EW Weekly, October 9, 2020

ASCRS mourns loss of Alan S. Crandall, MD
Alan S. Crandall, MD, former president of ASCRS, died on October 2 following a sudden illness. Dr. Crandall, in addition to serving as ASCRS president from 2009–2010, was an inaugural member of the ASCRS Glaucoma Clinical Committee formed in 1997 and was the inaugural recipient for the ASCRS Foundation Chang Humanitarian Award in 2018. Dr. Crandall, 73, was well known for his humanitarian work around the world. He spent 39 years at the John A. Moran Eye Center at the University of Utah in Salt Lake City, Utah, where he was the John E. and Marva M. Warnock Presidential Endowed Chair of Ophthalmology and Visual Sciences and served as Director of Moran’s glaucoma and cataract divisions. “Alan was a talented surgeon, dedicated educator, and passionate humanitarian caregiver who always put others in front of him,” said Terry Kim, MD, ASCRS President. “We will all miss his good friendship, sound advice, and countless stories about overcoming adversity in his personal and professional life that were always filled with humor and amazement. On behalf of the ASCRS family, I extend the deepest sympathies and condolences to his wife, Julie, his son, David, and all his family and friends.”

Data from Phase 2a, 2b clinical trials for treatment of Demodex blepharitis
Tarsus Pharmaceuticals released data from its two Phase 2 trials—Io, a Phase 2a single-arm, open-label trial, and Europa, a Phase 2b randomized, vehicle-controlled trial—for TP-03, a drop treatment for Demodex blepharitis designed to inhibit parasite-specific GABA-CI channels. According to the company’s press release, these studies provided findings consistent with previous Phase 2 trials. In the Phase 2a trial, 72% of patients on TP-03 had collarette cure and 78% saw mite eradication by day 42. In the Phase 2b trial, 80% of participants taking the drug had collarette cure (compared to 16% in the control group) and 73% had mite eradication (compared to 21% of controls) by day 42. At baseline, patients in these trials had at least 10 collarettes on their upper lids, mild to severe lid margin erythema, and at least 1.5 mites per lash on upper and lower lids. TP-03 was used twice a day in each eye for 42 days with no other treatment for blepharitis used during or 14 days prior to the study.

Preliminary results from Phase 1/2 trial of new treatment for primary Sjogren’s syndrome
TearSolutions announced completion and preliminary results from a Phase 1/2 study of Lacripep for primary Sjogren’s syndrome. According to a press release from the company, patients with Sjogren’s are deficient in lacritin, a protein that promotes basal tearing and has an impact on ocular surface health. Lacripep is the bioactive 19 amino acid fragment of lacritin and could thus be considered a replacement therapy that could restore homeostasis in the patients who are deficient, a press release posted to the company’s Facebook page stated. The trial, designed to test proof of concept and inform the design of further trials, resulted in a statistically significant reduction of inferior corneal staining as well as improvement in burning and stinging symptoms after 2 weeks. There were no serious adverse events related to taking Lacripep, according to the company.

Proof-of-concept for novel uveitis treatment
Proof-of-concept was achieved for TRS01 to treat active anterior non-infectious uveitis, according to a press release from Tarsius Pharma. The dose-ranging, randomized, double-masked, controlled Phase 1/2 trial included 16 participants who received a high or low dose of TRS01. According to the company, the high dose performed better than the low dose in clearing anterior chamber cells from baseline, reducing pain, and improving visual acuity.

Survey reveals patient perception and adherence to annual eye exams
A survey put out by Johnson & Johnson Vision found that while 80% of adults consider an eye exam as important to overall health and 68% thought healthy vision is related to quality of life and 61% safety, just 46% actually get an annual exam. According to the survey, 32% said they didn’t seek an annual exam because their vision hadn’t changed, 24% reported cost as a barrier, and 16% cited the pandemic. Only 47% of those surveyed thought eyesight deterioration could be prevented, and 46% considered vision loss a part of aging that they have no control over. Only 25% of participants knew that an eye exam could help detect diabetes, 10% cardiovascular disease, and 9% cancer. The survey was conducted in August 2020 and included more than 6,000 adults in the U.S., Japan, China, Germany, Russia, and the U.K.

20/Happy in 2020: ASCRS continues master class
This weekend ASCRS continues its “20/Happy in 2020: The ASCRS Master Class in Refractive Cataract Surgery,” which includes 18 AMA PRA Category 1 Credits as well as non-CME symposia that attendees can view live or watch later at their own pace. Every other week, live symposia will be aired on Saturdays, avoiding conflicts with clinic and OR time. At the conclusion of the multi-week master class, participants will receive a frameable certificate. A total of nine CME modules will cover topics including preoperative diagnostics, IOL calculations, IOL design, patient selection, education, and counseling, efficiency, and more, with discussion and expertise provided by a faculty of 80 surgeons from around the world. Sessions consist of lectures, audience Q&A, and live panel discussions. Attendees who don’t attend sessions live will have the opportunity to watch recorded versions. This Saturday, October 10 features module 5, a session on “Office Management—The Premium IOL Practice.” Learn more and register at https://ascrs.org/20happy.

Research highlights
  • A retrospective chart review evaluated 10-year results of using an intravitreal dexamethasone implant in patients with retinal vein occlusion (RVO), diabetic macular edema (DME), or uveitis. Three hundred and fifteen eyes that received a total of 1,216 dexamethasone implants for these indications over a period of 63.9±4.6 weeks were included in the review—90 had RVO, 59 central RVO, 62 DME, and 154 uveitis. BCVA improved significantly in those with RVO, central RVO, and DME. Those with uveitis who received dexamethasone implants did not see significant changes in BCVA overall, except those who were younger, had prior vitrectomy, and no history of glaucoma. IOP and patients needing glaucoma medications increased significantly. Cataract progression or having cataract surgery occurred in 58.8% of phakic eyes in the study; BCVA was significantly improved in the eyes that had surgery. The authors of the review published in Clinical Ophthalmology concluded that repeat dexamethasone implants for these indications can result in “significant anatomic benefits,” though visual benefits were only observed in RVO, DME, and select uveitis patients.
  • Nine patients with Fuchs endothelial corneal dystrophy had DSAEK in one eye and DMEK in the other and long-term corneal changes were compared in a study published in Cornea. OCT tomography, Scheimpflug imaging, and in vivo confocal microscopy through focusing was assessed with time between imaging and the DSAEK and DMEK procedures being 76±22 and 37±9 months, respectively. The investigators found a lower rate of higher order aberrations in the posterior cornea and lower total stromal backscattering (haze) in the DMEK group, which they concluded could contribute to superior visual outcomes of DMEK. DSAEK, they wrote, inherently has more stromal backscattering (haze) because of the stromal tissue that’s included.

Product news
  • John Weiss & Son launched the Merilas 810 shortpulse laser in the U.K.
  • Beovu (brolucizumab, Novartis) is now available in Canada to treat wet AMD.
  • TearRestore launched a new warm compress-like therapy in the form of reusable heat packs placed in a mask that still allows the patient to see.

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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