Eyeworld

63 EW RETINA October 2015 "There is the potential for extru- sion with these types of devices," Dr. Charles cautioned. "There's a high likelihood of extrusion of these large implants in the subconjunctival space, especially because of the need to utilize needles to replenish the reservoir periodically." He equates the technology to glaucoma valve implants—and that vitreoretinal specialists often treat patients with blebitis or endophthal- mitis resulting from a breakdown of the bleb and its subsequent infec- tion. Some of the more promising devices are "on the cusp of starting larger phase trials" that will address some of the questions/concerns, "but for now, it's very difficult to know what will come out on top and whether or not it's any better than what we're doing now," Dr. Jumper said. AMD and cataract surgery Knowing the visual potential for an eye with both AMD and cataract is crucial in managing patient expecta- tions, Dr. Jumper said. "We need to directly communicate with the cata- ract surgeon about the visual poten- tial to help them decide if moving forward with cataract surgery will be beneficial," he said. Cataract surgery itself "has no impact" on AMD progression, and "anti-VEGF therapy can and should be continued on schedule while pro- ceeding with cataract surgery," Dr. Charles said. Further, if the patient has dry AMD, "they're not likely to convert to wet because of the cata- ract surgery," Dr. Jumper said. Dr. Charles recommends pa- tients receive an anti-VEGF injection "a few days before phaco," but Dr. Jumper is more comfortable with a few weeks between the two proce- dures to eliminate questions about postop/post-injection inflammation or infection. Well-constructed wounds do not need to be sewn closed, and because injections place "very little external pressure inward on the eye," wound complications as a result of an intra- vitreal injection are uncommon. EW Editors' note: Dr. Charles has financial interests with Alcon (Fort Worth, Texas). Dr. Jumper has financial interests with Allergan (Dublin, Ireland), Genentech (South San Francisco), Ophthotech (New York), and Regeneron (Tarrytown, N.Y.). Contact information Charles: scharles@att.net Jumper: jmichaeljumper@gmail.com Join Beaver-Visitec at AAO Experience the Benefi ts of Ophthalmic Endoscopy at our Hands-on Wet Lab! See. Diagnose. Treat. Learn more about the benefi ts of ophthalmic endoscopy for the surgical treatment of retinal diseases and other applications such as foreign body removal and visualization of anterior and posterior segments of the eye. Endo Optiks® Ophthalmic Endoscopy Course & Wet Lab Highlights of the Wet Lab: • Ophthalmic endoscopy overview • Technical hands-on wet lab with BVI surgical representatives Beaver-Visitec International, Inc. 411 Waverley Oaks Road, Waltham, MA 02452 Tel: 1.866.906.8080 Fax: 1.866.906.4304 www.beaver-visitec.com BVI, BVI Logo and all other trademarks are property of Beaver-Visitec International (BVI) © 2015 BVI Location: On AAO 2015 Retinal Subspecialty Day The Venetian, Las Vegas Room: Venetian Hospitality, Parlor PL2, Palazzo Tower Date: Friday, November 13, 2015 Time: Reservations and Refreshments at 5:30 pm While at AAO, stop by Booth 1221 to see a complete line of BVI Ophthalmic Products REGISTER ONLINE NOW endooptiks.com " We need to directly communicate with the cataract surgeon about the visual potential to help them decide if moving forward with cataract surgery will be beneficial. " –J. Michael Jumper, MD

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