SAN FRANCISCO — An ophthalmic clinical registry would help ophthalmologists improve outcomes, comply with government regulations and boost revenues, according to a speaker.At the American Glaucoma Society annual meeting, William L. Rich III, MD, the medical director of health policy for the American Academy of Ophthalmology, outlined the form, function and potential benefits of registries.
Author: Healio ophthalmology
Combination of micro-stent implant, cataract surgery lowers IOP in open-angle glaucoma
SAN FRANCISCO — In mild to moderate open-angle glaucoma, suprachoroidal micro-stent implantation in conjunction with phacoemulsification may safely lower IOP, according to a presenter here.The objective of the device is to sustain a low IOP, as well as reduce the dependence on antihypertensive medications, Steven D. Vold, MD, said at the American Glaucoma Society annual meeting.
Physicians need to be prepared for IOP spikes after glaucoma surgery
SAN FRANCISCO — Glaucoma procedures, even minimally invasive ones such as trabecular meshwork ablation, require preparation for potential complications including IOP spikes, a presenter said here.”The best offense is a good defense, and avoiding such complications is truly better than managing them,” Carla J. Siegfried, MD, said at the American Glaucoma Society annual meeting.
BLOG: Is my practice overstaffed? Part 1
Some of the most common questions asked today, as practice costs rise and reimbursements decline, are, “Are we overstaffed? Are our staffing costs too high?” The fundamental productivity of your practice’s non-physician support staff can be assessed with one common ratio. A simple percentile ratio can be derived by adding up the fully burdened annual lay support staff wages, payroll taxes and benefits, and dividing the resulting total figure by your practice’s annual collections. In a general ophthalmology practice, the typical range falls between 28% and 32%, with that much (Read more...)
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Intra-Tenon’s injection of MMC for trabeculectomy may lead to better blebs
SAN FRANCISCO — A newer method of applying mitomycin C may create more ideal trabeculectomy blebs by better diffusion of the antimetabolite, according to a presenter here.“The ideal bleb is diffuse with normal vascularity. The scary bleb is focal, cystic and avascular; it is prone to leaks, blebitis and endophthalmitis,” Michele C. Lim, MD, said at the American Glaucoma Society annual meeting.
Tubes alleviate increased IOP in young patients with juvenile immune arthritis
SAN FRANCISCO — Glaucoma can be blinding in young patients with juvenile immune arthritis, and although medical management is limited, surgical management with tube implantation can be somewhat successful, according to one presenter’s observations. “I prefer valved tubes in these situations, mostly because of their predictability,” Joseph A. Caprioli, MD, said at the American Glaucoma Society annual meeting, adding that he prefers a rigid plate design rather than silicone. Potential problems include tube exposure due to erosion from steroids or eye rubbing, as well as iris adhesions.
Glaucoma shunt compares favorably with trabeculectomy at 1 year
SAN FRANCISCO — A glaucoma shunt and trabeculectomy yielded largely similar outcomes, although the shunt offered faster visual recovery, a speaker told colleagues here.“There are some potential advantages of Ex-Press. Specifically, for people who are comfortable doing a trabeculectomy, it’s a very short learning curve,” Yvonne M. Buys, MD, FRCSC, said at the American Glaucoma Society annual meeting.
Innovative surgical technique may manage adult primary glaucoma
SAN FRANCISCO — A novel surgical procedure may be effective in reducing IOP in patients with adult primary glaucoma, according to a presenter here.“The fact that the conjunctiva and sclera is spared makes this surgical procedure a very promising first-line surgical glaucoma treatment,” David G. Godfrey, MD, said in a poster presented at the American Glaucoma Society annual meeting.
Hyphemas commonly follow trabecular meshwork ablation in open-angle glaucoma
SAN FRANCISCO — Trabecular meshwork ablation is generally safe in treating open-angle glaucoma even though hyphemas may occur afterward, according to a physician.“It is important to remember that hyphemas can occur anytime when there is blood reflux,” Arthur J. Sit, SM, MD, said at the American Glaucoma Society annual meeting.
IOP reduced after stent implantation, postoperative prostaglandin analogue
SAN FRANCISCO — Implantation of a suprachoroidal stent and use of postoperative topical travoprost may reduce IOP in phakic open-angle glaucoma patients who have uncontrolled IOP while on two topical ocular hypotensive medications, according to a presenter here.”Following stent implantation, IOP and medication burden were significantly lowered in the absence of significant adverse events,” Jonathan S. Myers, MD, said in a poster presented at the American Glaucoma Society annual meeting.
Ab interno micro-stent reduces IOP, glaucoma medication use
SAN FRANCISCO — A micro-stent was beneficial in reducing IOP and medication use alone and in combination with phacoemulsification, according to a study presented here. Manfred R. Tetz, MD, discussed data on the Hydrus micro-stent (Ivantis) at the American Glaucoma Society annual meeting.
Glaucoma CPT codes for shunt revision under review
SAN FRANCISCO — Notwithstanding a “hit” in 2013 to cataract surgeons, ophthalmology has fared better than other specialties with regard to reimbursement adjustments over the past 5 years, according to a presenter here.“We’re actually in the plus category,” Cynthia Mattox, MD, said at the American Glaucoma Society annual meeting.
Multiple measurements needed to determine efficacy of IOP-lowering therapy
SAN FRANCISCO — Because IOP measurements are a “moving target,” glaucoma specialists have yet to agree on the best way of assessing the therapeutic effect of ocular hypotensive therapy, according to a presenter here.“We can’t make decisions based on single pressure measurements,” Anthony D. Realini, MD, MPH, said at the American Glaucoma Society annual meeting. Rather, several pre-treatment measurements and several on-treatment measurements are needed in order to decipher meaningful trends in IOP behavior.
Ahmed valves with no patch grafts may manage glaucoma long term
SAN FRANCISCO — Glaucoma may be managed long term with Ahmed valves implanted without using patch grafts, according to a presenter here.Higher initial IOP, younger age and inferotemporal location were risk factors for valve failure, Felix Gil-Carrasco, MD, said in a poster presented at the American Glaucoma Society annual meeting.
Study: IOP, medications reduced 1 year after implantation of two micro-bypass stents
SAN FRANCISCO — IOP reduction of more than 10 mm Hg was sustained at 1 year in a study evaluating implantation of two Glaukos iStents in patients with open-angle glaucoma not controlled on one medication, a presenter said here.“For us as glaucoma surgeons, this really does offer us hope that there may be a new surgical option that could be available to medically uncontrolled open-angle glaucoma patients in the future,” L. Jay Katz, MD, said at the American Glaucoma Society annual meeting.
Weinreb lauded as AGS Innovator
SAN FRANCISCO – It takes about 15 years to translate something from the laboratory to the clinic, Robert N. Weinreb, MD, said in his acceptance of the AGS Innovator Award. Citing the number of years that elapsed between building the first confocal laser ophthalmoscope in 1983 in the laboratory to its broader acceptance, Weinreb told colleagues at the American Glaucoma Society annual meeting, “I thought if you did something better, people would beat a path to your door.”
Allegro continues studies of integrin peptide therapy
Allegro Ophthalmics has completed enrollment of a phase 1b/2a study of the impact of its integrin peptide therapy on wet age-related macular degeneration, according to a company news release. In addition, Allegro has begun a second study of the therapy’s impact on diabetic macular edema.Safety is the primary endpoint of the dose-ranging, monotherapy wet AMD study of ALG-1001, with secondary endpoints of improvement in central macular thickness and best corrected visual acuity.
IOP-lowering effect of excimer laser trabeculostomy stable over long term
SAN FRANCISCO — Excimer laser trabeculostomy is an effective IOP-lowering procedure, shown to consistently lower IOP over 5 years, according to a poster presented at the American Glaucoma Society annual meeting.”ELT is a MIGS procedure requiring no foreign body implantation,” poster coauthor Michael S. Berlin, MD, told Ocular Surgery News. The study findings are significant, he said, because the results are achieved with excimer laser trabeculostomy (ELT) alone, not combined with cataract surgery.
Removal of mini shunt unnecessary in cases of blebitis
SAN FRANCISCO — Managing blebitis in patients with an Ex-Press mini glaucoma shunt implanted under a scleral flap does not call for removal of the device, a speaker said here. Nor does the shunt need to be removed in cases of endophthalmitis, Steven R. Sarkisian Jr., MD, told colleagues at the American Glaucoma Society annual meeting.