Spectral domain, three-dimensional (3-D), high-resolution optical coherence tomography (OCT) represents a step forward in OCT technology, with precise registration, complete data set acquisition, and improved coverage of the retina being the major advantages.
A feasibility study of a novel beta radiation epiretinal brachytherapy system for age-related macular degeneration produced favorable 1-year results. The radiation was administered in combination with bevacizumab in two study arms. Patients had a mean improvement in visual acuity of 13.1 lines.
Arteriolarization, with a large artery feeding many branching arterioles, may explain why some eyes with choroidal neovascularization fail to respond to anti-vascular endothelial growth factor treatment. Dynamic high-speed indocyanine green angiography can identify this morphology and be used to direct photodynamic therapy toward the feeder artery. Initial results with this intervention are promising.
Three prestigious Association for Research in Vision and Ophthalmology (ARVO) awards will be presented to clinical researchers at the ARVO 2008 Annual Meeting (April 27–May 1) in Fort Lauderdale, FL. The awardees also will present lectures focusing on their research.
The American Academy of Ophthalmology (AAO) and the American Society of Cataract and Refractive Surgery (ASCRS) have joined with the FDA and the National Eye Institute to form a joint task force to discuss the design of a study to identify dissatisfied post-LASIK patients, define their significant symptoms, and examine the effects of those symptoms on quality of life.
The National Eye Institute Visual Function Questionnaire (NEI-VFQ-25) is correlated with reading speed and restricted activity days.
Fewer retinal redetachments were reported following combined vitrectomy and scleral buckling procedures than with either procedure alone in a retrospective study. Factors such as the surgeon's skill and preoperative preparations also influence the outcome of retinal detachment surgery, however.
Postmenopausal hormones taken by women actually may decrease the risk of developing advanced stages of age-related macular degeneration (AMD), especially if women took oral contraceptives previously, according to a report in the April issue of Archives of Ophthalmology.
Torsional phacoemulsification may be more efficient than standard phaco. In an experiment in which beads were aspirated or rejected inside a cell serving as an anterior chamber, longitudinal ultrasound phaco was less than 50% aspiration efficient as demonstrated by bead rejection from the phaco tip, whereas torsional phaco had nearly the aspiration efficiency of irrigation/aspiration alone.
Dr. McDonnell discusses whether futures markets, which are sometimes more accurate in their predictions than experts, could possibly be used to identify promising therapies to explore.
After completing its review of safety and efficacy data currently available, an independent data safety monitoring board once again has recommended that two pivotal phase III clinical trials, known collectively as the Fluocinolone Acetonide in Diabetic Macular Edema Study, continue under the current protocol, without change.
Reichert Inc. has received 510(k) clearance from the FDA to market its spectral optical coherence tomography (OCT) system (Optopol SOCT Copernicus) in the United States.
University of Rochester researchers recently put to test the bias against corneas from older donors.
Deep anterior lamellar keratoplasty resulted in satisfactory best spectacle-corrected visual acuity levels after 18 months follow-up. The rate of graft clarity was almost 90% and the rate of stromal rejection was low. However, the rate of endothelial cell loss at 18 months postoperatively was high.
The off-label use of intravitreal drugs may have a promising future for treating patients with diabetic retinopathy, but currently the dosing of these drugs is suboptimal. There is no solid track record for the drugs because controlled clinical trials are lacking and all follow-up periods have been too short to reach any definitive conclusions about safety and efficacy.
The periodic assessment of vision function with visual field testing is a standard and important part of the management of primary open-angle glaucoma (POAG). Automated achromatic static threshold perimetry is the preferred technique, although other static and kinetic techniques are acceptable alternatives in patients who are unable to complete automated perimetry reliably or when the technology is not available.
Epi-LASIK provides slightly better refractive outcomes 3 months postoperatively compared with standard LASEK, which may be due to the quicker and smoother separation of the epithelial layer from Bowman's membrane and the absence of alcohol with its negative effect on energy absorption of the excimer laser.
A long-term study of 292 eyes found that LASEK is a safe and effective treatment for patients with low to moderate levels of myopia. A significant difference was seen in spherical equivalent and uncorrected vision acuity preoperatively to postoperatively.
Treatment of substantial levels of coma and trefoil using wavefront-guided excimer surface ablation resulted in very good visual outcomes. These patients fared well when compared with patients who underwent LASIK early after the introduction of the procedure and compared with those with atypical topographies who underwent LASIK in the late 1990s. The results still fell slightly short of the outcomes achieved in patients with normal corneal topographies.
Four femtosecond laser microkeratomes have received FDA approval. An ophthalmologist reviews differences between the devices, why they may be important, and considerations for building a next-generation laser microkeratome.
Clinical trials are under way evaluating a corneal inlay (AcuFocus ACI 7000, AcuFocus) for the treatment of presbyopia. An ophthalmologist summarizes the features of the inlay, its mechanism for improving near vision, and promising safety and efficacy results.
Micro-burst torsional phacoemulsification seems to be a good choice of power modulation in that it requires the least energy usage at the expense of slightly greater foot pedal time when compared with continuous torsional phaco.
A variety of techniques has been introduced for the surgical management of intraoperative floppy iris syndrome (IFIS). Method selection may be based on preoperative assessment of IFIS severity, although these cases may be unpredictable and surgeons need to be equipped to use a range of alternatives to enable a safe outcome.
Alimera Sciences has entered into a second exclusive worldwide agreement with Emory University to explore oxidative stress management, specifically, the reduction of reactive oxygen species, as a treatment for ophthalmic diseases.
Addition Technology has received regulatory clearance from Health Canada to market its corneal implants (Intacs) for keratoconus and myopia indications.
Posterior capsule rupture (PCR) is the most common major complication occurring during cataract surgery. Although the potential for serious sequelae exists, cases with PCR may have a good outcome if the event is recognized early and managed appropriately according to the features of the individual case.
A new instrument for measuring IOP (iCare Tonometer, Tiolat Oy; available through Rhein Medical) seems to obtain values that correlate well with Goldmann applanation tonometry.
Topical gatifloxacin (Zymar, Allergan) administered either 1 day or 1 hour prior to anterior segment surgery is effective in eliminating conjunctival bacteria.
In a comparison study of two glaucoma operations, patients who underwent tube shunt surgery were more likely to maintain IOP control and avoid persistent hypotony and reoperation, while those who underwent trabeculectomy with mitomycin C needed less supplemental medical therapy. Patients in both treatment groups had large IOP reductions, and there was no significant difference in pressure between them at 6 months and 1 year.
Clinicians have an array of techniques and devices available to them for assessing progression of glaucoma, and more are under development. Such tools rely on either subjective or objective measurements, with the latter generally providing more reliable results. Frequent, long-term follow-up with one or more of those approaches will increase the likelihood of detecting progression early.
