EW Weekly, February 7, 2020

First patient implanted with EVO lens in trial
The first patient has been implanted in a U.S. human clinical study for the EVO/EVO+ Implantable Collamer Lens (STAAR Surgical), according to a company press release. The study will be done at more than 12 ophthalmology clinics around the U.S. The first patient in the study was from Price Vision Group in Indianapolis, Indiana. EVO has a central port that does away with the need for a peripheral iridotomy before implanting the lens.

EyePoint, Equinox sign agreement to develop vorolanib for wet AMD, DR, RVO
EyePoint Pharmaceuticals and Equinox Science have signed an agreement to develop the tyrosine kinase inhibitor vorolanib to treat wet age-related macular degeneration (AMD), diabetic retinopathy (DR), and retinal vein occlusion (RVO), according to a news release. Vorolanib is under development as EYP-1901 using EyePoint’s bioerodible Durasert technology, which is a miniature, injectable, sustained-release intravitreal drug that lasts for 6 months. EyePoint recently met with the FDA to clarify the pathway for a Phase 1 clinical trial. Data from the trial should be ready by the second half of 2021.

Rare Pediatric Disease designation given for QR-421a for retinitis pigmentosa
QR-421a (ProQR Therapeutics) has received a Rare Pediatric Disease designation from the U.S. FDA, according to a company press release. It is designed to treat patients with retinitis pigmentosa caused by mutations in exon 13 of the USH2a gene. QR-421a is a first-in-class investigational RNA-based oligonucleotide that is designed to restore functional usherin protein by using an exon skipping approach to stop or reverse vision loss. By receiving this designation, the drug will receive priority review to encourage treatments for rare pediatric diseases.

Research briefs
  • Persistent and clinically significant ptosis was seen in more than 3% of patients having clear corneal sutureless phacoemulsification, reported Mohsen Bahmani Kashkouli, MD, and coresearchers. Their cohort study focused on the frequency of transient (1 month) and persistent (at least 6 months) postoperative ptosis after clear corneal sutureless phacoemulsification. A total of 234 patients (313 eyelids) were included among the patients who had phaco from October 2016 to June 2018 at a tertiary center. Margin reflex distance 1 (MRD1), MRD2, and levator function were measured. Clinical ptosis was defined as any postop drop of MRD1, while clinically significant ptosis was an MRD1 drop of 2 mm or greater. Photo-based ptosis was analyzed by a masked oculo-facial plastic surgeon at the study’s conclusion. Persistent clinical, clinically significant, and photo-based ptosis were 25.4%, 3.2%, and 3.3%. There was a significantly lower preop levator function in eyes with persistent postop ptosis. There was no other factor that was significantly different between eyelids with or without postop ptosis, such as surgery duration or surgeon experience. Patients should be counseled preop about the risk for clinically significant ptosis, the researchers concluded. The study appears in the American Journal of Ophthalmology.
  • There has been little change in the past few decades in glaucoma burden based on sex differences, according to Xin Ye and coresearchers, whose study investigated global burden of glaucoma and sex by year, age, and socioeconomic status using disability-adjusted life years (DALYs). Researchers used global, regional, and national sex-specific DALY numbers as well as crude DALY rates and age-standardized DALY rates caused by glaucoma and by year and age, as obtained by the Global Burden of Disease Study 2017. Changes in glaucoma DALY number and crude rates were similar for both sexes between 1990 and 2017. Among men, age-standardized DALY rates were consistently lower, from 10.7 in 1990 to 9.4 in 2017 once controlling for population size and age. The rates for women were 8.8 in 1990 and 8.0 in 2017. Men had higher rates of glaucoma than women of the same age, with sex differences increasing with age. Men continue to have a higher glaucoma burden, as do those of an older age and lower socioeconomic status. The findings may enhance public awareness of sex differences in glaucoma burden and emphasize the importance of sex-sensitive health policy to manage vision loss from glaucoma, they concluded. The research is published in Acta Ophthalmologica.
  • Ophthalmological disorders are often found in children with autism spectrum disorder, particularly among those with intellectual disability, according to Raoul Kanav Khanna and researchers, who focused in their prospective study on ophthalmic disorders in children with autism spectrum disorder. Analyzing a sample of 51 children, researchers found ophthalmic disorders in 39% of them. Thirty-five percent had significant refractive errors, and 10% presented with strabismus. Children with autism had significantly lower verbal and performance quotients, although no significant result was found between the presence of ophthalmic disorders and autism severity, level of communication and social contact, or modulating behavior. There were lower verbal and performance quotients in children who did not achieve monocular visual acuity testing. Ophthalmologists and child psychiatrists should perform ophthalmological exams in children with autism spectrum disorder as their eye disorders may otherwise go undetected, they concluded. The research appears in Graefe’s Archive for Clinical and Experimental Ophthalmology.
  • Patient demographics, biometry data, and cataract severity all significantly correlated with operative time in an analysis of preop clinical characteristics that affect cataract surgery operative time, according to K. Matthew McKay, MD, and coresearchers. Their large-scale, retrospective cohort study reviewed cases of cataract extraction and IOL insertion over a year by Comprehensive Ophthalmology at Massachusetts Eye and Ear. A total of 1,349 cataract surgeries in 1,072 patients were included. The mean operative time was 22.1 minutes; attending surgery identity was the most important factor associated with operative time. Longer operative time was associated with male sex, increased body mass index, first-eye surgery, left operative eye, advanced cataract, iris hook use, Malyugin ring use, trypan blue use, a history of diabetic retinopathy, short axial length, and a shallow anterior chamber depth. Incorporating these factors into predictive algorithms may help create more predictable surgical scheduling and better use of operative resources, the researchers concluded. The study is published in the Journal of Cataract & Refractive Surgery.

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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