EyeWorld Today is the official daily of the ASCRS Symposium & Congress. Each issue provides comprehensive coverage editorial coverage of meeting presentations, events, and breaking news
Issue link: https://daily.eyeworld.org/i/124055
Meeting Reporter A closer look at the latest in MIGS by Vanessa Caceres EyeWorld Contributing Writer www.AcrySofReSTOR.com CAUTION: Federal (USA) law restricts this device to the sale by or on the order of a physician. INDICATIONS: The AcrySof® IQ ReSTOR® Posterior Chamber Intraocular Lens (IOL) is intended for primary implantation for the visual correction of aphakia secondary to removal of a cataractous lens in adult patients with and without presbyopia, who desire near, intermediate and distance vision with increased spectacle independence. The lens is intended to be placed in the capsular bag. WARNING/PRECAUTION: Careful preoperative evaluation and sound clinical judgment should be used by the surgeon to decide the risk/ benefit ratio before implanting a lens in a patient with any of the conditions described in the Directions for Use labeling. Physicians should target emmetropia, and ensure that IOL centration is achieved. Care should be taken to remove viscoelastic from the eye at the close of surgery. Some patients may experience visual disturbances and/or discomfort due to multifocality, especially under dim light conditions. Clinical studies with the AcrySof® ReSTOR® lens indicated that posterior capsule opacification (PCO), when present, developed earlier into clinically significant PCO. Prior to surgery, physicians should provide prospective patients with a copy of the Patient Information Brochure available from Alcon for this product informing them of possible risks and benefits associated with the AcrySof® IQ ReSTOR® IOLs. Studies have shown that color vision discrimination is not adversely affected in individuals with the AcrySof® Natural IOL and normal color vision. The effect on vision of the AcrySof® Natural IOL in subjects with hereditary color vision defects and acquired color vision defects secondary to ocular disease (e.g., glaucoma, diabetic retinopathy, chronic uveitis, and other retinal or optic nerve diseases) has not been studied. Do not resterilize; do not store over 45° C; use only sterile irrigating solutions such as BSS® or BSS PLUS® Sterile Intraocular Irrigating Solutions. ATTENTION: Reference the Directions for Use labeling for a complete listing of indications, warnings and precautions. © 2013 Novartis 1/13 RES12192JAD A Monday morning paper session focused on microinvasive glaucoma surgery (MIGS)—thought of as the hot topic in glaucoma right now. "This is where the action is in surgical glaucoma today," said Jason Bacharach, MD, San Francisco. Presenters Brian Flowers, MD, Fort Worth, Texas, and Steven Vold, MD, Fayetteville, Ark., focused on results from trials with the CyPass Micro-Stent (Transcend Medical Menlo Park, Calif.). The CyPass is a microstent undergoing clinical trials in the United States right now with the COMPASS trial. It has been available in Europe for clinical assessment since 2009, according to the company website. Dr. Flowers focused on results from the DUETTE trial in 43 patients, noting that 12-month results showed better IOP control and lower medication burden. Dr. Vold noted that the COMPASS trial is showing sustained IOP control and reduced medication use for up to two years. Dr. Bacharach presented results from a trial with the third-generation iStent (Glaukos, Laguna Hills, Calif.). The stent is under investigation in a trial with one group of patients having cataract surgery and another group that is not having cataract surgery. The trial will have 500 subjects total, but so far there is preliminary clinical data from 11 subjects. All eyes thus far have a best-corrected visual acuity of less than 20/32 at six months. The stent also shows a reduction in IOP and medication use at one year, Dr. Bacharach said. Another paper from Jacky W.Y. Lee, MD, Hong Kong, focused on corneal changes after selective laser trabeculoplasty (SLT). The research he presented found that there is an average 1% decrease in central corneal thickness at one week, which goes back to baseline at one month. The mean endothelial cell count decreases by 4.5% after SLT but regains baseline levels at one month. "This is one of the first and largest series to show transient changes in endothelial cell counts and central corneal thickness after a single SLT session," Dr. Lee said. Julie Schallhorn, MD, San Francisco, reported on IOP changes after laser vision correction. Looking at data from 91,024 patients— 174,666 eyes—researchers found an IOP decrease of 3.1 mm Hg on average for LASIK and 2.9 mm Hg on average for PRK at one week. The IOP in the PRK patients seemed to stabilize after one week, but the LASIK patients' IOP did not stabilize until the one-month mark. This is believed to be due to the effect of the lamellar flap, Dr. Schallhorn said. Dr. Schallhorn's paper was named Best Paper of Session. Other papers at the MIGS session focused on further research into ab interno stents, IOP after canaloplasty after mitomycin-C, and related topics. EW Editors' note: Dr. Bacharach has financial interests with Allergan (Irvine, Calif.), Alcon (Fort Worth Texas), Glaukos, and other ophthalmic companies. Dr. Flowers has financial interests with Alcon, iScience (Menlo Park, Calif.), Merck (Whitehouse Station, N.J.), and Transcend Medical (Menlo Park, Calif.). Dr. Lee has financial interests with Abbott Medical Optics (Santa Ana, Calif.), Alcon, and Allergan. Dr. Schallhorn has no financial interests related to her comments. Dr. Vold has financial interests with Alcon, Allergan, Glaukos, and other ophthalmic companies.