilocarpine approved in the United States.

Hi. My name is Jennifer Loh, and I'm from Miami, Florida, in private practice. I had the honor today of presenting a paper at the American Academy of Ophthalmology in Chicago on the effects of CSF-1, which is the lowest effective concentration of pilocarpine approved in the United States. In our paper, we looked at the mean reduction in pupil size attributed to CSF-1, and also its improvement of near visual acuity. Patients used the drop for 15 days. We measured endpoints at day 1, day 8, and day 15. We found throughout the study that there was a mean reduction in pupil size of 30 percent at all measured time points. And this also corresponded with an improvement in near visual acuity of greater than 3 lines without a loss of distance visual acuity. And this is important because we've come to understand that it's, for a presbyopic drop to function well, it needs to improve near vision without affecting distance vision and with minimal side effects. What was also interesting in our study was we found that patients near vision actually improved, especially from day 1 through day 8, and this was thought to be attributed to neuro-adaptation, which we also find in patients with multifocal contact lenses, or multifocal IOLs placed during cataract surgery, and this is thought, again due to the patients learning how to adapt to their new, near-vision focal point. Other papers have also shown that a reduction in pupil size for about 30 percent is important to help reduce the symptoms of presbyopia, and we found that a pupil size between 2 to 3 millimeters is very beneficial to achieve this effect. In our paper, the adverse events were mild. There were no serious adverse events. The most common one reported was a headache. Yeah, I think that, I mean, I think the fact that, patients near visual acuity improved over those few days that were analyzed, I think, was important. Also in the paper, on between day 8 and day 15, we changed the second dose. So, the dosing for Qlosi or CSF-1 is BID, but it's not really BID When you think BID, you think Q12 hours. This was not done that way. In the study, it was dose 1, like the initial dose, and then the first 2 time points were dose 2 hours later. Between day 8 and day 15, though, we looked at dosing after 3 hours from the initial dose, and this was done to look at, to see if we could extend the duration of effect of Qlosi to get to that closer to 8 hours, which is considered probably an ideal time range that patients want. They want to use the drop and have 8 hours of near vision. So that was not mandated by the FDA, but we looked at it in order to see, again, if we could kind of achieve a longer duration. So instead of dosing it 2 hours after the first dose, it was dosed at 3 hours, and that did seem to help. I think. What was also interesting, you could really see the correlation in pupil size. As the pupil that, you know, we measured every hour for those, those 8-hour time periods, as the pupil got bigger, you definitely saw that drop in your vision. So there's certainly a correlation there. And I don't know, I think it was just a really interesting study. We also looked at low luminance, so there was a filter placed over the visual acuity screen that patients had to read, that was to simulate dim vision, and patients did not lose the distance vision. So I think that was also really important, and there might have been some neuro-adaptation to that too, and that was more reassuring to show that probably using Qlosi would not reduce patient's vision at night.

CSF-1, the lowest effective concentration of pilocarpine approved in the U.S., was studied for its effects on pupil size and near visual acuity. Over 15 days, a 30% reduction in pupil size was observed, improving near visual acuity by over three lines without affecting distance vision. Neuro-adaptation was noted, similar to multifocal lens adaptation. Mild adverse events, primarily headaches, were reported. Adjusting the dosing interval from two to three hours extended the duration of effect, maintaining near vision for up to eight hours without compromising distance vision, even in low light conditions.

The results of a new study has shown that photobiomodulation, a non-invasive treatment, may be another method for treating dry age-related macular degeneration (AMD). David S. Boyer, MD, of Retina-Vitreous Associates Medical Group in Los Angeles, reported that this therapy can reduce the risk of visual loss and show disease progression.

Boyer reported the results at the 2024 American Academy of Ophthalmology (AAO) annual meeting in Chicago.

“It’s promising news for patients who typically experience slow, progressive vision loss year after year,” commented Boyer in a press release issued by AAO.

This is good news for patients with dry AMD, for whom few treatment options are available. To date, only life-style and dietary modifications have been recommended.

A total of 100 patients (148 eyes) participated in the study. These patients, who had high-risk intermediate AMD, were randomized to receive photobiomodulation or an active sham treatment. Treatment was administered 3 times a week for 3 weeks and repeated every 4 months.

The results showed that after 2 years of treatment, 53% of treated patients had more than 5 letters improvement in the best-corrected visual acuity which was in contrast to 18% of untreated patients who lost more than 5 letters of vision. In addition, the treated patients had a 73% decrease in new-onset geographic atrophy, compared with a 24% incidence of disease progression in the untreated patients.

Photobiomodulation, a non-invasive treatment, shows promise in treating dry age-related macular degeneration (AMD) by reducing visual loss risk and disease progression. A study involving 100 patients demonstrated significant improvements in visual acuity and decreased incidence of geographic atrophy in treated patients compared to untreated ones. This therapy, already used in various medical conditions, employs light wavelengths to enhance cellular function in retinal cells. It offers a potential early intervention for dry AMD, with FDA review of its Biologics License Application anticipated in December 2024.

Non-invasive, painless laser can reduce risk of vision loss

Deanna H. Dang

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