Eyeworld

JUL 2013

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

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58 EW MEETING REPORTER July 2013 ARVO continued from page 54 Reporting from the 2013 Association for Research in Vision and Ophthalmology meeting, Seattle Age-related choroidal Neovascularization (IVAN) found visual acuity gains achieved after the first three monthly injections of either ranibizumab or bevacizumab were maintained at 24 months. (Ranibizumab is marketed as Lucentis, bevacizumab is marketed as Avastin, both by Novartis in the U.K.) "What differences there are, are small," said Simon Harding, MD, Liverpool, England. The U.K. study findings are similar to the U.S.'s Comparison of Age-Related Macular Degeneration Treatment Trials (CATT), with bevacizumab showing non-inferiority to ranibizumab. When it comes to drug cost, ranibizumab costs about $1 million/ quality-adjusted life years "and is not any more effective than bevacizumab PRN," he said. Dr. Harding said "monthly bevacizumab may be the best compromise between safety and costs without loss of efficacy." Of potential concern is that a greater drop in serum vascular endothelial growth factor was seen in the bevacizumab arm, but the relevance is not yet known. Editors' note: Dr. Harding has financial interests with Novartis. GEFAL: Lucentis, Avastin similar The French Evaluation Group Avastin Versus Lucentis found noninferiority between bevacizumab (Avastin) and ranibizumab (Lucentis). In the GEFAL study, 255 patients received 1.25 mg of bevacizumab and 246 patients received 0.5 mg ranibizumab. As with other comparator studies, patients were dose-loaded for three months and then assessed for treatment at subsequent visits. In both drug groups, a mean of seven injections per patient were necessary. During a press conference, lead author Laurent Kodjikian, MD, Lyon, France, said more systemic Image sources: Howard Frisk, Tim Thompson, Michael Ramey, www.visitseattle.org serious adverse events were reported with bevacizumab, but the sample size was small and no definitive conclusions could be drawn. Editors' note: Dr. Kodjikian has financial interests with Alcon (Fort Worth, Texas), Allergan (Irvine, Calif.), Bausch + Lomb, Bayer (Leverkusen, Germany), Krys Group, Novartis (Basel, Switzerland, Thea (Clermont-Ferrand, France), and Carl Zeiss Meditec (Jena, Germany). Triplet optical design for IOLs A triplet-type optical design produced large changes in power in response to miniature lens compression, according to a poster presentation from Enrique Josua Fernandez and Pablo Artal, Murcia, Spain. "Existing accommodating IOLs do not provide enough power change to the eye," they said. "Future accommodating IOLs should have high sensitivity to the small compression/stretching forces that occur inside the eye." Their triplet design includes haptics that evenly distribute the forces released by the ciliary muscle and capsule during the accommodative effort. "The haptics could be designed to operate in combination with a special capsular ring," they said. Editors' note: Both researchers have patents pending related to the triplet design. Early vision assessment reliable Early vision assessment and assessing late vision on only returning patients are valid measures of operative quality where follow-up is poor, according to a poster presentation. Nathan Congdon, MD, Hong Kong, and colleagues validated two strategies to determine visual outcomes in developing areas with poor followup after cataract surgery. Each of 40 centers in 10 countries in Asia, Africa, and Latin America enrolled 40-120 consecutive cataract patients. Of the 3,708 participants, 51.5% returned to their clinics after 40 days. "Early assessment of all subjects or later assessment of only those returning spontaneously to clinic provide a sufficiently valid indication of hospital performance to be useful to program planners," Dr. Congdon said. "In view of these results, we suggest that WHO cataract surgical targets be modified to include evidence-based values, including specific targets for early VA assessment." Editors' note: Dr. Congdon has no related financial interests. Mucosal-penetrating particles show potential for AMD Kala Pharmaceuticals (Waltham, Mass.) presented preclinical data suggesting that topical delivery of a small molecule receptor tyrosine kinase inhibitor (RTKi), formulated using Kala's proprietary mucosalpenetrating particle (MPP) technology, greatly enhanced drug levels in the retina, the company said in a news release. The preclinical data suggested that topical RTKi-MPP showed a five-fold enhancement in retinal drug concentration over a non-MPP nanoparticle control in non-pigmented rabbits, a single dose of RTKi-MPP resulted in retinal drug levels that were >40 higher than the drug's IC50 for KDR, an RTK also known as VEGFR2, for up to 24 hours, and topical administration was well tolerated. Bioptigen intros first 1 µm OCT system for ophthalmic research Bioptigen (Research Triangle Park, N.C.) introduced 1 µm axial resolution imaging to its line of Envisu spectral-domain optical coherence tomography (OCT) systems. Now, NKT Photonics' (Birkerod, Denmark) SuperK supercontinuum laser integrates with Bioptigen's 300 nm spectrometer to achieve cellular-level in vivo ophthalmic imaging for preclinical research. EW

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