Exploring how technological and pharmaceutical advancements will change the field, four ODs discussed primary areas to watch in this year during a rapid-fire lecture at the American Academy of Optometry 2019 meeting in Orlando. Participants were:
Jacob Lang, OD, FAAO, of Stillwater, MN
Jaclyn Garlich, OD, FAAO, of Boston
Mark Buboltz, OD, FAAO, of Bloomington, MN
Roya Habibi, OD, FAAO, FSLS, of Seattle
Myopia control contact lenses
Historically, ODs have looked at orthokeratology as the gold standard for myopia control but now, soft lens technology is catching up.
Daily-wear soft contact lenses have been approved for myopia control, featuring dual-focus, distance-centered lenses with low refractive error and axial length.
Related: Spectacle lenses do more: Embrace new technology
Myopia prevention drops
Low-dose atropine is a known solution for slowing myopia progression, but a new drug called micropine has entered the scene.
“This is testing 0.01 % and 0.1 % atropine,” Dr. Garlich says, noting that research indicates that myopia progression can be slowed by as much as 60 to 70 percent.
Presbyopia treatment drops
Multiple companies are working on presbyopia drops. Different modes of action involve miosis to increase depth of focus or addressing lens elasticity directly.
“The average result is around two lines of near vision improvement,” Dr. Garlich says.
Presbyopic surgical option
The latest presbyopic surgical options include corneal inlays such as Kamra (SightLife), which offers a 1.6-mm aperture to create a slight pinhole effect with a modified monovision approach.
Raindrop, another corneal inlay option, has been recalled by the U.S. Food and Drug Administration (FDA) due to the risk of corneal haze.
Trifocal and light-adjustable intraocular lenses (IOL) are emerging with options available from Alcon (AcySof IQ PanOptix), (Johnson & Johnson Vision (Tecnis Symfony), and RxSight (Light Adjustable Lens).
In particular, options like extended range of vision lenses are designed for elongating focus and offering continuous vision with high contrast. Light-adjusted IOLs bring new ways to help eyecare practitioners lock in the correct prescription for patient comfort by featuring lens optics that can be adjusted up to three times each, three to five days apart.
ODs may be interested in new intracameral medications such as Dexycu (EyePoint). This is dexamethasone intraocular suspension 9 percent that dissolves within a month.
“We can see that, when compared to the placebo in about 60 percent of patients, their anterior chamber cleared,” Dr. Lang says.