Eyeworld

MAR 2012

EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.

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March 2012 performing poorly on the driving test were older and had lower vision, but had similar degrees of visual field loss, compared to controls, she said. "This may actually be a best- case scenario," Dr. Bhorade pointed out, "because 75% of the glaucoma patients eligible to participate in this study declined, and the most com- mon reasons for declining were dis- comfort with the driving course or fear of losing their driving license." Sunday, March 4 New science in glaucoma Douglas J. Rhee, M.D., reported that his research group has identi- fied a molecule that may play an im- portant role in the regulation of IOP in humans on the third day of the American Glaucoma Society (AGS) meeting. "IOP regulation is related in part through turnover of the ex- tracellular matrix within the trabec- ular meshwork," he said. SPARC (secreted protein, acidic, and rich in cysteine) is a protein within the ex- tracellular matrix. Dr. Rhee's research demonstrated that upregu- lating SPARC expression increased outflow resistance and raised IOP in experimental models in vitro and in mouse models in vivo, confirming its role in IOP regulation. "SPARC joins an elite group of proteins that have demonstrated this level of evi- dence," he said. "This discovery and others like it get us closer to under- standing how IOP is regulated and what may cause glaucoma." Kaweh Mansouri, M.D., used the contact lens-based Triggerfish 24-hour con- tinuous IOP monitor (Sensimed, Lausanne, Switzerland) to evaluate circadian IOP on two days a week apart in a group of glaucoma pa- tients and suspects to determine if IOP varies similarly from day to day within individuals. "Continuous 24- hour IOP monitoring demonstrated moderate short-term repeatability of circadian IOP patterns," he said. "These findings suggest that data from a single 24-hour IOP monitor- ing session can be used in clinical practice for the management of glaucoma patients." Glaucoma's ef- fect on patient mobility was evalu- ated by Pradeep Ramulu, M.D. "It TORIC/LRI MARKERS S9-2033 Pre-Operative Alignment Marker For marking patient on gurney or at slit lamp prior to procedure • Three fine marking points at 3, 6 and 9 for accurate reference • Properly angled handle allows an unimposing approach to patient is well known that individuals with glaucoma are more likely to stop driving and to have more frequent falls than patients without glau- coma," he said. His group postulated that glaucoma patients may tend to stay home more as a consequence. He utilized a cellular tracking device on patients to see if having glau- coma reduced their travel away from home compared to a control group of glaucoma suspects. "Glaucoma was associated with fewer daily ex- cursions from home," he said, "and among glaucoma patients, the more advanced the visual field loss, the more likely they were to stay home as well." He pointed out that being confined to home may have detri- mental effects on fitness and health, and he suggested that interventions to help these patients travel safely away from home should be consid- ered. EW MEETING REPORTER 137 Unmet needs in glaucoma As physicians get closer and closer to having a practical tool for continu- ous IOP assessment in clinical prac- tice, the importance of doing so has become a topic of debate in the glaucoma community. "The ability to continuously measure IOP has been sought after for a long time," said Arthur Sit, M.D. "With recent advances in technology, this dream continued on page 138 S9-2060 Mendez Style Degree Gauge Intra-operative ring for aligning to steep axis and defining LRI points • Large 11.7mm internal diameter provides for maximum visualization • Beveled surface reduces reflections form microscope lighting • Crisp laser etched markings every 5˚ for greater marking accuracy S9-2065 Axis Marker Works inside the Degree Gauge to mark prime meridian (steep axis) for LRIs and Toric alignment. • Fits inside Degree Gauge perfectly • Crisp edges create a fine demarcation • Length of marks accommodates both limbal and corneal marking S9-2050 LRI Marker Provides crisp marks at commonly used LRI Positions • Fits inside Degree Gauge perfectly • Creates symmetrical, opposing marks for 30˚, 45˚ and 60˚ incisions • Fine arc connects degree endpoints for easy, acurate incisions 2500 Sandersville Road, Lexington, KY 40511 Phone: 1-800-354-7848, 859-259-4924 Fax: 859-259-4926 E-mail: stephensinst@aol.com Web: www.stephensinst.com

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