Optometry

Results of a survey of 124 ophthalmologists show interest in preservative-free formulations of IOP-lowering medications to preserve ocular surface health. Preservative-free timolol maleate (Timoptic in Ocudose, Aton Pharma) can be a good choice for appropriately selected patients, according to one ophthalmologist.

Implantation of a trabecular micro-bypass (iStent, Glaukos Corp.) in patients with open-angle glaucoma who are undergoing cataract surgery represents an alternative surgical approach that can provide clinically significant reductions in IOP and use of ocular hypotensive medications.

Endocyclophotocoagulation (ECP) can be performed easily in patients with medically controlled glaucoma who are undergoing cataract surgery, to provide additional IOP lowering and reduce medication use. Misunderstanding that ECP is a completely different procedure than transscleral cyclodestruction contributes to under-use of this very safe procedure, according to one ophthalmologist.

Recent literature has identified ocular perfusion pressure as a glaucoma risk factor. Ophthalmologists need to be aware of the growing evidence supporting this theory, according to one expert.

Hyperemia is one of the main reasons why patients with glaucoma do not adhere to or persist with their topical therapeutic regimen. Patients end up switching to another possibly more tolerable medication, and the changing of medications has significant financial implications. Latanoprost has the lowest incidence of hyperemia among the prostaglandin analogs. Patient adherence is crucial in a chronic progressive disease such as glaucoma, where non-adherence can lead to visual loss and decline in quality of life, creating societal health and economic burdens.

Longer duration of use of monotherapy with prostaglandin analogues may be associated with lower annual costs of glaucoma treatment because adjunctive therapy is one of the primary factors affecting the cost of care, suggest findings of a retrospective analysis of a pharmacy claims database.

Hideo Ozawa, the founder and chairman of Nidek Co. Ltd., is being remembered as a visionary who combined optics and electronics to advance vision technology around the world. Ozawa, 79, died June 16.

The efficacy and tolerability of continuing latanoprost 0.005% (Xalatan, Pfizer) after 6 weeks of latanoprost monotherapy versus switching to bimatoprost 0.03% (Lumigan, Allergan) was investigated in an investigator-masked, randomized, parallel-group trial. The results showed good efficacy and tolerability in patients whose therapy was switched to bimatoprost and suggest that bimatoprost may be tolerated better after latanoprost pre-treatment.

Anti-vascular endothelial growth factor monotherapy appears to be an effective treatment for retinal angiomatous proliferation, according to results of a small, retrospective chart review. Although the results indicate that in most cases repeated injections would be needed to achieve improvement or stable vision, treatment based on ocular coherence tomography-confirmed presence of fluid could achieve outcomes similar to monthly injections.

Non-penetrating Schlemm's canaloplasty may be a safe and effective alternative to standard trabeculectomy. A retrospective comparison study found no statistically significant differences in IOP reduction or medication usage at up to 1 year of follow-up. Adjunctive procedures and complications were similar in the two groups of patients, although no long-term hypotony was seen in the canaloplasty group.

Bausch & Lomb has opened a new 300,000-square-foot global pharmaceutical headquarters building in Madison, NJ. The company maintains its worldwide headquarters in Rochester, NY, and has research and development functions in locations around the world.

The first microincisional IOL (Akreos MICS IOL, Bausch & Lomb) has been introduced in the U.S. market. The lens is a single-piece hydrophilic acrylic IOL designed for delivery through a 1.8-mm incision. Its material and design offer several advantages, according to three surgeons who have used it.

A meta-analysis based on data from 12-month trials including patients treated with brimonidine 0.1% with a preservative (Alphagan P 0.1% with Purite, Allergan) and patients using brimonidine 0.15% (Alphagan P 0.15%, Allergan) showed better systemic safety and tolerability with the lower-concentration product.

Brimonidine 0.2%/timolol 0.5% fixed-combination ophthalmic solution effectively lowers and controls IOP and is likely to be associated with increased patient adherence to therapy and decreased unwanted side effects such as ocular irritation, according to one ophthalmologist.

A dual-linear phacoemulsification platform (available on the Stellaris, Bausch & Lomb) separates phaco and vacuum, allowing cataract surgeons to maximize their control over the cataract removal procedure.

As members of Congress return home for August recess, the nation's dialogue continues over how best to provide health-care coverage to 44 million uninsured Americans.

The large variety of available OVDs allows the surgeon to tailor the surgery to meet any specific needs a patient may have.

One surgeon's preference for an ophthalmic surgical device (OVD) of 1.6% sodium hyaluronate (Amvisc Plus, Bausch & Lomb) was reinforced by a study that found it superior to another OVD during phaco and OVD removal.

A new phaco tip (Fine OZil Tip, MicroSurgical Technology) for use with a proprietary handpiece (OZil, Alcon Laboratories) improves the safety and efficiency of phacoemulsification using torsional ultrasound with a biaxial microincisional technique. Modification of the phaco parameters improves chopping and segment removal.

Two prominent cornea specialists have been appointed chairmen of ophthalmology departments in Miami and New York City.

An ophthalmic viscosurgical device of 2.3% sodium hyaluronate (Healon 5, Abbott Medical Optics) makes one ophthalmologist's prechopping-assisted phacoemulsification technique safer and easier, he says.

The belief that truly new experiences become less common as one gets older and, therefore, life becomes more predictable, is one that this doctors thinks is commonly held. But a surprising event happens while on a flight home to challenge this.

Surgeons discuss their preferences and techniques for using various ophthalmic viscosurgical devices in eyes with intraoperative floppy iris syndrome.

The most recent results from the 2008 American Society of Cataract and Refractive Surgery/European Society of Cataract and Refractive Surgeons survey on foldable IOLs requiring removal or other secondary intervention highlight changes over time in the complications associated with various lens types.

The current version of a proprietary phaco system (WhiteStar Signature, Abbott Medical Optics) features fluidics control software that allows automatic switching from longitudinal ultrasound to transversal (Ellips) on recognition of occlusion and back again to longitudinal on occlusion break. Results of a prospective study show the benefits of this technology for optimizing the efficiency of cataract removal.

Ketorolac tromethamine 0.45% (Acuvail, Allergan) is a preservative-free ophthalmic NSAID recently approved for twice-daily use in treating pain and inflammation after cataract surgery. Its novel formulation is designed to promote drug delivery and tolerability.

Researchers are looking into corneal biomechanics as a means to screen patients for keratectasia. An expert reviews signal interpretation from a non-contact applanation tonometer as it relates to corneal biomechanical indices such as corneal hysteresis and also discusses improved signal patterns that may result in more meaningful corneal biomechanical analysis than previously proposed metrics.

NicOx announced an agreement to reacquire the development and commercialization rights to an experimental glaucoma medicine from partner company Pfizer.

In a study conducted by the Pan-American Collaborative Retina Study Group, treatment of diffuse diabetic macular edema with bevacizumab (Avastin, Genentech) was shown to improve vision.

The FDA will resume scientific review of the STAAR Surgical Co. premarket approval (PMA) application for its toric implantable contact lens ([TICL]; Visian Toric Implantable Collamer Lens) for patients with myopia and astigmatism after removing the "integrity hold" restrictions it put in place in 2007, according to the company.