SLT vs. ALT

SLT is equivalent to ALT in terms of IOP lowering at one year. Both are safe and effective procedures for patients with open-angle glaucoma.

SOURCE: Damji KF, Bovell AM, Hodge WG, et al. Selective laser trabeculoplasty versus argon laser trabeculoplasty: results from a one-year randomized clinical trial. Br J Ophthalmol 2006;90(12):1490-4.

New Optometry Schools?

Taken from Dr. Art Epstein's editorial in "Optometric Physician" Volume 6, #46, November 20, 2006:

"At least two and possibly three new optometry schools will be opening in the not-too-distant future. One school is in Pomona, CA, the second in Texas and the third in Arizona. I have heard but not confirmed that these programs are fully funded. All of them are affiliated with osteopathy programs."

RETINAL STEM CELLS RECOVER VISION

MacLaren RE, Pearson RA, MacNeil A, et al. Retinal repair by transplantation of photoreceptor precursors. Nature. 2006 Nov 9;444(7116):203-7.

For the first time, researchers have successfully transplanted retinal stem cells into mice with photoreceptor loss, allowing the mice to regain some vision.

“We worked on the theory that cells at a later stage of development might have a higher probability of success upon transplantation. And we show here that cells taken from when the retina is about to be formed, can be successfully transplanted and integrated into the adult or degenerating retina,” says researcher Robin Ali, Ph.D., of the Institute of Ophthalmology at University College London. The new cells not only survived, but also developed into rod photoreceptors and connected to neurons, providing visual signals to the brain. Improvements in pupillary and nervous response to light stimuli were recorded. To attain these results in the human retina, rather than use fetal cells, researchers point to a cluster of cells on the margin of the adult retina which have stem cell-like properties—in other words, they are capable of self-renewal. These could be harvested through minor surgery and grown in the lab to become photoreceptor precursors before being re-implanted on the retina,” Dr. Ali says.The researchers say that this transplant could have positive effects against age-related macular degeneration or retinitis pigmentosa, but they warn that any human application of this treatment is at least five years away.

CATARACT SURGERY AND MACULAR DEGENERATION

Current Opinion in Ophthalmology - Abstract: Volume 18(1) February 2007 p 9-12 Is cataract surgery a risk factor for progression of macular degeneration?.


There is a suggestion of increased risk or progression of age-related macular degeneration after cataract surgery, which is related to the increased exposure of the retina to short-wavelength light.
Recent findings: Cell culture and animal work has described retinal and retinal pigment epithelium phototoxicity on acute light exposure. Clinical studies suggest that the use of short-wavelength-blocking (blue-blocker) intraocular lenses can help but may also affect visual function and circadian rhythm.
Summary: Evidence to date fails to prove conclusively that light alone or cataract surgery can induce or cause the progression of age-related macular degeneration. A randomized clinical study of the use of blue-blocking lenses to prove or disprove the ability of these intraocular lenses to help in preventing progression of age-related macular degeneration is needed.

STATUS OF TORIC INTRAOCULAR LENSES

Current Opinion in Ophthalmology - Abstract: Volume 18(1) February 2007 p 58-61 Status of toric intraocular lenses.

These lenses can be used as an alternative or adjunct to corneal astigmatic incisions for correcting preexisting astigmatism in patients with cataracts. They are a particularly attractive option in those cases where limbal-relaxing incisions are not powerful or predictable enough.

In this study, the Acrysof Toric intraocular lenses provided excellent visual outcomes and exhibited excellent rotational stability. The average lens rotation was less than 4[degrees] from the lens' initial placement at 6 months after surgery.

Summary: Toric intraocular lenses provide excellent vision for astigmatic cataract patients, and new designs are significantly improving visual acuity by minimizing the risk of rotation.

SYSTANE LIQUIGEL RECALLED

Alcon Recalls Preservative-Free Dry Eye Therapy
On behalf of Alcon, the Academy is alerting you to a voluntarily recall of Alcon’s Systane Free Liquid Gel eye drops. The recall follows reports from 11 consumers that the preservative-free liquid gel contained mold.
Alcon reports that due to the characteristics of these molds, the development of an infection is unlikely. Alcon has received no reports of fungal infections associated with the 11 reports. The company is voluntarily recalling Systane Free Liquid Gel because eye drops that become contaminated after opening the bottle may cause eye infections.
You should immediately stop using and dispensing Systane Free Liquid Gel. Shortly, you will receive in the mail recall information from a company by the name of Stericycle, Inc. Follow the instructions and return all trade sizes and samples of Systane Free Liquid Gel to the address provided. Alcon has written a letter providing more details.
No other formulations of Systane lubricant eye drops are included in this recall. Alcon has determined that the cause of the problem is the specific formulation of Systane Free Liquid Gel, and is not the result of any manufacturing processes.
If you are contacted by a patient, request that they immediately stop using Systane Free Liquid Gel and recommend they call toll free (866) 608-3936 for instructions regarding returning the product and receiving a free bottle of the original formulation of Systane lubricating eye drops.
Visit the Systane Health Care Professionals Web site for more information, including a press release issued by Alcon.

INTACS for post LASIK ectasia

I still think the best treatment for post-LASIK ectasia is to treat your greediness first. Don't refer high myopes for LASIK. Consider ICL instead.

OSN SuperSite - Intacs stabilized ectasia in post-LASIK corneas for 5 years

Aritificial Cornea Update

Review of Optometry