EW Weekly, November 1, 2019

- Secondary analyses announced from Phase 2 trial for NCX 470 for glaucoma
- Primary endpoint met in Phase 2b trial of Zimura for geographic atrophy
- First patient dosed in third cohort of OPTIC trial for ADVM-022 gene therapy for wet AMD
- Rare Pediatric Disease designation given to sepofarsen for LCA10
- Clinical program for MicroLine for presbyopia accelerated
- Submit your nomination for the inaugural ASCRS Educator Award
- In a prospective, randomized, comparative study, SMILE offered more safety and objective visual acuity compared with LASIK, reported Xiaonan Yang, PhD, and coresearchers. SMILE also had comparable stability and efficacy and slightly inferior predictability. All 60 patients had a maximum myopic meridian exceeding 10 D. Thirty eyes were corrected with SMILE, and 30 were corrected with femtosecond LASIK. All patients received preop and 6-month postop exams. At 6 months, the uncorrected visual acuity was –0.01 and –0.05 in the SMILE and LASIK eyes, respectively (P = 0.080). Corrected visual acuity was –0.07 and –0.08, respectively (P = 0.624). Postop sphere equivalent was –0.20 and –0.03, respectively. The measured corneal thickness was lowered by 137.40 µm and 155.06 µm, respectively. Changes in higher-order aberrations and spherical aberration were slightly smaller with SMILE compared with LASIK. The study is published in the Journal of Cataract & Refractive Surgery.
- A randomized clinical trial was not able to show that goniosynechialysis with phaco had additional IOP lowering after 1 year compared with the use of phaco alone, according to Rahat Husain, MD(Res), and coresearchers. All patients had synechial primary angle-closure disease and cataract. The 78 patients were randomized to have phaco with IOL implantation alone or phaco, IOL implantation, and goniosynechialysis. The main outcome was successful control of IOP at 12 months, defined as an IOP of 21 mm Hg or lower without the use of topical IOP-lowering medications and a lowering of the IOP by 20% or more from baseline IOP. The mean IOP baseline in the phaco-alone group was 22.3 mm Hg and 22.9 mm Hg for the phaco/goniosynechialysis group. At 1 year, the mean IOP was 14.3 mm Hg for the phaco-alone group and 15.9 mm Hg for the phaco/goniosynechialysis group. Successful control at 1 year took place in 52.5% of patients in the phaco-alone group and 57.9% in the phaco/goniosynechialysis group. Medication use decreased from a mean of 2.2 at baseline to 0.5 in the phaco-alone group and 1.9 to 0.6 in the phaco/goniosynechialysis group. Postop complications were similar in both groups and included IOP spike, excessive anterior chamber inflammation, and posterior capsule opacification. The research appears in JAMA Ophthalmology.
- Clinicians should limit their reliance on eyelid margin vascularization as a diagnostic criterion for meibomian gland dysfunction (MGD), Max Blumberg, MD, and coresearchers concluded, based on results from their cross-sectional study. Consecutive cornea clinic patients were enrolled, and eyelid margin vascularization was graded qualitatively from slit lamp photos. Skin pigmentation was quantified from digital photos. MGD was designed as an abnormal quantity or quality of meibum or increased pressure required to express meibum. Additional tests performed included infrared meibography, Schirmer’s testing, and a dry eye questionnaire. Among the 47 participants, eyelid margin vascularization was less common in subjects with dark compared to light pigmentation, although the prevalence of MGD as seen via clinical evaluation did not vary significantly between the groups. Use of eyelid margin vascularization alone was not sensitive for MGD diagnosis. Sensitivity was 17% when limited to those with dark pigmentation. The study appears in Clinical Ophthalmology.
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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