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PROPOSED MEDICARE LEGISLATION
Introduced Bill Aimed at Preventing Medicare Physician Payment Cuts

Two senators have introduced legislation aimed at preventing deep cuts in Medicare physician payments in 2002. The proposed "Medicare Physician Payment Fairness Act of 2001" would set the physician conversion factor for 2002 at 0.9% below 2001 levels, instead of the 5.4% below 2001 levels prescribed by the "2002 Medicare Physician Fee Schedule."

Senators James Jeffords of Vermont and John Breaux of Louisiana introduced the new legislation because they believed that the 5.4% reduction would have a dramatic effect on physician reimbursement and put elderly patients' access to medical care at risk.

The proposed legislation would also direct MedPac, the group that determines the formula for establishing Medicare physician payments, to look into replacing the current formula with one that better reflects the costs of physician services. The gross domestic product determines, in part, the current formula. The American Academy of Optometry has endorsed the bill.

NEW-LINE TREATMENT
U.S. Developer of Scleral Expansion Procedure Seeks FDA Approval

A new first-line treatment for glaucoma and ocular hypertension was reported at the recent annual meeting of the American Academy of Ophthalmology.

The scleral expansion band procedure (SRP) inserts a tiny implant just below the sclera and outside the cornea. It expands the sclera to increase the tone of the underlying muscle, opening the trabecular meshwork to increase outflow. It also helps patients to accommodate better.

Dr. Aaron W. Rifkin of Ontario studied this procedure under the auspices of Health Canada, the Canadian equivalent of the Food and Drug Administration (FDA). Presby Corp. of Dallas, the developer of the technology, is seeking FDA approval.

In Dr. Rifkin's study, the SRP caused a median reduction in intraocular pressure of more than 7 mm Hg and improved focusing ability at distance and near. All of his patients had been on at least one medication pre-operatively; 90% were off medication entirely after the procedure.

Presby Corp. hopes to make the procedure available in the United States in about 2 years.

Income level linked to rate of blindness

After reviewing literature published since 1990 regarding inequalities in the prevalence and causes of blindness according to socioeconomic status, investigators in India claim that lower socioeconomic status, whether between or within countries, is strongly associated with rates of blindness. The researchers determined that people in developing countries are more likely to experience blindness as a result of cataract, refractive error and trachoma, whereas in developed countries, blindness is primarily associated with age-related macular degeneration.

FDA APPROVES PUREVISION
B&L to Compete in 30-Day Wear Contact Lens Market with CIBA Vision

K Bausch & Lomb has received Food and Drug Administration approval for its 30-day wear PureVision contact lenses. The lenses are made of silicone hydrogel, which allows for continuous use, including overnight wear. Company officials say that the AerGel technology used in the PureVision lenses helps to balance oxygen and water to increase patient comfort.

In October, CIBA Vision entered the 30-day wear arena with its Focus Night and Day lens, which company officials claim allows more oxygen to enter the eye.

Although this product gives CIBA Vision a head start, it's too early to tell which product will gain greater market share.