The 2013 annual meeting of the American Academy of Ophthalmology was held last week in New Orleans. As always, there was an overwhelming selection of instructional activities including spotlight sessions, symposia, papers, courses, posters, skills transfer programs, and videos.
If you were unable to attend or did attend but would like to access the material, AAO Meetings on Demand is available for purchase with more than 200 hours of synchronized presenter slides and audio. Here are some of the original papers and scientific poster highlights from this year’s meeting:
Cataract surgery:
- Dr. Kenneth Hoffer presented the Hoffer H-5 5th generation IOL calculation formula, which accounts for a patient’s race and gender in predicting effective lens position.
- Dr. Samuel Masket compared a variety of methods for predicting outcomes in post-laser vision correction eyes and found newer methods such as OCT-based formula and ORA are promising in post-LVC IOL calculations.
- Dr. Mayank Bansal compared results of sutured scleral-fixated IOLs vs. glued intrascleral haptic-fixated IOLs. The glued group had more stable fixation, better visual outcome, and fewer complications.
- Dr. Burkhard Dick evaluated effective phacoemulsification time (EPT) in 1500 cataract surgery procedures (750 manual and 750 laser) and found that the use of the Catalys femtosecond laser resulted in a >99% reduction in EPT.
- Dr. Shamik Bafna presented data comparing two capsulotomy centering techniques (scanned capsule vs. pupil center) with the Catalys OCT-guided laser. The scanned capsule method allowed more complete and symmetric capsule optic overlap. Twenty five percent of the pupil centered and none of the scanned capsule centered eye had incomplete capsule optic coverage.
- Dr. John Hovanesian discussed a multicenter study that evaluated wound leakage from sutured clear corneal cataract incisions in 204 eyes. The intraoperative leak rate using up to 1 oz. of force was 30%.
- Dr. Terry Kim shared results of an ocular sealant to prevent wound leak within the first week after cataract surgery. The ocular sealant was safe and effective, and it was superior to suture for preventing wound leaks.
Cornea and Refractive surgery:
- Dr. Mark Terry reported on the use of SF6 gas for prolonged support after DMEK. This technique has reduced the rebubble rate with no toxic effect, pupillary block, or primary graft failure.
- Dr. William Trattler studied the efficacy of transepithelial CXL in eyes with keratoconus. One-year data on 99 eyes showed a 57.6% and 49.4% improvement of 1 or more lines of UCVA and BSCVA, respectively.
- Dr. Francis Price shared results of a LASIK vs. contact lens patient satisfaction survey that showed LASIK patients had significantly improved night vision but increased dryness at 1 year.
- Dr. Daniel Durrie evaluated the novel use of an ocular shield after PRK and LASIK to accelerate recovery and found that binocular 20/20 vision or better was achieved within 4 hours in 99% of patients.
- Dr. Mohammed Sleem compared transepithelial and epithelium-off CXL in keratoconus patients. One-year results showed the transepithelial method to be less painful with similar efficacy and fewer complications than the epithelium-off technique.
- Dr. Talal Althomali presented data on same day topographic-guided PRK and CXL in patients with forme fruste keratoconus. The same-day combined procedure was safe and offered good vision at 1-year followup.
- Dr. William Culbertson showed that femtosecond laser intrastromal astigmatic keratotomy using the Catalys laser to create paired 80% depth incisions with an arc length of 70 degrees at the 7.0 mm optical zone is a safe method to reduce low amounts of corneal astigmatism to an optically insignificant level.
- Dr. Minoru Tomita reported that pupil size does not influence visual acuity after KAMRA inlay implantation.
- Dr. Keith Walter demonstrated the safety and efficacy of the FS200 femtosecond laser to assist in corneal tattoo for cases of iris defects.
Glaucoma:
- Dr. Thomas Samuelson shared results of an international study of a Schlemm canal scaffold for IOP reduction in POAG. After 2 years, mean IOP and medication use continued to be reduced from baseline.
- Dr. Matthias Grieshaber reported results for a new implant for Schlemm canal surgery in patients with POAG. The Stegmann Canal Expander was safe and effective in lowering IOP, which decreased from 27.1 mmHg preoperatively to 12.5 mmHg at 1 month and 13.1 mmHg at 9 months.
- Dr. Michelle Khan discussed results of a trial comparing combined cataract surgery with iStent vs. Trabectome. The iStent group had a greater reduction in both IOP and medication use at 1 year.
- Dr. Angela Baldwin presented the 2-year results of a canaloplasty study that showed this technique to be effective at reducing IOP and glaucoma medication use in patients with OAG.
- Dr. Nafees Baig evaluated intraoperative IOP changes during FLACS with the Victus laser in Chinese patients. This study found a significant increase in IOP from a mean of 16.8 mmHg preop to 42.4 mmHg while suction was on.
- Dr. Amaldo Santos compared phacoemulsification vs. peripheral iridotomy for chronic primary angle closure and found that the former treatment (phaocemulsification) was more effective in lowering IOP and preventing its long-term increase.
- Dr. Ye Elaine Wang presented data from a study to investigate the association between oral contraceptive use and prevalence of glaucoma in woman age 40 years or older in the United States. Oral contraceptive use for greater than 3 years was associated with increased risk of glaucoma (odds ratio of 1.94). Other factors included older age, African American race, and later age of menarche.
Retina:
- Dr. Allen Ho presented 3-year safety and performance results of the Argus II retinal prosthesis system in retinitis pigmentosa patients with bare light perception or worse vision before implantation. The implant improved visual function and functional vision tasks.
- Dr. Michael Ip reported on 36-month results of intravitreal ranibizumab for treating diabetic retinopathy from the RISE and RIDE trials. The data showed that ranibizumab reverses the progression of diabetic retinopathy.
- Dr. Peter Campochiaro discussed long-term outcomes of ranibizumab for treating RVO from the RETAIN study. Within 4 years of starting treatment, 75% of BRVO and 50% of CRVO patients no longer required injections.
- Dr. David Boyer presented the first human wet AMD experience with integrin peptide therapy (ALG-1001). It was found to be well tolerated and had a clinically significant effect with improvements in BCVA and lesion regression lasting at least 3 months off treatment.
- Dr. Peter Kaiser discussed subgroup analyses of the VIEW 1 and VIEW 2 studies, and concluded that for a subgroup of patients with early persistent fluid during the first 4 visits, aflibercept 2 mg every 2 weeks may be more beneficial than either every 8 weeks or ranibizumab 0.5 mg every 4 weeks during the 16-52 week interval.
- Dr. Chirag Shah also presented data from VIEW 1 and 2 studies showing that aflibercept was up to 50% more effective than ranibizumab in flattening RPE elevation in patients with wet AMD.