At Press Time

ASCRS and ARVO Highlights

At Both Meetings, the Focus was on Aging Eyes.

■ Due to an unusual quirk in scheduling, the 2007 meetings of the American Society of Cataract and Refractive Surgery (ASCRS) and the Association for Research in Vision and Ophthalmology (ARVO) both took place in a 2-week period covering late April and early May. The ASCRS meeting was held in San Diego and ARVO took place in its usual location, Fort Lauderdale, Fla.

A key topic of this year’s ASCRS meeting was the growing role of presbyopia-correcting multifocal and accommodative IOLs (PC-IOLs) in everyday practice. Two years have passed since the Centers for Medicare and Medicaid Services (CMS) made its landmark decision allowing cataract surgery patients covered by Medicare to pay the additional cost of premium lenses, so ASCRS provided a major forum for presentations on such subjects as patient education and selection, and the pros and cons of "mixing and matching" PC-IOLs as opposed to bilateral implantation.

A meeting highlight was the release of the results of an industry-sponsored Harris Interactive survey designed to gauge how much cataract surgery patients and the general public know about presbyopia and PC-IOLs. The poll involved responses from 500 individuals between the ages of 45 and 65 who had not undergone cataract surgery and 250 people whose eyes had received PC-IOLs.

The survey showed an overall lack of knowledge about presbyopia, even among the group that had already received PC-IOLs. In this group, only 10% of respondents could provide an accurate definition of presbyopia. The group representing the general adult population did even worse, with only 9% able to correctly define presbyopia. In the general population group, most respondents believed that the preferred treatment for presbyopia is prescription eyeglasses.

Though the overall results of the survey indicated a great need for patient education in the area of presbyopia presbyopia and presbyopia correction, 84% of the patients who had already received PC-IOLs said they would recommend the lenses to their friends. This indicates a high level of patient satisfaction and the potential for continuing growth driven by expanding patient education efforts.

Also released at ASCRS were the results of the 2006 Duffey/Leaming survey of U.S. Trends in Refractive Surgery. With responses received from 628 refractive surgeons, the 10th annual survey indicated that 32% of surgeons are implanting PC-IOLs compared to 25% in 2005. The survey also found strong growth trends in the use of wavefront for custom ablations and in epi-LASIK for vision correction. LASIK retained its place as the favored form of vision correction between -8 D and +3 D, while femtosecond lasers continued to gain on still-dominant mechanical microkeratomes as a flap-cutting technique.

► David J. Apple, M.D., professor of ophthalmology and pathology and Director of the David J. Apple Center for Ocular Biodevices at the John A. Moran Eye Center, University of Utah, was inducted into the Ophthalmology Hall of Fame. Dr. Apple, a pioneer in IOL pathology, is widely recognized for his study on the correct placement of IOLs to avoid posterior capsular opacification and for his tireless efforts as an educator. Dr. Apple, 65, is the youngest inductee ever to be so honored.

► Steven Schallhorn, M.D., who recently retired as head of refractive surgery for the U.S. Navy, delivered the prestigious Binkhorst Lecture. He said that after years of study of various vision-correction procedures, the Navy found that the combination of wavefront-guided technology and femtosecond-laser flap-creation produces better results than conventional LASIK. As a result, some naval aviators are now permitted to undergo LASIK in a procedure using the VISX Star CustomVue platform and the IntraLase femtosecond laser.

► Richard L. Lindstrom, M.D., a widely respected Minnesota ophthalmic surgeon, was elected president of ASCRS for a 1-year term.

Several major new products were introduced at the ASCRS meeting. These included:

► The Stellaris Vision Enhancement System from Bausch & Lomb. This phaco system is designed to facilitate microncision surgery and is customizable for either vacuum or flow-based fluidics. Bausch & Lomb says that the Stellaris System will enable surgeons to optimize results with any catraact surgery technique.

► The WhiteStar Signature phaco system with Fusion Fluidics from Advanced Medical Optics (AMO). AMO says this next-generation system combines the proven performance of AMO’s WhiteStar technology with the safety of a revolutionary fusion dual-pump fluidic system. A streamlined user interface and easy-touse accessories enhance efficiency of the operating room environment.

► Multipulse Laser Trabeculoplasty (MLT) from Iridex Corp. This technology is the same proposed mechanism as selective laser trabeculoplasty (cellular cascade), but offers a new way to trigger the mechanism — a thermal rise vs. selective targeting. Also unique is the multifunctionality of the laser, clinically for glaucoma, retina, transscleral, transpupillary and more. The multifunctional laser delivery includes the probes, LIO, slit lamp, G-Probe and DioPexy probe. Another major benefit, says Iridex, is that MLT is offered at a much lower price than existing laser trabeculoplasty treatments.

David J. Apple, M.D., was inducted into the Ophthalmology Hall of Fame.

ARVO Highlights

More than 10,000 ophthalmologists attended the annual ARVO meeting, considered the most important worldwide meeting in the field of vision research.

The theme of this year’s meeting was "The Aging Eye," chosen to emphasize the fact that the first wave of baby boomers reached the age of 60 in the past year.

"The four eye diseases most responsible for vision loss — AMD, cataract, glaucoma and diabetic retinopathy — are all associated with aging," says Frederick Ferris, M.D., president of ARVO. "We need to focus on what we can do to help these people."

ARVO keynote speakers were William Novelli, CEO of AARP, and Paul Lee, M.D., J.D., of Duke University. This year’s keynote theme was "Public Health Impact of Eye Diseases in the Elderly: What Can Be Done About It?"

With continued high interest in new treatments for AMD, Regeneron Pharmacueticals released positive clinical data on its VEGF Trap-Eye at ARVO and announced it is moving the drug into phase 3 studies. VEGF Trap-Eye is widely considered to be the most promising new therapy for wet AMD currently in clinical trials.

"We are very encouraged by the preliminary observation in the phase 2 wet AMD trial that the most intense dosing regimen studied, 2 mg delivered by intravitreal injection every 4 weeks, resulted in an average gain of more than 10 letters after 12 weeks of treatment," said George D. Yancopoulos, M.D., Ph.D., president of Regeneron Research Laboratories.

In other ARVO news, Frederick H. Davidorf, M.D., professor of ophthalmology at Ohio State University, presented results of his study demonstrating that patients with uveal melanoma, the most common form of eye cancer, have an increased risk of developing colon cancer. He recommended that ophthalmologists urge uveal melanoma patients and their blood relatives to have regular screenings for colon cancer.