Journal of Cataract and Refractive Surgery This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Remarkable reduction of precipitates on intraocular lenses by oral macrolide antibiotics
In the course of clinical practice, we noted that patients who had taken oral clarithromycin to treat bronchitis showed considerable reduction of intraocular lens (IOL) precipitates and subjective improvement in visual function. Thus far, methods for cleaning IOLs are limited to surgical intervention (eg, scraping or IOL extraction). Regardless of attempts to surgically clean IOLs by scraping, precipitates immediately return; therefore, IOL extraction and reimplantation remains the sole approach for recovery of visual function. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - November 30, 2019 Category: Opthalmology Authors: Kazuichi Maruyama, Hirokazu Sakaguchi, Shizuka Koh, Kohji Nishida Tags: Correspondence Source Type: research

Controversies on the use of nonsteroidal antiinflammatory drugs and steroids in pseudophakic cystoid macular edema prophylaxis
Regarding the article by Laursen et  al.,1 we believe some discussion is required. Specifically, the authors reviewed the current available evidence on the prevention of macular edema in patients with diabetes having cataract surgery. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - November 30, 2019 Category: Opthalmology Authors: Andrzej Grzybowski, Piotr Kanclerz Tags: Letters Source Type: research

Reply
Our analysis included almost 900 patients across 6 random clinical trials. The main conclusion was that NSAIDs with or without topical steroids were superior to topical steroids alone in preventing PCME in patients with diabetes without macular edema before surgery. We previously found similar results for nondiabetic patients in a systematic review and meta-analysis1 performed before the conclusion of the PREMED study.2,3 (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - November 30, 2019 Category: Opthalmology Authors: Sophie Bryde Laursen, Jesper H øiberg Erichsen, Lars Morten Holm, Line Kessel Tags: Letters Source Type: research

New device for ciliary sulcus suture fixation of intraocular lens
Sugiura et  al.1 described a new device, the Ciliary Sulcus Pad Injector (Duckworth& Kent Ltd.), for ciliary sulcus suture fixation. They sought to show the superiority of this new instrument compared with preexisting techniques2,3 for ciliary sulcus suture fixation of an intraocular lens (IOL). In both ab interno fixation and ab externo fixation, the needle is blindly inserted in the ciliary sulcus, leading to a high risk for complications (eg, ciliary body bleeding). Sugiura et  al. developed the Ciliary Sulcus Pad Injector as a safer instrument for piercing the ciliary sulcus. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - November 30, 2019 Category: Opthalmology Authors: Marco Nardi, Giuseppe Covello, Michele Figus, Chiara Posarelli Tags: Letters Source Type: research

Reply
The reference I used to make the Ciliary Sulcus Pad Injector was the needle injector produced by Rumex Co. I was not aware of the Trimarchi injector, which is very similar to the Rumex needle injector. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - November 30, 2019 Category: Opthalmology Authors: Takeshi Sugiura Tags: Letters Source Type: research

Smartphone-aided technique to quantify toric intraocular lens alignment
Toric intraocular lens (IOL) alignment along the desired axis is of paramount importance for accurate visual and refractive outcomes. Judicious preoperative planning and precise execution intraoperatively are the key factors that determine the IOL orientation postoperatively. After surgery, the position of the IOL with respect to the desired axis is usually confirmed on slitlamp examination; however, additional methods have been described. These methods include anterior segment optical coherence tomography, use of the editing function of Photoshop (Adobe), and use of a refractive power –corneal analyzer system. (Source: ...
Source: Journal of Cataract and Refractive Surgery - November 30, 2019 Category: Opthalmology Authors: Amar Pujari, Saumya Yadav, Ritika Mukhija, Jayanand Urkude, Namrata Sharma Tags: Correspondence Source Type: research

Handshake riveting flanged technique for Yamane method of intrascleral fixation of an intraocular lens
Yamane et  al.1 described the flanged double-needle technique for secured transscleral fixation of an intraocular lens (IOL). Effortless externalization of the trailing haptic is a concern, and various modifications have been described.2–5 The handshake technique to facilitate trailing haptic externalizati on has been described for a glued variant of the secondary IOL fixation method.6,7 Kusaka et al.8 described a riveting technique for iridodialysis repair in which the flanged and riveted ends of the suture hold the peripheral iris tissue in place. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - November 30, 2019 Category: Opthalmology Authors: Priya Narang, Amar Agarwal Tags: Correspondence Source Type: research

Partial-thickness scleral tethering suture for optimum fixation and centration of transscleral-sutured intraocular lens –capsule complex
We describe a surgical technique for fine-tuning the centration of a transscleral-sutured modified capsular tension ring (CTR) –intraocular lens–capsular bag complex using a partial-thickness scleral tethering suture placed posterior to the external episcleral portion of a transscleral suture loop. The technique can be used for adjusting the centration of any intraocular supporting or prosthetic device that is transscle rally sutured in a “hanging” technique, such as capsular tension segments, modified CTRs, capsular anchoring devices, or iris prostheses. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - November 30, 2019 Category: Opthalmology Authors: Bo Li, Michael E. Snyder Tags: Technique Source Type: research

Cataract surgery operating times: Relevance to surgical and visual outcomes
In a public health system, such as the United Kingdom's National Health Service (NHS), “time is money.” Thus, it was reassuring for our group that over the 5-year duration of the Nderitu and Ursell study,1 the increase in operating room efficiency and surgical techniques enabled a timesaving of 3 minutes per case. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - November 30, 2019 Category: Opthalmology Authors: Cheng F. Kong, Brendon W.H. Lee, Adarsh George, Melvin L.H. Ling, Neeranjali S. Jain, Ian C. Francis Tags: Letters Source Type: research

Reply
We concur that it is important to maintain high-quality cataract surgery. Indeed, we could not agree more that there should be an uncompromising focus on achieving the best possible visual outcomes for patients and on minimizing complications. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - November 30, 2019 Category: Opthalmology Authors: Paul Nderitu, Paul Ursell Tags: Letters Source Type: research

Refractive surprise after phacoemulsification in a post-laser in situ keratomileusis case
A 52-year-old woman presented with a history of cataract surgery performed 3 months prior. The patient presented with a refractive surprise of +2.00 −2.5 × 75. Her uncorrected distance visual acuity (UDVA) was 20/80 (Snellen) and the corrected distance visual acuity (CDVA) was 20/30. A detailed history revealed that the patient had undergone a laser in situ keratomileusis (LASIK) procedure approximately 20 years ago. Case sheets revealed that a +24 diopter (D) monofocal foldable intraocular lens (IOL) was implanted, and on clinical evaluation, it was found to be well placed in the capsular bag (Figure 1). (Source: Journ...
Source: Journal of Cataract and Refractive Surgery - November 30, 2019 Category: Opthalmology Authors: Marcony R. Santhiago, Priya Narang, Amar Agarwal Tags: Consultation Section: Refractive Source Type: research

December consultation #2
It is important to consider both corneal and intraocular approaches to resolve such a case. One treatment option is a LASIK procedure. It is possible, even 20 years after the initial refractive procedure, to lift the LASIK flap and apply a new treatment on the residual estromal bed. However, this approach is neither typical nor easy to execute in such cases because of the length of time elapsed since the first LASIK procedure, which puts the integrity of the previous flap at risk. There is also a greater possibility of epithelial growth in the interface because of the manipulation of a long-existing scar. (Source: Journal ...
Source: Journal of Cataract and Refractive Surgery - November 30, 2019 Category: Opthalmology Authors: Jos é Beniz, Luiz Arthur F. Beniz Tags: Consultation Section: Refractive Source Type: research

December consultation #3
I have seen multiple cases like this over the years, and as much as I would have liked to apportion blame to the IOL surgery, each time it has come down to the cornea or tear film. The devices that most help to resolve these difficult cases are wavefront aberrometers, such as the iTrace (Tracey Technologies), OPD Scan III (Maraco), or KR-1W (Topcon), which separate the whole-eye wavefront from the corneal wavefront, and the HD Analyzer (Visiometrics S.L.), which separates the whole-eye ocular scatter index (OSI) from the tear film OSI. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - November 30, 2019 Category: Opthalmology Authors: Arthur Cummings Tags: Consultation Section: Refractive Source Type: research

December consultation #4
This is a classic hyperopic refractive surprise after cataract surgery in a patient who has undergone myopic laser vision correction in the past. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - November 30, 2019 Category: Opthalmology Authors: A. John Kanellopoulos Tags: Consultation Section: Refractive Source Type: research

December consultation #5
New IOL calculation formulas have improved visual outcomes in patients undergoing cataract surgery with a history of previous LASIK. However, the preoperative examination is critical in understanding whether other factors may impact a patient ’s final visual outcome. Patient’s with a history of previous LASIK expect that, following cataract surgery, their vision will return to excellent UCVA and CDVA. The preoperative examination can help identify whether there are abnormalities in the corneal shape that may be contributing to a pati ent’s reduced CDVA. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - November 30, 2019 Category: Opthalmology Authors: William Trattler Tags: Consultation Section: Refractive Source Type: research