Vol. VI, No. 22
May 30, 2007
New Journal Studies
Preoperative NSAIDs can prevent cystoid macular edema after routine cataract surgery
This prospective, randomized study of 179 eyes finds that no patient treated with topical indomethacin before and after surgery had angiographic CME, compared to 15 percent in the group treated only after surgery and 32 percent of controls. BCVA at three months was also significantly higher in the group treated before and after surgery. Journal of Cataract & Refractive Surgery, May 2007 http://www.jcrsjournal.org/article/PIIS0886335007003148/abstract
Suturing clear corneal incisions may reduce risk of post-cataract surgery endophthalmitis
This retrospective review of 815 consecutive surgeries identified five cases of infection in the un-sutured group and none in the sutured group. Patients who began antibiotic drops within 24 hours of surgery and those who received 5 percent povidone iodine drops after wound closure had a lower incidence of endophthalmitis. British Journal of Ophthalmology, June 2007 http://bjo.bmj.com/cgi/content/abstract/91/6/728
MMC shows promise in treating ocular surface squamous neoplasia
A prospective, randomized trial finds that this sunlight-related disease resolved in 24 of 26 patients treated with mitomycin C, compared with none in the control group. There were no complications at six weeks of followup. Ophthalmology, May 2007 http://www.ophsource.org/periodicals/ophtha/article/PIIS0161642006013303/abstract
Punctal plugs may be a viable alternative to refractive surgery in some patients
This small retrospective study of patients with low refractive errors who presented for initial refractive surgery or re-treatment surgery finds that after punctal plugs were inserted, 86 percent gained at least one line of Snellen UCVA, while 52 percent gained more than two lines. As a result, 92 percent declined to pursue further refractive surgery. Journal of Refractive Surgery, May 2007 http://www.journalofrefractivesurgery.com/showAbst.asp?thing=15190
Patients with exfoliative glaucoma may achieve better IOP control with bimatoprost This cross-over study of 129 patients finds that significantly more patients treated with bimatoprost reached a target diurnal IOP less than 17 mmHg, compared with latanoprost- treated eyes (45 percent vs. 28 percent), and significantly fewer bimatoprost-treated patients were non-responders. More bimatoprost-treated patients reported at least one adverse event. British Journal of Ophthalmology, June 2007 http://bjo.bmj.com/cgi/content/abstract/91/6/757
Epiretinal prosthesis can help patients with retinitis pigmentosa perform simple visual tasks
Three blind patients with light perception or no light perception performed significantly better than chance in 83 percent of tests. The prototype retinal prosthesis was combined with an external video source. American Journal of Ophthalmology, May 2007 http://www.ajo.com/article/PIIS0002939407000670/abstract
Looking for answers to the second outbreak of an extremely rare eye infection within a year
First it was Bausch & Lomb’s ReNu products, linked to fungal keratitis last spring. Now the CDC reports that AMO’s Complete MoisturePlus solution is associated with Acanthamoeba keratitis. Why? The incidence of Acanthamoeba and fungal keratitis has been on the rise since 2004. The etiology is under investigation, but there are theories about the inadequate antimicrobial efficacy of multipurpose solutions: Elmer Tu, MD, believes it may be tied to a reduced use of chlorine to decontaminate public water supplies in response to a federal environmental mandate. The American Journal of Ophthalmology, plans to rush his study into publication on the Internet some time next week. Late last year, R. Doyle Stulting, MD informed the U.S. Food and Drug Administration (FDA) that its study of multipurpose solutions may not be adequate to predict their performance under conditions of actual use. Dr. Stulting collected the contact lens cases, lenses and solution containers from seven patients with confirmed or probable Fusarium keratitis referred to him last spring. He found that while the Fusarium isolates were inhibited by fresh solution in original solution containers and contact lens cases, they survived in the drying films of multipurpose solution.His research was published in the Dec. 6 issue of Cornea. http://online.wsj.com/article/SB118048287133617875.html?mod=djemHL
Specialty News & Views
First study to show link between two gene variants and progression to late-stage AMD
While other studies have found CFH Y402H and LOC387715 A69S are associated with AMD, this latest study links them to an increased risk of progressing to advanced disease. Presence of both gene variants combined with risk factors such as smoking and weight increased the risk of progression 19-fold. http://aao.org/education/news/sit/retina/0115.cfm
Positive early results for VEGF trap for wet AMD
Regeneron Pharmaceuticals, Inc. presented Phase 2 results evaluating the VEGF Trap- Eye at the 2007 Annual Meeting of the Association for Research in Vision and Ophthalmology. The VEGF Trap, a type of VEGF blocker, produced a statistically significant reduction in retinal thickness at 12 weeks. http://aao.org/education/news/sit/retina/0114.cfm
Academy News
2007 Annual Meeting program is now online
You can begin searching courses, symposia, spotlight sessions, and offerings with Breakfasts with the Experts. This year’s search tool offers a new category, “special interest,” allowing you to search for new courses or those endorsed by committees such as the Young Ophthalmologists and Academy Seniors. The Subspecialty Day Online Program is also available to search by meeting, speaker or keyword.
AM Online Program: http://www.aao.org/meetings/annual_meeting/program/onlineprogram07.cfm
Subspecialty Day Online Program: http://www.aao.org/meetings/annual_meeting/program/subday07.cfm
Academy now taking advance orders for the 2007-2008 Basic and Clinical Science Course
Revised annually, this year’s major revisions include: Section 4: Ophthalmic Pathology and Intraocular Tumors; Section 7: Orbit, Eyelids, and Lacrimal System and Section 9: Intraocular Inflammation and Uveitis. https://secure3.aao.org/store/common/index.cfm?mode=kilwwvgz&subsystem=ORD&pr imary_id=0280957
Send your patients to a trusted online education resource to learn more about the recent Acanthamoeba keratitis outbreak
The Academy Foundation’s new Web site now includes information about the infection and instructions on proper contact lens care. AMO has recalled its Complete MoisturePlus solution in response to a CDC investigation linking it to this rare eye infection. http://www.eyecareamerica.org/eyecare/news/keratitis_alert_may07.cfm
Physician resources on Acanthamoeba keratitis can be found on the Academy Web site
* Bacterial Keratitis PPP http://www.aao.org/education/guidelines/ppp/bacterial_keratitis.cfm
* EyeNet Magazaine article, “How to diagnose and treat Acanthamoeba keratitis” http://www.aao.org/news/eyenet/pearls/pearls_nov.htm
* Refractive Errors PPP: guidelines for contact lens hygiene and care (PDF) http://aao.org/education/guidelines/ppp/loader.cfm?url=/commonspot/security/getfile.cfm &PageID=1290
* Updated guidelines for contact lens care from the Quality of Care and Knowledge Base Development Secretariat. It advises rubbing lenses to clean them, even with “no rub” solutions. http://www.aao.org/education/statements/alerts/lens_guidelines.cfm
Industry News
AMO recalls its Complete MoisturePlus solution in response to a CDC investigation linking it to Acanthamoeba keratitis
The CDC determined that the risk of developing this infection was at least seven times greater for those consumers who used Complete MoisturePlus solution versus those who did not. There is no evidence yet that the product itself is contaminated. http://www.amo-inc.com/download/pr-cmp-ecp.pdf
How to report cases of Acanthamoeba keratitis to the FDA
Report cases that you treated from 2004 to 2007 to MedWatch, the FDA's voluntary reporting program: online at www.fda.gov/medwatch/report.htm; by phone at 800.332.1088; by fax at 800.332.0178 or mail at MedWatch, Food and Drug Administration, 5600 Fishers Lane, Rockville, MD, 20852-9787. Additional information about Acanthamoeba infection is available from the CDC Web site.
No headline link: link for “CDC Web site” http://www.cdc.gov/ncidod/dpd/parasites/acanthamoeba/index.htm
Advanced Medical Optics confirms interest in acquiring Bausch & Lomb
AMO issued a statement last week confirming reports that it is interested in entering Bausch & Lomb's "go shop" process with the intention of buying the company by making a better offer than Warburg Pincus, a private equity firm which earlier this month offered a deal worth $4.5 billion. http://phx.corporate-ir.net/phoenix.zhtml?c=131956&p=irol- newsArticle&ID=1006652&highlight=
