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.
Both quantitative and qualitative methods of detecting glaucomatous progression are useful, but optic disk photography remains the gold standard. New software for statistical analysis is helpful but should be an adjunct used with more established approaches.
The steps taken in the search for a cure for Leber's congenital amaurosis can serve as a model for other inherited eye disorders, according to an expert who delivered the Jackson Memorial Lecture at the 2007 American Academy of Ophthalmology annual meeting.
Early detection and treatment of incident choroidal neovascularization in eyes with age-related macular degeneration may offer patients the best opportunity to retain vision. Clinical trials have provided guidance on defining patient risk and the frequency of follow-up. An ongoing study is examining the role of noninvasive technologies as monitoring tools.
A prospective, randomized, open-label study compared bromfenac 0.09% (Xibrom, ISTA) and ketorolac tromethamine 0.4% (Acular LS, Allergan) as part of a postoperative medication regimen in patients undergoing PRK. Control of pain, burning, photophobia, and foreign body sensations were similar in the two treatment groups. Both agents were safe as there was no difference in re-epithelialization between the two agents.
Azithromycin 1% ophthalmic solution (AzaSite, Inspire Pharmaceuticals) has many properties that make it a rational choice for the treatment of blepharitis. Evaluations conducted by two ophthalmologists yielded favorable results in showing azithromycin was safe, well-tolerated, and resulted in rapid and dramatic improvement of both anterior and posterior lid margin disease.
Levofloxacin 1.5% (Iquix, Santen/Vistakon) is the only newer generation fluoroquinolone approved for the treatment of bacterial corneal ulcers. Extensive research indicates levofloxacin has maintained potent broad-spectrum activity against important ocular pathogens and that the 1.5% formulation offers excellent pharmacokinetics and safety profiles.
Analysis of the effect of nepafenac 0.1% (Nevanac, Alcon Laboratories) indicated that compared with diclofenac 0.1% (Voltaren, Novartis Pharmaceuticals) nepafenac might be more tolerable by patients after cataract surgery.
Moxifloxacin hydrochloride ophthalmic solution 0.5% (Vigamox, Alcon) seems to be a safe antimicrobial agent when injected intracamerally following cataract surgery. The eyes that received moxifloxacin had a significantly lower mean intraocular pressure value three months postoperatively compared with the control eyes that received balanced saline solution.
Findings of a recent study show that loteprednol 0.5%/tobramycin 0.3% and dexamethasone 0.1%/tobramycin 0.3% were equivalent in reducing the signs and symptoms of blepharokeratoconjunctivitis. Some safety concerns emerged, however, concerning elevated IOP in patients treated with the dexamethasone/tobramycin product.
Performing ECP at the time of cataract surgery has significant benefits for both patients and surgeons. After cataract removal and IOL implantation, there is plenty of room to get behind the iris with an endoscope and apply laser energy to the ciliary epithelium.
Long-term outcomes of a study of optic neuritis have shown that even one brain lesion ≥3 mm at the time of the first episode can be predictive of development of multiple sclerosis, making a brain MRI an essential part of patient management.
A basic understanding of corneal topography is paramount for effective screening and follow-up of refractive surgery patients in order to exclude those who are at risk for postoperative ectasia and to manage those who develop that complication.
The FDA's recent announcement that it is reviewing serious adverse effects, including death, that have occurred following the use of botulinum toxins for the management of juvenile cerebral palsy and other large-muscle, lower-limb spasticities applies primarily to the non-cosmetic formulation of botulinum toxin type A (Botox) rather than the cosmetic version (Botox Cosmetic), Allergan said in a statement.
The Centers for Medicare and Medicaid Services (CMS) has issued an emergency notice to correct a typographical error in the relative value unit of the new Current Procedural Terminology code for complex retina detachment, said the American Academy of Ophthalmology (AAO) in a notice to members.
The FDA has accepted Sirion Therapeutics' new drug application (NDA) for difluprednate ophthalmic emulsion 0.05% (Durezol) and has granted it priority review, the Tampa, FL-based company has announced.
NeoVista Inc. has announced that the American Medical Association Current Procedural Terminology Editorial Panel has released a new Category III code for the company's novel epiretinal beta radiation therapy to treat neovascular age-related macular degeneration.
A Cleveland Clinic research team has developed the first animal model of age-related macular degeneration (AMD), and it is expected to enable researchers to study the development and progression of AMD and conduct pre-clinical testing of new therapeutics.
IOLs that dislocate postoperatively may be repositioned rather than removed. A surgeon describes techniques for rescuing a dislocated sulcus-fixated IOL and a subluxated in-the-bag IOL.
