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Volume 20, Number 45
20 November 2015




Alphaeon will buy LENSAR

Alphaeon (Irvine, Calif.) announced earlier this week its intention to buy Orlando, Fla.-based LENSAR, which makes femtosecond laser systems for cataract surgery. The deal is said to be worth about $59 million and is expected to close before the end of the year.





PanoCam pediatric imaging system granted FDA approval

The PanoCam LT, a compact, wireless imaging system designed to detect a number of external, anterior, and posterior segment vision disorders in newborn children, has been granted U.S. regulatory approval, said developer Visunex (Fremont, Calif.). Early research conducted in Asia, Brazil, and the United States suggests that 1 in 70 children born may have some form of vision disorder, the company added, and vision screening is not currently provided as standard of care in most neonatal centers.





Lucentis effective for PDR

A clinical trial funded by the National Institutes of Health (NIH, Washington, D.C.) has found Lucentis (ranibizumab, Genentech, South San Francisco) is highly effective in treating proliferative diabetic retinopathy (PDR). The trial, conducted by the Diabetic Retinopathy Clinical Research Network (DRCR.net), compared Lucentis with panretinal photocoagulation. The findings demonstrate the first major therapy advance in nearly 40 years, according to the NIH.

The DRCR.net randomized 305 participants (394 eyes) with PDR in one or both eyes to Lucentis or laser. About half of the eyes assigned to the laser group required more than one round of laser treatment. The Lucentis arm (0.5 mg/0.05 ml) was a PRN protocol after a 3-month dose-loading phase. Lucentis was allowed as rescue therapy in the laser group, and about 53% of those patients received at least one Lucentis injection. Conversely, only 6% of those in the Lucentis arm needed laser therapy (predominantly to treat retinal detachment or bleeding).

At 2 years, there was little change in side vision with injection (average worsening of 23 decibels) but a substantial loss of side vision with laser (average worsening of 422 decibels). The vitrectomy rate was lower in the Lucentis group (8 of 191 eyes) than in the laser group (30 of 203 eyes).





Phase 2 topical insert for glaucoma shows promising results

The first randomized, controlled phase 2 study comparing the Helios bimatoprost ocular insert to twice-daily timolol eye drops showed the insert provided sustained reduction in intraocular pressure (IOP) for 6 months and IOP reduction of 4-6 mm Hg at the study's primary endpoint of 12 weeks, developer ForSight VISION5 (Menlo Park, Calif.) said in a news release.

The phase 2 study enrolled 130 subjects; about 90% of subjects retained inserts in both eyes for 6 months without clinician assistance, the company said. Mean diurnal IOP after washout was 23.8 mm Hg. A sustained reduction in IOP from a single dose of the bimatoprost insert was observed to be 4-6 mm Hg across the three diurnal time points at the primary endpoint of 3 months, and clinically relevant IOP reduction continued through 6 months.





Registry yields data on endophthalmitis

Data reported through the IRIS Registry (American Academy of Ophthalmology, AAO, San Francisco) shows no significant difference in endophthalmitis rates between the three most commonly used anti-vascular endothelial growth factor treatments for wet age-related macular degeneration, the AAO said in a press release, with a difference in infection rates among the three at 0.01%. Data was compiled on about 1.1 million injections given to about 175,000 unique patients from 2013 to 2014. However, endophthalmitis rates appeared to be slightly higher in eyes that had cataract surgery combined with anterior vitrectomy.





Low-dose atropine slows myopia in children

Researchers say medicated eye drops may be the key to fighting rapidly worsening eyesight in children with myopia. Results from a 5-year clinical trial show that drops of low-dose atropine significantly slowed the progression of nearsightedness in children with fewer side effects than higher dosages, according to Donald T. Tan, FRCS, professor of ophthalmology, Singapore Eye Research Institute and the Singapore National Eye Centre.

The study began enrolling in 2006, with 400 children age 6 to 12 randomly assigned a daily dose of atropine. Three different groups took drops nightly at concentrations of 0.5, 0.1, or .01% for 2 years. Doctors then stopped the medication for 12 months. For children whose eyes became more myopic during that year off (-0.5 D or more), researchers started another round at 0.01% for another 2 years. Atropine eye drops at 0.01% slowed myopia progression by an estimated 50% compared to children not treated with the medication in an earlier study, Dr. Tan said.





RESEARCH BRIEFS

  • In vitrectomized and iris-lens diaphragm injured eyes, viscoelastic-aided non-Descemet's stripping automated endothelial keratoplasty (nDSAEK) effectively facilitated graft adherence and reduced graft dislocation, according to Y. Ren and colleagues. They conducted a prospective consecutive case series of 21 cases (11 males, 10 females; mean age: 58.9±12.4 years) with bullous keratopathy that underwent nDSAEK. Effective graft adherence was achieved in all cases intraoperatively. Postoperatively, partial graft dislocation was seen in 2 cases because of hypotony (intraocular pressure, 6 and 5 mm Hg, respectively) due to postoperative cyclodialysis as demonstrated on anterior segment optical coherence tomography. Hypotony was successfully managed conservatively with spontaneous graft reattachment. One year postoperatively, the median best corrected visual acuity improved to 20/50. The mean endothelial cell loss was 14.7±12.6% and 20.5±11.1% at 6 months and 1 year, respectively. The study is published in Eye and Contact Lens.
  • The Haigis formula was more accurate than the SRK/T formula not only in predicting the refractive outcome but also in predicting corneal astigmatism correction by toric IOLs, according toYoungsub Eom, MD, and colleagues. They retrospectively conducted a cross-sectional study comparing the corneal plane effective cylinder power of toric IOLs (target induced astigmatism vector [TIA]) predicted by the SRK/T and Haigis formulas with the cylindrical correction achieved postoperatively (surgically induced astigmatism vector [SIA]). All eyes were implanted with an AcrySof toric IOL (Alcon, Fort Worth, Texas). The mean postoperative SIA was 1.80±0.55 D. The magnitude of error predicted by the SRK/T and Haigis formulas was 0.31±0.40 D and 0.23±0.40 D, respectively. The median absolute magnitude of error predicted by the Haigis formula was statistically significantly smaller than that predicted by the SRK/T formula (P<.001). The median absolute error predicted by the Haigis formula (0.35 D) was also statistically significantly smaller than that predicted by the SRK/T formula (0.43 D) (P=.003). The study is published in the Journal of Cataract & Refractive Surgery.
  • Femtosecond laser small incision lenticule extraction (SMILE) showed good safety, efficacy, and stability in correcting moderate to high myopia, and patients were highly satisfied, according to H. Miao and colleagues. Fifty-four patients (37 women, 17 men) who underwent SMILE were enrolled; baseline mean spherical equivalent was -6.50±1.64 D. No patient lost two or more lines of corrected distance visual acuity. Total higher-order aberrations (HOAs) and coma significantly increased after SMILE (P<.05), whereas total spherical aberrations and trefoil changed only slightly. The mean modulation transfer function cutoff frequency was 36.66±8.54 cycles per degree (cpd) before surgery and 37.81±6.89 cpd at 18 months postoperatively; the mean objective scatter index was 0.62±0.33 before surgery and 0.71±0.38 at 18 months postoperatively. No significant difference was found between the three time points (P>.05). Mean patient satisfaction was 9.31±0.64 (with a maximum score of 10). The study is published in the Journal of Refractive Surgery.
  • NEW PRODUCT BRIEFS

  • Alcon (Fort Worth, Texas) introduced Contoura Vision, the latest advance in its WaveLight refractive portfolio. Contoura Vision is a topography-guided LASIK treatment designed to provide surgeons the ability to perform more personalized laser procedures for myopic patients with or without astigmatism.
  • DigiSight (San Francisco) has launched the Paxos portfolio of products that includes a HIPAA-compliant cloud-based portal, a vision assessment smartphone application (Paxos Checkup), a mobile imaging device (Paxos Scope), and Paxos Analytics that together allow physicians and researchers to monitor patient data in real time.
  • 2020EHR has launched two new electronic health record systems: Medflow 2.0 and MDoffice Cloud, the latest advancement in EHR and practice management technology. Medflow 2.0 EHR automated care plans are enhanced with features to make ophthalmology assessments run smoothly and efficiently. In addition, the simplified process links treatment profiles and findings automatically with the correct ICD-10 codes. MDoffice Cloud will allow ophthalmologists to access their patient data seamlessly and on-the-go.



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