Month: January 2013

Scleral Necrosis after Plaque Radiotherapy of Uveal Melanoma: A Case-Control Study

Purpose:
To identify risk factors and outcome of scleral necrosis after plaque radiotherapy of uveal melanoma.

Design:
Case-control study.

Participants:
A total of 73 cases with scleral necrosis and 73 controls without necrosis after plaque radiotherapy. Controls were matched for anteroposterior tumor epicenter and follow-up duration.

Intervention:
Plaque radiotherapy with iodine-125, cobalt-60, iridium-192, or ruthenium-106.

Main Outcome Measures:
Scleral necrosis.

Results:
Of 5057 patients treated with plaque radiotherapy for uveal melanoma, 73 (1%) developed radiotherapy-induced scleral necrosis. Scleral necrosis occurred in <1% of patients (3/1140) when plaque radiotherapy was used (Read more...)

Visualization of Blebs Using Anterior-Segment Optical Coherence Tomography after Glaucoma Drainage Implant Surgery

Objective:
The current study investigated the internal structure of blebs using anterior-segment optical coherence tomography (AS-OCT) in patients who had undergone Ahmed glaucoma valve (AGV) (New World Medical Inc, Rancho Cucamonga, CA) implantation and compared the differences between successful and failed surgeries.

Design:
Cross-sectional, observational study.

Participants:
A total of 76 patients who had undergone AGV implantation.

Methods:
The blebs after AGV implantation were examined using AS-OCT. The relationship between intraocular pressure (IOP) or the number of glaucoma medications and intrableb parameters was evaluated. Success was defined as IOP ≤21 (Read more...)

Lower-concentration prostaglandin analogue may reduce adverse effects

HYDERABAD, India — A 0.01% concentration of bimatoprost showed comparable efficacy and significantly improved tolerability compared to the standard 0.03% formulation.“Prostaglandin analogues are first-line therapy for glaucoma, as they have shown the best efficacy in reducing IOP with a single daily administration. However, side effects such as hyperemia and itchy sensation are common complaints,” Barun K. Nayak, MD, said in an industry-sponsored symposium at the joint meeting of the Asia-Pacific Academy of Ophthalmology and All India Ophthalmological Society.

Early detection, treatment key to management of choroidal melanoma, nevus

BALTIMORE — Early detection and treatment and close long-term surveillance are critical for the management of choroidal nevus and melanoma, two experts told colleagues here.“Prior to about 1970, enucleation was done for almost any lesion, regardless of its size, that was suspected to be possible melanoma,” Jerry A. Shields, MD, said at Macula 2013. “That’s undisputed. It was believed that that saved lives.”

Specialist warns against discontinuing steroids after corneal transplantation

HYDERABAD, India — New lamellar techniques have reduced the risk of graft rejection after corneal transplantation, but low-dose steroid therapy should not be discontinued, particularly in patients with African ancestry, pre-existing glaucoma or steroid-induced ocular hypertension, according to a specialist. “A paper published by W. Barry Lee in 2009 reported an average incidence of 10% with DSEK, and a large series published by M.O. Price in the same year estimated a graft rejection probability of 7.6% by 1 year and 12% by 2 years,” Rajesh Fogla, MD, said at the (Read more...)

At 10 years, AREDS formulation still reduces risk of AMD progression

BALTIMORE — Dietary supplements continued to reduce the risk of advanced age-related macular degeneration or neovascular AMD 10 years out, according to a study presented here. At Macula 2013, Emily Y. Chew, MD, elucidated results of the Age-Related Eye Disease Study, a multicenter, randomized clinical trial that included 4,757 patients with varied AMD severity; 3,549 patients participated in the 10-year follow-up examination.

Angle closure involves interplay of multiple anatomical, physiological factors

HYDERABAD, India — New imaging technologies have enabled specialists to determine that an interplay of multiple anatomical and physiological factors are involved in the pathogenesis of angle closure. “We have been able to learn quite a lot on angle closure by using imaging technologies, particularly [ultrasound biomicroscopy] and anterior-segment [optical coherence tomography]. We are studying new risk factors such as iris thickness, smaller anterior chamber width area and volume, and greater lens vault,” Tin Aung, MD, said at the joint meeting of the Asia-Pacific Academy of Ophthalmology and All India (Read more...)

FDA approves Ampio’s IND for Optina for treatment of diabetic macular edema

Ampio Pharmaceuticals, Inc. announced today that the FDA has accepted the Company’s IND for Optina™ for the treatment of diabetic macular edema (DME). Ampio plans to commence enrollment in a clinical trial in the first quarter of 2013. The FDA granted Optina™ 505(b)(2) status in July, 2012. Drugs designated under this pathway can be approved on a single trial.

ICG angiography with PDT useful for serous pigment epithelial detachments

WAIKOLOA, Hawaii — Indocyanine green angiography-directed photodynamic therapy provides positive resolution of persistent cases of serous retinal pigment epithelial detachment, a speaker said here.According to Scott W. Cousins, MD, indocyanine green (ICG) angiography with PDT provides approximately 40% resolution of serous retinal pigment epithelial detachment (PED).

Double-K method can improve outcomes in calculating IOL power for post-RK eyes

WAIKOLOA, Hawaii — Using the effective refractive power in a double-K method can improve outcomes when calculating IOL power for post-RK eyes, a surgeon said here.“We do pretty well with post-RK eyes just using the effective refractive power, which is essentially the central corneal power, which is a number you can get from any state-of-the-art topographer,” Mark Packer, MD, FACS, said at Hawaiian Eye 2013.

Ideal IOL power calculations achievable

WAIKOLOA, Hawaii — Manipulation of seven elements can lead, within 5 years, to the perfect IOL calculation, wherein perfection is measured as one-eighth of a diopter of intended outcomes in every patient, according to a speaker here.According to Jack T. Holladay, MD, MSEE, FACS, speaking at Hawaiian Eye 2013, the seven elements that will make ideal IOL power calculations achievable include the formula, biometers, corneal power, new developments in B-scan, improved precision of femtosecond lasers, intraoperative aberrometry and adjustable IOLs.

Surgeon recounts reimbursement dos and don’ts for common femtosecond cataract procedures

WAIKOLOA, Hawaii — The use of femtosecond laser for cataract surgery in the U.S. is changing the way cataracts are managed, a speaker said here. “I definitely don’t think this technology is going away,” Richard S. Davidson, MD, said at Hawaiian Eye 2013, citing the benefits of the laser technology for cataract treatment: more accurate effective lens position, less endothelial cell loss and more precise astigmatism correction.

Very high-frequency collagen cross-linking enhances astigmatic keratotomy

WAIKOLOA, Hawaii — A novel combination of accelerated cross-linking and femtosecond astigmatic keratotomy may significantly enhance the efficacy of the astigmatic keratotomy in a variety of scenarios, a speaker said here. Reporting on behalf of A. John Kanellopoulos, MD, at Hawaiian Eye 2013, presenter Vance M. Thompson, MD, FACS, illustrated the positive effects of the procedure in four situations: after PK, after cataract surgery, as regression enhancement, and in clear cornea incisions. In all cases, accelerated corneal cross-linking enhanced the effect of astigmatic keratotomy, Thompson said.