Journal of cataract and refractive surgery最新文献

{"title":"Establishing the ground truth for keratoconus progression: combining repeated measures and adapting precision limits to disease severity in tomography.","authors":"Dr Shafi Balal, Dr Yijun Cai, Ms Lynn Kandakji, Dr Siyin Liu, Dr Pádraig J Mullholand, Mr Marcello Leucci, Dr Nikolas Pontikos, Dr Daniel Gore, Bruce Allan","doi":"10.1097/j.jcrs.0000000000001692","DOIUrl":"10.1097/j.jcrs.0000000000001692","url":null,"abstract":"<p><strong>Purpose: </strong>Keratoconus progression is defined with reference to precision limits in corneal tomography. We set out to analyse measurement precision using a contemporary tomography device (MS-39, CSO Italia, Florence, Italy) in a large sample of keratoconus patients.</p><p><strong>Setting: </strong>Moorfields Eye Hospital, London, UK.</p><p><strong>Design: </strong>Prospective and retrospective analysis of clinical data.</p><p><strong>Methods: </strong>For a range of key corneal tomographic indices, repeatability and reproducibility were compared in a prospective series of 1,248 scans (n= 208 eyes) with 2 observers each acquiring 3 scans per eye. Measurement repeatability for single measures versus the mean of 3 consecutive measures was then compared using the same dataset. 95% repeatability coefficients (RC) were mapped at each unit interval through the measurement range in a retrospective analysis of 13,734 scans (n=4,578 eyes) to adapt progression thresholds to disease severity. Finally, keratoconus classification using alternate progression definitions was compared at 1 and 2 year time points.</p><p><strong>Results: </strong>For all corneal tomographic indices examined, no significant differences were found between MS-39 measurement repeatability and reproducibility (p>0.05), repeatability was (average) 44% improved using the mean of 3 consecutive measures, and measurement repeatability deteriorated as keratoconus advanced. Progression was classified incorrectly in over 50% of cases at both time points where adaptive thresholds and repeated measures were not used.</p><p><strong>Conclusions: </strong>MS-39 measurement precision is not significantly influenced by the operator. Consecutive repeated measures and adaptive thresholds for observed change in key tomographic parameters based on device specific precision limits tailored to disease severity are necessary for accurate classification of progression.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144150395","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":"Calorimetric Method for Measuring Phacoemulsification Energy Delivered During Cataract Surgery.","authors":"Dr Rosa Braga-Mele, Satish Yalamanchili, Sarah Makari, Guangyao Jia","doi":"10.1097/j.jcrs.0000000000001730","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001730","url":null,"abstract":"<p><strong>Purpose: </strong>The purpose of this study was to determine the ultrasound (US) energy delivered to the eye during cataract surgery in Joules, a universal System Internacional (SI) unit of energy. This SI energy unit of measurement allows for comparison among various US modalities, phacoemulsification systems and other applications.</p><p><strong>Setting: </strong>Laboratory.</p><p><strong>Design: </strong>Experimental laboratory phacoemulsification energy dissipation model.</p><p><strong>Methods: </strong>A calorimetric method of energy measurement was used, with a US handpiece, tip, and sleeve were held in place by an adaptor into a test chamber holding 0.5 g of water. Thermocouples measured the water temperature rise. The ultrasound power was tested in 10% increments from 10% to 100% with each ultrasound modality.</p><p><strong>Results: </strong>High repeatability was observed in both the torsional and longitudinal modality, as indicated by a coefficient of variation less than 0.5 for each power level and the low standard deviation magnitude across the tests (0.020 J/s to 0.149 J/s in the torsional modality and 0.036 J/s to 0.150 J/s in the longitudinal modality, depending on ultrasound power levels). Third order polynomials demonstrated strong and non-linear correlations between ultrasound energy and power levels as indicated by high R2 values (>0.99).</p><p><strong>Conclusion: </strong>A calorimetric ultrasound energy measurement method provides greater insight into the total energy in the eye. Measuring total phacoemulsification energy in Joules allows for a standardized way to compare total energy across variable platforms and to be used as a potentially more clinically relevant proxy for assessing and improving clinical outcomes.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144540343","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":"Barrett RX tool for intraocular lens power calculation in pseudophakic eyes undergoing intraocular lens exchange.","authors":"Klemens Paul Kaiser, Tyll Jandewerth, Joukje C Wanten, Christoph Lwowski, Mariam Sobhi, Rudy M M A Nuijts, Thomas Kohnen","doi":"10.1097/j.jcrs.0000000000001732","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001732","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the accuracy of refraction prediction after intraocular lens (IOL) exchange using a software integrated in a Scheimpflug-based biometer.</p><p><strong>Setting: </strong>Two tertiary referral hospitals.</p><p><strong>Design: </strong>A first case series.</p><p><strong>Methods: </strong>Eyes that underwent uneventful bag-to-bag IOL exchange between 2017 and 2024 and complete pre- and postoperative measurements were included. IOL exchange was performed by two experienced surgeons. IOL power was calculated using the Barrett RX formula integrated in Pentacam software (Oculus Optikgeräte GmbH, Wetzlar, Germany), incorporating both phakic and pseudophakic biometric data and subjective refraction. Prediction errors were computed by comparing actual postoperative and predicted refractions. Moreover, a unpublished estimation formula was applied.</p><p><strong>Results: </strong>Twenty-five eyes of 25 patients (mean age 60.2±11.4 years) were included. Mean interval between primary IOL implantation and exchange was 25.3±31.5 weeks. In 11/25 eyes, a different IOL model was implanted during the exchange. Using the Barrett RX formula, the mean prediction error (MPE) was 0.02±0.32D, mean absolute error (MAE) 0.27±0.17D, and median absolute error (MedAE) 0.22D. A total of 56% and 92% of eyes were within ±0.25D and ±0.50D of target refraction, respectively. The conventional formula yielded a comparable MPE of -0.12±0.68D (p=0.479), but higher MAE and MedAE (0.53±0.42D and 0.40D, p<0.001), with 32% and 56% of eyes within ±0.25D and ±0.50D, respectively.</p><p><strong>Conclusion: </strong>The Barrett RX formula has been demonstrated to be an efficacious method for calculating IOL power in eyes undergoing IOL exchange, with more than half of cases within ±0.25D of the predicted post-exchange refraction.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528130","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":"Genetic Variants in Genes Regulating Lens Capsule Structure and Stability in Dead Bag Syndrome - Part 1.","authors":"Abhay R Vasavada, Sankaranarayanan Rajkumar, Shail A Vasavada, Vaishali Vasavada, Suchi Dholu, Vijaylaxmi Meena","doi":"10.1097/j.jcrs.0000000000001733","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001733","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate potential genetic variants associated with spontaneous Posterior Capsule Rupture (sPCR) in patients diagnosed with Dead Bag Syndrome (DBS).</p><p><strong>Setting: </strong>Iladevi Cataract and Intraocular Lens (IOL) Research Centre and Raghudeep Eye Hospital, Ahmedabad, Gujarat, India.</p><p><strong>Design: </strong>Laboratory Study.</p><p><strong>Methods: </strong>We collected blood samples from 30 DBS patients and 37 controls. Whole-exome sequencing (WES) was performed. Genetic variants in genes encoding extracellular matrix (ECM) components of the lens capsule were screened. The association of selected variants with DBS was analysed using the Optimal Unified Sequence Kernel Association Test (SKAT-O) in R and Logistic Regression. Genes showing significant associations were further analysed using in silico predictions via the Ensembl Variant Effect Predictor (eVEP) to assess their potential impact on protein function.</p><p><strong>Results: </strong>Three genes-FBN2 (P=.027, OR=4.9, 95% CI=0.56-42.72), LAMB1 (P=.005, OR=11.0, 95% CI=1.56-77.31), and LAMB2 (P=.091, OR=8.2, 95% CI=1.03-65.57)-were found to be positively associated with DBS. A total of 15 distinct, functionally deleterious genetic variants, including 6 in FBN2, 3 in LAMB1, and 6 in LAMB2 genes were identified across 17 (56.7%) patients with DBS. Of the 17 patients, 5 (29.4%) carried a common genetic variant (p.Ile1547Thr; rs35915664, MAF=0.016) in the LAMB1 gene, which was absent in controls.</p><p><strong>Conclusions: </strong>The genetic variants found in FBN2, LAMB1, and LAMB2 genes may compromise the strength and stability of the lens capsule over time, predisposing individuals to DBS and sPCR later in life. The study shows for the first time that the DBS has a genetic predisposition.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528131","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":"Investigating the Effect of Different Riboflavin Concentrations on Corneal Biomechanical Properties in Cross-linking.","authors":"Xueqi Lin, Shichu Liu, Jiayue Yuan, Jing Cong, Qianhong Feng, Wenyu Xie, Yufeng Yan, Yuliang Rao, Chenli Feng, Hao Zhou, Jinhui Dai","doi":"10.1097/j.jcrs.0000000000001731","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001731","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the corneal cross-linking (CXL) efficacy of riboflavin (RF) at 5 different concentrations (0.1%, 0.25%, 0.5%, 0.75%, 1.0%) and determine the optimal concentration for maximizing the cornea's biomechanical performance.</p><p><strong>Setting: </strong>Department of Ophthalmology, Zhongshan Hospital, Fudan University.</p><p><strong>Design: </strong>Experimental study.</p><p><strong>Methods: </strong>The corneal epithelium was removed from all eyes. In the first part, 0.1% to 1.0% RF solutions were applied to rabbit eyes for 30 minutes, with 20% dextran used as the vehicle for the RF solutions. After application, RF concentration in the cornea and aqueous humor were evaluated. In the second part, after applying different RF solutions, the corneas underwent CXL with 9 mW/cm2 ultraviolet-A light for 10 minutes. Stress-strain curves, Young's modulus, and resistance to enzymatic digestion were measured.</p><p><strong>Results: </strong>107 eyes were used in total. RF concentrations in the cornea were 447.57 ± 28.72 μg/g, 536.51 ± 19.59 μg/g, 885.89 ± 111.77 μg/g, 1280.46 ± 103.86 μg/g, and 1668.68 ± 89.02 μg/g from 0.1% to 1.0% RF solutions, respectively. Following CXL, the corneal stress of the other four groups was 123%, 147%, 116%, and 69% relative to the 0.1% RF group at 10% strain. Similarly, after CXL with RF solutions at five concentrations, the residual corneal dry weights were 0.45 ± 0.08 mg, 0.53 ± 0.03 mg, 0.62 ± 0.07 mg, 0.50 ± 0.04 mg, and 0.35 ± 0.05 mg, respectively.</p><p><strong>Conclusions: </strong>The 0.5% RF group achieved the optimal corneal biomechanical performance under controlled experimental conditions, with decreased efficiency as the RF concentration further increased.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144528132","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":"Changes in the Sulcus and Anterior Chamber after horizontal or vertical intraocular lens orientation: a prospective randomized study.","authors":"Mayank A Nanavaty, Catherine Offer, Campbell Kier, Christopher Way, Paul Frattaroli, Stephen Bremner","doi":"10.1097/j.jcrs.0000000000001727","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001727","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the changes in ciliary sulcus (CS) and anterior chamber diameters (ACDi) following horizontal or vertical orientation of the intraocular lens (IOL) in the capsular bag in relation to preoperative axial length (AL) and anterior chamber depth (ACD).</p><p><strong>Settings: </strong>University hospital.</p><p><strong>Design: </strong>Prospective, randomized study.</p><p><strong>Methods: </strong>The first eye was randomized to receive the IOL horizontally or vertically and the second eye had the opposite orientation. Undilated UBM at 0-180o, 45-225o, 90-270o and 135-315oaxes were performed pre- and at 6 weeks. Data on preoperative AL and ACD was collected. a) Primary outcome measure: Change in CS and ACDi in relation to preoperative AL and ACD. b) Secondary outcome measure: Postoperative CS and ACDi in the horizontal vs. vertical IOL placement groups and right vs. left eyes.</p><p><strong>Results: </strong>Forty-six patients (92 eyes) were recruited. After horizontal placement of the IOL, there was a significant correlation between AL and change in horizontal CS for right (r=0.68, p=0.01) and left eyes (r=0.68, p=0.04). After vertical placement, there was a significant correlation between AL and ACD with change in vertical ACDi in right (AL: r=0.71,p=0.01; ACD: r=0.66,p=0.02) and left eyes (AL: r=0.93,p<0.01; ACD: r=0.65,p=0.04) respectively. There was no significant difference in pre- and postoperative change with horizontal and vertical IOL placements in the right vs. left eyes.</p><p><strong>Conclusion: </strong>When the IOL is horizontal in the capsular bag, the horizontal CS increases with decrease in AL. The vertical ACDi increases with increased AL or ACD when the IOL is vertical in the capsular bag.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553678","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":"Prescription Patterns in Descemet Membrane Endothelial Keratoplasty (DMEK): A European Survey.","authors":"Yexin Ye, Fabio de Rooij, Nicolas Alejandre, Frank J H M van den Biggelaar, Tristan Bourcier, Béatrice Cochener-Lamard, Francisco C Figueiredo, David J Galarreta, Jesper Ø Hjortdal, Gary L A Jones, Naomi Nathan, Rudy M M A Nuijts, Vito Romano, Andreia M Rosa, Berthold Seitz, Marie-José Tassignon, Katrin Wacker, Mor M Dickman","doi":"10.1097/j.jcrs.0000000000001726","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001726","url":null,"abstract":"<p><strong>Purpose: </strong>To assess current prescription patterns in Descemet Membrane Endothelial Keratoplasty (DMEK) in Europe.</p><p><strong>Setting: </strong>Countries affiliated with the European Cornea and Cell Transplantation Registry (ECCTR) and the European Vision Institute Clinical Research Network (EVICR.net).</p><p><strong>Design: </strong>Cross-sectional study (European survey).</p><p><strong>Methods: </strong>An electronic survey was distributed to 16 national societies to gather data on prescription patterns for DMEK. Responses were categorized by three clinical goals: prevention of postoperative endophthalmitis, graft rejection, and pupillary block and glaucoma.</p><p><strong>Results: </strong>Responses from 136 surgeons revealed that medication protocols mainly came from departmental protocols (54%) or personal experiences (48%) rather than national guidelines (22%) (multiple answers were allowed). Infection prevention primarily relied on intraoperative (72%) and postoperative (92%) antibiotics, with preoperative use less common (18%). Steroids were the mainstay for rejection prevention, used intraoperatively (59%), postoperatively (100%), and occasionally preoperatively (13%). Steroids were typically tapered to once daily after six months (46%) and discontinued after varying durations (65%). Dexamethasone was the preferred steroid. For high-risk DMEK, the most common approach was adding another topical (30%) or systemic immunosuppressive drug (24%), such as cyclosporine or mycophenolate. For graft rejection, most respondents increased topical steroid frequency (85%) or added (peri)bulbar steroid injections (42%). Pupillary block and glaucoma prophylaxis mainly involved intraoperative mydriatics (34%); intraocular pressure-lowering agents were rarely used (0.7-2.2%). For steroid-induced ocular hypertension, the common approach was switching to a lower-potency steroid (40%) or reducing steroid frequency (43%).</p><p><strong>Conclusions: </strong>Current prescription patterns in routine and high-risk DMEK vary significantly, reflecting the lack of standardized guidelines.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144484514","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":"Haptics and Axis Stability of Customized Vertical Implantable Collamer Lens Implantation.","authors":"Boliang Li, Mingrui Cheng, Yadi Lei, I-Chun Lin, Xun Chen, Xiaoying Wang","doi":"10.1097/j.jcrs.0000000000001728","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001728","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the postoperative vault, haptic position, and axis stability of vertical implantable collamer lens (ICL) implantation.</p><p><strong>Setting: </strong>Fudan University Eye and ENT Hospital, Shanghai, China.</p><p><strong>Design: </strong>Prospective.</p><p><strong>Methods: </strong>This study included patients who underwent ICL implantation. Three months postoperatively, the vault, haptic position, and axis were measured.</p><p><strong>Results: </strong>Ninety-eight eyes from 98 patients were included. At 3 months postoperatively, the vault was 517.10 ± 200.08 µm in the vertical group and 506.88 ± 204.19 µm in the horizontal group (P = .803). There was a significant difference in the distribution of haptics in the ciliary sulcus (ICS) between the two groups (P = .045). In the vertical group, an average of 0.90 ± 0.83 haptics near the incision and 1.33 ± 0.81 haptics away from the incision were located in the sulcus, showing a significant difference (P = .002). In those undergoing toric ICL implantation, 54% of eyes in the vertical group and 79% in the horizontal group experienced rotation, with a significant difference (P = .042). In the horizontal group, there were significant differences in both the vault and difference value between vertical and horizontal sulcus-to-sulcus (vSTS - hSTS) between the non-rotated and rotated subgroups (P = .019 and P = .035, respectively).</p><p><strong>Conclusion: </strong>Customized vertical ICL implantation does not affect refractive outcomes and achieves an ideal vault. Situating the haptic near the incision in the ciliary sulcus is relatively more difficult for vertical implantation. Vertical implantation improves ICL stability in patients with a large vSTS - hSTS.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475401","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":"Six-month Performance and Safety of an Iris-Fixated Multifocal Intraocular Lens for Presbyopia Correction in Phakic Eyes.","authors":"Joukje C Wanten, Julián Cezón, Rudy M M A Nuijts, Juan A Duran de la Colina, Mariano Royo, Chul Myong Choe, Jae Ho Choi, Chan Soo Park, Il Hwan Koh, Daniel Casado Rodríguez, Noël Jc Bauer, José L Güell","doi":"10.1097/j.jcrs.0000000000001722","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001722","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the six-month effectiveness and safety of a novel foldable multifocal iris-fixated phakic IOL (pIOL) for presbyopia correction.</p><p><strong>Setting: </strong>Multicenter study at 7 sites.</p><p><strong>Design: </strong>Nonrandomized prospective clinical trial.</p><p><strong>Methods: </strong>Presbyopic patients without cataracts undergoing bilateral multifocal pIOL implantation (Ophtec ArtiPlus) were studied. The primary outcome for efficacy was the visual acuity at distance, intermediate, and near. Secondary outcomes included endothelial cell density (ECD), postoperative refraction, binocular defocus curve, vision quality, spectacle independence, and patient satisfaction.</p><p><strong>Results: </strong>A total of 49 subjects (98 eyes) were included. At six months, the mean binocular uncorrected distance intermediate, and near visual acuity were -0.05±0.09, -0.02±0.07, and 0.02±0.08 logMAR, respectively. The ECD remained stable with a mean value of 2771±289 cells/mm2 at six months postoperatively. The mean spherical equivalent was -0.42±0.33 diopters (D), with 95% eyes having a prediction error within ±1.0D and 77% within ±0.5D. The binocular distance-corrected defocus curve showed a visual acuity of 0.20 logMAR or better over a range of +1.0D to -3.5D. Patient satisfaction was high, with a mean score of 3.5 on a 4-point scale, and 83% of the patients reported spectacle independence. 47%, 35%, and 96% of patients reported experiencing glare, halos, and starbursts at well-tolerated levels, respectively. Notably, only 2% of patients found halos and starbursts to be very bothersome.</p><p><strong>Conclusion: </strong>Bilateral ArtiPlus multifocal pIOL implantation demonstrated good visual acuity from distant to near and maintained stable ECD over six months. Patients reported high levels of satisfaction and spectacle independence, despite some optical disturbances.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309966","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":"Clinical Data Registry Comparing Outcomes of Two Light Adjustable Lenses.","authors":"John Doane, T Hunter Newsom, Stephen Slade, Vance Thompson, Nicholas Bruns, John Vukich","doi":"10.1097/j.jcrs.0000000000001721","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001721","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the clinical performance of the light adjustable lenses (LAL) to the LAL+ with an increased central power to have broader depth of focus.</p><p><strong>Setting: </strong>Private practice clinics.</p><p><strong>Design: </strong>Prospective, non-randomized, non-masked, multi-center.</p><p><strong>Methods: </strong>Clinical data collection registry of patients bilaterally implanted with the LAL or LAL+ (RxSight, Inc.). Outcome measures included subjective manifest refraction; monocular best corrected distance, intermediate and near visual acuity; binocular uncorrected distance, intermediate, and near visual acuity; and binocular uncorrected best focus visual acuity at differing contrast levels.</p><p><strong>Results: </strong>91.1% and 93.5% of LAL and LAL+ eyes had an MRSE within 0.50 D of target, respectively. 92.0% and 89.0% of LAL and LAL+ patients had a binocular uncorrected distance visual acuity (UCDVA) of 20/20 or better after adjustment, respectively. 86.0% and 93.0% of LAL and LAL+ patients had binocular uncorrected best focus visual acuity of J1 or better at 100% contrast, respectively. Distance corrected intermediate and near visual acuity was better with the LAL+ compared to the LAL, consistent with its further broadened depth of focus. Best corrected distance vision was only slightly reduced for LAL+ (1 letter), with both lenses achieving high levels.</p><p><strong>Conclusions: </strong>Both the LAL and LAL+ achieved excellent refractive and binocular visual outcomes at distance, intermediate and near. The broadened depth of focus of the LAL+ was clinically evident and led to less anisometropia. The ability of patients to binocularly select and adjust their refraction according to their visual goal is a unique therapeutic approach to cataract refractive patients.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144309961","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}