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    Dry Eye Treatment: Simple, Safe, and Inexpensive

    Cornea
    2015;34(2):188-192

    How effective is punctal occlusion using hypromellose 2 percent for dry eye disease? Capita et al. evaluated the low-cost treatment and found that it was safe and effective.

    In this prospective randomized trial, conducted at a single center in Brazil, the researchers evaluated 38 patients (76 eyes) who had dry eye secondary to rheumatic diseases. In each patient, the lower lacrimal punctum of one eye was occluded, and the other eye underwent a sham procedure. Patients were not aware of which eye received the active treatment.

    In the occluded eyes, significant improvements were noted in all parameters at the 28- and 56-day marks, with reductions in complaints of burning, itching, redness, tearing, and foreign-body sensation. There were no patient-reported side effects and no complications during the 24-month follow-up. At the end of the study, 10 patients spontaneously requested occlusion in both eyes.

    Hypromellose is an inexpensive, semisynthetic gelling agent made from cotton. It adapts to the dimensions of the lacrimal canaliculus and is highly biocompatible. Although a hypromellose plug can’t be removed once inserted, it biodegrades over a mean duration time ranging between four and eight weeks.

    Femtosecond and Phacoemulsification: Ranking Intraoperative Complications

    Journal of Cataract and Refractive Surgery
    2015;41(1):47-52

    In a head-to-head comparison, Abell et al. evaluated femtosecond laser–assisted and conventional phacoemulsification cataract surgery. They found that the two procedures appear to be equally safe, with an overall low rate of significant intraoperative complications.

    For this prospective single-center comparative cohort study, the researchers evaluated 4,080 eyes. Of these, 1,852 eyes treated with femtosecond laser served as the study group, while 2,228 that had standard phaco served as controls. Patient demographics and baseline characteristics were similar between the two groups.

    Anterior capsule tears occurred in 34 femtosecond eyes (1.84 percent) and in five control eyes (0.22 percent), and anterior capsulotomy tags occurred in 30 femtosecond eyes (1.62 percent) and in one control eye (0.004 percent). The incidence of posterior capsule tears between the two groups (eight femtosecond and four control eyes) did not reach statistical significance.

    The researchers concluded that the rate of significant intraoperative complications likely to affect refractive outcomes was low in both groups—and that femtosecond laser–assisted surgery is as safe as conventional phacoemulsification surgery.

    Genetics of IOP

    Human Molecular Genetics
    Published online Jan. 30, 2015

    In an investigation of the heritability of primary open-angle glaucoma (POAG), Springelkamp et al. performed a genome-wide association study of intraocular pressure (IOP) using single-nucleotide polymorphisms (SNPs) imputed to the 1000 Genomes reference panel. They identified a new locus associated with IOP.

    This meta-analysis evaluated the two population-based Rotterdam studies (n = 8,105). The most significantly associated SNP was rs58073046 within the gene ARHGeF12. Independent replication in five additional population-based studies (n = 7,471) resulted in an effect size in the same direction that reached statistical significance. The SNP was also significantly associated with POAG in two independent case-control studies (total of 1,225 cases and 4,117 controls).

    The ARHGeF12 gene plays a role in the RhoA/RhoA kinase signaling, which has been identified as a promising target for glaucoma therapy. It also binds to ABCA1 and links the ABCA1, CAV1/CAV2, and GAS7 pathway to Mendelian POAG genes.

    Biobank Research and Public Acceptance

    JAMA
    2015;313(4):417-419

    In an online survey, Tomlinson et al. examined the association between a person’s moral concerns and his or her willingness to donate tissue to a biobank. They found that, overall, members of the general U.S. population are willing to donate to biobank research—but that this willingness may begin to decrease when specific research scenarios are highlighted.

    The survey included 1,599 participants. At baseline, 68 percent agreed that they would be willing to donate tissue samples and medical information for biobank use. However, that level of support dropped to 55 percent when participants were told that any samples or information would be used to develop patents and earn profits for commercial companies. It dropped further, to 49.5 percent, with the disclosure that their samples/information would be used to develop safer and more effective abortion methods.

    The researchers also queried respondents about consent options. The highest-ranking options were 1) blanket consent combined with a statement alerting donors to possible moral, religious, or cultural concerns and 2) blanket consent combined with an option to withdraw.

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    Roundup of Other Journals is written by Jean Shaw and edited by Deepak P. Edward, MD.

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