Allergan, Valeant update

The ongoing pursuit of Allergan (Irvine, Calif.) by Laval, Canada-based Valeant continues, with Valeant now suggesting it may make an increased offer. News services have said the Canadian company may be willing to go more than $200/share for Allergan.

A combination drug comprising triamcinolone acetonide and moxifloxacin hydrochloride (TriMoxi formulation) and a second variation that includes vancomycin (TriMoxiVanc formulation) have shown promise in early studies as single, injectable intraocular doses that eliminate the need for drops postoperatively, developer Imprimis Pharmaceuticals (San Diego) said.

Luminate, previously known as ALG-1001 (Allegro Ophthalmics, San Juan Capistrano, Calif.), has entered phase 2 studies for the treatment of diabetic macular edema (DME).

London Eye Hospital Pharma (U.K.) has "initiated U.S. discussions to gain clinical data" for its iolAMD lens system, a "novel intraocular lens system designed to restore lost vision and provide an independent lifestyle for patients with early, intermediate, and advanced dry AMD and other macular diseases including diabetic maculopathy," the company said in a press release.

RESEARCH BRIEFS

• The centration of the treatment zone as measured by the Pentacam was better for patient-controlled fixation during small incision lenticule extraction (SMILE) than active eye tracker-assisted femtosecond laser-assisted LASIK (FS-LASIK), according to A. Lazaridis and colleagues. They compared 69 myopic eyes of 36 patients who underwent SMILE to 69 myopic eyes of 36 patients treated with FS-LASIK. All procedures were performed by a single surgeon using the VisuMax platform (Carl Zeiss Meditec, Jena, Germany). The Pentacam (Oculus, Wetzlar, Germany) was used for preoperative and postoperative topography and pachymetry. In SMILE cases, the mean decentration of the lenticule from the center of the entrance pupil was 0.326±0.196 mm (range: 0.014 to 1.062 mm), whereas the distribution of the lenticule centers demonstrated a nasalization pattern. In FS-LASIK cases, this value was 0.452±0.224 mm (range: 0.02 to 1.040 mm), whereas the ablation centers were distributed randomly. The decentration from the reference point of its technique (coaxial corneal light reflex in SMILE, the entrance pupil center in FS-LASIK) was significantly more extended in the FS-LASIK group (P<.001). The study is published in the Journal of Refractive Surgery.
• A loss to follow-up (LTF-referring to patients who discontinued visits for more than 2 years) was relatively common in hospital-based dry eye management in an Asian community, according to K.H. Poon and colleagues. Further, elderly patients have difficulty attending clinics due to nonmedical problems, which may require a more holistic approach. Of 505 patients, 240 (47.5%) were LTF between 2006 and 2010. Associated demographic factors for LTF were male sex, non-Chinese ethnicity, and age group <30 years old (all P<0.05). The reasons for LTF through the telephone survey (response rate 77.9%) were categorized into three broad groups: stabilized dry eye condition (47%), personal/social factors (25%), and perceived insufficiency of healthcare delivery (28%). Only two (1.1%) were considered as management failures. The younger patients (age <50 years) were more likely to become LTF (P<0.001) due to stabilized dry eye disease, compared to older patients who were more likely to be LTF due to personal/social reasons (P=0.02). The study is published in Patient Preferences and Adherence.
• Meibomian gland dysfunction (MGD) is widespread and has significant impact on patients' quality of life. Eyelid hygiene is the mainstay of treatment but is unstandardized and requires commitment from the patient and encouragement from the ophthalmologist, stated J.M. Benitez del Castillo and colleagues. Blephasteam (Spectrum Thea, Newcastle Under Lyme, U.K.) is an eyelid warming device designed to be an easy-to-use and standardized treatment for MGD. In the present study, 73 patients were treated for 21 days with twice daily Blephasteam sessions. The primary efficacy variable, a symptomatology visual analog scale score, declined from 63.07±21.23 (mean ± standard deviation) on day 0 to 41.90±25.49 on day 21. There were also improvements in a number of secondary efficacy variables including subjective ocular symptoms and clinical signs and symptoms of MGD and dry eye, though tear film breakup time and tear osmolarity were not improved. Global efficacy was assessed as satisfactory or very satisfactory in 83.8% of cases. Patient-reported subjective ocular symptoms declined during the study. Most patients found the device comfortable and were able to continue with normal activities (reading, watching TV, using a computer) during the Blephasteam session. No safety or tolerability issues were identified. The study is published in Clinical Ophthalmology.