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. Wed, 08 Feb 2012 23:31:40 +0100 http://www.medworm.com/index.php?rid=5496621&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011017056%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=5496621 Tue, 13 Dec 2011 17:01:47 +0100 5496621 http://www.medworm.com/index.php?rid=5496620&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011017032%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=5496620 Tue, 13 Dec 2011 17:01:47 +0100 5496620 http://www.medworm.com/index.php?rid=5496619&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011017044%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=5496619 Tue, 13 Dec 2011 17:01:47 +0100 5496619 http://www.medworm.com/index.php?rid=5496618&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011017020%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=5496618 Tue, 13 Dec 2011 17:01:47 +0100 5496618 http://www.medworm.com/index.php?rid=5496617&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015999%2Fabstract%3Frss%3Dyes We thank Drs. Naseri and Chang for their comments on our article and their contribution to the discussion of the role of surgical simulators in ophthalmology resident training. Our study investigated the effect of simulator training on intraoperative surgical performance, and its primary findings were statistically significant improvements in phacoemulsification time, phacoemulsification power, and adjusted phacoemulsification time. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496617 Tue, 13 Dec 2011 17:01:47 +0100 5496617 http://www.medworm.com/index.php?rid=5496616&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011016002%2Fabstract%3Frss%3Dyes Many residency programs, including ours at the University of California San Francisco, have acquired surgical simulator technology without persuasive peer-reviewed evidence to quantify its value in improving resident education and outcomes. Studies such as the one by Belyea et al. attempting to document the value of simulator training are important because of the significant cost of the technology relative to the budgets of most residency programs. However, we are concerned that the study design and results do not adequately support the conclusions. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496616 Tue, 13 Dec 2011 17:01:47 +0100 5496616 http://www.medworm.com/index.php?rid=5496615&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015847%2Fabstract%3Frss%3Dyes We agree with Dr. Glasser that the intraocular penetration of topical fluorometholone is lower than that of other steroids. We performed a similar study in which we compared the effects of diclofenac and fluorometholone in preventing postoperative breakdown of the blood–aqueous barrier and cystoid macular edema. We also compared the above-mentioned effects of diclofenac and betamethasone. We observed that diclofenac was more effective than the steroid and that betamethasone induced elevation in intraocular pressure in postoperative pseudophakic eyes. We based the design of the present study on these findings. The most essential reason for selecting fluorometholone as the control drug was its similarity in appearance to nepafenac; this enabled us to perform a double-masked scientific comp... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496615 Tue, 13 Dec 2011 17:01:47 +0100 5496615 http://www.medworm.com/index.php?rid=5496614&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015835%2Fabstract%3Frss%3Dyes The recent article by Miyake et al. on post cataract–surgery cystoid macular edema left me with questions about study design and financial disclosures. The results are not surprising given that fluorometholone 0.1% is known to have poor corneal penetration and would not be expected to have significant effects on the posterior segment. Why not compare nepafenac with a steroid with better penetration, one that is more commonly used as part of the post cataract–surgery regimen (eg, prednisolone acetate 1.0%), another nonsteroidal agent with proven penetration and efficacy in treatment or prevention of postoperative cystoid macular edema, or an inert control? (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496614 Tue, 13 Dec 2011 17:01:47 +0100 5496614 http://www.medworm.com/index.php?rid=5496613&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015975%2Fabstract%3Frss%3Dyes We appreciate the interest and comments of Dr. Kamal. To respond to the first comment, we agree that measurement of foveal thickness after 4 weeks is too early to detect all cases of macular edema. In our study, the postoperative follow-up visits were scheduled in accordance with our standard postoperative evaluations; therefore, the measurements were taken 4 weeks after cataract extraction. We tried to account for this by reviewing patients’ records after 6 months to determine the number of visits for post-cataract clinical macular edema after the last study visit. We agree with Dr. Kamal that we certainly could have missed some cases, but this applies to both groups. If we had measured 6 weeks after cataract extraction or at another fixed time point, we also could have missed some case... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496613 Tue, 13 Dec 2011 17:01:47 +0100 5496613 http://www.medworm.com/index.php?rid=5496612&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015987%2Fabstract%3Frss%3Dyes In the recent article by Dieleman et al., the methods and discussion were not adequate. First, measuring foveal thickness at 4 weeks is too early to detect all cases of macular edema, which peaks at 4 to 6 weeks and may develop several months after the surgery, as discussed in the article. Moreover, only 1% of macular edema cases show a significant decrease in vision and subsequent improvement can occur in 3 to 12 months in 80%. Hence, all patients might not have come for extra clinic visits, making the follow-up inadequate and not representative. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496612 Tue, 13 Dec 2011 17:01:47 +0100 5496612 http://www.medworm.com/index.php?rid=5496611&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015744%2Fabstract%3Frss%3Dyes Dr. Carifi pointed out 3 main issues with the oval capsulorhexis. First, the IOL should be placed in the capsular bag only after converting the posterior capsule rupture into a PCCC. Second, the sulcus-fixated IOL whose optics were captured with oval capsulorhexis could lead to IOL instability. Third, the diaphragm between anterior and posterior segments created by an oval capsulorhexis is weaker than that created by a small capsulorhexis. Our opinion on these issues is as follows: (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496611 Tue, 13 Dec 2011 17:01:47 +0100 5496611 http://www.medworm.com/index.php?rid=5496610&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015756%2Fabstract%3Frss%3Dyes Singh et al.’s recent article on oval capsulorhexis for posterior polar cataract associated with preexisting capsule defect highlights important points in the surgical management, as well as providing some very educational videos. Surprisingly, the authors used sulcus-fixated intraocular lenses (IOLs) in only 2 cases. They preferred the endocapsular implantation in most cases, even without converting the defect into a posterior circular continuous capsulorhexis (PCCC). Any type of IOL can be placed inside the capsular bag if a posterior capsule rupture can be converted successfully into a PCCC. A sulcus-fixated IOL represents the safest option for unstable posterior capsule rupture. In addition, a 3-piece IOL can be placed in the bag when the optic can be securely captured through the ... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496610 Tue, 13 Dec 2011 17:01:47 +0100 5496610 http://www.medworm.com/index.php?rid=5496609&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633501101577X%2Fabstract%3Frss%3Dyes The cataract classification we described is a simple guide to surgical complexity rather than an attempt to quantify a risk for a specific complication, ie, posterior capsule rupture. Although this complication may be a surrogate of surgical complexity, it was our aim to tailor the 3-point CC grade to a specific training task(s). To use the example Dr. Butler describes, a 70-year-old patient with pseudoexfoliation may require iris hooks and a capsular tension ring, which demands specific surgical skills and familiarity with these devices. In contrast, a 90-year-old patient with glaucoma, controlled intraocular pressure, and background diabetic retinopathy may not require any additional surgical skills compared with a younger patient without these comorbidities. In the event of a posterio... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496609 Tue, 13 Dec 2011 17:01:47 +0100 5496609 http://www.medworm.com/index.php?rid=5496608&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015793%2Fabstract%3Frss%3Dyes I believe the classification system for preoperative risk stratification for cataract surgery proposed by Gupta et al. is flawed in that no account of cumulative risk is made. Narendran et al. highlight the odds ratio (OR) and cumulative probability of vitreous loss with each risk factor and demonstrate that there is increasing risk with each additional risk factor present. Although the simple system proposed by Gupta et al. is appealing, it takes no account of this, which may falsely reassure. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496608 Tue, 13 Dec 2011 17:01:47 +0100 5496608 http://www.medworm.com/index.php?rid=5496607&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633501101594X%2Fabstract%3Frss%3Dyes With the toric IOL in place, a PKP regraft would lead to induced astigmatism even if the transplant were perfectly spherical. If the regraft were not spherical, it would lead to complex astigmatism in combination with the IOL. Therefore, placement of an endothelial keratoplasty under the failed PKP is a better choice if the patient had acceptable visual and refractive results before PKP failure, which this patient did. This case is a great example of why toric IOLs should be implanted after PKP only when the PKP failure can be treated with endothelial keratoplasty. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496607 Tue, 13 Dec 2011 17:01:47 +0100 5496607 http://www.medworm.com/index.php?rid=5496606&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015938%2Fabstract%3Frss%3Dyes Some surgical options to treat graft failure can yield good visual outcomes. Repeat PKP and endothelial keratoplasty, in particular DSAEK, are alternatives. A serious drawback of repeat PKP is the slow visual recovery resulting from large and unpredictable refractive changes; the implanted toric IOL should also be taken into consideration because refractive changes after PKP regraft are inevitable. The repeat PKP and IOL exchange can be performed at the same time or as a 2-stage procedure consisting of repeat PKP followed months later by IOL exchange. The first alternative avoids an additional surgery and allows rapid recovery of vision; however, it may result in large refractive errors because of the inability to predict the IOL power correctly. The risks of this procedure include poster... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496606 Tue, 13 Dec 2011 17:01:47 +0100 5496606 http://www.medworm.com/index.php?rid=5496605&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015926%2Fabstract%3Frss%3Dyes The overall picture suggests that the visual loss is caused by graft edema secondary to endothelial failure. Although the irregular astigmatism on topography is a concern, the patient achieved 20/25 CDVA after cataract surgery. Thus, the astigmatism is probably the result of epithelial irregularity secondary to edema. In-office epithelial debridement followed by topography of the deepithelialized cornea could differentiate epithelial irregularity from true corneal irregularity. Because the patient was satisfied after cataract surgery (before graft failure), he could have DSAEK. I make my main incision in the steep meridian and expect an approximate 1.00 D hyperopic shift postoperatively. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496605 Tue, 13 Dec 2011 17:01:47 +0100 5496605 http://www.medworm.com/index.php?rid=5496604&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015914%2Fabstract%3Frss%3Dyes In this case, several questions come to mind. First is whether continued medical treatment and a therapeutic contact lens (TCL) would resolve the visual problems or whether surgical treatment is needed. The corneal edema and irregular epithelium indicate corneal decompensation. Although medical treatment and TCL wear can alleviate the pain, they may have no effect on visual rehabilitation. I believe the patient should be treated surgically. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496604 Tue, 13 Dec 2011 17:01:47 +0100 5496604 http://www.medworm.com/index.php?rid=5496603&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015902%2Fabstract%3Frss%3Dyes The key issue in this case is astigmatic management. The implantation of the high-power toric IOL makes the eye have an inherent 3.00 diopters (D) of cylinder at the corneal plane. There are 3 possible approaches to rehabilitate the patient's vision. The first is a traditional PKP. The combination of the astigmatism from the repeat corneal transplantation and from the toric IOL will lead to challenging postoperative astigmatic correction. The curvature of the corneal plane would have to be adjusted to offset the astigmatism induced by the toric IOL. This is achievable as long as the axis of the toric IOL is known. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496603 Tue, 13 Dec 2011 17:01:47 +0100 5496603 http://www.medworm.com/index.php?rid=5496602&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015896%2Fabstract%3Frss%3Dyes Treatment of post-PKP corneal astigmatism has always been a challenge to ophthalmic surgeons. The introduction of refractive procedures, such as laser in situ keratomileusis (LASIK), femtosecond-assisted arcuate keratotomies, and toric IOL implantation, has offered effective approaches to manage this problem. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496602 Tue, 13 Dec 2011 17:01:47 +0100 5496602 http://www.medworm.com/index.php?rid=5496601&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015884%2Fabstract%3Frss%3Dyes Options for management of corneal endothelial failure after PKP include repeat PKP, endothelial keratoplasty, and keratoprosthesis implantation. The decision on the most appropriate treatment modality depends on several factors, including historical factors (eg, number of previous graft failures, spectacle-corrected or contact lens–corrected vision before graft failure, patient's ability to successfully wear a contact lens before graft failure), anatomic factors (eg, significant corneal stromal opacification, presence of an intracapsular toric IOL), and other factors that would complicate the performance of DSEK (eg, peripheral anterior synechiae, anteriorly positioned tube shunts, presence of an anterior chamber IOL, aphakia, partial or complete aniridia). (Source: Journal of Cataract a... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496601 Tue, 13 Dec 2011 17:01:47 +0100 5496601 http://www.medworm.com/index.php?rid=5496600&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015872%2Fabstract%3Frss%3Dyes This case highlights the potential problems associated with the use of advanced IOLs (toric and multifocal) concomitant with or after full-thickness corneal transplantation. In general, I avoid these IOLs because the corneal transplant has a finite survival and if a repeat transplant is required (as in this case), you are left with a refractive dilemma. When possible, I prefer post-PKP corneal refractive surgery to deal with residual refractive errors. The exceptions could be a very elderly recipient, where the risk for rejection is lower and the expected graft survival may exceed the life expectancy of the patient, or (as in this case) patients with keratoconus, where overall graft survival is quite high. This case also highlights the risk that any surgical intervention or manipulation co... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496600 Tue, 13 Dec 2011 17:01:47 +0100 5496600 http://www.medworm.com/index.php?rid=5496599&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015860%2Fabstract%3Frss%3Dyes A 51-year-old man who had previous penetrating corneal transplantation (penetrating keratoplasty [PKP]) for keratoconus in the right eye presented to his primary ophthalmologist 2 years later with a visually significant cataract. Because of high and relatively symmetric astigmatism, the patient had phacoemulsification with implantation of an Acrysof IQ toric intraocular lens (IOL) (SN60T7, Alcon Laboratories, Inc.) to correct post-PKP astigmatism. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496599 Tue, 13 Dec 2011 17:01:47 +0100 5496599 http://www.medworm.com/index.php?rid=5496598&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015732%2Fabstract%3Frss%3Dyes It has been 20 years since I first detected and reported browning or discoloration of silicone intraocular lenses (IOLs) made by Staar, Iolab, and Allergan. It is ironic that I have detected and now report browning in an acrylic multifocal IOL (Restor) and monofocal IOL (Acrysof) (both Alcon Laboratories, Inc.) and an aspheric blue light–filtering IOL (PY-60AD, Hoya Surgical Optics GmbH). These are the first observed and reported cases of these IOLs that have become discolored brown after implantation. There were reports of discolored IOLs in 2007 and 2008. These IOLs were stained blue; 1 from inadvertent use of methylene blue instead of trypan blue and 1 from the systemic use of a drug to treat urinary tract infection (Prosed DS) that contains methylene blue. Both IOLs were made of si... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496598 Tue, 13 Dec 2011 17:01:47 +0100 5496598 http://www.medworm.com/index.php?rid=5496595&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015720%2Fabstract%3Frss%3Dyes A 61-year-old African American man presented with decreased vision of 2 months duration. Examination revealed a significant lenticular astigmatism and sectoral cataract as a result of an amelanotic iris lesion. Slitlamp optical coherence tomography (OCT) revealed angle crowding. An excisional biopsy was performed along with phacoemulsification in the right eye, with intraocular lens implantation for meridional lenticular astigmatism. Histopathology and histoimmunochemistry confirmed a diagnosis of uveal mesectodermal leiomyoma. Lenticular astigmatism may be a subtle sign of an anterior segment tumor. Anterior segment slitlamp OCT is an effective tool in diagnosing as well as monitoring small interval changes in these types of tumors.Financial Disclosure: No author has a financial or propri... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496595 Tue, 13 Dec 2011 17:01:47 +0100 5496595 http://www.medworm.com/index.php?rid=5496588&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011016099%2Fabstract%3Frss%3Dyes Purpose: To determine the homeostatic response of postoperative intraocular pressure (IOP) by analyzing postoperative IOP trends after sutureless phacoemulsification.Setting: Asan Medical Center, Seoul, South Korea.Design: Comparative case series.Methods: Normotensive eyes were treated with sutureless phacoemulsification with in-the-bag posterior chamber IOL (PC IOL) implantation. The patients were randomly divided into 3 groups according to the intended immediate postoperative IOP as follows: Group 1, IOP less than 10 mm Hg; Group 2, IOP 10 to 21 mm Hg; Group 3, IOP over 21 mm Hg. The surgeon intentionally attempted supranormal, normal, or subnormal pressurization. The IOP was measured immediately after surgery and 2 hours, 4 hours, 1 day, 1 week, and 1 month postoperatively.Results: Grou... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496588 Tue, 13 Dec 2011 17:01:47 +0100 5496588 http://www.medworm.com/index.php?rid=5496585&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015355%2Fabstract%3Frss%3Dyes Purpose: To evaluate the refractive shift in pseudophakic eyes of children after their 10th birthday.Setting: Storm Eye Institute, Charleston, South Carolina, USA.Design: Case series.Methods: One eye of each patient with at least 2 refractions at a minimum of a 1-year interval after the 10th birthday was analyzed.Results: One hundred fourteen pseudophakic eyes (114 patients) were identified. The mean initial refraction was −0.65 diopter (D) ± 2.27 (SD) and the mean final refraction, −1.78 ± 2.82 D. The mean shift in refraction was −1.13 ± 1.36 D; the mean shift in refraction per year was −0.30 ± 0.38 D. Postoperative refraction could be predicted by regression analysis (P (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496585 Tue, 13 Dec 2011 17:01:47 +0100 5496585 http://www.medworm.com/index.php?rid=5496576&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015367%2Fabstract%3Frss%3Dyes Purpose: To compare the central postoperative vault of a phakic intraocular lens (pIOL) to correct myopia, myopic astigmatism, and hyperopia and identify ocular and lens parameters that might predict the vault amount.Setting: Fernández-Vega Ophthalmological Institute, Oviedo, Spain.Design: Cohort study.Methods: Three months after implantation of Implantable Collamer Lens pIOLs to correct myopia, hyperopia, and myopic astigmatism, central vault was measured using optical coherence tomography. Patients were divided into groups according to the preoperative anterior chamber depth (ACD) to compare the effects of ACD, white-to-white (WTW) distance, and lens diameter on postoperative pIOL vault.Results: Hyperopic pIOLs had statistically significantly lower vault followed by myopic pIOLs and tor... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496576 Tue, 13 Dec 2011 17:01:47 +0100 5496576 http://www.medworm.com/index.php?rid=5496573&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015380%2Fabstract%3Frss%3Dyes Conclusions: Retinal image quality was similarly reduced with PRK and LASIK, with no significant differences between the 2 methods. Some PRK patients had a residual refractive error that might have been related to corneal-wound healing still present 3 months postoperatively.Financial Disclosure: Dr. Arjona is an investor in and Drs. Güell and Pujol are investors in and consultants to Visiometrics S.L., Terrassa, Spain. None of the other authors 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=5496573 Tue, 13 Dec 2011 17:01:47 +0100 5496573 http://www.medworm.com/index.php?rid=5496572&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013861%2Fabstract%3Frss%3Dyes Conclusions: Visual acuity, refractive outcomes, and anterior corneal HOAs were comparable between eyes after uneventful femtosecond laser single pass or double pass after suction loss affecting the pupillary area. A new femtosecond laser pass performed immediately after incomplete flap due to intraoperative suction loss provided good visual and optical outcomes.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=5496572 Tue, 13 Dec 2011 17:01:47 +0100 5496572 http://www.medworm.com/index.php?rid=5496569&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011018013%2Fabstract%3Frss%3Dyes As 2012 begins, we reflect on a year of progress at the Journal of Cataract & Refractive Surgery and look ahead with excitement to the coming year. Every issue of JCRS is a product of innumerable hours of effort, and we wish to take this opportunity to thank all those who make JCRS the leading peer-reviewed anterior segment surgery journal. Each of us is a reader, and among these readers we also find authors, reviewers, editorial board members, office staff, advertisers, and publishers. Every person who touches the journal in one or another way has contributed something to its success, and to the efforts of each of these people, the journal is indebted. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496569 Tue, 13 Dec 2011 17:01:47 +0100 5496569 http://www.medworm.com/index.php?rid=5433352&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015458%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=5433352 Tue, 22 Nov 2011 16:29:28 +0100 5433352 http://www.medworm.com/index.php?rid=5433351&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015446%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=5433351 Tue, 22 Nov 2011 16:29:28 +0100 5433351 http://www.medworm.com/index.php?rid=5433350&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015422%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=5433350 Tue, 22 Nov 2011 16:29:28 +0100 5433350 http://www.medworm.com/index.php?rid=5433349&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015677%2Fabstract%3Frss%3Dyes Abad JC, Vargas A: Gaping of radial and transverse corneal incisions occurring early after CXL, 2222 Abdel-Aziz S. see Werner L, 378 (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433349 Tue, 22 Nov 2011 16:29:28 +0100 5433349 http://www.medworm.com/index.php?rid=5433348&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015653%2Fabstract%3Frss%3Dyes The Editorial Board thanks the following scientific referees for contributing their time and expertise to review manuscripts submitted to the Journal of Cataract & Refractive Surgery from October 2010 to October 2011. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433348 Tue, 22 Nov 2011 16:29:28 +0100 5433348 http://www.medworm.com/index.php?rid=5433347&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011014878%2Fabstract%3Frss%3Dyes I read with interest the scholarly article by Masket and Fram in which another hypothesis for pseudophakic negative dysphotopsia has been advanced. I was disturbed by one sentence on page 1206 in which the authors state “the findings in the current study, therefore, suggest that Osher’s ‘incision shadow’ is an unlikely cause of chronic negative dysphotopsia.” (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433347 Tue, 22 Nov 2011 16:29:28 +0100 5433347 http://www.medworm.com/index.php?rid=5433346&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011014866%2Fabstract%3Frss%3Dyes We thank our colleagues for their interest in our work. We were also surprised by the results of this experiment. We expected to find that sutures caused less ingress of bacterial-sized particles of India ink, not more. We shared the standard assumption that suturing an incision would increase its resistance to penetration of bacteria. Interpretation of these results has caused us to think of suturing in a number of different ways. First, the act of passing a suture creates a track for invasion along the suture. We assumed this track was plugged by the suture and did not allow ingress, assuming also that the suture diameter closely approximated that of the needle used to cut the stromal tissue. However, as soon as any tension is applied to the suture when it is tied, the corneal tissue ins... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433346 Tue, 22 Nov 2011 16:29:28 +0100 5433346 http://www.medworm.com/index.php?rid=5433345&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011014854%2Fabstract%3Frss%3Dyes We were fascinated to read that suturing corneal incisions apparently promoted India ink ingress through clear corneal incisions (CCIs). This appears contrary to all surgical principles, a large body of surgical evidence, and the combined 52 years of surgical experience of our group. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433345 Tue, 22 Nov 2011 16:29:28 +0100 5433345 http://www.medworm.com/index.php?rid=5433344&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011014921%2Fabstract%3Frss%3Dyes We appreciate Dr. Naeser’s interest in our work. As he stated, in our study we evaluated the outcomes with a specific type of toric IOL using the Alpins vector method for evaluating astigmatic outcomes. We followed this procedure for analyzing the changes occurring in astigmatism step by step. We are surprised by the concern expressed in the letter because the data requested were included and analyzed in detail in the article. A more careful reading of the article would probably answer the questions. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433344 Tue, 22 Nov 2011 16:29:28 +0100 5433344 http://www.medworm.com/index.php?rid=5433343&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633501101491X%2Fabstract%3Frss%3Dyes In their recent study, Alió et al. used numerous indices to characterize the refractive results of toric intraocular lens (IOL) implantation. I suggest a more systematic approach. There are 2 objectives of toric IOL implantation. The first is to reduce (flatten) the refractive cylinder by aligning the weaker toric IOL meridian with the steeper corneal meridian. The flattening effect is a reduction of the refractive cylinder in the selected meridian. The second objective is to avoid torsion (torque), revealed by a rotation of the refractive cylinder meridian. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433343 Tue, 22 Nov 2011 16:29:28 +0100 5433343 http://www.medworm.com/index.php?rid=5433342&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633501101501X%2Fabstract%3Frss%3Dyes I appreciate the opportunity to respond to Dr. Pirouzian’s detailed critique of my guest editorial. Dr. Pirouzian was an early advocate of intraocular refractive surgery in children, and I am aware of his work through peer-reviewed publications and presentations at professional meetings. Readers should know that some statements in quotation marks in his letter are not direct quotes from the guest editorial. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433342 Tue, 22 Nov 2011 16:29:28 +0100 5433342 http://www.medworm.com/index.php?rid=5433341&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015008%2Fabstract%3Frss%3Dyes I read with interest the guest editorial about appropriate research design for studies of refractive surgery in children. As a trained pediatric and refractive ophthalmologist who has designed and conducted randomized laser refractive clinical trials in the United States Air Force, my comments are as follows: (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433341 Tue, 22 Nov 2011 16:29:28 +0100 5433341 http://www.medworm.com/index.php?rid=5433340&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011014957%2Fabstract%3Frss%3Dyes We appreciate Dr. Carifi’s interest and welcome the opportunity to respond to his comments. The benchmark numbers quoted by Dr. Carifi are far below the standard for laser vision correction, so there certainly is a need for better refractive results. A number of variables contribute to errors in final refractive outcome after cataract surgery. However, since the introduction of optical biometry, IOL position is now the main source of error in IOL power calculation rather than an axial length measurement error. One of the most important determinants of effective lens position is the anterior capsule opening. Therefore, we believe that precise size, shape, and centration of the laser capsulotomy will directly improve refractive outcomes with all types of IOL implantation. Further long-term... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433340 Tue, 22 Nov 2011 16:29:28 +0100 5433340 http://www.medworm.com/index.php?rid=5433339&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011014945%2Fabstract%3Frss%3Dyes I would like to commend Friedman et al. for reporting their interesting experience with an optical coherence tomography-guided femtosecond laser in cataract surgery. As discussed, precision of the capsulorhexis could improve the optical performance in cases of “premium” intraocular lenses (IOLs). In cases of monofocal IOL implantation, it remains to be demonstrated that the minimal difference in capsulorhexis size and shape found in this study would have a significant impact on the refractive outcome. To date, only 55% to 66% of eyes achieve a final refraction within 0.5 diopter of the target. More than the capsulorhexis, many other things can be the contributing factors. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433339 Tue, 22 Nov 2011 16:29:28 +0100 5433339 http://www.medworm.com/index.php?rid=5433338&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015112%2Fabstract%3Frss%3Dyes This patient has 3 main problems for visual rehabilitation: (1) aphakia, (2) aniridia, and (3) corneal cicatricial opacification reaching the optical axis with massive irregular (cicatricial) astigmatism. The situation is complicated by secondary glaucoma. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433338 Tue, 22 Nov 2011 16:29:28 +0100 5433338 http://www.medworm.com/index.php?rid=5433337&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015100%2Fabstract%3Frss%3Dyes This patient has 4 major surgical issues that must be remedied to achieve maximum visual recovery; that is, repair of the cornea, removal of debris from the anterior segment, physiologic repair of the iris, and placement of an appropriate implant. Because there is evidence that the posterior segment is functional, this case represents an opportunity for restorative anterior segment reconstruction in its best situation for significant visual recovery. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433337 Tue, 22 Nov 2011 16:29:28 +0100 5433337 http://www.medworm.com/index.php?rid=5433336&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015094%2Fabstract%3Frss%3Dyes This patient has several problems. She has a fully scarred cornea that will never provide an adequate transparency for good vision, uncontrolled IOP that is related to scarring of the trabecular meshwork at the torn iris root and/or partial occlusion of the trabecular meshwork by prolapsed vitreous, and aphakia. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433336 Tue, 22 Nov 2011 16:29:28 +0100 5433336 http://www.medworm.com/index.php?rid=5433335&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015082%2Fabstract%3Frss%3Dyes The injury to this patient's eye has produced irregular astigmatism, corectopia with iris disinsertion, and aphakia without significant residual capsule support. The significant steepening of the central cornea and what appears to be superficial corneal haze suggest heaped up epithelium or subepithelial scarring. Goals of rehabilitation include (1) reduction, regularization, and/or elimination of corneal astigmatism; (2) IOL implantation in the absence of capsule support; and (3) restoration of the pupil by iris reconstruction, implantation of an iris prosthesis, or both. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433335 Tue, 22 Nov 2011 16:29:28 +0100 5433335 http://www.medworm.com/index.php?rid=5433334&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015070%2Fabstract%3Frss%3Dyes Complete iris loss due to trauma causes severe aesthetic limitations and visual impairment due to photophobia, aberration disorders, glare effects, and loss of depth of focus. There are 2 possible approaches to this patient. One would be to use a scleral-fixated iris-diaphragm IOL (Ophtec). Different diaphragm configurations and different colors are available, with the models having comparable C-loop haptics. The drawback of these IOLs is that they are poly(methyl methacrylate) and require a large corneal incision for implantation, thus risking intraoperative complications and high postoperative astigmatism. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433334 Tue, 22 Nov 2011 16:29:28 +0100 5433334 http://www.medworm.com/index.php?rid=5433333&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015069%2Fabstract%3Frss%3Dyes Although the visual and aesthetic reconstruction of this anterior segment could be accomplished in multiple ways, 3 principles would apply broadly. First, with an abnormal iris and angle, a sclerally fixated IOL would provide the best solution for the aphakia. This could be done with suturing or gluing, depending on the surgeon's preference and comfort level. A-scans of this eye could be obtained; however, IOLMaster biometry (Carl Zeiss Meditec) would probably not work with the visual axis opacity. The keratometry or entire IOL calculation could be based on the contralateral eye. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433333 Tue, 22 Nov 2011 16:29:28 +0100 5433333 http://www.medworm.com/index.php?rid=5433332&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015057%2Fabstract%3Frss%3Dyes This anterior segment reconstruction presents 4 major challenges: (1) reconstruction or prosthetics of the iris (with cosmetic and functional aspects); (2) the optical performance of the cornea; (3) a solution for the aphakia (without causing posterior segment complications); (4) management of the IOP increase. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433332 Tue, 22 Nov 2011 16:29:28 +0100 5433332 http://www.medworm.com/index.php?rid=5433331&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015045%2Fabstract%3Frss%3Dyes A 23-year-old woman sustained a combined blunt and perforating injury in the right eye caused by a glass fragment from an exploding champagne bottle. She had emergency treatment at a regional hospital with suturing of the corneal wound and was then transferred to a university hospital for reconstructive surgery of the anterior segment. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433331 Tue, 22 Nov 2011 16:29:28 +0100 5433331 http://www.medworm.com/index.php?rid=5433330&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013514%2Fabstract%3Frss%3Dyes We describe an unusual case involving a concomitant superficial corneal metallic foreign body and occult intralenticular metallic foreign body following traumatic injury. To our knowledge, this has not been reported. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433330 Tue, 22 Nov 2011 16:29:28 +0100 5433330 http://www.medworm.com/index.php?rid=5433327&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013186%2Fabstract%3Frss%3Dyes A 33-year-old woman with corneal ectasia after radial and astigmatic keratotomy had corneal collagen crosslinking with resultant gaping of the inferior incisions (2 radials and 1 transverse) that required suturing. At 6 months, the incisions healed leaving fibrotic scars. Visual acuity, refractions, corneal photographs, and topographic and corneal wavefront measurements are presented. At 2.5 years, the topographic inferior corneal irregularity continued to improve.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=5433327 Tue, 22 Nov 2011 16:29:28 +0100 5433327 http://www.medworm.com/index.php?rid=5433326&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013174%2Fabstract%3Frss%3Dyes We describe a case in which the LASIK surgery following PKP seemed to benefit the patient by preventing complete dehiscence of the graft–host junction.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=5433326 Tue, 22 Nov 2011 16:29:28 +0100 5433326 http://www.medworm.com/index.php?rid=5433325&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011014817%2Fabstract%3Frss%3Dyes Anterior segment imaging in the pediatric population using commercially available equipment is rewarding but can be challenging. Successful imaging requires familiarity with the imaging modality used, a positive attitude, and the ability to quickly develop rapport with children. In this review, we demonstrate how external and slitlamp photography, Scheimpflug imaging, handheld digital fundus camera, ultrasound biomicroscopy, and anterior segment optical coherence tomography can be valuable in the documentation, diagnosis, and management of pediatric anterior segment disease. Families understand their child’s disease process when it is demonstrated photographically and feel more motivated and involved in their care. Compliance with treatment is often enhanced through this process.Financia... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433325 Tue, 22 Nov 2011 16:29:28 +0100 5433325 http://www.medworm.com/index.php?rid=5433324&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011014842%2Fabstract%3Frss%3Dyes Conclusion: The peripheral rings of the study IOL, by expanding the capsular bag and preventing IOL surface contact with the anterior capsule, appear to prevent opacification of the capsular bag.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=5433324 Tue, 22 Nov 2011 16:29:28 +0100 5433324 http://www.medworm.com/index.php?rid=5433323&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011014799%2Fabstract%3Frss%3Dyes Conclusions: A gradual detrimental effect on initial intraocular surgical skill with decreasing stereoacuity was shown. This calls for studies of the impact of deficient stereopsis on long-term training effects.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=5433323 Tue, 22 Nov 2011 16:29:28 +0100 5433323 http://www.medworm.com/index.php?rid=5433322&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013873%2Fabstract%3Frss%3Dyes Conclusions: Simulated outcomes suggest that overall results for a group of patients whose toric IOL surgery planning is performed with the dual-zone automated keratometry data from the biometer will be equivalent to those when manual keratometry is used. The reduced site-to-site variability with the biometer suggests an operational advantage.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=5433322 Tue, 22 Nov 2011 16:29:28 +0100 5433322 http://www.medworm.com/index.php?rid=5433320&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633501101385X%2Fabstract%3Frss%3Dyes Conclusion: After PRK to eliminate and correct refractive errors in anisometropic amblyopia, visual acuity improved significantly in 70% of adult patients with no previous occlusion or chemical penalization treatment.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=5433320 Tue, 22 Nov 2011 16:29:28 +0100 5433320 http://www.medworm.com/index.php?rid=5433318&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013253%2Fabstract%3Frss%3Dyes Purpose: To examine differences in efficacy, accuracy, safety, and changes in aberrations between femtosecond and mechanical microkeratome laser in situ keratomileusis (LASIK) for myopia.Setting: Department of Ophthalmology, Shanghai First People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China.Design: Evidence-based manuscript.Methods: Data sources, including PubMed, Medline, EMBASE, and Cochrane Controlled Trials Register, were searched to identify potentially relevant prospective randomized controlled trials. Primary outcome measures were efficacy (uncorrected distance visual acuity ≥20/20), accuracy (±0.50 diopter mean spherical equivalent), and safety (loss of ≥2 lines of corrected distance visual acuity). Aberrations and postoperative complications were sec... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433318 Tue, 22 Nov 2011 16:29:28 +0100 5433318 http://www.medworm.com/index.php?rid=5433316&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013228%2Fabstract%3Frss%3Dyes Conclusions: Ultraviolet-A light associated with riboflavin CXL is an efficient procedure to stabilize and improve progressive keratoconus. The results reinforce previous studies highlighting the efficacy and safety of the procedure. A large prospective randomized clinical trial is needed.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=5433316 Tue, 22 Nov 2011 16:29:28 +0100 5433316 http://www.medworm.com/index.php?rid=5433314&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013836%2Fabstract%3Frss%3Dyes Conclusion: The BIL IOL met the ISO criteria; that is, primary PCCC was safe in healthy eyes and in eyes with ocular comorbidities and no eye developed PCO over a mean follow-up of 26.1 ± 21.3 months.Financial Disclosure: Drs. Gobin, Mathysen, Van Looveren, and De Groot have no financial or proprietary interest in any material or method mentioned. Additional disclosure is 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=5433314 Tue, 22 Nov 2011 16:29:28 +0100 5433314 http://www.medworm.com/index.php?rid=5433313&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633501101337X%2Fabstract%3Frss%3Dyes Conclusions: After 5 years, there were no significant differences in color perception, scotopic contrast sensitivity, or photopic contrast sensitivity between the blue light–filtering (yellow-tinted) IOL and the IOL with a UV-light filter only (untinted). The potential advantage of the tinted IOL in providing protection to macular cells remains unclear.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=5433313 Tue, 22 Nov 2011 16:29:28 +0100 5433313 http://www.medworm.com/index.php?rid=5433312&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011014891%2Fabstract%3Frss%3Dyes Conclusions: The risk for postoperative endophthalmitis in ISBCS appears to be at least as low as and possibly lower than published rates for unilateral surgery, particularly when recommended precautions are taken. Intracameral antibiotics significantly reduced the risk for postoperative endophthalmitis.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=5433312 Tue, 22 Nov 2011 16:29:28 +0100 5433312 http://www.medworm.com/index.php?rid=5433311&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013265%2Fabstract%3Frss%3Dyes Conclusion: The expected refraction after phacoemulsification and implantation of a light-adjustable IOL toward the hyperopic side of the desired refraction could be considered when using the optimized constants for all formulas.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=5433311 Tue, 22 Nov 2011 16:29:28 +0100 5433311 http://www.medworm.com/index.php?rid=5433310&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011014805%2Fabstract%3Frss%3Dyes Conclusions: Endothelial cell loss and corneal thickness change 12 months after lock-in agreed well with those reported in the literature after phacoemulsification with IOL implantation. The UV light exposure for adjustment and lock-in procedures did not add to the endothelial damage caused by the cataract 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=5433310 Tue, 22 Nov 2011 16:29:28 +0100 5433310 http://www.medworm.com/index.php?rid=5433309&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011014982%2Fabstract%3Frss%3Dyes We describe a chop technique that enables the surgeon to consistently achieve complete division of brunescent and black cataracts.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=5433309 Tue, 22 Nov 2011 16:29:28 +0100 5433309 http://www.medworm.com/index.php?rid=5433308&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015021%2Fabstract%3Frss%3Dyes Although the results with intraocular lenses (IOLs) have been improving for more than 6 decades, IOL predictability is still variable. With the latest advances in premium IOLs (toric, bifocal/multifocal, or accommodating), the requirements for preoperative diagnostics and surgical techniques have become more demanding. A predicted refractive outcome, for example, in bifocal IOL technology should be close to emmetropia because otherwise the IOL optics with 2 or more foci will not be effective. A patient will not benefit from these IOLs unless she/he wears glasses (which the patient did not expect) or she/he has a secondary intervention. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433308 Tue, 22 Nov 2011 16:29:28 +0100 5433308 http://www.medworm.com/index.php?rid=5496571&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015768%2Fabstract%3Frss%3Dyes We describe a novel technique of implanting both a black occlusive device and a clear poly(methyl methacrylate) intraocular lens (IOL) in the capsular bag during phacoemulsification surgery. If the need should arise at a later date, this approach will allow safer and easier explantation of the black occlusive device, avoiding the need for IOL exchange.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=5496571 Thu, 17 Nov 2011 05:00:00 +0100 5496571 http://www.medworm.com/index.php?rid=5496587&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015343%2Fabstract%3Frss%3Dyes Purpose: To determine predictors of long-term intraocular pressure (IOP) after cataract surgery.Setting: Hunter Holmes McGuire Veterans Administration Hospital, Richmond, Virginia, USA.Design: Case series.Methods: Clinical variables, IOP by applanation tonometry, anatomic features on anterior segment optical coherence tomography (AS-OCT), and gonioscopy were assessed before and after uneventful cataract surgery in eyes with open filtration angles. Multivariate linear regression of preoperative measurements was used to predict the mean IOP from 2 to 18 months postoperatively.Results: The study enrolled 77 eyes (77 patients). Prediction of the mean postoperative IOP improved when up to 4 preoperative IOP values were averaged (r2 = 0.20) compared with using the final preoperative IOP value on... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496587 Tue, 15 Nov 2011 05:00:00 +0100 5496587 http://www.medworm.com/index.php?rid=5496578&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015379%2Fabstract%3Frss%3Dyes Conclusions: Both IOLs provided excellent distance and near visual acuity and contrast sensitivity. The Group 2 IOL gave better intermediate distance results.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=5496578 Tue, 15 Nov 2011 05:00:00 +0100 5496578 http://www.medworm.com/index.php?rid=5496570&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015719%2Fabstract%3Frss%3Dyes We describe a method of lifting and replacing the laser in situ keratomileusis (LASIK) flap to reduce the incidence of epithelial ingrowth beneath the flap after LASIK enhancement. In the rapid flaporhexis technique, the flap edge is opened by 1 clock hour with a Sinskey hook and the flap is peeled back after the exposed edge is grasped with a forceps. When necessary, further blunt retraction of the flap is performed with a triangular polyvinyl acetate sponge. After ablation and before the flap is replaced, a triangular sponge is used to clear epithelial remnants from the interface. This method consistently produces a smooth epithelial dissection and decreases the possibility that epithelium is retained beneath the flap.Financial Disclosure: Neither author has a financial or proprietary in... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496570 Tue, 15 Nov 2011 05:00:00 +0100 5496570 http://www.medworm.com/index.php?rid=5496596&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013526%2Fabstract%3Frss%3Dyes This study investigates microbial inoculation of the sterile bag covers after single use and whether this contamination carries a realistic risk for cross-infection. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496596 Mon, 14 Nov 2011 05:00:00 +0100 5496596 http://www.medworm.com/index.php?rid=5496593&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013277%2Fabstract%3Frss%3Dyes A 23-year-old woman with the diagnosis of anterior uveitis in the left eye was referred to our clinic. Circumferential midzonal iris epithelial cysts were observed in the right eye and corneal endothelial pigment precipitates and diffuse pigment discharge in the anterior chamber of the left eye. Topical prednisolone acetate was prescribed. After 2 days, hyperemia and pain decreased in the left eye and started in the right eye. During the following 3 months, the patient experienced 3 similar episodes, which resulted in diffuse pigment deposition in the anterior chamber angles. Intraocular pressure (IOP) elevation was observed after 1 week and 3 weeks in the left eye and right eye, respectively. Topical antiglaucomatous medication was prescribed. Nine months after the last episode, the uncor... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496593 Mon, 14 Nov 2011 05:00:00 +0100 5496593 http://www.medworm.com/index.php?rid=5496590&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011014969%2Fabstract%3Frss%3Dyes Purpose: To determine whether the addition of a bioadhesive drug-delivery system to topical azithromycin induces intraocular inflammation and damage when introduced intraocularly by different approaches and in varying doses.Setting: John A. Moran Eye Center, Salt Lake City, Utah, USA.Design: Experimental study.Methods: Commercial topical azithromycin 1.0% was duplicated, including the benzalkonium chloride, but without inclusion of the Durasite bioadhesive drug-delivery system. Injections of 50 μL, 25 μL, and 10 μL of the antibiotic solutions were administered in a masked fashion to 2 rabbits; 1 eye (study eye) in each rabbit was randomized to receive azithromycin with the delivery system and the fellow eye (control eye) to receive azithromycin without the delivery system. Two rabbits ... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496590 Mon, 14 Nov 2011 05:00:00 +0100 5496590 http://www.medworm.com/index.php?rid=5496584&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015124%2Fabstract%3Frss%3Dyes Purpose: To evaluate the intraobserver repeatability and validity of biometric measurements with a newly developed auxiliary A-scan ultrasound apparatus at a rural clinic.Setting: Rural county hospital in China.Design: Evaluation of diagnostic technology.Methods: Patients awaiting surgery for age-related cataract were consecutively enrolled for preoperative A-scan biometric measurements. The applanation A-scan was performed by 2 experienced nurses, with 1 using the conventional handheld method and the other using the new method with the auxiliary desktop apparatus. Two consecutive measurements were performed with each method. The 95% limits of agreement (LoA) and Bland-Altman plot were used to assess and compare the intersession measurement repeatability between the 2 methods.Results: Data... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496584 Mon, 14 Nov 2011 05:00:00 +0100 5496584 http://www.medworm.com/index.php?rid=5496580&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015161%2Fabstract%3Frss%3Dyes Conclusion: Results show the NAVQ is a reliable, valid instrument that can be incorporated into the evaluation of presbyopic corrections.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=5496580 Mon, 14 Nov 2011 05:00:00 +0100 5496580 http://www.medworm.com/index.php?rid=5496579&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011014829%2Fabstract%3Frss%3Dyes Purpose: To compare visual, refractive, and satisfactory outcomes between a new-generation sectorial addition multifocal intraocular lens (IOL) (Lentis Mplus LS-312; study group) and a diffractive apodized multifocal IOL (Restor SN6AD1; control group).Setting: Private practice, Driebergen, and Department of Ophthalmology, Academic Medical Center, Amsterdam, The Netherlands.Design: Comparative case series.Methods: Refractive and visual outcomes at near and distance, patient satisfaction, and dysphotopsia scores were recorded 3, 6, and 12 months postoperatively.Results: The study group comprised 90 eyes and the control group, 143 eyes. Three months postoperatively, the mean uncorrected distance visual acuity (UDVA) was not statistically significantly different between the study group and the... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496579 Mon, 14 Nov 2011 05:00:00 +0100 5496579 http://www.medworm.com/index.php?rid=5496594&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633501101323X%2Fabstract%3Frss%3Dyes A 56-year-old woman with diabetic retinopathy and chronic myelogenous leukemia had phacoemulsification cataract removal and hydrophilic acrylic intraocular lens (IOL) (Akreos MI-60) implantation in both eyes. One month after surgery, significant IOL opacity and severe cystoid macular edema were observed in both eyes. After bilateral intravitreal injection of bevacizumab (Avastin) to control macular edema, central clearing of the IOL opacity was observed in both eyes. Two months after the injection, the IOL opacity had almost disappeared from both eyes. To our knowledge, this is the first case of early postoperative bilateral IOL opacity in a hydrophilic acrylic IOL cleared after anti-vascular endothelial growth factor (VEGF) intravitreal injection. The role of anti-VEGF therapy in clearing... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496594 Fri, 11 Nov 2011 05:00:00 +0100 5496594 http://www.medworm.com/index.php?rid=5496592&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011014830%2Fabstract%3Frss%3Dyes Conclusions: The new IOL has large optic and overall diameters, smooth and undulating haptics, and a convex–concave optic profile. Results show that these characteristics minimize the possibility of interaction with the primary IOL and uveal tissues, decreasing the likelihood of optical aberrations and pigmentary dispersion.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=5496592 Mon, 07 Nov 2011 05:00:00 +0100 5496592 http://www.medworm.com/index.php?rid=5496591&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011014994%2Fabstract%3Frss%3Dyes Purpose: To analyze the changes in optic surface roughness before and after injection of various intraocular lens (IOL) models using atomic force microscopy (AFM).Settings: Departments of Ophthalmology, Medical University of Graz, General Hospital Linz and University Hospital Basel; Upper Austria University, School of Applied Health and Social Sciences, Linz, Austria.Design: Experimental study.Methods: The morphology and surface roughness of 3 hydrophobic acrylic IOLs from different manufacturers were analyzed by AFM in liquid using the tapping mode. First, AFM was performed on IOLs taken from the original package without further manipulation. In a second step, under sterile conditions, an experienced cataract surgeon loaded the IOLs into the appropriate injection system and pushed them th... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496591 Mon, 07 Nov 2011 05:00:00 +0100 5496591 http://www.medworm.com/index.php?rid=5496589&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015148%2Fabstract%3Frss%3Dyes This study enrolled 31 eyes (29 patients; mean age 30 years). The mean UDVA was significantly better 12 months postoperatively (0.88 logMAR) than preoperatively (1.40 logMAR) (P=.001), as was the mean CDVA (0.29 logMAR versus 0.44 logMAR) (P=.04). The mean spherical equivalent was −6.57 diopters (D) preoperatively and −2.84 D at 12 months (P=.01). The mean keratometry (K) reading decreased from 52.07 D (range 45.9 to 63.1 D) to 46.15 D (range 39.2 to 52.9 D) for K1 (P (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496589 Mon, 07 Nov 2011 05:00:00 +0100 5496589 http://www.medworm.com/index.php?rid=5496586&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011014908%2Fabstract%3Frss%3Dyes Purpose: To evaluate anterior chamber biometric factors associated with the degree of angle widening and intraocular pressure (IOP) reduction after phacoemulsification.Setting: University of California, San Francisco, California, USA.Design: Case series.Methods: Anterior chamber parameters obtained by anterior segment coherence tomography were compared preoperatively and 3 months postoperatively. Measurements included the angle opening distance 500 μm anterior to the scleral spur (AOD500), trabecular–iris space area 500 μm from the scleral spur (TISA500), iris curvature (I-Curv), anterior chamber angle (ACA), trabecular–iris space area, anterior chamber volume, anterior chamber width, and lens vault (LV).Results: The study enrolled 73 eyes. The mean patient age was 77.45 years ± 7.... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496586 Mon, 07 Nov 2011 05:00:00 +0100 5496586 http://www.medworm.com/index.php?rid=5496581&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011015136%2Fabstract%3Frss%3Dyes Conclusions: Concise informed consent information sheets at lower reading grade levels and videotape presentation optimized patient understanding of the risks, benefits, and treatment alternatives to cataract surgery. The cost–benefit of these results is important because better patient understanding has the potential to decrease the risk for indemnity payments awarded because of inadequate informed consent.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=5496581 Mon, 07 Nov 2011 05:00:00 +0100 5496581 http://www.medworm.com/index.php?rid=5496577&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633501101515X%2Fabstract%3Frss%3Dyes This study enrolled eyes that had AcrySof toric IOL implantation. The AL was measured using optical coherence biometry or immersion A-scan biometry. Corneal astigmatism was determined by manual keratometry and topography. The IOL alignment was vertical, horizontal, or oblique. Rotational stability was measured using the purpose-designed software, and the mean absolute difference was determined. The effect of AL and IOL alignment on rotational stability was determined 6 months postoperatively.Results: The study evaluated 168 eyes (168 patients). The mean AL was 23.86 mm ± 1.63 (SD), (range 19.50 to 29.03 mm). The median IOL rotation was 0.3 degree from baseline to 1 week, 1.0 degree from 1 week to 1 month, 0.2 degree from 1 to 3 months, and 0.1 degree from 3 to 6 months. The maximum rotati... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496577 Mon, 07 Nov 2011 05:00:00 +0100 5496577 http://www.medworm.com/index.php?rid=5496574&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013915%2Fabstract%3Frss%3Dyes Conclusions: The new optical ray-tracing algorithm for individualized LASIK ablation profiles to treat moderate to high myopic astigmatism was efficacious, safe, and predictable. The UDVA in eyes with high myopic astigmatism was better than in those treated with wavefront-guided LASIK.Financial Disclosure: Drs. Schumacher and Mrochen are paid scientific consultants to and Drs. Seiler and Cummings and Mr. Maus are members of the medical advisory board of Wavelight, Erlangen, Germany. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496574 Fri, 28 Oct 2011 04:00:00 +0100 5496574 http://www.medworm.com/index.php?rid=5496597&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011014933%2Fabstract%3Frss%3Dyes Numerous studies assess cataract surgery outcomes, identify risk factors for poor outcome, and define target areas that need improvement. However, these studies fail to address a more fundamental question: Is there any evidence that monitoring cataract surgery outcomes improves the quality of future care? The few studies that have investigated this have small numbers (N (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496597 Mon, 24 Oct 2011 04:00:00 +0100 5496597 http://www.medworm.com/index.php?rid=5496575&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633501101488X%2Fabstract%3Frss%3Dyes Conclusions: These 3-year results support the safety and efficacy of the corneal inlay to correct presbyopia in naturally emmetropic presbyopic patients. However, despite a significant gain in UNVA and UIVA, 28.3% of patients lost 1 line of CDVA.Financial Disclosure: Acufocus, Inc., California, USA, financially supports the Research Foundation for Promoting Opthhalmology, Salzburg, Austria, as the clinical research center of the University Eye Clinic, Paracelsus Medical University, Salzburg. Dr. Grabner received travel expenses from Acufocus, Inc. Dr. Riha currently works as a clinical application specialist for Acufocus, Inc. Drs. Seyeddain, Hohensinn, Nix, Rückl, and Dexl have no financial or proprietary interest in any material or method mentioned. (Source: Journal of Cataract and Refr... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496575 Mon, 24 Oct 2011 04:00:00 +0100 5496575 http://www.medworm.com/index.php?rid=5338708&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013988%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=5338708 Sun, 23 Oct 2011 05:15:52 +0100 5338708 http://www.medworm.com/index.php?rid=5338707&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013976%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=5338707 Sun, 23 Oct 2011 05:15:52 +0100 5338707 http://www.medworm.com/index.php?rid=5338706&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013952%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=5338706 Sun, 23 Oct 2011 05:15:52 +0100 5338706 http://www.medworm.com/index.php?rid=5338705&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013964%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=5338705 Sun, 23 Oct 2011 05:15:52 +0100 5338705 http://www.medworm.com/index.php?rid=5338704&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013423%2Fabstract%3Frss%3Dyes In their article on the long-term results of scleral-fixated posterior chamber intraocular lenses (PC IOLs), McAllister and Hirst reviewed the records of patients with sutured scleral-fixated PC IOLs operated on from 1993 to 2008. In this retrospective case series, complications included suture breakage (6.1%), suture exposure (11%), and endophthalmitis. Sixteen surgical procedures were performed 1 week after scleral-fixated PC IOL insertion, and 6 of these were suture related (5 suture breakage, 1 scleral graft for suture exposure). We would like to share our experience with sutureless PC IOL implantation techniques in eyes with deficient capsule support. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5338704 Sun, 23 Oct 2011 05:15:52 +0100 5338704 http://www.medworm.com/index.php?rid=5338703&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013435%2Fabstract%3Frss%3Dyes He et al. reported their evaluation of the optical aberrations induced by Vilupuru et al. during Eddinger-Westphal (EW) electrically stimulated accommodation in a 10-year-old rhesus monkey. They concluded that during accommodation, the crystalline lens fell from the nonlinear downward shift of vertical coma in only the right eye of the monkey. However, in the left eye of this same monkey, vertical coma shifted upward, implying the exact opposite, that the crystalline lens rises (in defiance of gravity) during accommodation. The authors are unable to explain this contradiction. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5338703 Sun, 23 Oct 2011 05:15:52 +0100 5338703 http://www.medworm.com/index.php?rid=5338702&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013411%2Fabstract%3Frss%3Dyes We appreciate this opportunity to clarify our measures to prevent recurrence of this error. Until this error occurred, it was standard practice to have the antibiotic drawn up and on the scrub tray with a blunt cannula. Since the error, the antibiotic is drawn up at the end of the procedure and a needle is used. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5338702 Sun, 23 Oct 2011 05:15:52 +0100 5338702 http://www.medworm.com/index.php?rid=5338701&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633501101340X%2Fabstract%3Frss%3Dyes Qureshi and Clark report a case of macular infarction due to the inadvertent intraocular injection of cefuroxime that was intended as a subconjunctival injection. This serves as a timely warning of the dangers of excessive antibiotic dosage. However, I am not happy with their suggested way of preventing this mistake in the future. To mitigate the chance of a similar occurrence, they attach a different needle to the syringe containing the antibiotic than the needle used for intracameral injection. Surely, rather than mitigation, prevention of this complication could be achieved by the simple expedient of never having substances not intended for intracameral use on their instrument tray until the case is finished. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5338701 Sun, 23 Oct 2011 05:15:52 +0100 5338701 http://www.medworm.com/index.php?rid=5338700&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013447%2Fabstract%3Frss%3Dyes I agree with Guarnieri et al. that cortical fragments can often be treated conservatively with topical steroids. In my experience, however, medical management of true lens nuclear fragments has limited success. Often there is early improvement but with tapering of the steroid, corneal edema and iritis return. In situations in which surgery is not readily available or acceptable to the patient, topical antiinflammatory agents do have a role. Nevertheless, as the authors themselves indicate, endothelial cell loss is a significant concern with prolonged exposure to lens fragments in the anterior chamber. Specular microscopy may be helpful in decision making and prognosis in such cases. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5338700 Sun, 23 Oct 2011 05:15:52 +0100 5338700 http://www.medworm.com/index.php?rid=5338699&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013459%2Fabstract%3Frss%3Dyes Recently, Pandit et al. published a case of corneal edema resulting from retained lens material 8.5 years after phacoemulsification. We agree with the authors that this complication is more frequent than published reports suggest because we think it could be related to surgical procedures or intraoperative complications in which cortical lens material is left in the periphery of the capsular bag (eg, pupillary miosis). (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5338699 Sun, 23 Oct 2011 05:15:52 +0100 5338699 http://www.medworm.com/index.php?rid=5338698&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013575%2Fabstract%3Frss%3Dyes This patient developed bilateral iatrogenic keratectasia after a LASIK procedure for a correction that lies within the usual limits. However, the pre-LASIK posterior float in Figure 1 seems to be higher than 50 μm. This might indicate an unrecognized keratectasia, probably forme fruste keratoconus, given the age of the patient at the time of the initial surgery. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5338698 Sun, 23 Oct 2011 05:15:52 +0100 5338698 http://www.medworm.com/index.php?rid=5338697&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013563%2Fabstract%3Frss%3Dyes Post-LASIK ectasia is a challenging problem that we must solve because the involved patients are very disappointed that a procedure performed to allow spectacle independence has led to a refractive disaster. Of the proposed solutions, ICRS implantation and CXL are probably the most interesting, although their efficacy remains controversial. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5338697 Sun, 23 Oct 2011 05:15:52 +0100 5338697 http://www.medworm.com/index.php?rid=5338696&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013551%2Fabstract%3Frss%3Dyes This is an interesting case of bilateral ectasia after LASIK in a patient with apparently normal preoperative corneal topographies. The most likely causes for the ectasia are undiagnosed keratoconus and excessive keratectomy depth. It is possible that this patient had very early keratoconus in which the cone was small enough for epithelial thickness changes to compensate fully such that the front-surface topography appeared normal, as previously described. The corneal topography back surface shows a slightly elevated and eccentric apex, which may indicate the presence of a subsurface cone masked by epithelium. The keratometric map shows skew astigmatism in both eyes, which might also indicate keratoconus. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5338696 Sun, 23 Oct 2011 05:15:52 +0100 5338696 http://www.medworm.com/index.php?rid=5338695&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633501101354X%2Fabstract%3Frss%3Dyes A 58-year-old contact-lens-intolerant man had myopic laser in situ keratomileusis (LASIK) 13 years ago followed by collagen crosslinking (CXL) in the right eye and intrastromal corneal ring segment (ICRS) implantation in the left eye 14 months ago because of late secondary ectasia. He came for consultation because of low quality of vision, theoretically because of high anisometropia. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5338695 Sun, 23 Oct 2011 05:15:52 +0100 5338695 http://www.medworm.com/index.php?rid=5338694&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013290%2Fabstract%3Frss%3Dyes Limbal relaxing incisions (LRIs) are one of the more commonly performed adjunctive procedures with phacoemulsification to correct preexisting astigmatism, primarily because of the cost effectiveness and the predictable surgical profile. We conducted a prospective interventional study to evaluate the effect and stability of LRIs in reducing preexisting astigmatism at the time of phacoemulsification. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5338694 Sun, 23 Oct 2011 05:15:52 +0100 5338694 http://www.medworm.com/index.php?rid=5338693&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013356%2Fabstract%3Frss%3Dyes Posterior capsule opacification (PCO) is the most common long-term complication after cataract surgery. The reported incidence of PCO varies widely, ranging from 15% to 50% depending on length of follow-up, intraocular lens (IOL) material and design, surgical technique, and method of implantation. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5338693 Sun, 23 Oct 2011 05:15:52 +0100 5338693 http://www.medworm.com/index.php?rid=5338692&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013460%2Fabstract%3Frss%3Dyes Miyake et al. classified capsular block syndrome (CBS) as an intraoperative, early postoperative, or late postoperative complication of cataract surgery. Recently, a 58-year-old woman with bilateral uveitis who was followed for Behçet disease with bilateral uveitis consulted us because of a bilateral progressive decrease in vision. Bilateral corticosteroid-induced cataracts had been removed by phacoemulsification and intraocular lens (IOL) implantation 20 year earlier. Both eyes had been quiet for the past 5 years. The slitlamp examination showed a fibrotic ring on the capsulorhexis margin glued to the IOL, an accumulation of milky white liquid between the IOL and the opacified posterior capsule, and cortical material in the capsular bag. Optical coherence tomography (OCT) confirmed CBS... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5338692 Sun, 23 Oct 2011 05:15:52 +0100 5338692 http://www.medworm.com/index.php?rid=5338691&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013393%2Fabstract%3Frss%3Dyes We describe the results of clear lens extraction in 7 eyes of 4 Alport-syndrome patients. Three patients (6 eyes) had both anterior and posterior lenticonus; the fourth patient had spontaneous rupture of the anterior lens capsule, resulting in an acute drop in vision. Clear lens extraction was an effective method for visual rehabilitation in Alport syndrome 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=5338691 Sun, 23 Oct 2011 05:15:52 +0100 5338691 http://www.medworm.com/index.php?rid=5338688&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013381%2Fabstract%3Frss%3Dyes Conclusion: The combination of 2 diffractive profiles to achieve far, intermediate, and near correction is validated. Further clinical investigations are required to validate these principles.Financial Disclosure: Dr. Houbrechts 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=5338688 Sun, 23 Oct 2011 05:15:52 +0100 5338688 http://www.medworm.com/index.php?rid=5338687&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013320%2Fabstract%3Frss%3Dyes Conclusion: Formulas for analysis of light split between different foci of multifocal diffractive IOLs are useful in interpreting diffraction efficiency dependence on physical characteristics, such as blaze heights of the diffractive grooves and wavelength of light, as well as for optimizing multifocal diffractive optics.Financial Disclosure: Disclosure is 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=5338687 Sun, 23 Oct 2011 05:15:52 +0100 5338687 http://www.medworm.com/index.php?rid=5338686&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013332%2Fabstract%3Frss%3Dyes Conclusion: The new-generation multifocal IOL provided adequate distance, intermediate, and, to a lesser extent, near vision with high rates of spectacle freedom. Halos occurred, and other photic phenomena should be expected in a small percentage of 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=5338686 Sun, 23 Oct 2011 05:15:52 +0100 5338686 http://www.medworm.com/index.php?rid=5338683&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013241%2Fabstract%3Frss%3Dyes Purpose: To evaluate the accuracy of refractive prediction of 4 intraocular lens (IOL) power calculation formulas in eyes with axial length (AL) greater than 25.0 mm and to propose a method of optimizing AL to improve the accuracy.Setting: Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA, and Department of Ophthalmology, Goethe University, Frankfurt am Main, Germany.Design: Case series.Methods: Refractive prediction errors with the Holladay 1, Haigis, SRK/T, and Hoffer Q formulas were evaluated in consecutive cases. Eyes were randomized to a group used to develop the method of optimizing AL by back-calculation or a group used for validation. Further validation was performed in 2 additional data sets.Results: The optimized AL values were highly correlated with the IOLMa... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5338683 Sun, 23 Oct 2011 05:15:52 +0100 5338683 http://www.medworm.com/index.php?rid=5338680&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011012193%2Fabstract%3Frss%3Dyes Conclusion: Hybrid monovision may be an effective approach for managing loss of accommodation after cataract surgery and may be the method of choice in cases of waxy vision caused by bilateral multifocal IOL implantation.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=5338680 Sun, 23 Oct 2011 05:15:52 +0100 5338680 http://www.medworm.com/index.php?rid=5338679&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013368%2Fabstract%3Frss%3Dyes Conclusions: Although there were no statistically significant differences in contrast sensitivity, range of accommodation, dysphotopsia, or subjective patient satisfaction or preference between the 2 IOLs, the difference in CDVA was statistically significant, but not clinically important (relative difference 1.5%), in favor of the spherical IOL.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=5338679 Sun, 23 Oct 2011 05:15:52 +0100 5338679 http://www.medworm.com/index.php?rid=5338673&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013204%2Fabstract%3Frss%3Dyes Purpose: To compare refractive outcomes, higher-order aberrations (HOAs), and contrast sensitivity of myopic wavefront-guided aspheric laser in situ keratomileusis centered on the coaxially sighted corneal light reflex or on the line of sight.Setting: Okamoto Eye Clinic, Ehime, Japan.Design: Comparative case series.Methods: Data at 3 months were compared based on the distance between the coaxially sighted corneal light reflex and the line of sight (P-distance) as follows: distance greater than 0.25 mm (high-distance group), distance greater than 0.15 mm and less than 0.25 mm (intermediate-distance group), and distance less than 0.15 mm (low distance group).Results: The chart review included 317 eyes in the corneal-light-reflex group and 269 eyes in the line-of-sight group. The mean postope... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5338673 Sun, 23 Oct 2011 05:15:52 +0100 5338673 http://www.medworm.com/index.php?rid=5338669&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013502%2Fabstract%3Frss%3Dyes We describe a technique of femtosecond laser-assisted enhancement after primary LASIK with a mechanical microkeratome-created flap. The vertical side-cut incision by the femtosecond laser creates a wound configuration that decreases mechanical trauma to the epithelium and prevents epithelial cell migration. These factors may decrease the risk for post-LASIK enhancement epithelial ingrowth.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=5338669 Sun, 23 Oct 2011 05:15:52 +0100 5338669 http://www.medworm.com/index.php?rid=5338668&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013484%2Fabstract%3Frss%3Dyes We describe several simple modifications of the big-bubble technique to improve surgeon comfort and reduce the risk for complications, with emphasis on our ophthalmic viscosurgical device (OVD)-assisted incision technique. By coating the overlying stroma with OVD prior to entering the big bubble, space is maintained in the pre-Descemet plane. This prevents collapse of the big bubble and allows an air–OVD exchange. We have successfully used this technique in 72 consecutive cases without a perforation during the entry incision to the bubble space of the DALK procedure.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=5338668 Sun, 23 Oct 2011 05:15:52 +0100 5338668 http://www.medworm.com/index.php?rid=5338667&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013848%2Fabstract%3Frss%3Dyes David J. Apple, MD, 69, passed away in August 2011 following a long and difficult battle with the many side effects of radiation therapy for throat cancer. David was a renowned ophthalmic pathologist and a pioneer in research of the pathology of intraocular lens (IOL) complications as well as cataract surgery in general. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5338667 Sun, 23 Oct 2011 05:15:52 +0100 5338667 http://www.medworm.com/index.php?rid=5433321&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013927%2Fabstract%3Frss%3Dyes Purpose: To evaluate the relationship between the thinnest point in corneal thickness and the refractive state, keratometry, age, sex, and the ocular side.Setting: Eye clinics in Germany and Austria and the Department of Ophthalmology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.Design: Cross-sectional study.Methods: Medical records of refractive surgery candidates from 2006 to 2010 were reviewed. Univariate variance analysis, covariance analysis, Bravis-Pearson correlations, Spearman rank correlations, and t tests were performed to analyze the relationship between the thinnest point in corneal thickness and the biometric parameters.Results: The study evaluated 4600 eyes. The mean thinnest point in corneal thickness was 549 μm ± 33 (SD). Refractive state, mean keratome... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433321 Thu, 20 Oct 2011 04:00:00 +0100 5433321 http://www.medworm.com/index.php?rid=5496582&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013903%2Fabstract%3Frss%3Dyes Purpose: To perform an objective functional assessment of the impact of blue-light filters on cortical processing to evaluate the potential side effects of the filters on higher tier visual function at the neural level.Setting: Department of Ophthalmology, Otto-von-Guericke-University Magdeburg, Magdeburg, Germany.Design: Cohort study.Methods: Multifocal pattern-reversal visual-evoked potentials (multifocal VEPs) were recorded monocularly in pseudophakic patients with a clear intraocular lens (IOL) under 2 conditions: (1) stimulus perception through a yellow filter with the filter characteristics of an AF-1 YA-60BB IOL (blue filtering); (2) stimulus perception through a neutral filter that homogeneously attenuates the effective stimulus intensity as under the blue-light filtering condition... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5496582 Mon, 17 Oct 2011 04:00:00 +0100 5496582 http://www.medworm.com/index.php?rid=5433328&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013496%2Fabstract%3Frss%3Dyes A 79-year-old man had uneventful phacoemulsification at an outside facility. During the postoperative period, his vision worsened secondary to chronic cystoid macular edema (CME). The patient was referred to the Veteran Affairs Boston Healthcare System for review 2 years and 4 months after the initial cataract procedure. The CME was confirmed, and a large pearly white globule that moved with changes in head position was noted. Surgical removal was performed, and nuclear magnetic resonance spectroscopy identified the unknown substance as petroleum jelly. The patient was treated with topical ketorolac tromethamine and prednisolone acetate with subsequent resolution of inflammation and CME, resulting in a corrected distance visual acuity of 20/25. The visual acuity was maintained 5 years aft... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433328 Mon, 17 Oct 2011 04:00:00 +0100 5433328 http://www.medworm.com/index.php?rid=5433319&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013289%2Fabstract%3Frss%3Dyes Purpose: To assess flap-thickness predictability with a pendular microkeratome (130 μm head).Setting: Eye Institute of Thrace, Democritus University of Thrace, Alexandroupolis, Greece.Design: Clinical trials.Methods: The study comprised 263 eyes (132 patients). Laser in situ keratomileusis was performed using the 130 μm head of the Carriazo pendular microkeratome; right eyes were treated first. Ultrasound pachymetry and topography were used for central corneal thickness (CCT) and keratometry (K) measurements. Evaluation included flap thickness, flap diameter, and flap shape.Results: The mean flap thickness was 125 μm ± 22 (SD) (range 74 to 187 μm) in right eyes and 112 ± 21 μm (range 61 to 190 μm) in left eyes. Flap thickness was significantly correlated with preoperative CCT (r = ... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433319 Fri, 14 Oct 2011 04:00:00 +0100 5433319 http://www.medworm.com/index.php?rid=5433329&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013472%2Fabstract%3Frss%3Dyes We present a case that had a unique pigmented region associated with the area of lenticonus and provides insights that may help identify the factors responsible for the development of posterior lenticonus. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5433329 Thu, 13 Oct 2011 04:00:00 +0100 5433329 http://www.medworm.com/index.php?rid=5496583&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013897%2Fabstract%3Frss%3Dyes Conclusion: Results indicate that using 5% povidone–iodine for 15 minutes or 10% povidone–iodine for 5 minutes can prevent the growth of most post-cataract surgery endophthalmitis bacterial isolates.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=5496583 Mon, 10 Oct 2011 04:00:00 +0100 5496583 http://www.medworm.com/index.php?rid=5433317&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013885%2Fabstract%3Frss%3Dyes Conclusions: If 1 of 6 parameters were over a chosen threshold, the probability that a patient would present with keratoconus would be almost 3 in 1000 instead of 9 in 1000 in a LASIK surgery cohort. Despite low sensitivity and specificity, some parameters provided by the corneal analyzer offered high negative likelihood ratios and deserve more study with bigger samples.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=5433317 Fri, 07 Oct 2011 04:00:00 +0100 5433317 http://www.medworm.com/index.php?rid=5338689&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013344%2Fabstract%3Frss%3Dyes We report intraoperative capsular block syndrome occuring during the first 50 femtosecond laser–assisted cataract surgeries performed in our facility. Two patients had uneventful combined laser fragmentation, capsulotomy, and corneal incision procedures. In both cases, following transfer to the operating room and manual removal of the laser-cut capsulotomy, posterior capsule rupture was noted during hydrodissection, resulting in posterior dislocation of the lens. Pars plana vitrectomy, removal of the crystalline lens, and sulcus implantation of an intraocular lens were performed in both patients with good visual outcomes. Femtosecond laser–assisted cataract surgery changes the intraoperative environment with the generation of intracapsular gas and laser-induced changes in the cortex. W... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5338689 Fri, 23 Sep 2011 04:00:00 +0100 5338689 http://www.medworm.com/index.php?rid=5338685&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011013216%2Fabstract%3Frss%3Dyes Conclusions: Toric IOL implantation in patients with cataract and corneal astigmatism provided good distance and near visual outcomes and acceptable intermediate visual outcomes, allowing patients with considerable amounts of corneal astigmatism to achieve spectacle independence at distance and near.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=5338685 Fri, 23 Sep 2011 04:00:00 +0100 5338685 http://www.medworm.com/index.php?rid=5338676&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633501101251X%2Fabstract%3Frss%3Dyes Conclusion: The results indicate that uveitis is not a formal contraindication to primary IOL implantation in the management of pediatric cataract surgery in cases with full control of intraocular inflammation.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=5338676 Fri, 23 Sep 2011 04:00:00 +0100 5338676 http://www.medworm.com/index.php?rid=5338675&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011012211%2Fabstract%3Frss%3Dyes Conclusion: Corneal endothelial cell loss during phacoemulsification was significantly higher when the phaco tip was in the bevel-down position than in the conventional bevel-up position.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=5338675 Fri, 23 Sep 2011 04:00:00 +0100 5338675 http://www.medworm.com/index.php?rid=5240773&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011012314%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=5240773 Thu, 22 Sep 2011 16:57:03 +0100 5240773 http://www.medworm.com/index.php?rid=5240772&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011012302%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=5240772 Thu, 22 Sep 2011 16:57:03 +0100 5240772 http://www.medworm.com/index.php?rid=5240771&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011012296%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=5240771 Thu, 22 Sep 2011 16:57:03 +0100 5240771 http://www.medworm.com/index.php?rid=5240770&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011012284%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=5240770 Thu, 22 Sep 2011 16:57:03 +0100 5240770 http://www.medworm.com/index.php?rid=5240769&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011012065%2Fabstract%3Frss%3Dyes External landmarks can belie internal suture entry sites. Agarwal et al. rightly identify a common challenge in any scleral suturing procedure; namely, where to pass the suture. They prefer the use of 1.5 mm posterior to the limbus as an external landmark for identification of iris insertion. Although it is appealing to have a numeric value to a fixed reference point, a number of factors can come into play that may give one a false sense of security. First, identification of the limbus is difficult in most individuals, as its breadth can make a single point difficult to rely on, particularly since a single eye's relative limbal anatomy can vary depending on the meridian of suture passage. Interpersonal variability can be quite significant as well, especially when comparing long myopic ey... Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5240769 Thu, 22 Sep 2011 16:57:03 +0100 5240769 http://www.medworm.com/index.php?rid=5240768&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011012077%2Fabstract%3Frss%3Dyes A “hang-back” iridodialysis repair technique was recently described by Snyder and Lindsell. It entails suspending the iris from the sclera using a 10-0 polypropylene suture. We practice a similar technique except that instead of passing the polypropylene suture directly through the iris and sclera, we use a 26-gauge needle to engage the iris and guide the suture out of the eye. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5240768 Thu, 22 Sep 2011 16:57:03 +0100 5240768 http://www.medworm.com/index.php?rid=5240767&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011012028%2Fabstract%3Frss%3Dyes The idea of inserting a human cataract into an animal eye to create a phacoemulsification model was first reported by Tolentino and Liu in 1975. However, ophthalmology skill laboratory development now involves wider practices; ie, efficient methods for animal eye harvest, fixation, and preparation. Cataract induction in animal eyes is an example of such “preparations.” Microwave energy and chemical treatment have been used, human cataracts have been implanted, and cooked chestnuts have been inserted to prepare the animal eye for phacoemulsification. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5240767 Thu, 22 Sep 2011 16:57:03 +0100 5240767 http://www.medworm.com/index.php?rid=5240766&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS088633501101203X%2Fabstract%3Frss%3Dyes We read with interest the article by Mohammadi et al. Ophthalmology training involves practicing surgery in animal, cadaver, or artificial eyes. Because nucleotomy forms the major part of phacoemulsification, simulation of the human nucleus has been attempted. We have removed human lens nuclei from patients who had extracapsular cataract extraction (ECCE) and implanted them in enucleated goat eyes for phacoemulsification training. The nucleus was delivered carefully, stored in Ringer lactate at 4°C, and transported to an experimental operating room. A side-port incision was made and an ophthalmic viscosurgical device (OVD) injected into the anterior chamber. A corneal tunnel incision 3.2 mm was made and capsulorhexis performed. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5240766 Thu, 22 Sep 2011 16:57:03 +0100 5240766 http://www.medworm.com/index.php?rid=5240765&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011012041%2Fabstract%3Frss%3Dyes We thank McKelvie et al. for their comments on our article. First, we used Pearson correlation analysis (r value) to evaluate the relationship between the spherical aberrations of each IOL. If our null hypothesis is valid and if 6 variables are independent, the differences are significant at a probability of 6Cn × 0.05n × 0.95(6−n). The probability that the differences are significant in 5 or more variables is 1.80 × 10−6. This means that the possibility of statistical errors is very small. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5240765 Thu, 22 Sep 2011 16:57:03 +0100 5240765 http://www.medworm.com/index.php?rid=5240764&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011012053%2Fabstract%3Frss%3Dyes We commend Taketani and Hara for evaluating spherical aberration in 3 aspheric intraocular lens (IOL) models in a model eye. The negative correlation between IOL power and spherical aberration reported is consistent with our published model eye results for the ZA9003 (Abbott Medical Optics, Inc.) but not for the SN60WF (Alcon Laboratories, Inc.) or the Adapt AO (Bausch & Lomb) IOLs (). It is interesting that the authors use 6 univariate correlations with significance tests to analyze spherical aberration and power but no statistical tests to compare IOL models. Unfortunately, this methodology is prone to type 1 error inflation with a 26.5% probability that a result may be “statistically significant” purely by chance. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5240764 Thu, 22 Sep 2011 16:57:02 +0100 5240764 http://www.medworm.com/index.php?rid=5240763&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011012235%2Fabstract%3Frss%3Dyes Fortunately, this 49-year-old's nonamblyopic right eye has excellent visual acuity, especially considering multiple surgical procedures. With the left eye's history of strabismic amblyopia and the finding of a hypoplastic optic nerve, the visual prognosis after cataract removal is not promising. A posterior approach to this dislocated dense cataract should still be considered. However, an anterior segment surgeon can provide a reasonable alternative. Initially, a scleral pocket is dissected inferonasally by performing a partial-thickness limbal incision and then extending intrascleral posteriorly with a crescent knife, as described by Hoffman et al. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5240763 Thu, 22 Sep 2011 16:57:02 +0100 5240763 http://www.medworm.com/index.php?rid=5240762&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011012168%2Fabstract%3Frss%3Dyes Following is how I would manage this case: Maintain a 2-chambered eye. Use a scleral-sutured modified Cionni CTR or a standard CTR with an Ahmed segment and a single-piece acrylic IOL. Prevent anisometropia by choosing the IOL power with the knowledge that the sutured bag will often sit more forward in the eye than the predicted effective lens position. Amblyopia is often actually subluxated lens–induced irregular astigmatism. Good visual acuity is frequently achieved. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5240762 Thu, 22 Sep 2011 16:57:02 +0100 5240762 http://www.medworm.com/index.php?rid=5240761&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011012156%2Fabstract%3Frss%3Dyes Zonular dehiscence can be treated by complete removal of the lens (intracapsular cataract extraction [ICCE]) or by preserving the lens capsule using capsule-stabilizing devices. In this case, with large zonular dehiscence (8 hours) and advanced nuclear cataract, capsule preservation might be extremely difficult. If complete lens removal were chosen, it would probably be preferable to perform ICCE through a large scleral tunnel to minimize the risk for posterior lens dislocation. Scleral or iris fixation of a posterior chamber IOL is then optional; however, iris-supported anterior chamber IOLs are much simpler to implant and have a similar safety profile and visual outcomes. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5240761 Thu, 22 Sep 2011 16:57:02 +0100 5240761 http://www.medworm.com/index.php?rid=5240760&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011012144%2Fabstract%3Frss%3Dyes In Colombia, I see many subluxated cataracts, but few with such advanced cataract. In this case, we can try an anterior approach using a dispersive OVD and trypan blue stain. Also, using MST capsule holders or regular iris retractors, one can obtain a continuous curvilinear capsulorhexis. The key factor of severe decentration because of the advanced cataract means that phacoemulsification could have complications. I would work with a vitreoretinal surgeon, performing lensectomy and vitrectomy with a band of 360 degrees of laser. I would then implant a scleral-sutured foldable 3-piece IOL through a 3.0 mm self-sealing incision or implant an iris-sutured foldable IOL. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5240760 Thu, 22 Sep 2011 16:57:02 +0100 5240760 http://www.medworm.com/index.php?rid=5240759&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011012132%2Fabstract%3Frss%3Dyes We strongly prefer to preserve native capsule and anterior segment anatomy as much as possible and to avoid or minimize vitreous manipulation, particularly given the retinal history in the contralateral eye. Although this dense lens is markedly decentered, we are somewhat reassured by the relative flattening of the more dislocated edge, indicating that the remaining intact zonular fibers superotemporally are of reasonable strength. The visible, but stretched zonular fibers suggest no vitreous prolapse. Accordingly, gentle surgery and obsessive attentiveness to maintaining a pressurized anterior segment gives an excellent chance of preventing vitreous prolapse during phacoemulsification. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5240759 Thu, 22 Sep 2011 16:57:02 +0100 5240759 http://www.medworm.com/index.php?rid=5240758&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011012120%2Fabstract%3Frss%3Dyes I would recommend the following anterior segment approach using local anesthesia: Create the primary incision in the superotemporal quadrant opposite the area of exposed zonule. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5240758 Thu, 22 Sep 2011 16:57:02 +0100 5240758 http://www.medworm.com/index.php?rid=5240757&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011012119%2Fabstract%3Frss%3Dyes In my experience, lenses that are subluxated inferiorly are much more challenging because the superior zonular fibers tend to be markedly weak, allowing the lens to drop due to gravity's affect, in addition to the obviously weak inferior zonular fibers. Lenses that are subluxated superiorly tend to have stronger superior zonular fibers relative to the very weak inferior ones. In addition, inferior lens equator flattening indicates much stronger superior zonular fibers relative to the inferior ones because the weaker inferior zonular fibers have allowed the lens to flatten in that location only. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5240757 Thu, 22 Sep 2011 16:57:02 +0100 5240757 http://www.medworm.com/index.php?rid=5240756&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011012107%2Fabstract%3Frss%3Dyes A 49-year-old man is referred by his retinal surgeon for management of a superotemporal, subluxated, extremely dense nuclear cataract in the left eye. He has a complex ocular history; in addition to ectopia lentis he has strabismic amblyopia in the left eye for which extraocular muscle surgery was performed at age 30 years. A sister also has ectopia lentis; however, there is no family history of Marfan disease, connective tissue, or metabolic disorders. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5240756 Thu, 22 Sep 2011 16:57:02 +0100 5240756 http://www.medworm.com/index.php?rid=5240754&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011012089%2Fabstract%3Frss%3Dyes Keratectasia is a rare but severe complication of laser in situ keratomileusis (LASIK). As the number of patients who have refractive surgery increases, more cases of ectasia are being recognized. The best predictor for the development of ectasia after LASIK is the presence of an overlooked ectatic disorder preoperatively, in which case LASIK is an aggravating factor for the acceleration of the ectatic process. (Source: Journal of Cataract and Refractive Surgery) Journal of Cataract and Refractive Surgery journals http://www.medworm.com/rss/comments.php?id=5240754 Thu, 22 Sep 2011 16:57:02 +0100 5240754 http://www.medworm.com/index.php?rid=5240750&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011011746%2Fabstract%3Frss%3Dyes Conclusions: Penetrating keratoplasty with adjunctive MMC decreased several refractive variables in patients with previous PKP. These results compare well with those in the published literature and suggest PRK is as effective as, and probably safer than, laser in situ keratomileusis in treating refractive error in these cases.Financial Disclosure: No author has financial or proprietary interests 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=5240750 Thu, 22 Sep 2011 16:57:02 +0100 5240750 http://www.medworm.com/index.php?rid=5240748&cid=s_38496_30_f&fid=38496&url=http%3A%2F%2Fwww.jcrsjournal.org%2Farticle%2FPIIS0886335011011709%2Fabstract%3Frss%3Dyes Conclusions: The OCT-based corneal topographer, with its faster acquisition time, provided more consistent measurements than the Scheimpflug-based corneal topographer. The OCT-based corneal topographer seems promising for evaluating highly irregular corneas, as in cases of advanced keratoconus.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=5240748 Thu, 22 Sep 2011 16:57:02 +0100 5240748