News

Recent reports from expert panels emphasize the complexity of dry eye disease, reflecting advances in understanding of this disease in the past decade. Along with this new grasp of the condition's complexity, diagnostic and treatment approaches must evolve as well. New tools and methods for diagnosis and treatment have been developed and have entered clinical practice, while others are in the pipeline or still primarily used in research settings.

Clinical trials are not intended just to assess treatment effects; they also provide a great deal of invaluable information, said Frederick Ferris III, MD, when he delivered the Jackson Memorial Lecture during the opening session of the American Academy of Ophthalmology annual meeting.

Anti-vascular endothelial growth factor (VEGF) therapy has swept through ophthalmology over the past several years, dramatically changing clinicians? approach to the treatment of neovascular age-related macular degeneration (AMD). Although this form of therapy has been shown to be effective in several clinical trials, much remains to be learned about its clinical application.

In today's podcast, Carol L. Shields, MD, shares tips for diagnosing and managing pigmented conjunctival lesions, and Glenn J. Jaffe, MD, describes how spectral-domain optical coherence tomography could affect clinical care and clinical trials. Also, Hans E. Grossniklaus, MD, details worrisome features of iris tumors, and Sue J. Vicchrilli, COT, OCS, relays reasons that ophthalmologists should stay up to date on coding matters.

The consequences of uncontrolled glaucoma progression can be severe. Technology companies have risen to the challenge with sophisticated diagnostic devices, but it falls to the average clinician to make the best use of these tools in monitoring patients' disease status over the years.

The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, was honored for excellence in the area of Best Research in Ophthalmology Times? 2008 Best Programs Awards.

Gene therapy has resulted in functional vision for patients with Leber's congenital amaurosis (LCA), said Albert Maguire, MD, of the University of Pennsylvania, Bryn Mawr. That research is the result of a 13-year effort by Dr. Maguire and colleagues.

Although 40% of eye examinations are performed by ophthalmologists, dispensing ophthalmology practices are not retaining customers, said Arthur De Gennaro, president of Arthur De Gennaro & Associates LLC, Lexington, SC, an ophthalmic practice management firm that specializes in optical dispensary issues.

Results of the 2008 International Society of Refractive Surgery/American Academy of Ophthalmology (ISRS/AAO) survey show trends detected in prior years are continuing, including a demonstration of surgeon confidence in the safety, efficacy, and value of modern laser vision correction procedures.

Enrollment has been completed in a series of phase III studies investigating voclosporin (Lumeniq, Lux Biosciences) as a steroid-sparing agent for the treatment of noninfectious uveitis, according to Quan Dong Nguyen, MD, assistant professor of ophthalmology, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore.

The 1990s brought a decade of advances in the medical therapy of glaucoma. That decade saw the introduction of a new carbonic anhydrase inhibitor, dorzolamide (Trusopt, Merck); the first prostaglandin, latanoprost (Xalatan, Pfizer); the first alpha-2 agonist, brimonidine (Alphagan, Allergan); and the first fixed-combination carbonic anhydrase inhibitor/beta-blocker, dorzolamide and timolol (Cosopt, Merck).

In a series of presentations, speakers at an educational program outlined the benefits of technologies for premium cataract surgery including a microincision platform (Stellaris Vision Enhancement System), an accommodating IOL (the Crystalens HD), and an advanced optics aspheric lens (Akreos), all from Bausch & Lomb. The evening program, held at the Georgia Aquarium, also featured two live cataract surgery cases performed in Beverly Hills, CA, by Uday Devgan, MD.

In this podcast, John F. Doane, MD, FACS, discusses addressing presbyopia with accommodating IOLs, and Scott W. Cousins, MD, talks about the role of injury and inflammation in the pathogenesis of dry age-related macular degeneration (AMD). Also Scott M. MacRae, MD, relays the current limitations of laser vision correction, and Paul Sternberg Jr., MD, speaks about new approaches to the treatment of dry AMD.

Skillful physician-patient communication is paramount to successful prevention and management of dissatisfied LASIK patients, said Jennifer Morse, MD, assistant clinical professor of psychiatry, University of California San Diego.

Studies with a night-driving simulator (NDS) found that changes in night-driving performance were associated strongly with the type of treatment used to perform LASIK, and that wavefront-guided procedures were correlated with better performance. The study involved 59 patients (98 eyes) who were tested preoperatively and 6 months postoperatively with the NDS, set to simulate nighttime driving on a rural road at 55 miles per hour, with and without glare.

Planning is underway for a large national prospective study to evaluate postLASIK quality-of-life outcomes in a clinical setting, said Malvina B. Eydelman, MD, director, division of ophthalmic and ear, nose, and throat devices, Center for Devices and Radiological Health (CDRH)/FDA, Rockville, MD.

Refractive surgeons need to remember that the tear film is the most important refracting surface of the eye, and if it is abandoned, surgical outcomes will suffer, said Eric D. Donnenfeld, MD, clinical professor of ophthalmology, New York University.

Scientific evidence does not support the hypothesis that thinner preoperative central corneas are an independent risk factor for postLASIK ectasia, said William B. Trattler, MD, director of cornea at the Center for Excellence in Eye Care, Miami. Eyes with a thin cornea (less than 500 µm) and normal topography are at no greater risk than those with thicker corneas of developing postoperative ectasia and may be biomechanically strong and similar to thicker corneas in their behavior, Dr. Trattler added.

Refractive surgeons may consider the diagnosis of LASIK chronic pain syndrome in postLASIK patients complaining of moderate to severe eye pain in the absence of dry eye or any other identifiable cause, said Steven E. Wilson, MD.

The 2008 annual meeting of the American Academy of Ophthalmology (AAO) is featuring several new and forthcoming patient education, clinical education, and practice management products produced by the AAO to meet the educational and practice needs of its members. During the meeting, these products are available at the academy's resource center and online.

Thirteen ophthalmologists were presented with the American Academy of Ophthalmology (AAO) Lifetime Achievement Honor Awards for their contributions to the academy and the ophthalmology profession.

A cyclic 13-amino acid peptide (POT-4, Potentia Pharmaceuticals Inc.) is the first complement-binding therapy tested in humans with wet age-related macular degeneration (AMD). Philip Rosenfeld, MD, PhD, of the Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, presented results from the phase I Clinical Trial Assessment of Safety for POT-4 (ASaP) that indicate the drug appears to be safe and well tolerated and released slowly from a deposit in the vitreous cavity.

An antioxidant eye drop (OT-551, Othera) is being investigated to treat geographic atrophy in dry age-related macular degeneration (AMD), said Paul Sternberg, MD, from the Vanderbilt Eye Institute, Vanderbilt University School of Medicine, Nashville, TN.

A pepidomimetic inhibitor of the receptor for C5aR (JPE1375) blocks the mechanism that draws inflammatory cells into the disease process of age-related macular degeneration (AMD). When blocked, the numbers of neutrophils and macrophages decrease substantially, and in turn, choroidal neovascularization (CNV) also decreases, according to Anthony Adamis, MD, Department of Ophthalmology & Visual Sciences, University of Illinois.

Twenty-five-gauge sutureless vitrectomy has been increasing in popularity. In conjunction with this surge, however, is the observation that the procedure is associated with increased postoperative complications such as hypotony, choroidal detachment, and an increased incidence of endophthalmitis. Richard Kaiser, MD, from the Retina Service of Wills Eye Institute, Philadelphia, focused on endophthalmitis and noted that the 25-gauge procedure has a risk of infection that is 12.4 times greater than the 20-gauge procedure.

Alcon Inc. has executed a new agreement and broadened an existing agreement with two different companies to expand its products under development.

A proprietary purified human neural stem cell product (HuCNS-SC, StemCells), when transplanted into a well-established animal model, may protect the retina from progressive degeneration, according to researchers.

The multi-component IOL (PrecisionLens) is a novel, foldable implant technology consisting of three optical elements (two exchangeable) that was created to produce an emmetropic result reliably in all patients who undergo cataract surgery or refractive lens exchange.

Arriving at the proper IOL power is difficult to achieve in patients who have undergone prior cornea-altering refractive procedures such as LASIK, PRK, or RK.

The American Academy of Ophthalmology (AAO) has announced the participants for its 2009 Leadership Development Program (LDP).