Articles

New technologies and surgical techniques are redefining the refractive surgery arena in ophthalmology. With the progress of customized wavefront-guided LASIK and the use of phakic intraocular lenses (IOLs), today's refractive surgeon can offer a wider range of services to the patient.

Favorable Phase I study results have led to the launch of a Phase I/II trial evaluating the efficacy and safety of AdPEDF (GenVec) treatment of exudative AMD, said Timothy Stout, MD, at the World Ophthalmology Congress.

With the world's population getting older and the rate of blindness increasing in regard to that aging population, cataract surgeons worldwide are facing some clinical challenges in the years ahead, according to Stephen A. Obstbaum, MD, of United States.

Encouraging results have been achieved in a pilot clinical trial of selective epiretinal brachytherapy for exudative age-related macular degeneration (AMD), reported Eugene de Juan, Jr., MD, at the World Ophthalmology Congress.

In the new treatment era for exudative age-related macular degeneration (AMD) heralded by the availability of locally administered anti-VEGF drugs, intravitreal monotherapy with triamcinolone injection may no longer be considered as a current therapy for this neovascular condition, said Jost Jonas, MD, at the World Ophthalmology Congress.

With an aim to further improve efficacy and safety outcomes achieved with anti-VEGF therapy for AMD, ongoing studies with pegaptanib sodium (Macugen, OCI/Eyetech Pharmaceuticals) are evaluating the potential benefits of early treatment initiation and of using an induction/maintenance approach, said Anthony P. Adamis, MD, at the World Ophthalmology Congress.

Interim results from a Phase I study suggest that intravitreal injection of VEGF Trap (Regeneron Pharmaceuticals) is a promising new approach for the treatment of exudative age-related macular degeneration, said Quan Dong Nguyen, MD, at the World Ophthalmology Congress.

There is a wide range of technology available in cataract surgery today and it's easy for ophthalmologists to get excited and carried away by the technology. However, it's the attention to detail; going back to basics about incisions; pre- and post-surgical management; and the proper use of intraocular lenses that also need to be stressed.

Suggesting a change in the way physicians diagnose glaucoma, Robert Weinreb, MD, outlined a new paradigm for diagnosis of the disease in his Glaucoma Society of International Ophthalmology Congress (GCIOC) Day Lecture, presented Monday at the World Ophthalmology Congress. Dr. Weinreb said that the glaucoma field is undergoing a revolution in diagnosis. He said there is a transition from reliance solely on visual fields to the increased use of structural analysis of the optic disk and RNFL. "It's something that was initiated 20 years ago," explained Dr. Weinreb. "Changes are very, very slow in glaucoma, as it does in all medical disciplines. We have reached an infliction point in glaucoma diagnosis where we are about to reap the benefits of this revolution."

The femtosecond laser (IntraLase) holds promise for advancing penetrating keratoplasty (PKP) in the near future, said Denise Fornazari de Oliveira, MD, at the World Congress of Ophthalmology.

Age-related macular degeneration (AMD) is a common cause of vision loss worldwide, particularly in industrialized nations, where it is the main cause of blindness among people of 65 and older, explained Paul Mitchell, MD, at the World Ophthalmology Congress.

The future of penetrating keratoplasty (PKP) may be "a lot more work, but no more money" as Michael Belin, MD, of the United States jokingly described it Monday, but the number of PKP procedures are definitely presenting options for the corneal surgeon.

There is a wide range of technology available in cataract surgery today and it's easy for ophthalmologists to get excited and carried away by the technology. However, it's the attention to detail; going back to basics about incisions; pre- and post-surgical management; and the proper use of intraocular lenses that also need to be stressed.

Establishing the correct diagnosis and modifying therapy appropriately based on response are fundamental in the successful management of bacterial keratitis, said Richard L. Abbott, MD, at the World Congress of Ophthalmology.

Refractive surgeons wishing to achieve successful penetrating keratoplasty need only plan their surgeries more closely.

A target IOP should be set whenever the diagnosis of ocular hypertension or glaucoma is first made, and it should be re-evaluated at each follow-up visit as part of the assessment of the efficacy of treatment for stopping visual field progression and protecting the optic nerve, said Curt Hartleben, MD, at the World Congress of Ophthalmology.

Evidence-based medicine has provided some guidance on the management of herpes simplex virus (HSV) keratitis, but there are still many questions left unanswered, said Thomas J. Liesegang, MD, at the World Congress of Ophthalmology.

Imaging is an essential part of glaucoma management, but while structural damage is frequently apparent before identifiable visual field loss occurs, both functional testing and quantitative imaging should always be performed in eyes with either early or moderate disease, said David F. Garway-Heath, MD.

For six days São Paulo, Brazil, will be the "Mecca" of ophthalmology. On Sunday, it was "get-acquainted day" as ophthalmic colleagues met to renew friendships with fellow colleagues and friends in industry. The Exhibit Hall opened late in the morning, drawing crowds of physicians to view the latest technology in ophthalmology.

More than 15,000 ophthalmologists from more than 110 countries are registered to attend, and more than 4,000 scientific papers were submitted for consideration. The schedule features more than 400 sessions in addition to subspecialty days, with some 2,400 speakers from all regions of the world.

The 2006 World Ophthalmology Congress (WOC) commenced Sunday in São Paulo, Brazil. With the first non-governmental organization (NGO) forum on vision and blindness prevention. The forum promoted the visibility of non-profit organizations that focus both on blindness prevention and assisting the visually impaired, contributing to an exchange of experiences between entities from all continents and from different socioeconomic realities, as well as organizing and providing a complete record of entities that cater to this area.

Asia Pacific Survey

This month we had the pleasure of speaking with Zdenek Gregor, FRCS, FRCOphth, President of the European Society of Ophthalmology (SOE). You can read what he had to say in our interview with Dr Gregor. Just as a taster, here is some background information on the society.

Novartis Ophthalmics' and Genentech's investigational treatment for AMD has again delighted its developers by meeting its one-year primary efficacy endpoint of maintaining vision in patients with wet AMD during the first year of the two-year ANCHOR study.

Accommodative lenses on the whole are showing significant promise and have certain advantages over multifocal IOLs because they do not have different refractive zones, contrast or glare problems

I was delighted with the results. My patient's subsequent visits at 12 and 18 months post surgery were equally encouraging as endothelial cell count and corrected vision remained unchanged

Anterior chamber angle-supported phakic intraocular lenses have now become a viable alternative for the correction of moderate and high refractive errors with excellent levels of efficacy, predictability and safety.

CE-marked since October 2004 and approved by the FDA in March 2005, the ReZoom IOL (AMO, Santa Ana, California, USA) was designed to provide hyperopic cataract patients with greater independence from glasses, although good visual outcomes can also be achieved in other patients. However, patient selection is essential and one of the criteria that candidates for multifocal IOLs must fulfil is an adaptable and open-minded personality. Patients should not have unrealistic expectations and should not be looking for perfect vision. Surgeons must also emphasize to patients that neuroadaptation is required to adjust to a new visual system and this might take a few months.

Since its inception in 1956, the European Society of Ophthalmology (SOE) has grown from a small entity into a conglomerate of national ophthalmological societies from all 40 European countries, representing more than 40,000 European ophthalmologists. We speak with President Zdenek Gregor about the changing face of the society, the importance of collaboration and the way the society has adapted to an ever-evolving Europe.

Happy New Year to you all and welcome to the second edition of Ophthalmology Times Europe.