This year's meeting of the American Society of Cataract and Refractive Surgery just concluded in San Francisco. The Moscone center was bustling for the subspecialty day followed by the general session days of scientific papers, symposia, courses, and posters. The latest techniques and technology were discussed and a number of companies unveiled new products. Here are some of the ones I found most interesting:
Tetraflex IOL: This new IOL from Lenstec shows promise as a truly accommodating lens. It is an anteriorly vaulted flexible acrylic monofocal lens with a 5.75 mm square-edged optic. It has an accommodative amplitude of 2.4 ± 1.0 D and can be injected through a 2.5 mm incision. Accommodation data in patients from the FDA trial shows 100% ≥2 D, 69% ≥3 D, and 44% ≥4 D. The lens is currently used in Europe and is awaiting approval in the United States.
ReSTOR +3.0 D IOL: Alcon's new aspheric multifocal IOL has a reduced add power to provide +2.5 D at the corneal plane. This allows an increased range of vision as demonstrated by defocus curves, without sacrificing acuity. In fact, visual acuity was improved at many of the near and intermediate points tested, and patients have less difficulty with glare and halo. This may be attributable to the new design of the lens with 9 apodized steps rather than 12 in the +4 D model. International investigators reported similar results from sites in North America, South America, and Europe.
ORange: This device is WaveTec Vision's new intraoperative wavefront aberrometer. It attaches to the operating microscope and measures refraction in seconds by utilizing Talbot-Moire technology. The Orange has a wide dynamic range (-15 D to +25 D) and is able to obtain accurate refraction on aphakic and pseudophakic eyes as well as eyes that have had previous keratorefractive surgery. It can be used to improve refractive results by aiding in alignment of toric IOLs, verifying the efficacy of LRIs, and confirming the refraction after IOL insertion.
Optura: Bausch & Lomb's new fluoroquinolone besifloxacin has received an approval recommendation for the treatment of bacterial conjunctivitis from the FDA's advisory committee. This new agent may have an advantage over current fluoroquinolones against resistant organisms, particularly MRSA.
Bepreve: Bepotastine is a topical, non-sedating, highly selective H1-receptor antagonist developed by Ista pharmaceuticals and awaiting FDA approval for the treatment of ocular itching associated with allergic conjunctivitis. Phase 3 studies showed statistically significant reductions in the primary endpoint of ocular itching as well as significant effects on other signs or symptoms or ocular allergy, including nasal symptoms.
IZip: This tissue adhesive from I-Therapeutix is awaiting FDA approval for use in sealing corneal incisions. It is an ocular bandage that is well tolerated, persists for several days, and does not interfere with wound healing. We are all familiar with the use of cyanoacrylate glue for treating small corneal perforations and the role of Tisseel in pterygium surgery. Tissue adhesives may also be used for sealing corneal and scleral wounds (i.e., cataract incisions, lacerations, keratoplasty wounds, LASIK flaps, sclerotomy sites, etc.). By ensuring a watertight seal in full-thickness wounds and providing a barrier to organisms, these products have the potential to reduce the risk of postoperative infection.