CRSToday Europe News — June 2008

Good Visual Results Reported After Toric ICL Implantation in High Myopes
Postoperative visual function after implantation of the Toric Implantable Collamer Lens (ICL; STAAR Surgical Company, Monrovia, California) was superior to wavefront-guided LASIK for the correction of high myopic astigmatism, according to Akihito Igarashi, MD, and colleagues from Saint Marianna University School of Medicine, Kawasaki, Japan.

In a study of 43 eyes, 22 underwent Toric ICL implantation, and 21 were treated with wavefront-guided LASIK for the correction of more than 6.00 D of myopic astigmatism. Igarashi et al found that ocular higher-order aberrations were not significantly changed after Toric ICL implantation (0.10 ±0.03 µm preoperatively vs 0.12 ±0.04 µm postoperatively), but they were significantly higher after wavefront-guided LASIK (0.13 ±0.08 µm preoperatively vs 0.20 ±0.10 µm postoperatively). Additionally, the authors found that contrast sensitivity was significantly improved after Toric ICL's implantation compared with deterioration after wavefront-guided LASIK.

Season of Birth May Impact Eyesight
Genetic factors may play the strongest role in nearsightedness, according to Yossi Mandel, MD, and colleagues at E. Wolfson Medical Center in Israel. Light exposure before and just after birth may also generate biological signals that influence the development of the eye's ability to focus and refract light properly, according to their study published in Ophthalmology. Mandel et al suggest that the influence of light on visual development in this perinatal period may occur through mother-to-baby biological signals before birth, the baby's direct exposure to light after birth, or both factors.

More than 276,000 Israeli servicemen and women were included in the retrospective, population-based study which medically evaluated the prevalence of myopia. All participants were born in Israel and were therefore exposed to the same seasonal light variations.

Mandel et al found that the risk of moderate and severe myopia varied with seasonal levels of light; the highest prevalence rates occurred in participants born in June and July and the lowest were observed in participants born in November and December. The correlations were highly statistically significant.

Court Preserved Peer-Review Process
A recent court ruling that could have "significantly threatened the integrity of the Journal of the American Medical Association's (JAMA) peer-review process" was decided in the favor of the medical community, according to a statement from JAMA's Editor-in-Chief, Catherine DeAngelis, MD, MPH, and editorial counsel Joseph P. Thornton, JD. The ruling came after attorneys for Pfizer Inc. (New York, New York) issued subpoenas to the medical journals last year to obtain confidential information.

According to the statement, JAMA and Archives of Internal Medicine have argued for months that the sanctity of the confidential peer-review process should not be violated. "The subpoenas sought all documents regarding the decision to accept or reject manuscripts, copies of rejected manuscripts, the identities of peer reviewers and the manuscripts they reviewed, and the comments by and among peer reviewers and editors regarding manuscripts, revisions, and publication decisions," Dr. DeAngelis said.

"JAMA and our Archives journals have historically and deliberately kept unpublished manuscripts and peer review comments confidential … [which] allows the peer review process to work in an unrestrained environment," Dr. DeAngelis said.

Caffeine Prevented UV Damage, Cataract Formation
Alkaloids in tea and coffee may exert an anticataractogenic effect on the lens, according to researchers from the University of Maryland School of Medicine in Baltimore.

Investigators induced the development of cataracts in the freshly isolated lenses of mice through irradiation with UV-B light. The researchers then adjusted the exposure level of the UV to decrease the rubidium transport activity to approximately 60% of basal controls. The adjustment was accompanied by a simultaneous decrease in the levels of glutathione and adenosine triphosphate to 50% and 40% of their original amount in the dark controls, respectively.

The deteriorations were significantly preventable in the presence of caffeine, and the loss of rubidium transport was nearly completely thwarted, according to the authors.

The researchers concluded that "observed effects are attributable in part to caffeine's UV screening effect, acting in combination with its other properties, such as via scavenging oxyradicals and maintaining cyclic AMP [adenosine monophosphate], the latter by inhibiting phosphodiesterase."

In Memoriam
Joel K. Shugar, MD, MSEE, died unexpectedly on May 26, after a skydiving accident in Eloy, Arizona. He was 49 years old. Dr. Shugar was the Medical Director of the Nature Coast Eye Care Institute in Perry, Florida.

Of his many contributions to ophthalmology, perhaps the most notable was his use of intracameral epinephrine in eyes with intraoperative floppy iris syndrome (IFIS). Dr. Shugar found that a combination of epinephrine and Shugarcaine (dubbed epi-Shugarcaine) counteracted IFIS in patients with a history of tamsulosin use. Shugarcaine is a diluted mixture of 4% unpreserved lidocaine and balanced salt solution.

IFIS is characterized by a floppy, billowing iris that exhibits progressive miosis during cataract surgery, has a propensity to prolapse through all surgical incisions and into the phaco port, and is unresponsive to pupillary stretching.

— Compiled by Leah D. Farr, News and Industry Editor

Correction
The headquarters for Optonol, Ltd., is located in Neve Ilan, Israel. This information was incorrect in the article, "Combined Surgery for Patients With Cataracts and Glaucoma," published in the April 2008 issue. CRST Europe regrets the error.