EW Weekly, November 20, 2020

Two BAK-preserved eye drops inactivate SARS-CoV-2
Bausch Health and Bausch + Lomb announced research that shows two of its eye drops preserved with benzalkonium chloride (BAK)—LUMIFY (brimonidine tartrate ophthalmic solution 0.025%) and BESIVANCE (besifloxacin ophthalmic suspension 0.6%)—appeared to inactivate SARS-CoV-2 in vitro. Leadership stated in a company press release that the clinical relevance of these findings is not yet known, but the company plans to continue its review of the data and determine next steps. These findings were observed in a study that researched the antiviral effect of the eye drops against SARS-CoV-2, which causes COVID-19, in a Vero E6 host cell. Dosing in the study was representative with typical instructions for use with the drops; the virus was inactivated at all contact times, according to the press release. At this point, the company stated that these drops should be used only for approved indications and according to their directions for use.

Promising results from supraciliary MIGS device
iSTAR Medical announced positive results from the European clinical trial of its MINIject MIGS device. The 1-year results of the STAR-II trial, which enrolled 29 POAG patients, saw a 38% reduction in IOP (mean 15.1 mm Hg) from baseline with 45% of patients not requiring any IOP-lowering medications during this timeframe as well (mean baseline medications was 2.9). The company’s press release stated that in the patients who were medication free, IOP was reduced 46% to a mean of 13.1 mm Hg at 1 year. No significant adverse events or corneal concerns were noted. Follow-up of these patients will continue for an additional year. The company’s press release noted that these results are consistent with the STAR-I data, which enrolled 25 patients and has follow-up of 2 years and was recently published in the British Journal of Ophthalmology.

New data from Phase 2 clinical trial for dry eye nasal spray
Oyster Point Pharma presented new data from its Phase 2 clinical trial for OC-01 (varenicline), a nasal spray to treat the signs and symptoms of dry eye. According to a press release from the company, the research found that one dose of the spray significantly reduced goblet cell area and perimeter, as seen via in vivo confocal microscopy, compared to placebo. This, the company stated, indicates goblet cell degranulation to release mucus in the treatment group. The study included 18 patients with dry eye disease.

Real-world data from cataract surgery intraocular anti-inflammatory injection
EyePoint Pharmaceuticals announced real-world retrospective data from a multicenter study of DEXYCU, dexamethasone intraocular suspension injected after cataract surgery. Of the 641 eyes included in the study, 40% had complete anterior chamber cell clearing by postop day 1, 65.1% by day 8, 85% by day 14, and 89.7% by day 30. Patients with no anterior chamber flare were 78.5%, 93.3%, 97.8%, and 97.2% at postoperative day 1, 8, 14, and 30, respectively. Target BCVA was achieved in 97% of eyes, according to the company, and mean IOP postop day 1 was 18.6 mm Hg, decreasing through the 30-day postop period.

ASCRS launches Journal Club
Join ASCRS’ interactive Journal Club on Tuesday, December 8 from 9:00–10:00 p.m. ET for the inaugural session of a monthly series in which a panel of experts will discuss two pre-selected manuscripts from the Journal of Cataract & Refractive Surgery. Nick Mamalis, MD, and Leela Raju, MD, will co-moderate these free, CME sessions, open to all ASCRS members. For more information, go to ascrs.org/clinical-education/journal-club.

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, November 21 features module 8, a session on “Real World Case Studies in Patient IOL Selection and Management.” Learn more and register at https://ascrs.org/20happy.

Research highlights
  • A recent paper published in the journal Eye discussed “mask-associated dry eye” (MADE) and a specific case of postoperative MADE. Overall, the authors described MADE as a form of dry eye that occurs due to ill-fitting masks that leak air. They reported a patient who had uncomplicated cataract surgery. Initially postop the patient was pleased with her vision, but the authors noted that hours later she experienced blurred vision and discomfort. They observed UCVA of counting fingers, corneal haze, and superficial staining. There was no epithelial defect, wound leak, IOP was normal, and there was no intraocular inflammation. The patient was advised to continue postop drops per recommendations and not use her face mask as much as possible. The patient’s vision was restored within 2 days and no dry eye was noted at postop week 1. The authors think this is the first published reported case of visual loss due to MADE after cataract surgery. They think the patient’s mask, which was loose at the nose, directed breath onto the still anesthetized ocular surface, creating a type of exposure keratopathy. They recommended taping the top of the face mask pre- and postop to restrict air that could be directed up toward the eye postop.
  • Risk of developing high myopia in adulthood based on age of myopia onset was evaluated using Chinese dataset with 12 years of follow-up. The research is based on an ongoing, population-based prospective cohort twin study that began in 2006. The twins were followed up until 17 years or older, and 443 who developed myopia were included in this study. The mean age of myopia onset in the group was 11.7 years old and 12.2% of the group developed what was considered high myopia (–6 D or greater) by adulthood. The researchers found that the younger the age of myopia onset, the greater chance of developing high myopia. They reported that each year of delayed onset of myopia reduced the likelihood of developing high myopia, emphasizing the importance of myopia prevention. The research is published in JAMA Ophthalmology.

Product news
    The European Medicines Agency Committee for Medicinal Products for Human Use recommended approval for the marketing authorization application of Aerie Pharmaceutical’s Roclanda (netarsudil and latanoprost ophthalmic solution, 0.02%/0.005%). This recommendation goes to the European Commission for a final decision, which is expected within 2 months. Roclanda is already FDA approved and marketed as Rocklatan in the U.S.
  • Lumenis launched Digital Duet, described by the company as the first digital SLT-YAG system on the market.
  • Topcon launched Chronos Automated Binocular Refraction System with SightPilot guided refraction software.
  • EyeMD EMR Healthcare Systems unveiled its EyeMD EMR 2.0, an all-in-one EMR, PM, and PACS system.
  • Alcon launched the AcrySof IQ Vivity presbyopia-correcting IOL in Canada.

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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