Journal of cataract and refractive surgery最新文献

{"title":"Visual performance after implantation of a new trifocal IOL with an advanced hydrophobic acrylic biomaterial.","authors":"Thomas Kohnen, Klemens Paul Kaiser, Marvin Biller, Petra Davidova, Annika Klinkenbusch, Eva Hemkeppler, Jakob Wend, Zubeida H Omerovic, Myriam Böhm","doi":"10.1097/j.jcrs.0000000000001688","DOIUrl":"10.1097/j.jcrs.0000000000001688","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the one-year efficacy and safety of the one-piece multifocal intraocular lens (IOL) Clareon PanOptix CNWT (Alcon, Fort Worth, TX, USA).</p><p><strong>Setting: </strong>Department of Ophthalmology, Goethe-University, Frankfurt, Germany.</p><p><strong>Design: </strong>A prospective, single-centre, single-arm, interventional study.</p><p><strong>Methods: </strong>Cataract patients underwent bilateral implantation of a Clareon PanOptix multifocal IOL following phacoemulsification. Examinations included manifest refraction, uncorrected visual acuity (UCVA) and distance-corrected visual acuity (DCVA) at 4m, 80cm, 60cm, 40cm, and 30cm, defocus test, contrast sensitivity (CS) under photopic and mesopic conditions and a questionnaire on subjective quality of vision (QoV), optical phenomena, and spectacle independence. The primary outcome was visual acuity after 12 months post operatively.</p><p><strong>Results: </strong>The binocular UCVA was -0.04 ± 0.08 logMAR and at intermediate (80cm and 60cm) and near (40cm and 30cm) -0.03 ± 0.05, -0.04 ± 0.11 and 0.05 ± 0.11, 0.19 ± 0.12 logMAR, respectively. The binocular distance-corrected defocus curve showed a peak at 0.0 D and -2.0 D with -0.07 and -0.02 logMAR, and between +0.50 and -3.00 D within 0.10 logMAR. At 12 months, there was no evidence of glistenings in any eye. Twenty-four (89%) participants would choose the IOL again and 23/27 (85%) would recommend the IOL to others.</p><p><strong>Conclusion: </strong>The trifocal Clareon PanOptix IOL provides patients with good visual performance and spectacle independence at all distances without evidence of IOL glistenings.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119772","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":"Rotational stability, centration, and patient satisfaction with the Clareon Panoptix Toric intraocular lens.","authors":"Nuria Garzón, Javier García-Bella, Pedro Arriola-Villalobos, José M Martínez-de-la-Casa, Celia Villanueva, Julián García-Feijoo","doi":"10.1097/j.jcrs.0000000000001687","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001687","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the rotational stability, decentration, visual outcomes, and patient satisfaction after bilateral implantation of the trifocal toric intraocular lens (IOL), Clareon PanOptix Toric (Alcon, Fort Worth, TX, USA).</p><p><strong>Setting: </strong>San Carlos Hospital, Madrid, Spain.</p><p><strong>Design: </strong>Prospective, single-center, observational, non-comparative.</p><p><strong>Methods: </strong>Patients aged 50 years or older suitable for cataract surgery without comorbidities and with regular corneal astigmatism >1.50D were bilaterally implanted with the Clareon PanOptix Toric IOL and followed up for 3-months. Outcomes measured included IOL displacement and rotation, quantified by the PIOLET software. Additionally, refraction and uncorrected visual acuity (UDVA) at far (4 m) were measured, along with corrected visual acuities, monocular and binocular, at far (CDVA), intermediate (DCIVA), and near (DCNVA) distances.</p><p><strong>Results: </strong>A total of 80 eyes from 40 patients were included in this study. At 3 months, the mean rotation was 1.04 ± 0.97 degrees, and the mean displacement was 0.19 ± 0.36 mm along the X-axis and 0.19 ± 0.25 mm along the Y-axis. The postoperative spherical equivalent was -0.09 ± 0.35 D. Binocularly, the mean visual acuities were CDVA, -0.03 ± 0.05 logMAR; DCIVA, 0.07 ± 0.08 logMAR; and DCNVA, 0.09 ± 0.07 logMAR. Regarding satisfaction, 97% of patients indicated they were either very satisfied or fairly satisfied.</p><p><strong>Conclusion: </strong>The bilateral implantation of the Clareon PanOptix Toric IOL demonstrates excellent rotational stability, minimal decentration, and effective astigmatism correction. It provides strong visual acuity outcomes and high patient satisfaction, making it a viable option for patients seeking spectacle independence.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119770","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":"Depicting the Epithelium and Stroma Profiles of Post-Laser Vision Correction Ectasia by Optical Coherence Tomography.","authors":"Nan-Ji Lu, Robert Herber, Lin Wang, Ioannis M Aslanides, Jia-Qi Ai, Qin-Mei Wang, Le-Le Cui, Jos J Rozema","doi":"10.1097/j.jcrs.0000000000001684","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001684","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate changes in the epithelium and stroma in patients with post-laser vision correction (LVC) ectasia using spectral-domain optical coherence tomography (SD-OCT) and to compare these changes with those observed in post-LVC stable eyes.</p><p><strong>Setting: </strong>Eye Hospital of Wenzhou Medical University, Wenzhou, China.</p><p><strong>Designs: </strong>Retrospective case-control study.</p><p><strong>Methods: </strong>Scheimpflug tomography and SD-OCT were performed on post-LVC stable and ectasia eyes. The postoperative remodeling pattern of epithelium and stroma were described. All SD-OCT machine-derived parameters were evaluated based on their receiver operating characteristic (ROC) curves, area under the curve (AUC), sensitivity, and specificity to discriminate between post-LVC stable and ectasia eyes.</p><p><strong>Results: </strong>One hundred and eleven eyes from 111 post-LVC stable patients (41 post-Trans-photorefractive keratectomy [TransPRK] eyes, 34 post-laser in situ keratomileusis [LASIK] eyes, and 36 post-small incision lenticule extraction [SMILE] eyes) and 23 eyes from 23 post-LVC ectasia patients (one post-TransPRK ectasia eye, one post-sub-Bowman's keratomileusis ectasia eye, one post-laser assisted sub-epithelial keratomileusis ectasia eye, and 20 post-LASIK ectasia eyes).The unique epithelium remodeling pattern were observed in both post-LVC stable and ectasia eyes, in the latter as a \"horseshoe\"-like pattern. The top three ranked AUC ROC SD-OCT parameters were all derived from epithelium, including epithelium 5mm superior-inferior (cutoff value = -0.675, AUC = 0.956), epithelium 5mm inferior (cutoff value = 52.41, AUC = 0.937), and epithelium thickness range (cutoff value = -23.685, AUC = 0.936).</p><p><strong>Conclusions: </strong>The characteristic remodeling pattern and the machine-derived SD-OCT parameters describing the epithelium remodeling of post-LVC ectasia could potentially be used for its diagnosis.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144119768","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":"Development of machine learning-based models for vault prediction in implantable collamer lens surgery according to implant orientation.","authors":"Timoteo González-Cruces, Francisco Javier Aguilar-Salazar, Jordi Marfany Tort, Álvaro Sánchez-Ventosa, Alberto Villarrubia, Jose Lamarca Mateu, Rafael I Barraquer, Sergio Pardina, David Cerdán Palacios, Antonio Cano-Ortiz","doi":"10.1097/j.jcrs.0000000000001623","DOIUrl":"10.1097/j.jcrs.0000000000001623","url":null,"abstract":"<p><strong>Purpose: </strong>To develop a prediction model based on machine learning to calculate the postoperative vault and the ideal implantable collamer lens (ICL) size, considering for the first time the implantation orientation in a White population.</p><p><strong>Setting: </strong>Arruzafa Ophthalmological Hospital (Cordoba, Spain) and Barraquer Ophthalmology Center (Barcelona, Spain).</p><p><strong>Design: </strong>Multicenter, randomized, retrospective study.</p><p><strong>Methods: </strong>Anterior segment biometric data from 235 eyes of patients who underwent ICL lens implantation surgery were collected using the anterior segment optical coherence tomography CASIA II to train and validate 5 types of multiple regression models based on advanced machine learning techniques. To perform an external validation, a dataset of 45 observations was used.</p><p><strong>Results: </strong>The Pearson correlation coefficient between observed and predicted values was similar in the 5 models in the external validation, with least absolute shrinkage and selection operator regression being the highest ( r = 0.62, P < .001), followed by random forest regression model ( r = 0.60, P < .001) and backward stepwise regression ( r = 0.58, ρ < 0.001). In addition, the predictions generated by the different models showed closer agreement with the actual vault compared with the Nakamura formulas. Using the new methods, about 70% of the observations had a prediction error below 150 μm.</p><p><strong>Conclusions: </strong>Advanced forms of regressions models based on machine learning allow satisfactory calculation of the ideal lens size, offering greater precision to surgeons customizing surgery according to implant orientation.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"412-419"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065820","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":"How to reduce free radicals during phacoemulsification: electron paramagnetic resonance measurements comparing the production of free radicals in different use cases.","authors":"Christina Giger-Lange, Jakob Barz, Heiko Heim","doi":"10.1097/j.jcrs.0000000000001625","DOIUrl":"10.1097/j.jcrs.0000000000001625","url":null,"abstract":"<p><strong>Purpose: </strong>To detect free radicals during phacoemulsification in different use cases and with emulsification of lens tissue.</p><p><strong>Setting: </strong>Institute for Interfacial Engineering and Biotechnology, Fraunhofer Institute, Stuttgart, Germany.</p><p><strong>Design: </strong>Experimental study.</p><p><strong>Methods: </strong>3 experimental setups were used: (1) setup without running fluidics to produce air bubbles inside the system, (2) circulation fluidic setup to compare measurements with and without cataractous lens material, and (3) a surgery-comparable system that closely mimics a realistic setup. Porcine lenses were incubated for 1.25 hours in formalin to simulate middle hard cataracts and emulsified in a test chamber. Free radicals were captured by the spin-trapping agent 5,5'-dimethyl-1-pyrroline N-oxide and measured using electron paramagnetic resonance spectroscopy.</p><p><strong>Results: </strong>Hydroxyl radicals were the predominant free radicals detected. The maximum amount of radicals was produced when air bubbles were allowed to build up inside the system. Less radicals were produced during lens emulsification compared with application without lens. This effect was enhanced when the phacotip was in close contact with the lens during the whole procedure. In the surgery-comparable setup, the least amount of free radicals was detected.</p><p><strong>Conclusions: </strong>For the first time, we were able to analyze free radicals during phacoemulsification of lens tissue. We show that emulsification of lens tissue reduces the production of free radicals, an effect that is enhanced during close contact of the tissue with the phacotip. In addition, we show that air bubbles should be avoided during cataract surgery because they may enhance free radical production. Furthermore, running fluidics remove most of the radicals making oxidative stress less likely.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"420-426"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399269","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: Evidence-based functional classification of simultaneous vision intraocular lenses: seeking a global consensus by the ESCRS Functional Vision Working Group.","authors":"Sheraz Daya, Erik Mertens, Francesco Carones, David Shahnazaryan","doi":"10.1097/j.jcrs.0000000000001638","DOIUrl":"10.1097/j.jcrs.0000000000001638","url":null,"abstract":"","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"436"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501415","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":"Modern cataract surgery with simplified technology: new trend?","authors":"Liliana Werner","doi":"10.1097/j.jcrs.0000000000001657","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001657","url":null,"abstract":"","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":"51 5","pages":"353-354"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143992922","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":"Dissatisfaction after implantation of EDOF intraocular lenses.","authors":"Joukje C Wanten, Noël J C Bauer, Tos T J M Berendschot, Frank J H M van den Biggelaar, Rudy M M A Nuijts","doi":"10.1097/j.jcrs.0000000000001615","DOIUrl":"10.1097/j.jcrs.0000000000001615","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the symptoms, etiology, and treatment of patient dissatisfaction after extended depth-of-focus (EDOF) intraocular lens (IOL) implantation.</p><p><strong>Setting: </strong>University Eye Clinic, Maastricht University Medical Center, the Netherlands.</p><p><strong>Design: </strong>Retrospective case series.</p><p><strong>Methods: </strong>For this study, all medical records of patients who received an EDOF IOL from July 2020 to July 2022 were reviewed. Patients were included if they had reported any dissatisfaction after surgery. The main outcome parameters were reasons for dissatisfaction (subjective complaints) and the presumed etiology of the complaints.</p><p><strong>Results: </strong>Of 202 patients (354 eyes) who underwent EDOF IOL implantation, 83 eyes (22.8%) of 52 dissatisfied patients were included. Blurred vision was the predominant complaint, reported in 78 eyes (94%). Photic phenomena were reported in 21 eyes (25.3%), with 16 eyes (76.2%) experiencing coexisting blurred vision. The major etiologies for dissatisfaction in this cohort were residual ametropia (51.8%), dry eye disease (26.5%), and posterior capsular opacification (12.0%). Treatments were administered to 85.5% of the eyes, including interventions such as artificial tears, spectacles, or refractive surgery enhancement. A small number of patients (n = 12; 5.9%) remained dissatisfied despite intervention.</p><p><strong>Conclusions: </strong>Based on this real-world data study, dissatisfaction after EDOF IOL implantation can be effectively identified and treated in most cases.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"399-405"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033050","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":"Disinfection of outpatient ophthalmic devices: a critique of \"semicritical\" designation.","authors":"Irene C Kuo","doi":"10.1097/j.jcrs.0000000000001635","DOIUrl":"10.1097/j.jcrs.0000000000001635","url":null,"abstract":"<p><p>Ophthalmic devices used in outpatient clinics are undergoing scrutiny by regulatory agencies and hospital infection control groups. Applying a nearly century-old classification for disinfection and sterilization of reusable devices and instruments, they are faulting ophthalmologists for not using high-level disinfection (HLD) listed in newer manufacturer instructions for use. By this classification, A-scan and B-scan ultrasound probes, fundus and laser contact lenses, and gonioscopy lenses are grouped with other \"semicritical\" devices, such as gastrointestinal endoscopes, laryngoscope blades, and anorectal manometers, and therefore require sterilization or HLD. HLD, however, varies by geographic region, compatibility with material, and disinfectant availability. Because HLD necessitates turnover time, clinics must buy more devices to maintain patient volume. Therefore, manufacturers have no incentive to develop sustainable or reusable devices. Most important, however, none of the ophthalmic devices in question has been associated with spread of infection. In short, the mandate for HLD seems to be arbitrary, reactive to perception of possible infection risk from classification of the eye as a \"mucous membrane,\" and devoid of evidence that HLD decreases risk of infection transmission relative to current cleaning and disinfection methods. In the manner that the Ophthalmic Instrument Cleaning and Sterilization Task Force Regulatory raised concerns that regulatory agencies arbitrarily were imposing costly infection control measures for intraocular ophthalmic surgery without evidence that they improved patient safety, a similar task force is needed to address regulatory HLD mandates for clinic devices used in tens of millions of patient encounters for decades without infection transmission.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"355-358"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12018133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating ASC-4 transfer rates in cataract surgery: insights into timing and causes of hospital transfers.","authors":"Nicholas R Stange, Matthew P Rauen","doi":"10.1097/j.jcrs.0000000000001613","DOIUrl":"10.1097/j.jcrs.0000000000001613","url":null,"abstract":"<p><strong>Purpose: </strong>To describe the causes, timing, and contributing factors of direct hospital transfer cases from an ophthalmology-specific ambulatory surgery center (ASC) and to identify potential strategies for decreasing future transfers.</p><p><strong>Setting: </strong>A large ophthalmology surgery center in Des Moines, Iowa.</p><p><strong>Design: </strong>Retrospective review.</p><p><strong>Methods: </strong>A retrospective chart review was performed on patients requiring hospital transfer from a Midwest ophthalmology-specific surgery center from March 2022 through July 2024. Variables reviewed included patient demographics, comorbidities, prior surgeries/surgical complications, results of preoperative physical examinations, type of surgery and anesthesia performed, the type and timing of each complication, and the reasons for transfer. Each transfer was assessed for its necessity, preventability, and outcome.</p><p><strong>Results: </strong>22 patients required hospital transfer of 24 960 admissions for a rate of 0.88 per 1000 admissions (95% CI, 0.58-1.33). Only 5 (23%) transfer cases were temporally related to anesthesia or surgery. The other 17 (77%) had concerns first noted before the induction of anesthesia. 9 (41%) of the surgeries were completed, 1 (5%) partially completed, and the remaining 12 (55%) surgeries were cancelled. The reasons for transfer were largely cardiac-related and/or blood pressure-related (18/22, 82%). Nearly a third of the transfers (7/22, 32%) were considered preventable.</p><p><strong>Conclusions: </strong>Hospital transfers from ASCs are rare, and all-cause hospital transfer rates may overestimate the true risk of ocular surgery. Most patients requiring hospital transfer were identified in the preoperative area. Greater attention to preoperative physical examination reports could potentially prevent some hospital transfers.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"376-381"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143005960","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}