SciCombinator

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Journal: Journal of cataract and refractive surgery

168

We present an overview of currently available toric intraocular lenses (IOLs) and multifocal toric IOLs. Relevant patient selection criteria, IOL calculation issues, and surgical techniques for IOL implantation are discussed. Clinical outcomes including uncorrected visual acuity, residual refractive astigmatism, and spectacle independency, which have been reported for both toric IOLs and multifocal toric IOLs, are reviewed. The incidence of misalignment, the most important complication of toric IOLs, is determined. Finally, future developments in the field of toric IOLs are discussed. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Concepts: Refractive error, Lens, Ophthalmology, Contact lens, Presbyopia, Cataract, Toric lens, Intraocular lens

167

PURPOSE: To compare the visual outcomes of additional multifocal intraocular lenses (IOLs) for sulcus fixation with those of standard multifocal IOLs in the capsular bag. SETTING: Department of Ophthalmology, Rudolf-Virchow-Klinikum Glauchau, Glauchau, Germany. DESIGN: Prospective controlled clinical trial. METHODS: Eyes had phacoemulsification and implantation of a monofocal IOL in the capsular bag and an additional aberration-free diffractive IOL in the ciliary sulcus (multifocal add-on IOL group). Measurements of uncorrected and distance-corrected distance, intermediate, and near visual acuities; contrast sensitivity; and defocus curve were performed 3 months postoperatively. Results were compared with those in eyes with an aberration-correcting diffractive posterior chamber IOL (multifocal PC IOL group). RESULTS: The multifocal add-on IOL group comprised 34 eyes of 20 patients and the multifocal PC IOL group, 31 eyes of 17 patients. Cataract surgery, IOL implantation, and the postoperative course were uneventful in all cases. There were no statistically significant differences in uncorrected and distance-corrected distance, intermediate, or near visual acuities between the 2 groups. The median uncorrected distance visual acuity was 0.00 logMAR in both groups, and the median uncorrected near visual acuity was 0.10 logMAR in both groups. Contrast sensitivity testing yielded significantly better results in the multifocal add-on IOL group, especially at spatial frequencies over 1.5 cycles per degree. Defocus curves were similar in the 2 groups. CONCLUSION: Visual performance with a multifocal diffractive add-on IOL was equivalent to that achieved with a commonly used multifocal diffractive PC IOL. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Concepts: Eye surgery, Statistical significance, Contact lens, Ophthalmology, Lens, Visual acuity, Cataract, Intraocular lens

30

To assess the safety and efficacy of a 0.38% submicron formulation of loteprednol etabonate (LE) gel for the treatment of postoperative inflammation and pain after cataract surgery.

29

To determine the contribution of posterior corneal astigmatism to total corneal astigmatism and the error in estimating total corneal astigmatism from anterior corneal measurements only using a dual-Scheimpflug analyzer.

Concepts: Astigmatism

28

This literature review looks at the current status of multifocal intraocular lenses (IOLs) in cataract surgery. The results of implantation of multifocal IOLs of diffractive, refractive, and hybrid diffractive-refractive design are described with regard to uncorrected near and distance visual acuity and spectacle independence. The occurrence of photic phenomena and contrast sensitivity loss with multifocal IOLs are also addressed. FINANCIAL DISCLOSURE: Neither author has a financial or proprietary interest in any material or method mentioned.

Concepts: The Current, Corrective lenses, Eye surgery, Contact lens, Ophthalmology, Cataract, Visual acuity, Intraocular lens

28

To assess the long-range outcomes of photorefractive keratectomy (PRK) using functional and topographic criteria in myopic eyes with suspected keratoconus.

Concepts: Phototherapeutic keratectomy, Myopia, Ophthalmology, LASIK, Photorefractive keratectomy

28

To objectively measure the strength of the capsulotomy performed with a femtosecond laser-assisted technique or performed manually in a pig-eye laboratory study.

Concepts: Manual transmission

28

PURPOSE: To assess the repeatability and accuracy of optical biometry (Lenstar LS900 optical low-coherence reflectometry [OLCR] and IOLMaster partial coherence interferometry [PCI]) and applanation ultrasound biometry in highly myopic eyes. SETTING: Division of Preventive Ophthalmology, Zhongshan Ophthalmic Center, Guangzhou, China. DESIGN: Comparative evaluation of diagnostic technology. METHODS: Biometric measurements were taken in highly myopic subjects with a spherical equivalent (SE) of -6.00 diopters (D) or higher and an axial length (AL) longer than 25.0 mm. Measurements of AL and anterior chamber depth (ACD) obtained by OLCR were compared with those obtained by PCI and applanation A-scan ultrasound. Right eyes were analyzed. Repeatability was evaluated using the coefficient of variation (CoV) and agreement, using Bland-Altman analyses. RESULTS: The mean SE was -11.20 D ± 4.65 (SD). The CoVs for repeated AL measurements using OLCR, PCI, and applanation ultrasound were 0.06%, 0.07%, and 0.20%, respectively. The limits of agreement (LoA) for AL were 0.11 mm between OLCR and PCI, 1.01 mm between OLCR and applanation ultrasound, and 1.03 mm between PCI and ultrasound. The ACD values were 0.29 mm, 0.53 mm, and 0.51 mm, respectively. These repeatability and agreement results were comparable in eyes with extreme myopia (AL ≥27.0 mm) or posterior staphyloma. The mean radius of corneal curvature was similar between OLCR and PCI (7.66 ± 0.24 mm versus 7.64 ± 0.25 mm), with an LoA of 0.12 mm. CONCLUSION: Optical biometry provided more repeatable and precise measurements of biometric parameters, including AL and ACD, than applanation ultrasound biometry in highly myopic eyes. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any material or method mentioned.

Concepts: Refractive surgery, Presbyopia, Ophthalmology, Eyeglass prescription, Accuracy and precision, Staphyloma, Cornea, Myopia

28

To evaluate clinical results of intrastromal corneal ring segments (ICRS) in a large series of post-laser in situ keratomileusis (LASIK) ectasia and determine which clinical parameters were related to the success of this technique.

Concepts: Carcinoma in situ, Keratomileusis, In situ, Laser, LASIK

28

To compare the corneal astigmatism (magnitude and axis location) derived by total corneal power (TCP), automated keratometry, and simulated keratometry.

Concepts: Ophthalmology, Comparisons, Astigmatism, Comparison, Cornea