The 2014 American Academy of Ophthalmology Annual Meeting was recently held in Chicago. As usual, there was a wide range of activities including spotlight sessions and symposia, original papers, instructional courses, scientific posters, skills transfer programs, videos, a technology pavilion, and the learning lounge. Here’s a brief review of this year’s most popular topics and technologies:
Cataract Surgery:
Dr. Stewart Galloway discussed the results of a retrospective study of 2,300 patients receiving transzonular injection of combined triamcinolone-moxifloxacin with and without vancomycin to decrease inflammation, prophylax against infection, and reduce the use of topical eye drops after cataract surgery. The study concluded that intravitreal injections had a significant benefit and were safe.
Dr. Charles Reilly compared the safety and efficacy of ReSure Sealant to suture for preventing wound leak in cataract surgery patients and found that the sealant provided better wound resistance to leaks (no leaks vs. 31% suture leaks).
Dr. Eric Donnenfeld shared a new algorithm for IOL power calculation in long and short eyes using intraoperative aberrometry. The algorithm improved refractive outcomes in these eyes.
Dr. Pavel Stodulka presented 1-year results on laser arcuate incisions with the VICTUS Femtosecond Laser Platform. The data was comparable to that for toric IOLs and better than that for manual astigmatic incisions.
Dr. Samuel Masket investigated the influence of OVDs on intraoperative aberrometry and showed that low molecular weight low concentration hyaluronate based OVDs are equivalent to BSS for aphakic lens power calculation.
Dr. Jason Brinton analyzed more than 3,200 multifocal IOL refractive outcomes with intraoperative aberrometry with and without streaming refractive data (ORA with VerifEye and ORA, respectively) and found that better results were obtained with streaming refractive data.
Dr. Alan Crandall studied the effect of OMS302 (phenylephrine/ketorolac) on pupil diameter in patients with diabetes during IOL replacement and found that this new drug improved pupil management in this patient population, which is prone to intraoperative miosis.
Refractive Surgery:
Dr. Francis Price reported 2-year results for patient satisfaction with LASIK and contact lenses. The prospective study found that LASIK significantly improves the ease of night driving but temporarily increases dry eye symptoms.
Dr. Erik Mertens assessed clinical outcomes of the Visian ICL with central port (V4C model). The 1-year data demonstrated good predictability, efficacy, safety, and stability.
Dr. Jay Pepose compared depth of focus and contrast sensitivity in patients with the Kamra corneal inlay, Crystalens AO, AcrySof ReSTOR 3.0 and Tecnis multifocal IOLs. Patients with the inlay had the largest range of vision and best mesopic contrast sensitivity.
Dr. Juan Battle shared 10-year follow-up data on keratoconus patients treated with the STAAR toric ICL, which showed that this ICL is safe, effective, and rotationally stable.
Dr. John Vukich presented 3-year results of a small-aperture corneal inlay for the treatment of presbyopia. The mean UCNVA improved from J8 to J2 while the mean UCDVA was essentially unchanged.
Dr. Gregory Parkhurst presented an update on the Raindrop corneal hydrogel inlay for presbyopia, which provided good binocular acuity, low visual symptoms, and high patient satisfaction.
Dr. Harvey Uy discussed a case series of 20 presbyopic patients who underwent lens-based accommodation restoration using a femtosecond laser. The results suggest that this is a promising and safe technique.
Cornea:
Dr. Anshu Arundhati compared 5-year graft survival between PK, DSAEK, and DALK and found that graft survival is better for DSAEK and DALK with less risk of rejection and glaucoma.
Dr. Hamidreza Hasani evaluated accelerated vs. conventional corneal collagen crosslinking (CXL) for progressive keratoconus. The refractive and visual outcomes, biomechanical and central corneal thickness changes, and endothelial cell loss were found to be similar for both methods.
Dr. Khalid Tabbara evaluated PRK with CXL in keratoconus and showed that this procedure is safe and effective in mild keratoconus.
Dr. Joseph Tauber studied Lifitegrast 5% in patients with dry eye disease and found that this novel drug improved dry eye symptoms with no serious ocular adverse events.
Dr. Parag Majmudar reported on the efficacy of additional LipiFlow treatment for MGD and evaporative dry eye. The multicenter study confirmed a continued benefit of LipiFlow treatment for these patients.
Dr. Marianne Price discussed 1-year results of a study comparing loteprednol 0.5% gel to prenisolone acetate 1% solution in patients having DMEK. Both groups had a similarly low rate of rejection and the loteprednol group had significantly less IOP elevation.
Glaucoma:
Dr. David Huang shared data from the Advanced Imaging for Glaucoma Study and concluded that FD-OCT may be useful for predicting glaucomatous visual field damage in glaucoma suspects.
Dr. Carolina Gracitelli evaluated the rates of retinal ganglion cell loss in glaucoma patients with and without optic disc hemorrhages and found that disc hemorrhages are a risk factor for progression and are associated with more rapid estimated RGC loss.
Dr. George Beiko analyzed IOP control in patients undergoing trabecular micro bypass stent implantation combined with cataract surgery and found these patients were able to decrease their topical glaucoma medications.
Dr. Magda Rau discussed results of a study evaluating the CyPass supraciliary implant with cataract surgery, and showed that at 1-year this device is safe, decreases IOP and reduces glaucoma medications.
Dr. Thomas Samuelson presented data from a study of the Hydrus intracanalicular microstent with cataract surgery, which resulted in reduced IOP and medication use.
Retina:
Dr. David Boyer discussed 2-year outcomes of the READ-3 Study. High dose ranibizumab (2 mg) showed no improvement compared to 0.5 mg for the treatment of diabetic macular edema.
Dr. Baruch Kuppermann evaluated dexamethasone intravitreal implant for patients with previously treated diabetic macular edema and found the implant significantly improved visual and anatomic outcomes in these patients.
Dr. Quan Nguyen presented 2-year results of the VISTA/VIVID Trials of intravitreal aflibercept injection for diabetic macular edema. This medication significantly improved BCVA compared with laser at week 52 and maintained the gains in BCVA through week 100.
Dr. Marco Zarbin reviewed arterial thromboembolic events in studies using ranibizumab for the treatment of diabetic macular edema. Ranibizumab demonstrated systemic safety, and there was no suggestion of a causal relationship for cardiovascular or cerebrovascular events.
Dr. Helmut Sachs reported 1-year data of the Alpha IMS chip to restore vision in 26 blind patients with retinitis pigmentosa. This transchoroidal surgery is safe and resulted in improved visual function in the majority of patients.
Dr. Nathan Steinle presented a comparison of intravitreal C3F8 gas injection to intravitreal ocriplasmin for vitreomacular traction and showed that C3F8 is an inexpensive treatment option for this condition, even after failed ocriplasmin injection.
Access to the material is available through AAO Meetings on Demand.