EW Weekly, December 21, 2018

December 21, 2018
Volume 24 , Number 49

Alcon acquires Tear Film Innovations

Alcon (Fort Worth, Texas) has acquired Tear Film Innovations (Carlsbad, California), the maker of the iLux Device used to treat meibomian gland dysfunction. The iLux received 510(k) clearance from the U.S. Food and Drug Administration (FDA) in December 2017 and is currently available in the U.S. and Canada.

First small aperture IOL implanted in the U.S.

The first small aperture IOL has been implanted in the U.S. by AcuFocus (Irvine, California) using its IC-8 small aperture lens as part of a pivotal study, according to a company press release. The FDA recently approved an Investigational Device Exemption for the pivotal study. The prospective, multicenter, parallel-group study will include about 475 patients with bilateral cataracts.

Acquisition of ianTECH completed by Zeiss

Carlo Zeiss Meditec (Jena, Germany) has completed its acquisition of ianTECH (Reno, Nevada), a company focused on microinterventional cataract surgery technology.

CBD may worsen IOP in glaucoma patients

Topically applied cannabidiol (CBD) appears to increase the IOP inside the eyes of mice, reported Sally Miller and coresearchers in a new study. Cannabidiol is a chemical component inside marijuana, which is used by some glaucoma patients to treat the condition. Among the mice in the study, CBD increased IOP by 18% for at least 4 hours after use. Although tetrahydrocannabinol, or THC, was found to lower IOP, the use of CBD in combination with THC blocked this effect. Male mice in the study had an IOP decrease of nearly 30% after exposure to THC alone; in female mice, there was an IOP drop of 17% after 3 hours. When comparing the effect of THC and CBD on mice without specific neuroreceptors affected by the two substances, researchers identified neuroreceptors CB1 and GPR18 by which the first substance lowered IOP. The study results appear in Investigative Ophthalmology & Visual Science.

Wasatch Photonics partners with Notal Vision for home-based OCT system

Notal Vision (Manassas, Virginia) announced that it will collaborate with Wasatch Photonics (Logan, Utah) to help develop its modular Notal Home OCT System, designed to monitor for wet age-related macular degeneration (AMD) between standard of care examinations. Notal also announced that it initiated its first U.S.-based study in October and is enrolling AMD patients with a visual acuity as low as 20/400 to evaluate device performance. Previous studies took place in Israel. The U.S. FDA recently granted the system a Breakthrough Device designation.

Give yourself the gift of ASCRS education and the chance to win an iPad: Register for the Annual Meeting

The year is almost over, and you've been busy preparing for the holidays. Be sure to pick something up for yourself by registering for the 2019 ASCRS/ASOA Annual Meeting.* If you register before 11:59 p.m. EST Monday, Dec. 24, you will be entered into an Apple iPad giveaway.** The Annual Meeting, being held May 3-7, 2019 in San Diego, is the largest U.S. meeting for anterior segment surgeons. This year ASCRS is offering the Annual Meeting + ASCRS Subspecialty Day category,*** which provides you with full access to all ASCRS programming such as instructional courses, symposia and ASCRS Subspecialty Day programming. This allows you to tailor your meeting experience by freely choosing which educational offerings to attend, making the annual meeting a truly personalized event.

*Must have current membership to attend the Annual Meeting.
**One random winner selected.
***Does not include Skills Transfer Labs.

Research briefs

  • Use of the iStent inject (Glaukos, San Clemente, California) and cataract surgery led to safe IOP levels and medication reductions in eyes with predominantly primary open angle glaucoma (POAG) or pseudoexfoliative glaucoma (PEX) over a 36-month period, according to Fritz Hengerer and coresearchers. Their prospective, nonrandomized, consecutive cohort study included 81 eyes, all of who had ab interno iStent inject implantation after cataract surgery. The IOP, number of medications, and proportion of eyes with a 20% or greater IOP reduction were among the efficacy endpoints. Safety measures included corrected distance visual acuity, adverse events, and secondary surgeries. Among all eyes, 32.1% had previous glaucoma surgery. Fifty-six percent were on three to four medications, and one eye was medication-free. The mean IOP decreased 37% at 36 months postop; the mean medication burden was lowered by 68% (0.8 versus 2.5 medications preop). The IOP decreased by 20% or more in 78% of eyes, and 100% of eyes had an IOP of 18 mm Hg or lower. Results were similar in both POAG and PEX subgroups. The study appears in Ophthalmology and Therapy.
  • Information presented by video about excimer laser treatment lowered the total consultation time compared with a conventional consultation, reported Philipp Baenninger, MD, and coresearchers in their single-center randomized trial. Patients were randomly assigned for a conventional face-to-face consultation or a conventional consultation with additional video-assisted information. Knowledge and satisfaction with the informed consent process along with anxiety regarding surgery also were measured. Among 113 patients (58 in the conventional group and 55 in the interventional group), there was no difference in knowledge, satisfaction with informed consent, and anxiety toward surgery. However, total consultation time was significantly lower in the interventional group compared with the conventional group. Video assistance could improve efficiency by a double-digit percentage at an equal cost as a conventional consultation, the researchers concluded. The research is published in the Journal of Cataract & Refractive Surgery.
  • Among various ophthalmic conditions, an increased risk for Alzheimer's disease was found in patients with established AMD diagnoses and both recent and established diabetic retinopathy, reported Cecilia Lee and coresearchers. However, they did not find an increased risk for Alzheimer's associated with cataract surgery. Their study, which included 3,877 participants from the Adult Changes in Thought study, identified 792 Alzheimer's cases among 31,142 person-years of follow-up. The recent and established hazard ratio were 1.46 (P=.01) and 0.87 (P=0.19) for glaucoma, 1.20 (P=0.12) and 1.50 (P<.001) for AMD, and 1.50 (P=0.045) and 1.50 (P=0.03) for diabetic retinopathy. The study appears in Alzheimer's and Dementia.
  • Surgeon and patient discretion regarding cataract surgery has a substantial cost effect and the potential to decrease surgical volume by up to 13% with the decision to delay surgery as a result of patient mortality, according to Tyler Oostra and coresearchers. Their study focused on the cost effect of surgeon and patient discretion regarding cataract surgery and how this affects population healthcare costs. Researchers used a model of cataract progression created from preexisting published data and combined with mortality data and Medicare cataract statistics to estimate the effect of mortality on decreasing cataract surgery if surgery was delayed until cataract progression occurred. When combining 5-year death rates, delaying surgery until progression occurred led to a 1.1% decrease in surgery for nuclear sclerosis at age 45, which increased to a 33.8% decrease by age 90. A 1.5% decrease in surgery for cortical cataract at age 45 increased to a 51.1% decrease by age 90. A 1.6% decrease in surgery for posterior subcapsular at age 45 increased to a 59.7% decrease by age 90. The effect of this decrease in surgical volume on Medicare was estimated to be a 13% overall decrease in cataract surgery annually at a cost of ~$660 million dollars per year. The study is published in Clinical Ophthalmology.

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; Nathan Radcliffe, MD, glaucoma editor; and Vance Thompson, MD, refractive editor.

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