OMDI as an Alternative to Prostaglandin Analogues in Low or Nonresponders

Joseph F. Panarelli, MD; and Neda Shamie, MD

Eyetube

Joseph F. Panarelli, MD, sits down with Neda Shamie, MD, to discuss a phase 3, nonrandomized, two-phase, open-label, multicenter study that evaluated the IOP-lowering efficacy and safety of omidenepag isopropyl (OMDI) in patients with primary open-angle glaucoma or ocular hypertension who did not respond or responded poorly to latanoprost. What were the results? To access the full review, please visit the link here: https://pubmed.ncbi.nlm.nih.gov/37853676/

Managing Keratoconus With Scleral Lenses

Advances in technology have driven significant improvements in patient care and outcomes.

Jason E. Compton, OD, FAAO

Modern Optometry

Scleral lenses have become a cornerstone in the management of keratoconus. They now offer a new approach to a condition that has been traditionally challenging to correct with other optical solutions. These lenses, characterized by their large diameter that vaults over the cornea and rests on the sclera to create a smooth optical surface that effectively mitigates corneal irregularities, have experienced significant evolution in both design and application to enhance the visual acuity of patients with keratoconus.1 Studies have demonstrated that scleral lenses provide patients a markedly improved mean logMAR visual acuity compared with traditional glasses and rigid gas permeable lenses.2 This advancement has not only broadened the scope of visual rehabilitation for patients with keratoconus, but has also paved the way for more practitioners to get involved in their care. ADVANCES IN SCLERAL LENS TECHNOLOGY Over the past decade, scleral lens technology has undergone transformative improvements in design, material, manufacturing technology, and fit, which has significantly affected the treatment of keratoconus. These advances are not just incremental; they represent a paradigm shift in how scleral lenses are used to enhance patient outcomes. Design Recent innovations in scleral lens design have been driven by a deeper understanding of the optical and physiological challenges of managing keratoconus. For instance, the introduction of customizable front-surface eccentricity and toricity directly addresses the unique higher-order aberrations seen in keratoconus.3,4 Other design advances involve better alignment with the ocular shape, including sector-specific and purely custom zones. Practitioners can now accommodate the most extreme variations in landing zones, improving comfort and stability without compromising corneal integrity.5 Material The evolution of scleral lens materials from PMMA to silicone hydrogel represents a leap forward for corneal health. Hyper Dk materials mark another significant advance, offering unparalleled oxygen permeability to promote corneal health in our patients with keratoconus, reduce the risk of corneal edema, and support extended wear times without compromising comfort or vision.6,7 Manufacturing The adoption of computer-assisted design and manufacturing technologies has ushered in a new era of precision in scleral lens production. These technologies allow the fabrication of lenses that are custom-molded to the wearer’s unique ocular surface topography, offering an unprecedented level of fit customization.

How to Implement the –JZ Modifier

Reporting zero waste when administering therapeutics is going to look a little different this year. Here’s why.

Joy Woodke, COE, OCS, OCSR

Retina Today

Reporting drug usage and waste in the retina clinic has always been trickier than you would expect. Given the sheer volume of therapeutics used to treat everything from diabetic eye disease to AMD—and now geographic atrophy—it’s a crucial coding skill to have. Since 2017, to obtain full reimbursement for single-dose containers, vials, and packages for both the injected and discarded amounts of a drug, 1 unit or greater, physicians have reported the –JW modifier, discarded drug not administered. The Centers for Medicare and Medicaid (CMS) have monitored the use of the –JW modifier and, because of noncompliance, have reported incomplete data on drug wastage. As a result, the CMS created a new modifier, –JZ, zero drug amount discarded/not administered to any patient, that went into effect January 1, 2023.1 Collectively, the claims data from the –JW and –JZ modifiers will be used to calculate discarded drug refunds for manufacturer rebate requirements. Physicians shouldn’t be too surprised, considering CMS announced this change in their Final Rule in November 2022.1 The –JZ modifier was effective starting January 1, 2023, but the required use of the –JZ modifier was set for July 1, 2023. This new modifier will be appended to the Healthcare Common Procedure Coding System (HCPCS) code representing the drug used. If not reported when applicable, claims could be subject to audits, and if not used by October 1, 2023, claims may be returned as unable to process. The –JW and –JZ modifiers are required for single-dose containers, vials, and packages based on the FDA-approved labeling. It is important to confirm if the drug is considered a single dose by reviewing the vial or package labeling.