Eyeworld

APR 2013

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

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February 2011 April 2013 Dry eye/ocular surface developer EyeGate Pharma (Waltham, Mass.) has said. Iontophoresis is a noninvasive technique that "achieves higher drug levels inside the eye by promoting the movement of charged substances across biological membranes by applying a low electrical current forming an electrical field." "Because it employs corticosteroids, this is probably not going to be an everyday, ongoing topical therapy," Dr. de Luise said, predicting patients will come into the office over a short episode—maybe two or three times a week for three to four weeks—for treatment. "Although the science is good, it seems to be a somewhat cumbersome modality," he said. Dr. Latkany said his main concern is using steroids in the eye, but "the technology sounds exciting, and it brings up a whole new con- cept of how we can potentially freely use steroids to treat patients." Although cataract development is a potential side effect of long-term steroid use, "it's such a routine surgery I would almost scratch that off the list as a deterrent to a new dry eye treatment," he said. Increasing the risk of glaucoma, however, remains a concern. Dr. de Luise said this will likely be a "niche product for cornea and uveitis specialists but probably less often employed by general ophthalmologists." "This is a complex delivery system that I don't think is going to be used for the mild dry eye patient," Dr. Latkany said. Lifitegrast A first-in-class small molecule, lifitegrast (SARcode, Brisbane, Calif.) is an immunomodulator. The com- pound targets T-cell mediated chronic inflammation and "works by blocking the binding of two important proteins that mediate the inflammatory cascade that is associated with dry eye. We don't know everything about dry eye, but we do know that inflammation is a foundational change in almost all dry eye types, whether evaporative or due to aqueous phase deficiency," Dr. de Luise said. He predicts that the compound might be able to be used synergistically with topical cyclosporine—similar to how adding a second glaucoma drop often helps patients reach their target pressures. In a study on patients with moderate dry eye, "there was a significant reduction in corneal fluorescein staining inferiorly, which is the most common place that we look. Secondary points included total staining and tear production so that EW FEATURE 47 patients felt significantly better as well," Dr. Donnenfeld said. The integrin inhibitor works to target T-cells by prohibiting LSA-1 from binding, thereby preventing T-cell modulation, he added. "Lifitegrast has a very rapid onset of action in treating dry eye, with a very high safety profile," Dr. Donnenfeld said. "It also improves tear production." "The results from these initial trials look promising," Dr. Pepose said, "but that's no guarantee of FDA approval." RX-10045 RX-10045 (Resolvyx, Cambridge, Mass.) is a resolvin. "Resolvins are very powerful mediators for the reduction of inflammation," Dr. de Luise said. "They're derived from omega-3 fatty acids, and they may prevent the loss of goblet cells, continued on page 48 OCuSOFT Introduces ® ™ Retaine ® MGD is a revolutionary preservative-free ophthalmic emulsion that moisturizes, revolutionar y preser vative-free m lubricates and protects moderate to severe dr y eyes. dry Retaine® MGD™ Droplets ELECTROSTAT ATTRACT LECTROST TIC TTRACTION T T r JOETQPTJUJWFMZDIBSHFEJPOTUPUIFOFHBUJWFMZDIBSHFE # DPS OFBMFQJUIFMJVN r F Q M F O J T I F T U I F M J Q J E M B Z F S P G U I F U F B S G J M N U P QSPUFDU 3 B H B J O T U N P J T U V SF M P T T B O E Q SP W J E F M P O H M B T U J O H D P N G P S U For FREE samples and more inform ation, call (800) 233-5469 or visit ASCRS Booth #1802 information, www.retainebrand.com www.retainebrand.com © 2013 OCuSOFT, Inc., Rosenberg, TX 77471 USA OCuSOFT, T

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