The 2012 American Academy of Ophthalmology Annual meeting convened earlier this month in Chicago. The numerous activities at this year’s meeting included a wide selection of spotlight sessions and symposia, original papers, instructional courses, scientific posters, skills transfer programs, and videos. The technology pavilion, learning lounge, and breakfast with the experts were also back. I attended both the refractive surgery subspecialty day and the joint meeting. The following is a summary of the most popular topics:
Instruction Courses
New topics included the Kitaro DryLab and Wetlab systems, understanding OVDs, mirror telescope implant for AMD, “big bubble” technique of DALK, anterior segment OCT, DSAEK cliffhangers, and next generation technologies for the diagnosis and treatment of dry eye and meibomian gland dysfunction.
Original Papers and Scientific Posters
Cataract: femtosecond laser-assisted cataract surgery and astigmatism correction
- Dr. Jonathan Davidorf examined 175 manual cataract surgery videos and found there was no relationship between CCC morphology and IOL calculation predictability with Haigis and SRK-T formulae.
- Dr. Michael Lawless assessed 400 cataract surgeries and concluded that laser-assisted cataract surgery is safe and refractive results are similar to manual cataract surgery.
- Dr. Burkhard Dick reported on his first 400 laser cataract surgery procedures, which resulted in 98% free capsulotomy, low effective phaco time, and successful completion of challenging cases (i.e., mature cataract, Fuchs’ dystrophy, corneal opacity, pseudoexfoliation, glaucoma, IFIS, postvitrectomy, and small pupil).
- Dr. William Culbertson studied arcuate incisions with a femtosecond laser for cataract surgery and showed that the OCT-guided system created precise incisions.
- Dr. Pierre Fournie reported on the use of toric IOLs in cataract surgery for 29 eyes with keratoconus and demonstrated that such lenses are a therapeutic option in carefully selected patients.
Cornea: dry eye treatment and corneal collagen cross-linking (CXL)
- Dr. Jack Greiner evaluated the long-term effects of a single LipiFLow thermal pulsation treatment on dry eye patients with Meibomian gland dysfunction. Meibomian gland and dry eye questionnaire scores improved and persisted at 3 years.
- Dr. Sharon D’Souza reported on early results of accelerated CXL with the Avedro system. In the 25 eyes treated, there were no complications.
- Dr. Roy Rubinfeld studied epithelial-on CXL in 155 eyes and concluded that this technique is safe and effective for patients with corneal ectatic disease.
- Dr. William Trattler also reported results of an epithelial-on CXL study comparing this technique for eyes with mild, moderate, and severe keratoconus. The technique was found to be safe and effective in all 3 groups.
- Dr. David Touboul compared conventional epithelium-off and transepithelial CXL in 50 eyes each with keratoconus. One-year results showed the transepithelial method to be safer but less effective than the conventional technique.
- Dr. Denise Wajnsztajn discussed early complications in 206 eyes after CXL for keratoconus, which included delay in epithelial healing, hypertrophic healing, punctate keratopathy, sterile infiltrates, microbial keratitis, and corneal edema with scarring, and was more common in advanced keratoconus.
Glaucoma: minimally invasive glaucoma surgery
- Dr. Yiannis Iordanous performed a cost comparison of the trabectome, iStent, and endoscopic cyclophotocoagulation with glaucoma medication. At 6 years, all these procedures may be cost-effective alternatives to topical drugs.
- Dr. Peter Netland shared results of a multicenter clinical trial comparing Ex-PRESS miniature glaucoma device under scleral flap with trabeculectomy. IOP control of the 118 eyes was similar at the 1- and 2-year postoperative visits.
- Dr. Steven Vold assessed the 1-year safety of CyPass Micro-Stent implantation at the time of cataract surgery. The procedure was effective in lowering IOP and there were no significant adverse events.
- Dr. Inga Kersten evaluated the safety and efficacy of the AqueSys aquecentesis procedure. This MIGS technique resulted in reduction of IOP (~30% decrease) and number of medications after 12 months.
- Dr. Juan Battle presented 1-year follow up on 23 eyes receiving a minimally invasive drainage implant (MIDI Arrow) alone or in conjunction with cataract surgery. The device effectively lowered IOP (50-60%) without serious long-term adverse complications.
- Dr. Thomas Samuelson reported results on a 1-year multicenter study that found the Hydrus intracanalicular microstent to be a promising alternative to medical therapy for lowering IOP in patients with POAG when combined with cataract surgery.
Retina: intravitreal injections for the treatment of retinal diseases
- Dr. Baruch Kuppermann reported on integrin peptide therapy (ALG-1001), which is being evaluated for DME. It was found to be well tolerated, and patients showed significant improvement in BCVA and OCT CMT lasting 90 days after the last intravitreal treatment.
- Dr. Jean-Francois Korobelnik shared the 1-year results of the phase 3 GALILEO study, which demonstrated the efficacy of aflibercept for macular edema in CRVO.
- Dr. David Brown discussed the 1-year data of the phase 3 COPERNICUS study, which found that the visual improvement at week 24 from monthly aflibercept injections was maintained at week 52 with less frequent dosing.
- Dr. Paul Mitchell presented the RESTORE 36-month extension study results that found the 1-year visual function gains from ranibizumab for DME were maintained at 3-years.
- Dr. Michael Ip reported the 36-month results from the RISE and RIDE trials showing the efficacy of intravitreal ranibizumab for treating diabetic retinopathy.
- Dr. Peter Kaiser presented data from the VIEW1 & VIEW2 studies, which showed that aflibercept and ranibizumab are effective in treating wet AMD and improvements at week 52 were maintained through week 96.
- Dr. Baruch Kuppermann shared the data from 652 patients in two phase 3 trials that demonstrated Ocriplasmin results in higher rates of vitreomacular adhesion resolution and full-thickness macular hole closure compared to placebo.