Nancy Groves

In a comparison study of adjunctive medication for glaucoma therapy, the addition of brimonidine tartrate, a selective alpha-adrenergic agonist, to a prostaglandin analog achieved greater pressure-lowering than either of two carbonic anhydrase inhibitors.

Prostaglandin analogues preserved with benzalkonium chloride (BAK) can cause more extensive loss of goblet cells and a breakdown of cell-cell adhesions, which could increase the risk of ocular surface disease, according to findings from a pair of studies conducted in rabbits.

The medical profession was slow to adopt the concept of the risk factor, which was born from the marriage of statistics and probability theory. Gradually, however, it has become central to medicine and science and will assume even more importance in coming years.

Experiments have shown that oxidative stress is an early event following acute hydrostatic pressure elevation in vitro or IOP elevation in vivo. These findings suggest that oxidative damage could be an underlying mechanism for glaucomatous optic neuropathy.

Mouse model studies explore role of matrix metalloproteinase 9 (MMP9) in glaucoma-related axon loss. Initial findings revealed a significant difference in relative axon loss between the MMP9 knockout mice and wild-type control mice.

New research in a large family affected with autosomal dominant juvenile-and adult-onset primary open-angle glaucoma has shown that age of onset can predict severity of disease. Researchers also have demonstrated that at least one modifier gene or locus alters the severity of glaucoma caused by a particular myocilin mutation.

Outcomes from a long-term study of patients with small, suspicious choroidal melanoma suggest that observation is an effective strategy that is associated with very low melanoma-specific mortality rates and preservation of visual acuity.

Upgrades to specific confocal laser scanning systems (Heidelberg Retina Tomograph [HRT] and Heidelberg Retina Angiograph 2 [HRA 2], Heidelberg Engineering) should increase the utility of the devices, according to two physicians who have evaluated the new technology.

Livermore, CA-Engineers at Lawrence Livermore National Laboratory here have designed a dual deformable-mirror (DM) adaptive optics scanning laser ophthalmoscope (AOSLO) that can compensate for both higher- and lower-order aberrations and is user-friendly for both physicians and patients.

Las Vegas-The detection of visual field progression is a critically important aspect of the management of glaucoma, yet it remains a major challenge for clinicians, said Angelo P. Tanna, MD, speaking here during a Glaucoma Subspecialty Day program at the annual meeting of the American Academy of Ophthalmology.

Las Vegas-Studies of a 790-nm titanium-sapphire laser (SOLX 790, OccuLogix) used to perform trabeculoplasty in human donor eyes and in patients suggest that the laser may be an important tool for treatment of open-angle glaucoma due to benefits such as an IOP-lowering effect, low complication profile, and ability to repeat treatment periodically, according to Gabriel Simon, MD, PhD. He presented a poster on the findings of his research here at the annual meeting of the American Academy of Ophthalmology in Las Vegas.

Las Vegas-Identification and pretreatment of allergy patients can improve refractive surgical outcomes, said Deepinder K. Dhaliwal, MD, at a continuing medical education symposium at the American Academy of Ophthalmology annual meeting. About 20% to 30% of refractive surgery patients have associated allergies, she added.

Las Vegas-Ocular allergies affect up to 40% of the pediatric population, and this high prevalence has ramifications beyond providing symptom relief, said Terry Kim, MD, during a continuing medical education symposium here at the annual meeting of the American Academy of Ophthalmology.

Las Vegas-Steady-state visual evoked potential (SSVEP) is a promising research tool for vision assessment in the preverbal patient and one that is being used increasingly in the clinic, said William V. Good, MD, who discussed his research here during the annual meeting of the American Academy of Ophthalmology.

London-In an intra-individual comparison of spheric and aspheric monofocal IOLs, significantly better contrast sensitivity was observed in eyes in which the aspheric lens had been implanted, but there was no difference in best-corrected visual acuity (BCVA), said Katrin Petermeier, MD, University Eye Hospital, Eberhard-Karls University, Tuebingen, Germany.

Las Vegas-Laboratory experiments involving an overpressurization technique have demonstrated that acoustic transient cavitation is necessary to produce efficient phacoemulsification, according to Mark E. Schafer, PhD, speaking here at the annual meeting of the American Academy of Ophthalmology (AAO).

The shunt takes advantage of the naturally occurring pressure differential between the anterior chamber and the suprachoroidal space.

Las Vegas-Studies have found conflicting evidence that sleep apnea is a risk factor for glaucoma, with variable control groups and variability in defining sleep apnea and glaucoma contributing to the disagreement. Parag A. Gokhale, MD, speaking here at the annual meeting of the American Academy of Ophthalmology, said he sides with those who believe that a positive association exists between the two conditions.

Las Vegas-Primary acquired melanosis (PAM) of the conjunctiva is an uncommon but important disease. Although some studies have suggested that it occurs in as much as one-third of the population, most cases do not need treatment. The disease is potentially malignant, however, and arguments can be made for early treatment if risk factors are present, said Jerry A. Shields, MD, in his delivery of the Lorenz E. Zimmerman Lecture here at a combined meeting of the American Academy of Ophthalmology and the American Association of Ocular Pathologists.

London-In a comparison of visual outcomes with the femtosecond laser and mechanical microkeratomes following LASIK, both were very effective at targeting emmetropia. Eyes treated with the femtosecond laser, however, had faster visual recovery and better uncorrected visual acuity (UCVA) results at 3 months despite experiencing more transient symptoms immediately after surgery, reported Capt. Steve Schallhorn, MD, here at the XXIV Congress of the European Society of Cataract and Refractive Surgeons.

London-One-year data from an eye-to-eye comparison study of the IntraLase femtosecond laser (IntraLase Corp.) versus the Hansatome mechanical microkeratome (Bausch & Lomb) in myopic LASIK with the VISX Custom-Vue platform (Advanced Medical Optics/VISX) showed that refractive outcomes in both of the groups were excellent and identical despite clinically and statistically significant differences favoring the femtosecond laser earlier in the study.

London-Thin, shallow corneal flaps of approximately 80 to 90 ?m created with an IntraLase femtosecond laser (IntraLase Corp.) may produce the best results in refractive surgery, effectively eliminating pain and haze while producing long-term visual stability, said John Marshall, PhD, in a keynote address during a session on femtosecond lasers here at the XXIV Congress of the European Society of Cataract and Refractive Surgeons (ESCRS).

The problem of tissue drag, which once plagued ophthalmic surgeons, is largely a thing of the past?thanks to groundbreaking work conducted several decades ago by Leonard Apt, MD, currently professor of ophthalmology at the Jules Stein Eye Institute, University of California, Los Angeles (UCLA).

This year's scientific program includes more than 500 peer-reviewed courses.

Editor's Note: Part 1 of this two-part feature (see Ophthalmology Times, Sept. 15, 2006) presented a customer-focused approach for persuading patients to undergo LASIK or a premium cataract procedure. At the heart of this method is training staff to concentrate on identifying patients' needs and how to meet their expectations, rather than jumping to the cost or postsurgical outcomes.

Irvine, CA-Intravitreous dexamethasone in a biodegradable, extended-release implant (Posurdex, Allergan) produced significant improvements in visual acuity and was well tolerated in recent studies. Additional investigation comparing applicator versus incisional placement suggests that the applicator approach is quicker, is at least as safe, and results in similar outcomes, according to Baruch D. Kuppermann, MD, PhD.

Madison, WI-Results from a recent study have shown for the first time the potential of anti-vascular endothelial growth factor (VEGF) therapy to improve features of diabetic retinopathy, according to Micheal M. Altaweel, MD.

About one-third of patients displayed improvement in visual acuity at 1, 2, and 3 months after injection.

Fort Lauderdale, FL-A modified glaucoma valve made of a porous polymer material reduced outflow resistance in tests conducted in an animal model. The reduced resistance should in turn result in improved control of IOP over conventional implants, explained R. Rand Allingham, MD, at the annual meeting of the Association for Research in Vision and Ophthalmology.

Fort Lauderdale, FL-Multifocal visual evoked potentials (mfVEP) and standard automated perimetry (SAP) perform in a similar manner in eyes with high-risk ocular hypertension or early glaucoma, according to a comparison study. However, agreement between the two techniques reached only 80%, suggesting that they detect different defects in some cases, said Brad Fortune, OD, PhD, associate scientist, Discoveries in Sight, Devers Eye Institute, Portland, OR.