Risk of Laser Capsulotomy Higher in Multifocal IOL

Aurora, CO – A study found that implantation of multifocal IOLs corresponds with a higher incidence of laser capsulotomy than it does with a similar monofocal lens. According to the author of the study, laser capsulotomy occurs three times more with implantation of multifocal IOLs than it does with implantation of monofocal IOLs.

The poor vision quality occurs from an interaction between the multifocal optics and the posterior capsule opacification. It does not seem to induce more posterior capsule opacification than the monofocal IOL.

Analysis

The study compared posterior capsulotomy rates for patients that were implanted with the AcrySof SN60WF one-piece monofocal IOL, or the AcrySof ReSTOR SN60D3 or SA60D3 multifocal IOL. Both these later multifocal IOLs have been discontinued in the US and replaced with another aspheric model. The study included 142 eyes implanted with the multifocal IOL, and 275 eyes implanted with the monofocal lens.

The results showed that 22 eyes in the multifocal IOL group (15.49%) and 16 eyes (5.82%) in the monofocal group underwent capsulotomy. In each case, the capsulotomy occurred less than a year post-op.

According to the study’s author, “What we hypothesize is that multifocal IOLs already have a decrease in contrast sensitivity and you get an additive effect when you have posterior capsule opacification. So, patients are more likely to become more symptomatic with minimal opacification with a ReSTOR or a multifocal lens than they would with the same degree of opacification if it’s not a multifocal lens.”

Laser capsulotomy results in blurred reading vision and poor overall vision quality.

If you would like to learn more about this or other side effects of laser vision correction, please visit eyes.com to find an experienced eye doctor in your area.

Glaucoma Treatment: A New Hope

Southampton, England – Professor of ophthalmology at Southampton General Hospital, Andrew Lotery, and a team of international eye specialists, have discovered a gene mutation they say leads to glaucoma. This breakthrough will help hundreds of thousands of people across the globe suffering from this eye disease and the leading cause for blindness worldwide.

It is hoped that with the discovery of this gene, those who are most likely to get glaucoma will have the condition detected earlier and be treated earlier. Today glaucoma is treated by lowering pressure within the eye through taking drops or through surgery. However, glaucoma treatment is not effective for everyone and nearly all glaucoma patients are not diagnosed until their eyesight begins deteriorating.

Glaucoma often has no symptoms and vision loss can happen suddenly, especially to people who live in places without access to regular eye care. Treatment can stem blindness, but it must be caught in time. Otherwise, the optic nerve is damaged beyond repair.

Professor Lotery says that making progress against glaucoma means better understanding the basic biological process leading to the disease. Better treatments can then be developed in order to slow or halt it. Professor Lotery likens the finding of the gene and biological pathway to that of the genes found that cause macular degeneration and leading to better clinical treatments. It is expected that better treatments for glaucoma will eventually have the same result.

The Southampton Gift of Sight appeal supported Professor Lotery’s research in finding the genetic reasons for glaucoma.

If you would like to learn more about treatment for glaucoma, please visit our Eye Doctor Directory to find an experienced eye surgeon in your area.

Duke Scientists Identify Myopia Gene

Researchers at Duke University Medical Center, along with others, have discovered a gene linked to nearsightedness (myopia) in Dutch, British, and Australian subjects of Caucasian descent. Myopia is the world’s most common vision problem in the world and has long been thought to be hereditary, though no specific genes had heretofore been identified that could cause myopia. The immediate cause of myopic vision is the failure of the eye’s lens to focus an image exactly on the retina’s surface, but in front of it. This causes objects in the distance to appear blurry and unclear.

Though the research is still preliminary and gene therapy related to myopia is a long way off, scientists already believe that the eye is an ideal body part in which to conduct gene therapy because it is small and self-contained. It is still unclear whether gene therapy will, in the future, provide a useful alternative to current treatments for myopia, including LASIK vision correction surgery. Myopia is most commonly corrected with contact lenses and glasses.

Most myopia cases are mild and unrelated to other ocular pathologies. However, myopia can also be caused by or accompany serious eye diseases like retinal detachment, glaucoma, and macular degeneration.

If you are interested in myopia treatment or better eye care in general, please visit our eye doctor directory to find a qualified ophthalmologist in your area.

Biosynthetic Cornea May Provide Alternative to Transplant

Ottawa, Canada – Patients whose vision is impaired by a damaged cornea may soon have an alternative to a donor transplant to restore their vision. May Griffith of Linköping University in Sweden and Ottawa Hospital Research Institute has been working with colleagues to develop techniques for fabricating tissue replacements that can be used in place of  natural donor tissue.  Their most recent achievement is the successful testing of an artificial, biosynthetic cornea over the course of two years. Results with their synthetic cornea have proven to be as good or better than donor transplantation.

While more testing needs to be done on this artificial cornea and donor cornea transplantation is still the preferred treatment of corneal blindness, donor corneas are always scarce. Plastic corneas have been developed and used for years, but problematic side effects like infection and glaucoma have made them purely a last resort option.

This new corneal implant is special because it is made almost entirely from natural collagen, grown in vitro by corporate partner Fibrogen from yeast cells. This collagen was then molded into the shape of a cornea, mimicking the cornea’s stroma layer, which is mostly collagen.

All ten patients on whom the biosynthetic implants were tested had their vision restored to a level similar to corneal transplant patients, except that they needed contact lenses to smooth over bumps created by the implants. The team is currently testing alternatives to the sutures that cause those bumps, such as tissue adhesives.  Results were also excellent in cell growth, with all ten patients seeing the return of the infection-fighting epithelial cell layer.

New Way to Illuminate Eye for Ocular Disease Screening

College Park, MD – According to a study released by University College London, a device combining a high-sensitivity CCD camera can be combined with wavelength-specific illumination light emitting diodes (LED) to illuminate the interior of the eyeball much better than it has been previously. This may allow eye doctors to more easily screen patients for eye diseases, such as age-related macular degeneration and diabetic retinopathy.

The current method is an image of the eye created on red, green, and blue wavelengths. This can see some abnormalities, but adding another dimension, as with the LEDs, and doctors will be able to see the different light absorbing characteristics of the biological molecules called chromophores.

There are five light absorbing compounds in the eye, including retinal hemoglobins, choroidal hemoglobins, melanin, choroidal melanin, retinal pigment epithelium (RPE), and macular pigment. Each one has a different coloration that is distinct and can be seen in multispectral images. Adding the camera device, further mulitspectral images of the ocular fundus can be distinguished.

Using an algorithm, a parametric map showing the distribution of substances in the eye is made, which can allow the eye doctor to screen and identify pathologies at an earlier stage of development. This can be done at a much quicker speed than the current retinal imaging systems.

According to the authors of the study, the goal is to create a system that will become a routine part of eye exams by optometrists and ophthalmologists.

If you would like more information about technology used to treat eyes, please visit the Ophthalmic Technology page.

Alimera Sciences Receives FDA Review for New Diabetic Macular Edema Treatment

Atlanta, GA – Alimera Sciences, an Atlanta, Georgia based biopharmaceutical company, has been granted a priority review status by the Food and Drug Administration for their drug delivery system called Iluvien. Iluvien is a fluocinolone acetonide intravitreal insert used to treat diabetic macular edema (DME).

Iluvien is an extended release insert that delivers sub-microgram levels of fluocinolone acetonide, a steroid usually found in dermatological uses.

Alimera is conducting two phase 3 pivotal clinical trials (FAME Study) involving over 950 patients across the US, Canada, Europe and India using Iluvien. The trials will assess the efficacy and safety of Iluvien using a high dose and a low dose to treat DME. According to the Alimera press release, the “primary efficacy endpoint for the FAME Study is the difference in the percentage of patients whose best corrected visual acuity improved by 15 or more letters from baseline on the ETDRS eye chart at month 24 between the treatment and control groups.”

Diabetic macular edema is associated with diabetic retinopathy, and is a disease affecting the macula. The macula is the part of the retina responsible for central vision. Diabetic retinopathy causes the blood vessels to leak and cause swelling in the macula. Patients may have DME for years before noticing any blurring or loss of vision.

If you would like more information about DME or diabetic retinopathy and treatment for these diseases, please visit the Eye Doctor Directory to find an experienced eye doctor in your area today.

Alimera Sciences Receives FDA Review for New Diabetic Macular Edema Treatment

Atlanta, GA – Alimera Sciences, an Atlanta, Georgia based biopharmaceutical company, has been granted a priority review status by the Food and Drug Administration for their drug delivery system called Iluvien. Iluvien is a fluocinolone acetonide intravitreal insert used to treat diabetic macular edema (DME).

Iluvien is an extended release insert that delivers sub-microgram levels of fluocinolone acetonide, a steroid usually found in dermatological uses.

Alimera is conducting two phase 3 pivotal clinical trials (FAME Study) involving over 950 patients across the US, Canada, Europe and India using Iluvien. The trials will assess the efficacy and safety of Iluvien using a high dose and a low dose to treat DME. According to the Alimera press release, the “primary efficacy endpoint for the FAME Study is the difference in the percentage of patients whose best corrected visual acuity improved by 15 or more letters from baseline on the ETDRS eye chart at month 24 between the treatment and control groups.”

Diabetic macular edema is associated with diabetic retinopathy, and is a disease affecting the macula. The macula is the part of the retina responsible for central vision. Diabetic retinopathy causes the blood vessels to leak and cause swelling in the macula. Patients may have DME for years before noticing any blurring or loss of vision.

If you would like more information about DME or diabetic retinopathy and treatment for these diseases, please visit the Eye Doctor Directory to find an experienced eye doctor in your area today.

Moderate to Severe Myopic Astigmatism Corrected by ICLs

New York, NY – According to a study from Japan and published in the July 3 online edition of Ophthalmology, the Visian Implantable Collamer Lens (ICL) successfully corrects moderate to high myopic astigmatism.

Lead researcher Dr. Kazutaka Kamiya from University of Kitasato School of Medicine, Kanagawa, says, “These findings suggest that toric ICL implantation may become a viable alternative to corneal refractive procedures for the treatment of such eyes.” The researchers believe that toric ICL implantation is more successful for patients with this condition than keratorefractive surgical techniques. They previously reported toric ICL implantation was a better surgical procedure than wavefront-guided LASIK, which is still seen as one of the best refractive surgery techniques because of its safety, stability, efficacy, and predictability.

The Study

The study in the current paper reports on clinical outcomes performed last year in which toric ICLs were implanted in 56 eyes in 32 patients with moderate to high myopic astigmatism. In almost all of the eyes, there was no change in best spectacle corrected visual acuity or a gain of one line. There was a gain of two lines in five eyes, and a loss of one line in three, but no loss of two or more lines in any of the eyes.

In five of the eyes, there was a ten degree or more change of axis rotation or deteriorating visual acuity up to a week after the surgery. All five required repositioning of the ICL. However, 90% of the eyes were within 0.5 D of the attempted correction of spherical equivalent and all eyes were within 1.0 D of the targeted correction after a year.

The researchers are continuing observation to assess long-term safety of the surgical procedure, and are especially looking at toric-specific complications, such as axis-rotation.

Miniature Telescope to Improve Vision

United States health officials have approved a new technology—a tiny telescope implanted inside the eye—to counter age-related macular degeneration, one of the leading causes of blindness in older adults. The Implantable Miniature Telescope should help in the end stages of ARMD, which is a slow-progressing loss of central vision that blocks reading, watching television, and even eventually recognizing faces. Approximately two million Americans suffer from ARMD. The telescope will not affect one’s peripheral vision. The telescope makes the brain fuse two views into a single image, and the FDA warned that patients will need post-surgery rehabilitation to make the telescope work.

This new device is not for everyone who suffers from ARMD. The telescope is only for one very specific group of ARMD sufferers: Those who are 75 or older, with a certain degree of vision loss, and who also need a cataract removed. The potential side effects are corneal damage and worsened vision. Corneal damage as a result of implanting the telescope is what held up FDA approval for several years. The telescope does not promise perfect vision, but it will allow those who could not recognize a face to do so much better following implantation of the device.

The FDA states that in a 219-patient study, 90% of telescope recipients had their vision improved by at least two lines on an eye chart, and three-quarters of the recipients went from severe to moderate vision impairment.

To learn more about this technology and others available to improve vision, please contact an experienced eye care professional in your area today.

LASIK Undergoing Comprehensive Review

We like to think of LASIK as an accomplished technology and procedural innovation, but like many advanced medical technologies, questions remain about the safety and efficacy of the procedure and the technology that supports it. In response to anecdotal evidence of adverse vision effects experienced by some patients, possibly at a higher than expected rate, the US Food and Drug Administration (FDA) convened a public advisory panel of outside experts to review the process in 2008. What the experts heard suggested that there were many significant unanswered public health questions about LASIK.

As a result, the FDA that it decided to conduct a collaborative study with the National Eye Institute and the Department of Defense to examine the potential impact of LASIK on the quality of life of patients. The Quality of Life Project would be conducted in three phases. In the first phase, the FDA is attempting to design a questionnaire that will help doctors and regulators to better assess the quality of life impacts of LASIK treatment.

In the second phase, investigators will evaluate the quality of life and satisfaction following LASIK for patients at the Navy Refractive Surgery Center. As yet, there is no announced completion date for this phase.

Phase 3 will be a national multi-center clinical trial to study the impact on quality of life following LASIK. The goal is to assess the overall impact of LASIK on the general population, including its impact on some subpopulations that may be more vulnerable to adverse effects from the procedure.  This phase is expected to be completed in 2012.

Overall, LASIK is considered a relatively safe procedure, but the FDA is acting out of the “abundance of caution” that seems to be its guiding principle these days.

To learn more about this issue and whether LASIK is right for you, please talk to an eye doctor in your area about the procedure.