EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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March 2012 is about to come to fruition." There are two paradigms for continuous IOP monitoring, he said. One is a short-term approach, such as with a contact lens-based system that could record IOP for up to 24 hours. The other is an implantable system, per- haps attached to an IOL or incorpo- rated within a glaucoma drainage device, to provide long-term IOP monitoring. "These will likely be complementary in clinical practice, he said. Joseph Caprioli, M.D., was less optimistic about the role of con- tinuous IOP monitoring in clinical glaucoma management. "Currently there is no evidence that 24-hour IOP monitoring is important," he said. This is because the data on IOP variability as an independent risk factor for glaucoma progression is inconclusive, he said. "We need an appropriately designed clinical trial to demonstrate that it's a risk fac- tor." Dr. Sit agreed that we do not yet know the significance of short- term IOP fluctuation in the glau- coma disease process. "The ability to measure 24-hour IOP patterns will provide us with a better idea of its importance over time," he said.Nathan Radcliffe, M.D., dis- cussed sustained drug release ther- apy as another unmet need in glaucoma. "The benefits would be substantial," he said. He pointed out that adherence with topical medical therapy in glaucoma is notoriously poor and even patients who try to comply often fail. "Studies have shown that only about 40% of at- tempted eye drops actually hit the eye," he said. These problems could be overcome by a drug-eluting im- plant that takes compliance out of the hands of the patient. He also made the point that side effects of drugs on the ocular surface could be minimized or eliminated if drug de- livery were moved to the intraocular space. Further, sustained drug release would likely provide more continu- ous IOP reduction with less diurnal IOP fluctuation, which may help control the disease better. Diet and glaucoma A pair of studies evaluated the role of various nutrients in glaucoma. Sophia Wang, B.A., conducted an epidemiological cross-sectional study using a database containing detailed dietary information as well as self-reported glaucoma status. She found that people who intake high levels of calcium (greater than 800 mg/day) were 2.4-fold more likely to self-report glaucoma compared to