News

The focus was on innovation at this year's annual meeting of the Association for Research in Vision and Ophthalmology. Among the highlights were the latest developments in the areas of retinal disease, allergy, dry eye, and lid margin disease.

Berlin, Germany, will host the XXVI Congress of the European Society of Cataract and Refractive Surgeons from Sept. 13 to 17. The annual meeting will feature a diverse agenda that includes symposia, a workshop on visual optics, training courses, and exhibits.

Neovascular age-related macular degeneration treated with long-term use of intravitreal ranibizumab (Lucentis, Genentech) was safe and well tolerated in a group of patients participating in an extension study. Between the original studies and the extension trial, patients were followed for approximately 4 years, during which no safety signals were observed. Although problems linked to vascular endothelial growth factor inhibition were suggested, the lack of a control group makes proving a correlation difficult.

An immediate vitrectomy should be considered in patients with retained intravitreal fragments of the crystalline lens after complicated cataract surgery. Eyes that underwent immediate vitrectomy had better visual acuity and a lower retinal detachment rate than eyes that underwent delayed vitrectomy.

Before prescribing alpha blocker treatment, a primary care physician (PCP) should consider involving the cataract surgeon when treating a patient with a known diagnosis of cataract. So says an educational statement that is part of an initiative by the American Society of Cataract and Refractive Surgery and the American Academy of Ophthalmology launched to further educate PCPs about the connection between alpha blockers, such as tamsulosin (Flomax, Boehringer Ingelheim Pharamceuticals), and intraoperative floppy iris syndrome during cataract surgery.

Results of a recent survey by the American Society of Cataract and Refractive Surgery Cataract Clinical Committee provide insight into the clinical issues facing cataract surgeons and their patients taking alpha blocker drugs. Intraoperative floppy iris syndrome continues to challenge cataract surgeons and especially seems to be associated with tamsulosin (Flomax, Boehringer Ingelheim Pharmaceuticals), according to respondents.

To reduce the risk of endophthalmitis after cataract surgery a multimodal approach is needed. Assuring a water-tight wound closure without the use of stromal hydration and use of a fourth-generation fluoroquinolone are two important factors. An analysis of data from patients undergoing clear corneal cataract extraction at the University of Texas Southwestern Medical Center supports these recommendations.

Congress was able to block a pay cut for physicians who serve Medicare patients. Even though the American Society of Cataract and Refractive Surgery (ASCRS) and the American Academy of Ophthalmology (AAO) are pleased for the delay in the pay cut they maintain that the hard work is just beginning.

Alcon Laboratories and Advanced Medical Optics (AMO) have agreed to a patent cross-licensing arrangement relating to lubricious coatings for IOL insertion devices and one-piece IOL haptic designs

When treating diabetic macular edema (DME), the conventional laser treatment may be more effective than the newer drug therapy used to treat abnormal swelling around the eye, according to a National Eye Institute (NEI) study.

Patients being treated for glaucoma with bimatoprost ophthalmic solution 0.03% (Lumigan), who use the drug to reduce IOP, have been noticing a surprising side effect: longer and thicker eyelashes.

The American Academy of Ophthalmology (AAO) has named August Cataract Awareness Month to remind those at risk for cataracts to see their ophthalmologist to determine whether they have a cataract and if it should be removed.

The first in vivo tests of a wireless, soft contact lens sensor demonstrate that the device's measurements correspond with those taken via Goldmann tonometry. The contact lens sensor, which is designed to detect the tiny changes in corneo-scleral curvature induced by IOP changes, could be used potentially to monitor a patient's IOP changes over 24 hours.

The long-running Ocular Hypertension Treatment Study has produced many important clinical findings. Among them is the conclusion that African-American and white patients have similar responses to treatment with topical beta-blockers and prostaglandin analogs. The study also found that optic disk hemorrhages are a risk factor for progression from ocular hypertension to primary open-angle glaucoma.

A retrospective chart review of 200 charts from three centers found that physicians do not adhere consistently to the American Academy of Ophthalmology's Preferred Practice Patterns for glaucoma management. As the world's leading cause of irreversible blindness, the stakes are high to ensure that the patterns are being followed to maximize positive outcomes for patients with glaucoma.

In vitro studies using retinal neurosensory and pigment epithelial cell lines in culture are aiming to define the relative safety profiles of combination corticosteroids and anti-vascular endothelial growth factor (VEGF) agents being considered for intravitreal treatment of retinal diseases.

It is possible to remodel filtering blebs, but much like a home remodeling project, a bleb remodeling should only be undertaken with a plan, a careful review of options, and the realization that it may become more involved than initially expected.

Combination therapy to treat age-related macular degeneration seems to be a promising avenue of research. The gain in visual acuity can be sustained with fewer intravitreal injections. This approach might also reduce the overall cost of treatment.

The systemic complications associated with anti-vascular endothelial growth (VEGF) factor therapy for colon cancer are well documented. Those associated with intravitreal injection of anti-VEGF agents to treat neovascular age-related macular degeneration (AMD) seem to occur infrequently. Monitoring of these events has been limited thus far, however. Good methods need to be developed for post-marketing surveillance of anti-VEGF agents used to treat patients with AMD.

The 2-year results of the PrONTO Study indicated that intravitreal injections of ranibizumab (Lucentis, Genentech) produces rapid improvements in visual acuity (VA) and optical coherence tomography (OCT) outcomes in patients treated for neovascular age-related macular degeneration. The changes on OCT are visible before the changes in VA and allow ophthalmologists to determine each patient's need for additional dosing of ranibizumab.

A hydroxypropyl cellulose ophthalmic insert (Lacrisert, Aton Pharma), a once-daily, preservative-free insert that helps to retain moisture, stabilize the tear film, lubricate the eye, and increase tear break-up time, may be beneficial in the treatment of patients with dry eye due to lid function abnormalities, closure problems, or thyroid disease.

Out of seven anti-allergy medications examined in a laboratory study epinastine is a potent antihistamine but has minimal anticholingeric activity. Ideally, allergy medication should effectively target the histamine receptors without causing adverse effects such as ocular dryness.

Loteprednol etabonate ophthalmic suspension 0.2% and olopatadine HCl ophthalmic solution 0.1% were compared in a study for the treatment of allergic conjunctivitis. After 14 days of use, the topical corticosteroid demonstrated greater efficacy in improving Ocular Surface Disease Index scores and was preferred by a significantly higher proportion of patients. Both medications were safe and well tolerated, and both led to improved signs and symptoms.

New lubricant eye drops (Soothe XP Emollient Eye Drops, Bausch & Lomb) were specifically formulated to address lipid deficiency in the tear film, which is a critical factor in most patients with dry eye disease.

A new high-performance artificial tear product (Systane Ultra, Alcon Laboratories) was created with an intelligent delivery system designed to maximize comfort upon instillation and provide sustained symptomatic relief and ocular surface protection.

Tear hyperosmolarity is central to the dry eye disease process and the value of measuring tear osmolarity in the diagnosis of dry eye disease is well established. Alan Tomlinson, PhD, DSc, FCOptom, and Michael A. Lemp, MD, discuss the obstacles that physicians have come up against when attempting to diagnose dry eye effectively and accurately in a clinic setting. They also report on the latest research that has yielded some effective and user-friendly instruments, which now make osmolarity testing, and therefore, dry eye diagnosis, much easier.

Cyclosporine A ophthalmic emulsion 0.05% (Restasis, Allergan) is effective in treating moderate to severe dry eye in 70% to 75% of patients with the condition, and adding a specific artificial tear (Systane, Alcon Laboratories) to the treatment regimen may prove beneficial for many other patients.

An antimicrobial eyelid cleanser (SteriLid, Advanced Vision Research) reduces bacterial colonization in dry eye and blepharitis. The cleanser's active ingredient is linalool, a naturally occurring oil effective against a number of organisms.