Light adjustable lens in eyes with a history of radial keratotomy.

Purpose: To evaluate visual and refractive outcomes in eyes with a history of radial keratotomy (RK) implanted with the second-generation light-adjustable lens (LAL).

Setting: Private practice, multiple locations.

Design: Retrospective, consecutive case series.

The Benefit of Nocturnal IOP Reduction in Glaucoma, Including Normal Tension Glaucoma.

Nocturnal intraocular pressure (IOP) profiling has shown that the peak IOP usually occurs at night, particularly in patients with glaucoma. Multiple studies have demonstrated that these nocturnal IOP elevations drive glaucomatous progression, often despite stable daytime IOP. Existing vascular dysregulation and decreased nighttime blood pressure compound the damage via low ocular perfusion pressure while elevated nocturnal IOP disrupts axonal transport.

Application of Negative Pressure by the Ocular Pressure Adjusting Pump to Provide a Sustained Reduction in IOP.

Purpose: To evaluate the sustainability of IOP reduction with continuous negative pressure application over an extended duration with use of the Ocular Pressure Adjusting Pump.

Methods: Prospective, controlled, open-label, randomized, single site, pilot study. Subjects with primary open-angle glaucoma (OAG) were enrolled.

Varenicline Solution Nasal Spray 0.03 Mg for the Treatment of Dry Eye Disease Following Photorefractive Keratectomy.

Purpose: To evaluate the use of varenicline solution nasal spray 0.03 mg (VNS) as a treatment option for the signs and symptoms of dry eye disease following photorefractive keratectomy (PRK).

Patients And Methods: Subjects electing to undergo PRK were randomized to VNS (study group) or vehicle (control group) twice daily and started treatment with VNS 28 days prior to surgery with continued use of the treatment for 84 days after PRK.

Manometric Intraocular Pressure Reduction with Negative Pressure Using Ocular Pressure Adjusting Pump Goggles.

Objective: The ocular pressure adjusting pump is a novel noninvasive and nonpharmacological intraocular pressure (IOP)-lowering device consisting of goggles attached to a negative pressure (NP) pump. This study aimed to determine the effect of NP in ocular pressure adjusting pump goggles on IOP using continuous direct manometry.

Design: Prospective, single-arm, single center, basic physiological research trial.

Superonasal vs Inferonasal Subconjunctival Gel Stent Placement in Patients with Glaucoma.

Aim And Background: To compare the safety and efficacy of subconjunctival gel stent implantation in the superonasal (SN) vs inferonasal (IN) quadrants in the treatment of glaucoma.

Materials And Methods: Patients with a history of IN ( = 29) or SN, ( = 96) gel stent placement with ≥3 months of follow-up were included. Intraocular pressure (IOP) and the number of glaucoma medications were collected preoperatively and postoperatively at months 1, 3, 6, and 12.

Clinical outcomes of the light-adjustable lens in eyes with a history of prior corneal refractive surgery.

Purpose: To evaluate the visual and refractive outcomes in eyes with a history of laser corneal refractive surgery implanted with the second-generation light-adjustable lens (LAL).

Setting: Private practice, Sioux Falls, South Dakota.

Design: Retrospective, consecutive case series.

Varenicline Solution Nasal Spray for the Treatment of Dry Eye Disease Following LASIK.

Introduction: The purpose of this study is to evaluate the use of a varenicline solution nasal spray (VNS) for reducing the signs and symptoms of dry eye following laser in situ keratomileusis (LASIK).

Methods: Subjects electing to undergo LASIK were randomized to VNS (study group) or placebo/vehicle (control group) and initiated treatment with the nasal spray twice daily 28 days prior to surgery with continued treatment for 84 days following LASIK. After initiation of treatment, subjects were seen on the day of surgery and postoperatively on Days 1, 7, 28, 84 (3 months) and 168 (6 months).

Evaluating the safety and efficacy of epi-off corneal cross-linking in patients with thin corneas due to keratectasia.

Background: Corneal cross-linking (CXL) is a safe and effective procedure for slowing keratectasia progression in eyes with a corneal thickness of at least 400 µm. Limited research has evaluated the safety and efficacy of epi-off CXL in corneas thinner than 400 µm.

Objective: To evaluate the safety and efficacy of CXL to slow keratectasia progression in eyes with <400 µm preoperative corneal thickness.

Cataract surgery following refractive surgery: Principles to achieve optical success and patient satisfaction.

A growing number of patients with prior refractive surgery are now presenting for cataract surgery. Surgeons face a number of unique challenges in this patient population that tends to be highly motivated to retain or regain functional uncorrected acuity postoperatively. Primary challenges include recognition of the specific type of prior surgery, use of appropriate intraocular lens (IOL) power calculation formulas, matching IOL style with spherical aberration profile, the recognition of corneal imaging patterns that are and are not compatible with toric and/or presbyopia-correcting lens implantation, and surgical technique modifications, which are particularly relevant in eyes with prior radial keratotomy or phakic IOL implantation.

Localized Heat Treatment for Meibomian Gland Dysfunction: A Single-Center Retrospective Analysis of Efficacy over Time.

Significance: Meibomian gland dysfunction (MGD) can produce a myriad of symptoms. The effective treatment of MGD can reduce the burden of this condition. Although several studies have indicated that TearCare (Sight Sciences, Menlo Park, CA) is an effective treatment for MGD, no studies currently provide information regarding the duration of efficacy.

Radial keratotomy and cataract surgery: A quest for emmetropia.

A 75-year-old man with an ocular history of 8-cut radial keratotomy (RK) in both eyes presented for cataract surgery evaluation. He was previously correctable in spectacles in years prior despite his irregular corneas to 20/25 in the right eye and 20/30 in the left eye. He recently noticed a change in his overall visual function with significant nighttime glare and difficulty reading despite spectacle correction.

Negative Pressure Application via a Multi-Pressure Dial to Lower IOP in Patients with Suspected Glaucoma or Open Angle Glaucoma.

Prcis: The multi-pressure dial applies localized periocular negative pressure to safely and effectively lower IOP and represents the first non-invasive, non-pharmacologic device for IOP reduction.

Objective: To evaluate the safety and effectiveness of the Multi-Pressure Dial (MPD) system, a device that applies periocular negative pressure to lower intraocular pressure (IOP).

Setting: 6 investigational sites, United States.

Clinical Outcomes of a Non-Diffractive Extended Depth-of-Focus IOL in Eyes with Mild Glaucoma.

Purpose: To evaluate the clinical outcomes of a non-diffractive, wavefront-shaping extended depth-of-focus (EDOF) intraocular lens (IOL) in eyes with mild open-angle glaucoma (OAG).

Setting: Private practice; Sioux Falls, South Dakota.

Design: Prospective, open-label, interventional study.

Intraocular Pressure Measurement with Pneumatonometry and a Tonometer Tip Cover During Negative Pressure Application.

Purpose: This is a 2-part study to investigate the agreement between pneumatonometry and direct pressure transducer intraocular pressure (IOP) measurements in a perfusion organ culture (POC) model where (1) the perfusion fluid column is open to atmospheric pressure, holding IOP constant to permit evaluation of the impact of negative pressure (NP) on IOP measurements, and (2) the perfusion fluid column is a closed system, allowing IOP to vary with NP application.

Methods: The first part incorporated a fluid column open to atmospheric pressure, maintaining IOP constant to permit evaluation of the effect of applied NP on IOP measurement accuracy. In the second part, the POC column was closed, allowing IOP to vary with NP application and permit evaluation of agreement between pneumatonometry and pressure transducer measurements.

IOL power calculations after LASIK or PRK: Barrett True-K biometer-only calculation strategy yields equivalent outcomes as a multiple formula approach.

Purpose: To compare the accuracy of intraocular lens (IOL) power calculations performed using the biometer-embedded Barrett True-K formula vs a multiple formula approach using the ASCRS postrefractive calculator in eyes with previous myopic or hyperopic refractive surgery.

Setting: Cole Eye Institute, Cleveland Clinic, Cleveland, Ohio.

Design: Retrospective, consecutive case series.

Evaluation of Same-Day versus Next-Day Implantation of Intracanalicular Dexamethasone for the Control of Postoperative Inflammation and Pain Following Cataract Surgery.

Purpose: To evaluate the safety and efficacy of a sustained-release intracanalicular dexamethasone insert for postoperative inflammation and pain implanted in a clinical setting preoperatively or on postoperative day 1.

Methods: Single-site, retrospective, contralateral eye study of patients undergoing cataract surgery. Included were subjects with a dexamethasone intracanalicular insert implanted in the clinic immediately prior to surgery in one eye (same-day) and on postoperative day 1 (POD1) in the contralateral eye.

The Effect of Periocular Negative Pressure Application on Intraocular and Retrobulbar Pressure in Human Cadaver Eyes.

Introduction: To investigate the effect of applying negative pressure (vacuum) to the periocular space on intraocular pressure (IOP) and retrobulbar pressure (RBP) by use of the Multi-Pressure Dial (MPD) system (Equinox Ophthalmic, Inc.).

Methods: Two eyes of two full body cadavers were studied.

Acute Calcific Band Keratopathy as an Adverse Effect of Recombinant Human Nerve Growth Factor (Cenegermin): A Multicenter Case Series.

Purpose: Cenegermin, (OXERVATE) a recently Food and Drug Administration-approved topical formulation of recombinant human nerve growth factor, has been used for the treatment of neurotrophic keratopathy (NK). Corneal deposits have been previously reported as a potential adverse effect; however, the clinical characteristics, visual significance, and treatment options have not been fully described. The purpose of this article is to better characterize corneal deposits occurring during treatment with cenegermin for neurotrophic keratopathy.

High-Dose Oral Posaconazole for the Treatment of Recalcitrant Fungal Keratitis.

Purpose: To report the successful treatment of 3 cases of recalcitrant fungal keratitis (FK) with high-dose oral posaconazole.

Methods: This is a series of 3 patients from a single academic center with a culture-positive FK who were treated with oral posaconazole after failing to respond to conventional treatments.

Results: All 3 patients had a history of contact lens wear.

Depth-resolved Corneal Biomechanical Changes Measured Via Optical Coherence Elastography Following Corneal Crosslinking.

Purpose: To evaluate depth-resolved changes of corneal biomechanical properties in eyes with corneal ectasia after corneal crosslinking (CXL) using optical coherence elastography.

Methods: In a prospective pilot series of eyes with corneal ectasia, a custom high-speed swept source optical coherence tomography system was used to image the cornea before and 3 months after CXL during a low-speed applanating deformation while monitoring applanation force. Cross-correlation was applied to track frame-by-frame two-dimensional optical coherence tomography speckle displacements, and the slope of force versus local axial displacement behavior during the deformation was used to produce a two-dimensional array of axial stiffness (k).

Evaluation of negative pressure transfer through tissue in a benchtop cornea and eyelid model.

Purpose: A new glaucoma treatment device, known as the multi-pressure dial (MPD), has been introduced, which offers a novel approach to IOP reduction by delivering negative pressure to the periocular region. Clinical studies have demonstrated the IOP-lowering effect of the MPD via direct measurements using pneumatonometry. It remains unclear whether the eyelids, when closed, affect the transmission of negative pressure and subsequently affect IOP reduction.

Periodic normalization of the translaminar pressure gradient prevents glaucomatous damage.

The 24-hour intraocular pressure (IOP) rhythm is of interest to clinicians but its overall impact on glaucomatous progression remains unclear. Recent evidence has implicated the translaminar pressure gradient (TLPG), or imbalance between IOP and intracranial pressure, in the development of glaucoma. Evidence suggests that retinal ganglion cell death occurs as a result of decreased axonal transport only after a sustained, elevated TLPG.

Evaluation of the IOP-Lowering Effect of a Multi-Pressure Dial at Different Negative Pressure Settings.

Purpose: To evaluate the intraocular pressure (IOP)-lowering effect of a multi-pressure dial (MPD) at targeted negative pressure settings.

Methods: Prospective, intrasubject controlled study of 65 healthy subjects randomized to receive no negative pressure for 60 minutes or negative pressure application at designated levels of 25%, 50%, and 75% of baseline IOP for 20 minutes each. The main outcome measure was mean IOP with application of negative pressure.

Overnight Safety Evaluation of a Multi-Pressure Dial in Eyes with Glaucoma: Prospective, Open-Label, Randomized Study.

Purpose: To investigate the safety and tolerability of the multi-pressure dial (MPD) worn overnight for seven consecutive days.

Design: Prospective, open-label, randomized, single-site study.

Subjects: Twenty eyes of 10 subjects with open-angle glaucoma were fitted with an MPD and randomized to negative pressure application of -10 mmHg in one eye (study eye) worn overnight for 7 consecutive days.