News

San Francisco-For appropriately selected patients undergoing cataract surgery, implantation of a foldable, multifocal IOL (Array SA40 IOL, AMO) is the best available solution for providing good uncorrected near and distance vision, said Roger Onnis, MD, at the American Society of Cataract and Refractive Surgery annual meeting.

Fort Lauderdale, FL-Intravitreal injection of triamcinolone acetonide (Kenalog, Bristol-Myers Squibb) may be a safe and effective treatment for central retinal vein occlusion (CRVO), said Michael S. Ip, MD, at the annual meeting of the Association for Research in Vision and Ophthalmology.

Fort Lauderdale, FL-In eyes with predominantly classic subfoveal choroidal neovascularization (CNV) treated with photo- dynamic therapy (PDT) using verteporfin (Visudyne, Novartis Ophthalmics), vision remained stable and the need for additional treatment decreased dramatically over time, reported Peter K. Kaiser, MD, at the annual meeting of the Association for Research in Vision and Ophthalmology.

Fort Lauderdale, FL-Efforts to develop an episcleral anecortave acetate transscleral drug delivery system (AA-TSDDD), targeted for patients with age-related macular degeneration (AMD), are progressing initially in the rhesus monkey as preliminary devices are being redesigned to decrease postoperative problems, said Timothy W. Olsen, MD.

Fort Lauderdale, FL-A 4-day course of moxifloxacin ophthalmic solution 0.5% (Vigamox, Alcon) is a safe and effective treatment for bacterial conjunctivitis in adults and children as young as 1 month old, according to results from a phase III FDA study, reported Harold R. Katz, MD, who spoke on behalf of the Moxifloxacin Conjunctivitis Study Group at the annual meeting of the Association for Research in Vision and Ophthalmology. The fourth-generation fluoroquinolone received FDA approval in April for the treatment of bacterial conjunctivitis (see related article, Ophthalmology Times, June 1, 2003 issue, Page 1).

Fort Lauderdale, FL-High-dose (5 3 4-Gy fractions; 6 MeV) external-beam radiation therapy has only a modest and very short-lived benefit in the treatment of subfoveal choroidal neovascularization (CNV) secondary to age-related macular degeneration (AMD), according to an interim analysis of data from the Age-Related Macular Degeneration Radiotherapy Trial (AMDRT).

Fort Lauderdale, FL-In a phase I, multicenter, randomized trial, the anti-VEGF antibody fragment rhuFab V2 was shown to be safe and well-tolerated in eyes with neovascular age-related macular degeneration (AMD), according to Philip J. Rosenfeld, MD, PhD.

Fort Lauderdale, FL-Visual function improvement is still apparent and better than ex-pected more than 3 years following the first implantation of a subretinal Artificial Silicon Retina (ASR, Optobionics Corp.) micro-chip in patients experiencing vision loss from retinitis pigmentosa (RP). This degree of improvement could be due at least in part to a neurotrophic effect, said Alan Y. Chow, MD, co-developer of the ASR.

Editor's Note: Sherif Amer, MD, proposes a new hypothesis for pressure dissociation in optic disc edema due to increased intracranial pressure (ICP) (i.e., papilledema). This theory provides some insight into some of the clinically controversial scenarios that occur in increased ICP such as pseudotumor cerebri without papilledema, asymmetric or frankly unilateral papilledema, and progressive visual loss due to increased ICP without disc edema. The theory has merit and deserves further study and testing of the hypotheses generated. -- Andrew G. Lee, MD

San Francisco-Patients with a retinal nerve fiber layer (RNFL) thickness of 80 ?m or less are at high risk for developing future visual-field deterioration, said Gadi Wollstein, MD.

Des Plaines, IL-Addition Technology Inc. will sell its micro-thin prescription inserts (Intacs) for surgical vision correction in Australia, Mexico, and South Korea now that governments in those countries have given their approval.

San Francisco-Several studies have described LASEK as a good substitute for PRK or LASIK, but is it truly a better surgical option?

Vail, CO-Having an optical dispensary in a practice is an excellent way to provide full-service comprehensive eyecare for patients and has the potential to generate significant revenue for the practice, according to ophthalmic practice management specialist James Rienzo.

San Francisco-The euphoria associated with customized ablations has finally died down. Refractive surgeons are finding that there are limitations to wavefront technology, such as the cost of equipment, the additional time spent screening patients, and a learning curve for physicians and staff. But there also are limitations to the lasers and wavefront sensors.

San Francisco-Early LASIKdata for myopic astigmatism using Nidek's NAVEX platform, incorporating the OATz (Optimized Asphe-rical Transition Zone) ablation algorithm, results in exceptional treatment accuracy and quantitative and qualitative vision out-comes, said Arturo Chayet, MD, at the meet-ing of the American Society of Cataract and Refractive Surgery.

Washington, DC-Patients can keep their health-care providers even if they have to change to a health maintenance organization (HMO) in which their provider is not currently included, according to a recent ruling by the U.S. Supreme Court.

San Francisco-CustomCornea wavefront-guided LASIK using the LADARWave aberrometer and the LADARVision 4000 exci- mer laser (Alcon) has produced excellent outcomes in treating myopia and myopic astigmatism.

San Francisco-Three-year FDA clinical trial outcome data support the safety, efficacy, and predictability of the Implantable Contact Lens (ICL, STAAR Surgical) for the treatment of moderate to high myopia, said Stephen G. Slade, MD, at the American Society of Cataract and Refractive Surgery annual meeting.

San Francisco-LASIK with the MEL 80 ex-cimer laser (Carl Zeiss Meditec) guided by Corneal Refractive Surgery Master (CRS-Master)-generated, prolate optimized "aberration-smart ablation profiles" yields out- comes that are better than those achieved with most wavefront-guided treatments, said Dan Z. Reinstein, MD, MA (Cantab), FRCSC, at the annual meeting of the American So-ciety of Cataract and Refractive Surgery.

San Francisco-Could phakic IOLs some day emerge as the dominant refractive surgical approach, especially considering the past problems with early innovations?

San Francisco-In ongoing FDA clinical trial follow-up, the iris-claw myopic IOL (Artisan/Verisyse, Ophtec/AMO) continues to be associated with excellent refractive and visual outcomes along with outstanding safety and high patient satisfaction, said Elizabeth A. Davis, MD, FACS, at the American Society of Cataract and Refractive Surgery annual meeting.

San Francisco-Six-month results show wavefront-guided LASIK for treatment of low-to-moderate myopia and myopic astigmatism results in excellent uncorrected visual acuity (UCVA) with preservation of best-corrected vision, minimal induction of higher-order aberrations, and improvement in patient satisfaction with night vision, said Robert K. Maloney, MD, at the American Society of Cataract and Refractive Surgery meeting.

San Francisco-Use of a larger ablation optical zone size in customized laser-vision correction procedures can minimize surgery- induced increases in higher-order aberrations as well as increases in higher-order aberrations that occur with increasing pupil size, said Scott M. MacRae, MD, at the annual meeting of the American Society of Cataract and Refractive Surgery. Furthermore, the relationship between pupil size and measured higher-order aberrations emphasizes the importance of performing wavefront measurements with an aperture diameter that is at least 6 mm and preferably greater than the mesopic pupil diameter in order to obtain relevant data, Dr. MacRae said.

San Francisco-Pediatric LASIK is an investigational procedure, but it can be a feasible and safe modality for young patients with anisometropic amblyopia who truly have no other option for improving best-corrected vision, said Jonathan M. Davidorf, MD, at the annual meeting of the American Society of Cataract and Refractive Surgery.

"This is the paradox of vision: Sharp perception softens our existence in the world."

New York-Patients in need of treatment for retinal diseases and other maladies can now come to the New York Eye & Ear Infirmary's (NYEEI) state-of-the-art Retina Center.

Rochester, NY-Now that Bausch &Lomb has won its battle to release its generic version of brimonidine tartrate ophthalmic solution 0.2% (Alphagan, Allergan), the ophthalmic industry is waiting to see whether physicians will choose the generic version of the old standard or brimonidine tartrate 0.15% (Alphagan P, Allergan).

Spain-home of Toledo and some of the finest sword-makers in history, and home to the Alhambra and such people as Gaudi and Christopher Columbus-also lays claim to manyof history's most important ophthalmic families. The Barraquer family comes to mind, but there are others, including the Arruga family, which is the subject of this month's vignette.