SEP 2013

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

Issue link: https://digital.eyeworld.org/i/176967

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Page 80 of 98

78 EW MEETING REPORTER September 2013 continued from page 77 Live reports from the World Glaucoma Congress, July 17-20, Vancouver measured in millivolts rather than mm Hg, making it hard to know if the device's output accurately reflects IOP. To solve this problem, he utilized the water-drinking test: IOP is known to rise after consuming water, so he evaluated the device's output following the waterdrinking test, performing Goldmann tonometry in the fellow eye as a control. "The Triggerfish device detects the rise in IOP following the consumption of water, although its signal takes longer to normalize than does Goldmann tonometry in the fellow eye," he said. This discrepancy may provide insight into precisely how the Triggerfish device detects IOP changes and may help refine its output. att 149 a 49 s a #41 # # #4 tu h# h h siii ttth s V oo V boo Viii boo O AO AA The power of one Two types of incisions – one module Refractive laser-assisted CATARACT surgery Refractive laser-assisted CATARACT A AR CLEAR CORNEAL & RELAXING INCISIONS RELAXING INCISIONS • • • • Custom-designed incisions Topographically matched Topographically Added precision and reproducibility Intrastromal incisions possible Exclusively available for the FEMTO LDV Z6 Power Plus FE EMTO www.femtoldv.com www.femtoldv.com Clear corneal and relaxing incisions are pending FDA approval and are not yet available for sale in the United States. Please contact Ziemer for details. Current controversies in glaucoma: A debate series Rohit Varma, MD, U.S., and Arthur Sit, MD, U.S., debated the importance of IOP variability as a risk factor for the progression of open-angle glaucoma. "In the Collaborative Initial Glaucoma Treatment Study, the only IOP parameters associated with progression were those related to IOP changes over time," pointed out Dr. Varma. Dr. Sit countered that when other major studies are considered—including the Early Manifest Glaucoma Study (EMGS), the Advanced Glaucoma Intervention Study (AGIS), and the Ocular Hypertension Treatment Study (OHTS)— the relationship between IOP variability and glaucoma progression is inconsistent. "This may be due in part to the lack of a standard definition of IOP variability," Dr. Sit suggested. "IOP fluctuates from minute to minute, from day to day, and across the months between regular office visits. We have no standards for the interval over which IOP variation is assessed, nor standard methodology for quantifying IOP variability." Both sides agreed that the current level of evidence is inadequate to determine the true importance of IOP variability as a predictor of glaucoma progression. Joel Schuman, MD, U.S., and George Spaeth, MD, U.S., took opposite stands on the issue of whether optic nerve imaging will someday replace stereoscopic disc photography as the best way to assess optic structure in glaucoma. Dr. Schuman conceded early that, "If you are an expert clinical observer of the optic nerve, then optic nerve imaging is not likely to provide you with much additional information. For the rest of us, imaging is helpful." He highlighted the OHTS, in which eligibility was dependent upon an expert panel's opinion that a subject's optic nerves were normal at the start of the study. Yet years later, baseline imaging using the Heidelberg Retina Tomograph (HRT, Heidelberg Engineering, Heidelberg, Germany) was able to predict which patients would eventually develop

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