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3 February 2018 by Vanessa Caceres EyeWorld Contributing Writer reported that the proportion of cataract surgeries at ASCs rose from 43.6% in 2001 to 73% in 2014. 12 EW References 1. Kuriyan AE, et al. Vision loss after intravit- real injection of autologous "stem cells" for AMD. N Engl J Med. 2017;376:1047–1053. 2. Rockoff JD. Shire sues Allergan for antitrust suit. MarketWatch. Oct. 2, 2017. www. marketwatch.com/story/shire-sues-allergan- for-antitrust-suit-2017-10-02 3. Wang X, et al. Tamoxifen provides structural and functional rescue in murine models of photoreceptor degeneration. J Neurosci. 2017;37:3294–3310. 4. Neely DC, et al. Prevalence of undiagnosed age-related macular degeneration in primary eye care. JAMA Ophthalmol. 2017;135:570– 575. 5. Steptoe PJ, et al. Novel retinal lesion in Ebo- la survivors, Sierra Leone, 2016. Emerg Infect Dis. 2017;23:1102–1109. 6. Ventura LO, et al. Visual impairment in chil- dren with congenital Zika syndrome. J AAPOS. 2017;21:295–299. 7. TFOS International Dry Eye Workshop (DEWS II). Ocul Surf. 2017;15:269–650. 8. Solomon SD, et al. Diabetic retinopathy: A position statement by the American Diabetes Association. Diabetes Care. 2017;40:412–418. 9. U.S. Preventive Services Task Force seeks comments on draft recommendation statement on child vision screening. www. uspreventiveservicestaskforce.org 10. Keen M, et al. Treatment of acute conjunctivitis in the United States and evidence of antibiotic overuse: Isolated issue or a systematic problem? Ophthalmology. 2017;124:1096–1098. 11. Kane CK. Updated data on physician practice arrangements: Physician ownership drops below 50 percent. American Medical Association. www.ama-assn.org/sites/default/ files/media-browser/public/health-policy/ PRP-2016-physician-benchmark-survey.pdf 12. Stagg BC, et al. Trends in use of ambulato- ry surgery centers for cataract surgery in the United States, 2001–2014. JAMA Ophthalmol. 2018;136:53–60. write and publish the Tear Film and Ocular Surface Society's Dry Eye Workshop II (DEWS II). The report's various articles, published in the journal The Ocular Surface, are a sequel to the report's original 2007 publication. 7 Ophthalmology trends As diabetes rates increase, physi- cians across all specialties must give more attention to diabetes-related complications. In 2017, the Ameri- can Diabetes Association published updated guidelines for the preven- tion, assessment, and treatment of diabetic retinopathy. 8 The previous guidelines were published in 2002. The guidelines addressed newer diagnostic equipment such as OCT and newer treatment modalities. In the realm of eye screening, the U.S. Preventive Services Task Force issued a draft recommendation that said children ages 3 to 5 should have at least one vision screening to check for refractive errors, strabis- mus, and amblyopia. 9 An Ophthal- mology study focusing on screening for acute conjunctivitis found that 58% of patients received a prescrip- tion for antibiotic therapy that was not needed. 10 Within the business of medi- cine, the American Medical Associa- tion reported in 2017 that only 47% of physicians have an ownership stake in their medical practice; that was a 6 percentage point decline compared with findings in 2012. 11 The percentage of physicians with employed positions rose by 5 per- centage points. An emerging trend within cat- aract surgery was the shift for more procedures to take place at ambula- tory surgical centers (ASCs) instead of hospital outpatient departments. A study in JAMA Ophthalmology Ophthalmology news In early 2017, both consumer and trade news outlets reported on a New England Journal of Medicine article that said three Florida patients went blind after receiving eye injections of stem cells. 1 The outcome occurred after the experimental treatments were performed at a stem cell clinic; the stem cells were derived from the patients' own abdominal fat. The affected patients were in the early stages of age-related macular degen- eration (AMD). Also in 2017, an antitrust suit was filed by Shire Pharmaceuticals (Lexington, Massachusetts) against Allergan (Dublin, Ireland), alleging that Allergan's contracts with drug plans for Medicare Part D for Resta- sis eye drops (cyclosporine) blocked access to Shire's newer agent Xiidra (lifitegrast). 2 In April, a report in the Journal of Neuroscience shared the find- ing that tamoxifen, a drug used for breast cancer patients, offered protective effects against photore- ceptor degeneration. 3 Investigators speculated that use of the drug may warrant further study as a potential treatment for retinitis pigmentosa and atrophic AMD. Also related to AMD, a study in JAMA Ophthalmology reported that primary dilated eye exams failed to detect AMD in 25% of patients. The cross-sectional study included 644 people older than age 60 with normal macular health. 4 The ocular effects of serious viruses and diseases were covered in 2017 reports. Emerging Infectious Diseases reported that more than 14% of survivors of the Ebola virus in Africa had a unique retinal lesion that followed the anatomic distribu- tion of the optic nerve, and 7% had unilateral white cataracts. 5 A study of children born with congenital Zika syndrome in Brazil found visual impairment in all 32 infants in the study, according to a study in the Journal of the American Association for Pediatric Ophthalmology and Strabismus. 6 As a better understanding of dry eye develops, physicians and research scientists collaborated to Trends, news, approvals reflect ophthalmology's priorities O phthalmology news in 2017 was substantial and wide-ranging. It reflected overarching developments in medicine with the various approvals, news, and trends that emerged. Here are some select- ed highlights from ophthalmology news in 2017. Product approvals Glaucoma welcomed another agent to its armamentarium, netar- sudil ophthalmic solution 0.02% (Rhopressa, Aerie Pharmaceuticals, Irvine, California). Netarsudil will be used to lower IOP in patients with open angle glaucoma or ocular hy- pertension; the medication should be available by mid-second quarter 2018. Patients with ocular allergy will have another option available with the approval of cetirizine ophthal- mic solution 0.24% (Zerviate, Nicox, Sophia Antipolis, France) to treat ocular itch associated with aller- gic conjunctivitis. Formerly called AC-170, it is the first topical ocular formulation of cetirizine. Brimonidine tartrate ophthal- mic solution 0.025% (Lumify, Baus- ch + Lomb, Bridgewater, New Jersey) was approved as an over-the-counter drop for eye redness. Within retina, the use of ranibi- zumab (Lucentis, Genentech, South San Francisco) was approved for the treatment of myopic choroidal neo- vascularization, based on the results of the Phase 3 RADIANCE study. Also approved was tocilizumab (Actemra, Genentech) for giant cell arteritis. The long-awaited Light Ad- justable Lens (LAL) and the Light Delivery Device (RxSight, Aliso Viejo, California) were approved in late 2017. They are part of the first medical device system that can make small adjustments to the artifi- cial lens power after cataract surgery so patients can see better without glasses. EW ASCRS News A roundup of 2017 highlights Check your inbox every Friday for EyeWorld Weekly Update to keep up on all the news in 2018.

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