Publishing date: April 2018
Author(s): King C (1), Sherwin JC (1), Ratnarajan G (2), Salmon JF (1)
1 Oxford Eye Hospital, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.
2 QVH Eye Unit, Queen Victoria Hospital NHS Foundation Trust, East Grinstead, UK.
BACKGROUND/AIMS: To determine the mortality within 20 years of diagnosis of chronic open-angle glaucoma (COAG) and visual acuity and visual field progression of a cohort followed for 20 years.
Live surgery is great, but sometimes it’s complicated… I share my top tips
By I. Paul Singh
Most know me as an ophthalmic surgeon. But outside the clinic I play keyboard in a band, and the experience has really influenced my surgical skills. Not only has it helped me strengthen the ability of my non-dominant hand, it has helped me when it comes to performing live surgeries.
Pretty much every surgeon, whether doing live events or presenting on the podium, gets a little nervous. Me too – I’m not immune to a bit of stage fright! Performing live on stage with my band and talking to the audience has definitely helped me learn that your approach is what matters.
Kerry Solomon, MD, shares advice on how to incorporate the iStent Trabecular Micro-Bypass Stent (Glaukos) into a refractive cataract surgery practice and what criteria he uses to evaluate MIGS devices.
Glaukos announced that its travoprost intraocular implant with the iDose delivery system continued to provide sustained reduction in IOP in a 12-month interim cohort of patients in its US investigational new drug phase 2 clinical trial, according to a company news release. Implanted during a microinvasive procedure, the iDose Travoprost is filled with a special formulation of travoprost and is designed to continuously elute therapeutic levels of the medication from within the eye for extended periods of time. When depleted, the iDose Travoprost can be removed and replaced in a similar procedure.
oin ophthalmologists from 109 countries (and counting) who have already registered to attend the 36th World Ophthalmology Congress® (WOC2018) of the International Council of Ophthalmology 16–19 June in Barcelona, Spain. The WOC is the longest continuous medical meeting in the world and addresses all subspecialties and related interests in ophthalmology.
Latanoprostene bunod (LBN) is a topical ophthalmic therapeutic for the reduction of intraocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension (OHT). LBN is composed of latanoprost acid (LA) linked to a nitric oxide (NO)-donating moiety and is the first NO-releasing prostaglandin analog to be submitted for marketing authorization in the United States. The role of latanoprost in increasing uveoscleral outflow of aqueous humor (AqH) is well established. Herein, we review findings from nonclinical studies, which evaluated the role of NO in the IOP-lowering efficacy of LBN. Pharmacokinetic studies in rabbits and corneal homogenates indicate that LBN is rapidly metabolized to LA and butanediol mononitrate (BDMN). NO is subsequently released by BDMN as shown by increased cyclic guanosine monophosphate (cGMP) levels in (1) the AqH and iris-ciliary body after administration of LBN in rabbits and in (2) human trabecular meshwork (TM) cells after incubation with LBN. LBN reduced myosin light chain phosphorylation, induced cytoskeletal rearrangement, and decreased resistance to current flow to a greater extent than latanoprost in TM cells, indicating that NO released from LBN elicited TM cell relaxation. LBN also lowered IOP to a greater extent than latanoprost in FP receptor knockout mice, rabbits with transient OHT, glaucomatous dogs, and primates with OHT. Along with results from a Phase 2 clinical study in which treatment with LBN 0.024% resulted in greater IOP-lowering efficacy than latanoprost 0.005%, these data indicate that LBN has a dual mechanism of action, increasing AqH outflow through both the uveoscleral (using LA) and TM/Schlemm's canal (using NO) pathways.
Neurotrophic keratopathy – the loss of corneal sensation – has a poor prognosis with limited available treatment options
Current techniques for corneal neurotization can restore corneal sensation, but may be associated with significant morbidity
I describe two minimally invasive techniques for corneal neurotization: using a cadaveric nerve graft and an endoscopic approach
More ophthalmologists learning – and performing – these minimally invasive procedures may help more patients before devastating and irreversible damage occurs.
Elizabeth Yeu, MD, discusses how the iStent Trabecular Micro-Bypass Stent (Glaukos) has given her the opportunity to provide an option at the time of cataract surgery that could prevent the progression of a patients' glaucoma. In this article, she describes her experiences with the iStent, which makes this option possible via microinvasive glaucoma surgery (MIGS).
Bhavana Sharma,1 Aditi Dubey,2 Gaurav Prakash,3 Rasik B Vajpayee4–6
1Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, India; 2Department of Ophthalmology, Gandhi Medical College, Bhopal, India; 3Cornea and Refractive Surgery Services, NMC Eye Care, New Medical Center Specialty Hospital, Abu Dhabi, United Arab Emirates; 4Vision Eye Institute, Melbourne, VIC, Australia; 5Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia; 6North West Academic Centre, University of Melbourne, Melbourne, VIC, Australia
Abstract: Surgical management of keratoconus (KC) has undergone a paradigm shift in the last two decades and component corneal transplantation technique of deep anterior lamellar keratoplasty has established itself as a modality of choice for management of advanced cases of KC. Every now and then, new minimalist modalities are being innovated for the management of KC. On the same lines, a new technique, Bowman’s layer transplantation, for surgical management of moderate to advanced KC has been reported in recent years. The procedure has shown to be beneficial in reducing ectasia in advanced KC with minimal intraoperative and postoperative complications. In this review, we intend to describe available information and literature with reference to this new surgical technique – Bowman’s layer transplantation.
Keywords: keratoconus, Bowman’s Layer, keratoplasty, post PRK haze, component keratoplasty
Purpose: Rho-associated protein kinase (ROCK) inhibitors lower intraocular pressure (IOP) by increasing aqueous outflow through the trabecular meshwork (TM). The preclinical characterization of netarsudil, a new ROCK/norepinephrine transporter (NET) inhibitor currently in clinical development, is presented herein.
Ocular infections, such as acute bacterial keratitis and postoperative endophthalmitis, can cause rapid, significant, and permanent visual impairment. Successful management requires early diagnosis, in addition to the correct antibiotic choice administered at appropriate therapeutic levels for the optimum duration, to eradicate the causative organism. This CME activity will discuss emerging delivery systems in the management of ocular infections.
Macular Vessel Density in Glaucomatous Eyes with Focal Lamina Cribrosa Defects
Ghahari, Elham MD*; Bowd, Christopher PHD*; Zangwill, Linda M. PHD*; Suh, Min Hee MD*,†; Shoji, Takuhei MD, PHD*,‡; Hasenstab, Kyle A. PHD*; Saunders, Luke J. PHD*; Moghimi, Sasan MD*; Hou, Huiyuan MD, PHD*; Manalastas, Patricia Isabel C. MD*; Penteado, Rafaella C. MD*; Weinreb, Robert N. MD*
Journal of Glaucoma: February 16, 2018 - Volume Publish Ahead of Print - Issue - p
Original Study: PDF Only
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