Eric Donnenfeld, MD, FAAO, FACS, clinical associate professor of ophthalmology, New York University Medical Center, shares his insights on a few of the most significant topics and clinical sessions from the American Academy of Ophthalmology (AAO) annual meeting.
Give us a hot topic of the day.
RxSight’s Light Adjustable Lens (LALs), the first and only lens that can be adjusted in the eye following cataract surgery, is becoming a significant force in the ophthalmic field.
In refractive cataract surgery, the presentation Initial Clinical Experience with the LAL+ presented by Steven Slade, MD, of Slade & Baker Vision in Houston, Texas, discussed how a light adjustable extended-depth-of-focus (EDOF) lens is now being designed that allows you not only to adjust the focus to achieve optimal results, but also could give you additional reading facility.
Wait, talk about this new lens first.
Glance side note:This new EODF lens is called the LAL+, the latest addition to RxSight’s LAL product family. It will build on the LAL’s ability to correct down to 0.5 D of astigmatism (the lowest level FDA approved for treatment).
And no, it’s not yet available, although the company is reporting an anticipated Q1 2024 release.
Gotcha. Now back to our conversation.
When using this lens, doctors aim for plano in the dominant eye and for a -0.50 D in the non-dominant eye, which—with the EDOF addition of near vision—may give patients reasonable reading vision and a subtle reduction in vision at distance.
I think this is an extraordinary technology for patients who are challenged to achieve optimal results with refractive accuracy following cataract surgery.
Who would be the target patient base for this?
Our patients who have had previous laser-assisted in situ keratomileusis (LASIK), where a surgeon can't do a LASIK adjustment because of the inability to create a second flap.
Which session did you find most clinically informative?
The presentation IOP at Month 3 With Travoprost Intraocular Implant vs. IOP at Screening While on Prostaglandin Analog Monotherapy presented by Jason Bacharach, MD, discussed the iDose TR (travoprost intraocular implant) from the Glaukos Corporation that has been designed to deliver a slow eluting dose of travoprost oil into the eye to lower intraocular pressure (IOP), possibly lasting for 2 to 3 years.
This device could be another disruptive addition to the management of glaucoma, pending both FDA approval and commercial availability.
The potential benefits associated with iDose TR for patients could be that it:
- Obviates the need for topical medications
- Removes toxicity
- Maintains a steady state of drug delivery (without peaks and troughs)
- Removes compliance issues common with taking glaucoma drops on a regular basis.
The high-dose medication appears to be safe and effective, and the surgical technique is certainly something that is easily accomplished by anyone who performs cataract surgery.
From my perspective, this could revolutionize glaucoma management, and would be a welcomed addition if approved by the FDA.
Can I get more details on this iDose TR?
Glance side note …
See here for details on the implant, including clinical trial data. The implant’s new drug application (NDA) was accepted by the FDA back in May 2023.
With a Prescription Drug User Fee Act (PDUFA) date of December 22, 2023, we may be hearing an update on its approval status soon.
Now back to our conversation…
So what’s on your agenda for Monday?
Spotlight on Cataract: Complicated Phaco/IOL Cases—My Top 5 Pearls, a symposium presented by David Chang, MD, from 8 am to 12 pm PST on Monday, Nov. 6, 2023.
This is an annual event where Dr. Chang presents cases and then has a podium of 16 doctors who are all experts in the field discuss their top five pearls for managing complicated cataract cases or situations in 7 minutes or less.
It’s one of the best parts of the AAO meeting and something that I will be looking forward to.
Click here to watch the session live via the AAO app (but make sure you’re logged in as an attendee beforehand).
The American Academy of Ophthalmology annual meeting is being held Nov. 3-6, 2023, in San Francisco, California.