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.

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 candidate...
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 the s...
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