Evaluating the relative value of intraoperative aberrometry versus current formulas for toric IOL sphere, cylinder, and orientation planning
To retrospectively review toric intraocular lens (IOL) outcomes and compare actual results to those expected from preoperative calculations and intraoperative aberrometry (IA) in normal eyes. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 27, 2019 Category: Opthalmology Authors: Kerry D. Solomon, Helga P. Sandoval, Richard Potvin Tags: Article Source Type: research

Slitlamp protractor: Refinement of existing slitlamp toric scale
We describe a simple modification to the preexisting protractor scale on the slitlamp to facilitate toricity measurement at each degree. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 27, 2019 Category: Opthalmology Authors: Amar Pujari, Jayanand Urkude, Rashmi Singh, Saumya Yadav, Ritika Mukhija, Namrata Sharma Tags: Correspondence Source Type: research

Measuring aberrations of multifocal and extended depth-of-focus intraocular lenses
Studies comparing the optical quality of intraocular lenses (IOLs) in  vivo are proliferating. This increase in popularity is largely driven by the availability of aberrometers in clinical and laboratory environments. However, the approach to interpreting aberrometry results in pseudophakic patients has been insufficient in many cases, especially when considering mul tifocal or extended depth-of-focus (EDOF) IOLs. In the majority of published studies that compared the optical quality between multiple IOLs and pupil sizes, the authors present the root mean square (RMS) as a fait accompli. (Source: Journal of Cataract a...
Source: Journal of Cataract and Refractive Surgery - September 27, 2019 Category: Opthalmology Authors: Antonio J. Del Águila-Carrasco, Eleni Papadatou, Phillip J. Buckhurst Tags: Correspondence Source Type: research

Phakic intraocular lens implantation for the correction of hyperopia
The prevalence of myopia is much higher than hyperopia. Hence, there are relatively few studies investigating phakic intraocular lens (pIOL) implantation for the correction of hyperopia. This review aimed to summarize the available relevant literature on the efficacy and safety of pIOL implantation for the correction of hyperopia and hyperopic astigmatism. At present, two types of pIOLs are used to correct hyperopia and hyperopic astigmatism: anterior chamber iris-fixated pIOLs and posterior chamber implantable collamer lenses. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 27, 2019 Category: Opthalmology Authors: Abdulaziz A. Alshamrani, Saad S. Alharbi Tags: Review/Update Source Type: research

Diagnosis of keratoconus progression by Fourier-domain optical coherence tomography should be correlated with Scheimpflug tomography
In a recent article, Ouanezar et  al.1 studied 134 keratoconus cases to define a new anatomic criterion for progressive keratoconus based on corneal optical coherence tomography (OCT). The authors stated that corneal thickness was better evaluated by OCT than by scanning-slit corneal topography on the basis of an interobserver rep eatability comparison between the Orbscan IIz topographer (Bausch + Lomb Surgical, Inc.) and the RTVue Fourier-domain OCT device (Optovue, Inc.). In an earlier study, Meyer et al. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 27, 2019 Category: Opthalmology Authors: Swati Agrawal, Ashi Khurana Tags: Letter Source Type: research

Posterior elevation as a risk factor for corneal ectasia after small-incision lenticule extraction
In a case report by Pazo et  al.,1 a patient developed unilateral corneal ectasia 15 months after small-incision lenticule extraction (SMILE). The authors stated that the preoperative topography of the affected eye was normal, with a maximum keratometry value of 44.9 diopters (D) and a minimum thickness of 582 μm. They rep orted no significant inferior–superior (I–S) asymmetry on the curvature maps and unremarkable anterior and posterior elevation maps. However, it seems as though the case was suspicious for subclinical keratoconus preoperatively. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 27, 2019 Category: Opthalmology Authors: George D. Kymionis, Michael A. Grentzelos, Nafsika Voulgari Tags: Letter Source Type: research

Reply
It is well known that preoperative abnormal topographic abnormality, low residual stromal bed thickness, thin corneas, young age, and high myopia are factors that might increase the risk for developing corneal ectasia after corneal refractive surgery.1 As outlined, this patient had thicker than average corneal thickness. The anterior elevation map showed an asymmetric bowtie pattern with an I –S index of 1.0 D, which is below the recognized 1.4 D cutoff, and there was no skewed radial axis. Furthermore, the patient was 23 years old and the treatment size was small; therefore, this patient was deemed a suitable c...
Source: Journal of Cataract and Refractive Surgery - September 27, 2019 Category: Opthalmology Authors: Richard N. McNeely, Jonathan E. Moore Tags: Letter Source Type: research

Avoiding the anterior one third of the cornea might not prevent ectasia after laser vision correction
In a case report, Pazo et  al.1 described a patient with unilateral ectasia after small-incision lenticular extraction (SMILE). However, we believe that the contralateral left eye also had signs of early ectasia (Figure 1). (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 27, 2019 Category: Opthalmology Authors: Arturo S. Chayet, Julio C. Moreno, Susana Y áñez, Yunuen Bages, Pablo Adamek Tags: Letter Source Type: research

Reply
Chayet et  al. stated they believe that working in the anterior one third of the cornea allows for better biomechanics and that operating in the central one third or posterior two thirds of the cornea might not provide better biomechanics. As stated, we agree that further clinical research is required to bet ter understand the biomechanical impact of the various forms of laser surgery. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 27, 2019 Category: Opthalmology Authors: Richard N. McNeely, Jonathan E. Moore Tags: Letter Source Type: research

Unilateral whorl-like corneal epitheliopathy
A 45-year-old South Asian woman presented with a 2-month history of acute onset of unilateral dry-eye symptoms with significant irritation and blurry vision in the left eye. She reported increasing difficulty using the computer, itching, and eye pain after work in both eyes but significantly more pronounced in the left eye. Artificial tears provided no relief of symptoms in the left eye. Initially, an optometric physician, who diagnosed her with acute corneal abrasion in the left eye, treated her with lubricating drops and ointments. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 27, 2019 Category: Opthalmology Authors: Majid Moshirfar, Anisha N. Somani, Grant C. Hopping Tags: Consultation section: Cataract Source Type: research

October consultation #2
This patient with recurrent unilateral ocular complaints, a lid lesion, and keratitis unresponsive to numerous medications as well as a negative work-up for infectious agents leaves us with numerous diagnostic possibilities. These include: viral shedding from the lid lesion as with molluscum, eyelid deformity with corneal exposure, limbal stem cell deficiency of uncertain etiology, ocular surface dysplasia or neoplasia, superior limbic keratoconjunctivitis, vernal keratoconjunctivitis, herpes group viruses, Acanthamoeba keratitis, eyelid foreign body, medicamentosa, and many others. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 27, 2019 Category: Opthalmology Authors: Joel Sugar Tags: Consultation section: Cataract Source Type: research

October consultation #3
This is a patient with recurrent unilateral epithelial keratopathy that is unresponsive to any medical treatment aside from a BCL. Although we are given the information that there is a verrucous growth on the left upper lid, we are never explicitly told of the appearance of the palpebral conjunctiva on left upper lid eversion. The appearance of whorls in the epithelium can indicate high turnover of epithelial cells from a recurrent trauma or limbal stem cell deficiency. BCLs provide protection of the cornea from mechanical irritation, leading us more down the path of recurrent mechanical trauma. (Source: Journal of Catarac...
Source: Journal of Cataract and Refractive Surgery - September 27, 2019 Category: Opthalmology Authors: Aman Mittal, Gene Kim Tags: Consultation section: Cataract Source Type: research

October consultation #4
Given the history and figures, my first diagnosis would be superior limbic keratoconjunctivitis secondary to the left upper lid lesion. Certainly, I would also excise the verrucous growth of the left upper lid, and I would send the specimen for pathology and HPV detection. I would initiate main therapy according to the pathology of the lid lesion (eg, if HPV-positive, topical IFN α2b and retinoic acid or topical cidofovir have been recommended1; adding oral cimetidine might also be helpful2). For treatment of recurrent erosion of cornea, I would perform epithelial debridement with the use of a diamond burr to polish ...
Source: Journal of Cataract and Refractive Surgery - September 27, 2019 Category: Opthalmology Authors: Ladan Espandar Tags: Consultation section: Cataract Source Type: research

October consultation #5
This patient has a recurrent corneal epithelial defect. Typical causes of recurrent corneal epithelial defect include anterior epithelial basement membrane dystrophy (EBMD) and other corneal dystrophies associated with recurrent epithelial erosions,1 infectious causes, neurotrophic cornea, medicamentosa, floppy eyelid syndrome, and foreign bodies, among others. However, this patient is unique in that she does not have typical slitlamp findings associated with many corneal dystrophies; has been treated extensively for potential infectious causes without positive viral, bacterial, or other culture results; has intact corneal...
Source: Journal of Cataract and Refractive Surgery - September 27, 2019 Category: Opthalmology Authors: Michael Murri Tags: Consultation section: Cataract Source Type: research

October consultation #6
This is an interesting scenario of unilateral recurrent epithelial breakdown. We would begin with meticulous examination of the ocular surface with emphasis on the lids to pick up even mild abnormalities on the lid margin and lashes. A comprehensive dry-eye workup for both eyes comprising a Schirmer test and tear-film breakup time, detailed analysis of meibomian glands by an ocular surface analyzer, and tear matrix metalloproteinase-9 detection will add to our understanding of the case. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 27, 2019 Category: Opthalmology Authors: Manisha Acharya, Abhishek Dave Tags: Consultation section: Cataract Source Type: research

Editor's comment
The topical IFN α2b was discontinued after 3 months. The patient underwent epithelial debridement along with a small superior perilimbal conjunctival biopsy. The histological assessment of the epithelial cells and conjunctival tissue did not reveal any neoplastic elements in either specimen. Repeated bacterial/vir al cultures along with PCR for HPV, microsporidia, and herpetic viruses were all negative. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 27, 2019 Category: Opthalmology Authors: Majid Moshirfar Tags: Consultation section: Cataract Source Type: research

Erratum
In the March 2019 article, “Intraocular pressure changes before and after surgery for spontaneous in-the-bag intraocular lens dislocation” (J Cataract Refract Surg 2019; 45:305–311), there were errors in the names of the authors. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 27, 2019 Category: Opthalmology Tags: Erratum Source Type: research

Challenges of pediatric IOL implantation
Although childhood cataract is rare, it is the leading cause of treatable blindness, estimated to be the cause of 5% to 20% of pediatric blindness worldwide.1 This disability is gaining importance and is a primary topic of Vision 2020: The Right to Sight, a global initiative of the International Agency for the Prevention of Blindness and the World Health Organization, the aim of which is to end avoidable vision loss. The biological characteristics of children's eyes make the treatment of pediatric cataracts particularly challenging. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 27, 2019 Category: Opthalmology Authors: Thomas Kohnen Tags: From the editor Source Type: research

Editorial Board
(Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 27, 2019 Category: Opthalmology Source Type: research

Masthead
(Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 27, 2019 Category: Opthalmology Source Type: research

Table of Contents
(Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 27, 2019 Category: Opthalmology Source Type: research

Visual Acuity Chart
(Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 27, 2019 Category: Opthalmology Source Type: research

Extended Depth-of-Focus Technology in Intraocular Lenses
The extended depth-of-focus (EDF) intraocular lens (IOL) is an emerging technology that is designed to improve range of vision, especially at intermediate distances. In this short review, we describe the clinical performance of four emerging EDF IOL technologies: small aperture design, bioanalogic IOL, diffractive optics, and non-diffractive optical manipulations. The American Academy of Ophthalmology has generated a consensus statement for EDF IOLs that provided benchmarks and recommendations for classifying an implant as an EDF IOL and provided standardized testing criteria for evaluating performance. (Source: Journal of...
Source: Journal of Cataract and Refractive Surgery - September 18, 2019 Category: Opthalmology Authors: Thomas Kohnen, Rajaraman Suryakumar Source Type: research

Comparison of Accelerated Crosslinking Alone, Accelerated Crosslinking with Simultaneous Intrastromal Corneal Ring Segments, and Accelerated Crosslinking with Simultaneous Topography-Guided Photorefractive Keratectomy in Progressive Keratoconus and Other Corneal Ectasias: A Prospective Non-Randomized Interventional Study
To compare accelerated collagen crosslinking (CXL) alone, CXL with simultaneous intrastromal corneal ring segments (CXL-ICR), and CXL with simultaneous topography-guided photorefractive keratectomy (CXL-TG-PRK) in progressive keratoconus, pellucid marginal degeneration (PMD) or laser in-situ keratomileusis (LASIK)-induced ectasia. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 12, 2019 Category: Opthalmology Authors: Neera Singal, Stephan Ong Tone, Raymond Stein, Matthew C. Bujak, Clara C. Chan, Hall F. Chew, Sherif El-Defrawy, Yaping Jin, Christoph Kranemann, Theodore Rabinovitch, David S. Rootman, Allan R. Slomovic, Ashley Cohen, David Dai, Wendy Hatch Source Type: research

Factors Predicting Successful Customized Excimer Laser Treatment in Irregular Cornea
To identify factors associated with a successful wavefront-guided customized treatment (WG-CT) with excimer laser in highly aberrated corneas. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 12, 2019 Category: Opthalmology Authors: Rana Hanna, Michael Mimouni, Ana Belen Plaza, Jorge L. Ali ó Source Type: research

Femtosecond laser with integrated anterior segment optical coherence tomography as a tool to detect pre-existing posterior capsular dehiscence and increase safety in posterior polar cataracts
To determine the efficacy of femtosecond integrated anterior segment optical coherence tomography (ASOCT) for the detection of posterior capsular dehiscence in posterior polar cataracts (PPC). To evaluate the safety of phacoemulsification in these eyes undergoing Femtosecond Laser Assisted Cataract Surgery (FLACS). (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 12, 2019 Category: Opthalmology Authors: Prof (Dr.) Mahipal S. Sachdev, Dr. Raghav Malik, Dr. Hemlata Gupta, Dr. Ritika Sachdev, Dr. Gitansha Shreyas Sachdev Source Type: research

Transient corneal ectasia after phacoemulsification in an eye with INTRACOR
We report a case of transient corneal ectasia developed after phacoemulsification in an eye previously treated with INTRACOR. There was a myopic refractive surprise after the cataract surgery. Corneal tomography showed an increase in keratometry and elevation profile compared to preoperative exam. Soft contact lens and intraocular pressure lowering medications were prescribed as interim treatment. Clinical improvement was seen gradually, and resolution of myopia and ectasia was achieved at 3 months. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 10, 2019 Category: Opthalmology Authors: Tommy CY. Chan, Jason CK. Chan, Nai-Man Lam, John SM. Chang Source Type: research

The Risk of Posterior Capsule Rupture during Phacoemulsification Cataract Surgery in Eyes with Previous Intravitreal Anti Vascular Endothelial Growth Factor Injections.
Prior intravitreal anti-VEGF injections are a significant under reported risk factor for posterior capsule rupture during cataract surgery. There is a dose related risk which is statistically and clinically significant. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 10, 2019 Category: Opthalmology Authors: Anindyt M. Nagar, Joshua Luis, Nimrath Kainth, Georgios D. Panos, Cordelia J. Mckechnie, Sudeshna Patra Source Type: research

Phacoemulsification in eyes with Long Anterior Zonules
To study the safety of phacoemulsification in eyes with long anterior zonules [LAZ]. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 10, 2019 Category: Opthalmology Authors: Mona Khurana, Deep Dashrathbhai Shah, Ronnie Jacob George, Lingam Vijaya, Shantha Balekudaru Source Type: research

Safety and efficacy of a small aperture capsular bag fixated intraocular lens in eyes with severe corneal irregularities
Intraocular lens (IOL) surgery in eyes with severe corneal irregularities is challenging. The aim of this study was to implant a small aperture lens (IC-8, Acufocus) in these cases to reduce high order aberrations and provide better central visual acuity. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 7, 2019 Category: Opthalmology Authors: Mehdi Shajari, Marc J. Mackert, Julian Langer, Thomas Kreutzer, Armin Wolf, Thomas Kohnen, Siegfried Priglinger, Wolfgang J. Mayer Source Type: research

Transient Effect of Suction on Retinal Neuro-vasculature in Myopic Patients after Small Incision Lenticule Extraction
To characterize retinal neuro-vasculature changes after small incision lenticule extraction (SMILE) in myopic patients. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - September 7, 2019 Category: Opthalmology Authors: Jiayan Liu, Rahul Singh Tonk, Amy Michelle Huang, Elaine Han, Carol L. Karp, Minzhi Zeng, Huyong Zou, Yu Zheng, Wei Luo, Xiangyin Sha, Zhiping Liu Source Type: research

Crystalline lens changes after selective laser trabeculoplasty in Afro-Caribbean patients with open-angle glaucoma; report 4 of the West Indies Glaucoma Laser Study (WIGLS)
To characterize changes in nuclear, cortical, and posterior subcapsular lens opacities after selective laser trabeculoplasty (SLT) in Afro-Caribbean eyes with primary open-angle glaucoma (POAG). (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - August 30, 2019 Category: Opthalmology Authors: Tony Realini, Hazel Shillingford-Ricketts, Darra Burt, Goundappa K. Balasubramani Tags: Article Source Type: research

Bag-in-the-lens implantation helps avoid posterior synechiae of the iris after phacovitrectomy
To compare the rate of posterior synechiae of the iris  (PSI) occurrence after phacovitrectomy between a group with lens-in-the-bag (LIB) implantation, that is, implantation in the capsular bag, and a group with bag-in-the-lens (BIL) implantation. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - August 30, 2019 Category: Opthalmology Authors: Cl ément Auchère Lavayssiere, Anne-Laure Lux, Guillaume Beraud, Alice Degoumois, Christian Billotte, Éric Denion Tags: Article Source Type: research

Comparison of formulas accuracy for iol power calculation based on measurements by a swept-source optical coherence tomography optical biometer
Older and newer formulas provide accurate IOL power calculations when using SS-OCT optical biometer measurements. More than 80% of eyes are expected to have a prediction error within 0.50 D. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - August 30, 2019 Category: Opthalmology Authors: Giacomo Savini, Kenneth J. Hoffer, Nicole Balducci, Piero Barboni, Domenico Schiano-Lomoriello Source Type: research

West Indies Glaucoma Laser Study (WIGLS) 4. Crystalline Lens Changes Following Selective Laser Trabeculoplasty in Afro-Caribbeans with Open-Angle Glaucoma
Selective laser trabeculoplasty therapy is not associated with progressive nuclear, cortical, or posterior subcapsular lens opacities through 3 years of follow-up in Afro-Caribbean eyes with open-angle glaucoma. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - August 30, 2019 Category: Opthalmology Authors: Tony Realini, Hazel Shillingford-Ricketts, Darra Burt, Goundappa K. Balasubramani Source Type: research

Bag-in-the-lens implantation avoids posterior synechiae of the iris after phacovitrectomy
To compare the rate of occurrence of posterior synechiae of the iris (PSI) after phacovitrectomy between a group with Lens-In-the-Bag (LIB) implantation, i.e. implantation in the capsular bag and a group with Bag-In-the-Lens (BIL) implantation. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - August 30, 2019 Category: Opthalmology Authors: Cl ément Auchère Lavayssiere, Anne-Laure Lux, Guillaume Beraud, Alice Degoumois, Christian Billotte, Éric Denion Source Type: research

Nuclear scaffold technique: The three-dimensional indigenous capsular bag support used in conjunction with intraocular lens scaffold and capsular tension ring to prevent posterior capsule rupture in zonulopathy
We describe a technique for performing phacoemulsification in zonular dehiscence less than 90 degrees by using hard nuclear fragments as a scaffold. In this technique, in conjunction with capsular tension ring (CTR), hard nuclear fragments and intraocular lens (IOL) are used as scaffolds during different steps of nuclear emulsification to prevent posterior capsule rupture and aggravation of zonulopathy. Devices such as capsular hooks, CTR, and IOLs are used to support capsular bag associated with zonulopathy. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - August 30, 2019 Category: Opthalmology Authors: Rohit Om Parkash, Shruti Mahajan, Tushya Om Parkash, Tushar Om Parkash, Milan Rai Source Type: research

Visual performance and positional stability of a capsulorhexis fixated EDOF IOL
Six month outcomes following FLACS capsulotomy assisted cataract surgery and insertion of the FEMTIS Comfort MF15 (EDOF) capsule-fixated IOL demonstrated excellent refractive predictability, minimal IOL shift and high patient satisfaction. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - August 30, 2019 Category: Opthalmology Authors: Erica Darian-Smith, Patrick Versace Source Type: research

Anterior Chamber Lens Sizing: A Comparison of White-to-White and Scleral-Spur-to-Scleral-Spur Methods
Horizontal white-to-white measurement without adjustment most accurately represents anterior chamber sizing. Vertical meridian lens orientation may minimize complications when placing an anterior chamber intraocular lens. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - August 29, 2019 Category: Opthalmology Authors: Cameron Bruner, David F. Skanchy, John P. Wooten, Alice Z. Chuang, Gene Kim Source Type: research

Reasons for Explantation, Demographics and Material analysis of 200 Intraocular Lens explants
This retrospective cross-sectional study of 200 explanted intraocular lenses (IOL) reveals the major cause for explantation to be late-postoperative IOL calcification. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - August 29, 2019 Category: Opthalmology Authors: Tabitha Neuhann, Timur M. Yildirim, Hyeck-Soo Son, Patrick R. Merz, Ramin Khoramnia, Gerd U. Auffarth Source Type: research

Quantification of residual ophthalmic viscosurgical device after irrigation/aspiration in experimental cataract surgery in  vitro
To determine the distribution and quantity of ophthalmic viscosurgical device (OVD) retained in the lens capsular bag after irrigation/aspiration (I/A) in experimental cataract surgery. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - August 28, 2019 Category: Opthalmology Authors: Hisato Gunji, Tetsutaro Ohki Tags: Laboratory science Source Type: research

Comparative meta-analysis of toric intraocular lens alignment accuracy in cataract patients: Image-guided system versus manual marking
This meta-analysis studied toric intraocular lens (IOL) alignment accuracy using image-guided and manual marking methods by comparing the axis misalignment of toric IOLs, percentage of eyes with toric IOL axis misalignment within ±5 degrees, postoperative astigmatism, difference vector, and postoperative uncorrected distance visual acuity. The methodological quality was assessed using the modified Quality Assessment of Diagnostic Accuracy Studies-2 tool. Continuous variables were analyzed using weighted mean differences, an d dichotomous variables were compared using the odds ratio. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - August 28, 2019 Category: Opthalmology Authors: Fengqi Zhou, Wu Jiang, Zhuoling Lin, Xiaoyan Li, Jing Li, Haotian Lin, Weirong Chen, Qiwei Wang Tags: Review/Update Source Type: research

Posttraumatic posterior capsular defect: Assessment of 3 cases
Traumatic cases in ophthalmology are of special concern. The extent of injury can vary from simple superficial epithelial defect to gross ocular avulsions, or from a simple concussion injury to a penetrating injury. In cases of blunt trauma, the manifestations are variable, and amongst the many complications, lenticular injuries require detailed evaluation. The usual lens injuries are opacification of lens matter, with or without any capsular discontinuity; however, in the presence of media opacity, the assessment of posterior capsular integrity is a difficult task. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - August 28, 2019 Category: Opthalmology Authors: Amar Pujari, Namrata Sharma Tags: Correspondence Source Type: research

Long-term effects of mitomycin-C on residual aberration and optical quality after photorefractive keratectomy in eyes with low to moderate myopia
The introduction of mitomycin-C (MMC) has improved the outcomes of photorefractive keratectomy (PRK) by preventing haze formation and reducing light scatter.1 Mitomycin-C is routinely used when the ablation depth goes beyond certain limits (eg, ablations deeper than 60  mm) and in hyperopic and highly toric ablations.2 Some surgeons use MMC for every excimer laser ablation regardless of the intended correction. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - August 28, 2019 Category: Opthalmology Authors: Seyed Farzad Mohammadi, Tahereh Abdolahinia, Elham Ashrafi, Somayeh Heydari, Sepideh Jamali Tags: Correspondence Source Type: research

Reply
In his letter, Dr. Packard states that the recorded incision enlargements might not reflect the true incision size for each injector. It is true that every measurement system has uncertainty, and our study might have been limited by the resolution of the ruler and the stability of the human hand. To mitigate this issue, we used very thin purpose-made F-gauges with rounded edges to prevent incision enlargement. The F-gauges were designed to increase in increments of 0.1  mm (±0.01 mm) to allow precise assessment of the width of the incision. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - August 28, 2019 Category: Opthalmology Authors: Alejandro Arboleda, Esdras Arrieta, Mariela C. Aguilar, Krystal Sotolongo, Derek Nankivil, Jean-Marie A. Parel Tags: Letters Source Type: research

Postoperative variations in intraocular lens injector dimensions and corneal incisions
In their article, Arboleda et  al.1 describe a study of rabbit eyes comparing 13 intraocular lens (IOL) injectors and their effect on clear corneal wounds. Various measurements of the size of the injectors were taken, and these were then related to the size of incision needed for the injectors to pass through. All initials inci sions were 1.8 mm; they were then enlarged with the same knife used to make the initial incision. The authors state that incision enlargement was performed in 0.1 mm increments. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - August 28, 2019 Category: Opthalmology Authors: Richard Packard Tags: Letters Source Type: research

Toric implantable collamer lens implantation in a patient with keratoconus
A 39-year-old woman was seen because of dissatisfying results after an implantable collamer lens (ICL) (Visian ICL, STAAR Surgical Co.) implantation in the left eye. The ICL implantation was performed in 2017 because of stable keratoconus with contact lens intolerance. The preoperative corrected distance visual acuity (CDVA) was 20/25 in the right eye ( −1.25 −3.0 × 40) and 20/25 in the left eye (−0.25 −7.25 × 145). A 13.7 mm ICL (−7.5 +6.0 × 54) was implanted in the left eye at the horizontal axis. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - August 28, 2019 Category: Opthalmology Authors: Rudy M.M.A. Nuijts, Isabelle E.Y. Saelens Tags: Consultation section: Refractive Source Type: research

September consultation #2
Toric ICL is a safe and effective alternative for astigmatism correction with a good rotational stability1; however, it is well known that its diameter calculation could be problematic and could lead to vault-related complications, more importantly, in keratoconus cases. This occurs because sulcus-to-sulcus (STS) and white-to-white (WTW) measurements do not always have a predictable and reliable correlation and different devices have important WTW measurement variability.2 (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - August 28, 2019 Category: Opthalmology Authors: Andrea C órdoba, Alejandro Navas Tags: Consultation section: Refractive Source Type: research

September consultation #3
The implantation of an ICL for myopia and myopic astigmatism in eyes with keratoconus has a great potential to end with an unpredictable outcome because of cone, irregular astigmatism, and instable refraction. Changing refraction and progression of the disease because of the biomechanically instable cornea causes fluctuation in vision. In the presented case, a hypervault of the implanted ICL also caused pigment dispersion and an imprecise refractive outcome. Because the patient reports blurry vision with diplopia in the left eye, a surgical correction is warranted. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - August 28, 2019 Category: Opthalmology Authors: Thomas Kohnen Tags: Consultation section: Refractive Source Type: research

September consultation #4
The blurry vision and diplopia are most likely attributable to corneal irregularities secondary to the keratoconus. Although the toric ICL might improve the regular astigmatic component, assuming it will stay in the correct axis, it does nothing to improve higher-order aberrations (HOAs). (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - August 28, 2019 Category: Opthalmology Authors: Donald R. Sanders Tags: Consultation section: Refractive Source Type: research