Managing Focal Resistance During Canaloplasty Using Green iLumin Tip Feedback

Mahmoud A. Khaimi, MD

Eyetube

Mahmoud Khaimi, MD, shares key steps for troubleshooting focal resistance during iTrack Advance canaloplasty (Nova Eye Medical). Proper cannula orientation is shown to support initial canal entry and prevent microcatheter prolapse into the anterior chamber. The green iLumin tip provides positional feedback as the microcatheter advances. Resistance at the 9–10 o’clock region is managed by withdrawing one clock hour, delivering 1-2 clicks of OVD, and re-advancing. After complete 360° catheterization, viscodilation is performed during continuous withdrawal (3-4 clicks per clock hour), followed by OVD removal. Financial Disclosure: Consultant (Nova Eye Medical)

Myopia Research Review

A look at recent studies evaluating methods to control myopia and prevent its progression.

Shora Ansari, OD, MS, FAAO

Modern Optometry

Myopia affects a growing portion of the global population and is a common cause of visual impairment.1 A recent systematic review and meta-analysis found that more than one-third of children globally were nearsighted, with projections indicating this number could approach 40% by 2050.2 These data reflect a more than threefold increase in global myopia prevalence in children and adolescents over the past 3 decades, highlighting a significant public health concern worldwide. Over the past decade, interventions aimed at slowing axial elongation, including low-dose atropine drops, orthokeratology (ortho-k), soft multifocal contact lenses, and specialized spectacle lenses, have gained traction. More recently, combination therapies, emerging spectacle lens designs, and light-based technologies have garnered attention. This article reviews recent clinical trials evaluating standalone and combined modalities. ATROPINE AND ORTHO-K Recent research has increasingly focused on the combination of low-dose (typically 0.01%) atropine and ortho-k for myopia control in children. A 2-year randomized clinical trial compared ortho-k alone versus ortho-k plus 0.01% atropine in patients with a spherical equivalent refraction of -1.00 D to -3.00 D.3 The combined treatment were found to slow axial elongation by approximately 0.18 mm over 2 years (0.30 mm in the combination group vs 0.48 mm in the monotherapy group). However, no statistically significant differences in axial length were observed between the groups for patients with myopia greater than 3.00 D.3 Additionally, although the study spanned 2 years, the combined treatment effect was more pronounced during the first 12 months. In another study, Yu et al found that, after 12 months, axial elongation was significantly slower in the ortho-k plus 0.01% atropine group (0.10 ±0.14 mm) versus the ortho-k plus placebo group (0.20 ±0.15 mm).4 Notably, the difference was seen mainly in the first 4 months; afterward, the effects were similar. In 2023, Tan et al reported axial elongation to be significantly slower in the ortho-k plus 0.01% atropine group (0.17 ±0.19 mm) versus ortho-k alone (0.35 ±0.20 mm) over 2 years, with the strongest additive effect occurring during the first 6 months.5 Chen et al explored whether combination therapy benefitted children whose axial lengths increased by more than 0.3 mm despite 1 year of ortho-k therapy.6 Chinese children less than 7 years of age were retrospectively assigned to either ortho-k plus 0.01% atropine or ortho-k alone for 2 additional years. The results showed no significant difference in axial length progression between the two groups, which is consistent with other earlier studies, suggesting the efficacy of combination therapy declines over time.

Biogen Enters GA Treatment Market After Major Acquisition

Eyetube

Pharma giant Biogen announces its intention to acquire Apellis in a multi-billion dollar deal; a recently approved first-of-its-kind presbyopia drop is commercially launched; and Kodiak Sciences releases phase 3 data for its diabetic retinopathy drug candidate. Learn more about your ad choices. Visit megaphone.fm/adchoices