New and notable at the AAO meeting

October’s Academy meeting proved eye care’s innovation streak won’t end soon. OM’s editorial board and staff highlight the products and technologies that could especially impact your practice.

By OM staff and correspondent reports

Abbott’s Tecnis Symfony IOL, the country’s first extended depth of focus lens, received star billing at a Saturday evening event during the conference. Physicians including Richard Lindstrom, MD and Elizabeth Davis, MD discussed results published in an abstract showing that of 1211 presbyopic patients who received the Symfony following cataract surgery, 97% achieved binocular uncorrected distance, and 91% would recommend this IOL to friends and family.

Alcon’s CyPass Micro-Stent (1) is the first FDA-approved MIGS device to target the uveoscleral pathway/suprachoroidal space to increase aqueous humor outflow and decrease IOP. It’s approved for treating patients with mild to moderate primary open-angle glaucoma in conjunction with cataract surgery, and can reduce the use of drops.

Alcon’s platform for Digitally Assisted Vitreoretinal Surgery, NGENUITY 3D (2), helps eliminate surgeon neck and back aches by allowing retinal surgeons to operate looking at a high-definition 3D screen, instead of bending their necks to look through the eye-piece of a microscope. In addition to a 3D view not previously available on standard television monitors, the system allows surgeons to increase magnification while maintaining a wide field of view, use digital filters to customize views during each procedure, and operate using lower light levels. The system was launched in collaboration with TrueVision 3D Surgical.

Alcon’s Online Toric IOL calculator is designed for cataract surgeons treating patients with corneal astigmatism. This system has a redesigned, optimized user interface and integrates the Barrett Toric algorithm, which the company says offers best-in-class preoperative prediction of residual astigmatism versus other formulas and nomograms.

Inotek’s trabodenoson, designed to restore the eye’s natural pressure control ability, is a first-in-class, highly selective A1 subtype adenosine mimetic for glaucoma and ocular hypertension. It binds to epithelial cells in the trabecular meshwork, up-regulating gelatinases that clean out and remodel the meshwork, increasing outflow and restoring a healthier IOP. The drug is in phase 3 trials; another version with latanoprost is in phase 2 trials.

i-Optics debuted upgrades to its Cassini Corneal Shape analyzer (3) that the company says will improve preoperative diagnostics for cataract surgery candidates, reducing refractive surprises post-surgery. New features include the Total Corneal Astigmatism algorithm upgrade, a proprietary technology that delivers customized posterior cornea measurements; new software that will provide eye movement information during its acquisition as well as a warning signal when excessive eye movement is detected; faster acquisition time to conduct a topography examination; and “Cassini Insight Diagnostics” that enables users to review critical diagnostic and patient-flow statistics so they can measure and improve user performance.

Nidek’s new solid-state green laser, the GYC-500/GYC-500 Vixi (4), achieves stable treatment outcomes for multiple applications, including retinal photocoagulation, trabeculoplasty and iridotomy. Housed in a small console, the 5.7-inch color touchscreen LCD includes an intuitive graphic user interface for quick and easy setup and verification of treatment parameters. The laser offers a wide range of selectable delivery units, including scan delivery units that are added to a wide range of green laser delivery systems. Nidek says the GYC-500 Vixi has 22 preprogrammed scan patterns.

Nidek’s MP-3 Microperimeter measures local retinal sensitivity for functional assessment of the retina, displaying results over a color fundus image that correlates retinal anatomy to retinal function. Recently granted 510K clearance, the device now has a wider range of stimulus intensity, from 0 to 34 dB, compared to the MP-1. It measures perimetric threshold values, even for normal eyes; a maximum stimulus luminance of 10,000 asb allows evaluation of low-sensitivity. Retinal morphology can be evaluated with the 12-megapixel fundus camera included in the MP-3 unit, which acquires high-resolution images and allows easy image acquisition.

Optos’ OptosAdvance (5) image management software lets clinicians review, annotate, refer and archive images from many ophthalmic diagnostic devices via industry standard DICOM. Designed to work on any type of computer or from any tablet, the software can be integrated with most EMR systems. Data within the screen views can be arranged according to the user’s preferences. It automatically saves images and other data to the Optos Cloud.

The software is offered in Optos’ Daytona plus ultra widefield retinal imaging device, which provides non-mydriatic, high-resolution digital images of up to 200 degrees, or up to 82% of the retina in under a second, in a single, noncontact Optomap image. The addition of OptosAdvance enables simple documentation, monitoring and referral processing of images to aid in patient management and better patient flow. Other features of the Daytona plus include four image modalities, all images presented in proprietary ProView, new hardware that enhances the resolution in superior and inferior fields and color options.

Physicians Angels Virtual Scribe enables users to securely manage patient data in a practice EMR in real time. Through secure, HIPAA-compliant connections, the Virtual Scribe “listens” to the doctor-patient encounter and transcribes it, enters CPT/ICD codes, eRx orders, notes and other relevant data to the patient’s EHR — the physician does not perform any data entry during the exam. After the exam, the physician reviews charts with the Virtual Scribe via the secure VOIP connection, speaks any necessary edits and signs off.

Quantel Medical’s fully integrated 577-nm yellow laser EasyRet Photocoagulator uses the company’s proprietary ELBA fiber laser technology. The result is a pure 577-nm yellow wavelength in a uniform top-hat laser spot profile, the company says. The EasyRet has many settings for treatment of pathologies including diabetic retinopathy, macular edema and central serous chorioretinopathy; its Single Spot treatment mode and MultiSpot mode lets surgeons customize a train of short pulses for better management of thermal effect on tissues.

ReVision Optics’ Raindrop (6) Near Vision inlay is indicated for patients between 41 to 65 years of age with emmetropic eyes who cannot focus clearly on near objects or small print. These patients need reading glasses with +1.50 to +2.50 diopters of power, but do not need glasses or contacts for clear distance vision.

Shire’s Xiidra (lifitegrast) is the only prescription eyedrop indicated for the treatment of both signs and symptoms of dry eye disease in adult patients. The novel small molecule integrin antagonist works by inhibiting T cell-mediated inflammation by blocking the binding of two critical cell surface proteins (lymphocyte function-associated antigen 1 and intercellular adhesion molecule 1); the result is an overall reduction in inflammatory responses. Xiidra is marketed in individual-unit doses for its b.i.d. application.

TearScience’s LipiScan is a high-definition gland imager that enables clinicians to efficiently evaluate meibomian glands in the practice setting. TearScience says the imager is fast and intuitive to use, with patented dynamic meibomian imaging (DMI) technology producing high-definition images.

Tele2020 is a business model that makes use of telemedicine to deliver patient leads to your practice on-site or online with increased examination opportunities from employers.

Thea Pharmaceuticals’ Mydrane intracameral solution combines phenylephrine (0.31%), tropicamide (0.02%) and lidocaine (1%) to obtain an efficient, fast and stable mydriasis and intraocular anesthesia during cataract surgery with a single 0.2 ml injection. Available in the European Union, Mydrane is not yet approved in the United States.

Topcon’s 3D OCT-1 Maestro system combines a color, high-resolution, non-mydriatic retinal camera with the latest Spectral Domain OCT technology, along with inPoint registration whic indicates the location of the OCT image within the fundus image. The Maestro features a compare function, an automatic segmentation of retinal nerve fiber layer, ganglion cell layer, GCL + IPL, and GCL + IPL + RNFL, total retina along with an extensive reference database. A rotating touch panel and fully automated operation make the device practice-friendly.

VisionCare’s two new offerings, the Scleral Scale Ruler (SSR) and the Lens Exchange System (LES), facilitate complex lens exchange procedures, the company says. The SSR is a small, stainless steel universal reference tool that enables surgeons to mark 180-degree symmetrical positions for their sclerotomies on a variety of eye globe and limbus sizes for greater precision.

The LES aids the intraoperative handling and maneuvering of intraocular devices during complex IOL-to-IOL exchange procedures with a flexible cord and connector system that act as an extension of the IOL haptics. They are designed to simplify the procedure and make it more predictable. The system is intuitive and allows reproducible lens centering and stabilization, according to the company.

In Zeiss’ new laser vision correction procedure, ReLEx SMILE (small-incision lenticule extraction), a thin disc-shaped lenticule is cut within the corneal stroma. The lenticule is subsequently removed through a small opening incision on the superficial cornea, foregoing the need to create a corneal flap for refractive correction.

The SMILE procedure is performed with the Zeiss VisuMax femtosecond laser. According to Zeiss, the side-cut created for SMILE is 2 to 4 mm, making it 80% smaller than the approximately 20-mm side-cut created for femto-LASIK. In addition, Zeiss lists a 30% smaller cap incision area for SMIILE, compared with femto-LASIK. OM