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.
Author: Healio ophthalmology
HARBOR study shows similar results for four anti-VEGF dosing regimens
BALTIMORE — Four dosing regimens of ranibizumab yielded similar safety and efficacy, with few ocular and systemic adverse events, a speaker said here.“This is significant and clinically meaningful in terms of performance of treatment within all four arms,” Carl D. Regillo, MD, OSN Retina/Vitreous Board Member, said at Macula 2013.
Genetic testing becoming more reliable in gauging AMD risk factors
BALTIMORE — Although refinements are needed, genetic testing for risk assessment in age-related macular degeneration is gaining momentum, a speaker said here.“We’ve made great leaps in the understanding of the genetic basis behind macular degeneration in less than half a decade,” Ivana K. Kim, MD, said at Macula 2013. “Over 25 genes to date have been reported to influence AMD risk. Identification of these major genetic risk factors has elucidated some potential pathways for therapeutic intervention, namely the complement pathway.”
Flapless all-laser procedure outperforms femto-LASIK for high myopia
HYDERABAD, India — A flapless procedure proved more effective than femto-LASIK in the treatment of high myopia and produced fewer dry eye complaints in a series of patients, according to a presenter here.ReLEx small-incision lenticule extraction uses the VisuMax femtosecond laser (Carl Zeiss Meditec) to carve out a lenticule within the cornea in order to correct refractive errors. No excimer ablation is used, and the lenticule is separated and removed through a small incision.
Transepithelial phototherapeutic keratectomy enhances visual outcomes of collagen cross-linking
HYDERABAD, India — Epithelial removal using transepithelial phototherapeutic keratectomy during corneal collagen cross-linking results in better visual and refractive outcomes compared to mechanical epithelial debridement, according to one surgeon.“It is proved that the epithelium at the keratoconus apex is thinner than in the surrounding area. Transepithelial [phototherapeutic keratectomy] allows the excimer laser, set at 50 µm, to ablate the epithelium but also a few microns of stroma at the apex, smoothening the corneal surface before [cross-linking],” Vardhaman Kankaria, MD, said at the joint meeting of the Asia-Pacific Academy of Ophthalmology (Read more...)
Aberration-optimized ablation profile improves vision in pseudophakic patients
HYDERABAD, India — An aberration-optimized LASIK procedure yielded good, stable results in pseudophakic patients implanted with monofocal IOLs, according to one surgeon. “The procedure provides improved uncorrected near and intermediate vision, maintaining distance vision with high levels of patient satisfaction,” Robert Edward Ang, MD, said at the joint meeting of the Asia-Pacific Academy of Ophthalmology and All India Ophthalmological Society.
Written agreements sometimes needed, sometimes not, expert says
WAIKOLOA, Hawaii — Although the questions have been asked and answered and asked again, a speaker here addressed the regulatory and legislative issues that he continues to see. “I can’t remember a time when I shook my head more often than the year 2012,” OSN Regulatory/Legislative Section Editor Alan E. Reider, JD, said in a presentation at the joint opening of Hawaiian Eye 2013 and Retina 2013.
Speaker updates clinicians on Medicare reimbursement, coding
WAIKOLOA, Hawaii — Even though changes are looming, over the past 10 years, there have not been significant changes in reimbursement; however, many CPT codes have had an adjustment in their relative value units, which are the drivers of reimbursements, according to a speaker here. Over the past year, there were some positive changes to the RVUs, as well as some decreases, Donna McCune, vice president of Corcoran Consulting Group, told ophthalmologists gathered at the joint opening of Hawaiian Eye 2013 and Retina 2013.
Speaker advises incremental approach to incorporating frugality into practice
WAIKOLOA, Hawaii — Using the mnemonic ASPEN, one speaker here presented incremental steps that ophthalmologists can take to enhance their practices by adopting frugal innovations.Frugality is necessary to offset the inevitable reckoning that will come with Medicare cutbacks, OSN Practice Management Section Manager John B. Pinto said at the joint opening of Hawaiian Eye 2013 and Retina 2013.
Vertical, horizontal vectors affect lower lid laxity
WAIKOLOA, Hawaii — Involutional ectropion is probably the most common variety of lower eyelid malposition, causing laxity of the margin that turns away from the globe, a speaker said here.Conversely, in involutional entropion, the margin turns inward and may be confused with trichiasis, Jeremiah Tao, MD, FACS, said at Hawaiian Eye 2013.
Distinguishing cause of droopy eyelids determines management approach
WAIKOLOA, Hawaii — There are a number of different causes of droopy or heavy eyelids, and management for each may be different, a speaker said here. When a patient presents with a dermatochalasis-type picture, it is important to determine the cause, Wendy W. Lee, MD, said at Hawaiian Eye 2013.
Access to cataract surgery still low among women in India
HYDERABAD, India — Despite the increased rate of surgery performed in the last 10 years, cataract remains a leading cause of blindness in India, particularly among women, according to one surgeon here. More modern techniques such as microincision phaco and implantation of premium IOLs have been introduced in recent times, but only a very small part of the population can afford the increased costs.
President of India addresses ophthalmologists at APAO-AIOS meeting
HYDERABAD, India — Shri Pranab Mukherjee, the president of India and chief guest at the joint meeting of the Asia-Pacific Academy of Ophthalmology and All India Ophthalmological Society, praised both societies for their contributions in fighting blindness in Asia. “Governments alone cannot combat blindness as effectively as collaborative ventures involving individual doctors, medical associations, volunteer organizations and nongovernmental organizations,” he said.
Dry eye prevalence high in rural India, but modifiable risk factors can be addressed
HYDERABAD, India — Dry eye is a common condition in the population of rural India, according to a study, which also discussed modifiable risk factors that could be addressed to decrease prevalence and prevent sight-threatening complications.“We investigated the presence of dry eye by Schirmer’s test and [tear breakup time] in the rural population aged 40 years or older in district Gurgaon, state of Haryana. Of the 2,427 individuals with age 40+, 2,014 participated in the study,” Noopur Gupta, MD, said here at the joint meeting of the Asia-Pacific Academy of (Read more...)
Ophthalmologists can help patients relieve psychological burden of glaucoma
HYDERABAD, India — Glaucoma patients need and deserve the support of their ophthalmologists, who can help them form a realistic but positive attitude toward their condition. Henry Edwards, MD, addressed the audience at the joint meeting of the Asia-Pacific Academy of Ophthalmology and All India Ophthalmological Society in the double role of psychiatrist and glaucoma patient, now at an advanced stage.
Perfluoro-n-octane, upright head position effective in inferior retinal detachment repair
A staged two-procedure approach involving pars plana vitrectomy, perfluoro-n-octane tamponade and upright head positioning was effective in repairing inferior retinal detachments, according to a study.The interventional case series analyzed 159 eyes of…
Oral antibiotic beneficial in treatment of meibomian gland dysfunction
Oral minocycline reduced inflammatory cytokine levels in patients with moderate or severe meibomian gland dysfunction, a study determined.The prospective clinical trial examined 60 eyes of 60 patients with stage 3 or 4 meibomian gland dysfunction.
Iluvien gains marketing authorization in Spain
The Spanish Agency of Medicines and Medical Devices granted Alimera Sciences authorization to market Iluvien in Spain for the treatment of vision impairment associated with chronic diabetic macular edema that is unresponsive to available therapies, acc…
Temporal artery biopsy associated with risk of postop facial nerve damage
A study found that temporal artery biopsy resulted in a 16% incidence of postoperative facial nerve damage, which fully resolved in more than half of the affected patients.Incisions made closer to the orbital rim and brow increased the risk of postop f…
HHS proposes new guidelines for Medicaid, CHIP, health insurance marketplaces
New Affordable Care Act rules proposed this week by HHS Secretary Kathleen Sebelius set guidelines for eligibility notices and appeals in Medicaid, the Children’s Health Insurance Program and Exchanges, plus give states additional operational flexibility for Medicaid programs.“Today, we are proposing a rule to provide Americans with access to affordable, high-quality health coverage and give states more flexibility to implement the law in a way that works for them,” Sebelius said in a press release.