1: J Cataract Refract Surg. 2010 Aug;36(8):1445. 

C-Ten as ideal therapeutic option.

Thomann UM, Schipper I.

Lucerne, Switzerland.

Publication Types:
    Letter

PMID: 20656184  [PubMed - in process]

2: J Cataract Refract Surg. 2010 Aug;36(8):1445-6. 

Correction of data about the frequency of fibers in the anterior chamber in
cataract surgery.

De Buysser F.

Puurs, Belgium.

Publication Types:
    Letter

PMID: 20656183  [PubMed - in process]

3: J Cataract Refract Surg. 2010 Aug;36(8):1444. 

Collagen crosslinking in pseudophakic bullous keratopathy.

Gatzioufas Z, Seitz B.

Homburg/Saar, Germany.

Publication Types:
    Letter

PMID: 20656182  [PubMed - in process]

4: J Cataract Refract Surg. 2010 Aug;36(8):1444-5. 

Reply: Collagen crosslinking in pseudophakic bullous keratopathy.

Ghanem RC.

Publication Types:
    Letter

PMID: 20656181  [PubMed - in process]

5: J Cataract Refract Surg. 2010 Aug;36(8):1443. 

August consultation #9.

Falavarjani KG.

Tehran, Iran.

PMID: 20656180  [PubMed - in process]

6: J Cataract Refract Surg. 2010 Aug;36(8):1442. 

August consultation #7.

Franchini A.

Florence, Italy.

PMID: 20656179  [PubMed - in process]

7: J Cataract Refract Surg. 2010 Aug;36(8):1442-3. 

August consultation #8.

Sekundo W.

Marburg, Germany.

PMID: 20656178  [PubMed - in process]

8: J Cataract Refract Surg. 2010 Aug;36(8):1441-2. 

August consultation #6.

Agarwal A.

Chennai, India.

PMID: 20656177  [PubMed - in process]

9: J Cataract Refract Surg. 2010 Aug;36(8):1440-1. 

August consultation #5.

Hattenbach LO.

Ludwigshafen am Rhein, Germany.

PMID: 20656176  [PubMed - in process]

10: J Cataract Refract Surg. 2010 Aug;36(8):1439-40. 

August consultation #4.

Kim CY.

Seoul, Korea.

PMID: 20656175  [PubMed - in process]

11: J Cataract Refract Surg. 2010 Aug;36(8):1439. 

August consultation #3.

Dureau P.

Paris, France.

PMID: 20656174  [PubMed - in process]

12: J Cataract Refract Surg. 2010 Aug;36(8):1438-9. 

August consultation #2.

Hindman HB.

Rochester, New York, USA.

PMID: 20656173  [PubMed - in process]

13: J Cataract Refract Surg. 2010 Aug;36(8):1438. 

Cataract Surgical Problem August consultation #1.

Menapace RM.

PMID: 20656172  [PubMed - in process]

14: J Cataract Refract Surg. 2010 Aug;36(8):1436-7. 

Refinement of lens power selection for sulcus placement of intraocular lens.

Spokes DM, Norris JH, Ball JL.

Publication Types:
    Letter

PMID: 20656171  [PubMed - in process]

15: J Cataract Refract Surg. 2010 Aug;36(8):1435-6. 

Phacoemulsification through a circular polarizing filter using the birefringent
and photoelastic characteristics of ocular tissues.

Hwang H, Kim E, Kim M.

Publication Types:
    Letter

PMID: 20656170  [PubMed - in process]

16: J Cataract Refract Surg. 2010 Aug;36(8):1432-1434. 

Refractive lens exchange with intraocular lens implantation in hyperopic eyes of
a patient with Angelman syndrome.

Trivedi RH, Wilson ME.

From the Miles Center for Pediatric Ophthalmology, Storm Eye Institute,
Department of Ophthalmology, Medical University of South Carolina, Charleston,
South Carolina, USA.

We describe a patient with Angelman syndrome with severe developmental delay who
was visually impaired by uncorrected high hyperopia and poor control of
accommodation. Refractive lens exchange with intraocular lens implantation was
performed in both eyes when the patient was 22 years of age. Satisfactory
anatomical and functional outcomes were achieved and maintained during 3 years
of follow-up. Refractive lens exchange can be useful in patients with severe
neurobehavioral disorders in the presence of high refractive error and poor
accommodative control. FINANCIAL DISCLOSURE: Neither author has a financial or
proprietary interest in any material or method mentioned. Copyright (c) 2010
ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

PMID: 20656169  [PubMed - as supplied by publisher]

17: J Cataract Refract Surg. 2010 Aug;36(8):1427-1431. 

Calcification of hydrophilic acrylic intraocular lenses in combined
phacovitrectomy surgery.

Walker NJ, Saldanha MJ, Sharp JA, Porooshani H, McDonald BM, Ferguson DJ, Patel
CK.

From the Oxford Eye Hospital (Walker, Saldanha, Sharp, Porooshani, Patel),
Neuropathology Department (McDonald), and Nuffield Department of Clinical
Laboratory Sciences (Ferguson), University of Oxford, John Radcliffe Hospital,
Oxford, United Kingdom.

Two cases of postoperative intraocular lens (IOL) calcification in patients
implanted with the Akreos Adapt IOL at the time of combined phacovitrectomy are
described, along with clinical review of all patients implanted with this IOL
type at our institution between November 2006 and September 2008. The IOLs
explanted from the 2 cases were examined using scanning electron microscopy
(SEM) and energy-dispersive X-ray spectroscopy (EDX). The SEM of the explanted
IOLs showed crystalline anterior surface and subsurface deposits; by EDX, the
deposits showed high concentrations of calcium and phosphorous, consistent with
calcium apatite. Twenty patients (20 eyes) attended for cohort review, and none
showed IOL opacification. The reason calcification occurred in the 2 cases
remains unknown, but clinicians should be aware of this potential complication.
FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any
material or method mentioned. Copyright (c) 2010 ASCRS and ESCRS. Published by
Elsevier Inc. All rights reserved.

PMID: 20656168  [PubMed - as supplied by publisher]

18: J Cataract Refract Surg. 2010 Aug;36(8):1421-1426. 

Bilateral persistent fetal vasculature in an adult: Clinical manifestations and
surgical outcomes.

Zhao YE, Chen D, Li JH.

From Eye Hospital, Wenzhou Medical College, Wenzhou, Zhejiang, China.

A 23-year-old man presented with bilateral persistent fetal vasculature (PFV).
Examination revealed bilateral cataracts, lens subluxation, elongated ciliary
processes, and persistent hyaloid vessel remnants with mild posterior segment
involvement. Extracapsular cataract extraction combined with posterior
capsulectomy and anterior vitrectomy was performed in the right eye; lensectomy,
posterior capsulectomy, anterior vitrectomy, superior peripheral iridectomy, and
anterior chamber intraocular lens implantation were performed in the left eye.
Postoperatively, the corrected distance visual acuity improved (20/100 in the
right eye and 20/40 in the left eye) and the cosmetic appearance was
satisfactory. This case shows that in rare cases of bilateral PFV, the natural
course can be benign, with functional, although amblyopic, vision. In selected
cases, late surgical intervention can improve vision and cosmetic appearance.
FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any
material or method mentioned. Copyright (c) 2010 ASCRS and ESCRS. Published by
Elsevier Inc. All rights reserved.

PMID: 20656167  [PubMed - as supplied by publisher]

19: J Cataract Refract Surg. 2010 Aug;36(8):1398-1420. 

Glistenings and surface light scattering in intraocular lenses.

Werner L.

From the John A. Moran Eye Center, University of Utah, Salt Lake City, Utah,
USA, and the Berlin Eye Research Institute, Berlin, Germany.

Glistenings are fluid-filled microvacuoles that form within the intraocular lens
(IOL) optic when the IOL is in an aqueous environment. They are observed in all
types of IOLs but have been mainly associated with hydrophobic acrylic IOLs.
Experimental and clinical studies suggest the various hydrophobic acrylic IOLs
on the market exhibit different tendencies toward glistenings. Factors
influencing glistening formation include IOL material composition, manufacturing
technique, packaging, associated conditions such as glaucoma or those leading to
breakdown of the blood-aqueous barrier, as well as concurrent use of ocular
medications. Although the impact of glistenings on postoperative visual function
and the evolution of glistenings in the late postoperative period remain
controversial, IOL explantation has rarely been reported. The phenomenon of
surface light scattering has also been described in association with hydrophobic
acrylic IOLs. Its mechanism of formation is controversial but may be related to
long-term phase separation water near the IOL surface, although not seen as
microvacuoles. FINANCIAL DISCLOSURE: The author has no financial or proprietary
interest in any material or method mentioned. Copyright (c) 2010 ASCRS and
ESCRS. Published by Elsevier Inc. All rights reserved.

PMID: 20656166  [PubMed - as supplied by publisher]

20: J Cataract Refract Surg. 2010 Aug;36(8):1392-1397. 

Retinal safety of the irradiation delivered to light-adjustable intraocular
lenses evaluated in a rabbit model.

Werner L, Chang W, Haymore J, Haugen B, Romaniv N, Sandstedt C, Chang S, Mamalis
N.

From the John A. Moran Eye Center (Werner, W. Chang, Haymore, Haugen, Romaniv,
Mamalis), University of Utah, Salt Lake City, Utah, and Calhoun Vision, Inc.
(Sandstedt, S. Chang), Pasadena, California, USA.

PURPOSE: To evaluate the safety to the retina of a light-delivery device used to
irradiate a light-adjustable intraocular lens (IOL) after implantation in a
rabbit model. SETTING: John A. Moran Eye Center, University of Utah, Salt Lake
City, Utah, USA. METHODS: In this study, rabbits had phacoemulsification with
implantation of an ultraviolet (UV)-filtering light-adjustable IOL (study IOL)
in 1 eye and a custom-made silicone IOL without a UV filter (control IOL) in the
opposite eye. The study IOLs were irradiated at 1.0, 2.0, 3.0, and 5.0 times the
expected maximum UV irradiation doses and the control IOLs, at 0.3, 0.6, 1.0,
and 2.0 times. One week after irradiation, slitlamp and fundus (indirect
ophthalmoscopy) examinations were performed. The rabbits were then humanely
killed and their eyes enucleated and processed for histopathology. RESULTS: The
16 eyes with the study IOL (with UV filter) showed no signs of corneal, anterior
segment, or retinal toxicity on histopathologic evaluation. The 16 eyes with the
control IOL (no UV filter) also showed no signs of corneal or anterior segment
toxicity; however, 3 eyes receiving the higher radiation doses had focal areas
of retinal damage consistent with laser burn. CONCLUSION: Pigmented rabbit eyes
with a light-adjustable IOL with a UV filter showed no signs of retina toxicity
after near-UV light exposure up to 5 times the expected maximum treatment
dosage. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest
in any material or method mentioned. Additional disclosures are found in the
footnotes. Copyright (c) 2010 ASCRS and ESCRS. Published by Elsevier Inc. All
rights reserved.

PMID: 20656165  [PubMed - as supplied by publisher]

21: J Cataract Refract Surg. 2010 Aug;36(8):1385-1391. 

Effect of 3 excimer laser ablation frequencies (200 Hz, 500 Hz, 1000 Hz) on the
cornea using a 1000 Hz scanning-spot excimer laser.

Khoramnia R, Lohmann CP, Wuellner C, Kobuch KA, Donitzky C, Winkler von
Mohrenfels C.

From Augenklinik (Khoramnia, Lohmann, Kobuch, Winkler von Mohrenfels), Klinikum
rechts der Isar, Technische Universitaet Muenchen, Munich, and WaveLight AG
(Wuellner, Donitzky). Erlangen, Germany.

PURPOSE: To evaluate the possible side effects on human and porcine cadaver eyes
induced by excimer laser ablation with 3 ablation frequencies. SETTING:
Augenklinik, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich,
Germany. METHODS: Central epithelial abrasion was performed on porcine and human
donor eyes. Next, the porcine eyes were photoablated (-9.00 diopters) at 1 of 3
frequencies (200 Hz, 500 Hz, or 1000 Hz) using a prototype 1000 Hz excimer
laser. The human eyes were ablated at 1000 Hz. The surface of the stroma as well
as the structure and ultrastructure of the corneal cells and stroma were
examined using light microscopy, transmission electron microscopy, and scanning
electron microscopy (SEM). Special attention was given to the detection of
potential thermal damage and the evaluation of corneal smoothness. RESULTS:
Histopathologic examination showed very low to almost no differences between the
3 repetition rates. In all cases, SEM showed an equally smooth surface.
CONCLUSIONS: The structural and ultrastructural evaluation of corneas treated
with ablation frequencies of 200 Hz, 500 Hz, and 1000 Hz showed no specific side
effects associated with the high repetition rates. The ablation quality was
comparable in the 3 frequency groups. However, the treatment time was
significantly less with a high repetition rate, indicating the clinical
potential in refractive surgery of excimer lasers with a repetition rate of 1000
Hz. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in
any material or method mentioned. Additional disclosures are found in the
footnotes. Copyright (c) 2010 ASCRS and ESCRS. Published by Elsevier Inc. All
rights reserved.

PMID: 20656164  [PubMed - as supplied by publisher]

22: J Cataract Refract Surg. 2010 Aug;36(8):1380-1384. 

Effect of intracameral epinephrine use on macular thickness after uneventful
phacoemulsification.

Bozkurt E, Yazici AT, Pekel G, Albayrak S, Cakir M, Pekel E, Yilmaz OF.

From Beyoglu Eye Training and Research Hospital, Istanbul, Turkey.

PURPOSE: To evaluate changes in central macular thickness using optical
coherence tomography after uneventful cataract surgery combined with
intracameral epinephrine use. SETTING: Beyoglu Eye Training and Research
Hospital, Istanbul, Turkey. METHODS: This prospective case series comprised eyes
of consecutive patients who had uneventful phacoemulsification and in-the-bag
intraocular lens (IOL) implantation between August 2005 and January 2006. The
eyes were randomly assigned to 1 of 2 groups. In 1 group, 0.2 mL epinephrine
(1:5000 solution) was injected just after the clear corneal incision was
created. The other group (control) did not receive epinephrine. Optical
coherence tomography was performed in all eyes preoperatively as well as
postoperatively at 1 day, 1 week, and 1, 3, and 6 months. RESULTS: The
epinephrine group comprised 73 eyes (73 patients) and the control group, 76 eyes
(86 patients). In both groups, the increase in retinal thickness from
preoperatively to 1, 3, and 6 months postoperatively was statistically
significant (P<.05); the difference was not statistically significant at 1 day
or 1 week in either group (P>.05). There were no statistically significant
differences between the 2 groups in mean retinal thickness throughout the
follow-up (P>.05). Clinically significant macular edema occurred in 3 eyes in
the epinephrine group and 3 eyes in the control group. CONCLUSION: Although
epinephrine is a well-known risk factor for central macular edema, intracameral
injection of 0.2 mL epinephrine (1:5000) did not increase the risk for central
macular edema in eyes with no risk factors that had uneventful
phacoemulsification with IOL implantation. FINANCIAL DISCLOSURE: No author has a
financial or proprietary interest in any material or method mentioned. Copyright
(c) 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

PMID: 20656163  [PubMed - as supplied by publisher]

23: J Cataract Refract Surg. 2010 Aug;36(8):1373-1379. 

Assessment of patient satisfaction with outcomes of and ophthalmic care for
cataract surgery.

Colin J, El Kebir S, Eydoux E, Hoang-Xuan T, Rozot P, Weiser M.

From Service d'Ophtalmologie (Colin), Centre Hospitalier Universitaire
Pellegrin, Bordeaux, MAPI SAS (El Kebir, Eydoux), Lyon, and private ophthalmic
centers, Paris (Hoang-Xuan, Weiser), and Marseille (Rozot), France.

PURPOSE: To assess patient satisfaction with cataract surgery care. SETTING:
Private and public health ophthalmic centers, France. METHODS: This prospective
longitudinal multicenter observational study enrolled patients attending
consultation for a preoperative visit from September 2007 to February 2008.
Patients were eligible if they had uncomplicated cataract and agreed to
participate. At the preoperative visits, medical data and disease history were
collected. At the first postoperative visit (at 1 to 7 days), the following data
were collected: patient status, surgical procedure, and follow-up (patient
management, complications, medications). Patients completed a questionnaire
after each visit to assess satisfaction with their management and follow-up
before, during, and after surgery (up to 30 days postoperatively). RESULTS: Of
the 781 patients enrolled by 91 ophthalmologists, 41 were excluded for not
meeting eligibility criteria, leaving 740 patients in the statistical analysis.
Cataract extraction was by phacoemulsification. The incision was 2.2 to 3.2 mm
in 94.7% of cases, and the intraocular lens was acrylic in 96.3% of cases.
Anesthesia was mainly topical (56.8%) or local (42.1%). The most frequent
postoperative treatments were nonsteroidal antiinflammatory eyedrops and
combined steroidal and antibacterial eyedrops (95.9% and 94.7%, respectively).
Most patients (96.4%) said the surgery results met their expectations, and 67.2%
reported being able to perform activities they could not do preoperatively.
Overall, 98.2% of patients said they were satisfied with their management.
CONCLUSION: Assessment of the management and follow-up of patients having
cataract surgery showed that the care provided was in accordance with the
expectations of French patients. FINANCIAL DISCLOSURE: No author has a financial
or proprietary interest in any material or method mentioned. Copyright (c) 2010
ASCRS and ESCRS. All rights reserved.

PMID: 20656162  [PubMed - as supplied by publisher]

24: J Cataract Refract Surg. 2010 Aug;36(8):1365-1372. 

Evaluation of bilateral minimum thickness of normal corneas based on
Fourier-domain optical coherence tomography.

Prakash G, Ashok Kumar D, Agarwal A, Sarvanan Y, Jacob S, Agarwal A.

From Dr. Agarwal's Group of Eye Hospitals, Chennai, India.

PURPOSE: To determine the normative ranges and various aspects of the
relationship between the minimum corneal thicknesses (MCT) in fellow eyes and
the location of the MCT in relation to the central cornea using Fourier-domain
optical coherence tomography (OCT). SETTING: Tertiary care ophthalmic hospital,
Chennai, India. METHODS: In this cross-sectional observational trial, both eyes
of consecutive healthy young subjects with a low refractive error and no
clinical or topographic evidence of corneal disorders had bilateral pachymetric
assessment with a Fourier-domain OCT platform (RTVue). The MCT, central corneal
thickness (CCT), and x-y coordinates of the MCT location were noted. RESULTS:
The CCT and MCT followed a normal distribution with a good correlation. The
difference between CCT and MCT was approximately 5 mum in right eyes and left
eyes (P<.05 for both). The difference in CCT was the best predictor of the
difference in MCT. The mean distance from the center (0.63 mm +/- 0.13 [SD],
right eyes; 0.66 +/- 0.17 mm, left eyes) was well correlated. The MCT points in
fellow eyes tended to be symmetrical along the vertical midline. The mean
angular distance between mirror-superimposed MCT points was 20.54 +/- 17.6
degrees and the mean linear distance, 0.25 +/- 0.17 mm. CONCLUSIONS: The
findings establish normative MCT pachymetry data and location using
Fourier-domain OCT. The MCT and CCT points, although symmetrical, differed
significantly in location and magnitude and should be evaluated separately in
normal eyes and eyes with disease. FINANCIAL DISCLOSURE: No author has a
financial or proprietary interest in any material or method mentioned.
Additional financial disclosures are found in the footnotes. Copyright (c) 2010
ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

PMID: 20656161  [PubMed - as supplied by publisher]

25: J Cataract Refract Surg. 2010 Aug;36(8):1358-1364. 

Corneal power measurement with a rotating Scheimpflug imaging system after
Descemet-stripping automated endothelial keratoplasty.

Prasher P, Muftuoglu O, Bowman RW, Cavanagh HD, McCulley JP, Mootha VV.

From the Department of Ophthalmology, University of Texas Southwestern Medical
Center, Dallas, Texas, USA.

PURPOSE: To evaluate alterations in corneal power parameters after
Descemet-stripping automated endothelial keratoplasty (DSAEK) using rotating
Scheimpflug imaging. SETTING: University of Texas, Southwestern Medical Center,
Dallas, Texas, USA. METHODS: Eyes that had DSAEK were evaluated with a rotating
Scheimpflug imaging system (Pentacam). The outcome parameters were mean anterior
and posterior keratometry (K), mean anterior radius of curvature and posterior
radius of curvature, anterior and posterior astigmatism, central corneal
thickness (CCT), true net power, corneal volume, keratometric power deviation,
and mean zonal-equivalent K readings. These values were compared with those in a
control group of age and sex-matched normal eyes. RESULTS: The DSAEK group
comprised 32 eyes (28 patients) and the control group, 32 eyes. The mean
anterior K, posterior K, and true net power were 42.53 diopters (D) +/- 1.52
(SD), -6.80 +/- 0.55 D, and 40.55 +/- 1.79 D, respectively, in the DSAEK group
and 43.60 +/- 1.62 D, -6.20 +/- 0.31 D, and 42.49 +/- 1.57 D, respectively, in
the control group. The posterior radius of curvature, anterior and posterior K
values, and true net power were statistically significantly lower in DSAEK eyes
than in control eyes (P<.01). The equivalent K readings were significantly lower
in all zones in DSAEK eyes than in control eyes (P<.01). The mean CCT was
significantly higher in DSAEK eyes than in control eyes (628 +/- 46 mum versus
553 +/- 35 mum) (P<.01). CONCLUSION: The true net power of the cornea decreased
significantly after DSAEK, mainly because of an increase in posterior curvature.
FINANCIAL DISCLOSURE: No author has a financial or proprietary interest in any
material or method mentioned. Copyright (c) 2010 ASCRS and ESCRS. Published by
Elsevier Inc. All rights reserved.

PMID: 20656160  [PubMed - as supplied by publisher]

26: J Cataract Refract Surg. 2010 Aug;36(8):1349-1357. 

Collagen copolymer toric posterior chamber phakic intraocular lenses to correct
high myopic astigmatism.

Alfonso JF, Baamonde B, Madrid-Costa D, Fernandes P, Jorge J, Montes-Mico R.

From Fernandez-Vega Ophthalmological Institute (Alfonso, Baamonde,
Madrid-Costa), Surgery Department (Alfonso, Baamonde), School of Medicine,
University of Oviedo, Oviedo, and GIO (Montes-Mico), Optics Department, Faculty
of Physics, University of Valencia, Valencia, Spain; Clinical & Experimental
Optometry Research Laboratory (Fernandes, Jorge), Department of Physics
(Optometry), School of Sciences, University of Minho, Braga, Portugal.

PURPOSE: To assess the safety, efficacy, stability, and predictability after
implantation of a toric intraocular copolymer (Collamer) lens (pIOL) to correct
high myopic astigmatism. SETTING: Fernandez-Vega Ophthalmological Institute,
Oviedo, Spain. METHODS: This study evaluated eyes that had implantation of a
toric pIOL. Outcome measures were the uncorrected (UDVA) and corrected (CDVA)
distance visual acuities (Snellen decimal), refraction, and postoperative
complications. RESULTS: The study included 15 eyes of 12 patients (9 women).
Preoperatively, the mean manifest spherical refraction was -1.98 diopters (D)
+/- 1.32 (SD) (range -0.50 to -5.50 D) and the mean refractive cylinder, -4.85
+/- 0.83 D (range -6.50 to -4.00 D). At 12 months, the mean refractive cylinder
was -0.55 +/- 0.52 D (range -1.50 to 0.00 D), with 93.3% of eyes having less
than 1.00 D of cylinder. The mean spherical equivalent was -0.31 +/- 0.42 (range
-1.00 to 0.75 D), with more than 70% of eyes within +/-0.50 D of the target. For
the astigmatic components, 93.3% of eyes were within +/-1.00 D of J0 (r(2) =
0.98) and all eyes were within +/-1.00 D of J45 (r(2) = 0.98). The mean UDVA was
0.70 +/- 0.20 and the mean CDVA, 0.83 +/- 0.12. The overall efficacy index was
0.90. Postoperatively, all eyes had unchanged CDVA or gained 1 or more lines.
CONCLUSION: The refractive outcomes and improvement in UDVA and CDVA were
rapidly achieved and remained fairly consistent throughout the follow-up period,
supporting the use of toric pIOLs in eyes with high astigmatism. FINANCIAL
DISCLOSURE: No author has a financial or proprietary interest in any material or
method mentioned. Copyright (c) 2010 ASCRS and ESCRS. Published by Elsevier Inc.
All rights reserved.

PMID: 20656159  [PubMed - as supplied by publisher]

27: J Cataract Refract Surg. 2010 Aug;36(8):1344-8. 

Scattered ultraviolet emissions during refractive surgery using a
high-frequency, wavefront-optimized excimer laser platform.

Bower KS, Edwards JD, Ryan DS, Coe CD, Hope RJ, Sliney DH.

From the Ophthalmology Service (Bower, Ryan, Coe, Hope), Walter Reed Army
Medical Center, Washington, DC; Department of Ophthalmology (Edwards),
University of Florida College of Medicine, Jacksonville, Florida; and Consulting
Medical Physicist (Sliney), Fallston, Maryland, USA.

PURPOSE: To evaluate occupational ultraviolet (UV) exposure during
photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK) with
the Allegretto Wave Eye-Q 400 Hz excimer laser. SETTING: Walter Reed Center for
Refractive Surgery, Washington, DC, USA. METHODS: Intraoperative UV measurements
were performed during PRK with epithelial removal using an Amoils brush, PRK
with epithelial removal using 20% ethanol, or femtosecond LASIK. A LaserStar
power/energy meter with a silicone detector (model PD-10) was used for the
measurements. The maximum pulse energy 25.4 cm from the corneal surface was
recorded for each surgical procedure. Measurements were evaluated using a
worst-case scenario for exposure of operating room personnel, and the results
were compared with the occupational exposure limit set by the International
Commission on Non-Ionizing Radiation Protection. RESULTS: Measurements were
taken during 15 cases of each procedure. The mean maximum exposure was 129.38
nJ/pulse +/- 79.48 (SD) during brush PRK, 69.72 +/- 68.80 nJ/pulse during
ethanol PRK, and 29.17 +/- 13.82 nJ/pulse during LASIK. The mean maximum
exposure per eye was 0.085 mJ/cm(2), 0.046 mJ/cm(2), and 0.01 mJ/cm(2),
respectively. The worst-case cumulative exposure during a heavy workday of 20
patients (40 eyes) was calculated at 3.92 mJ/cm(2), 1.51 mJ/cm(2), and 0.79
mJ/cm(2) for brush PRK, ethanol PRK, and LASIK, respectively. CONCLUSION:
Results indicate that the excimer laser platform used in the study may yield
greater UV exposure than previous systems; however, the levels did not exceed
occupational exposure limits. FINANCIAL DISCLOSURE: No author has a financial or
proprietary interest in any material or method mentioned. Published by Elsevier
Inc.

PMID: 20656158  [PubMed - in process]

28: J Cataract Refract Surg. 2010 Aug;36(8):1336-1343. 

Visual outcomes after wavefront-guided photorefractive keratectomy and
wavefront-guided laser in situ keratomileusis: Prospective comparison.

Moshirfar M, Schliesser JA, Chang JC, Oberg TJ, Mifflin MD, Townley R,
Livingston MK, Kurz CJ.

From the Department of Ophthalmology and Visual Sciences (Moshirfar, Chang,
Oberg, Mifflin, Livingston), John A. Moran Eye Center, University of Utah School
of Medicine (Schliesser), Salt Lake City, Utah; Wilford Hall Medical Center
(Townley), Lackland Air Force Base, Texas; David Grant United States Air Force
Medical Center (Kurz), Travis Air Force Base, California, USA.

PURPOSE: To compare visual outcomes between wavefront-guided photorefractive
keratectomy (PRK) and wavefront-guided laser in situ keratomileusis (LASIK).
SETTING: Academic center, Salt Lake City, Utah, USA. METHODS: In this randomized
prospective study, myopic eyes were treated with wavefront-guided PRK and or
wavefront-guided LASIK using a Visx Star S4 CustomVue platform with iris
registration. Primary outcome measures were uncorrected (UDVA) and corrected
(CDVA) distance visual acuities and manifest refraction. Secondary outcome
measures were higher-order aberrations (HOAs) and contrast sensitivity. RESULTS:
The PRK group comprised 101 eyes and the LASIK group, 102 eyes. At 6 months, the
mean UDVA was -0.03 logMAR +/- 0.10 [SD] (20/19) and 0.07 +/- 0.09 logMAR
(20/24), respectively (P = .544). In both groups, 75% eyes achieved a UDVA of
20/20 or better (P = .923); 77% of eyes in the PRK group and 88% in the LASIK
group were within +/-0.50 diopter of emmetropia (P = .760). There was no
statistically significant difference between groups in contrast sensitivity at
3, 6, 12, or 18 cycles per degree. The mean postoperative HOA root mean square
was 0.45 +/- 0.13 mum in the PRK group and 0.59 +/- 0.22 mum in the LASIK group
(P = .012), representing an increase factor of 1.22 and 1.74, respectively.
CONCLUSIONS: Wavefront-guided PRK and wavefront-guided LASIK had similar
efficacy, predictability, safety, and contrast sensitivity; however,
wavefront-guided PRK induced statistically fewer HOAs than wavefront-guided
LASIK at 6 months. FINANCIAL DISCLOSURE: No author has a financial or
proprietary interest in any material or method mentioned. Copyright (c) 2010
ASCRS and ESCRS. All rights reserved.

PMID: 20656157  [PubMed - as supplied by publisher]

29: J Cataract Refract Surg. 2010 Aug;36(8):1330-1335. 

Four-year experience with a silicone refractive multifocal intraocular lens.

Fujimoto K, Honda K, Wada YR, Tanaka M, Irie T.

From a private practice, Osaka, Japan.

PURPOSE: To assess the long-term outcomes after implantation of a foldable
silicone refractive multifocal intraocular lens (IOL). SETTING: Private
practice, Osaka, Japan. METHODS: This retrospective study evaluated eyes that
had implantation of an Array SA40N silicone refractive multifocal IOL with a
follow-up of up to 4 years. Outcome measures were refraction, corneal
astigmatism, uncorrected (UDVA) and corrected (CDVA) distance visual acuities,
uncorrected (UNVA) and corrected (CNVA) near visual acuities, incidence of glare
and halos, patient satisfaction, time to neodymium:YAG (Nd:YAG) laser
capsulotomy, and spectacle dependence. RESULTS: The study comprised 41 patients
(72 eyes) with a mean age of 48.7 years +/- 13.4 (SD) (range 18 to 71 years) and
a mean scotopic pupil size of 5.7 +/- 1.0 mm (range 4.0 to 8.5 mm). The
refraction and corneal astigmatism were stable throughout the 4-year follow-up.
The mean acuity values 1 month postoperatively were as follows: UDVA, 0.06
logMAR; CDVA, 0.08 logMAR; UNVA, 0.24 logMAR; CNVA, 0.04 logMAR. The change at 4
years was not significant for any visual acuity (P>.64). Patient satisfaction
with near vision decreased at 2 years (P = .054). An Nd:YAG laser capsulotomy
was performed in 48 eyes (66.7%) a mean 21.7 +/- 16.3 months postoperatively.
CONCLUSIONS: The silicone refractive multifocal IOL provided good and stable
distance and near visual acuities over the 4-year follow-up, even though it was
anticipated that slight posterior capsule opacification would affect near
vision. FINANCIAL DISCLOSURE: No author has a financial or proprietary interest
in any material or method mentioned. Copyright (c) 2010 ASCRS and ESCRS.
Published by Elsevier Inc. All rights reserved.

PMID: 20656156  [PubMed - as supplied by publisher]

30: J Cataract Refract Surg. 2010 Aug;36(8):1323-1329. 

Effect of astigmatism on visual acuity in eyes with a diffractive multifocal
intraocular lens.

Hayashi K, Manabe SI, Yoshida M, Hayashi H.

From the Hayashi Eye Hospital (K. Hayashi, Manabe, Yoshida) and the Department
of Ophthalmology (H. Hayashi), School of Medicine, Fukuoka University, Fukuoka,
Japan.

PURPOSE: To examine the effect of astigmatism on visual acuity at various
distances in eyes with a diffractive multifocal intraocular lens (IOL). SETTING:
Hayashi Eye Hospital, Fukuoka, Japan. METHODS: In this study, eyes had
implantation of a diffractive multifocal IOL with a +3.00 diopter (D) addition
(add) (AcrySof ReSTOR SN6AD1), a diffractive multifocal IOL with a +4.00 D add
(AcrySof ReSTOR SN6AD3), or a monofocal IOL (AcrySof SN60WF). Astigmatism was
simulated by adding cylindrical lenses of various diopters (0.00, 0.50, 1.00,
1.50, 2.00), after which distance-corrected acuity was measured at various
distances. RESULTS: At most distances, the mean visual acuity in the multifocal
IOL groups decreased in proportion to the added astigmatism. With astigmatism of
0.00 D and 0.50 D, distance-corrected near visual acuity (DCNVA) in the +4.00 D
group and distance-corrected intermediate visual acuity (DCIVA) and DCNVA in the
+3.00 D group were significantly better than in the monofocal group; the
corrected distance visual acuity (CDVA) was similar. The DCNVA with astigmatism
of 1.00 D was better in 2 multifocal groups; however, with astigmatism of 1.50 D
and 2.00 D, the CDVA and DCIVA at 0.5m in the multifocal groups were
significantly worse than in the monofocal group, although the DCNVA was similar.
With astigmatism of 1.00 D or greater, the mean CDVA and DCNVA in the multifocal
groups reached useful levels (20/40). CONCLUSION: The presence of astigmatism in
eyes with a diffractive multifocal IOL compromised all distance visual acuities,
suggesting the need to correct astigmatism of greater than 1.00 D. FINANCIAL
DISCLOSURE: No author has a financial or proprietary interest in any material or
method mentioned. Copyright (c) 2010 ASCRS and ESCRS. Published by Elsevier Inc.
All rights reserved.

PMID: 20656155  [PubMed - as supplied by publisher]