EyeWorld Asia-Pacific December 2015 Issue

59 EWAP DEVICES December 2015 role” in AMD. Simply put, ECT uses living cells “encapsulated” within semipermeable polymer membranes and supportive matrices. The technology allows a therapeutic agent to be engineered into the cells; by encapsulating the cells the technology prevents immune system rejection while still allowing the therapeutic product to disseminate to their target sites. “Unlike gene therapy, this technology is reversible, which makes it more attractive,” Dr. Charles said. Drug reservoirs Numerous retinal disorders mandate monthly monitoring and/or treatment, and “refillable drug delivery devices may one day be the thing that’s going to help decrease the retreatment rate,” Dr. Jumper said. But the technology would bring with it as many questions as it addresses, namely cost, implantation techniques, and patient selection, among others. “There is the potential for extrusion with these types of devices,” Dr. Charles cautioned. “There’s a high likelihood of extrusion of these large implants in the subconjunctival space, especially because of the need to utilize needles to replenish the reservoir periodically.” He equates the technology to glaucoma valve implants—and that vitreoretinal specialists often treat patients with blebitis or endophthalmitis resulting from a breakdown of the bleb and its subsequent infection. Some of the more promising devices are “on the cusp of starting larger phase trials” that will address some of the questions/ concerns, “but for now, it’s very difficult to know who will come out on top and whether or not it’s any better than what we’re doing now,” Dr. Jumper said. AMD and cataract surgery Knowing the visual potential for an eye with both AMD and cataract is crucial in managing patient expectations, Dr. Jumper said. “We need to directly communicate with the cataract surgeon about the visual potential to help them decide if moving forward with cataract surgery will be beneficial,” he said. Cataract surgery itself “has no impact” on AMD progression, and “anti-VEGF therapy can and should be continued on schedule while proceeding with cataract surgery,” Dr. Charles said. Further, if the patient has dry AMD, “they’re not likely to convert to wet because of the cataract surgery,” Dr. Jumper said. Dr. Charles recommends patients receive an anti-VEGF injection “a few days before phaco,” but Dr. Jumper is more comfortable with a few weeks between the two procedures to eliminate questions about postop/ post-injection inflammation or infection. Well-constructed wounds do not need to be sewn closed, and because injections place “very little external pressure inward on the eye,” wound complications as a result of an intravitreal injection are uncommon. EWAP Editors’ note: Dr. Charles has financial interests with Alcon (Fort Worth, Texas). Dr. Jumper has financial interests with Allergan (Dublin, Ireland), Genentech (South San Francisco), Ophthotech (New York), and Regeneron (Tarrytown, NY). Contact information Charles: scharles@att.net Jumper: jmichaeljumper@gmail.com CALENDAR OF MEETINGS 2016 DATE MEETING VENUE February 5-9 World Ophthalmology Congress 2016 (WOC) www.woc2016.org Guadalajara Mexico March 25-29 The 31st Asia-Pacific Academy of Ophthalmology Congress (APAO) www.apaophth.org/ Chinese-Taipei Taiwan May 6-10 ASCRS-ASOA Symposium and Congress (ASCRS) www.ascrs.org New Orleans USA June 24-26 31st Annual Meeting of the Japanese Society of Cataract & Refractive Surgery (JSCRS) www.jscrs.org Kyoto Japan July 27-30 29th Asia-Pacific Association of Cataract and Refractive Surgeons Annual Meeting (APACRS) www.apacrs.org Bali Indonesia September 10-14 XXXIV Congress of European Society of Cataract and Refractive Surgery (ESCRS) www.escrs.org Copenhagen Denmark October 15-18 Annual Meeting of American Academy of Ophthalmology (AAO) www.aao.org Chicago USA Newer diagnostics - from page 57