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Review of Ophthalmology Online April 01 

Volume 2, Number 13 Monday, April 1, 2002


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    Inside This Issue

Go CIBA Vision to Market Implants That May Reverse Presbyopia and Treat Glaucoma
Go Key Refractive Surgery Trends
Go The Incidence of Ocular Toxicity of Preservatives with Glaucoma Medications
Go Outcomes Faster, More Stable in Myopia Patients Undergoing LASIK
Go Increased Mortality in Women with Cataract
Go Briefly

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CIBA Vision to Market Implants That May Reverse Presbyopia and Treat Glaucoma

CIBA Vision has acquired from Dallas-based Presby Corp the rights to a surgical technique that has shown promising results in initial clinical studies in the treatment of presbyopia, ocular hypertension and primary open angle glaucoma.

The license agreement includes the worldwide rights to market and sell Presby Corp¡¯s scleral expansion implants, as well as a specialized automated incision device and blades. These products are used in a surgical technique that has shown promising results in initial clinical studies in the treatment of presbyopia. CIBA Vision will assume responsibility for manufacturing the products.

The implants consist of four separate segments made from polymethylmethacrylate (PMMA) and are implanted within the sclera. The implants re-establish the anterior segment spacing as it is found in a non-presbyopic eye. This minimally invasive procedure can be completed by trained physicians on an outpatient basis using topical and/or local anesthesia. Patients have reported improved near vision almost immediately after the procedure.

In addition to the procedure¡¯s effect on presbyopia, a study shows promising early results that the implants can be successfully used in the treatment of ocular hypertension and primary open angle glaucoma. For glaucoma, the study indicates the implants work by increasing the aqueous humor outflow.

CIBA Vision expects to begin marketing and distributing the products later this year in Europe and Canada. Presby Corp has completed Phase I FDA trials and has received clearance to proceed with the clinical studies required for U.S. market approval.
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Key Refractive Surgery Trends

Results are in from the 2001 survey of the 980 U.S. members of the International Society of Refractive Surgery. Key findings include:

LASIK remains the dominant refractive surgery for refractive errors from -12.00 to +3.00 D

The VISX excimer laser and the Hansatome microkeratome are the most frequently used instruments for LASIK.

SOURCE: J Refract Surg 2002;18:185-188. Go Back

The Incidence of Ocular Toxicity of Preservatives with Glaucoma Medications

Patients who use preserved glaucoma medications are much more likely to experience discomfort upon instillation, burning-stinging, foreign body sensation, dry eye sensation, tearing and eyelid itching than those who use preservative-free eyedrops, according to a survey of more than 4,100 patients. Moreover, most of the adverse reactions induced by preserved glaucoma medication are reversible after removing preservatives. The prevalence of signs and symptoms was dose dependent, increasing with the number of preserved drops.
SOURCE: British Journal of Ophthalmology 2002;86:418-423.
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Outcomes Faster, More Stable in Myopia Patients Undergoing LASIK

Either spherical or astigmatic LASIK surgery provides faster and more stable outcomes in myopia patients than spherical or astigmatic photorefractive keratectomy (PRK), although all of the four procedures may yield excellent outcomes, according to a new study.

Researchers analyzed the visual acuity in 619 eyes of 388 consecutive patients who had refractive surgery during a two-year period. The patients were divided in to two groups: those who had mild-to-moderate myopia and those who had high myopia (spherical equivalent of -6.12 D or more).

In those with mild-to-moderate myopia, the researchers found comparable results between either a flap-based procedure or a PRK procedure. However, the flap-based procedure yielded better results than PRK in patients with high myopia. Corrections for astigmatism did not increase the risk of poor visual outcome and were highly effective at reducing cylinder in most patients, the researchers reported.

SOURCE: Van Gelder RN et al. J Cataract Refract Surg 2002;28:462-76.
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Increased Mortality in Women with Cataract

In diabetics, cataract is associated with higher risk of death. In non-diabetics the data are conflicting, but some indicate an association between one type of cataract (nuclear) and increased mortality. For the first time, a study has shown that, among the elderly (age 65 and older) non-diabetic population, cataract is associated with higher mortality in women but not in men.

This sex effect suggests that women may be exposed to risk factors that increase both the risk of cataract and mortality, and that men may have little or no exposure to these "sex specific" factors. Possible risk factors that warrant further investigation may be those associated with some pregnancy and childbearing experience, the authors suggest.

The excess mortality in women with cataract was consistent for cardiovascular, respiratory and other non-cancer causes of death. There was no association between cataract and mortality from cancer.

SOURCE: British Journal of Ophthalmology 2002;86:424-428.
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  • THE EDITORS OF REVIEW OF OPHTHALMOLOGY SAVOR A SWEET MOMENT. They were named as Finalists in four categories of this year¡¯s Jesse H. Neal National Business Journalism Awards, presented by American Business Media. Pictured (front row, l to r) are editor-in-chief Christopher Glenn, senior editor Walter Bethke, senior editor Gillian McDermott, (back row, l to r) associate editor Michael Beirne and art director Frank Sau.
  • MEDENNIUM RECEIVES AUSTRALIAN APPROVAL OF SMART PLUG. Medennium¡¯s SmartPlug, a one-size-fits-all punctum plug, received a Certificate of Listing in the Australian Therapeutic Goods Administration Register. This approval allows SmartPlug to be sold in Australia, and it follows the 2001 approvals in Europe and Canada. SmartPlug is unique in that it is made of a thermodynamic acrylic polymer. It is a thin rigid rod when removed from the package, but seconds after insertion into the punctum it transforms into a soft gel-like, long-term plug that conforms to the patient¡¯s punctum.
  • ADVANCED VISION RESEARCH LAUNCHES THERATEARS IN CANADA. Advanced Vision Research has introduced preservative-free TheraTears Lubricant Eye Drops to eyecare professionals and pharmacy retailers across Canada. TheraTears, which not only wet but also rehydrate dry eyes, will be available in 24 single-use containers (0.6ml each) for sale to pharmacies and eyecare specialists across Canada. Free samples and patient brochures in both French and English are available by contacting Advanced Vision Research.
  • VITREOUS HEMORRHAGE DRUG MISSES PRIMARY GOAL IN TRIAL. Drug developer ISTA Pharmaceuticals said Vitrase, its experimental drug intended to treat severe vitreous hemorrhage, did not meet its primary goal in late-stage clinical trials. ISTA said Vitrase did not show a statistically significant improvement over placebo in achieving the primary target of the trials. The primary endpoint was clearing the vitreous hemorrhage enough to allow diagnosis and treatment of the underlying cause of the bleeding within three months after taking Vitrase.
  • NEI SAYS AGE-RELATED THREATS TO SIGHT MAY NEARLY DOUBLE BY 2030. An estimated 3.5 million people are nearly or completely blind in the United States today. This figure will double by 2030 if preventive measures in eye care are not taken, according to a report from the National Eye Institute and Prevent Blindness America. Nearly 2 million people will be completely blind by this time, and 3.2 million people will have extremely poor vision, according to David S. Friedman, MD, MPH, principal investigator of the report.
  • LAUREN BACALL SPEAKS OUT ABOUT AMD. Actress Lauren Bacall is the spokesperson for a new campaign, "Raising America¡¯s Eye-Q," aimed at raising awareness about macular degeneration. The campaign will encourage people to take a pledge for healthy vision as a reminder to get annual eye exams. A Novartis Ophthalmics-sponsored survey found that Americans over age 45 lack awareness about macular degeneration and the importance of screening for it. Go Back


Send them to AllAboutVision.com, a website you can trust to properly educate your patients on eye health and vision correction options. The site contains more than 500 pages of information on contact lenses, eyeglasses, refractive surgery, eye problems and diseases, and much more.


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