EW Weekly, December 4, 2020

Survey: Public lacks understanding of cataract treatment options
A survey conducted by Johnson & Johnson Vision found that there is still a lack of understanding among the general public when it comes to cataract treatment options. Most people surveyed (70%) understood what cataracts were and that surgery was the most common treatment (85%), according to the company’s news release. Only 30% of those surveyed said they would be very likely to have cataract surgery. According to the J&J press release, the number one reason was fear. Nearly 30% of these people reported that they were afraid of the procedure; 28% had concerns about efficacy; and 22% lacked an understanding about the procedure itself. According to company leadership, the survey reveals a need for increased education and reassurance of the safety and efficacy of cataract surgery, one of the most common outpatient procedures in the world. In addition to this survey, recently released statistics from the Global Burden of Disease study found no significant reduction in the number of people with treatable vision loss since 2010. A press release from the Moran Eye Center stated that there was a 15.4% reduction in avoidable blindness since 2010 after adjusting for aging populations, but no reduction for moderate or severe vision loss.

Proof-of-concept study for epigenetic reprogramming in the eye
Research published in the journal Nature showed success at “resetting the aging clock” and reversing glaucoma-like vision loss in animals, according to a press release from Harvard Medical School and Massachusetts Eye and Ear Infirmary. The press release stated that this proof-of-concept study involved epigenetic reprogramming in the retina. It was conducted by using an AAV vehicle to introduce three genes associated with embryonic development into mouse retinas. In the mice, the researchers observed nerve regeneration in damaged optic nerves, reversal of vision loss in the glaucoma model, and vision loss reversal in aging mice without glaucoma. According to the press release, the researchers emphasize the need for replication in future studies, including in different animal models.

Second Phase 3 study launched for first-in-class dry eye drug
Bausch Health Companies, the parent company of Bausch + Lomb, began a second Phase 3 study evaluating NOV03 perfluorohexyloctane, described by the company as a first-in-class investigational drug for dry eye disease associated with meibomian gland dysfunction. NOV03, which has a novel mechanism according to the company, is a water-free, preservative-free solution with EyeSol technology from the company Novaliq. At this point, the study has reached 85% of its enrollment goal, the company’s press release stated.

Pre-IND meeting for multi-dose latanoprost formulation
TearClear announced a successful pre-IND meeting with the FDA for its preservative-free, multi-dose, proprietary latanoprost formulation. The meeting included clinical study design. According to the company’s press release, TearClear plans to file its IND by mid-2021 via the 505(b)(2) NDA pathway. TearClear seeks to improve how topical medications are delivered by capturing preservatives before they are dropped on the ocular surface.

Company acquires investigational gene therapy
Janssen Pharmaceuticals acquired the rights to Hemera Bioscience’s HMR59 gene therapy. This intravitreal-injected gene therapy is being investigated as a possible treatment for geographic atrophy. According to the company’s news release, HMR59 is designed to help retina cells make CD59, a protein that helps protect the retina from damage that is often low in patients with AMD, in order to prevent further damage and preserve vision. At this point a Phase 1 study for the gene therapy is complete and a second Phase 1 study looking at HMR59 in patients with wet AMD is in progress.

CMS released CY 2021 MPFS Final Rule
According to an ASCRS ASOA Government Relations Alert, CMS released its CY 2021 MPFS Final Rule on Tuesday. The rule set the 2021 conversion factor at $32.41, a decrease of $3.68 from CY2020. The rule did not include substantial changes to mitigate pending payment cuts associated with changes to E/M codes. It included 2021 Quality Payment Program proposals and expanded telehealth benefits permanently, beyond the public health emergency instituted with the COVID-19 pandemic. ASCRS is continuing its work with the surgical and specialty community to urge Congress to implement a three-point plan to address E/M related payment cuts before the end of the year. This plan includes adjusting the E/M portion of the 10- and 90-day global codes, halting implementation of the G2211 add-on code, formerly GPC1X, and holding physicians harmless for additional cuts caused by new E/M policies. For more information, read the full alert.

ASCRS launches Journal Club
ASCRS will continue its Grand Rounds, a virtual CME event for ASCRS members, on December 16 at 8:00 p.m. EST with the Cullen Eye Institute at Baylor College of Medicine. The moderators, Terry Kim, MD, and Sumitra Khandelwal, MD, along with Baylor faculty will cover case presentations, offer clinical pearls, and host a panel discussion. This CME offering is approved for 1.0 AMA PRA Category 1 Credit.

Introducing ASCRS’ new podcast
ASCRS launched its new podcast—Ophthalmology Quicksand Chronicles with Nicole Fram, MD, and Elizabeth Yeu, MD—last month. Each episode of the podcast will include discussion of cases that did not go as planned—the “quicksand” moments—with the hosts and guests reflecting on lessons learned from their experience. In the first episode, Iqbal “Ike” Ahmed, MD, shared one of his quicksand cases with a nanophthalmic eye and shared how this experience helped him grow and improve as a surgeon. Listen to this and upcoming podcasts on YouTube or by subscribing it on Spotify, Apple, Google, Stitcher or TuneIn by searching “Ophthalmology Quicksand Chronicles.”

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, December 5 features module 9, the last session of the Master Class on “What’s Ahead in 2021 and Beyond?” Learn more and register at https://ascrs.org/20happy.

Research highlights
  • For the first time, researchers from the University of Connecticut have isolated and studied, using single-cell RNA sequence analysis, non-myelinating corneal Schwann cells that ensheathe stromal axons. According to an article published by the university’s news website, gaining a better understanding of these cells could further knowledge of corneal pain, healing, and nerve regeneration. Researchers in the article described how a better understanding of gene expression of these cells, even within different areas of the cornea, could help advance treatments for chronic dry eye and post-LASIK dry eye. The study is published in the Journal of Neuroscience Research.
  • A single-practice study evaluated endothelial cell density and cell morphology after phacoemulsification cataract surgery and Kahook Dual Blade (New World Medical) or phaco and iStent (Glaukos). The study included 21 patients who had phaco+KDB in one eye and phaco+iStent in the other. Both procedures were associated with postop endothelial cell loss, according to the authors, but the eye that received iStent saw more loss (–9% change from baseline compared to –3.4% change from baseline in the Kahook eye). The study authors wrote that the clinical findings of this research are unknown and future studies that look at the long-term effects of glaucoma procedures on corneal health and endothelial cell density are merited. The research is published in the journal Clinical Ophthalmology.

Product news
Alcon launched Systane Ultra Hydration Lubricant Eye Drops Preservative Free 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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