EW Weekly, May 29, 2020

Results from study with ranibizumab Port Delivery System
Genentech announced positive topline results from its Phase 3 Archway study, which evaluated its Port Delivery System of ranibizumab in patients with wet AMD. The Port Delivery System is a refillable implant that delivers a continuous dose of the drug with refills every 6 months in the study, according to the company’s press release. The study found that patients who had the Port Delivery System had similar visual acuity when compared to those who received monthly ranibizumab 0.5 mg injections. According to the company, the delivery system was well tolerated in this study, but a separate study is evaluating long-term safety and tolerability of using a Port Delivery System for wet AMD treatment. The Port Delivery System is also being studied for treatment of diabetic macular degeneration.

FDA accepts EYSUVIS NDA resubmission
The FDA accepted Kala Pharmaceuticals’ NDA resubmission for EYSUVIS (loteprednol etabonate ophthalmic suspension, 0.25%), as a treatment for signs and symptoms of dry eye, according to the company. Kala reported that the FDA set October 30 as its goal to complete the review of the NDA.

Mynosys Cellular Devices changes name and expands product pipeline vision
Mynosys Cellular Devices, known for the ZEPTO Precision Cataract Surgery platform, announced that it changed its name to Centricity Vision. The company said that the new name reflects its core in technology that creates precise, centered capsulotomies and also its evolution as a vision care company. Centricity Vision also stated its intention to expand its product pipeline into refractive surgery beyond the ZEPTO platform.

ASCRS and IJCAHPO Technicians & Nurses Program virtual broadcast
Technicians and nurses are encouraged to join a virtual broadcast series of topics from the 2020 Technicians & Nurses Program sponsored by IJCAHPO and ASCRS. The program will have the latest information on cataract and refractive surgical topics with the potential to earn up to 21 IJCAHPO credits over 3 days. Part 1 and 2, which are purchased together with the potential for up to 14 IJCAHPO credits, will take place June 6 from 8:00 a.m.–5:00 p.m. CDT and June 13 from 8:00 a.m.–5:00 p.m. CDT. Part 3, purchased separately, will take place June 27 from 8:00 a.m.–5:00 p.m. CDT for the potential of up to 7 IJCAHPO credits.

ASOA webinar series continues
ASOA continues its eight-part webinar series with supplemental live Q&A. The most recent sessions in the series—Resuming Your Practice … A Digital Journey of Discovery to Help Restore Normalcy—took place this week, May 27–28. The final two sessions will occur next week, June 2–3. The recorded sessions will be available on demand. The series provides 12 COE Category A credits. Find more details here.

COVID-19: News You Can Use
Stay up to date with information about COVID-19 specifically curated for ophthalmologists and their practices with ASCRS’ COVID-19: News You Can Use series. This series is a repository of information including links, tips, and resources to help navigate the fluid COVID-19 landscape, including considerations for reopening practices.

Research highlights
  • Scientists developed a comprehensive atlas of 12 cell types in the trabecular meshwork and surrounding tissues to better understand how eyes maintain IOP homeostasis and how it could become dysregulated in diseases like glaucoma. Gaurang Patel, PhD, and coauthors first identified, from more than 17,000 genes from more than 8,700 cells of eight eyes, the 12 cell types that are responsible for regulating IOP outflow and maintenance. “Significantly, we identified two distinct expression patterns (myofibroblast- and fibroblast-like) from cells located in the trabecular meshwork (TM), the primary structural component of the conventional outflow pathway,” Patel et al. wrote. “We also located Schwann cell and macrophage signatures in the TM.” Schlemm’s canal, according to the research, showed a combination of lymphatic and blood vascular gene expression, and gene expression was correlated to cells in the ciliary muscle and scleral spur. This research, according to the investigators, shows the diversity of cells involved in the regulation of aqueous outflow, settles the “long-standing controversy” of the number of TM outflow cell types (two), and “provide[s] essential information” that could lead to better drug targets for future glaucoma therapies. The research is published in the Proceedings of the National Academy of Sciences.
  • An international, longitudinal, multicenter, randomized controlled trial compared selective laser trabeculoplasty (SLT) and topical medication as a first-line treatment in patients with mild to moderate POAG or exfoliation glaucoma. The study of 167 total patients (83 randomized for SLT and 84 for medication), 145 of whom completed 24 months of follow-up, found significant improvements in glaucoma-specific quality of life areas, as measured by the Glaucoma Outcomes Assessment Tool, in both groups. The SLT group saw greater “between-group” improvements in social well-being. IOP reduction, according to the study, was 18.6% higher in the medication group compared to SLT, but more people in the medication group had conjunctival hyperemia and eyelid erythema. The research is published in the British Journal of Ophthalmology.
  • A prospective, longitudinal, randomized study evaluated pain after PRK in patients receiving oral or topical NSAIDs. Patients administered topical ketorolac 0.4% every 12 hours or took oral naproxen sodium 220 mg every 12 hours for the first 72 hours postop. Peak pain was higher in the oral NSAID group, and pain scores on day 2 were significantly higher in the oral NSAID group as well. Overall, pain scores on day 2 and 3 postop were the highest in both groups compared to those reported on day 1, 4, and 5, according to the study authors. This study appears in Clinical Ophthalmology.
  • Researchers evaluated autologous serum tears to treat severe contact lens-induced limbal stem cell deficiency (LSCD) in 20 eyes of 14 consecutive patients in a prospective, uncontrolled, interventional case series published in the journal Cornea. The serum tears were taken for at least 2 weeks with follow-up for at least 2 months. The average duration of soft contact lens use was 15.6 years prior to the diagnosis of contact lens-induced LSCD, and all eyes had recurrent or persistent corneal epithelial defect, stromal scarring, opacity, and other findings pre-treatment. After what the study authors described as aggressive treatment with autologous serum tears, the signs and symptoms of LSCD at least stabilized in all eyes within 2 weeks. Signs and symptoms resolved completely in six eyes within this timeframe and resolved in nine eyes at 4 weeks and five eyes at 8 weeks. The study authors concluded that with early identification, aggressive treatment with autologous serum tears can reverse contact lens-induced LSCD.

Product news
  • Microdacyn60 Eye Care (Sonoma Pharmaceuticals) received the CE Mark. In the U.S., this product is marketed as Acuicyn Antimicrobial Eyelid and Eyelash Hygiene solution.

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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