Reply
If researchers choose a 1-sided test, they must select which of the 2 options they think is most appropriate based on their expectation of the result. Therefore, this decision must be made before any descriptive exploration of the data. The choice  must rely on an assumption of a certain direction or outcome that is confirmed by robust research before the decision is made.1 Furthermore, 1-sided tests have more statistical power if you have a strong rationale for the directionality of a difference/relationship. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - May 28, 2019 Category: Opthalmology Authors: Mathias V. Melega, Monica Alves, Rodrigo Pessoa Cavalcanti Lira, Iuri Cardoso da Silva, Bruna Gil Ferreira, Hermano L.G. Assis Filho, Fernando Rodrigo Pedreira Chaves, Alexandre A.F. Martini, Livia Maria Dias Freire, Roberto dos Reis, Carlos Eduardo Leite Tags: Letters Source Type: research

Impact of preoperative corneal astigmatism on visual performance after multifocal intraocular lens implantation
In their study, Lee et  al.1 evaluated the outcomes of conventional phacoemulsification and femtosecond laser–assisted cataract surgery with multifocal intraocular lens (IOL) implantation. In the study, patients were divided into the following 3 groups: (1) femtosecond, (2) femtosecond with arcuate keratotomy, and ( 3) conventional phacoemulsification. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - May 28, 2019 Category: Opthalmology Authors: Hossein Aghaei, Acieh Es'haghi Tags: Letters Source Type: research

Steering evolution
One of the most critical tools for refractive cataract surgeons is arguably the intraocular lens (IOL) power calculation. It is our decoder for optimal IOL selection and a preoperative and intraoperative guide leading us to the best possible refractive outcome. Advances in the methodology and capabilities of these vital calculations have evolved tremendously in recent years, moving our calculations closer to prediction than estimation. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - May 28, 2019 Category: Opthalmology Authors: Thomas Kohnen Tags: From the editor Source Type: research

Reply
We were not aware of the paper or the meeting presentations when we submitted our manuscript. Our cataract grading concept was developed by Joao Br ás and Wolfgang Sickenberger in cooperation with Carl Zeiss Meditec AG. Although the concept by Panthier et al. also uses images of the lens taken with the same SS-OCT device, the algorithm for the cataract quantification is quite different. We used raw data of the scans and our own algorithm, whi ch was coded in MATLAB. The high resolution and contrast of the SS-OCT images of the lens lend themselves to this kind of analysis, so it is not astonishing that several research gr...
Source: Journal of Cataract and Refractive Surgery - May 28, 2019 Category: Opthalmology Authors: Oliver Findl, Jo ão E.G. Brás, Wolfgang Sickenberger, Nino Hirnschall Tags: Letters Source Type: research

Cataract quantification using swept-source optical coherence tomography
The stated purpose of the study by Br ás et al.1 was to develop and evaluate a cataract quantification method using a swept-source optical coherence tomography (SS-OCT) device (IOLMaster 700, Carl Zeiss Meditec AG). We were disappointed that the authors failed to cite our article published in your journal in December 2017,2 well befor e the submission of their paper at the end of March 2018. Our abstract explicitly states the purpose of our study: “To assess a new objective cataract grading method based on lens densitometry on swept-source optical coherence tomography…scans provided by the IOLMaster 700.” We showed...
Source: Journal of Cataract and Refractive Surgery - May 28, 2019 Category: Opthalmology Authors: Christophe Panthier, Alain Saad, Helene Rouger, Damien Gatinel Tags: Letters Source Type: research

Reply
Seiler et  al. apparently overlooked that our study was registered with clinicaltrials.gov, which can be confirmed using the registration number reported in our paper (NCT01956474).A They are also mistaken about the design of other registered CXLUSA trials, none of which include an epi-off control arm. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - May 28, 2019 Category: Opthalmology Authors: R. Doyle Stulting, William B. Trattler, Jonathan M. Woolfson, Roy S. Rubinfeld Tags: Letters Source Type: research

A simple tool to assess an implantable collamer lens vault
Smartphone-based ocular imaging is gaining immense importance at present. Better quality smartphone camera applications, reasonable cost, and easy handling make this instrument a quicker and reliable tool for ophthalmic imaging. Smartphones alone might not be able to capture the magnified high-definition (HD) images of the anterior or posterior segment, but a simple attachment can make it very easy. Previously, we described the smartphone –macro lens combination to acquire better quality images of the anterior as well as posterior segments and also the quantification of iris torsion. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - May 28, 2019 Category: Opthalmology Authors: Amar Pujari, Alisha Kishore, Tarjani Makwana, Namrata Sharma Tags: Correspondence Source Type: research

Corneal crosslinking without epithelial removal
Stulting et al.1 recently reported 2-year data from a proprietary epithelium-on (epi-on) corneal crosslinking (CXL) protocol clinical trial. They stated, “Epithelium-on CXL using this new protocol halted the progression of keratoconus and ectasia after LASIK. It was safer and provided more rapid visual recovery than CXL with epithelial removal…” (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - May 28, 2019 Category: Opthalmology Authors: Theo Seiler, J. Bradley Randleman, Paolo Vinciguerra, Farhad Hafezi Tags: Letters Source Type: research

Photo Award
Category: Fluorescein Angiography –2nd Place (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - May 28, 2019 Category: Opthalmology Source Type: research

Progression in a patient with subclinical keratoconus: Is corneal crosslinking necessary?
This case concerns a 25-year-old man who was followed up in our cornea department for 4  years. Corneal crosslinking (CXL) was performed in the left eye because of progressive clinical keratoconus 2 years prior. The corrected distance visual acuity (CDVA) in the left eye was 16/20 with the correction of the manifest refraction, which was −1.00 −2.00 @ 120. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - May 28, 2019 Category: Opthalmology Authors: Kemal Tekin, Mustafa Koc Tags: Correspondence Source Type: research

Prevention of macular edema in patients with diabetes after cataract surgery
To evaluate the efficacy of topical steroids  ± nonsteroidal antiinflammatory drugs (NSAIDs), depot steroids, and antivascular endothelial growth factors (anti-VEGFs) in preventing pseudophakic cystoid macular edema (PCME) after cataract surgery in patients with diabetes, a systematic literature search for randomized controlled trials publi shed after 1990 was carried out in Cochrane, EMBASE, and PubMed databases. A meta-analysis was performed using risk ratios for PCME as the primary outcome and visual acuity, macular thickness, and adverse events as the secondary outcomes. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - May 28, 2019 Category: Opthalmology Authors: Sophie Bryde Laursen, Jesper H øiberg Erichsen, Lars Morten Holm, Line Kessel Tags: Review/Update Source Type: research

Progressive corneal ectasia after LASIK in an eye that already had intrastromal corneal ring segments implantation and corneal crosslinking
A highly symptomatic 37-year-old man was referred, reporting blurred vision in the right eye and history of bilateral laser in situ keratomileusis (LASIK) surgery years ago. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - May 28, 2019 Category: Opthalmology Authors: Marcony R. Santhiago Tags: Consultation section: Refractive Source Type: research

June consultation #2
There are not any specific medical and/or surgical treatments including CXL and/or penetrating keratoplasty (PKP) that can confidently claim halting the progression of ectasia over a span of several decades. This patient had LASIK at the age of 25. However, we do not have information concerning the initial attempted correction or know whether femtosecond or microkeratome was used to create the flap. He has already undergone ICRS implantation and CXL. OCT is reflecting a thick flap of 189 μm with thinnest part of the cornea being 423 μm on the pachymetric map. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - May 28, 2019 Category: Opthalmology Authors: Majid Moshirfar Tags: Consultation section: Refractive Source Type: research

June consultation #3
If there is continued progression in a post-LASIK ectasia patient who has undergone CXL once, I would try to achieve stability with repeat CXL. It is not clear which type  of CXL this patient failed, but if he did not have epi-off CXL, I would perform this and monitor closely for diffuse lamellar keratitis or corneal melt. If for some reason the patient could not have epi-off CXL, I would recommend transepithelial CXL. I would monitor the riboflavin loading step ca refully to ensure adequate riboflavin penetration. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - May 28, 2019 Category: Opthalmology Authors: Nicole Lemanski Tags: Consultation section: Refractive Source Type: research

June consultation #4
Keratectasia occurred in this case obviously because of the thick flap (423 μm − 189 μm means that the residual stromal bed thickness is 234 μm). This also explains the nonresponse to CXL. Hatami-Marbini and Jayaram1 showed that during CXL, only the anterior part of the cornea is stiffened, which means that mainly the flap was crosslinked with minor influence on the ov erall stiffness of the cornea. Another standard CXL would not make a difference, and a deeper CXL (longer imbibition, more ultraviolet-A) might become dangerous for the endothelium. (Source: Journal of Cataract and Refractive Surgery)
Source: Journal of Cataract and Refractive Surgery - May 28, 2019 Category: Opthalmology Authors: Theo G. Seiler, Theo Seiler Tags: Consultation section: Refractive Source Type: research