Author: Healio ophthalmology

Trabeculectomy successfully used as primary treatment in glaucoma patients

CORONADO, Calif. — As a primary intervention, trabeculectomy with mitomycin C had a higher success rate than tube shunt surgery at 1 year in patients with glaucoma and no prior ocular surgery, according to a study presented here.“Not only was the overall success rate higher in the trabeculectomy group but the rate of complete success was significantly higher,” Steven J. Gedde, MD, said at the American Glaucoma Society meeting, where he reported 1-year results of the Primary Tube Versus Trabeculectomy Study.

Reduced IOP with CyPass plus phaco maintained at 2 years

CORONADO, Calif. — IOP reduction was sustained at 2 years in patients with mild to moderate primary open-angle glaucoma who underwent CyPass micro-stent implantation at the same time as cataract surgery in the COMPASS trial, Quang H. Nguyen, MD, and colleagues reported in a poster presented at the American Glaucoma Society meeting.In the randomized intervention trial, 374 patients underwent the combination of phacoemulsification plus CyPass micro-stent (Alcon) implantation, with 61.2% of those patients maintaining mean IOP between 6 mm Hg and 18 mm Hg at 2 years. Of the 131 (Read more...)

Study: Erosions more frequent in corneal than scleral patch grafts

CORONADO, Calif. — Corneal patch grafts eroded faster and more often than scleral patch grafts in patients who underwent glaucoma tube shunt implantation, according to a study presented at the American Glaucoma Society meeting. Azra Idrizovic, DO, and colleagues undertook the study to compare specifically the rates of corneal and scleral patch graft erosion in eyes with glaucoma drainage implants and to examine the risk factors associated with tube erosions.

Business education gives a boost to clinical practice

Investing in a Master of Business Administration degree or some other type of business education can significantly improve an ophthalmologist’s clinical practice and provide enterprising opportunities. Jai G. Parekh, MD, MBA, FAAO, managing partner at Brar-Parekh Eye Associates in Woodland Park and Edison, New Jersey, said earning an MBA is analogous to having undergone refractive surgery. “I see through a different lens now as everything is more ‘macro’ to me, after having practiced for so many years in a ‘micro’ fashion,” he said.

Middle-age man experiences unilateral sudden-onset vision loss

A 44-year-old man with no significant medical or ocular history was referred by an outside optometrist to Ophthalmic Consultants of Boston for sudden-onset painless decreased vision of the right eye that began 4 days before presentation. At that time, the patient was also experiencing fevers, fatigue, 3 weeks of painless sores on the roof of his mouth, and spots on his palms and soles. His primary care physician obtained blood work, including CBC, ESR, BMP, HIV, Lyme, rheumatoid factor, RPR, ANCA and ANA, which were all negative except for an (Read more...)

A few books, a mentor and a clear sense of purpose can help forge a practice’s path to success

Most ophthalmologists focus on the sciences during their 4 to 5 years of college education and then are immersed in a very challenging medical school environment for 4 more years, with minimal to no formal training in business or practice management. This is repeated during their 1 year of internship and 3 years of residency. Those who perform a fellowship in a well-managed private practice environment have the opportunity to learn some business and practice management skills, but enhancing clinical and surgical skills remains the top priority.Fortunately, most young ophthalmologists (Read more...)

Analysis: Baerveldt implant reduces IOP more than Ahmed glaucoma valve

CORONADO, Calif. — On average over time, the Baerveldt glaucoma implant reduced IOP significantly more than the Ahmed glaucoma valve but with more sight-threatening complications, Donald L. Budenz, MD, MPH, said at the American Glaucoma Society meeting.Budenz presented a 5-year analysis of pooled data from the Ahmed Baerveldt Comparison Study and the Ahmed Versus Baerveldt Study, both randomized clinical trials.

Xen reduces both IOP and medication use in refractory glaucoma

CORONADO, Calif. — In a group of refractory glaucoma patients, the ab interno placement of Allergan’s Xen45 gel stent reduced both IOP and medication use at 12 months, Davinder S. Grover, MD, MPH, and colleagues reported in a poster presented at the American Glaucoma Society meeting.Of 65 patients implanted with the gel stent, 76.3% achieved a 20% or greater reduction in IOP from baseline, and 69.2% of patients needed fewer medications. At baseline, 84.6% of patients were using more than three hypotensive medications; the mean number of medications decreased from (Read more...)

Iridex launches G-Probe Illuminate at American Glaucoma Society meeting

CORONADO, Calif. — Iridex announced the availability of its G-Probe Illuminate at the American Glaucoma Society meeting here. The G-Probe Illuminate, which can be used for office-based procedures or in the operating room, has built in transillumination, allowing for visualization of the ciliary body and consequent targeted transscleral cyclophotocoagulation, according to a company press release.

Potential FDA pick favors approving drugs before efficacy demonstrated

President Donald J. Trump is said to be considering picking former HHS official Jim O’Neill to lead the FDA, a move that would signal the administration is serious about loosening regulations on the drug approval process.Trump has yet to name a replacement for Robert M. Califf, MD, who stepped down as FDA commissioner when the new president was inaugurated, according to tradition. He would likely find an ally in O’Neill, who appears to favor the approval of drugs before their efficacy has been established.

PUBLICATION EXCLUSIVE: From the outside looking in at anti-VEGF therapy

As an anterior segment surgeon, I am a little out of my comfort zone commenting on the details of the many studies evaluating the indications and outcomes after the use of anti-VEGF therapy. I do not perform intravitreal injections of anti-VEGF, nor do any of the 26 doctors at Minnesota Eye Consultants. We do, however, have many patients in our practice who are being treated by retina specialist colleagues.My first impression is that intravitreal anti-VEGF therapy for wet age-related macular degeneration, diabetic retinopathy and macular edema from a host of (Read more...)

VIDEO: Expert identifies new ways to improve profitability

ATLANTA – We need to look at how much it costs us to do business, Owen Dahl, MBA, FACHE, LSSMBB, said at MedPro 360. “We don’t often understand how much it costs us to see a patient, for example,” he said. Dahl has been a health care manager for nearly 40 years and has authored several books, including Lean Six Sigma for the Medical Practice: Improving Profitability by Improving Processes.