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Ophthalmology Times Europe – Clinical Insights for Eye Specialists

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Heidelberg Engineering: Enhancing the Patient Journey

Clinical

1rem

Approved by the FDA in March 2005 for use in cataract patients with or without presbyopia, Alcon's AcrySof ReSTOR lens is the first apodized diffractive intraocular lens (IOL) to be made available. The approval was granted based on clinical trials which found that patients experienced the highest level of freedom from glasses ever achieved in IOL clinical trials.

Clinical experience with AcrySof ReSTOR lens in cataract patients

Major advances have been made in the understanding of the pathogenesis of posterior capsule opacification (PCO) post-cataract surgery, and improvements in surgical technique and lens biocompatibility and design have reduced the rates of opacification in recent years. Nonetheless, opacification remains an important complication in patients undergoing phacoemulsification or extracapsular cataract extraction combined with intraocular lens (IOL) placement, with approximately up to 25% of patients developing visually significant PCO during the first five years post surgery.

How sharp is sharp?

Epi-LASIK combines the advantages of both LASEK and LASIK while minimizing the disadvantages of each

Epi-LASIK seen as advanced surface ablation procedure

The fundamental issue of wound integrity has dissuaded me from pursuing further research and development of this technique

Trends in phacoemulsification

The formation of Elschnig pearls is a highly dynamic process and is detectable even over very short time intervals. Elschnig pearls can appear or disappear within one day, according to Oliver Findl, MD, from the Medical University of Vienna, Austria.

Progression and regression of Elschnig pearls within 1-day-intervals illustrate the dynamic behaviour of PCO

At the ESCRS meeting, cataract surgeons can get familiar with BVI's Virtuoso platform and VirtuaLens' immersive VR IOL simulator

BVI, VirtuaLens will showcase new technologies at ESCRS 2025

Alcon, Bausch + Lomb and Johnson & Johnson will debut new research findings during the European Society of Cataract and Refractive Surgeons Congress in Copenhagen, Denmark

Upcoming company presentations from Alcon, J&J, B+L at ESCRS 2025

New support offers a streamlined experience for surgeons and patients 

Keys to optimising phaco efficiency

The transaction is anticipated to close in 6 to 12 months subject to customary closing conditions and regulatory approval

Alcon announces acquisition of STAAR Surgical, EVO ICL lenses

Frank Kerkhoff, MD, shares his experiences with the Johnson & Johnson Tecnis Odyssey lens

Q&A: Early research findings and clinical experiences with a new multifocal IOL

At the 2025 ASCRS meeting, Robert Ang, MD said small aperture IOLs can benefit all patients, especially those with complex corneas or who have undergone previous corneal refractive surgery

At the 2025 American Society of Cataract and Refractive Surgeons (ASCRS) meeting in Los Angeles, California, Robert Ang, MD, head of cornea and refractive surgery at the Asian Eye Institute in Makati City, Philippines, spoke to the Eye Care Network. He shared the research findings he brought to the ASCRS congress, focused on the IC-8 Apthera small-aperture IOL (Bausch & Lomb).

"For patient selection, first, we are targeting a very important group of patients, who are difficult to treat and also difficult to please," Dr Ang said. "These patients [underwent] these surgeries before because they don't want glasses, and now they don't want glasses 

 after cataract surgery." According to Dr Ang, a small aperture IOL will benefit all patients, but especially those with complex corneal pathologies and a history of prior surgeries.

"Refractive targeting is very, very crucial. We want them to be between 0.75 to -1," Dr Ang continued, calling this refractive zone the "sweet spot" for small aperture IOL implantation. Accurate and informative keratomety readings are also crucial, he said, though they can be difficult to achieve. "In this tough, tough population, sometimes it's hard to do," he said. "But the good surprise is that even if we miss target, distance vision remains good."

Overall, Dr Ang said he wants clinicians to remember that a small aperture IOL is suitable for a wide range of patient needs. "The small aperture IOL is not a niche product," he emphasised. "Before we [focused on] the challenging, post-refractive patients, we [studied] the population of normal eyes with normal corneas. That's how we found out that this small aperture optic extends depth of focus and gives good intermediate and near vision. So don't hesitate to use them on normal corneas and normal patients...they're applicable to everybody who wants cataract surgery. Just target well and counsel well."

Videos

At the 2025 ASCRS meeting, Dr Ang said small aperture IOLs can benefit all patients, especially those with complex corneas or who have undergone previous corneal refractive surgery

Robert Ang, MD, explains why a small-aperture IOL is "not a niche product"

Brent Kramer, MD, of Vance Thompson Vision speaks at the 2024 AAO meeting

At the American Academy of Ophthalmology (AAO) meeting in Chicago, Illinois, Brent Kramer, MD, visited the Eye Care Network booth to discuss his presentation. In this video, he talks about using the MKO Melt in lieu of IV anaesthesia ahead of ocular surgery.

Editor's note: The below transcript has been lightly edited for clarity.

: Hey guys, my name is Brent Kramer. I'm an ophthalmologist at Vance Thompson Vision. I practice in Sioux Falls and Alexandria. Today, I'm going to talk a little bit about how we do modern anaesthesia with cataract surgery with the MKO Melt, brought to you by ImprimisRx.

So the MKO Melt is a game changer, and three reasons why I think that you should consider implementing it into your practice. One: patient experience. Patients hate needles and they love the slow build anaesthesia of the MKO Melt, and so they're not having to wait until they've been prepped, wheeled back to the OR, anxiety building the whole time to get that anaesthesia. As soon as they get brought back, they get an MKO Melt, and instead of anxiety building, they become more and more relaxed leading up to the surgery. So patient experience is huge, and that's the primary reason why we love it. 

The second reason, the most important part is a patient experience, and driving that is the team experience. So we love that, the experience the team has with the MKO Melt. We don't ask our nurses anymore to do the most painful part of the procedure, which is the IV stick. With the MKO Melt, our nurses are able to focus on building rapport with the patient, getting to know the patient, getting them calm before surgery, answering their questions and all that, and not having to hassle with an IV. It also, you know, doesn't slow our OR down with a tough needle stick or anything like that, pulling the CRNA out for a tough needle stick, all of that stuff. 

Third, and I think, you know, a huge reason and a growing reason why we love the MKO Melt, is it's opioid free. It's Versed [midazolam, Roche], ketamine, ondansetron [Zofran, GSK], and we are able to perform cataract surgery without any opioids. Cataract surgery is the most-performed surgery in America, and if ophthalmologists were able to perform it without opioids, that's less fentanyl being made, less fentanyl being diverted and just a better world.

So, MKO Melt and recovery. You know, when you think of...let's start with IV anaesthesia, because that's kind of the traditional way of doing anaesthesia. You start with a big hit and a high plasma concentration of drug, and then it slowly wears off, and it takes time, versus the MKO Melt is a slower build. You don't get as much of a plasma concentration because you don't need it. And then it's a slow [wear] off. So our patients, you know, we get them in the car, and when they get home, they're not tripping or having difficulty getting back into the house. They have their day with the surgery, they're not, you know, too, too sedated or nauseous for the rest of the day. So that is great. 

You know, when I think of the beneficial cases of Melt—and in our surgery center, you know, we do primarily do cataract surgery, but we also do a lot of complex cases—and you'd be surprised how much of those complex cases we're using Melt for. And so for us, you know, cataracts are low hanging fruit in regards to who to start with Melt, but we're doing it for a lot of our endothelial keratoplasty, our standalone MIGs, some of our patients that are anxious, we still start with the Melt, because we love that kind of base form, and then they get an IV for rescue. And I would say about 5% of our patients get an IV going back for surgery, but only 1% of those patients are actually using the IV. So it's pretty rare. In regards to, you know, patients that we don't use Melt for, typically, patients that are getting blocked. So if we're doing a retrobulbar block, they're usually getting a little bit of propofol, getting an IV in, and so then we just use IV anaesthesia.

Brent Kramer, MD, presents on an alternative to IV sedation for cataract surgeries and complex cases

AAO 2024: An oral anaesthetic offers relief for both patients and care teams

AAO 2024: Two-year clinical feasibility trial outcomes for a dual-optic IOL system for the treatment of presbyopia and cataract

George O. Waring, IV, MD, provides insights from an on-demand poster as part of the annual American Academy of Ophthalmology taking place in Chicago, Illinois. This poster was titled, "Two-Year Clinical Feasibility Trial Outcomes for a Dual-Optic IOL System for the Treatment of Presbyopia and Cataract."

This transcript has been lightly edited for clarity.

Hi, it's George Waring IV, from the Waring Vision Institute in Mount, Pleasant, South Carolina, and it's my pleasure to discuss something really exciting here at the American Academy of Ophthalmology in Chicago. It's been a jam packed meeting, lot of extraordinary innovations in the pipeline, and one of the ones we're most excited about is modular accommodative IOLs. And we had the really wonderful opportunity to present on the OmniVu, modular lens system by Atia Vision. We presented the 24-month results, which is really exciting to start to get some long-term data on how this next generation of accommodating lenses are performing. And what we found was that we had an excellent safety and efficacy profile. These lenses are maintaining stability, refractive stability, over 24 months within a 1/2 diopter. And I think that's one of the really exciting things about this lens. This is a more physiologic lens. This is a two-piece system with a modular, exchangeable anterior optic and a fluid-filled, shape-changing base that provides accommodation. So this does a few things for us. It allows for adjustability over time, which is really exciting. It also creates a potential space for us for things like drug illusion or even virtual reality. Everything's on the table for the future. But I think most importantly, and most immediately, it's a more physiologic lens, as I mentioned, this maintains the natural capsule in a capsule filling way. Well, what does that mean? We believe that this can have some real benefits to promote effective lens position over time, and we really believe that this bore out in our 2-year data. When we look at the uncorrected binocular visual acuity outcomes, uncorrected distance acuity binocular was 20/16 intermediate 20/20, and near J1 and that's really exciting because, again, it promotes this idea of a full continuous range with, what we found to be, over four and a half diopters into focus at the 20/32, level, with really a natural range and also excellent quality of vision. So these are monofocal-like quality. It's a monofocal optic, but with the performance of an extended range, full vision range, actually, and that's amazing. So we marry the effective lens position opportunity with a continuous range with a high quality vision. Our results looking at, in a non-comparative way, the contrast sensitivity also behaves in a monofocal-like state. So ladies and gentlemen, we're really excited about this data, 2-year long-term data. We were very thankful to get to present it, and we're real optimistic about what the future holds with this technology.

Abdelrahman Elhusseiny, MD, MSc, discusses his AAO presentation on risk of posterior capsular rupture in fellow-eyes cataract surgery

Ahead of this year's American Academy of Ophthalmology (AAO) meeting, Abdelrahman Elhusseiny, MD, MSc, sat down to discuss his presentation, "Risk of Posterior Capsular Rupture in Fellow-Eyes Cataract Surgery." Here, he details findings from the research he presented at AAO 2024 in Chicago, Illinois. 

. The American Academy of Ophthalmology is holding its annual meeting this year in Chicago. At that meeting, Dr Abdelrahman Elhusseiny is making a presentation titled "Risk of Posterior Capsular Rupture in Fellow Eyes Cataract Surgery." First, what are the key points of your presentation?

The main, key point is that the risks and the rates of posterior capsular rupture during cataract surgery are well documented in the literature. But what we don't know is the impact of having posterior capsular rupture [PCR] in one eye, on the risk of developing posterior capsular rupture in the second eye. And that is the main goal of our study, to quantify the risk of posterior capsular rupture in the second eye in patients who had the history of PCR in their first eye.

What factors contribute to the increased risk of posterior capsular rupture in patients undergoing cataract surgery on their fellow eye?

We conducted the multivariate logistic regression model to adjust for confounding factors, to see if history of PCR itself is an independent risk factor of developing PCR on the other eye. And after adjusting of all confounding factors, or non-confounding factors, we found that the risk is 1.7. We don't know the explanation for that, but there are two theories in our minds. 

The first one is tissue factors. Several studies showed difference in the capsular thickness and the mechanical strength variation in the posterior capsule between different individuals. Second explanation is patient factors: patients with difficult positioning, uncooperative patients, [or patients with] deep sockets are more susceptible to complications in both eyes.

Are there specific surgical techniques or preoperative assessments that can help reduce the risk of posterior capsular rupture in fellow eye surgeries?

 As in any pre-op planning for cataract surgery, you take a good history from the patients. Make sure that if they had the history of pars plana vitrectomy, that increased the risk of PCR more than 10 introvitreal injections. We conducted multiple studies showing that more than 10 injections increases the risk of PCR. [A] history of trauma, history of pseudoexfoliation, all of that. And these all are known risk factors. 

But what we are adding in our study is taking a history from the patient, if they had PCR in their first eye, then you know, and you can counsel the patient that they are at increased risk of developing PCR in the second eye. Because, interestingly, in our study, most of the patients, about 72% of the patients, did not have an obvious risk factor for PCR intraoperatively or even during the [preoperative] planning.

How do the outcomes of posterior capsular rupture in the second eye compare to the first eye?

So, in terms of visual outcomes, we compared the visual outcomes of patients who had a PCR in their second eye to patients who did not have a PCR, and that visual outcome was better in the patients who did not have PCR. But comparing PCR in the second eye versus PCR in the first eye was comparible.

What are the key considerations for managing these complications?

The main thing is pre-op planning, counseling. Make sure that you have what you need in the room. You know, get comfortable with identifying the risk factors, identifying the capsular rupture when it first happens. You can use Kenalog [triamcinolone acetonide] and the usual technique for managing posterior capsular rupture. Kenalog, assess the capsular support, good anterior vitrectomy and evaluate if you need to proceed with the surgery, with implanting an IOL, or refer to a retina specialist, based on the situation, based on the site and the size of the rupture.

Given the potential risks, how should ophthalmologists counsel patients with a history of posterior capsular rupture in one eye when planning surgery for the second eye?

I think the first thing is to try to dig deep into the operative note for the patient to see if there is any red flags, like uncooperative patients or patients who are anxious during the surgery...Try to talk to the patient about how the surgical procedure goes. If the patient is completely uncooperative or has medical problems, like coughing or severe COPD, you can talk to the anesthesia team to see how [to] make this patient as comfortable as you can. That's one thing. The other thing is, counsel the patient that, given the history of the first eye, there's still an increased risk in the second eye.

AAO 2024: Quantifying risks and avoiding posterior capsular rupture in the second eye

Dr Rick Lewis discusses the FLigHT procedure and ViaLase laser at the 2024 European Society of Cataract and Refractive Surgeons (ESCRS) meeting

This year, the European Society of Cataract and Refractive Surgeons holds its congress in Barcelona, Spain. We spoke with Rick Lewis, MD, about the femtosecond laser image-guided high precision trabeculotomy (FLigHT) procedure from ViaLase, the company’s recent CE mark and 36-month results he presented at the meeting.

Editor’s note: The below transcript has been lightly edited for clarity.

 This year, the meeting of the European Society of Cataract and Refractive Surgeons is in Barcelona. Joining me today, I have Dr Rick Lewis, who is the Chief Medical Officer at ViaLase, who's going to talk about what he's bringing to the meeting. Dr Lewis, thank you so much for being here.

 Thank you for the kind introduction. You know, it's a pleasure to be here and share what I think is very exciting data from our initial phase one safety study at ViaLase. We evaluated channel patency, intraocular pressure and safety over a 36-month period in our initial cohort of open angle glaucoma patients, looking at the FLigHT treatment; FLigHT stands for [femtosecond laser] image-guided high precision trabeculotomy. This was a prospective, single-centre study. It wasn't randomised. It was 18 eyes with 12 patients and started back in 2020. We had our prototype machine and were able to create, without any safety issues, a channel in the trabecular meshwork of 200 by 500 microns, and this is a non-incisional trabeculotomy. What separates the approach with ViaLase is that the patient interface, like what you get with IntraLase or LenSx, is applied to the patient's eye after applying topical anesthetic. The procedure takes minutes. There's no incision, there's no restrictions post-op, there's no hyphema, and the patient has a trabeculotomy.

We were able, in the study, to follow them over the course of 3 years. Our data is impressive. We got pressure reductions of almost 7 millimeters. A few patients did need to require medications, but the vast majority did not, and our safety, both initially and at 3 years, was remarkably good. So we're very excited about this.

We're actually in the middle of other studies now, some of our pivotal studies, and we're happy to report that we have applied for and received EU approval, European Union approval, to launch this product in Europe, [either at the] end of this year, or more likely, the first quarter of next year. This will be, again, the FLigHT treatment with ViaLase. So it's an exciting time. We have a number of presentations at this year's ESCRS meeting, including the iNovation session.

This particular abstract will be presented in the scientific programme. We have a series of other meetings, and are very excited to launch this new approach to treating glaucoma.

: I was lucky enough to report on that CE Mark that the ViaLase laser received in the EU just just a few weeks ago. What do you think that that approval, and this procedure, says about the changing landscape of both glaucoma care and refractive care?

 I've been in glaucoma for close to 40 years, and it's always been frustrating. You know, historically, we have treated glaucoma with topical eye drops, which we all know patients are non-compliant and create a significant ocular surface problem for those patients, not only in glaucoma, but for refractive and cataract surgery. The ability to create a trabeculotomy without a corneal incision will add a unique and special opportunity in treating these patients, both early and late in the disease. And I think that represents, truly, like you say, a paradigm shift in the management of this disease. I'm excited by it. And when you look at the technology, most everyone gets excited by it. This is very unique, and it isn't even the creation of the trabeculotomy. It's our imaging system, both gonioscopic imaging and OCT imaging, that allows very precise placement. With a commercialised device, we will be able to place one, two, three or even four channels. And there is very little risk involved in this, and it avoids all the problems that happen with intraocular trabeculotomy. So a very exciting opportunity. And again, between this and some of the other laser treatments, I think the paradigm of using medications early will probably be changed.

: The other major aspect of the FLigHT procedure that makes it so unique is that it's something that extends treatment to patients regardless of their lens status. What do you think is so important about accessibility, especially for patients in Europe?

: Well, you know, the issue with lens status has to do, of course, with all the approved MIGS treatments. In any area, whether it's Europe or North America, the approval process demanded that a cataract surgery be done in conjunction with most of the device-related MIGS procedures. Well, not everybody, of course, has cataracts, or perhaps has had cataract surgery in the past, and cannot be a combined procedure. The opportunity here to do it in phakic eyes and pseudophakic eyes, in primary glaucoma and secondary glaucoma, in a variety of age groups, whether it's...an ideal treatment in the future for early juvenile-onset glaucoma, and certainly even in the elderly. Because the risk factor is significantly reduced. Now, we don't have data yet on some of these secondary glaucomas, but the opportunity is obvious and will certainly be pursued.

: I know that you and I have discussed how we're both turning our European conference travel into vacations this year, because we're smart! But the ESCRS is 

 a big congress. Tell me a little bit about what you're looking forward to discussing or debating with your colleagues there.

: You know, ophthalmology is such an exciting field, and there's so many things going on at all these different levels. You know, whether it's cornea, refractive or cataract, the new lenses, the laser-adjusted lenses, the ability to treat glaucoma with non-pharmaceutical ways, you know, the cornea treatment, there's exciting areas of replacing cornea. You learn so much at these meetings, and just getting to see your colleagues and hear the latest presentations, I feel very fortunate that I'm in ophthalmology. I can't think of a more exciting field than this.

: Well, I feel very fortunate that you've joined me this morning to discuss the meeting, and I'm sure that our viewers will feel the same. Thank you so much for your time and safe travels!

Rick Lewis, MD, speaks about a non-pharmaceutical approach to treating glaucoma with laser technology

ESCRS 2024: 36-month results following femtosecond laser image-guided high precision trabeculotomy (FLigHT)

Noel Brennan, MScOptom, PhD, a clinical research fellow at Johnson and Johnson

At this year's ARVO meeting in Seattle, Washington, the Eye Care Network spoke with Noel Brennan, MScOptom, PhD. The clinical research fellow at Johnson and Johnson shared highlights from his presentation on myopia control and predictive modeling.

Note: The below transcript has been lightly edited for clarity.

Hi, I'm Noel Brennan. I'm a clinical research fellow at Johnson and Johnson. I'm here at ARVO 2024 in Seattle. I have a presentation here called 3-year myopia control efficacy can be predicted from 1 year data. Now, the background to this is that the gold standard for myopia control studies has kind of been a 3-year study. But there's a few problems with this, because keeping kids in a control group for 3 years is, perhaps, not ethically acceptable any longer. And in addition, we've noticed that some of the longer-term studies, the control groups seem to be becoming perhaps contaminated, as parents are aware that the kids are progressing too fast and maybe withdraw them from the study, or perhaps even seek treatment outside of the study protocol. So we wanted to see if we can predict these longer term efficacy numbers from short-term data. 

And our initial attempt to do this kind of failed, because we couldn't find enough studies that had 3-year control and treated groups. But, what we're able to do initially, then, was just look at progression. So we looked at 1-year axial elongation, and axial elongation is really the, the benchmark that we use for looking at progression. And we found a lot of studies for that had 3-year data, and the correlation was really quite good. And we could deduce from that, that you are getting double the efficacy at 3 years that you are getting at 1 year. So what the presentation here has done is built on that. 

We found a few additional studies that were published, and we went back and reviewed some of the earlier work that we had. And in the end, we found 15 studies where we could correlate 1-year efficacy with 3-year efficacy. And rather incredibly, the correlation was, the R-squared value, was 0.97, which is quite remarkable, even though the quality of the studies was not necessarily that great. So this is further support for that concept that 3-year efficacy is going to be double 1-year efficacy. And you might say why isn't a triple? And that's because we get this initial treatment effect in the first year that is that is quite large and strong, and it subsides over the subsequent years. 

And how do we make sense of this? You know, what, what what news can we report with all this information? Well, first of all, you know that from a regulatory standpoint, perhaps we don't need to do 3-year studies, and we need to review what we perhaps should do. The second point for clinicians, though, is if you have robust 1-year clinical data from a trial, you can use that to predict how well that particular intervention will perform in the longer term. And certainly now, from our perspective, this is what we base our understanding of efficacy on, it's the 1-year axial reduction that we see. And if you have a list of these, you'll get the rank order. And we think that's the way really that we should be moving forward for the future. So the next steps for this research really are that we're trying to put together a complete model, a comprehensive model, of efficacy, so that we can predict what's going to happen beyond 3 years, so to 6 years and 12 years, and we're well on the way there. So for ophthalmologists, you know, the key thing here is what does the 1-year data look like? So you need a robust 1-year trial, and if you look at the data and put them in rank order, that rank order is going to maintain over the longer term, so you can work out which treatments are the most efficacious. But the 1-year data really should be a multi-site, randomised, controlled trial with a large sample size, because we do see some data where the trials are not so strong in their design, and we get can get some strange numbers from that. So we do need quality, 1-year trials.

At this year's ARVO meeting, the Eye Care Network got a glimpse at the future of paediatric myopia control research

ARVO 2024: Predicting the efficacy of myopia control methods using 1-year data

Dr Rah discussed the in-home use test of BioTrue Hydration Plus multipurpose contact lens solution (Bausch + Lomb) on patients who are considering lens dropout.

ARVO 2024: Novel contact lens solution bolsters comfort in potential lens wear dropouts

At ARVO 2024, Marjorie Rah, OD, PhD, FAAO, presented a poster on an in-home use test of BioTrue Hydration Plus multipurpose contact lens solution (Bausch + Lomb) to measure increased comfort for contact lens wearers. This test was limited to patients who self-reported consideration of discontinuing lens wear in the 6 months following the initial appointment. Only patients who reported dryness as a factor for discontinuation were considered.

Of the 202 participants, 90% of patients reported improved comfort following the switch to the new multipurpose solution, and 86.6% agreed they are more likely to continue contact lens wear following the study. These findings were self-reported in a survey completed by patients.

Hi everyone, I'm here with Dr. Marjorie Rah, who is presenting a poster at ARVO on the in-home use of a novel contact lens solution in contact lens wearers on the verge of dropout. So welcome, Dr. Rah. I'm so glad that you could make it.


Of course. So first, can you tell me a little bit about the topline results of the study?


Absolutely. So after our launch of BioTrue Hydration Plus multipurpose solution, we conducted an in-home use test with 202 soft contact lens wearers. They had to be at least 18 to be in the study and know what contact lens solution they were using. And in this particular instance, they had to have said to us upfront that they were considering dropping out of contact lens wear in the next 6 months due to dryness or discomfort. So the reason that's important is because of the inspiration behind our product being largely from the TFOS DEWS II report and the bioinspired ingredients that we have in it that help with dryness.

So we asked these potential dropouts to use BioTrue Hydration Plus for 7 days. And then we gave them a survey about their experience with the product. And it was very positive responses. 90% agreed that their contact lenses felt comfortable and hydrated all day. High percentages also said that it improved their lens wearing experience. Really, one of the key things we found was that 88.6% agreed that they would likely continue to try to wear contact lenses after trying BioTrue Hydration Plus. So you know the results basically show that changing a solution or selecting a solution can positively impact the wearing experience of our patients.


Yeah, that's fascinating. So I'm also curious, did any participants seek treatment for dry eye during the study? Like any additional supplemental therapies?


No, not that we're aware of during the study.


Okay. And then I'm also just curious, how was improved comfort measured in the study?


We asked them to answer survey questions that were agree/disagree. So we gave them a 7-point scale. So there were, you know, strongly agree, agree, slightly agree, but there was also a neutral response. So if they didn't have an opinion, one way or another, they could pick that. And then there were an equal number of disagree spots. And we asked them about improvements in comfort and summarize those who agreed that there was an improvement.


Fantastic. And were there any surprises along the way within the study?


I don't know if it's a surprise, but I think one thing that we do tend to overlook is the importance of a lens care solution. I think we oftentimes go to the lens or lens material first, and don't recognize that a lens care solution is important as well.


And what are some key takeaways that you want to really drive home to optometrists?


I think that the main key takeaway is, you know, kind of what I've already said: if you have patients that have dryness and discomfort, don't forget about your contact lens solution. That the care system can make a difference in these frequent replacement lens patients.


Is there anything else that you want to mention that we haven't touched on?


Just that this study demonstrates the real world positive impact that BioTrue Hydration Plus multipurpose solution has on the comfort of our contact lens wearing patients.


Great. Well, fantastic. Thank you again, Dr. Rah for taking the time to chat today. I really appreciate it and can't wait to hear more about it and hope your poster goes well.

Marjorie Rah, OD, PhD, FAAO, discussed the in-home use test of BioTrue Hydration Plus multipurpose contact lens solution (Bausch + Lomb) on patients who are considering lens dropout.

Video Series

NOFOLLOW

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Josefina Botta, MD, MSc, at ASCRS 2024

Well, hello, everyone, I'm Dr Josefina Botta from Buenos Aires, Argentina, and today we're here in Boston, attending the ASCRS meeting. This year, it's been phenomenal. We had such a good turnout. I actually presented my real results using the RayOne EMV toric lens. 

It's been really challenging to be able to present it here, for the American audience, not because they don't get with the message we're trying to deliver, but only because they don't have the lens yet. So I've been trying to introduce the lens for them. It's a real, really good lens; it's monofocal plus, that's a way we actually picture it to everyone. So we've been able to show results, show how stable the lens is in the bag. It doesn't rotate, the calculation is pretty accurate. And you're going to be able to give your patients real good distance vision, intermediate vision. And sometimes, when you play a bit with micromonovision or minimonovision, you're going to be able to deliver some functional near vision. So of course, we're not talking about a trifocal lens, but still very functional, very practical, from our point of view. 

And also in correlation with what I'm just explaining, we will be working with the RayPRO platform, which is a digital platform that it's been created by Rayner, both for desktops and [as an app]. The only thing you need to do is to introduce your patient's email address, the type of lens you placed, it doesn't have to be a Rayner lens of course, because we're trying to be collaborative and work around with everyone. And we're very focused on their responses to the Cat-PROM5 questionnaire where they would answer what their experiences so we are very focused into the patient's experience. And we were able to actually come up with really good conclusions that we weren't expecting. Their number one complaint, the number one reason why they wouldn't be happy with our surgeries is because of dysphotopsias, and not much in relation to the use of glasses after surgeries. 

We're going to be presenting these results in the upcoming ESCRS this year in Barcelona. So we hope to find you there and if there's any questions you may be able to contact myself or a member of our team. Thank you very much.

Josefina Botta, MD, MSc, discusses her real-world experiences with the RayOne EMV toric lens

ASCRS 2024: Real-world results with an enhanced monovision toric lens

Leonard Borrmann, CEO of CentricityVision, speaks at ASCRS

At this year's ASCRS meeting in Boston, Massachusetts, Leonard Borrmann, CEO at Centricity Vision, spoke at the Eyecelerator event about the company's newest product, ZEPTOLink, including first-in-human data from the device.

I'm Leonard Borrmann, and I'm the CEO at Centricity Vision. And I'm here at ASCRS, where we're launching our new product ZEPTOLink. We're really excited about ZEPTOLink. ZEPTOLink is the first and only product that's capable of creating a 360-degree, instantaneous capsulotomy. Earlier this week, at Eyecelerator, I presented some of our first in-human data on ZEPTOLink. We had 4 doctors do 61 cases of patients undergoing cataract surgery, treated with ZEPTOLink. All 61 of the patients had complete capsulotomies with no signs of tags or tears. The results, in terms of capsulotomy diameter and circularity, were extremely precise. A capsulotomy size at 5.1, and circularity very, very low at five one-hundredths of a millimeter. We're really excited about the data. The procedure itself was all performed in less than 13 seconds, in all cases. It's very cost-effective in terms of getting it into the operating room. And we're really excited about the possibilities that ZEPTOLink brings in terms of improving outcomes for your premium patients, making complex cases just a little less challenging, and most importantly, doing all of that in a very productive, efficient and cost-effective manner.

The technology, which creates a 360-degree, instantaneous capsulotomy, appeared at the Eyecelerator event

ASCRS 2024: First-in-human data from Centricity Vision's ZEPTOLink IOL positioning system

Elizabeth Yeu, MD, speaks at ASCRS 2024

At this year's ASCRS meeting, we spoke with Elizabeth Yeu, MD, as she concluded her term as president of the ASCRS. In this video, she discusses a case report, detailing how the triple procedure can be beneficial for different patient populations. The data discussed are from her ASCRS presentation, 'Human corneal endothelial cell transplantation combined with cataract extraction and PCIOL in subject with corneal oedema.'

Hi, my name is Elizabeth Yeu. I'm a cornea, cataract and refractive surgeon at Virginia Eye Consultants. I have been so fortunate to be involved with the Aurion clinical trials, which we were able to do the phase 1 and 2 studies in El Salvador to make sure that we were looking at the human corneal endothelial cells [CEC] with a proprietary ROCK [rho-kinase] inhibitor and find out the right dosing. But at the same time, we were also able to help with different patient populations.

In doing so we were able to help certain patients, for example, an 85-year-old patient who had a very significant cataract with 20/800 vision and a 700-micron cornea. And this patient certainly needed to have some kind of procedure where we could take care of both at the same time. In the US, obviously, this would be a patient that's standard of care who would absolutely be considered an an EK [endothelial keratoplasty] procedure at the same time with a combined cataract surgery. So absolutely recognising that having done multiple corneal endothelial cell injection therapy patients and seeing the results of that, we said, well, absolutely, let's do the cataract surgery and consider a triple procedure, see how this patient does because we know how successful the CEC therapies have been for our patients.

So thus, we did perform for this 20/800 patient with a significant cataract and a thickened cornea, a triple procedure doing the phacoemulsification and the human corneal endothelial cell injection therapy that also had the ROCK inhibitor.

And lo and behold, absolutely wonderful results that we could see. In terms of any differences in the way that surgical procedure was performed, absolutely not. Just a routine cataract surgery for a mature brunescent lens. And at the end of the procedure, we perform the normal injection therapy of the cells as we normally would have after bringing the pupil down.

And after 2 months, there was a 200 micron decrease in the corneal thickness from 700 microns down to 500 microns. And the patient by post-op month 6–there was gradual improvement of vision–but the patient by post-op month 6 was 20/25 with a 500-micron cornea from limbus to limbus.

These patients look like none other. It is completely different than the kind of patients we see with allograft postoperative cadaveric donor corneas, because it is not just clearing of the central 70% of the cornea. It is limbus to limbus clearing and 500 microns of glistening pure clearing of the full 11 to 12 diameter cornea.

It is completely life altering for these patients that we see postoperatively and it just makes you realise that we are going to be able to potentially change the way that we are able to help our patients in the US, in the future, globally as well, for our visually significant cataracts who also have have visually significant endothelial disease.

It's very promising therapy for both our pseudophakic as well as our phakic patients who have significant endothelial damaged corneas. Thank you.

Elizabeth Yeu, MD, discusses a corneal case report at ASCRS 2024

Cataract & Refractive

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