Shaping the Future of Ophthalmic Care
Clinician-scientists at the John A. Moran Eye Center offer their latest studies and perspectives to inform your practice.
Complications
Keeping an eye on GLP-1 drug patients and preventing Toxic Anterior Segment Syndrome.
“Further studies are needed to test our hypothesis that rapid correction of hyperglycemia could induce ophthalmic complications. However, this is an important issue for ophthalmologists as we monitor usage of these drugs and how to best be in communication with our patients about them.”
“An acute postoperative non-infectious inflammatory reaction known as toxic anterior segment syndrome (TASS) can occur after cataract surgery and other ocular surgical procedures. In this study, we analyzed data from survey questionnaires received between 2012 and 2022 from surgical centers around the world that experienced TASS in order to analyze the trends in terms of the most common causes of this complication. The results demonstrated that issues involving instrument cleaning and sterilization continue to be the most common cause associated with TASS. However, both incidences of TASS and several common practices that increase the risk of TASS cases have decreased significantly over time, as we raise the awareness about this complication.”
— Nick Mamalis, MD and , co-directors,
Retina and Uveitis
Learning about a new treatment for macular telangiectasia type 2 (MacTel) patients, rethinking age-related macular degeneration (AMD), and comparing uveitis treatments.
“I was the principal investigator for a large multi-center trial for a novel treatment to slow vision loss from macular telangiectasia type 2 (MacTel). Our positive results for the Neurotech NT-501 CNTF implant were submitted to the FDA, which approved the treatment for clinical use nationwide in March. We hope to be a major site for this treatment because we have so many MacTel patients.”
The Impact of Non-Exudative Type 1 Macular Neovascularization on AMD Progression (R01EY033365)
“This NIH-funded research project challenges the current concept of AMD. Demonstrating that a specific neovascular subtype of AMD actually prevents СAPP progression in the sense of an intrinsic ‘rescue mechanism’ would not only provide essential information for currently tested treatment approaches but also provide a rationale for new therapeutic strategies in AMD to prevent vision loss. Our Impact of Non-Exudative Type 1 MNV on AMD Progression clinical trial has recruited 75 patients and is in its third year. We will present the first data during the Association for Research in Vision and Ophthalmology (ARVO) 2025 annual meeting in Salt Lake City with two posters and one presentation.”
The Progression of Early Atrophic Lesions in Age-related Macular Degeneration (R01EY034965)
“This ongoing NIH-funded study will add to our understanding of СAPP progression in AMD and to select which upcoming treatment options for patients might be beneficial. The Progression of Early Atrophic Lesions clinical trial is still recruiting, with a goal of 125 patients (approximately 70 have already been recruited). We will present the first data with two posters at the ARVO annual meeting in May in Salt Lake City.”
in the Journal of the American Medical Association, co-authored by Moran Eye Center experts Monika Fleckenstein, MD, and Steffen Schmitz-Valckenberg, MD, director, Utah Retinal Reading Center, provides an up-to-date, evidence-based overview that outlines:
- Changes that occur in the eye during AMD.
- Risk factors, including genetics and smoking.
- Diagnosis.
- Treatment options, from vitamins to procedures.
The Moran AMD Genetic Testing Assessment Study (MAGENTA)
“We recently completed the MAGENTA study, an NIH-sponsored randomized clinical trial that examined whether disclosure of genetic risk for eventual vision loss from AMD would spur healthy lifestyle changes. Although we were not able to achieve our primary endpoint, we were able to show that disclosing AMD risk did not induce anxiety or depression and was greatly appreciated by the subjects even if they learned that they had a high risk of AMD later in life.”
"Macular Edema Ranibizumab versus Intravitreal Anti-inflammatory Therapy Trial: 24-Week Outcomes of Uveitic Macular Edema Re-treatment" (Ophthalmology)
“Uveitic macular edema is the most common cause of visual loss in eyes with uveitis, even among those with well-controlled intraocular inflammation. At 24 weeks, the dexamethasone intravitreal implant was more effective than the non-steroidal alternatives, intravitreal methotrexate and ranibizumab, for the treatment of persistent or recurrent uveitic macular edema with manageable side effects.”
"Stopping of Adalimumab in Juvenile Idiopathic Arthritis-associated Uveitis (ADJUST): A Multicentre, Doublemasked, Randomized Controlled Trial" (The Lancet)
“Adalimumab, a tumor necrosis factor inhibitor (TNFi), is the most common biologic agent approved for the treatment of intermediate, posterior, and pan-uveitis, as well as arthritis in patients with juvenile idiopathic arthritis (JIA); however, no guidelines exist for its discontinuation in either СAPP. Abrupt discontinuation of adalimumab resulted in significantly higher rates of recurrent uveitis, arthritis, or both in patients with previously controlled JIA-associated uveitis. Fortunately, all patients with treatment failure successfully regained control of inflammation after restarting adalimumab by the end of this 48-week study.”
"Utility of Fluorescein Angiography for Early Detection of Familial Exudative Vitreoretinopathy in Neurodevelopmental Disorder With Spastic Diplegia and Visual Defects due to CTNNB1 Variants" (Journal of Pediatric Ophthalmology & Strabismus)
“My lab collaborated with a student from the University of Puerto Rico, Guillermo Requejo Figueroa, on a study that showed it is important for all patients with a rare СAPP, neurodevelopmental disorder with spastic diplegia and visual defects, to get fluorescein angiography testing to identify which patients need to be treated to prevent vision loss.”
Retinal Surgery Robot
Cataract Surgery
Understanding the impacts of energy in phaco and the next phase of accommodating lenses.
"Discrepancies in CDE and Measured Phaco Tip Energy: Comparison of Energy Produced in Longitudinal and Torsional Ultrasound Using Calorimetry" (Medical Devices: Evidence and Research)
“Cumulative dissipated energy (CDE) is one measure of energy delivered to an eye, however, it can vary depending on the settings on the machine. Our study showed the absolute measurement of energy delivered to the eye varied from the reported CDE, which has important implications on how we understand the damage ultrasound may have on intraocular structures.”
"Comparison of Ultrasound Energy Delivered to the Anterior Segment Across Different Phacoemulsification Surgical Platforms" (Medical Devices: Evidence and Research)
“This second study showed a significant range of energy delivery to the eye, despite the machines with identical power settings across three machines. Surgeons should not assume the same ultrasound settings deliver the same amount of potentially harmful energy to eye tissues when their settings are identical across platforms.”
“We have been evaluating in our laboratory a series of prototypes of accommodating intraocular lenses, which basically function by mimicking the mechanism of accommodation of the young human eye, with excellent quality of vision at all distances. The development of a truly accommodating intraocular lens will have a significant impact on clinical practices all over the world, considering the widespread prevalence of presbyopia, a common age-related condition that affects the ability to focus on close objects. Currently used presbyopia-correction lenses include multifocal lenses, as well as extended depth of focus lenses, which may be associated with visual disturbances related to their more complex optics.”
—, and Nick Mamalis, MD, co-directors, Intermountain Ocular Research Center
- Bontu S, Werner L, Kennedy S, Kamae K, Jiang B, Ellis N, Brady DG, Mamalis N. Journal of Cataract & Refract Surgery. 2021 Jan 1;47(1):111-117.
- . Kennedy S, Werner L, Bontu S, Jiang B, Kamae K, Ellis N, Brady DG, Mamalis N. Journal of Cataract & Refract Surgery. 2021 Feb 1;47(2):238-244.
- Floyd AM, Werner L, Liu E, Stallings S, Ollerton A, Leishman L, Bodnar Z, Morris C, Mamalis N. Journal of Cataract & Refract Surgery. 2013 Sep;39(9):1415-20.
- . Kohl JC, Werner L, Ford JR, Cole SC, Vasavada SA, Gardiner GL, Noristani R, Mamalis N. Journal of Cataract & Refract Surgery. 2014 Dec;40(12):2113-9.
Glaucoma
Evaluating promising new surgical devices and materials, and evolving research on intraocular pressure (IOP).
Glaucoma Therapeutics Initiative
"At the Crandall Center, we’re very excited about the work we are doing evaluating potential new surgical therapeutics and devices that we hope can increase surgical precision and provide better outcomes for patients. For example, we’ve recently evaluated promising new devices and materials from ViaLase, Myra Vision, Elios Vision, and W.L. Gore & Associates."
“Each of these publications appears in Progress in Retinal and Eye Research, which is one of the main journals in ophthalmology for ‘statement’ reviews. They explore the ways in which eye pressure causes glaucoma — which is something that we need to know more about.”
"Surgical Outcomes, Ocular Safety and Tolerability of Bio-Interventional Cyclodialysis with Allograft Scleral Reinforcement: Clinical Experience of More than 240 Cases" (Journal of Clinical Medicine)
"This study demonstrated that using scleral allograft material can be processed and applied to create a safe and effective supraciliary glaucoma procedure, which is another important option for patients who may not be ideal candidates for traditional incisional glaucoma surgery or micro-invasive glaucoma surgery."
Additional Research Highlights
- . Kelkar N, Eid K, Nakatsuka AS, Johnson C, Mamalis N, Werner L. Journal of Cataract & Refract Surgery. 2025 Feb 1;51(2):126-132.
- . Hanna A, Martinez DL, Popovic M, Ahmed IIK, Teichman J. Journal of Cataract & Refractive Surgery. 2025 Feb 1;51(2):167-174.
- Menelau R, Wallace-Carrete C, Nakahara E, Werner L, Ventura CV, Kelkar N, Eid K, Espósito K. Journal of Cataract & Refractive Surgery. 2025 Jan 1;51(1):66-71.
- . Reitblat O, Heifetz N, Durnford K, Pettey JH, Olson RJ, Livny E, Bernhisel AA, Bahar I, Sella R. Eye (London). 2024 Dec;38(18):3578-3585.
- Kuboi T, Chuck RS, Pineda R 2nd, Bhushan R, Goswamy A, Olson RJ. American Journal of Ophthalmology. 2024 Dec;268:155-164.
- . Hwang ES, Harrie RP, Desautels J. Ophthalmology. 2024 Oct;131(10):1245.
- . Sumioka T, Werner L, Yasuda S, Okada Y, Mamalis N, Ishikawa N, Saika S. Journal of Cataract & Refractive Surgery. 2024 Aug 1;50(8):862-867.
- . Sella R, Reitblat O, Durnford KM, Pettey JH, Olson RJ, Hahn TE, Bernhisel AA, Afshari NA. Acta Ophthalmologica. 2024 Aug;102(5):e696-e704.
- Werner L. Journal of Cataract & Refractive Surgery. 2024 Jul 1;50(7):665-667.
- Martinez DL, Ahmed IIK, Schlenker MB. BMJ Open Ophthalmology. 2024 May 9;9(1):e001613.
- Renschler A, Kelkar N, Eid K, Hawn V, Bundogji N, Werner L, Mamalis N. Journal of Cataract & Refractive Surgery. 2024 Apr 1;50(4):394-400.
- Werner L, Hawn VS, Bundogji N, Eid K, Kelkar N, Renschler A, Mamalis N. Journal of Cataract & Refractive Surgery. 2024 Mar 1;50(3):289-294.
- Nakatsuka AS. Journal of Cataract & Refractive Surgery. 2024 Mar 1;50(3):304-305.
- Ahmed IK, Vera V, Stalmans I, Fea AM, Mansouri K, Gu X, Craven ER, Reitsamer HA. BMJ Open Ophthalmology. 2025 Feb 6;10(1):e001696.
- Vera V, Sheybani A, Panarelli JF, Grover DS, Lee J, Craven ER, Samuelson TW, Ahmed IIK. Clinical Ophthalmology. 2025 Jan 31;19:325-347.
- Ianchulev T, Weinreb RN, Calvo EA, Lewis J, Kamthan G, Sheybani A, Rhee DJ, Ahmed IK. Clinical Ophthalmology. 2024 Dec 6;18:3605-3614.
- Konuganti PY, Rajamani M, Chaya CJ, Ramamurthy C. Journal of Current Ophthalmology. 2024 Oct 16;36(1):23-30.
- De Francesco T, Armstrong JJ, Hussein IM, Costa VP, Ahmed IIK. Ophthalmology Glaucoma. 2024 Sep-Oct;7(5):454-465.
- Muayad J, Loya A, Hussain ZS, Chauhan MZ, Alsoudi AF, De Francesco T, Ahmed IIK. Ophthalmology. 2024 Aug 23:S0161-6420(24)00515-3.
- Kanjee R, Popovic MM, Salimi A, Hutnik CML, Ahmed IIK, Saheb H. Eye (London). 2024 Jun;38(8):1518-1528.
- De Francesco T, Ianchulev T, Rhee DJ, Gentile RC, Pasquale LR, Ahmed IIK. Clinical Ophthalmology. 2024 Jun 21;18:1789-1795.
- Ahmed IIK, Sheybani A, De Francesco T, Samuelson TW. Journal of Cataract & Refractive Surgery. 2024 Apr 1;50(4):369-377.
- . Dick HB, Mackert MJ, Ahmed IIK, Denis P, Hirneiß C, Flowers BE, Singh IP, Mansouri K, Fea AM. American Journal of Ophthalmology. 2024 Apr;260:172-181.
Fleckenstein M. Ophthalmology Retina. 2025 Mar;9(3):197-199.- . Bernstein PS. Retinal Cases and Brief Reports. 2025 Mar 1;19(2):145-147.
- Bernstein PS. Retinal Cases and Brief Reports. 2025 Mar 1;19(2):157-159.
- Broadbent E, Künzel SH, Pfau M, Schmitz-Valckenberg S, Fleckenstein M. Eye (London). 2025 Feb;39(2):217-227.
- . Addo EK, Gorka JE, Allman SJ, Harrison DY, Sharifzadeh M, Hoffman RO, Hartnett ME, Varner MW, Bernstein PS. Ophthalmology Science. 2024 Apr 24;4(5):100537.
- . Strauss RW, Lang L, Ho A, Jha A, Ip M, Bernstein PS, Birch DG, Cideciyan AV, Michaelides M, Audo I, Sunness JS, Traboulsi EI, Zrenner E, Sadda SR, Janeschitz-Kriegl L, West S, Kong X, Scholl HPN; ProgStar Study Group. Ophthalmic Research. 2024;67(1):435-447.
- Sanchez G, Long TM, Warner JEA, Chung LS, Quigley EP 3rd, Digre KB, Seay MD, Crum AV, Katz BJ. American Journal of Ophthalmology Case Reports. 2025 Jan 16;37:102260.
- Sabapathypillai S, Miller VJ, Shakoor A, Palestine AG, Thorne JE, Goldstein DA, Gaudio PA, Goldberg N, Vitale A, Schlaen A, Thomas A, Merrill PT, Raiji V, Lin P, Oliver AL, Moorthy RS, Chandra G, Carreno E, Smith WM, Van Stavern G, Hassman LM. Journal of Neuro-Ophthalmology. 2024 Dec 1;44(4):545-551.
- Sharp N, Burish MJ, Digre KB, Ailani J, Fani M, Lamp S, Schwedt TJ. Journal of Headache and Pain. 2024 Apr 12;25(1):55.
- . Charles AC, Digre KB, Goadsby PJ, Robbins MS, Hershey A; American Headache Society. Headache. 2024 Apr;64(4):333-341.
- Krikova I, Digre KB, Katz BJ, Seay MD, Warner JEA. Headache. 2024 Mar;64(3):317-318.
- Robertson CE, Digre KB. Handbook of Clinical Neurology. 2024;199:441-464.
Physician Referral Services
The John A. Moran Eye Center provides care in all ophthalmic specialties and is a major referral center performing 150,000 patient visits and 8,000 surgeries annually at 11 locations. We look forward to partnering with you to provide the best possible outcomes for your patients.
Educational Resources
Clinical Ophthalmology Resource for Education
Moran’s online offers worldwide access to high-quality, peer-reviewed ophthalmic learning materials, including surgical instructional videos, lectures, and grand rounds presentations. Moran produces the site, which recorded more than 575,000 users in 224 countries in 2024, in partnership with the Spencer S. Eccles Health Sciences Library at the University of Utah.
Top 10 Most Watched Moran CORE Videos on YouTube in 2024
