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This phase 2b/3 trial follows new, positive 2-year data from the phase 2 ALTITUDE trial, in which sura-vec was well-tolerated in subjects with non-proliferative diabetic retinopathy

REGENXBIO launches phase 2b/3 trial of sura-vec for diabetic retinopathy

Q&A: Understanding the influences on molecular confirmation after genetic testing for IRDs

The agreement is for a planned clinical trial of AXPAXLI (also known as OTX-TKI) for the treatment of non-proliferative diabetic retinopathy (NPDR).

Ocular Therapeutix receives FDA agreement under special protocol assessment for registrational trial of AXPAXLI

Sandoz will oversee commercialization of the product across the European Union (excluding Germany), Switzerland, Norway, Australia, Hong Kong, Vietnam, and Malaysia under the terms of the agreement.

Lupin and Sandoz sign licensing deal for biosimilar ranibizumab across multiple regions

Ophthalmology Times connects eye care professionals with surgery, imaging, gene therapy, & diagnostic advances to enhance clinical and patient care.

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With the advent of intravitreal agents that block the negative effects of vascular endothelial growth factor among patients with age-related macular degeneration, ophthalmologists have begun to seek a higher level of performance from their diagnostic equipment.

Faster diagnostic software reduces errors

The medical records service, Google Health, lets users enter information such as medications taken, procedures undergone and lab tests.

Google Health lets patients centralize their history

When Joseph J. Sokol, MD, decided to break out on his own about a year ago, one of his first major decisions was choosing an electronic medical record company.

Effective electronic medical record system boosts efficiency

The 14th annual Glaucoma 360 conference will take place February 6 to 8, 2025, at the Westin St. Francis on Union Square in San Francisco, California. Co-founded by Adrienne Graves, PhD, and Andrew Iwach, MD, and hosted by Glaucoma Research Foundation, the three-day event highlights progress in glaucoma care while fostering innovation and collaboration.

The conference opens on Thursday, February 6, with a gala to celebrate advancements in the field, followed by the New Horizons Forum on Friday, February 7, which serves as an incubator for innovation. Topics include artificial intelligence in glaucoma management, neuroprotection and vision restoration, and cross-species insights from veterinary ophthalmology. Carla J. Siegfried, MD, president of the American Glaucoma Society, will deliver the keynote address.

The program on Saturday, February 8, begins with a continuing medical education program featuring M. Roy Wilson, MD, MS, who will present the Shaffer-Hetherington-Hoskins Lecture, and concludes with an optometric symposium. Visit 

SAP Partner

The 14th annual Glaucoma 360 conference, co-founded by Adrienne Graves, PhD, and Andrew Iwach, MD, and hosted by Glaucoma Research Foundation, will be held from February 6-8, 2025, at the Westin St. Francis in San Francisco, California. The event will focus on the latest advancements in glaucoma care and encourage innovation and collaboration.

California dreaming: 2025 Glaucoma 360 brings celebration, innovation, and education to San Francisco

 podcast, Robert T. Chang, MD, from Stanford University, discusses the role of large language models (LLMs) and AI in ophthalmology. He explains how LLMs, like ChatGPT, are transforming information retrieval, patient communication, and education.

Chang emphasizes how AI assists clinicians in documenting patient interactions, creating customized educational content, and exploring potential future uses, such as efficient data aggregation for research. He also addresses challenges, including ethical concerns around data privacy and the need for clinicians to verify AI outputs. 

Chang highlights how LLMs could streamline workflows and support both patient care and professional training, offering a promising, albeit cautious, outlook on AI's impact in ophthalmology.

Robert T. Chang, MD, from Stanford University discusses how large language models are transforming ophthalmology by enhancing patient communication, documentation, and education, while also addressing ethical considerations and potential future applications in glaucoma care.

Innovation Series: Putting the buzz of large language models in ophthalmology into perspective with Robert T. Chang, MD

 EyePod podcasts focusing on innovation in ophthalmology. Throughout this series, we'll be hearing insights from various stakeholders including those in clinical practice, academia, and industry. The overarching message in this podcast is intended to be informational and not promotional. Today, our host Ehsan Sadri, MD, engages in a conversation with Jeffry Weinhuff, who is managing partner of Visionary Ventures. And just a quick note: the thoughts and opinions expressed are those of the speakers and do not necessarily represent the opinions of this publication.

 in Newport Beach, California, and is board-certified, fellowship-trained in treating LASIK, cataract, and glaucoma surgeries. He is a co-founder of Visionary Ventures Fund and a consultant to Tarsus.

, a series of venture capital funds which is a leading investor in drugs and devices for the eye. Visionary has current financial interests and serves on board of directors of the following companies: Aurion Biotech; Centricity Vision; CorneaGen; IanTrek; ONL Therapeutics; Orasis Pharmaceuticals; Pelage Pharmaceuticals; Re-Vana Therapeutics; Surface Ophthalmics; Sydnexis; Surface Ophthalmics; TearClear.

Explore cutting-edge ophthalmology innovations in this new series on the Ophthalmology Times EyePod podcast. Throughout this series, we'll hear insights from various stakeholders in clinical practice, academia, and industry. In this episode, host Ehsan Sadri, MD, engages in a conversation with Jeffry Weinhuff, managing partner at Visionary Ventures, exploring trends and offering advice for individuals driven by an entrepreneurial mindset.

(EyePod) From idea to impact: Navigating ophthalmic innovation

Neda Shamie, MD, and Peter J. McDonnell, MD, discuss the evolving role of femtosecond laser-assisted cataract surgery (FLACS) in ophthalmology, highlighting its benefits in addressing corneal astigmatism, capsulotomy precision, and aiding complex cases, while acknowledging regional variations in patient interest and emphasizing the need for ongoing evaluation in the context of advancing premium lens technology.

The views and perspectives expressed are those of Dr. Shamie and Dr. McDonnell.

This transcript has been edited for clarity.

Hi, everyone, and welcome to this episode of the 

This is Sheryl Stevenson, group editorial director with the Eye Care Group here at MJH Life Sciences, and we are joined today by our co-chief medical editors from the West Coast to the East Coast.

Dr. Peter J. McDonnell is the director of the Wilmer Eye Institute at Johns Hopkins University School of Medicine in Baltimore, Maryland, and Dr. Neda Shamie is a cataract, LASIK, and corneal surgeon and partner of the Maloney-Shamie Vision Institute in Los Angeles, California, as well as an adjunct clinical professor of ophthalmology at the USC Keck School of Medicine.

In this episode, Dr. Neda Shamie and Dr. Peter McDonnell explore the current landscape of femtosecond laser-assisted cataract surgery, sharing insights on its integration into their practices, emphasizing its benefits in addressing corneal astigmatism, enhancing capsulotomy precision, and aiding in complex cases, while acknowledging regional variations in patient interest and the need for ongoing evaluation of its impact on outcomes and advancements in premium lens technology.

 Hi, it's Peter McDonnell, and we're here with the podcast on Ophthalmology Times where we're talking about the exciting new developments in our field of ophthalmology. I'm excited to be here with my co-chief medical editor, Dr. Neda Shamie.

Neda, femtosecond laser-assisted cataract surgery [FLACS]...That took the world by storm a few years ago and there been new developments in the last year or two in terms of pipeline of approved products. So, share with me where currently...where does femtosecond laser-assisted surgery fit in your practice?

 Well, thank you, Peter. It's great to be here with you again and having these kind of casual conversations about topics that are front and center in our practice.

I've been doing femtosecond laser cataract surgery for 12 years now. I initially started with LenSx and then had experience with the Catalys and then more recently have had experience with the Ally or the LENSAR laser.

In my practice, possibly because I'm in Los Angeles, West LA, the type of practice that I have where patients seek me out because of the premium offerings that we have, we have a large percentage of our patients who choose to have femtosecond laser surgery...more than the majority; it's close to 90-plus percent. As we know, laser cataract surgery has been approved for treatment of astigmatism. And so I make sure that if I am offering laser cataract surgery, it is in cases where the patient has corneal astigmatism that can be treated with the limbal-relaxing incisions that the laser can make.

Although I love the other steps of the surgery that the laser really has fine tuned and adds a level of precision that I say that, even as great of a surgeon as I am because I had the best mentor in Peter McDonnell, I still am not as good as a laser is. I love...I think femtosecond laser-enabled cataract surgery is a very elegant way of doing cataract surgery.

And there's controversy as to whether or not there are benefits. Most definitely, I think the benefit of addressing the corneal astigmatism in my hands...if it's less than one diopter I use the laser, .5 to about 1.25 or 1.5. I use a laser to create limbal-relaxing incisions that are very, very reliable and now with image guidance, perfectly positioned based on prior measurements preop.

But I also like the centration of the capsulotomy. I like the perfect sizing of the capsulotomy so that there is overlay of the lens implant. I like that it helps me in complex cases, or very dense cataracts. It softens the nucleus of the cataract such that, at least in my hands, I feel that it's a more reliable way of doing cataract surgery with the least amount of energy used. So it's great. I mean...currently with the Ally, I'm really enjoying the image guidance. The image guidance with the Ally laser, it's streamlined and it really allows me to feel comfortable with toric lens implantation and toric alignment because the Ally, based on image guidance using the Pentacam, creates these nubs in the capsulotomy so that I know exactly where the axis of the toric alignment should be. So that's my thought...my two cents on it.

 Yeah, well, I have no financial interest in any of the companies that make this technology but I really like the technology. It's very impressive to me. We looked rigorously in our institution at things like endothelial cell counts and postoperative visual acuities, etc. between the femtosecond laser and 'traditional' phaco and could not find demonstrable advantages in most of these areas. Certainly, the centration and the circularity of the capsulorhexis is advantaged with the femtosecond laser, I think.

But it is interesting, you mentioned how, in certain markets, it's really valued by the population if you can offer this. And in our area, Baltimore and Washington, DC, are very interestingly very different markets in that regard. There's much greater interest in the national capital region in the laser-assisted surgery than there is in Baltimore. So, you know, it is a matter of being sensitive and responsive to the desires of the population in the area in which you live. And since you're in the Los Angeles area, it doesn't surprise me that that's probably something that a high percentage of the population values. So I think having that comfort with it and being able to offer it to the appropriate patients makes total sense.

 Yeah, absolutely. Obviously, one of the biggest hurdles is if you operate at a surgery center that does not have access to the laser it wouldn't be possible. I'm grateful and feel really privileged that in our surgery center we have one of each of the three lasers currently available to us. Our experience has been really positive with it.

But, as you said, the data doesn't speak as to anything that is of a significant difference as far as a benefit to the laser. And that's where the challenge is, is to really...how we decide to fit it into our practice really comes down to patient choice. I don't press it on our patients at all. This is a choice that the patients make. Our practice draws patients who are interested in advanced technology.

And then also, it's important to note that again it's not approved for anything other than correcting astigmatism.

So with that, there's a lot of information out there. I would love for the next generation of ophthalmologists to have at least some introduction to laser because my expectation is that there will be opportunities, especially in the premium lens sector, that there may be some benefits to using laser, if you're implanting a toric lens, if you're implanting premium lenses like presbyopia correcting lenses, as far as centration and tilt of the lens and maybe with data that can those kinds of differences can be elucidated.

 Yeah, I agree with you. Once I think we have an accommodating lens that works really well that it may be necessary to pair that with a device like the femtosecond laser. So it's a fun field and I'm sure there'll be exciting progress and developments in the coming years. It'll be really fun to follow this along as we get more and more experienced with it.

Wilmer Eye Institute

In this podcast, Neda Shamie, MD, and Peter J. McDonnell, MD, discuss real-world experiences, patient choices, and the nuances of integrating femtosecond laser-assisted cataract surgery into practice, offering insights into the latest developments in ophthalmology.

EyePod: Integrating cutting-edge pipeline devices for enhanced cataract surgery

In this episode, Neda Shamie, MD, and Peter J. McDonnell, MD, discuss the benefits and challenges of implementing the many options from the premium lens pipeline into practice, emphasizing the importance of customization based on patients' lifestyles and expectations, while also addressing concerns and sharing their positive experiences with the evolving technology in the field.

 Hi, everyone, and welcome to this episode of the 

In this episode, Dr Shamie and Dr McDonnell discuss the benefits and challenges of implementing the many options from the premium lens pipeline into practice, emphasizing the importance of customization based on patients' lifestyles and expectations, while also addressing concerns and sharing their positive experiences with the evolving technology in the field.

 Hi, everyone! This is Neda Shamie, and welcome to another episode of 

 EyePod, where I have the pleasure of sitting here with Dr. Peter McDonnell, who's a colleague, a dear friend, and my mentor—all-time mentor—talking about different subjects that hopefully are of interest to you. They are most definitely of interest to us and very applicable and relevant to our day-to-day practice.

Today, we're going to be talking about premium lenses and how we can implement them in our practice, where the value is to our patients, and what our experience has been between Peter and I [me]. I'm hoping you'll take some pearls from this conversation.

Welcome, Peter. So nice to be here with you again.

 Great to be with you, Neda. It's a great time to be an ophthalmologist, isn't it? With all the technology that we can bring to help our patients lead better lives including, so often, spectacle independence. The premium IOLs have done a great service to our profession and our patients, don't you think?

 I absolutely agree. I think, especially with the further advances and the most recent generation of these premium lenses, I forge ahead in my practice with real enthusiasm and offering my patients the lenses. 

It's brought a lot of fun into what we do as cataract surgeons in that we are not only clarifying the vision, improving their vision, but also potentially impacting their quality of life by, like you said, offering options that could potentially get them out of glasses. 

And a lot of our patients now are empowered with that information ahead of time. They come in expecting a premium offering. But it's also fun when a patient had no such expectation to be able to make that offer, and what a gift that could be to them.

So when I was training with you and I was your fellow...we were all excited because toric lenses became available. The challenge now with the premium lenses is that, unlike how it was 20 years ago where we really had only one option and it was pretty straightforward discussion, the chair time has increased. 

And I think we still sadly don't see enough surgeons offer premium lens options, presbyopia-correcting lens options, to their patients partly because I think the feedback we're getting from our colleagues is that the chair time is more challenging for them; the discussion potentially is more confusing; and they're afraid of unhappy patients. Because when patients invest in premium lenses their expectations are higher and the chances of them being potentially unhappy is higher.

But I think you and I can maybe share our experience how it's added a lot of value to our practice. It's added a lot of value to how I interact with my patients. And it's kind of...it has put me on the map, in a sense. This is something I take great pride in is that when a patient comes to me, I spent a lot of time customizing the treatment plan to them. And that customization really comes down to trying to find what the best lens option would be for them.

 Well, thank you for alluding to my age, how long I've been practicing, and that I antedate all this great modern technology. 

But you're right on. To me, it's so fun to talk to people and say, Hey, what do you do for a living? What do you do for fun? Find out are they the avid golfers? Are they people who drive at night? Are they the Type A perfectionists? Are they the easygoing, fun people? What, what's their definition of 'wonderful' in terms of vision and then using our best knowledge and experience to match their hopes and goals and expectations with the technology available to us. 

And so it really gets away from the one size fits all, all patients are the same sort of thing and lets us use all that judgment and experience. That's why we went to medical school.

I'll just say there are some docs who had negative experiences maybe early on and that's caused them to wonder do they want to continue offering these to patients. I think of some of the warning signs of maybe patients to avoid; people with some pretty advanced dry eye; maybe people with epithelial basement membrane dystrophy in the cornea that's going to cause corneal irregularity; maybe macular degeneration, looking and make sure there's not some macular pathology that would decrease contrast sensitivity. 

So we definitely want to avoid particularly early on in our experience offering this technology to patients who are potentially borderline or bad candidates. But you're exactly right, matching the right lens to the right patient with the right expectations. It's just so rewarding both for surgeons and for patients.

And I think there are so many different options that could match your comfort level as a surgeon. And again, as we both alluded to, the quality of the technology has improved and the type of vision our patients are getting from the trifocal lenses that are available to us now is so superior to what the previous generations were that I really urge any surgeon who may have had suboptimal outcomes with the previous generation lenses to really consider the fact that these newer lenses are game changers. 

They really are changing the way we approach cataract surgery patients and there's now small-aperture lens options. There are light adjustable lenses, nondiffractive, presbyopia-correcting lenses, extended-range lenses, trifocal lenses—a lot of different options, a lot of opportunity for education through 

 and other sources to really pick what fits comfortably in your hands as a surgeon. 

I would really urge you to enter this field because honestly, as a cataract surgeon, you're going to fall behind. Patients will come to your practice expecting such offerings and you may lose that patient if you don't offer them a customized approach to treatment.

So with that, I am going to end our session here. 

Hopefully, this was some enticement to really pursue more resources to engage in the premium cataract surgery field. And we're always here for help if you'd like more information.

EyePod: Navigating the premium lens landscape from pipeline to practice

Eyenuk Inc. founder and CEO Kaushal Solanki, PhD, went from working for the Defense Department to founding a company with a focus on artificial intelligence for ophthalmology. Find out what led him to make that jump.

 This transcript has been edited for clarity.

Welcome to EyePod, a podcast series from ophthalmology times in which we engage with key opinion leaders in interviews about the latest innovations in the areas of surgery, clinical diagnosis, therapeutics, imaging, device technology, gene and cell therapy, practice management, and other cutting edge topics. I'm your host, David Hutton. 

My guest today is Eyenuk founder and CEO, Kaushal Solanki, thank you so much for joining us today. 

In this episode, we're going to discuss the current state of AI and ophthalmology. But first, tell us what drives someone with a background in electrical engineering, working for the Defense Department to form a company with a focus on AI for ophthalmology.

Thanks, David for having me. So, you know, that's where it gets personal, right. So when I was trained as a machine learning, or artificial intelligence scientist, I got my PhD from UC Santa Barbara. I was working at a startup company with my PhD advisor, working on cutting-edge work with drones and satellite imaging and whatnot. 

My expertise was processing automatically information from these images to come to very actionable conclusions for the DOD, and other projects. And one day I just made a routine visit to an optometrist who was just across the street, and he now is a friend of mine, but at the time he said, Kaushal, you might have silently developing glaucoma. I'm like, What do you mean? And he said, you have a bigger cup-to-disc ratio. You go to see an ophthalmologist as soon as possible. 

I tried to make an appointment for an ophthalmologist and it took like four and a half months. I remember I had the best insurance that money could buy. But still, I had to wait. So that gave me time to look at the problem, and it turns out some of the skills that I had on automatic analysis of images using artificial intelligence, could be applied to, you know, these problems in healthcare, where, you know, if people like me have problems with access, I'm sure there would be millions globally who would have something similar. 

It checked out pretty soon, when I looked at this problem and related problems, diabetic retinopathy turned out to be one. Again, it hit home where my father who had diabetes for like, almost 10 years, and never had an eye exam. And so that confirms that this is really a problem of knowledge access that can be solved by using artificial intelligence by analyzing these images at the point of care. That led to founding of the company, and fast forward to today, we are very proud to have usage on five continents globally, in 18 countries and growing. So, that's the story.

What are some of the trends we're seeing in AI and ophthalmology?

So, let me start with looking at AI in healthcare, and I got a very fresh look at how AI could assist healthcare, and this was when the company was founded back in 2010. 

You know, no one was talking about using AI in healthcare. It's been a lot more recent, where activity has picked up. I could think of it from a very basic fundamental. Looking at that, I look at three ways that AI could help healthcare. 

First is what I call a spell check AI. So, it works in the background and flags any errors for existing programs. 

Second, is fully autonomous, where AI is letting a healthcare professional scale, especially specialists to places where they have not been available anywhere. 

Third is what I call superpower AI, which goes above and beyond what doctors could do today. It can come up with biomarkers or metrics of predictive biomarkers that could do things that doctors cannot do today. 

With that framework in mind, we applied it to ophthalmology, which is also a very great opportunity, so to speak, because ophthalmology is a field where it's actionable. So you know, doctors can provide a treatment, do a cataract surgery, do something simple and a patient walks away with restored vision. 

With that in mind, unfortunately, we are still in these situations where patients are losing vision without any symptoms. and, and hence, that's where AI comes in, especially for the field of ophthalmology. If only we could detect these diseases in patients early enough, we have the treatments, we have surgical tools to restore vision. Which really doesn't exist in many other fields. A patient could go through cataract surgery or anti-VEGF treatments and their vision is restored. But we need detection tools to screen a population to find these diseases. and that's where AI comes in, enabling early disease detection, for monitoring of diseases, and again, for improving accuracy of doctors using spellcheck that I mentioned.

You kind of alluded to it, but what makes AI particularly attractive option for use in ophthalmology?

So, like I said, ophthalmology is a field where clinicians can do something so long as diseases are detected early. Now, when we look at early disease detection for diseases like diabetic retinopathy, anybody with diabetes, which is 500 million patients worldwide, is vulnerable to losing vision. But we do not have enough specialist resources and healthcare professionals to screen this large growing population. 

That's where AI could come in a fully autonomous manner, to detect disease, identify those patients who need further monitoring or treatment. They can go see an ophthalmologist in time and get the diseases treated. If you look at the regulatory landscape, ophthalmology is the only field where fully autonomous AI is cleared by the FDA, or global regulatory bodies. That is also something that brings to fore the advancements that AI in ophthalmology has made.

Whenever AI is brought up often the initial thought is that it's going to replace humans. Tell us how this technology is actually designed to help humans be more efficient?

I think what I would say is that this technology is designed to help humans be a lot more effective. So, then I would go back to what I mentioned previously, AI could provide a spell check, and nobody in the world would say spell check in a word processor is not useful. For those who have an existing system in place, AI could work in the background, make them more effective. 

For situations where diabetes patients are not seeing their eye care doctor, we could make it autonomous and let the screening happen at the point of care. This could be primary care clinics or it could be pharmacies, where the mass screening or mass disease detection could happen, and those specialists could come in. 

We can start using superpower AI, which is, you know, monitoring of smallest changes between successive visits, and using that to predict what's going to happen in the future so that we start helping these patients a lot more.

Excellent, just how can AI be used by ophthalmologists ultimately to provide better outcomes for their patients?

So again, like I said, going back, AI could work like a spell check, especially for ophthalmologists. AI could also help predict outcomes, which is also something, our group is working on. Looking at the smallest of changes that happen between successive visits and quantify it, which is something that doctors really cannot do on their own. It just takes a lot of time and effort, which is not practical. But we will not just look at these changes, but we will also use them to predict the potential outcomes for patients.

It can also help ophthalmologists by offloading the routine screening to primary care, which is again, today, people like me needing to wait four and a half months, and then just finding out that I'm fine. It's not the best use of their time. Those routine screenings can happen in primary care offices. Those who need treatment, that's where ophthalmologist and retina specialist or glaucoma specialist could be a lot more effective.

What are some of the eye diseases that AI can now screen for?

AI can already screen for multiple vision-threatening diseases like diabetic retinopathy, where anyone with diabetes is vulnerable to vision loss that progresses without any symptoms. It can also screen for age-related macular degeneration, the leading cause of blindness in seniors. You know, typically anybody over 55 is vulnerable to this macular degeneration, and that can also be detected - progresses without any symptoms, like other diseases that can be detected. 

The third is glaucoma, where it is, you know, it is also one of the leading causes of blindness globally, and especially for African Americans, and signs of this disease can be detected. Now, these diseases are already approved, and in use in global markets, but not yet in the US, only diabetic retinopathy is cleared. 

The human eye is a unique organ in our body that can provide non-invasive imaging of the microvasculature, the cardiovascular system, the optic nerve head, which is an extension of the brain. So, looking into the future, this also provides detection, early detection of diseases like Alzheimer's disease, or cardiovascular risk, or chronic kidney disease, and many of these chronic conditions that manifests in the body because of issues in microvasculature. 

So, if we have microvasculature issues in the eye, you can be sure that a similar mechanism is happening in the kidneys or in the heart. So, we already have early stages of work on Alzheimer's disease, for example, working with Mayo Clinic on defining structural markers that can predict or detect worsening of the brain before any actual dementia-like symptoms occur. So that's just one example of the things that can be seen in the eye, and a final comment here is that, as I said, this retinal imaging with AI has the potential to be a diagnostic platform of tomorrow.

You mentioned that you have more approvals globally than we do here in the U.S. Is there any timetable for getting more approvals here in the U.S.?

We are absolutely working on getting more approvals in the U.S. and that makes our system a lot more powerful. We recently announced approval of AMD and glaucoma in addition to diabetic retinopathy in the European Union. There are systems installed, people are trained to take these images, and it's just a click of a button that they start getting a lot more powerful reports. 

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