Journal of cataract and refractive surgery最新文献

{"title":"Small-Incision Lenticule Extraction with Prophylactic Cross-Linking: A Systematic Review and Meta-Analysis.","authors":"Kareem Sadek, Oreoluwapo Maxwell, Brendan K Tao, Isra M Hussein, Marko M Popovic, Clara C Chan","doi":"10.1097/j.jcrs.0000000000002046","DOIUrl":"10.1097/j.jcrs.0000000000002046","url":null,"abstract":"<p><strong>Topic: </strong>Keratorefractive lenticule extraction (KLEx) treats myopia and myopic astigmatism while preserving corneal biomechanics better than flap-based procedures. KLEx with prophylactic accelerated corneal cross-linking (KLEx-CXL) has been proposed for thinner corneas, higher myopia, or borderline tomography, but its incremental value remains uncertain.</p><p><strong>Clinical relevance: </strong>KLEx-CXL may reduce biomechanical instability, but adds operative time, cost, and protocol variability. Comparative evidence is needed to determine whether it improves outcomes over KLEx alone.</p><p><strong>Methods: </strong>MEDLINE, Embase, Scopus, Web of Science, CENTRAL, and CINAHL were searched to July 2, 2026. Comparative adult studies with at least 6 months' follow-up reporting refractive or visual outcomes were included. Two reviewers extracted data, assessed risk of bias, and rated certainty using GRADE. Random-effects meta-analyses pooled mean differences.</p><p><strong>Results: </strong>Nine studies included 730 eyes: 386 KLEx and 344 KLEx-CXL. Residual MRSE was similar overall (MD 0.03 D; 95% CI, -0.01 to 0.06; P=0.17), with no consistent timepoint-specific difference. A small residual difference was confined to moderate-myopia cohorts (0.09 D; 95% CI, 0.04 to 0.15) and absent in high myopia. KLEx showed a 1-month advantage in uncorrected distance vision (MD -0.04 logMAR), safety index (MD 0.07), and efficacy index (MD 0.08), resolving by 12 months. Corrected vision was similar throughout. Biomechanical measures favored KLEx-CXL. Early haze was transient; no ectasia occurred. Certainty was low.</p><p><strong>Conclusion: </strong>KLEx and KLEx-CXL achieved similar residual refraction and corrected visual acuity. KLEx-CXL produced measurable biomechanical reinforcement but transiently delayed early uncorrected visual recovery. Current evidence supports reserving prophylactic cross-linking for higher-risk eyes.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850768","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":"Photorefractive Keratectomy in Keratoconus: Long-Term Outcomes from a Pre-Cross-Linking Era Cohort.","authors":"Gustavo E Tamayo, Natalia Moros, Eduardo J Polania-Baron, Claudia Castell, Pilar Vargas","doi":"10.1097/j.jcrs.0000000000002047","DOIUrl":"10.1097/j.jcrs.0000000000002047","url":null,"abstract":"<p><strong>Purpose: </strong>To describe long-term visual, refractive, and topographic outcomes after photorefractive keratectomy (PRK) in keratoconus patients treated before corneal cross-linking (CXL) became available.</p><p><strong>Setting: </strong>Single private ophthalmic center in Bogotá, Colombia.</p><p><strong>Design: </strong>Retrospective observational study.</p><p><strong>Methods: </strong>1,532 archived paper charts from all patients at the practice between 1996 and 2004 were screened. Patients with keratoconus who underwent PRK using multiple excimer laser techniques, with adequate preoperative documentation and available for re-evaluation after ≥20 years, were included. Outcomes included uncorrected (UDVA) and corrected distance visual acuity (CDVA), refractive spherical equivalent, astigmatism, and keratometry.</p><p><strong>Results: </strong>Sixty-eight keratoconus patients treated with PRK were identified; 16 patients (29 eyes) with available long-term follow-up were included, (mean follow-up of 22 years). UDVA improved from 0.81 ± 0.50 to 0.46 ± 0.36 logMAR (P = .005) and CDVA from 0.14 ± 0.17 to 0.08 ± 0.11 logMAR (P = .02), although not significant after excluding eyes that later required keratoplasty. Spherical equivalent decreased by 1.51 D (P = .001), and astigmatism by 0.82 D (P = .03). Maximum keratometry showed no significant change (P = .19). Four eyes (13.8%) required keratoplasty, including 3 of 7 (43%) with advanced disease. The remaining 25 eyes (86.2%) did not require keratoplasty, although some required additional interventions.</p><p><strong>Conclusion: </strong>In this small pre-CXL cohort, mild-to-moderate keratoconus eyes had visual and refractive improvement, while keratoplasty was required mainly in advanced cases. These findings offer historical observational context rather than evidence of safety or efficacy.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850708","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":"Safety and Performance of a New Cohesive Ophthalmic Viscosurgical Device - a Multicenter, Partially Comparative Randomized Study.","authors":"Carmen Vogt, Maria Xeroudaki, Alexander Fridberg, Björn Johansson","doi":"10.1097/j.jcrs.0000000000002048","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000002048","url":null,"abstract":"<p><strong>Purpose: </strong>To confirm the clinical safety and overall performance of Minivisc® Plus, a cohesive ophthalmic viscosurgical device (OVD).</p><p><strong>Setting: </strong>Multicenter study conducted at 6 sites in Sweden and Belgium.</p><p><strong>Design: </strong>Prospective, randomized, partially comparative, multicenter post market study.</p><p><strong>Methods: </strong>Subjects requiring anterior segment ophthalmic surgery were eligible for inclusion. The study consisted of two phases. In Phase A (90-day follow-up), a randomized comparison was conducted between Minivisc® Plus and Healon GV® Pro. In Phase B, eyes were treated with Minivisc® Plus and followed for 30 days. Primary endpoint was incidence of intraocular pressure (IOP) ≥30 mmHg at 7 days following operation. Secondary endpoints included postoperative inflammation, corneal endothelial cell density (ECD), surgeon-reported device performance, and the incidence of adverse events (AEs) and device deficiencies (DDs).</p><p><strong>Results: </strong>In total, 163 eyes were included in the study: 54 eyes in Phase A (25 eyes treated with Minivisc® Plus and 29 eyes treated with Healon GV® Pro) and 109 eyes in Phase B. All surgical procedures were phacoemulsification cataract surgeries, apart from two cases (both in Phase B), which were glaucoma surgeries. Two eyes (1.5%) treated with Minivisc® Plus exhibited intraocular pressure (IOP) ≥30 mmHg at postoperative day 7. Inflammation grading, ECD loss, and the incidence of AEs were comparable between the study substances throughout the 90-day follow-up period. Surgeon-reported assessments indicated comparable device performance between the two OVDs.</p><p><strong>Conclusions: </strong>This study demonstrates the safety of Minivisc® Plus in terms of IOP spikes, postoperative ocular inflammation, ECD loss, with clinical performance comparable to that of Healon GV® PRO.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":3.7,"publicationDate":"2026-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880483","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":"Enhancing cataract surgery training through a secure microscope-integrated live video supervision system.","authors":"David Beckers, Lena Beckers, Philipp Zeitschel, Florian Kretz","doi":"10.1097/j.jcrs.0000000000001974","DOIUrl":"10.1097/j.jcrs.0000000000001974","url":null,"abstract":"","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"943-945"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147868515","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 : Evaluating large language models vs residents in cataract and refractive surgery: comparative analysis using the American Academy of Ophthalmology Self-Assessment Program.","authors":"Avi Wallerstein, Mathieu Gauvin","doi":"10.1097/j.jcrs.0000000000002000","DOIUrl":"10.1097/j.jcrs.0000000000002000","url":null,"abstract":"","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"955"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148295015","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: Use of intracameral antibiotics prophylaxis in patients with posterior capsule rupture during cataract surgery: systemic review and meta-analysis.","authors":"Jeroen van Rooij","doi":"10.1097/j.jcrs.0000000000002016","DOIUrl":"10.1097/j.jcrs.0000000000002016","url":null,"abstract":"","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"950-951"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148352036","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":"Cataract extraction with capsular bag scleral fixation in a patient with a congenital lens coloboma.","authors":"Susan Xia, Matthew Starr, Ruti Sella","doi":"10.1097/j.jcrs.0000000000001937","DOIUrl":"10.1097/j.jcrs.0000000000001937","url":null,"abstract":"","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"948"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147432942","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 new-generation and traditional intraocular lens power calculation formulas in pediatric primary implantation.","authors":"Sabatiello Christian, Alfano Pasquale","doi":"10.1097/j.jcrs.0000000000002002","DOIUrl":"10.1097/j.jcrs.0000000000002002","url":null,"abstract":"","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"952-953"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148264558","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":"Phakic presbyopic intraocular lenses: systematic review.","authors":"Javier H González-Lugo, Hao Zhang, Jorge L Alió, Marcielle Ghanem, Ronald Steven Medalle, Jorge L Alió Del Barrio","doi":"10.1097/j.jcrs.0000000000001940","DOIUrl":"10.1097/j.jcrs.0000000000001940","url":null,"abstract":"<p><strong>Topic: </strong>Presbyopia affects nearly 2 billion individuals worldwide and remains a major unmet challenge in refractive surgery. This systematic review evaluated the visual, refractive, and safety outcomes of phakic intraocular lenses (pIOLs) specifically designed for presbyopia correction, including multifocal and extended depth-of-focus (EDOF) models. Eligible participants were presbyopic adults undergoing unilateral or bilateral pIOL implantation. Comparisons across optical designs and fixation types were examined in relation to visual performance and adverse events.</p><p><strong>Clinical relevance: </strong>Current presbyopia-correcting options, including corneal procedures and refractive lens exchange, may compromise accommodation or optical quality. Phakic presbyopic IOLs aim to restore full-range vision while preserving the crystalline lens, potentially offering a safer, reversible alternative.</p><p><strong>Methods: </strong>This review followed PRISMA guidelines and was prospectively registered in PROSPERO (CRD420251138158). Comprehensive searches were conducted in MEDLINE, PubMed, EMBASE, Registers, and the Cochrane Library through July 2025. Eligible studies included clinical trials and observational studies reporting visual, refractive, safety, or patient-reported outcomes of presbyopia-correcting pIOLs. Risk of bias was assessed using the Cochrane and ROBINS-I tools.</p><p><strong>Results: </strong>6 studies (354 eyes) were included. Contemporary pIOL designs; EVO Viva Implantable Collamelar Lens, trifocal Implantable Phakic Contact Lens, and ArtiPlus achieved at least 75% of eyes within ±0.50 diopter of target refraction, and 80% to 90% of patients attained functional spectacle independence. Glare and halos were commonly reported but generally mild. No sight-threatening adverse events occurred during short-term follow-up.</p><p><strong>Conclusions: </strong>Early evidence suggests favorable short-term safety and functional outcomes for presbyopia-correcting pIOLs while preserving the crystalline lens and residual accommodative function. However, evidence remains limited by short follow-up, small sample sizes, and industry sponsorship. Independent, long-term studies are required to establish their definitive role in refractive surgery.</p><p><strong>Registration: </strong>PROSPERO CRD420251138158.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"927-935"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147490859","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":"Atypical Acanthamoeba keratitis in an eye with previous radial keratotomy: diagnostic and therapeutic challenges.","authors":"Marc Bautista-Cortiella, Elena Arias-García, Álvaro Cabezas-Vicente, Altea Martínez-García, Ester Fernández-López","doi":"10.1097/j.jcrs.0000000000001956","DOIUrl":"10.1097/j.jcrs.0000000000001956","url":null,"abstract":"","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"946-947"},"PeriodicalIF":3.7,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147654012","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}