EW Weekly, May 17, 2019

- FDA approves EYLEA injection for diabetic retinopathy
- First patient enrolled in Phase 3 trial for dry eye treatment
- Results announced from ex-U.S. proof-of-concept trial with ALG-1007 for dry eye
- 6-month data reported from Phase 1/2 trial of AAV-RPE65 for RPE65-deficiency
- New eye/brain center opens in collaboration with Wills Eye
- Allergan awarded $48.5K at trial over Imprimis false ads
- Register now for “Great Surgery Begins with Great Communication: Managing Communications and Expectations with Our Patients” webinar
- High-output ophthalmology clinics may lead to better patient outcomes, particularly in developing nations, reported Jacob Cox, MD, and coresearchers in their study assessing associations between annual surgeon case volume and visual acuity after cataract surgery. The study included all adult eyes that had small incision cataract surgery or phacoemulsification with IOL replacement at Aravind Eye Hospital, Madurai, India, in 2015. The main outcome measure was the postop uncorrected visual acuity (UCVA) after cataract surgery. A total of 35,880 eyes were included in the study, and surgeries were performed by 69 surgeons who varied in annual case volume from 76 to 2,900 cases during the study period. Increasing annual surgeon case volume was independently associated with a statistically significant but clinically modest improvement in UCVA in phaco cataract extraction but not in small incision cataract surgery. The association was more pronounced when comparing surgeons with case volumes of 350 phaco cataract extractions a year or fewer. Surgeons who had a higher volume than this had similar results. Increased annual case volume also was associated with significantly lower complication rates. The concept of high-output ophthalmology clinics can benefit developing nations where there is a large backlog of untreated cataracts and the cataract-to-surgeon ratio is high, the researchers concluded. The study is published in Ophthalmology.
- Use of femtosecond laser-assisted cataract surgery (FLACS) in eyes with shallow chambers led to clearer corneas, less of an increase in central corneal thickness, lower anterior chamber inflammation, and better uncorrected distance visual acuity in the early postop period compared with conventional phaco, reported Viraj Vasavada, MD, and coresearchers. Their prospective, randomized, masked clinical study included patients with an anterior chamber of 2.5 mm or less who were randomized to have FLACS (n=91) or conventional phaco (n=91). Cumulative dissipative energy was lower in the FLACS group (P<.05). The mean central corneal thickness was significantly lower in the FLACS group at 1 day and 1 week, and there were fewer eyes with grade 2 anterior chamber cells and flare with FLACS at 1 day and 1 week. The uncorrected distance visual acuity was better with FLACS at 1 week. Although the reduction in endothelial cell density was lower in the FLACS group at 6 months, it was not a statistically significant difference. The research appears in the Journal of Cataract & Refractive Surgery.
- High serum cholesterol levels were associated with a higher risk of primary open angle glaucoma (POAG) in adults age 40 or older, according to Jae Kang, ScD, and fellow researchers. However, use of statins appeared to lower the risk for POAG. Their population-based cohort study included participants from the Nurses’ Health Study, the Nurses’ Health Study 2, and the Health Professionals Follow-up Study in which information on elevated cholesterol status, serum cholesterol levels, and statin use were self-reported every other year. Among the 136,782 participants in the three cohorts, there were 886 incidence cases of POAG. Every 20 mg/dL increase in total serum cholesterol was associated with a 7% increase in POAG risk. A history of any statin use was associated with a 15% lower risk of POAG, but a history of statin use for 5 years or more was associated with a 21% lower risk. The study is published in JAMA Ophthalmology.
- A survey of American Glaucoma Society members found that they would prefer for themselves microinvasive glaucoma surgery over traditional trabeculectomy or a glaucoma drainage device, reported Ta Chang, and coresearchers. The survey asked participants to adopt the role of a patient with POAG with progressive visual field loss and a need for glaucoma surgery at various IOP points. Among the 289 responses, the largest preferences were an ab interno trabeculotomy (20.3%), a XEN Gel Stent (Allergan) (18.6%), an iStent (Glaukos) with two devices (14.3%), and traditional trabeculectomy with mitomycin-C (14.1%). Most participants preferred non-bleb forming or conjunctiva-sparing procedures, even if they had low preop IOP levels. The study appears in Eye.
This issue of EyeWorld Weekly was edited by Stacy Jablonski and Vanessa Caceres.
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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