The EyeOP1 is a new medical device developed by EyeTechCare that uses therapeutic ultrasound to enable non-invasive treatment of refractory glaucoma.  The treatment can be administered on an outpatient basis and is performed under local anaesthaesia.  The patient simply lies down close to the command module and a disposable therapy device is placed on the globe of the eyeball.

An initial pilot study of the device demonstrated efficacy with results presented at ARVO in May 2011 (view detailed results here).

Presently, plans are underway for expanded studies at 20 medical centers around the world to further evaluate the effectiveness and the safety of the EYEOP1 device to treat glaucoma. One recently announced such study will be conducted at the Sam Rothberg Glaucoma Center of the Goldschleger Eye Institute at Sheba Medical Center in Israel (click here to learn more about the study at this location).

The primary objective of these studies is to demonstrate reduction of baseline IOP by more than 20% in participating patients after 12 months.

The Department of Ophthalmology at Triemli Hospital in Zurich is recruiting recipients for a study evaluating the efficacy and safety of Canakinumab (ILARIS®) to treat proliferative diabetic retinopathy secondary to type 1 and 2 diabetes.

Ten subjects will be enrolled to receive 150 mg Canakinumab (ILARIS®) by subcutaneous injection. Beginning on day 0, each subject will receive a subcutaneous injection of study drug every 8 weeks for 16 weeks, a total of 3 injections. All subjects will undergo regular follow-up assessments every 8 weeks through 24 weeks. Fluorescein angiography (FA) will be repeated every 8 weeks. The primary outcome being sought is the regression of retinal neovascularizations by week 24.

Key secondary outcomes sought include regression of diabetic macular edema, and change in best-corrected visual acuity.

Click here to learn more about this study.

Ophthalmology (May): There is a definite learning curve in femtosecond laser, and most of it has to do with the docking of the machine on the eye and resultant tilt. This can allow for incomplete rhexis with capsular tags (10.5%) which caused radial tears. Complications dropped precipitously after the first 100 cases. Care must be taken during the learning curve to watch for capsular tags and convert them to a curvilinear rhexis. Also, more difficult cortex removal was encountered with femtosecond.

Ophthalmology (May): Initial experience with femtosecond laser phaco resulted in two cases of dropped nucleus from hydrodissection. The surgeon concludes it is due to the very firm adherence of the capsulorhexis to the underlying lens, probably due to heat generation from the laser. To avoid this dreaded complication, one should hydrodissect  very carefully and slowly, after decompressing the anterior chamber by allowing egress of viscoelastic, and lifting the anterior capsule rim off the lens.

The NEI and the CATT Study Group have just released the two-year results of the CATT Study, comparing Avastin and Lucentis for the treatment of wet AMD. Basically, after two years, there is no significant difference either between the two drugs or the dosing methods studied – once monthly or as needed.

There were slightly more adverse events in those patients using Avastin than Lucentis, but the study’s authors concluded that the differences were not specifically associated with the use of Avastin, but more likely due to the age of the subjects in the study – a median age of 80 years.

For more details, please see the complete writeup at the following link.

Archives: researchers, using sophisticated 3D CT scanning, have demonstrated that eyebrow fat increases in volume in thyroid eye disease, just like the fat and soft tissue in the orbit. They suggest that eyebrow fat be examined more carefully and that standards and normals be established, so that eyebrow fat can be better addressed when surgical correction of thyroid eye disease is considered. Typically it is ignored as surgeons focus on the retrobulbar and orbital tissue that causes disfiguring exophthalmos (bulging out) of the eyeballs.

Archives: Sometimes, we can lower our guard once we surgically remove congenital cataract, but this article reminds us that glaucoma is very common in congenital cataract, and we need to be vigilant lest the glaucoma ruins our vision-restoring surgery. Researchers followed 114 infants with congenital glaucoma, and 9% developed glaucoma in the first year, whether they got an IOL or not. They suspect that 5 year data will show even more glaucoma. Nothing new here, really- just a wake-up call to remind us- doctor and parents- to keep a close eye on these kids

April Archives: Yet another use for the miracle drug! Filamentary keratitis is a very annoying disease where plugs of mucuc get stuck on the cornea and cause light sensitivity, pain and foreign body sensation. It is often found in ptosis, dry eye, SLK and prolonged patching. It can be hard to treat. Researchers had the idea that it is mostly due to a mechanical problem of the lid rubbing against the eye, so they figured that by injecting a little Botox in the eyelid muscle and thus weaken it, they can improve the situation. Indeed, 88% of 33 eyes improved. So if the usual treatment- debridement, artificial tear/ointment and Mucomyst drops don’t work, it’s worth a try. And you can use the rest of the bottle on your crows feet.

April Archives: It was inevitable. Doctors have documented dramatic loss of vision in a patient with Leber’s who sought stem cell treatment in China. Her vision went from about 20/80 to 20/600 (legal blindness), and baseline visual fields demonstrated severe loss after the treatment due to progressive optic atrophy. As stated many times on this site, people have to be wary of undergoing any kind of stem cell treatment that is not peer-reviewed by legitimate doctors/organizations- not only can one lose a lot of money, but it can also lead to permanent vision loss. One must consult a world-class eye institution for this kind of experimental treatment.

In a potential breakthrough, especially for those suffering from retinitis pigmentosa who have lost vision due to degenerated photoreceptors in their retina, scientists from the University College of London (UCL) Institute of Ophthalmology have managed to transfer immature (or progenitor) rod-photoreceptor cells – cells that are more developed than stem cells, but not quite mature rod cells – from healthy mice into those suffering from deficiencies in photoreceptors (blind mice) and, after a few weeks, have found that the transplanted cells appeared to be functioning almost as well as normal rod-photoreceptor cells and had formed the connections needed to transmit visual information to the brain.

To read more, please follow this link.

In late March, Bausch + Lomb and ISTA Pharmaceuticals, Inc. (Nasdaq: ISTA) announced that they have signed a definitive agreement under which Bausch + Lomb will acquire ISTA for $9.10 per share in cash, or a total of approximately $500 million.

Executives anticipate that Bausch + Lomb will help ISTA strengthen its pipeline and market its products by combining ISTA’s portfolio of non-steroidal, anti-inflammatory, allergy, and glaucoma drops (such as XIBROM and Bromday) to Bausch + Lomb’s portfolio of existing Rx ophthalmology and OTC eye health products. ISTA’s pipeline includes candidates in various stages of development to treat various ocular conditions including inflammation and pain, while Bausch + Lomb’s pipeline of pharmaceutical innovations include the first of a new class of ocular anti-inflammatory agents to come along in decades, and a promising approach to reducing intra-ocular pressure in patients with open-angle glaucoma or ocular hypertension.

Click here for the full press release.

Advanced Cell Technology (OTCBB: ACTC) recently announced that Bascom Palmer Eye Institute had received IRB approval to become the third U.S. clinical site for testing ACT’s human embryonic stem cell-derived retinal pigment epithelial cells in the treatment of dry age-related macular degeneration (dry AMD).

Bascom Palmer, one of the country’s premier eye institutes, joins UCLA’s Jules Stein Eye Institute and the Wills Eye Institute as the third U.S. site participating in the company’s Phase I/II clinical trials.

The Phase I/II trial is a prospective, open-label study designed to determine the safety and tolerability of the hESC-derived RPE cells following sub-retinal transplantation into patients with dry AMD. The trial will ultimately enroll 12 patients, with cohorts of three patients each in an ascending dosage format.

Click here to learn more about patient eligibility to participate in the trials.

To read more about the trials, please follow this link.

The results of a randomized, controlled clinical study involving 139 patients with Meibomian Gland Dysfunction (MGD), to be published in the April 2012 issue of Cornea, compared results for treatment of MGD with the LipiFlow® Thermal Pulsation System from TearScience versus warm compress.

Treatment with LipiFlow® provided sustained improvement, on average, in both signs and symptoms.

Further, the study demonstrated the clinical utility, safety and effectiveness of LipiFlow® in adult patients with MGD and dry eye symptoms.

Click here for further details on the study.

LipiFlow®, which applies heat and gentle pressure to a patient’s eyelid, is designed to liquefy and evacuate obstructions in Meibomian glands during a 12-minute in-office procedure. The goal of unblocking the glands is to allow them to resume their natural production of lipids required for a healthy tear film. LipiFlow®’s second generation product allows physicians to treat two eyes simultaneously.

I have a macular hole.

Large full thickness, 700 microns, extensive surrounding subretinal fluid, yellow deposits on RPE within hole, mild epiretinal membrane.

My question is would you recommend gas or silicone oil to treat the macular hole?

Family member has lattice dystrophy in both eyes.  17 years ago both eyes had corneal transplants (albeit not a same time).  2 years ago right eye had another corneal transplant again.  1 month ago left eye cornea transplant again.

Right eye has developed cataracts to the point of cloudy vision.  Left eye has a cataract also, but as the transplant surgery was only 3 weeks or so ago and so that eye is still healing and vision can’t be measured.

My question is:  can cataract surgery be performed after someone has had corneal transplants?  If so, what are the possible negatives in this situation? Will it prevent in any way future corneal transplants as they become necessary? Let me add that after right eye surgery the vision was crystal clear with a contact lens – but recently vision quickly degraded due to aggressive cataract.

We are advised by ophthalmologist that this aggressive and fast growing cataract issue was caused by the steroids/anti rejection drops.

Ophthalmology:  Researchers compared adjustable sutures to non-adustable in 404 cases. They found that in primary surgery in adults with exotropia, there was a higher success rate with adjustable (80 vs 69%), but no difference in esotropia or vertical muscles. These single-surgeon studies are hard to apply to the real world, as his technique may very well be different than that of many surgeons, and therefore surgeons will continue to do what works best for them.

Ophthalmology: Grafts using the DMEK technique (only transplanting Descemet’s membrane) had a lower graft failure rate (1% vs. 12% at 2 years) than DSEK (which includes a little stroma). At this rate, and with articles showing that eyes can clear up with no graft at all ( see last month’s post here at EyeDocNews), we’ll be grafting nothing but air in no time. Too bad these techniques are so difficult to learn, but I am sure, just like with phaco, the technology will get better and make things easier.

Ophthalmology: The Boston Ocular Surface Prosthesis is like a big, sophisticated contact lens. It can save the conjunctival fornix,  keep the cornea lubricated and be used a drug reservoir for antibiotic delivery to the cornea in severe cases of thermal injury, and thus it can truly save eyes that would otherwise would quickly go blind. It really ought to be available in every burn unit, and it’s easy to insert and remove.

Ophthalmology: Ultra-high OCT gives outrageously detailed view of tissue- it’s like looking at a histology slide. Researchers were able to very accurately distinguish pterygia from surface squamous neoplasia using this modality, which is critical as the latter requires a far different treatment approach. Too bad this gizmo is not widely available, but it would certainly come in handy before surgery if one has atypical pterygia.

Ophthalmology: As we know from the OHTS, the central corneal thickness (CCT) has a dramatic effect on IOP measurement and risk of glaucoma, and checking the CCT is essential in managing glaucoma. Some researchers have tried to create nomograms , where one can add or subtract from the IOP measured, in order to get a “true” IOP and thus a better idea of the risk. Wrong. Even with this adjustment, researchers were unable to better predict glaucoma. It seems the CCT exerts an independent factor. In my practice, I don’t use these nomograms- I simply am more aggressive when I see a thin CCT.