Journal of cataract and refractive surgery最新文献

{"title":"Intracorneal deposits after keratorefractive lenticule extraction (KLEx): the importance of instrument quality.","authors":"Klemens Paul Kaiser, Thomas Kohnen, Navid Ardjomand","doi":"10.1097/j.jcrs.0000000000001781","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001781","url":null,"abstract":"","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary graft failure in preloaded versus surgeon prepared DSAEK: a clinical and ex vivo correlation study.","authors":"Kamran M Riaz, Karanpreet S Multani, Liam Redden, Osamah Mian, Michael Szkarlat, Kai Ding, Jessica Ludwig, Onkar Sawant, Shahzad Mian","doi":"10.1097/j.jcrs.0000000000001785","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001785","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate whether primary graft failure (PGF) rates and endothelial cell loss (ECL) differ between surgeon-trephined/loaded and eye bank-preloaded Descemet stripping automated endothelial keratoplasty (DSAEK) grafts.</p><p><strong>Setting: </strong>Tertiary care academic center.</p><p><strong>Design: </strong>Retrospective case series and ex vivo laboratory study.</p><p><strong>Methods: </strong>Single-center review of 69 eyes undergoing DSAEK (2020-2023) divided into three groups based on graft preparation and eye bank source: A) eye bank-preloaded in EndoSerter (PL-ES), B) eye bank-preloaded in glass tube (PL-GT), and C) surgeon-trephined/loaded in EndoSerter (SL-ES). The primary clinical outcome was PGF (persistent corneal edema >3 months despite medical therapy). Secondary outcomes included visual outcomes and clinical complications (cystoid macular edema (CME) and rebubbling rate (RR)). The primary outcome of the laboratory study was percentage ECL (%ECL).</p><p><strong>Results: </strong>All lenticules were ≤80 µm. PGF was significantly higher in the PL-ES group (8/20; 40%) and PL-GT group (4/7; 57%) compared to the SL-ES group (1/42; 2%) (p < 0.0001). Grafts requiring rebubbling were more likely to experience PGF (p = 0.0176). PGF eyes were regrafted with SL-ES DSAEK; none experienced subsequent PGF. There were no significant differences in CME, RR, corrected distance visual acuity, and spherical equivalent. The ex vivo study included 9 PL-ES, 6 PL-GT, and 6 SL-ES grafts. %ECL was higher in both preloaded groups than SL-ES (p = 0.0354), though significance was not demonstrated on post-hoc analysis. Fluorescent imaging revealed more cell loss in preloaded grafts.</p><p><strong>Conclusions: </strong>Preloading and storage of DSAEK grafts may impact PGF rates clinically and ECL ex vivo.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023416","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: Videographic and microbiologic evaluation of eye drop bottle contamination in clinics: pilot study.","authors":"John M Tan, Sahita I Manda, Manjot K Gill, David J Palmer, Gareth M C Lema","doi":"10.1097/j.jcrs.0000000000001780","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001780","url":null,"abstract":"","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Pain Perception in Immediate versus Delayed Sequential Bilateral Cataract Surgery.","authors":"Cong Ngoc Nguyen, Thanapong Somkijrungroj, Pear Ferreira Pongsachareonnont, Wasee Tulvatana","doi":"10.1097/j.jcrs.0000000000001783","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001783","url":null,"abstract":"<p><strong>Purpose: </strong>To compare patient's reported pain perception between immediate sequential versus delayed sequential bilateral cataract surgery (ISBCS vs. DSBCS).</p><p><strong>Setting: </strong>King Chulalongkorn Memorial Hospital, Bangkok, Thailand.</p><p><strong>Design: </strong>Prospective cohort study.</p><p><strong>Methods: </strong>Eligible participants scheduled to undergo ISBCS and DSBC were consecutively enrolled. Topical anesthesia was administered for all procedures with no sedation used. Pain scores for each eye were assessed separately at 3 time points: immediately after surgery, day 1, and day 7 postoperation, using a verbal numeric rating scale from 0 to 10. A linear mixed-effects model was used to analyze the differences in pain scores between the two groups and adjusted for covariates, including surgical method, time point, operated eye, education level, surgeon experience, and surgical duration.</p><p><strong>Results: </strong>A total of 90 bilateral cataract patients (45 ISBCS and 45 DSBCS) were enrolled. Pain scores on Day 0 were low, with medians of 1 [0; 2] for both groups (p = 0.476). The linear mixed-effects model revealed no significant impact of surgical methods on pain scores, with a notable decrease in pain levels over time. Surgical duration significantly impacted pain, with each minute adding approximately 0.027 to the score. Additionally, patients with higher education levels reported higher pain scores.</p><p><strong>Conclusions: </strong>Pain related to cataract surgery was mild and resolved quickly in both ISBCS and DSBCS groups, with no significant differences between surgical methods or operated eyes. The effect of education level on pain perception suggests the importance of good preoperative counseling to set appropriate expectations.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying the reduction in economic and environmental waste from multi-use phacoemulsification tubing/cassettes and diamond blades.","authors":"Stephanie P Chen, Gitanjali B Baveja, David F Chang","doi":"10.1097/j.jcrs.0000000000001784","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001784","url":null,"abstract":"<p><strong>Purpose: </strong>To quantify and compare the cost, waste, and carbon emissions of single-use and reusable phacoemulsification tubing/cassettes and knives.</p><p><strong>Setting: </strong>Private, single-specialty ambulatory surgery center (Mountain View, CA, USA).</p><p><strong>Design: </strong>Retrospective data review.</p><p><strong>Methods: </strong>The cost, waste, and carbon emissions from using an approved multi-use tubing/cassette system from July 1, 2024 through June 30, 2025 were estimated and compared to those generated by single-use tubing/cassettes with the same phacoemulsification machine (Part 1). In Part 2, the cost, waste, and carbon emissions from reusable diamond knives were estimated and compared to those from using single-use metal knives for the equivalent number of cataract and other IOL-related surgeries over a 10-year period. Life-cycle equivalent analysis was performed to determine the carbon footprint of each component.</p><p><strong>Results: </strong>For 2,700 cataract and IOL-related surgeries performed during one year, reusable cassette/tubing packs reduced cost by 66.7% ($121,500 for single-use vs. $40,500 for multi-use). For every 1,000 procedures, the reusable pack would save 322.8 kg of plastic waste and 938.3 kgCO2eq, equivalent to driving a car 2,283mi (3,674km). Over 10 years, 50,100 procedures were performed at our center. For every 1,000 procedures, using diamond knives was estimated to save $18,300 (keratomes) and $12,130 (paracentesis blades) compared to disposable metal alternatives, as well as reducing plastic waste and carbon emissions by over 99%.</p><p><strong>Conclusions: </strong>Cost, waste, and carbon emissions are considerably reduced by reusable phacoemulsification products, such as diamond surgical knives and multi-use phacoemulsification tubing/cassettes. This provides a major opportunity to improve the sustainability of cataract surgery.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023378","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Refractive Outcomes after Secondary Scleral Sutured Toric Intraocular Lenses for the Correction of Corneal Astigmatism.","authors":"Vishal B Swaminathan, Rachel N Israilevich, Matthew R Starr","doi":"10.1097/j.jcrs.0000000000001778","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001778","url":null,"abstract":"<p><strong>Purpose: </strong>To describe refractive outcomes in eyes with regular corneal astigmatism undergoing scleral sutured toric intraocular lens (SSTIOL) placement with complete pars plana vitrectomy (PPV) using an MX60 toric intraocular lens (IOL) and 8-0 GoreTex suture.</p><p><strong>Setting: </strong>Academic clinical hospital, Mayo Clinic, Rochester, MN, USA.</p><p><strong>Design: </strong>Retrospective, single-institution, consecutive case series.</p><p><strong>Methods: </strong>All eyes in patients with over 1.0D of regular astigmatism undergoing secondary IOL implantation were included. Patients with irregular astigmatism or under the age of 18 were excluded. Primary outcomes included uncorrected distance visual acuity, best corrected visual acuity, degree of astigmatism, and mean percent reduction in cylinder after surgery.</p><p><strong>Results: </strong>Twenty-three eyes from 21 patients were included. Mean pre-operative uncorrected visual acuity was 1.12 ± 0.6 logMAR (20/270 Snellen; range 20/30- count fingers (CF) Snellen) and mean pre-operative keratometric astigmatism was 2.42 ± 1.07 D. Astigmatism improved in 22 (95.7%) eyes. Postoperatively, mean uncorrected visual acuity was 0.27 ± 0.26D logMAR (20/37 Snellen; range 20/20-20/150 Snellen) and mean best corrected visual acuity was 0.15 ± 0.23D logMAR (20/28 Snellen, range 20/20-20/150 Snellen) (p<0001). Mean post-operative refractive astigmatism was 0.76 ± 0.61D, and mean change in astigmatism was -1.66 ± 1.24D (p<0001), resulting in a 67.06 ± 25.48 mean percent reduction in cylinder. At the final post-operative visit, 16/22 (72.73%) eyes were within 1D, and 12/22 (54.55%) eyes were within 0.5D of planned refractive spherical equivalent target.</p><p><strong>Conclusions: </strong>Patients with regular corneal astigmatism in the absence of capsular support may benefit from astigmatic-correcting toric secondary IOLs. Patient selection and pre-operative counseling is imperative prior to proceeding with SSTIOL surgery.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Environmental Impact of Cataract Surgery and Strategies for Mitigation: A Life Cycle Assessment in an Academic Hospital.","authors":"Emma J Kooistra, Laura Golsteijn, Egid M van Bree, Sjoerd Elferink, Evelyn A Brakema, Floris Hermeling, Pleun Hemelaar, Anne Ottenbros, Niels Crama, Rosalie van Zelm, Hugo R Touw, Tim Stobernack","doi":"10.1097/j.jcrs.0000000000001777","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001777","url":null,"abstract":"<p><strong>Purpose: </strong>The healthcare sector significantly contributes to environmental challenges. Cataract surgery, as one of the most frequently performed procedures worldwide, presents an opportunity to address these challenges. This study identifies the main environmental hotspots of cataract surgery and evaluates strategies to reduce its environmental impact. A secondary objective was to compare process-based and monetary value-based methodologies for environmental assessment.</p><p><strong>Setting: </strong>Academic hospital in the Netherlands.</p><p><strong>Design: </strong>Cradle-to-grave Life Cycle Assessment (LCA) following ISO 14040/44 guidelines.</p><p><strong>Methods: </strong>The environmental impact of phacoemulsification cataract surgery was assessed, including all processes, products, and equipment used in the operating room. Key contributors to human health and ecosystem damage were identified. A monetary value-based analysis was performed using the same inventory data to compare methodological approaches.</p><p><strong>Results: </strong>Disposables (35%) and patient travel (31%) were the largest contributors to the environmental impact. Immediate sequential bilateral cataract surgery (ISBCS) reduced the impact by 19%, and simplifying surgical kits achieved a 10% reduction. Additional reductions were observed with renewable energy (-12%) and sustainable transportation (-8%). The monetary value-based approach yielded a fourfold higher carbon footprint than the process-based LCA, while identifying similar hotspots.</p><p><strong>Conclusions: </strong>The main environmental hotspots of cataract surgery were patient travel and disposable products. The most effective mitigation strategy to reduce the carbon footprint is implementing ISBCS. Additional mitigation strategies include reducing the use of disposable products, encouraging sustainable travel options, and switching to renewable energy. These findings highlight opportunities for ophthalmologists to contribute to more sustainable surgical care.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955648","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply: Accuracy of thick and thin intraocular lens power formulas using paraxial vergence calculation.","authors":"Kristian Næser, Rasmus Nielsen","doi":"10.1097/j.jcrs.0000000000001773","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001773","url":null,"abstract":"","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"DIGITAL 3D \"HEADS-UP\" LASIK SURGERY: FEASIBILITY, SURGICAL DURATION, COMPLICATION RATES AND COMPARISON WITH A CONVENTIONAL MICROSCOPE.","authors":"Alice Theuriau, Sarah Partouche, Damien Gatinel, Christophe Panthier","doi":"10.1097/j.jcrs.0000000000001776","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001776","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to compare LASIK surgery using the NGENUITY 3D visualization system (Alcon) with surgery conducted using the conventional microscope of the Wavelight EX500 excimer laser (Alcon), by an experienced surgeon (>500 procedures) and a young surgeon (<50 procedures).</p><p><strong>Settings: </strong>Single centre study at the Rothschild Foundation, Paris, France.</p><p><strong>Design: </strong>Prospective cross-sectional study.</p><p><strong>Methods: </strong>193 eyes from 99 patients were included: The experienced surgeon operated on 103 eyes (48 with a conventional microscope and 55 with a 3D microscope), while the young surgeon operated on 90 eyes (49 with a conventional microscope and 41 with a 3D microscope). Surgeon-dependent operative time for the excimer laser phase, notable intraoperative events, and complication rates during the first postoperative month were evaluated.</p><p><strong>Results: </strong>The mean operative time was 1 min 28 sec for the experienced surgeon and 2 min 03 sec for the young surgeon (p<0.05). For the experienced surgeon, mean operative time was 15 seconds longer with the 3D microscope (p<0.05), but this difference disappeared after the 39th operated eye. In the young surgeon's group, no significant difference in operative time was observed between the 3D and conventional systems. Two cases of intraoperative micro-erosions (one per surgeon, both in the 3D group) were reported, but no postoperative complications were noted.</p><p><strong>Conclusions: </strong>LASIK surgery using a 3D visualization system is safe and feasible. The learning curve for experienced surgeons is short, and young surgeons do not experience increased difficulty. The 3D system offers significant ergonomic and educational benefits, making it a promising tool for all skill levels.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955626","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: Accuracy of thick and thin intraocular lens power formulas using paraxial vergence calculation.","authors":"Felix M Wagner, Paul-Rolf Preußner","doi":"10.1097/j.jcrs.0000000000001772","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001772","url":null,"abstract":"","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}