Cheryl Guttman

The introduction of a new fourth-generation fluoroquinolone for ophthalmic use may prompt an assessment of the pros and cons of the available agents. James P. McCulley, MD, explains his continued preference for moxifloxacin 0.5% (Vigamox, Alcon).

Sulcus placement of a proprietary three-piece multifocal IOL (ReZoom, Abbott Medical Optics) is a viable option in eyes in which capsular bag support is not adequate to ensure good lens stability. Then, if the lens decenters in the sulcus, scleral suturing is a safe and effective option for recentering the IOL and restoring good vision.

An in vitro kill kinetics study evaluated eradication of 18 human ocular Staphylococcus isolates by commercial formulations of gatifloxacin 0.3% (Zymar, Allergan) and moxifloxacin 0.5% (Vigamox, Alcon Laboratories). Gatifloxacin demonstrated superior activity, which may be attributed to the presence of benzalkonium chloride 0.005% in its formulation.

The first microincisional IOL (Akreos MICS IOL, Bausch & Lomb) has been introduced in the U.S. market. The lens is a single-piece hydrophilic acrylic IOL designed for delivery through a 1.8-mm incision. Its material and design offer several advantages, according to three surgeons who have used it.

Results of a survey of 124 ophthalmologists show interest in preservative-free formulations of IOP-lowering medications to preserve ocular surface health. Preservative-free timolol maleate (Timoptic in Ocudose, Aton Pharma) can be a good choice for appropriately selected patients, according to one ophthalmologist.

A meta-analysis based on data from 12-month trials including patients treated with brimonidine 0.1% with a preservative (Alphagan P 0.1% with Purite, Allergan) and patients using brimonidine 0.15% (Alphagan P 0.15%, Allergan) showed better systemic safety and tolerability with the lower-concentration product.

A retrospective study analyzed outcomes of 345 consecutive eyes with the proprietary glaucoma minishunt (Ex-PRESS, Optonol) implanted, including 114 eyes having combined cataract surgery. During a mean follow-up of about 2 years, the implant provided effective IOP control whether used alone or in a combination procedure and was associated with few complications.

The efficacy and tolerability of continuing latanoprost 0.005% (Xalatan, Pfizer) after 6 weeks of latanoprost monotherapy versus switching to bimatoprost 0.03% (Lumigan, Allergan) was investigated in an investigator-masked, randomized, parallel-group trial. The results showed good efficacy and tolerability in patients whose therapy was switched to bimatoprost and suggest that bimatoprost may be tolerated better after latanoprost pre-treatment.

Endocyclophotocoagulation (ECP) can be performed easily in patients with medically controlled glaucoma who are undergoing cataract surgery, to provide additional IOP lowering and reduce medication use. Misunderstanding that ECP is a completely different procedure than transscleral cyclodestruction contributes to under-use of this very safe procedure, according to one ophthalmologist.