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A weekly e-journal
edited by Arthur B. Epstein, OD, FAAO
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| Volume
5, Number 18 |
Monday,
May 9, 2005 |
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Click
here for the current issue of Review
of Optometry.
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Off
the Cuff: Solution Confusion--Here We Go Again!
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With the long-awaited
reintroduction of B&Ls PureVision,
contact lens fitters have yet one more excellent
lens in their silicone hydrogel armamentarium.
As an early adopter of PureVision, I was pleased
to see its return to the U.S. market. But while
checking out the PureVision package insert,
something caught my eye. It turns out that AMO
UltraCare is contraindicated for use with the
PureVision.
By itself, that would not be disturbing, but
add to it CIBA Vision SOLO-Care Plus and Acuvue
Advance incompatibility, earlier reports of
clinically significant epithelial staining with
the PureVision and ReNu MultiPlus and recent
anecdotal reports concerning other silicone
hydrogel lens care product related corneal staining,
and you can see why I am concerned. You should
be too.
Silicone hydrogels may be the future of contact
lenses, but it is a future that can easily be
derailed if these new and unique lenses are
beset by constant lens care product incompatibilities.
It is time that the FDA recognized that silicone
hydrogels are different enough to be treated
differently and that they require additional
care product compatibility and safety testing.
Not all care products have silicone hydrogel
compatibility issues, but until the FDA acts,
we need to be vigilant and educate our silicone
hydrogel patients to use only products that
we know will not cause problems.

HRT
and Cataract
Hormone
replacement therapy (HRT) may protect against
the development of cataract, but epidemiological
studies in humans have been inconclusive. The
aim of this study was to assess the association
between hormone replacement therapy and cataract.
Participants were 10,000 women aged 45 years and
older with cataract and 10,000 age-matched controls.
The association between cataract and use of estrogen-only
HRT had an odds ratio of 1.13. This reduced to
0.81 after adjustment for examination frequency.
Similarly, the odds ratio for the association
between cataract and use of a HRT formulation
containing estrogen and progesterone was 1.18,
reducing to 0.86 after adjustment for examination
frequency.
Estrogen-only and estrogen-progesterone hormone
replacement therapies are associated with a small
reduced risk of cataract. This data adds to the
growing body of evidence on the systemic effects
of HRT.
SOURCE:
Aina FO, Smeeth L, Hubbard R, et al. Hormone replacement
therapy and cataract: a population-based case-control
study. Eye 2005;[Epub ahead of print].

Combination
of Bimatoprost and Latanoprost on IOP
This study evaluated
the effect of combining bimatoprost and latanoprost
on intraocular pressure (IOP) in primary open
angle glaucoma (POAG). A randomized clinical
trial was conducted on eighteen glaucoma patients.
In the first four weeks, latanoprost 0.005%
was prescribed for both eyes and any other anti-glaucoma
medication was discontinued. In the next four
weeks (Phase 1), bimatoprost 0.03% was combined
with latanoprost in one randomly assigned eye
(case eye) of each patient. In the following
four weeks (Phase 2), bimatoprost was discontinued
in the case eyes, while bimatoprost was substituted
for latanoprost in the fellow eye (control eye).
The IOP was measured at the end of the first
four weeks (baseline measurement) and weekly
during Phases 1 and 2.
In the case eyes, the mean IOP increased (1.8
mmHg) along Phase 1 (combined therapy) when
compared to baseline measurements. The IOP returned
to previous values after discontinuation of
bimatoprost in Phase 2. In the control eyes,
the mean IOP did not change throughout the study.
The combination of bimatoprost and latanoprost
in POAG increases the IOP and should not be
considered as a therapeutic option.
SOURCE: Doi LM, Melo LA
Jr., Prata JA Jr. Effects of the combination
of bimatoprost and latanoprost on intraocular
pressure in primary open angle glaucoma: a randomized
clinical trial. Br J Ophthalmol 2005;89(5):547-9.
Corneal
Astigmatism in Graves Ophthalmopathy
One
hundred-nine patients with inactive Graves'
ophthalmopathy and 109 age- and gender-matched
controls without Graves' ophthalmopathy were
examined using manual corneal keratometry. In
the Graves' patients, 52 percent had a CT scan
available for review, and 41 percent underwent
orbital, strabismus, and/or eyelid surgery with
a follow-up of keratometry over a mean period
of 1.7 years after surgery.
There was a statistically significant difference
between the Graves' and control eyes at 3.00D
to 3.25D in both eyes. The astigmatism was found
to be steeper at 95 to 100 degrees and 105 degrees
to 110 degrees in the right eyes only. In 10
Graves' patients, the astigmatism had caused
newly acquired reduced visual acuity. A greater
amount of astigmatism did not correlate with
specific CT findings. Following orbital, strabismus
and eyelid surgery, the diopters and meridians
of the astigmatism did not change.
Graves' ophthalmopathy may be associated with
greater with-the-rule corneal astigmatism, which
overall is not influenced by orbital, strabismus
or eyelid surgery. The astigmatism may possibly
be caused by soft-tissue fibrosis in the superolateral
orbital region.
SOURCE: Mombaerts I, Vandelanotte
S, Koornneef L. Corneal astigmatism in Graves'
ophthalmopathy. Eye 2005;[Epub ahead of print].
NEWS
& NOTES
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DEADLINES
APPROACHING FOR AAO 2005, SAN DIEGO.
The American Academy of Optometry
(AAO) is holding its annual meeting
from December 8 to 11, 2005, at
the Convention Center in San Diego.
Deadline for awards nominations
is May 16; the Call for Abstracts
dates are June 15 to August 1. Meeting
registration begins on July 6, 2005
and applications for AAO Student
Travel Fellowships must be submitted
by October 1. To learn more about
Academy 2005, go to www.aaopt.org/meetings/meeting5.
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AMO
TO ACQUIRE QUEST VISION TECHNOLOGIES.
Advanced Medical Optics, Inc. (AMO)
has exercised its option to acquire
Quest Vision Technologies, Inc.
Financial terms were not disclosed.
The companies entered into a one-year
research and evaluation licensing
agreement in May 2004 to develop
accommodating intraocular lens (IOL)
technologies and designs to address
presbyopia. At the time, AMO was
given the option to acquire Quest
Vision after one year. The accommodating
IOL being designed through an AMO
and Quest Vision collaboration provides
accommodation by altering the shape
of the optic with or without axial
movement. AMOs acquisition
gives it access to novel accommodating
IOL technologies that the company
hopes will add breadth to its growing
refractive IOL offering, which currently
includes the ReZoom multifocal lens,
which gained FDA approval in March
2005; the Verisyse phakic IOL; and
the Tecnis multifocal IOL. ReZoom
and Tecnis multifocal IOLs have
CE Mark approval in Europe for treatment
of presbyopia. For more information,
go to www.amo-inc.com.
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TWO-YEAR
CLINICAL TRIAL DATA RELEASED FOR
B&LS RETISERT FOR POSTERIOR
UVEITIS. The results of a two-year
Phase IIb/III clinical trial of
Bausch & Lombs Retisert
(fluocinolone acetonide intravitreal
implant) for the treatment of chronic,
noninfectious uveitis affecting
the posterior segment of the eye
have been released. The trial, conducted
at 26 centers in the United States
and one center in Singapore, included
278 people with noninfectious posterior
uveitis randomized to receive either
a 0.59-mg or 2.1-mg implant in the
affected eye, or in bilateral cases,
in the more severely afflicted eye;
the fellow eye was implant free.
Results showed a statistically significant
lower rate of disease recurrence
in eyes with Retisert (11.2 percent)
after two years, compared to the
recurrence rate in the year prior
to enrollment (59.7 percent) and
compared to the rate in the fellow
eyes (50.0 percent) after two years.
There were also statistically significant
decreases in systemic use of immunomodulatory
therapy and in periocular corticosteroid
injections after implantation. In
the eyes with Retisert, a statistically
significant improvement in visual
acuity occurred after two years
as well. The most common adverse
events included cataract progression
and increased IOP, which were anticipated
given the nature of the disease
and the type of drug used. They
were managed by conventional means,
including cataract surgery and the
use of eye drops or filtering surgery
to lower IOP. Patients in the study
will be followed for an additional
year. Bausch & Lomb aims to
make Retisert available in mid-2005.
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FOR
ODS SPECIALIZING IN GERIATRIC EYECARE:
WHITE HOUSE HOLDS CONFERENCE ON
AGING. Optometrists with an
interest in geriatric eyecare are
invited to attend the 2005 White
House Conference on Aging (WHCoA),
October 23 to 26, 2005, at the Hyatt
Regency Washington on Capitol Hill.
The theme of the conference is "The
Booming Dynamics of Aging: From
Awareness to Action." The conference
will include gerontology scholars,
leading advocates from senior organizations
and key healthcare providers--including
doctors of optometry--to focus on
aging issues. Their common mission
is to help shape national policy
that better meets the needs of current
and future senior citizens. About
1,200 WHCoA delegates are expected
to make recommendations to President
George W. Bush and the U.S. Congress
aimed at improving the physical
and psychological health of aging
individuals and enhancing their
social and economic security. Interested
optometrists can seek to be appointed
a delegate to the convention by
their state governor or states
U.S. senators or representative,
or they may seek appointment by
a national organization interested
in aging issues. They might also
participate in state "listening
sessions" or organize and host
their own WHCoA-approved and designated
event. Additional, provisional conference
attendee slots will be available
via an online application/nomination
process. For more information, go
to www.whcoa.gov.
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It’s
only been up and running a
few short weeks. Yet, it’s
already clear that the Check
Yearly. See Clearly.(SM) marketing
campaign is opening consumers’
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materials. |
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Optometric PhysicianTM
Editorial Board
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Chief Medical Editor
Arthur B. Epstein, OD, FAAO
Art/Production Director
Joe Morris
Circulation Director
Janice Miller
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Journal Reviews
Shannon Steinhäuser, OD, FAAO
CIP Team
• Alan G. Kabat, OD, FAAO
• Joseph Sowka, OD, FAAO
• Andrew Gurwood, OD, FAAO
Section Editors
• Murray Fingeret, OD, FAAO
• William Jones, OD, FAAO
• Paul Karpecki, OD, FAAO
• Ron Melton, OD, FAAO
• Bruce Onofrey, RPh, OD, FAAO
• John Schachet, OD, FIOS
• Joseph Shovlin, OD, FAAO
• Randall Thomas, OD, MPH, FAAO
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