- Study evaluates the potential for AI in cataract surgery
- Pre-clinical model for dry AMD
- Research finds up to 30% of wet AMD patients could stop injections
- Prospective study of a new home-based OCT device begins
- ASCRS news and events
January 21, 2022 • Volume 28, Number 3
Study evaluates the potential for AI in cataract surgery
A cross-sectional study evaluated the potential application of real-time surgical guidance during cataract surgery with a deep-learning network and computer vision tools. The paper published in JAMA Ophthalmology found that such a neural network was able to track the pupil and identify the surgical phase, then “[triggered] surgical guidance tools developed with computer vision,” the authors wrote. The research used surgical videos, which the “region-based convolutional neural network” then used to identify surgical phase. Depending on the surgical phase, computer vision-based algorithms “provided visual feedback to the surgeon.” The authors stated that this proof-of-concept study supports further investigation into a surgical microscope being integrated with neural networks and computer vision tools to provide surgical guidance feedback in real time.
Pre-clinical model for dry AMD
Researchers at Weill Cornell Medicine have developed a new pre-clinical model of dry AMD in an effort to improve identification and development of new treatment modalities and drug targets, a news article from the university reported. According to the article, previous mouse models did not sufficiently compare to dry AMD in humans. This new model develops and accumulates drusen, which is a main feature of the disease. The model is a mouse model in which the mice don’t have the RPE Clic4 gene, according to the paper published in Nature Communications. The news article from the university noted that this gene had not been identified in relation to AMD risk prior to this research. With this model, the researchers found that the lipids that formed drusen came from the RPE cells, not the blood. This, the news article stated, “represents a new treatment target for further development, [and] may also explain why treating patients with statins that lower cholesterol levels in the blood has not been an effective approach for treating dry AMD.”
Research finds up to 30% of wet AMD patients could stop injections
A study published in the Journal of Clinical Investigation by researchers at Johns Hopkins Medicine found that up to 30% of patients with wet AMD could safely stop anti-VEGF injections without further vision loss. The study, described as preliminary, included 122 patients with wet AMD who had three consecutive monthly anti-VEGF injections, followed by a treat-and-extend protocol. Patients whose eyes were quiet during the 12 weeks following had treatment paused with it reinitiated should the need arise based on vision, clinical exam, and/or imaging studies. The researchers also analyzed the aqueous fluid to identify proteins that may correlate with patient response. After 1 year, 38 of the 122 eyes (31%) entered a treatment pause, while 21 eyes (17%) failed the extension and needed monthly treatments by the end of year 1. The researchers observed that patients with an increased level of apolipoprotein-B100 required less frequent injections. The researchers noted that mice overexpressing this protein were partially protected from laser-induced CNV. The authors concluded that these biomarkers could identify patients with wet AMD who might not require such frequent, long-term anti-VEGF injections.
Prospective study of a new home-based OCT device begins
Kubota Vision announced that the first patient has been enrolled in a prospective study, taking place in Japan, evaluating its Patient Based Ophthalmology Suite, a home-based, self-monitoring OCT device. According to the company’s press release, this device could be used to detect nascent disease progression and support patient retreatment prior to vision loss. The device functions with network connectivity and cloud-based technologies to inform physicians of possible progression from the patient’s use of the device at home.
ASCRS news and events
- 2022 ASCRS Annual Meeting: Tier 1 pricing for registration for the ASCRS Annual Meeting in Washington, D.C., April 22–26, 2022, ends this Sunday, January 23. There is also an open call for complicated case video submissions.
- ASCRS Winter Symposium: Registration is open for the Winter Symposium in Park City, Utah, February 10–12. The meeting focuses on innovative techniques and controversies in anterior segment ophthalmology.
- Beyond 20/20: Beyond 20/20: An ASCRS Series in Modern Refractive Surgery and Presbyopia Therapy is a new, four-part educational series sponsored by the Refractive Clinical Committee that features CME and non-CME components. The first module begins January 26 at 8:00 p.m. ET. Learn more about the series and register here.
Research highlights
- The accuracy of several IOL power calculation formulas in short eyes was evaluated in research published in the journal Eye. The study included 172 eyes (AL ≤ 22.0 mm) of 172 patients who had cataract surgery performed by one surgeon with an IQ SN60WF IOL (Alcon). The formulas evaluated were Barrett Universal II, Haigis, Hoffer Q, Holladay 1, Holladay 2, Kane, SRK/T, T2, VRF, and VRF-G. The authors reported that the VRF-G, Haigis, and Kane formulas had the smallest mean absolute error and the highest percentages of eyes within 0.5 D of target (75.67%, 73.84%, and 75.16%, respectively). Looking at all formulas, the percentage of eyes within 0.5 D of target ranged from 66.28% to 75.67%.
- Nd:YAG laser capsulotomy for the treatment of posterior capsule opacification and its effect on IOL position and other anterior segment parameters was evaluated in research published in the journal Clinical Ophthalmology. According to the paper, 50 eyes of 50 consecutive patients were included; all of these patients had a single-piece C-loop acrylic IOL (AcrySof SA60AT, Alcon). The Anterion SS-OCT device (Heidelberg Engineering) was used to capture anterior segment images before the YAG procedure and 1 month postop. No statistically significant difference was found in anterior chamber depth after the YAG. More than half of the patients (n=28) had backward movement of the IOL. The remaining 22 saw the IOL moved forward or not at all. There were no significant differences in anterior chamber angle, anterior chamber volume, or central corneal thickness. CDVA improved after the YAG procedure.
Product news
- Avellino entered into a distribution agreement with Keeler for its AvaGen genetic eye test, allowing medical professionals to order the test online via Keeler’s website.
This issue of EyeWorld Weekly was edited by Stacy Jablonski and Liz Hillman.
EyeWorld Weekly (ISSN 1089-0319), a digital publication of the American Society of Cataract and Refractive Surgery (ASCRS), is published every Friday, distributed by email, and posted live on Friday.
Medical Editors: Eric Donnenfeld, MD, Chief Medical Editor; Rosa Braga-Mele, MD, Cataract Editor; Clara Chan, MD, Cornea Editor; Nathan Radcliffe, MD, Glaucoma Editor; and Vance Thompson, MD, Refractive Editor
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