Eyeworld

I DECEMBER 2019 | EYEWORLD | 49 at 2 [hours] following the instillation of the eye drops." They also found no statistically significant change in OSI, while there was significant change in pupil size between photopic and scotopic conditions. In terms of safety, Dr. Alió and Dr. Vargas also evalu- ated endothelial cell count and the ocular surface 1 month after instillation of FOV Tears and found no changes nor evidence of tachyphylaxis. "The only side effect was head- ache, which was reported in 10% of the patients," they wrote. Dr. Vejarano himself wrote that he has been taking the drops daily for 10 years. "Until now, I don't have any secondary effect that cause any risk for the normal health of the eye or put in jeopardy the visual capacity," he wrote. "I see 20/20 for far and near, and I am 52." Revitalizing the crystalline lens In contrast, working with the standard theory of presby- opia as described by Dr. Vejarano, Novartis has been devel- oping UNR844. Derived from EV06, a lipoic acid choline ester, Dr. Hovanesian said the drop is intended to increase the flexibility of the aging crystalline lens. A principal investigator for Novartis, Dr. Korenfeld wrote that UNR844 "is designed to reduce the disulfide bonds that form between proteins within the crystal- line lens. Crosslinking of these proteins constrains their movement, one relative to the other, and this results in reduced deformability of the lens when it is acted upon by the forces produced by ciliary muscle tone variations, and conveyed to the lens via the zonules. This pharmacologic approach does not go away in less than a day, and in stud- ies done so far, the effect after 90 days of dosing can last up to 7 months later without additional dosing." Given that the mechanism of action of UNR844 is on the crystalline lens itself, essentially reversing the aging process of which cataract formation is a part, could these drops delay or even prevent cataract formation? UNR844, Dr. Korenfeld said, "has that potential, but it has not been studied yet." In practice These drops will most likely play a role in the younger, phakic, pre-cataract group of presbyopes. This group includes emmetropes who've had great vision their whole life or those with previous LASIK, and who, in either case, became frustrated needing reading glasses. "It's interesting continued on page 50 STREAMLINE YOUR PATIENT FLOW ACCURATELY PROJECT YOUR SPACE NEEDS DESIGN YOUR OFFICE TO MAXIMIZE PATIENT VOLUME FLOW ASSESSMENT SPACE ASSESSMENT FACILITY PLANNING "We have made at least $5 for every dollar we spent on Practice Flow Solutions. Working with Practice Flow Solutions saved me from a really bad plan from the general architect. Your pre-design Assessment was very detailed and pointed out all the flow issues with the plan I had. Invaluable."

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