glaucoma

Aussie Tech Could End Glaucoma Eye Drops

Australian tech could end glaucoma eye drops

A clinical-stage Australian biotechnology company has begun recruiting glaucoma patients for a trial of a new implant that could end the need for daily eye drops.

PolyActiva has developed ocular implants that, when placed in the eye, provide sustained treatment over a six-month period, potentially removing the need for patients to manage their own treatment. Such a move could improve glaucoma outcomes, as several studies have demonstrated that up to 46% of patients don’t remember to use their drops or administer them poorly.

PolyActiva CEO Dr Russell Tait told Insight the technology had originally been developed for a different purpose, but its ability to carry a large amount of drugs in a small area and achieve zero order release, while maintaining separate control over the implant’s biodegradation made it ideal for delivering drugs to the eye.

“The implant is designed to deliver treatment for six months after which it will disappear without further intervention.”
Russell Tait, PolyActiva

“This product is designed to make the lives of glaucoma sufferers easier by removing the need for daily drop administration and thus improving treatment management,” Tait said.

“The implant is designed to deliver treatment for six months after which it will disappear without further intervention. We’re excited about starting our first clinical study and look forward to seeing how our lead candidate performs.”

According to Tait, the implant is capable of being administered in an ophthalmologist’s office under a slit-lamp using a custom-designed administration device.

“The implant itself is tiny – it’s about .2 mm in diameter and up to 4 mm in length, depending on the strength of the relevant product,” he explained.

“It sits in the lumen of a 27 gauge needle and it’s administered by clear corneal injection with a custom-built administration. For the glaucoma product it sits in the inferior angle of the interior chamber.”

The clinical trial will assess the safety and tolerance of the implant when administered to glaucoma patients and should be completed by the middle of 2019, with a view to eventually bringing the technology to market in around six years. Trials will initially be restricted to Australia, however as they progress Tait said the company would look to engage centres in the US as well.

“The major investors, MRCF [Medical Research Commercialisation Fund] and Yuuwa Capital, see this technology having a major potential impact on the lives of millions of glaucoma patients globally,” Dr Chris Nave, chairman of PolyActiva and CEO of the MRCF said.

“This innovative drug delivery technology has further potential applications, such as being used to administer other types of medication, including antibiotics and steroids for cataract surgery patients.”

PolyActiva’s first clinical candidate is designed to provide a constant daily therapeutic dose of latanoprost free acid for at least 26 weeks. Latanoprost is the active ingredient of a commonly prescribed glaucoma eye-drop treatment (Xalatan).

The Phase I clinical trial is being conducted under the Therapeutic Goods Administration Clinical Trial Notification (CTN) scheme at the Royal Victorian Eye and Ear Hospital in Melbourne, through the Centre of Eye Research Australia (CERA).

Article appeared on Insight

05/09/2018 • By Matthew Woodley

contact lens

A Warning for Contact Lens Wearers

Warning for contact lens wearers as infection increases

Blinding Acanthamoeba keratitis infections are on the rise, according to a new study led by UNSW’s Dr Nicole Carnt.

The research, which was conducted at Moorfields Eye Hospital in the UK while Carnt was on an NHMRC CJ Martin Biomedical Early Career Fellowship, found a threefold increase in Acanthamoebakeratitis infections in Southeast England since 2011. However, while the study is based on data from the UK, Carnt said its findings were equally important in Australia.

“It is absolutely imperative that regulators and those working in the optical sector take the findings seriously, and use the recommendations to take immediate and urgent action on prevention,” Carnt said.

“Contact lenses are medical devices and should be supplied with warnings regarding safe use.”

“It is absolutely imperative that regulators and those working in the optical sector take the findings seriously.”
Nicole Carnt, UNSW

Carnt told Insight she has been working with the Cornea and Contact Lens Society Australia (CCLSA) to develop a website dedicated to healthy contact lens wear, along with other initiatives to raise awareness.

“We are trying to encourage optometrists to talk about water related risks, as often they tend to skip over it as in the too hard basket or the risk too low to enforce the message,” she said.

“Yes, contact lenses are a lifestyle option and we don’t want people to be restricted but we do want them to be aware of the risks and take precautions where needed. Our message is to choose healthy contact lens wear.”

While the infection is quite rare, usually affecting 2.5 in 100,000 contact lens users per year, one in four people affected will need a corneal transplant to treat the disease and restore vision.

A member of the Acanthamoeba Keratitis Patient Support Group in the UK led by Carnt, Ms Irenie Ekkeshis, says more needs to be done to prevent new cases.

“This research confirms what those of us affected by Acanthamoeba keratitis have suspected for some time: that incidences of this awful, life-changing infection are on the increase,” Ekkeshis said.

“There’s more that should be done to prevent people from losing their sight to Acanthamoeba keratitis.”

The microorganism responsible for the infection can often be found in bodies of water such as lakes, oceans and rivers, as well as domestic tap water, swimming pools, hot tubs, soil and air. As such, Carnt said contact lens wearers needed to be aware of the risks associated with use around water.

Acanthamoeba keratitis is a largely preventable disease. People who wear reusable contact lenses need to make sure they thoroughly wash and dry their hands before handling contact lenses, and avoid wearing them while swimming, face washing or bathing,” she said.

“Daily disposable lenses, which eliminate the need for contact lens cases or solutions, may be safer and we are currently analysing our data to establish the risk factors for these.”

The study was published in the British Journal of Ophthalmology.

Article appeared on Insight

26/09/2018 • By Matthew Woodley

 

istent

iStent Significantly Reduces Unmedicated IOP in Glaucoma

iStent Significantly Reduces Unmedicated IOP in Glaucoma

Glaukos’ iStent inject trabecular micro-bypass system achieved a statistically significant reduction in unmedicated diurnal intraocular pressure (IOP) in patients undergoing cataract surgery, according to results from a two-year U.S. Investigational Device Exemption (IDE) pivotal trial data.

Results of the iStent inject prospective, randomised, multicenter clinical trial, which included 41 investigational sites and 505 open-angle glaucoma (OAG) subjects, were presented at the American Society of Cataract and Refractive Surgery (ASCRS) Annual Meeting by Dr. Thomas W. Samuelson, an ophthalmic surgeon at Minnesota Eye Consultants. In the study, 387 subjects were randomised to iStent inject in combination with cataract surgery and 118 subjects were randomised to cataract surgery only. Subjects were followed through 24 months with annual medication washouts.

The iStent inject met the study’s primary and secondary effectiveness endpoints as follows:

  • At 24 months, 75.3 per cent of the iStent inject cohort achieved a 20 per cent or greater reduction in unmedicated IOP, compared to 61.9 per cent for the cataract-only cohort.
  • At 24 months, the mean unmedicated IOP reduction was 6.9 mmHg for the iStent inject cohort, compared to 5.4 mmHg for the cataract-only cohort.
  • Through 24 months, the overall rate of adverse events for the iStent inject, in combination with cataract surgery, was similar to cataract surgery only.

Additional Findings

While not part of the effectiveness claims being pursued by the company, additional key findings include:

At 24 months, observed data show that the iStent inject cohort achieved a 31 per cent mean reduction in unmedicated (post-washout) IOP to 17.1 mmHg from an unmedicated (post-washout) mean baseline IOP of 24.8 mmHg.

At 24 months, observed data show that 62.6 per cent of the iStent inject cohort achieved unmedicated mean IOP at or below 18 mmHg, compared to 49.2 per cent for the cataract-only cohort.

At 23 months, observed data show that the iStent inject cohort achieved a 75 per cent reduction in the mean number of medications, compared to 47 per cent for the cataract-only cohort.

The iStent inject is designed to improve aqueous humor outflow into Schlemm’s canal and reduce IOP in mild-to-moderate Open Angle Glaucoma (OAG) patients undergoing cataract surgery. It includes two heparin-coated titanium stents preloaded into an auto-injection system that allows the surgeon to inject stents into multiple trabecular meshwork locations through a single corneal entry point.

The iStent inject relies on the same fluidic method of action as Glaukos’ first-generation iStent trabecular micro-bypass stent, which was approved by the U.S. Food and Drug Administration (FDA) in 2012 and has been shown to lower IOP in adult cataract patients with mild-to-moderate OAG. Each iStent inject stent is approximately 0.23 mm x 0.36 mm, or about one-third the size of iStent, which the company believes is the smallest medical device ever approved by the FDA.

The iStent inject is commercially available in the European Union, Armenia, Australia, Brazil, Canada, Hong Kong, Singapore and South Africa. The iStent inject is not approved for use in the U.S. Glaukos submitted a pre-market approval application for the iStent inject to the FDA in December 2017

Glaukos is also currently pursuing FDA approval for four additional MIGS surgical and sustained pharmaceutical therapy pipeline products, all of which are investigational in the U.S.:

  • iStent SA trabecular micro-bypass system, which is a standalone, two-stent procedure that is similar to the iStent inject and designed to reduce IOP in pseudophakic, mild-to-moderate OAG eyes.
  • iStent infinite trabecular micro-bypass system, which is a standalone, three-stent procedure, designed to reduce IOP in refractory OAG patients.
  • iStent supra suprachoroidal micro-bypass stent, which is designed to reduce IOP in mild-to-moderate OAG subjects undergoing cataract surgery by accessing the eye’s suprachoroidal space. This device is approved in the European Union.
  • iDose travoprost, which is an implant containing a special formulation of travoprost, a prostaglandin analog used to reduce IOP. Implanted during a micro-invasive procedure, the iDose travoprost is designed to continuously elute therapeutic levels of the medication from within the eye for extended periods of time.

Published by mivision | 9 May 2018

We Love Lasers – CPD evening

On Tuesday the 25th of August, Focus Laser Eye Centre hosted a 6pt CPD evening for optometrists with the theme We Love Lasers. With 5 talks presented by our leading Laser Surgeons, the evening was very rewarding.

Nigel Whittle of MTH Clinic says:

I’d like to thank you for a great educational experience tonight.

The venue, the practice, was transformed into an environment where I think we all felt comfortable and relaxed. That being, it provided a platform for easy understanding and information absorption from expert and dedicated surgeon specialists.

The topics covered were done so in a professional yet down-to-earth manner. I love lasers more now too!!

The catering was exceptional….. I suspect you had a hand in that yourself, so thanks there also.

Please pass on my sincere thanks to Dr’s Margaret and Richard and their associates.

 

Lessons Learned With Electronic Health Records ( EHR )

By Dr Richard Smith, MBBS, BSc, DO, FRCS, FRACS, FRANZCO
Published in Cataract & Refractive Surgery Today Europe’s (CRST) – June edition.

Transitioning to electronic health records involves a learning curve but can lead to increased efficiency and cost containment.

AT A GLANCE

  • The elimination of paper charts can yield savings in time, space, and money and increase access to patient data.
  • An Electronic Health Records ( EHR ) system can help provide a practice with a more modern style of patient consulting and facilitate patient education.
  • For some practices, adopting Electronic Health Records ( EHRs ) is one step toward a larger goal of transitioning to a paperless environment in which other processes, such as accounting and staff management, can be digitised as well.
fasting before cataract eye surgery

Why is fasting before cataract eye surgery important ?

Sometimes, even though patients know they will have intravenous sedation, they still do not understand why fasting before cataract eye surgery is necessary. On occasion a patient arrives for cataract surgery having eaten breakfast and unfortunately in these cases surgery has to be postponed, which can be very inconvenient for patients and doctors alike.

So why do you need to fast?

Fasting before cataract eye surgery reduces the risk of stomach contents/acid going the wrong way down into your lungs while you are asleep. Stomach acid can cause lung damage.

What is the correct way for fasting before cataract surgery?

  • NO solid food is to be eaten for at least 6 hours prior to your admission time.
  • NO fluids (except water, black tea or black coffee) are to be taken for at least 2 hours before your admission time.

Your regular medications may be taken at their usual time with a sip of water.

This is prepared by Anaesthetist
Dr Joanne Silverton 

eye conditions, cataract simulation

Cataracts – Causes, Symptoms, Diagnosis and Treatments

What are cataracts ?

Cataracts are a clouding of the crystalline lens of the eye. This in turn affects vision. Cataracts form for many reasons but the most common is age.  It is normal for people over the age of 65 to have some mild form of cataracts. Causes of Cataract development include age, steroid use, trauma, radiation, or as a result of other eye conditions such as glaucoma.  Cataracts can occur in one or both eyes, sometimes years apart, but it cannot spread from one eye to another.

Read more

state of the art, Best laser eye technology

State of the art – Medical best practice and architecture meet

IT’S HARD TO believe that beneath the welcoming, streamlined elegance and efficiency of the award-winning FOCUS Eye Centre in Kingsford, Sydney, is a century-old cottage. More remarkable is that the renovation work was completed to a strict six-month timetable on the very day promised by its architect Georgina Wilson.

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How to choose an ophthalmologist, Best laser eye technology

How to choose an Ophthalmologist that’s right for you

When it comes to eye surgery, there are a couple of key decisions that need to be made.

The first is to commit to the treatment and the next is to choose a particular Ophthalmologist to proceed. For some people finding the right specialist often comes before deciding to go ahead with treatment.

Making a choice is very much a personal process, but there’s a number of things to know — and questions to ask – that can help you make an informed decision with which you can be confident and comfortable and that’s right for you.

Read more

New Agents for Treating Dry Eye Syndrome

Authors: Simon E. Skalicky, Con Petsoglou, Avinash Gurbaxani, Clare L. Fraser, Peter McCluskey

Published article – abstract

Dry eye syndrome (DES) is characterized by an inadequate volume and/or quality of tears resulting in chronic ocular surface irritation and inflammation. Affecting up to 30 % of adults, DES has a considerable impact on visual function and quality of life. DES may complicate allergic ocular disease and allergy medication may exacerbate DES. The pathophysiology of DES involves osmotic, mechanical and inflammatory insults to the tear film, epithelium and subepithelial nerve plexus. Various immune-related molecular targets have been the focus of research aimed at developing new therapeutic agents for treating DES. This article provides an overview of established, new and future agents for treating DES.

LINK: New Agents for Treating Dry Eye Sydnrome