EyeWorld Weekly Update, April 14, 2017
- New potential therapeutictarget identified for PDR
- Novartis to in-license dry eye treatment
- Imprimis enters agreement for worldwide rights to Klarity
- Dry eye an overwhelmingly common symptom in those with Sjögren's syndrome
- NEI grant awarded to identify targets for AMD and other heritable retinal diseases
New potential therapeutictarget identified for PDR
Novartis to in-license dry eye treatment
Imprimis enters agreement for worldwide rights to Klarity
Dry eye an overwhelmingly common symptom in those with Sjögren's syndrome
NEI grant awarded to identify targets for AMD and other heritable retinal diseases
- Factors that increase the risk for pseudophakic cystoid macular edema (CME) after cataract surgery in patients with diabetes include duration, severity, diabetes type, lens hardness, and hemoglobin A1C level, reported Jin Yang, MD, PhD, and coinvestigators. Their prospective nonrandomized study followed patients with diabetes for up to 6 months after phacoemulsification to evaluate their foveal thickness, macular sensitivity, and corrected distance visual acuity. Three groups of patients were identified: nonpseudophakic CME, level 1 pseudophakic CME, and level 2 pseudophakic CME. Patients with subclinical level 1 CME had a 30% to 40% increase in foveal thickness and a 20% drop in macular sensitivity. Level 2 patients had a 40% or more increase in foveal thickness and a 20% decrease in macular sensitivity. Clinical pseudophakic CME occurred in 3.2% of patients. "A 40% or more increase in foveal thickness and 20% or more decrease in macular sensitivity offer an objective and reliable diagnostic standard to report pseudophakic CME in diabetics," the investigators concluded. The research is published in the Journal of Cataract & Refractive Surgery.
- A Failure Modes and Effects Analysis applied to bilateral same-day cataract surgery identified 15 significant potential failure modes. Led by Neal H. Shorstein, MD, investigators identified lapses in instrument processing and compounding errors with intracameral antibiotics that could lead to endophthalmitis or toxic anterior segment syndrome (TASS). They also found ambiguous documentation of IOL selection by surgeons, leading possibly to unintended IOL implantation. Among the 4,754 eyes in the study, one eye developed endophthalmitis, one had an unintended IOL implantation, and no eyes developed TASS. Recommendations from the investigators include improving oversight of cleaning and sterilization practices, separating lots of compounding drugs for each eye, and enhancing IOL verification procedures. The study is published in the Journal of Cataract & Refractive Surgery.
- Children with glaucoma have a health-related quality of life score similar to those described by children with severe congenital cardiac effects, those who have undergone liver transplants, and those who have acute lymphoblastic leukemia, according to Annegret Dahlmann-Noor, MD, PhD, and coinvestigators. They focused on functional vision and vision-related and health-related quality of life in children up to age 16 in their cross-sectional observational study. Investigators used three validated instruments to assess these areas: the Cardiff Visual Ability Questionnaire for Children, the Vision Impairment for Children, and the Pediatric Quality of Life Inventory version 4.0. Scores for functional visual acuity, vision-related quality of life, and health-related quality life were reduced in children with glaucoma. Parents reported a greater impact of glaucoma on their child's health-related quality of life than the children reported. The research is published in Ophthalmology.
- Corneal crosslinking (CXL) in children with keratoconus appears to be effective, according to a study led by Lisa McAnena, MB, BCh. Investigators reviewed various databases for all studies focused on standard, transepithelial, or accelerated protocols for CXL in patients age 18 or younger. They identified a total of 13 papers published between May 2011 and December 2014. There were 490 eyes examined (401 patients) with a mean age of 15.25 years. Nine papers were included in the meta-analysis; these papers showed a significant improvement in uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), and stable Kmax at 12 months as well as stable UCVA, improved BCVA, and improved Kmax at 24 months in a standard protocol group. In the transepithelial group, UCVA, BCVA, and Kmax were stable at 12 months. Standard CXL appeared effective in stopping the progression of keratoconus in pediatric patients at 12 months, but the investigators recommend more long-term studies. The research is published in Acta Ophthalmologica.
This issue of EyeWorld Weekly Update was edited by Amy Goldenberg and Vanessa Caceres.
EyeWorld Weekly Update (ISSN 1089-0319), a digital publication of the American Society of Cataract and Refractive Surgery and the American Society of Ophthalmic Administrators, 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; Reay Brown, MD, glaucoma editor; and Vance Thompson, MD, refractive editor.
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