MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'Journal of Cataract and Refractive Surgery' source. Sat, 20 Mar 2010 14:53:52 +0100 http://www.medworm.com/index.php?rid=3325225&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335010001100%2Fabstract%3Frss%3Dyes (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325225 Mon, 01 Mar 2010 00:00:00 +0100 3325225 http://www.medworm.com/index.php?rid=3325224&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335010001094%2Fabstract%3Frss%3Dyes (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325224 Mon, 01 Mar 2010 00:00:00 +0100 3325224 http://www.medworm.com/index.php?rid=3325223&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335010001082%2Fabstract%3Frss%3Dyes (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325223 Mon, 01 Mar 2010 00:00:00 +0100 3325223 http://www.medworm.com/index.php?rid=3325222&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011808%2Fabstract%3Frss%3Dyes In the December issue, in the article “Preoperative Topical Moxifloxacin 0.5% and Povidone–Iodine 5.0% Versus Povidone–Iodine 5.0% Alone to Reduce Bacterial Colonization in the Conjunctival Sac” (J Cataract Refract Surg 2009;35:2109-2114), the name of the first author is spelled incorrectly. The correct name of the first author is Orly Halachmi-Eyal, MD. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325222 Mon, 01 Mar 2010 00:00:00 +0100 3325222 http://www.medworm.com/index.php?rid=3325221&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633501000074X%2Fabstract%3Frss%3Dyes We can definitely claim that anterior segment OCT is a noncontact, high-resolution imaging technique with many possible clinical applications: keratoplasty, keratorefractive surgery, Descemet membrane detachment, ocular injury; even corneal infectious diseases. As far as we know, there are 3 commercially available spectral domain anterior segment modalities that do not require personal modifications: RTVue-100 (Optovue Inc.), Cirrus HD-OCT model 4000 (Carl Zeiss Meditec), and SOCT Copernicus HR (Optopol Technology SA). (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325221 Mon, 01 Mar 2010 00:00:00 +0100 3325221 http://www.medworm.com/index.php?rid=3325220&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010116%2Fabstract%3Frss%3Dyes At the time of writing this letter, the RTVue-100 (Optovue, Inc.) used by Wylęgala et al. is the only commercially available Fourier-domain optical coherence tomography (OCT) device that can scan the anterior segment without “personal” modifications. Similar to all commercially available Fourier-domain OCT devices, it uses shorter wavelength light than the Visante-OCT (Carl Zeiss Meditec) (840 nm versus 1310 nm). It scans at a faster rate (26 000 A-scans/s) than time-domain OCT devices (2048 A-scans/s for Visante-OCT). This improves image quality by achieving higher resolution and also reducing motion artifact. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325220 Mon, 01 Mar 2010 00:00:00 +0100 3325220 http://www.medworm.com/index.php?rid=3325219&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011699%2Fabstract%3Frss%3Dyes Systematic hyperopic outcomes after IOL implantations in extreme myopia are frequently observed clinically. I traced the problem to the use of the same IOL constants for both plus and minus IOLs and proposed as a solution to distinguish between positive and negative IOL powers by separate sets of IOL constants. This concept was shown to work in model calculations in my article as well as with clinical data in the Petermeier et al. article, producing a mean arithmetic prediction error of 0 D (see also typical results for one patient in ). (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325219 Mon, 01 Mar 2010 00:00:00 +0100 3325219 http://www.medworm.com/index.php?rid=3325218&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011687%2Fabstract%3Frss%3Dyes Haigis suggests a solution to overcome the problem of a systematic hyperopic outcome of intraocular lens (IOL) calculations with third-generation formulas in very long eyes. He proposes to distinguish between positive and negative IOL powers by different formula constants. For his formula, he proposed a constant of a0 = 2.77 mm for positive power IOLs and of a0 = 1.73 mm for negative power IOLs, corresponding to the SRK/T A-constants of 121.2 and 114.4, respectively. In a subsequent paper with Haigis as a coauthor, these A-constants were modified to 126.63 for positive-power MA60MA IOLs (Alcon, Inc.) and 104.43 for negative-power MA60MA IOLs. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325218 Mon, 01 Mar 2010 00:00:00 +0100 3325218 http://www.medworm.com/index.php?rid=3325217&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011766%2Fabstract%3Frss%3Dyes I have read Chee's article on posterior polar cataracts describing a similar rotationless chop technique. Similar to many innovative concepts in surgery, cross chop is a modification of preexisting techniques. Chee's success affirms my feeling that cross chop is reliable and safe; however, I would like to highlight a few distinctions. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325217 Mon, 01 Mar 2010 00:00:00 +0100 3325217 http://www.medworm.com/index.php?rid=3325216&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011705%2Fabstract%3Frss%3Dyes I read with interest the cross-chop technique described by Kim during which the chopper is used to make a horizontal chop in the heminucleus with the phaco probe bracing the fragment; the name comes from the “X” configuration caused by crossing the instruments. This technique is said to be a safe and consistent method of disassembling the lens without rotating the nucleus; it is particularly recommended for weak zonules. I agree this is an excellent technique and have been using it successfully to avoid rotating the nucleus when tackling complicated cataracts, such as the dense posterior polar cataract. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325216 Mon, 01 Mar 2010 00:00:00 +0100 3325216 http://www.medworm.com/index.php?rid=3325215&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011717%2Fabstract%3Frss%3Dyes We appreciate Calladine et al.'s very relevant study highlighting the benefits of performing stromal hydration at the end of phacoemulsification surgery. The architecture and integrity of clear corneal incisions are crucial in preventing endophthalmitis. Ingress of contaminants from the ocular surface into the anterior chamber has been speculated as an important mechanism for postoperative contamination. This may be particularly relevant ain cases of early postoperative hypotony. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325215 Mon, 01 Mar 2010 00:00:00 +0100 3325215 http://www.medworm.com/index.php?rid=3325214&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011778%2Fabstract%3Frss%3Dyes The comments of Hu et al. and Zaffar highlight some of the challenges faced when conducting similar clinical studies. While we recognize that a small amount of corneal edema at the CCI site commonly occurs as a direct result of cataract surgery, it is unlikely to occur in large amounts in routine cases. If a significant amount of edema occurs, it is easily visible at the end of surgery as a local area of white corneal opacification around the CCI; this was not seen in our study. In our study, stromal hydration was performed generously with balanced salt solution to produce a visibly significant amount of local corneal edema. While we accept this was a subjective intervention, the optical coherence tomography (OCT) images are objective and clearly demonstrate the boundary between hydrated ... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325214 Mon, 01 Mar 2010 00:00:00 +0100 3325214 http://www.medworm.com/index.php?rid=3325213&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011729%2Fabstract%3Frss%3Dyes I congratulate Calladine et al. on conducting a very useful and informative study. With an increasing number of cataract surgeons making smaller clear corneal incisions, it is important to know whether stromal hydration improves wound integrity and reduces the risk for wound leakage. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325213 Mon, 01 Mar 2010 00:00:00 +0100 3325213 http://www.medworm.com/index.php?rid=3325212&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011730%2Fabstract%3Frss%3Dyes We have some comments about the article by Calladine et al. that we would like to share with the authors. First, one factor that might cause the difference in architecture between hydrated clear corneal incisions (CCIs) and nonhydrated CCIs is the corneal stromal edema at the incision site induced by hydration. The authors might have to record the grade of edema at the CCIs before hydration under the surgical microscope. This measurement could serve as the baseline status of the CCI edema before hydration. The difference in the baseline status between the 2 study groups might contribute to the architectural differences detected by anterior segment optical coherence tomography. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325212 Mon, 01 Mar 2010 00:00:00 +0100 3325212 http://www.medworm.com/index.php?rid=3325211&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011845%2Fabstract%3Frss%3Dyes From the data given, there is no real need for additional testing because there seems to be a clear progression from 5 to 9 years postoperatively. That the surgeon implanted ICRS in the left eye confirms this. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325211 Mon, 01 Mar 2010 00:00:00 +0100 3325211 http://www.medworm.com/index.php?rid=3325210&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011833%2Fabstract%3Frss%3Dyes Late corneal ectasia is a rare complication of LASIK that could not have been anticipated in this patient at the time of surgery. The patient's vision has been good for 8 years, decreasing thereafter in the left eye only. Although the attempt to correct the ectasia with ICRS implantation cannot be commended, the high astigmatism likely developed because 2 segments were implanted rather than only an inferior segment, which is all that was required. After ring segment explantation, we must still solve the problem in the left eye, which will probably extend to the right eye in the near future. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325210 Mon, 01 Mar 2010 00:00:00 +0100 3325210 http://www.medworm.com/index.php?rid=3325209&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011821%2Fabstract%3Frss%3Dyes A 34-year-old woman had laser in situ keratomileusis (LASIK) in both eyes in August 2000 at another clinic. Preoperatively, the corrected distance visual acuity (CDVA) was 20/25 with −8.25 −0.50 × 175 in the right eye and 20/20 with −7.50 −0.75 × 175 in the left eye. Although no topographic information is available, Javal keratometry was 45.0/46.0@85 in the right eye and 45.0/46.0@90 in the left eye and central ultrasonic pachymetry was 522 μm and 529 μm, respectively. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325209 Mon, 01 Mar 2010 00:00:00 +0100 3325209 http://www.medworm.com/index.php?rid=3325208&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011353%2Fabstract%3Frss%3Dyes In 2005, Chang and Campbell published their finding of the association between intraoperative floppy-iris syndrome (IFIS) and tamsulosin (Flomax), a systemic α1-adrenergic antagonist typically prescribed for symptoms of benign prostatic hypertrophy. Intraoperative floppy-iris syndrome is characterized by loss of the normal muscle tone of the iris, resulting in persistent iris prolapse to the wound and intraoperative miosis. Since the first report, several preoperative and intraoperative strategies to combat this vexing problem have been designed. These strategies range from the use of preoperative cycloplegia with atropine, iris retractors, the Malyugin ring, altered fluidic parameters for phacoemulsification, and more retentive ophthalmic viscosurgical devices (OVDs) such as sodium hyalu... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325208 Mon, 01 Mar 2010 00:00:00 +0100 3325208 http://www.medworm.com/index.php?rid=3325207&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011316%2Fabstract%3Frss%3Dyes The iris billowing, iris prolapse, and intraoperative miosis associated with intraoperative floppy-iris syndrome (IFIS) can limit the anterior segment surgeon's ability to perform efficient and safe phacoemulsification. Identification of the association between systemic α-antagonists and IFIS has allowed appropriate planning and anticipation of surgical events. Several authors have described techniques for approaching these cases. The Malyugin pupil expansion device, which was recently introduced, has become the preferred device for IFIS cases in our training program because of its ease of use and the predictable pupillary aperture. Despite our enthusiasm, we have occasionally observed intraoperative behaviors of the Malyugin ring that can limit safe usage. For example, complete retrieval... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325207 Mon, 01 Mar 2010 00:00:00 +0100 3325207 http://www.medworm.com/index.php?rid=3325206&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011857%2Fabstract%3Frss%3Dyes Topical anesthesia is not widely used for foldable Artiflex phakic intraocular lens (pIOL) (Ophtec BV) implantation. Retrobulbar, peribulbar, and even general anesthesia are the more common techniques. As a less invasive technique, topical anesthesia reduces the risk for systemic complications and eliminates the complications from injection anesthesia such as globe perforation, retrobulbar hemorrhage, retinal vascular occlusion, ptosis, and optic nerve damage. The advantages of topical anesthesia are faster visual recovery, higher patient satisfaction, easy application, minimal discomfort on administration, rapid onset of anesthesia, and lower costs. To my knowledge, this is the first report of the efficacy of topical anesthesia for implantation of an Artiflex pIOL for the correction of my... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325206 Mon, 01 Mar 2010 00:00:00 +0100 3325206 http://www.medworm.com/index.php?rid=3325205&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011651%2Fabstract%3Frss%3Dyes A 19-year-old woman presented with a 3-day history of pain, redness, and diminution of vision occurring one day after collagen crosslinking (CXL) with riboflavin and ultraviolet-A had been performed for keratoconus in the right eye. On presentation, severe keratitis with a 7.0mm×6.0mm central infiltrate was present. Culture results from the patient's contact lens and corneal scrapings were positive for Pseudomonas aeruginosa. Keratitis can occur following CXL because of the presence of an epithelial defect, use of a soft bandage contact lens, and topical corticosteroids in the immediate postoperative period, and patients should be counseled about it.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325205 Mon, 01 Mar 2010 00:00:00 +0100 3325205 http://www.medworm.com/index.php?rid=3325204&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633500901164X%2Fabstract%3Frss%3Dyes We studied an enucleated postmortem eye from an 82-year-old white donor who had been implanted with a Pannu “universal” intraocular lens (IOL) in the anterior chamber approximately 20 years earlier. This IOL has design features characteristic of a 1-piece, C-loop posterior chamber IOL. Magnetic resonance imaging showed a relatively well-centered IOL in the anterior chamber with haptics impinging on the iris. Gross and light microscopic analyses of the eye and the IOL showed peripheral anterior synechiae enclaving one haptic, areas of angle widening, significant attenuation of the corneal endothelium, multiple areas of iris trauma secondary to optic and haptic iris abrasion, large areas of pigment dispersion in the angle, diffuse pigment accumulation within the anterior chamber, and att... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325204 Mon, 01 Mar 2010 00:00:00 +0100 3325204 http://www.medworm.com/index.php?rid=3325203&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010967%2Fabstract%3Frss%3Dyes We report a case of bilateral Descemet membrane detachment (DMD) after canaloplasty in a 70-year-old Portuguese man with primary open-angle glaucoma. The patient developed bilateral DMD immediately following consecutive (1 week apart) canaloplasty surgery in both eyes. Slitlamp biomicroscopy, gonioscopy, and Fourier-domain optical coherence tomography (FD-OCT) findings are described. On postoperative day 1, in both cases, slitlamp biomicroscopy revealed an unscrolled inferonasal DMD and a clear cornea with deep and quiet anterior chambers. Gonioscopy showed an intact, lightly pigmented, and distended trabecular meshwork with no evidence of suture extrusion. High-resolution FD-OCT revealed a widely dilated canal of Schlemm, trabecular distention, and a retrocorneal hyperreflective membrane ... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325203 Mon, 01 Mar 2010 00:00:00 +0100 3325203 http://www.medworm.com/index.php?rid=3325202&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011663%2Fabstract%3Frss%3Dyes We report the histological findings of secondary cataract in an eye with a spontaneously regressed retinoblastoma to obtain keys to clarify the mechanism of this phenomenon. During phacoemulsification, opacified anterior capsule was obtained, fixed in formalin, and embedded in paraffin. Paraffin sections of the specimen were histologically observed. Hematoxylin–eosin staining showed extracellular matrix accumulation in the extracted fibrous anterior subcapsular opacification. Immunohistochemistry revealed the presence of fibrous collagen types and cellular fibronectin. Presumed lens cells amid matrix were positively labeled for vimentin, α-smooth muscle actin, and phospho-Smad2. Histology of the fibrous anterior subcapsular opacification tissue showed the possibility of epithelial-mesen... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325202 Mon, 01 Mar 2010 00:00:00 +0100 3325202 http://www.medworm.com/index.php?rid=3325201&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011675%2Fabstract%3Frss%3Dyes A 72-year-old man presented with high astigmatism (2.25 −5.0 × 45) induced by long-term rotation of a toric intraocular lens (IOL). Corneal astigmatism was 3.78 diopters (D). The corrected distance visual acuity (CDVA) was 20/32. Because of the risk of repositioning, a secondary toric IOL of −3.0/6.0 D especially designed for sulcus implantation was piggybacked through 3.5 mm sutureless clear-corneal incision with a cylindrical axis obliquely crossed with that of the primary IOL. Eight months postoperatively, the corneal astigmatism was 5.04 D. The CDVA was 20/25 with a refraction of 1.0 −2.5 × 70. No interlenticular opacification or significant rotation or decentration of the secondary toric IOL was observed. The refractive properties of this pseudophakic eye were analyzed using a... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325201 Mon, 01 Mar 2010 00:00:00 +0100 3325201 http://www.medworm.com/index.php?rid=3325200&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011274%2Fabstract%3Frss%3Dyes Purpose: To evaluate the effect of altering microkeratome parameters (oscillation rates and head-advance speeds) and repeated blade use on human and porcine laser in situ keratomileusis interface surface quality and to evaluate correlations between human and porcine interface surface quality.Setting: Emory Vision, Atlanta, Georgia, USA.Methods: Corneal flaps were created in porcine eyes and human cadaver eyes with an Amadeus I microkeratome using varying head-advance speeds and oscillation rates. Microkeratome blades were used once in 18 porcine eyes, twice in 18 human eyes (simulating clinical use), and 5 times in 15 porcine eyes. The interface surface was imaged with electron microscopy, with overall bed quality and surface smoothness graded from 1 to 5 (smoothest to roughest) by 5 maske... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325200 Mon, 01 Mar 2010 00:00:00 +0100 3325200 http://www.medworm.com/index.php?rid=3325199&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011328%2Fabstract%3Frss%3Dyes Conclusions: Linezolid levels in the aqueous humor, conjunctiva, and cornea exceeded the minimum inhibitory concentration of most gram-positive organisms that cause bacterial keratitis and endophthalmitis. Linezolid could be a valuable alternative in cases of increased resistance to vancomycin.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325199 Mon, 01 Mar 2010 00:00:00 +0100 3325199 http://www.medworm.com/index.php?rid=3325198&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633500901133X%2Fabstract%3Frss%3Dyes Conclusions: The anterior optic surface of the acrylic IOL was vulnerable to forceps-induced surface depressions. Surface abnormalities were prevented by coating the anterior optic surface with OVD before grasping it with a metal insertion forceps.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325198 Mon, 01 Mar 2010 00:00:00 +0100 3325198 http://www.medworm.com/index.php?rid=3325197&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011754%2Fabstract%3Frss%3Dyes Purpose: To compare real-time intraocular pressure (IOP) between laser in situ keratomileusis (LASIK) and epithelial LASIK (epi-LASIK) in porcine eyes during flap creation using a microkeratome or an epikeratome, respectively.Setting: Vissum Madrid, Madrid, Spain.Methods: In this prospective study, a Moria microkeratome was used in 1 eye (LASIK group) and an Epi-K epikeratome in the other eye (epi-LASIK group) to create a lamellar corneal flap and an epithelial flap, respectively, in freshly enucleated porcine eyes. The IOP changes during the procedures were recorded by direct cannulation using a reusable blood pressure transducer connected to the anterior chamber.Results: Each group comprised 17 eyes. In the LASIK group, the mean IOP was 113.65 mm Hg ± 10.78 (SD) during suctioning and 11... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325197 Mon, 01 Mar 2010 00:00:00 +0100 3325197 http://www.medworm.com/index.php?rid=3325196&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011262%2Fabstract%3Frss%3Dyes Conclusion: Microwave keratoplasty reduced corneal curvature and has therapeutic potential as a noninvasive alternative to excimer laser surgical correction of myopia and as a treatment for corneal ectasia.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325196 Mon, 01 Mar 2010 00:00:00 +0100 3325196 http://www.medworm.com/index.php?rid=3325195&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011213%2Fabstract%3Frss%3Dyes Purpose: To compare straylight values before and 3 months after laser in situ keratomileusis (LASIK) and laser-assisted subepithelial keratectomy (LASEK) and to analyze the causes of any change.Setting: Private refractive surgery clinic, Driebergen, The Netherlands.Methods: Straylight was measured before and after LASIK or LASEK with a C-Quant straylight meter; values were recorded as the straylight parameter log(s). Main outcome measures were the difference between postoperative and preoperative straylight values and factors causing a difference between the values.Results: The study evaluated 102 eyes having LASIK and 137 eyes having LASEK. On average, there was significant improvement in straylight values postoperatively in both groups. The mean decrease was −0.016 log(s) in the LASIK ... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325195 Mon, 01 Mar 2010 00:00:00 +0100 3325195 http://www.medworm.com/index.php?rid=3325194&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011365%2Fabstract%3Frss%3Dyes Purpose: To evaluate the visual and refractive outcomes of limbal relaxing incisions (LRIs) to reduce astigmatism at the time of apodized diffractive multifocal intraocular lens (IOL) implantation.Setting: University of Texas Southwestern Medical Center at Dallas, Dallas, Texas, USA.Methods: This retrospective review comprised consecutive patients who had LRIs at the time of lens extraction and AcrySof ReSTOR IOL implantation. A subgroup of patients had subsequent laser in situ keratomileusis (LASIK) for residual refractive error correction.Results: The study evaluated 73 eyes (59 patients); 21 eyes (28.7%) of 59 patients had further LASIK (LRI+LASIK). The mean follow-up was 13.2 months ± 6.4 (SD). The mean keratometric astigmatism decreased from 1.49 ± 0.71 diopters (D) preoperatively t... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325194 Mon, 01 Mar 2010 00:00:00 +0100 3325194 http://www.medworm.com/index.php?rid=3325193&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633500901178X%2Fabstract%3Frss%3Dyes Conclusions: In this pilot series, the use of the 1000 Hz excimer laser did not lead to the clinical side effects that are potentially associated with the use of a high repetition rate. The safety, stability, and efficacy of the laser were high although no adjustments to the nomogram were made.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325193 Mon, 01 Mar 2010 00:00:00 +0100 3325193 http://www.medworm.com/index.php?rid=3325192&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010979%2Fabstract%3Frss%3Dyes Conclusions: Overall, the flap dimensions and refractive results were predictable and the complication rate was acceptable after LASIK using the new femtosecond laser for flap creation.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325192 Mon, 01 Mar 2010 00:00:00 +0100 3325192 http://www.medworm.com/index.php?rid=3325191&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011225%2Fabstract%3Frss%3Dyes Conclusions: Wavefront-guided LASIK and wavefront-optimized LASIK produced equivalent visual outcomes and no differences in HOAs. Wavefront-guided treatment could not be performed in many eyes because of difficulties during wavefront measurement.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325191 Mon, 01 Mar 2010 00:00:00 +0100 3325191 http://www.medworm.com/index.php?rid=3325190&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011237%2Fabstract%3Frss%3Dyes Conclusion: Manual limbal markings and iris-registration software were equally effective and safe in LASIK for myopic astigmatism, showing that checking cyclotorsion by manual limbal markings is a safe alternative when automated systems are not available.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325190 Mon, 01 Mar 2010 00:00:00 +0100 3325190 http://www.medworm.com/index.php?rid=3325189&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011298%2Fabstract%3Frss%3Dyes Purpose: To evaluate the repeatability of the Galilei dual-Scheimpflug analyzer in measuring corneal curvature, wavefront aberrations, pachymetry, and anterior chamber depth (ACD).Setting: Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA.Methods: Three consecutive measurements were performed in 1 eye of each subject. The following were evaluated: (1) mean total corneal power at the central, paracentral, and peripheral zones (0.0 to 4.0 mm, 4.0 to 7.0 mm, and 7.0 to 8.0 mm, respectively) and posterior corneal power (Kavg); (2) corneal higher-order wavefront aberrations (6.0 mm pupil); (3) mean pachymetry at the central, paracentral, and peripheral zones; and (4) ACD. Repeatability was assessed by calculating the within-subject standard deviation (SD), coefficient of var... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325189 Mon, 01 Mar 2010 00:00:00 +0100 3325189 http://www.medworm.com/index.php?rid=3325188&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011341%2Fabstract%3Frss%3Dyes Conclusions: The iris–optic distance was not statistically significantly different between eyes with severe negative dysphotopsia symptoms and nonsymptomatic eyes. However, when IOL exchange reduced the iris–IOL distance, the severe negative dysphotopsia symptoms resolved.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325188 Mon, 01 Mar 2010 00:00:00 +0100 3325188 http://www.medworm.com/index.php?rid=3325187&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011286%2Fabstract%3Frss%3Dyes Conclusions: Attempts to correct for posture-related ocular cyclotorsion did not influence SIA or its variance in a single-surgeon series. These results should be interpreted with full appreciation of the limitations of currently available techniques to correct for posture-related ocular cyclotorsion in the clinical setting.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325187 Mon, 01 Mar 2010 00:00:00 +0100 3325187 http://www.medworm.com/index.php?rid=3325186&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011249%2Fabstract%3Frss%3Dyes Conclusions: Phacoemulsification with stent implantation was more effective in controlling IOP than phacoemulsification alone; the safety profiles were similar.Financial Disclosure: The author has no financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325186 Mon, 01 Mar 2010 00:00:00 +0100 3325186 http://www.medworm.com/index.php?rid=3325185&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011304%2Fabstract%3Frss%3Dyes Purpose: To evaluate the clinical analgesic efficacy of 1.0 g oral acetaminophen (paracetamol) given in addition to topical anesthesia before phacoemulsification cataract surgery.Setting: Inpatient and outpatient ophthalmology clinics, Bydgoszcz, Poland.Methods: Consecutive patients with age-related cataract having phacoemulsification under topical anesthesia (tetracaine 0.5%) were enrolled in a prospective double-blind randomized placebo-controlled study. Patients were randomly assigned to preoperative oral administration of a placebo medication or to oral administration of 1.0 g acetaminophen. The main outcome measure was intensity of pain during and after surgery. Pain intensity was measured using a 10 cm baseline visual analog scale and a discrete 5-category verbal rating scale.Results... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325185 Mon, 01 Mar 2010 00:00:00 +0100 3325185 http://www.medworm.com/index.php?rid=3325184&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011250%2Fabstract%3Frss%3Dyes Conclusions: Professional baseball players have small higher-order optical aberrations when tested with naturally dilated pupils. No clinically significant differences were found between the 2 aberrometers. Statistically significant differences in trefoil were found between the players and the control population; however, the difference was clinically insignificant. It seems as though the visual system of professional baseball players is limited by lower-order aberrations and that the smaller HOAs do not enhance visual function over that in a control population.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325184 Mon, 01 Mar 2010 00:00:00 +0100 3325184 http://www.medworm.com/index.php?rid=3325183&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011377%2Fabstract%3Frss%3Dyes Conclusions: Filtering blue lights under mesopic conditions seemed to modify color discrimination in the green-to-blue bands postoperatively. The modification did not disturb overall color discrimination or cause subjective discomfort.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325183 Mon, 01 Mar 2010 00:00:00 +0100 3325183 http://www.medworm.com/index.php?rid=3325182&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011742%2Fabstract%3Frss%3Dyes Conclusions: There was no clear evidence of near acuity improvement despite statistically significant pilocarpine-induced anterior lens displacement. Further randomized controlled studies with standardized methods evaluating adverse effects (eg, PCO) are needed to clarify the tradeoffs.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325182 Mon, 01 Mar 2010 00:00:00 +0100 3325182 http://www.medworm.com/index.php?rid=3325181&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011791%2Fabstract%3Frss%3Dyes I describe a technique for implantation of a 1-piece acrylic foldable intraocular lens (IOL) using an irrigation cannula of the phaco machine without using an ophthalmic viscosurgical device (OVD). The irrigating cannula introduced through a side port provides excellent stability and positioning to the eye; if required, the cannula tip is used to guide the leading haptic of the IOL into the capsular bag. The fluid coming from the side port via a bimanual irrigation cannula maintains adequate formation of the capsular bag and anterior chamber while the foldable IOL is inserted. The hydroimplantation technique has the advantage of increased efficiency, reduced surgical time and cost, no need for OVD removal from behind the IOL or for additional instrumentation, no OVD-induced intraocular pr... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325181 Mon, 01 Mar 2010 00:00:00 +0100 3325181 http://www.medworm.com/index.php?rid=3325180&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335010000039%2Fabstract%3Frss%3Dyes I describe a technique for transscleral fixation of a posterior chamber intraocular lens (PC IOL) combined with penetrating keratoplasty. Partial-thickness trephination of the cornea is followed by full-thickness penetration of the anterior chamber at 12 o'clock and 6 o'clock through 5.5 and 2.0mm incisions, respectively. Scleral fixation of a PC IOL is performed through the incisions under a closed chamber followed by replacement of the diseased graft with a donor button. The results in 5 eyes of 5 patients with aphakic bullous keratopathy and lack of capsule support are reported.Financial Disclosure: The author has no financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325180 Mon, 01 Mar 2010 00:00:00 +0100 3325180 http://www.medworm.com/index.php?rid=3325179&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335010000714%2Fabstract%3Frss%3Dyes There are two kinds of light—the glow that illuminates and the glare that obscures.James Thurber One of the most vexing symptoms that can affect patients following modern cataract surgery is dysphotopsia. This photic phenomenon, which occurs in pseudophakic patients, has many different forms. So-called positive dysphotopsia is usually noted as phenomena such as light rings, arcs, streaks, flashes, and halos that may interfere with vision. These images are noted near the central axis of vision and can be induced by peripheral light sources. Positive dysphotopsia is usually related to bright artifacts of light on the retina. Tester et al. used the term dysphotopsia to describe the visual phenomena encountered by phakic and pseudophakic patients, including flashes of light, glare, and lig... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3325179 Mon, 01 Mar 2010 00:00:00 +0100 3325179 http://www.medworm.com/index.php?rid=3237866&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011420%2Fabstract%3Frss%3Dyes (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237866 Mon, 01 Feb 2010 00:00:00 +0100 3237866 http://www.medworm.com/index.php?rid=3237865&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011419%2Fabstract%3Frss%3Dyes (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237865 Mon, 01 Feb 2010 00:00:00 +0100 3237865 http://www.medworm.com/index.php?rid=3237864&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009011407%2Fabstract%3Frss%3Dyes (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237864 Mon, 01 Feb 2010 00:00:00 +0100 3237864 http://www.medworm.com/index.php?rid=3237863&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010025%2Fabstract%3Frss%3Dyes In their article about flap dislocation, Muñoz et al. state that topical brimonidine prevents the formation of subconjunctival hemorrhages after femtosecond laser in situ keratomileusis (LASIK) but significantly increases the risk for early flap dislocation. I offer some plausible explanations for the observed flap dislocation. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237863 Mon, 01 Feb 2010 00:00:00 +0100 3237863 http://www.medworm.com/index.php?rid=3237862&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633500901013X%2Fabstract%3Frss%3Dyes In their study concerning the use of intraoperative retinoscopy for intraocular lens (IOL) power estimation, Patwardhan et al. cited another report that used autorefractive optical biometry for IOL power calculation. They also reported the deficiencies of the latter method compared with intraoperative retinoscopy. The authors apparently overlooked my original publication on the subject of intraoperative retinoscopy for IOL power calculation, a technique that I have been using for approximately 30 years. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237862 Mon, 01 Feb 2010 00:00:00 +0100 3237862 http://www.medworm.com/index.php?rid=3237861&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010128%2Fabstract%3Frss%3Dyes In reply to the cataract surgical problem pertaining to cosmetic surgical options for a no-light-perception eye with a subluxated white cataract, many useful options were given. However, one option that should be considered is an opaque black iris-claw intraocular lens (IOL) (Ophtec BV) that can be enclavated to the iris (). This avoids the potentially risky prospect of removing the subluxated rock-hard cataract and does not require complex intraocular maneuvers or the need to suture the IOL to the sclera. A 5.0 mm corneal or scleral incision is required. The surgery can be performed under topical anesthesia and is very quick and well tolerated. We have found the use of iris-claw IOLs for phakic or aphakic purposes to be a very effective platform for lens fixation in complex situations. (S... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237861 Mon, 01 Feb 2010 00:00:00 +0100 3237861 http://www.medworm.com/index.php?rid=3237860&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010943%2Fabstract%3Frss%3Dyes Chee's strategy for patient positioning seems simple and elegant using this table. With severe kyphosis, we have found that the curve of the spine is so low under the head (when the head is horizontal) that we cannot get our feet under the bed for a temporal approach. It sounds as though this bed and position allow a temporal approach, which I think would be preferred. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237860 Mon, 01 Feb 2010 00:00:00 +0100 3237860 http://www.medworm.com/index.php?rid=3237859&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009961%2Fabstract%3Frss%3Dyes Muthialu et al. are to be commended for their innovative technique of using a parachute-like harness to securely strap the patient postured in the Trendelenburg position. However, they acknowledge that because of the limited leg room under the stacked up head and neck supports, the surgeon has to be seated superiorly rather than temporally, which is the preferred approach. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237859 Mon, 01 Feb 2010 00:00:00 +0100 3237859 http://www.medworm.com/index.php?rid=3237858&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009985%2Fabstract%3Frss%3Dyes In preparing our response, we thought it might be useful to investigate publications by Devine in the area of phacoemulsification to see what expertise and biases he brings to this discussion. A search of the National Library of Medicine database revealed 3 peer-reviewed publications since 1975, 2 of which are in the ophthalmic literature. Of these, one is an instrument/technique report and the other a letter to the editor. The letter is a rebuttal of work by Mackool and Sirota, similar to Devine's rebuttal of our work. A sentence from this letter starts, “Two other concerns are that the Millennium was apparently not tested with its Custom Control software and that the friction tests were performed with manual decentration.…” We have an interest in the thermal effects of phacoemulsif... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237858 Mon, 01 Feb 2010 00:00:00 +0100 3237858 http://www.medworm.com/index.php?rid=3237857&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009973%2Fabstract%3Frss%3Dyes The recent article by Han and Miller is, in my opinion, flawed and potentially misleading. The study attempts to draw several clinically relevant observations based on a comparison of the fluidics systems of 3 machines. However, it tested each of the 3 machines with the Alcon handpiece, needle, and sleeve. Each manufacturer's handpiece, needles, and sleeves are designed for its system and produce various degrees of resistance to inflow and outflow. The Alcon handpiece, needle, and sleeve used in the study are not recommended for use with the Stellaris system. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237857 Mon, 01 Feb 2010 00:00:00 +0100 3237857 http://www.medworm.com/index.php?rid=3237856&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010049%2Fabstract%3Frss%3Dyes We agree with Lipstock that flap SD and range are very important in flap thickness evaluation. Accordingly, we included that information in our article. Despite the fact that the femtosecond laser has been regarded as more accurate than blade microkeratomes, there are important differences between the intended and obtained flap thicknesses, as we and other authors have shown, possibly resulting in a thinner than recommended residual stromal thickness. The programmed (target) flap thickness should not be used to calculate the residual stromal thickness, and therefore accurate subtraction pachymetry is critical when performing femtosecond laser in situ keratomileusis. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237856 Mon, 01 Feb 2010 00:00:00 +0100 3237856 http://www.medworm.com/index.php?rid=3237855&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010037%2Fabstract%3Frss%3Dyes In their article comparing flap thickness results with 2 microkeratomes and a femtosecond laser, Rosa et al. focused discussion of the results on (1) how far the flap measurements differed from the targeted flap thickness and (2) the effect on flap thickness measurement of waiting 20 minutes after femtosecond flap creation to measure the stromal bed. The results showed a mean deviation from target that was greatest for the femtosecond laser when measured immediately after flap creation but least for the femtosecond laser when measured 20 minutes after flap creation. They theorized that temporary stromal dehydration after femtosecond flap creation may account for the difference when the readings were 20 minutes apart. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237855 Mon, 01 Feb 2010 00:00:00 +0100 3237855 http://www.medworm.com/index.php?rid=3237854&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010013%2Fabstract%3Frss%3Dyes We thank Varma and Ahmed for their helpful comments. While anterior chamber stability was not formally studied in this paper, the closed-system model of phacoemulsification implies that incisional leakage is related to anterior chamber instability. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237854 Mon, 01 Feb 2010 00:00:00 +0100 3237854 http://www.medworm.com/index.php?rid=3237853&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010001%2Fabstract%3Frss%3Dyes Liyanage et al. should be commended for attempting to study incisional leakage and potential anterior chamber stability during cataract surgery, although the latter was not formally studied. Unfortunately, the study has several methodological issues, including a very rudimentary method to measure irrigation and aspiration volume (graduations on irrigation bottle and aspiration bag, respectively). Measuring volume differences using a strain gauge might have been more precise. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237853 Mon, 01 Feb 2010 00:00:00 +0100 3237853 http://www.medworm.com/index.php?rid=3237852&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009948%2Fabstract%3Frss%3Dyes We agree that CH is more a measurement parameter specific to the Ocular Response Analyzer (ORA; Reichert, Inc.) than a well-defined physical property of the cornea and that much remains to be understood about the relationship between parameters measured by the ORA and their relative contribution to corneal elasticity and rigidity. We also agree that further studies of larger cohorts are needed to identify CH's role in the diagnosis of corneal disorders. For example, while some studies show decreased CH with increasing age, others report the opposite. The same ambiguity exists in our study and the study by Şahin et al. concerning CH and diabetes. Regarding these 2 studies, different results may be the result of specific differences. For example, in our study, patients were significantly o... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237852 Mon, 01 Feb 2010 00:00:00 +0100 3237852 http://www.medworm.com/index.php?rid=3237851&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009936%2Fabstract%3Frss%3Dyes In their recent article, Goldich et al. found that corneal hysteresis (CH), corneal resistance factor (CRF), and central corneal thickness were significantly higher in diabetic eyes than in healthy eyes and CH was claimed to be related to the corneal stiffness. However, we found significantly lower CH values in diabetic eyes than in eyes of healthy subjects. We believe that the statements that equate a higher CH with increased corneal stiffness are at best speculative in this context. Corneal hysteresis can increase or decrease with stiffening depending on the behavior of the viscous material element, so the change in CH alone has too many undefined degrees of freedom to say anything more than that CH is increased. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237851 Mon, 01 Feb 2010 00:00:00 +0100 3237851 http://www.medworm.com/index.php?rid=3237850&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010918%2Fabstract%3Frss%3Dyes I used to be a fan of lasering around the hinge area if I could find a cuff of fibrosis to lyse. I now often consider going back to reopen the bag with viscodissection. I then free the loops at the equator with a Sinskey hook and rotate the IOL 90 degrees. I then place a CTR over the IOL to ensure the capsule is well opened. Within 1 to 2 weeks, I open the posterior capsule and lyse any fibrous bands over the hinge area. My success with this technique is higher than with the laser alone, although the surgery can be difficult and tedious. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237850 Mon, 01 Feb 2010 00:00:00 +0100 3237850 http://www.medworm.com/index.php?rid=3237849&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010906%2Fabstract%3Frss%3Dyes This patient presents 3 months postoperatively with classic Z-syndrome; the temporal plate haptic is vaulted posteriorly, the nasal plate haptic is vaulted anteriorly, and there is marked noncorneal astigmatism along the long axis of the IOL. Judging by the loss of iris pigment temporally and residual cortical material superiorly, this appears to have been a difficult case that required an attempt at IOL repositioning 1 day postoperatively. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237849 Mon, 01 Feb 2010 00:00:00 +0100 3237849 http://www.medworm.com/index.php?rid=3237848&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633500901089X%2Fabstract%3Frss%3Dyes The Z-syndrome in the left eye has been associated with the Crystalens IOL. This IOL should be positioned so that both hinged haptics are vaulted posteriorly. If the IOL vaults anteriorly on 1 side only, a Z-configuration results. Patients with the syndrome typically present with decreased vision and a manifest refraction showing increased myopic astigmatism resulting from IOL tilting. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237848 Mon, 01 Feb 2010 00:00:00 +0100 3237848 http://www.medworm.com/index.php?rid=3237847&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010888%2Fabstract%3Frss%3Dyes Shortly after the launch of the initial version of the Crystalens IOL, surgeons noted the occurrence of Z-syndrome. Modifications were made to stiffen the haptics with the goal of reducing the incidence of the syndrome. However, even with the haptic modifications, the syndrome has occurred with the most recent versions of the IOL. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237847 Mon, 01 Feb 2010 00:00:00 +0100 3237847 http://www.medworm.com/index.php?rid=3237846&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010876%2Fabstract%3Frss%3Dyes The diagnosis in this case is acute asymmetric vault or Z-syndrome of the Crystalens accommodating pseudophakic IOL. It appears that during the initial surgeries, the IOL should not have been implanted in the current orientation in the left eye. Adequate anterior capsule in front of the plate haptics prevents the hinge–optic junction from flexing anteriorly. That the patient had poor vision so soon after surgery highlights why training courses for this IOL recommend not implanting the IOL unless there is adequate anterior capsule coverage overlying the plate haptics. Regarding adequate coverage, a 7.0 mm continuous curvilinear capsulorhexis (CCC) is probably the upper limit to afford proper posterior vaulting of the IOL. My guess is that the inferonasal anterior capsule edge is 8.0 mm o... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237846 Mon, 01 Feb 2010 00:00:00 +0100 3237846 http://www.medworm.com/index.php?rid=3237845&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010864%2Fabstract%3Frss%3Dyes The lenticular astigmatism in this case is an invariable result of asymmetric IOL vault (Z-syndrome) associated with the Crystalens. The syndrome may be caused by transient or gradual forces that deform the IOL, which may take on an asymmetric shape that persists. Transient forces may be due to an early postoperative wound leak or eye rubbing, which may occur during sleep. Gradual deformation may be caused by asymmetric capsule contraction associated with faulty haptic placement, zonule deficiency, capsule damage, retained cortex, or LEC-induced fibrosis. An oversized or eccentric capsulorhexis can contribute to the problem. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237845 Mon, 01 Feb 2010 00:00:00 +0100 3237845 http://www.medworm.com/index.php?rid=3237844&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010852%2Fabstract%3Frss%3Dyes The Crystalens HD IOL requires meticulous surgery. This includes ensuring accuracy in IOL power calculation, using a consistent surgical technique, and achieving the desired refractive outcome without inducing significant astigmatism. When these criteria are met, this IOL model can give a wide range of sharp vision and lessen spectacle dependence. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237844 Mon, 01 Feb 2010 00:00:00 +0100 3237844 http://www.medworm.com/index.php?rid=3237843&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010840%2Fabstract%3Frss%3Dyes In this case, capsule contraction and fibrosis are causing long-axis compression with asymmetric folding at the haptic–optic junction, which is typically seen with the Crystalens IOL. This Z-deformation can induce up to 4.00 D of asymmetric pseudophakic astigmatism. Keratometry readings are spherical, confirming a pseudophakic or noncorneal etiology for the astigmatism. The persistent striae in the posterior capsular bag at 3 months also suggest a shift in IOL position. Of note, the details of the IOL repositioning 1 day postoperatively, which did not improve vision, are not disclosed. Either way, repositioning the IOL should have corrected the problem because it was performed on the first postoperative day and capsule fibrosis had not yet developed. (Source: Journal of Cataract and Refr... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237843 Mon, 01 Feb 2010 00:00:00 +0100 3237843 http://www.medworm.com/index.php?rid=3237842&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010839%2Fabstract%3Frss%3Dyes Although the 3.00 diopters (D) of noncorneal astigmatism probably stem from the Z-shaped misalignment, neither the astigmatism nor the marked Z-configuration explains the CDVA of only 20/30. Macular optical coherence tomography (OCT) and a retinal consultation are indicated preoperatively, and the patient must understand that surgical intervention would be expected to improve the UDVA but not the CDVA. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237842 Mon, 01 Feb 2010 00:00:00 +0100 3237842 http://www.medworm.com/index.php?rid=3237841&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010827%2Fabstract%3Frss%3Dyes The complication in the left eye is typically referred to as Z-syndrome; however, it is essentially a consequence of capsule contraction in the presence of the highly deformable Crystalens IOL. The hallmarks of this condition are new noncorneal astigmatism, a tilted IOL with 1 haptic forward and the other back, striae in the posterior capsule, and capsulorhexis ovalization. Some patients report eye pain, perhaps related to zonular tension. End-to-end capsule contraction forces the IOL into a Z-configuration. Causes of this condition include retained lens cortex with an exuberant healing response, inadequate postoperative antiinflammatory medication, preoperative hyperopia, and a decentered or poorly sized capsulorhexis. Smaller capsular bags in hyperopic eyes can place the IOL in a greater... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237841 Mon, 01 Feb 2010 00:00:00 +0100 3237841 http://www.medworm.com/index.php?rid=3237840&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010815%2Fabstract%3Frss%3Dyes Recently (3 months ago), a 69-year-old woman had uneventful cataract surgery with implantation of a Crystalens HD intraocular lens (IOL) (Bausch & Lomb) in the right eye. Shortly afterward, similar surgery was performed in the left eye. However, according to the history, the vision in the left eye was poor initially and the IOL required repositioning on the first postoperative day. Nevertheless, vision in the left eye remains poor and the patient requests improvement. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237840 Mon, 01 Feb 2010 00:00:00 +0100 3237840 http://www.medworm.com/index.php?rid=3237839&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010098%2Fabstract%3Frss%3Dyes I report a case of loss of corneal endothelial density between 12 years and 20 years after iris-claw intraocular lens (IOL) implantation in the phakic eyes of a myopic patient. In 1991, Fechner et al. reported on 127 eyes of 70 patients in whom the iris-claw IOL had been implanted between November l986 and November 1991. Seventeen of the eyes had experienced considerable loss of corneal endothelial density that was correlated with 3 parameters: shallow anterior chamber, high IOL power (ie, a thick IOL), and older age. In 1991, the company changed the myopia iris-claw IOL to a slightly flatter design, the Artisan myopia IOL (Ophtec BV). (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237839 Mon, 01 Feb 2010 00:00:00 +0100 3237839 http://www.medworm.com/index.php?rid=3237838&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010165%2Fabstract%3Frss%3Dyes Since the day that the Alcon toric intraocular lens (IOL) was approved, I have been searching for a better solution for orienting the IOL with greater accuracy. Using a marking pen has been a suboptimal approach because the mark is an inexact estimation that seems counterintuitive to the precision that defines contemporary refractive cataract surgery. Moreover, the mark can easily diffuse 10 degrees or even disappear entirely by the time the surgeon sits down to operate. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237838 Mon, 01 Feb 2010 00:00:00 +0100 3237838 http://www.medworm.com/index.php?rid=3237837&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010189%2Fabstract%3Frss%3Dyes We report a case of implantation of the Crystalens AT-45SE and AT-52SE intraocular lenses in a highly myopic patient who had bilateral epikeratophakia surgery 15 years previously. Lessons learned from the first eye were taken into consideration when selecting the dioptric power for the fellow eye. With secondary interventions and meticulous lens calculations, the final outcomes were excellent and equivalent, allowing the patient to achieve uncorrected distance and intermediate visual acuities of 20/25 and near visual acuity of 20/50 in both eyes. To our knowledge, this is the first reported case of accommodating lens implantation in an epikeratophakic eye.Financial Disclosure: Dr. Labor and Ms. Janku-Lestock have no financial or proprietary interest in any material or method mentioned. Add... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237837 Mon, 01 Feb 2010 00:00:00 +0100 3237837 http://www.medworm.com/index.php?rid=3237836&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010141%2Fabstract%3Frss%3Dyes We report a case of toxic anterior segment syndrome (TASS) that developed after cataract surgery. A 78-year-old woman had uneventful phacoemulsification via a clear corneal incision with implantation of an acrylic intraocular lens. One day postoperatively, diffuse corneal edema and anterior chamber inflammation were evident. Topical antibiotic and steroid eyedrops were prescribed. The anterior chamber reaction decreased considerably, but corneal edema persisted. After a thorough investigation, the antiseptic solution used to soak surgical instruments before subsequent surgery was identified as the source of the problem.Financial Disclosure: Neither author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237836 Mon, 01 Feb 2010 00:00:00 +0100 3237836 http://www.medworm.com/index.php?rid=3237835&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010104%2Fabstract%3Frss%3Dyes A 45-year-old woman developed a corneal infiltrate 14 months after laser in situ keratomileusis (LASIK) enhancement in the left eye. The LASIK flap was lifted, scraped, and irrigated with fortified vancomycin and ceftazidime. Scraped samples were cultured and grew Brevundimonas vesicularis. The patient remained on topical ceftazidime until improvement was noted and was then switched to topical levofloxacin. The keratitis resolved on antibiotic agents with strong gram-negative coverage and a steroid. To our knowledge, this is the first report of a B vesicularis ocular infection.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237835 Mon, 01 Feb 2010 00:00:00 +0100 3237835 http://www.medworm.com/index.php?rid=3237834&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010505%2Fabstract%3Frss%3Dyes A 33-year-old man who was 2 years post laser in situ keratomileusis was found to have corneal ectasia. He was intolerant of rigid gas-permeable contact lenses and eventually chose to have placement of intrastromal corneal ring segments (ICRS) (Intacs) in the right eye. Two ICRS were implanted without complication, and postoperative examination showed improved visual acuity and decreased corneal elevation on scanning-slit tomography imaging. However, over the following 2 months, he complained of persistent pain in the right eye. Confocal microscopy showed a corneal nerve touching the superonasal ICRS. The ICRS was removed, and shortly thereafter the patient's pain resolved.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: J... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237834 Mon, 01 Feb 2010 00:00:00 +0100 3237834 http://www.medworm.com/index.php?rid=3237833&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633500900892X%2Fabstract%3Frss%3Dyes We present a patient with poor visual acuity and contact lens intolerance due to advanced keratoconus who had femtosecond-assisted placement of two 0.35 mm intrastromal corneal ring segments (ICRS) in the right eye. Postoperatively, both rings migrated inferiorly and overlapped each other in a double-stacked formation. This resulted in a dramatic central shift of the cone and flattening of the inferior paracentral cornea with significant improvement in vision. To our knowledge, this is the first report of double-stacked ICRS in a human cornea and raises the possibility that significantly thicker segments may provide enhanced anatomic and visual effects in some keratoectatic patients.Financial Disclosure: Neither author has a financial or proprietary interest in any material or method menti... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237833 Mon, 01 Feb 2010 00:00:00 +0100 3237833 http://www.medworm.com/index.php?rid=3237832&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010529%2Fabstract%3Frss%3Dyes The expansion of wavefront-sensing techniques redefined the meaning of refractive error in clinical ophthalmology. Clinical aberrometers provide detailed measurements of the eye's wavefront aberration. The distribution and contribution of each higher-order aberration to the overall wavefront aberration in the individual eye can now be accurately determined and predicted. Using corneal or ocular wavefront sensors, studies have measured the interindividual and age-related changes in the wavefront aberration in the normal population with the goal of optimizing refractive surgery outcomes for the individual. New objective optical-quality metrics would lead to better use and interpretation of newly available information on aberrations in the eye. However, the first metrics introduced, based on ... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237832 Mon, 01 Feb 2010 00:00:00 +0100 3237832 http://www.medworm.com/index.php?rid=3237831&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010499%2Fabstract%3Frss%3Dyes Conclusion: The age-related decrease in spectral transmission through the human lens could be modeled by a simple algorithm that may be useful in the design of intraocular lenses that mimic the characteristics of the human lens and in studies of color vision, psychophysics, and melanopsin activation.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237831 Mon, 01 Feb 2010 00:00:00 +0100 3237831 http://www.medworm.com/index.php?rid=3237830&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010517%2Fabstract%3Frss%3Dyes Conclusions: Compared with aphakic eyes, UV-blocking untinted IOLs reduced the blue-light irradiance value by 60%; yellow-tinted IOLs conferred an additional 17% to 56% reduction. The difference in lens power was significantly related to the blue-light irradiance value of some yellow-tinted IOLs.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237830 Mon, 01 Feb 2010 00:00:00 +0100 3237830 http://www.medworm.com/index.php?rid=3237829&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010785%2Fabstract%3Frss%3Dyes Purpose: To evaluate the uveal and capsular biocompatibility of intraocular lenses (IOLs) with a hydrophilic anterior surface and a hydrophobic posterior surface in a rabbit model.Setting: Eye Center, Affiliated Second Hospital, College of Medicine, Zhejiang University, Hangzhou, China.Methods: Modified silicone IOLs were produced by grafting 2-methacryloyloxyethyl phosphorylcholine (MPC) onto the anterior IOL surface using a plasma technique. A contact-angle test characterized the hydrophilicity of the IOL surface; physical and optical properties were determined by State Food and Drug Administration (SFDA) standards. Rabbits had phacomulsification and implantation a modified silicone IOL, a control silicone IOL, or a hydrogel IOL. Postoperative inflammation was assessed by aqueous flare m... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237829 Mon, 01 Feb 2010 00:00:00 +0100 3237829 http://www.medworm.com/index.php?rid=3237828&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010487%2Fabstract%3Frss%3Dyes Conclusions: This study shows that the mathematical accuracy of a dilution protocol does not ensure dosage accuracy in the clinical scenario. Inadequate mixing in a 1.0 mL syringe was probably responsible for the inaccuracy of protocol 2, indicating that small-volume syringes should not be used for mixing. However, protocol 1 had an acceptable range of variability. Replication of this study could evaluate other protocols and address concerns regarding the accuracy of intracameral antibiotic preparations.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237828 Mon, 01 Feb 2010 00:00:00 +0100 3237828 http://www.medworm.com/index.php?rid=3237827&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010773%2Fabstract%3Frss%3Dyes This study comprised patients with unilateral cataract who had phacoemulsification with implantation of an AcrySof ReSTOR SA60D3 multifocal IOL (multifocal group) or an AcrySof SA60AT single-piece monofocal IOL (monofocal group). Postoperative visual function, including uncorrected (UDVA) and corrected (CDVA) distance visual acuity; uncorrected (UNVA), corrected (CNVA), and distance-corrected near visual acuity; and contrast sensitivity were evaluated 1 week, 1 month, and 6 months postoperatively. Patient-reported vision and spectacle independence in the 2 groups were also compared.Results: Of the 161 eyes, 72 were in the multifocal group and 89 were in the monofocal group. The multifocal group had statistically significant better UNVA than the monofocal group from 1 week postoperatively t... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237827 Mon, 01 Feb 2010 00:00:00 +0100 3237827 http://www.medworm.com/index.php?rid=3237826&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010475%2Fabstract%3Frss%3Dyes Conclusions: The pupillometer accurately measured the horizontal pupil diameter at 1 lux, with no measurement more than 0.3 mm different from infrared photography measurements. The pupillometer had a slight negative bias that is unlikely to introduce an error greater than 0.5 mm in clinical measurements.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237826 Mon, 01 Feb 2010 00:00:00 +0100 3237826 http://www.medworm.com/index.php?rid=3237825&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009304%2Fabstract%3Frss%3Dyes Purpose: To evaluate the safety and efficacy of corneal collagen crosslinking (CXL) in patients with painful pseudophakic bullous keratopathy (PBK).Setting: University of São Paulo, São Paulo and Sadalla Amin Ghanem Eye Hospital, Joinville, Santa Catarina, Brazil.Methods: This prospective study included consecutive eyes with PBK that had CXL. After a 9.0 mm epithelial removal, riboflavin 0.1% with dextran 20% was applied for 30 minutes followed by ultraviolet-A irradiation (370 nm, 3 mW/cm2). Therapeutic contact lenses were placed for 1 week. Corneal transparency, central corneal thickness (CCT), and ocular pain were assessed preoperatively and 1 and 6 months postoperatively. Statistical analysis was by paired t tests.Results: Fourteen patients (14 eyes) with a mean age 71.14 years ± 11... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237825 Mon, 01 Feb 2010 00:00:00 +0100 3237825 http://www.medworm.com/index.php?rid=3237824&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009845%2Fabstract%3Frss%3Dyes Conclusion: In normal healthy eyes, once suction was released, blood-flow responses returned immediately to normal levels.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237824 Mon, 01 Feb 2010 00:00:00 +0100 3237824 http://www.medworm.com/index.php?rid=3237823&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009900%2Fabstract%3Frss%3Dyes Conclusion: Laser-assisted subepithelial keratectomy improved visual acuity in pediatric hyperopia with or without associated hyperopic anisometropic amblyopia.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237823 Mon, 01 Feb 2010 00:00:00 +0100 3237823 http://www.medworm.com/index.php?rid=3237822&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010463%2Fabstract%3Frss%3Dyes Conclusion: Fixation of PC IOL haptics in a limbus-parallel scleral tunnel provided exact centration and axial stability of the IOL and prevented distortion and subluxation in most cases.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237822 Mon, 01 Feb 2010 00:00:00 +0100 3237822 http://www.medworm.com/index.php?rid=3237821&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010451%2Fabstract%3Frss%3Dyes Conclusion: There were no clinically or statistically significant differences in ECC loss or visual acuity between phacoemulsification and SICS, although there was a small difference in the astigmatic shift.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237821 Mon, 01 Feb 2010 00:00:00 +0100 3237821 http://www.medworm.com/index.php?rid=3237820&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010153%2Fabstract%3Frss%3Dyes Conclusion: Preoperatively adjusting phaco parameters based on cataract grade helped improve overall efficiency by reducing the amount of energy and fluid used in the eye and reducing overall phaco time.Financial Disclosure: The author has no financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237820 Mon, 01 Feb 2010 00:00:00 +0100 3237820 http://www.medworm.com/index.php?rid=3237819&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010050%2Fabstract%3Frss%3Dyes Conclusions: Presbyopia-correction strategies cannot rely on accommodative anterior movement of the ciliary muscle. Forces on the uvea by crystalline lens–pupillary margin contact may increase with accommodation and lens growth, producing accommodative and age-dependent increases in muscle thickness and significant age-dependent anterior muscle displacement. Intraocular lens implantation removed these forces, allowing choroidal elasticity to restore the muscle to a youthful position; however, the increase in thickness was permanent and likely due to an age-dependent increase in connective tissue. This supports the geometric theory of presbyopia development and that the mechanical forces in human accommodation and presbyopia are very different from those in the rhesus monkey model.Financi... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237819 Mon, 01 Feb 2010 00:00:00 +0100 3237819 http://www.medworm.com/index.php?rid=3237818&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009997%2Fabstract%3Frss%3Dyes Conclusion: The OLCR biometry device provided precise and valid measurements and thus can be used for the preoperative examination of cataract patients.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237818 Mon, 01 Feb 2010 00:00:00 +0100 3237818 http://www.medworm.com/index.php?rid=3237817&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010177%2Fabstract%3Frss%3Dyes Purpose: To assess the validity of an internal optical path difference map of a refractive power/corneal analyzer system in determining the alignment of toric intraocular lenses (IOLs).Settings: Private practices, Spring Hill, Brisbane, and Chermside, Australia.Methods: This retrospective study comprised patients with more than 1.5 diopters of preexisting corneal astigmatism who had phacoemulsification and AcrySof toric IOL implantation. Preoperatively, the surgical eye was marked at the slitlamp microscope using a 4-point technique. The desired IOL orientation was marked with a Mendez marker based on the steep corneal axis. The toric IOL axis was measured 3 weeks postoperatively by rotating the slitlamp beam to align with the IOL axis indicator marks and using the Internal OPD Map on the ... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237817 Mon, 01 Feb 2010 00:00:00 +0100 3237817 http://www.medworm.com/index.php?rid=3237816&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009924%2Fabstract%3Frss%3Dyes Purpose: To analyze the effect of asphericity of intraocular lenses (IOLs) on vertical coma aberration after implantation of spherical, spherically neutral, and aspheric IOLs.Setting: Department of Ophthalmology, St. Thomas' Hospital, London, United Kingdom.Method: This observational study recruited patients from previous prospective randomized fellow-eye controlled studies comparing aspheric and spherical IOLs (3 spherical, 1 spherically neutral, and 2 aspheric IOLs). At postoperative follow-up visits, maximum pupil dilation was achieved and aberrometry was performed using an iTrace aberrometer with a pupil scan size of 5.0 mm. Data on Zernike coefficients Z(3,−1) (vertical coma), Z(3,+1) (horizontal coma), and Z(4,0) (spherical aberration) and on IOL power were extracted.Results: Two h... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237816 Mon, 01 Feb 2010 00:00:00 +0100 3237816 http://www.medworm.com/index.php?rid=3237815&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633500900947X%2Fabstract%3Frss%3Dyes Conclusions: Anterior capsule polishing, although it removed many LECs, did not decrease residual cell growth and, conversely, enhanced cell proliferation in capsular bag cultures. This might explain why polishing does not reduce PCO in clinical studies.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237815 Mon, 01 Feb 2010 00:00:00 +0100 3237815 http://www.medworm.com/index.php?rid=3237814&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009912%2Fabstract%3Frss%3Dyes Purpose: To determine the differences in the endophthalmitis rates in cataract surgery before and after prophylactic use of intracameral cefuroxime.Setting: University Hospital Fundación Alcorcón, Madrid, Spain.Methods: This prospective study evaluated patients who had cataract surgery at a university eye center over a 10-year period (1999 to 2008). Since the protocol's approval by the Hospital Board in October 2005 to the end of the 10-year period, cataract patients were routinely treated with prophylactic intracameral cefuroxime. A database was used to measure the occurrence of endophthalmitis postoperatively. Then, the incidence of endophthalmitis before and after generalized use of prophylactic cefuroxime was compared. The effect of cefuroxime was evaluated by the relative risk.Resul... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237814 Mon, 01 Feb 2010 00:00:00 +0100 3237814 http://www.medworm.com/index.php?rid=3237813&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010931%2Fabstract%3Frss%3Dyes We describe a protocol for adequate repositioning of free laser in situ keratomileusis (LASIK) corneal flaps created by a Moria M2 microkeratome even in the absence of fiduciary marks. In an enucleated porcine globe, a free flap was created by initially placing a longitudinal incision at the proposed hinge site followed by activating the forward pass of the automated microkeratome. A protocol was devised based on placement of a positioning dot on the free flap before the flap is retrieved from the microkeratome head. Preplaced surgical landmarks were used as a guide to determine the correct alignment of the free flap. Adequate orientation of the free flap to the stromal bed was achieved in 9 porcine eyes using the positioning dot method. The technique is applicable to the Moria M2 microker... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237813 Mon, 01 Feb 2010 00:00:00 +0100 3237813 http://www.medworm.com/index.php?rid=3237812&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010955%2Fabstract%3Frss%3Dyes Puncturing the anterior capsule in a patient with a very soft lens, an elastic capsule, and/or deficient zonular countertraction can be challenging even with a sharp needle or blade. The crossed-swords, capsule-pinch technique capitalizes on opposing forces from 2 needles directed toward each other with a “pinch” of the capsule between their tips. This affords a controlled and facile puncture of the capsule without creating stress on the zonules or anteroposterior displacement of the lens.Financial Disclosure: Neither author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237812 Mon, 01 Feb 2010 00:00:00 +0100 3237812 http://www.medworm.com/index.php?rid=3237811&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010797%2Fabstract%3Frss%3Dyes We describe a variation of the big-bubble technique in which air is injected into the anterior chamber before it is injected into the stroma. By observing the reflection created on the surface of the air, a needle can be inserted deep into the stroma without puncturing Descemet membrane. This allows safe and efficient separation of Descemet membrane. Moreover, air in the anterior chamber can be used as an indicator of successful Descemet membrane separation as air is shifted to the periphery with creation of the big bubble.Financial Disclosure: The author has no financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237811 Mon, 01 Feb 2010 00:00:00 +0100 3237811 http://www.medworm.com/index.php?rid=3237810&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633500901092X%2Fabstract%3Frss%3Dyes is the scourge of cataract surgeons but fortunately is a rare, although serious, event. Infection origin is almost always exogenous, which means the infecting organism gains access to the inner eye during surgery or early in the postoperative period. Asepsis and antisepsis are the keys to operative risk; ocular hygiene and topical antibiotic agents are the key to eliminating postoperative risk. Despite attempts to sterilize the ocular surface prior to surgical intervention, several studies have confirmed that bacterial contamination may survive the operative session and thereby gain access to the inner eye during surgery. Thereafter, wound security or lack of it may allow ingress of bacterial contamination, including suture presence or removal in the early postoperative period. (Source: J... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3237810 Mon, 01 Feb 2010 00:00:00 +0100 3237810 http://www.medworm.com/index.php?rid=3113280&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010220%2Fabstract%3Frss%3Dyes (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113280 Wed, 23 Dec 2009 14:48:40 +0100 3113280 http://www.medworm.com/index.php?rid=3113279&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010232%2Fabstract%3Frss%3Dyes (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113279 Wed, 23 Dec 2009 14:48:40 +0100 3113279 http://www.medworm.com/index.php?rid=3113278&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009010219%2Fabstract%3Frss%3Dyes (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113278 Wed, 23 Dec 2009 14:48:40 +0100 3113278 http://www.medworm.com/index.php?rid=3113277&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009008980%2Fabstract%3Frss%3Dyes Seymenoğlu and Baser state that the ocular abnormalities in Alport syndrome, such as glomerular lesions, result from a defect common to the formation of both basement membranes. However, it should be “renal” rather than “ocular” abnormalities. Gregory et al. proposed diagnostic criteria for Alport syndrome. As described in their , at least 4 of 10 criteria must be met. There is no need for the presence of ocular lesions to diagnose Alport syndrome. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113277 Wed, 23 Dec 2009 14:48:40 +0100 3113277 http://www.medworm.com/index.php?rid=3113276&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009080%2Fabstract%3Frss%3Dyes The “theoretical indicators” in our laboratory study have been scientifically tested and should be carefully considered to ensure the safety and efficacy of CXL. According to riboflavin high-performance liquid chromotography concentrations and calculations by the time-dependent diffusion equation results, the data obtained in the study confirm and comply well with basic investigations of standard CXL by Spoerl et al. and Wollensak and Iomdina. The critical points in our paper are fundamental in obtaining an adequate riboflavin intrastromal concentration and the most efficacious penetration of CXL, with the recommended depth of 250 μm to 300 μm of corneal stroma necessary to achieve the maximum postoperative biomechanical strength. The stress–strain tests reported by Kohlhaas et a... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113276 Wed, 23 Dec 2009 14:48:40 +0100 3113276 http://www.medworm.com/index.php?rid=3113275&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009079%2Fabstract%3Frss%3Dyes Baiocchi et al. measured stromal riboflavin using a 0.1% riboflavin–20% dextran solution and concluded there are concerns about safety and efficacy of transepithelial crosslinking. Their study has several limitations: (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113275 Wed, 23 Dec 2009 14:48:40 +0100 3113275 http://www.medworm.com/index.php?rid=3113274&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009031%2Fabstract%3Frss%3Dyes We agree with Blomquist that the number of left-handed surgeons in the study was small and this does limit the conclusions that can be drawn. However, the incidence of left-handedness among the American population (11%) is similar to the percentage of left-handed surgeons in this study (9.0%) and the percentage of surgeries performed by left-handed surgeons (9.8%). Because of the small number of left-handed residents, a specialized statistical model was used instead of a conventional multivariate logistic model. Based on the input from the reviewers, we examined the possibility of analytical problems compounding unwanted biases because of sparse data being divided into 2 groups, one of which contained 90% of the data and the other only 10% of the data. Analytical tests such as Bayesian and... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113274 Wed, 23 Dec 2009 14:48:40 +0100 3113274 http://www.medworm.com/index.php?rid=3113273&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009043%2Fabstract%3Frss%3Dyes Kim et al. recently published their finding of a significantly lower incidence of posterior capsule tear and vitreous loss in cataract surgery performed by left-handed residents. Statistical analysis was based on the number of cases performed by left-handed surgeons versus those performed by right-handed surgeons (170 versus 1560). However, the number of left-handed surgeons in the study was extremely small (3 left-handed compared with 33 right-handed surgeons), which severely limits any conclusions that can be drawn. The authors state that “the number of cases was more indicative than the number of residents because learning phacoemulsification cataract surgery is unique in several ways, including having “a very steep learning curve.” This argument is spurious. (Source: Journal of ... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113273 Wed, 23 Dec 2009 14:48:40 +0100 3113273 http://www.medworm.com/index.php?rid=3113272&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009008979%2Fabstract%3Frss%3Dyes We appreciate having another chance to point out that corneal CXL is a clinical procedure with complications and failures, and we are grateful that Kymionis et al. drew attention to more infrequent complications that were not mentioned in our discussion. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113272 Wed, 23 Dec 2009 14:48:40 +0100 3113272 http://www.medworm.com/index.php?rid=3113271&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009008967%2Fabstract%3Frss%3Dyes We were very interested in the study of the complication rate after corneal collagen crosslinking (CXL) by Koller et al. It is very important to warn the scientific community about the possible complications and failure rate of CXL since it is a relatively new technique. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113271 Wed, 23 Dec 2009 14:48:40 +0100 3113271 http://www.medworm.com/index.php?rid=3113270&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009008943%2Fabstract%3Frss%3Dyes In our article, the visual acuity data were collected in logMAR charts and the means obtained by the statistics were converted into decimal values. In the article, when we referred to Snellen values, we meant that the data were reported in decimal values; indeed, we should have described the conversion process that we used. We agree with Peterson about the importance of collecting the data using logMAR charts for both far and near and think all articles published in the journal should follow this recommendation. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113270 Wed, 23 Dec 2009 14:48:40 +0100 3113270 http://www.medworm.com/index.php?rid=3113269&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009008955%2Fabstract%3Frss%3Dyes In their article, Llovet et al. used uncorrected distance visual acuity and corrected distance visual acuity as key parameters to construct the reported primary outcomes and efficacy and safety indexes, respectively. Their methods state that the decimal notation for visual acuity was used at data collection and for all reporting. They also note that results were analyzed using the recommendation provided by Koch et al. in 1998 and imply that decimal notation was used in calculations for visual acuity means ± SD and also for the differences and ratios of those means. In the Koch et al. recommendation, brief mention is made of converting geometric mean acuities to decimal values but no details about the proper methods for such mathematical manipulations are given. Before and since that t... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113269 Wed, 23 Dec 2009 14:48:40 +0100 3113269 http://www.medworm.com/index.php?rid=3113268&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009110%2Fabstract%3Frss%3Dyes We have no doubt that what Lam says is true. The photopic pupils of most patients are less than 4.5 mm in size. With the Holladay EKR software, it is possible to select optical zones down to a diameter of 1.0 mm. We decided to study the 4.5 mm optical zone because it was the default setting. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113268 Wed, 23 Dec 2009 14:48:40 +0100 3113268 http://www.medworm.com/index.php?rid=3113267&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009006%2Fabstract%3Frss%3Dyes In their article, Tang et al. report that Scheimpflug Holladay equivalent keratometry readings (EKR) overestimate corneal powers compared with the back-calculated true corneal powers. The Holladay EKR values in their study are based on a central corneal zone 4.5 mm in diameter. However, in many cases, the Holladay EKR values can vary considerably depending on the size of the central corneal zone. Typically, the smaller the central corneal zone, the lower the Holladay EKR value. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113267 Wed, 23 Dec 2009 14:48:40 +0100 3113267 http://www.medworm.com/index.php?rid=3113266&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633500900902X%2Fabstract%3Frss%3Dyes Our study was born out of frustration with using the instrument for the very task for which we purchased it, measuring corneal power in post-keratorefractive surgery eyes. That frustration is not ours alone. Many have come to us privately at meetings after hearing the oral presentation of this paper to express misgivings over their Pentacam purchase. Recently, the American Society of Cataract and Refractive Surgery delisted the Pentacam EKR as one of the biometric entries to their post-refractive surgery IOL calculator (http://iol.ascrs.org/. Accessed October 13, 2009). The reason it was delisted is that it is less accurate than a standard corneal topographer. Another study, published in the same month as ours, concluded, “Corneal power measurements with the Pentacam Scheimpflug system s... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113266 Wed, 23 Dec 2009 14:48:40 +0100 3113266 http://www.medworm.com/index.php?rid=3113265&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009018%2Fabstract%3Frss%3Dyes In their article, Tang et al. conclude that the “Holladay equivalent keratometry readings (EKR) calculated using version 1.16r04 of the Scheimpflug system software was inaccurate in virgin corneas and in those with a history of laser in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), or radial keratotomy using current intraocular lens (IOL) power calculation formulas.” Unfortunately, their erroneous conclusions are due to 3 methodological errors. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113265 Wed, 23 Dec 2009 14:48:39 +0100 3113265 http://www.medworm.com/index.php?rid=3113264&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009008670%2Fabstract%3Frss%3Dyes We are glad to address the comments of Lieberman and Grierson. First, it must be pointed out that the measurement of the asphericity coefficient Q was not limited to the vertical meridian (axis 90). To our knowledge of the instrument used and the manufacturer's data, the measurement of the videokeratoscope involved several meridians of the cornea to calculate an average value of Q. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113264 Wed, 23 Dec 2009 14:48:39 +0100 3113264 http://www.medworm.com/index.php?rid=3113263&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009008669%2Fabstract%3Frss%3Dyes The recent article by Scholz et al. describes the change in curvature of the anterior corneal surface with age. Still remaining is the basis of our understanding of how we mathematically model the human cornea. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113263 Wed, 23 Dec 2009 14:48:39 +0100 3113263 http://www.medworm.com/index.php?rid=3113262&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633500900995X%2Fabstract%3Frss%3Dyes The patient's visual acuity is significantly influenced by the scar formation; the UDVA is 20/100 and shows no improvement with manifest refraction or contact lens overrefraction. Topographic findings show an abnormal pattern consistent with the scar formation and possible partial flap amputation (corneal thinning nasally) that occurred during pterygium excision. An additional examination I would perform is anterior segment optical coherence tomography (AS-OCT) to determine the residual flap dimensions and the corneal scar depth. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113262 Wed, 23 Dec 2009 14:48:39 +0100 3113262 http://www.medworm.com/index.php?rid=3113261&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009766%2Fabstract%3Frss%3Dyes The main issue in this case is irregular astigmatism and corneal scarring secondary to inadvertent LASIK flap removal. The irregular astigmatism in the right eye is causing reduced visual acuity and possibly night glare and halos. The goal in this case is to improve the corrected distance visual acuity (CDVA), and ideally the UDVA, in the right eye. I propose 4 treatment options for managing the corneal irregularity and scarring: (1) another trial of rigid gas-permeable (RGP) contact lens, (2) phototherapeutic keratectomy (PTK), (3) removal of the entire LASIK flap, or (4) lamellar keratoplasty. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113261 Wed, 23 Dec 2009 14:48:39 +0100 3113261 http://www.medworm.com/index.php?rid=3113260&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009754%2Fabstract%3Frss%3Dyes A 63-year-old white man presented for consultation in August 2009 for blurred vision after pterygium surgery. The patient had laser in situ keratomileusis (LASIK) in 1999 and no other ocular surgeries. During 2008 and early 2009, he noted a growth in the right eye that seemed to be enlarging. He was diagnosed with a pterygium and offered surgery. The history of LASIK surgery was not initially obtained. During the pterygium surgery in April 2009, the nasal pterygium did not behave normally and was noted to have a very central extension, which was excised. Immediately after surgery, it became apparent that the abnormal tissue was part of a LASIK flap that was not identified at the initial examination. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113260 Wed, 23 Dec 2009 14:48:39 +0100 3113260 http://www.medworm.com/index.php?rid=3113259&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009456%2Fabstract%3Frss%3Dyes We describe the management of intraoperative vertical gas breakthrough (VGB) during femtosecond laser flap creation in 3 patients. All eyes were immediately re-cut using 2 different microkeratomes, and the laser in situ keratomileusis treatments were completed on the same day. There were no postoperative complications. Corneal abrasion might predispose to VGB. Management of VGB is effective using microkeratomes. Caution is advised during placement of the suction ring and in eyes with preexisting corneal abrasion or loose epithelium if femtosecond laser keratectomy is used. The approach in terms of direction of the microkeratome re-cut is fundamental to the safety and successful re-cut with a microkeratome.Financial Disclosure: Neither author has a financial or proprietary interest in any m... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113259 Wed, 23 Dec 2009 14:48:39 +0100 3113259 http://www.medworm.com/index.php?rid=3113258&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009008931%2Fabstract%3Frss%3Dyes We describe the case of a 78-year-old highly myopic woman who had bilateral phacoemulsification with posterior chamber intraocular lens implantation. During surgery, the anterior chamber was extremely deep and the pupil was excessively dilated, consistent with lens–iris diaphragm retropulsion syndrome (LIDRS). Subsequent biomicroscopy revealed multifocal iris sphincter ruptures, a new finding associated with LIDRS.Financial disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113258 Wed, 23 Dec 2009 14:48:39 +0100 3113258 http://www.medworm.com/index.php?rid=3113257&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633500900950X%2Fabstract%3Frss%3Dyes We report a case of capsular bag distension syndrome that developed 6 years after uneventful phacoemulsification with implantation of a foldable, single-piece acrylic intraocular lens (IOL) (AcrySof MA60BM). Slitlamp microscopy revealed a deep anterior chamber with no flare or cells. The posterior capsular bag was distended by a homogeneous milky substance between the back of the IOL and the capsular bag. Using a pars plana approach, a 23-gauge bimanual capsulotomy and anterior vitrectomy were performed. Microbiological analysis revealed Propionibacterium acnes in the material inside the capsular bag. The postoperative period was uneventful. Four weeks after surgery, visual acuity was restored and there were no signs of intraocular inflammation. The origin of late capsular bag distension i... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113257 Wed, 23 Dec 2009 14:48:39 +0100 3113257 http://www.medworm.com/index.php?rid=3113256&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009493%2Fabstract%3Frss%3Dyes We report a case in which toric intraocular Collamer lenses (ICLs) effectively corrected the refractive errors of pellucid marginal degeneration (PMD). Preoperatively, in the patient's right eye, the manifest refraction was −10.5 −3.5 × 55, the uncorrected distance visual acuity (UDVA) was 20/1000, and the corrected distance visual acuity (CDVA) was 20/16; in the left eye, the manifest refraction was −11.0 − 6.5 × 130 and the UDVA and CDVA were 20/1000 and 20/20, respectively. After bilateral implantation of a toric ICL, in the right eye, the manifest refraction was +1.50 − 0.75 × 10, the UDVA was 20/16, and the CDVA was 20/12.5; in the left eye, the manifest refraction was +2.5 −3.25 × 125 and the UDVA and CDVA were 20/40 and 20/16, respectively. No sign of progressive di... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113256 Wed, 23 Dec 2009 14:48:39 +0100 3113256 http://www.medworm.com/index.php?rid=3113255&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009008591%2Fabstract%3Frss%3Dyes Two cases that developed a delayed hyperopic shift in refraction following implantation of a single-piece hydrophilic intraocular lens (IOL) are described. The haptics of the Akreos Adapt IOL were flexed anteriorly by capsular contraction, leaving a marked gap between the optic and the anterior capsule. A third case that had marked capsule phimosis and similar anterior flexion of the haptics but with a stable refraction is also described. In this case, the anterior and posterior leaves of the capsule fused peripherally and the IOL optic position was normal. The effective power of an IOL depends on the distance between the apex of the cornea and the center of the optic. Capsule contraction without fusion of the peripheral capsule can make the haptics of this IOL design flex anteriorly with ... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113255 Wed, 23 Dec 2009 14:48:39 +0100 3113255 http://www.medworm.com/index.php?rid=3113254&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009468%2Fabstract%3Frss%3Dyes Conclusions: Approximately half of refractive surgeons said they consider HIV-positive persons acceptable candidates for elective refractive surgery; a much lower proportion considered patients with AIDS acceptable candidates. The majority of the surgeons recommended additional precautions when performing refractive surgery on patients with HIV or AIDS.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113254 Wed, 23 Dec 2009 14:48:38 +0100 3113254 http://www.medworm.com/index.php?rid=3113253&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009869%2Fabstract%3Frss%3Dyes Various aspects of local anesthesia for cataract surgery, such as the anesthetic agents and their interaction with ocular nerve supply, anesthesia requirements, available clinical techniques and their inherent complications are reviewed. A comparative evaluation of clinical techniques in terms of efficacy, akinesia, and patient-perceived pain during both anesthesia administration and intraoperative cataract surgery is presented, along with the prevailing practice patterns of anesthesia techniques among refractive surgeons in the United Kingdom and United States. More randomized clinical trials are needed to facilitate statistical methods of metaanalysis to establish convincingly the overall benefits and efficacy of the various local anesthesia procedures in cataract surgery. The wide scope... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113253 Wed, 23 Dec 2009 14:48:38 +0100 3113253 http://www.medworm.com/index.php?rid=3113252&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009481%2Fabstract%3Frss%3Dyes Conclusions: The probe of the pulsed-electron avalanche knife duplicated the surgical feel of a 25-gauge cystotome and created a histologically smooth capsule cut. It may improve precision and reproducibility of creating a CCC, as well as improve its proper sizing and centration, especially in the face of surgical risk factors, such as weak zonules or poor visibility.Financial Disclosures: Drs. Palanker and Vankov hold patents to the pulsed electron avalanche knife technology, which are licensed to PEAK Surgical by Stanford University. Drs. Palanker and Chang are consultants to PEAK Surgical. Dr. Vankov is an employee of PEAK Surgical. Neither of the other authors has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surger... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113252 Wed, 23 Dec 2009 14:48:38 +0100 3113252 http://www.medworm.com/index.php?rid=3113251&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009316%2Fabstract%3Frss%3Dyes Purpose: To evaluate the action of mannose-6-phosphate (M6P) as an inhibitor of transforming growth factor-β1 (TGF-β1) and its effects on human corneal fibroblasts.Setting: Department of Academic Ophthalmology, Rayne Institute, St. Thomas' Hospital, London, United Kingdom.Method: Keratocytes were cultured in serum-containing medium with added TGF-β1 and in serum-containing medium containing TGF-β1 with M6P. Controls consisted of cells in serum-containing medium alone and cells cultured in serum-containing medium with M6P. Differentiation of fibroblasts into myofibroblasts was detected by immunohistochemistry for α-smooth muscle actin. Images were captured by laser confocal microscopy.Results: The differentiation of cells into myofibroblasts was significantly greater after culture in m... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113251 Wed, 23 Dec 2009 14:48:38 +0100 3113251 http://www.medworm.com/index.php?rid=3113250&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009444%2Fabstract%3Frss%3Dyes Conclusion: Results indicate that the cornea including the riboflavin film can be considered a composite 2-compartment system and that the riboflavin film is an integral part of the CXL procedure and important in achieving the correct stromal and endothelial UVA irradiance.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113250 Wed, 23 Dec 2009 14:48:38 +0100 3113250 http://www.medworm.com/index.php?rid=3113249&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009298%2Fabstract%3Frss%3Dyes Conclusion: Implantation of ICRS for advanced keratoconus was safe and effective, leading to significant improvement in UDVA, CDVA, and total aberrations.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113249 Wed, 23 Dec 2009 14:48:38 +0100 3113249 http://www.medworm.com/index.php?rid=3113248&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009008992%2Fabstract%3Frss%3Dyes Purpose: To evaluate and compare visual, refractive, and corneal aberrometric outcomes after implantation of 2 types of intrastromal corneal ring segments (ICRS) in eyes with early to moderate ectatic disease.Settings: Vissum Corporation-Instituto Oftalmológico de Alicante, Alicante, Spain.Methods: This retrospective analysis comprised consecutive eyes with grade I or grade II corneal ectasia (keratoconus, pellucid marginal degeneration, ectasia after laser in situ keratomileusis) that had Intacs (Group I) or KeraRings (Group K) ICRS implantation using femtosecond technology. Visual, refractive, and corneal aberrometric outcomes were analyzed and compared between groups over a 6-month follow-up.Results: Group I had 17 eyes and Group K, 20 eyes. One month postoperatively, there was a stati... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113248 Wed, 23 Dec 2009 14:48:38 +0100 3113248 http://www.medworm.com/index.php?rid=3113247&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009286%2Fabstract%3Frss%3Dyes Purpose: To analyze the risk for clinically significant epithelial ingrowth after primary laser in situ keratomileusis (LASIK) and flap-lift retreatment LASIK.Setting: Private practice, Beverly Hills, California, USA.Methods: All cases of primary and flap-lift retreatment LASIK performed by the same surgeon in a single surgical center between January 2004 and June 2007 were retrospectively reviewed. Cases that subsequently developed clinically significant epithelial ingrowth, defined as epithelial ingrowth impeding on the visual axis and negatively affecting uncorrected or corrected distance visual acuity, were identified and analyzed.Results: Clinically significant epithelial ingrowth occurred in none of the 3866 primary LASIK cases and in 15 (2.3%) of the 646 flap-lift retreatment cases ... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113247 Wed, 23 Dec 2009 14:48:38 +0100 3113247 http://www.medworm.com/index.php?rid=3113246&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633500900827X%2Fabstract%3Frss%3Dyes Conclusion: The algorithm that induced low error in corneal power estimation was relatively reliable in IOL calculation after myopic laser refractive surgery.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113246 Wed, 23 Dec 2009 14:48:37 +0100 3113246 http://www.medworm.com/index.php?rid=3113245&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009274%2Fabstract%3Frss%3Dyes Purpose: To compare central and paracentral corneal curvature measurements after myopic excimer laser surgery performed using a large optical zone (OZ) (6.5mm).Setting: Private practice.Methods: The mean simulated keratometry (SimK) value, average central power, corneal power of Placido rings 1 to 9 and the average central corneal power over the central 3.0mm (ACCP3mm) were measured using a TMS-2 corneal topographer.Results: Forty-two patients (mean correction −5.0 diopters [D]±2.2 [SD]) were prospectively enrolled. The mean SimK value (38.82 D±1.95) and the mean average central power (38.89±2.02 D) were not statistically significantly different, even when the sample was stratified according to the amount of induced correction (lower or higher than −5.00 D). The difference between t... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113245 Wed, 23 Dec 2009 14:48:37 +0100 3113245 http://www.medworm.com/index.php?rid=3113244&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009262%2Fabstract%3Frss%3Dyes Conclusion: The amount of IOL spherical aberration producing the best image quality after previous myopic wavefront-guided PRK varied widely and could be predicted based on the full spectrum of corneal HOAs.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. Additional disclosures are found in the footnotes. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113244 Wed, 23 Dec 2009 14:48:37 +0100 3113244 http://www.medworm.com/index.php?rid=3113243&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009250%2Fabstract%3Frss%3Dyes Purpose: To evaluate and compare the results of biaxial microincision and coaxial small-incision surgery in patients with cataract with coexisting exfoliation syndrome, uveitis, anterior or posterior synechias, phacodonesis, or previous intraocular surgery over an 8-week follow-up.Setting: Department of Ophthalmology, Mainz University, Mainz, Germany.Methods: Eyes were prospectively assigned (1:1) to have biaxial microincision ( (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113243 Wed, 23 Dec 2009 14:48:37 +0100 3113243 http://www.medworm.com/index.php?rid=3113242&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009008190%2Fabstract%3Frss%3Dyes Purpose: To evaluate the relationship between World Health Organization (WHO) cataract grade determined with a new device and (1) preoperative visual acuity and (2) the difficulty of specific steps in cataract surgery.Setting: Yamaguchi University Hospital, Yamaguchi, Japan.Methods: Patients who had cataract surgery between January 2006 and September 2008 were enrolled in this prospective study. Preoperatively, the Konan Anterior Segment Tri Camera System 1000 cataract analysis device was used to evaluate the WHO cataract grade in each eye. The main outcome measures were preoperative visual acuity, the time required for continuous curvilinear capsulorhexis (CCC) and for irrigation/aspiration (I/A), and the total effective phaco time (EPT).Results: Sixty-four eyes (53 patients) were evaluat... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113242 Wed, 23 Dec 2009 14:48:37 +0100 3113242 http://www.medworm.com/index.php?rid=3113241&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009109%2Fabstract%3Frss%3Dyes Purpose: To evaluate intraocular pressure (IOP) in the vitreous cavity during various stages of cataract surgery.Setting: University Eye Hospital, Ludwig-Maximilians University, Munich, Germany.Methods: In consecutive eyes having combined phacoemulsification, intraocular lens implantation, and pars plana vitrectomy, IOP was monitored in real time through a 25-gauge pars plana cannula connected to an external pressure transducer. Surgery was performed by standard clear corneal phacoemulsification with a 2.5 mm incision and a Mega-Tip (1.26 mm aperture) (Group 1) or by microcoaxial phacoemulsification with a CMP-Tip (0.80 mm aperture) (Group 2).Results: The 2 groups had 5 eyes each. The mean IOP in Group 1 and in Group 2, respectively, was 15.9 mm Hg ± 9.5 (SD) and 17.0 ± 13.5 mm Hg preope... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113241 Wed, 23 Dec 2009 14:48:37 +0100 3113241 http://www.medworm.com/index.php?rid=3113240&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009432%2Fabstract%3Frss%3Dyes Purpose: To evaluate the results of microincision cataract surgery (MICS) with toric intraocular lens (IOL) implantation to correct moderate to high astigmatism in patients with cataract.Setting: Vissum-Instituto Oftalmológico de Alicante, Alicante, Spain.Methods: This prospective nonrandomized study comprised patients with visually significant cataract and moderate to high astigmatism (>2.00 diopters [D]). After MICS, an Acri.Comfort 646 TLC toric IOL was implanted in the capsular bag. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities, residual refractive sphere, residual refractive and keratometric cylinders, and IOL axis alignment were measured after 3 months. Vector analysis of astigmatism was by the Alpins method.Results: The study included 21 eyes (12 patients). T... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113240 Wed, 23 Dec 2009 14:48:37 +0100 3113240 http://www.medworm.com/index.php?rid=3113239&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009008566%2Fabstract%3Frss%3Dyes Purpose: To compare the optical performance of aspheric Tecnis ZA9003 and spherical Sensar AR40e intraocular lenses (IOLs).Setting: Laboratory of Experimental Ophthalmology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.Methods: An aspheric IOL was implanted in 1 eye and a spherical IOL in the other eye of patients with bilateral age-related cataract. Contrast sensitivity was measured using 2 computerized tests (vertical sine-modulated gratings and circular sine-modulated patterns) with cycloplegia and a 5.0 mm artificial pupil under photopic conditions at optimum refractive correction and at several defocus levels. The depth of focus and the myopic shift (shift of optimum focus toward more myopic values at lower spatial frequencies) were determin... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113239 Wed, 23 Dec 2009 14:48:36 +0100 3113239 http://www.medworm.com/index.php?rid=3113238&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009067%2Fabstract%3Frss%3Dyes Conclusions: The repeatability limit was good and equivalent for the OSI, the MTF, and the Strehl ratio values. There was a wide interval between the normal and pathologic threshold for OSI measurements, indicating that the reliability of the double-pass device complies with the requirements for quantitative assessment of scattering.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113238 Wed, 23 Dec 2009 14:48:36 +0100 3113238 http://www.medworm.com/index.php?rid=3113237&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009092%2Fabstract%3Frss%3Dyes Conclusions: In patients in their 40s and 50s, the region of accommodation in phakic eyes was greater than in pseudophakic eyes; the region was similar in patients in their 60s and 70s. Because contrast sensitivity with and without glare was similar at all ages, visual function appeared to be comparable in patients 60 years and older.Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113237 Wed, 23 Dec 2009 14:48:36 +0100 3113237 http://www.medworm.com/index.php?rid=3113236&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009055%2Fabstract%3Frss%3Dyes Purpose: To quantify the benefits of expedited cataract surgery in improving visual acuity and reducing fall-related injuries in the older population.Setting: Developmental Neurosciences and Child Health: Neurons to Neighbourhoods, Vancouver, British Columbia, Canada.Methods: A systematic review of the literature was conducted. Studies were included if expedited cataract surgery was presented as a measure to enhance vision and to reduce injury. Published and unpublished studies with any type of study design were included. Studies were identified from 12 databases including Medline (1950 to 2008) and Embase (1980 to 2008). The metaanalysis was specific to randomized controlled trials (RCTs).Results: The review comprised 737 participants. Sufficient data for the metaanalysis were available t... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113236 Wed, 23 Dec 2009 14:48:36 +0100 3113236 http://www.medworm.com/index.php?rid=3113235&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335009009870%2Fabstract%3Frss%3Dyes Surgical management of hard cataracts can be problematic despite improvements in phacoemulsification devices. Phaco chop, considered one of the best techniques for dealing with hard cataracts, cannot always divide the hard cataract completely. We have devised a phaco forward-chop technique that can be implemented safely and efficiently following incomplete phaco chop in a hard cataract.Financial Disclosure: Neither author has a financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=3113235 Wed, 23 Dec 2009 14:48:36 +0100 3113235