Journal of cataract and refractive surgery最新文献

{"title":"Standards for analyzing astigmatic outcomes Part I: Astigmatism basics.","authors":"Thomas Kohnen, Kristian Naeser, Jack T Holladay, R Doyle Stulting, Li Wang, Adi Abulafia, Douglas D Koch","doi":"10.1097/j.jcrs.0000000000001644","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001644","url":null,"abstract":"<p><strong>Abstract: </strong>Astigmatism is the difference between the orthogonal principal planes of minimal and maximal powers of a toric surface, lens, or refraction. Corneal astigmatism is a common condition, and studies indicate that over 60% of individuals have more than 0.50 diopters (D) of astigmatism. Corneal astigmatism is measured in various ways, and measurements from different devices are usually not interchangeable due to variations in technology and the corneal regions that are imaged. The integrity of the ocular surface is critically important for accurately measuring corneal astigmatism. Optimizing the ocular surface before cataract surgery can significantly improve the accuracy of preoperative astigmatism measurements and refractive outcomes. It is advisable to obtain at least 2 or preferably 3 measurements when measuring corneal astigmatism. When a discrepancy in astigmatism meridian and magnitude occurs between the measurements, it is advisable to settle or at least minimize this discrepancy by repeating the measurements after optimizing the ocular surface. Posterior corneal astigmatism is an important component of total corneal astigmatism. Lens tilt can also induce visually significant refractive astigmatism and ideally should be accounted for in toric IOL planning.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542056","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":"Standards for Analyzing Astigmatic Outcomes II: Recommended statistical methods.","authors":"Douglas D Koch, Jack T Holladay, Kristian Naeser, Adi Abulafia, Li Wang, R Doyle Stulting, Thomas Kohnen","doi":"10.1097/j.jcrs.0000000000001645","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001645","url":null,"abstract":"<p><strong>Abstract: </strong>Surgically induced astigmatism (SIA) is the astigmatic component of the surgically induced refractive change. Vector prediction error (PE) is the key expression for evaluating refractive surgery, defined as the vector difference between the postoperatively observed refractive astigmatism and the refractive astigmatism predicted from the preoperative measurements. Astigmatic analysis of the SIA and PE includes both univariate and bivariate analyses. The magnitude of the refractive astigmatism is a predictor of visual function and a valuable component of astigmatic reporting. For vector metrics from bivariate analysis, data should be analyzed and displayed with double-angle plots. Vector calculations can be performed independent of or relative to a reference meridian or axis. Double-angle plots with convex polygons and statistical analysis for astigmatism data can be obtained easily with the wrap-up functions from the WHWK (Wilcox-Holladay-Wang-Koch) Statistical Software using the free software R Project for Statistical Computing or with Eyetemis software, which is also available online.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542053","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 Intraocular Lens Nomenclature.","authors":"Sheraz Daya, Erik Mertens, Francesco Carones, David Shahnazaryan","doi":"10.1097/j.jcrs.0000000000001638","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001638","url":null,"abstract":"","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-25","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":"Comparative evaluation of clinical results and patient-reported outcomes of enhanced monofocal and conventional monofocal intraocular lenses.","authors":"Ryota Kabura, Tetsuji Takeshita, Kyoka Furushima, Rumi Iwasaki, Rikako Fukuda, Hinako Amikawa, Tetsuro Oshika","doi":"10.1097/j.jcrs.0000000000001641","DOIUrl":"10.1097/j.jcrs.0000000000001641","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate and compare visual performance of two enhanced monofocal intraocular lenses (IOLs), XY1-EM (Vivinex Impress, Hoya) and DIB00V (TECNIS Eyhance, Johnson & Johnson) with that of a conventional monofocal IOL, XY-1 (Vivinex, Hoya).</p><p><strong>Setting: </strong>Kamiamakusa General Hospital, Kumamoto, Japan.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on 130 eyes from 75 patients, including 46 eyes (27 patients) implanted with XY1-EM, 47 eyes (26 patients) with DIB00V, and 37 eyes (22 patients) with XY-1.</p><p><strong>Results: </strong>Corrected-distance visual acuity was comparable across all three groups. Both enhanced monofocal IOLs (XY1-EM and DIB00V) demonstrated significantly superior distance-corrected visual acuity at 70 cm and 50 cm compared to the conventional monofocal IOL (XY1). The rates of spectacle independence were also significantly higher in the enhanced monofocal IOL groups. In a direct comparison between the two enhanced monofocal IOLs, XY1-EM exhibited a significantly better defocus curve at -1.5D than DIB00V. Patients reported higher subjective satisfaction for \"reading a newspaper\" and \"speed of adaptation to daily vision\" in the XY-1 group compared to the DIB00V group.</p><p><strong>Conclusions: </strong>The new enhanced monofocal IOL, Vivinex Impress XY1-EM, demonstrated significantly improved intermediate visual acuity compared to the conventional monofocal IOL. It also showed slightly superior intermediate visual acuity and higher subjective satisfaction compared to the other enhanced monofocal IOL evaluated in this study.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492029","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: Evidence-based functional classification of simultaneous vision intraocular lenses: seeking a global consensus by the ESCRS Functional Vision Working Group.","authors":"Filomena Ribeiro, H Burkhard Dick, Thomas Kohnen, Oliver Findl, Rudy Nuijts, Beatrice Cochener, Joaquín Fernández","doi":"10.1097/j.jcrs.0000000000001639","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001639","url":null,"abstract":"","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143597134","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":"Assessing Quality of Vision in Cataract Surgery: A Randomized Trial of Digital vs. Paper-Based Questionnaires.","authors":"Adi Porat Rein, Mats Lundström, Mor M Dickman, Matan Rosen, Yaron Finkelman, Anastasia Semionov, David Zadok, Adi Abulafia","doi":"10.1097/j.jcrs.0000000000001642","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001642","url":null,"abstract":"<p><strong>Purpose: </strong>To introduce a newly developed digital platform and compare its reliability and agreement with paper-based questionnaires for assessing quality of vision before and after cataract surgery.</p><p><strong>Setting: </strong>University-affiliated ophthalmology department and private clinic.</p><p><strong>Design: </strong>Prospective, randomized trial with parallel design of 1:1 allocation ratio without masking.</p><p><strong>Methods: </strong>Between 11/2021 and 6/2023, patients from a preoperative cataract clinic, aged ≥21 years, with cataracts in both eyes and internet access were randomly assigned by \"ALEA\" software to complete Catquest-9SF and Quality-of-Vision (QoV) questionnaires before surgery and after second eye surgery via paper or a newly developed digital European Registry of Quality Outcomes in Cataract and Refractive Surgery (EUREQUO) platform. Statistical analyses evaluated agreement between methods, and validation was by Rasch analysis.</p><p><strong>Results: </strong>Half (183/364, 50.3%) of the enrolled patients were allocated to digital questionnaires. After exclusion due to technical issues, missing questions, and withdrawal, 307/364 patients remained, of whom 159 (51.8%) filled in digital questionnaires. Half of all patients (n=154) underwent sequential surgeries on both eyes after a minimum one-month interval. Seventy-two (72/154, 46.8%) completed postoperative questionnaires. Comparative analysis found no significant differences between paper and digital methods. Catquest-9SF and QoV questionnaires demonstrated good precision and reliability (Rasch analysis). Postoperative vision improved at an average of 2.82 logits.</p><p><strong>Conclusion: </strong>The newly developed digital EUREQUO platform for patient assessment of quality of vision before and after cataract surgery with the Catquest-9SF and QoV questionnaires, offers a reliable alternative to traditional paper-based questionnaires, enhancing convenience for patients and providers.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501413","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":"Visual and subject-reported outcomes of a wavefront shaping extended depth of focus intraocular lens implanted bilaterally with monovision.","authors":"Miguel A Teus, Thomas Kohnen, James Ball, Isabelle E Y Saelens, Gerard Sutton, Michael Lawless, Caridad Perez Vives, Ruth Lapid-Gortzak","doi":"10.1097/j.jcrs.0000000000001636","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001636","url":null,"abstract":"<p><strong>Purpose: </strong>To report visual and subject-reported outcomes after bilateral implantation of non-diffractive extended-depth-of-focus (EDoF) intraocular lens (IOL) (AcrySof IQ Vivity) with monovision correction during cataract or refractive lens exchange (RLE) surgery.</p><p><strong>Setting: </strong>Europe, Australia, and New Zealand.</p><p><strong>Design: </strong>Subgroup analysis of Vivity registry.</p><p><strong>Methods: </strong>Binocular uncorrected and corrected visual acuities at distance (UCDVA/CDVA), intermediate (UCIVA/DCIVA), and near (UCNVA/DCNVA) were assessed at 3-6 months after implantation. Subject-reported outcomes (satisfaction, spectacle independence, visual disturbances) were evaluated. Data were reported by surgery type and monovision level at low (>-0.75D and ≤-0.50D), medium (>-1.00D and ≤-0.75D), and high (≤-1.00D).</p><p><strong>Results: </strong>Overall, 200 (of 885) subjects met the monovision criteria (cataract, n=170; RLE, n=24). Excellent binocular UCDVA and UCIVA and excellent/good UCNVA (mean±SD logMAR) were noted for cataract (0.031±0.102; 0.081±0.114; 0.217±0.144) and RLE (0.006±0.093; -0.003±0.089; 0.123±0.097) groups, respectively. Most subjects were spectacle-independent for distance and intermediate vision and very/fairly satisfied with sight; >87% from each surgery group reported no visual disturbances. Excellent UCDVA was preserved at low and medium monovision. Better UCNVA was observed for medium and high vs. low monovision levels, whereas spectacle independence for distance and intermediate was higher for medium vs. low/high monovision. High subject satisfaction and minimal visual disturbances were reported regardless of monovision level.</p><p><strong>Conclusions: </strong>Monovision correction with the non-diffractive EDoF IOL demonstrated excellent-to-good VA at all distances, high levels of spectacle independence and subject satisfaction, and minimal visual disturbances after cataract and RLE surgeries. Overall, medium monovision level performed most favorably, achieving good near VA while preserving excellent distance and intermediate vision.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467994","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 \"semi-critical\" designation.","authors":"Irene C Kuo","doi":"10.1097/j.jcrs.0000000000001635","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001635","url":null,"abstract":"","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of a Topical Antibiotic and Povidone-Iodine Versus Povidone Iodine Alone on Conjunctival Flora: A Systematic Review and Meta-Analysis.","authors":"Amelia Charlotte Rees, Mohammed Saleki","doi":"10.1097/j.jcrs.0000000000001626","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001626","url":null,"abstract":"<p><strong>Topic: </strong>This systematic review and meta-analysis aimed to determine whether adding preoperative topical antibiotics to povidone-iodine (PVI) offers any additional benefit over PVI alone in reducing conjunctival bacterial flora, thereby potentially lowering the risk of postoperative endophthalmitis. The participants included 1423 eyes undergoing elective intraocular surgeries (e.g., cataract, keratoplasty, trabeculectomy) or receiving intravitreal injections. The interventions studied were PVI combined with third-generation quinolones (levofloxacin, moxifloxacin, or gatifloxacin) compared with PVI alone. The outcome measure was post-intervention rate of positive conjunctival bacterial cultures prior to ophthalmic procedure.</p><p><strong>Clinical relevance: </strong>Postoperative endophthalmitis is a rare but serious complication of intraocular surgery, potentially leading to significant vision loss. While PVI is widely recognised as an essential prophylactic measure, the role of preoperative topical antibiotics remains debated. Defining the necessity of antibiotic use in routine cataract surgery is important, especially given the concerns about antibiotic resistance and the rising cost of healthcare. The current standard of care varies globally, with PVI commonly used alone in many regions, such as the UK.</p><p><strong>Methods: </strong>Studies were included based on the comparison of preoperative PVI with or without antibiotics in patients undergoing intraocular surgery. Searches were conducted in PubMed, Cochrane, and Embase databases, covering literature up to October 2024. Risk of bias was assessed using the Cochrane risk of bias tool.</p><p><strong>Results: </strong>Seven studies were included, comprising 1423 eyes. A meta-analysis revealed no significant difference in the reduction of conjunctival bacterial flora between PVI + antibiotics and PVI alone (OR: 0.77, 95% CI 0.42-1.42, p=0.41). Subgroup analysis showed that levofloxacin combined with PVI significantly reduced positive culture rates (OR: 0.48, 95% CI 0.29-0.81, p=0.006), while moxifloxacin and gatifloxacin did not show similar benefits. Moderate heterogeneity was observed across studies (I2=58%, p=0.04).</p><p><strong>Conclusion: </strong>This review found no conclusive benefit of using preoperative topical antibiotics alongside PVI in routine ophthalmic procedures. However, in patients at high-risk of endophthalmitis, levofloxacin may offer additional protection.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433232","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":"Relationship Between Intraocular Lens Power and Ocular Refraction Variations.","authors":"Damien Gatinel, Guillaume Debellemanière, Alain Saad, Jacques Malet","doi":"10.1097/j.jcrs.0000000000001633","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001633","url":null,"abstract":"<p><strong>Objective: </strong>To develop a theoretical method to predict the theoretical ratio between changes in intraocular lens (IOL) power (dP) and induced variations in ocular refraction (dR).</p><p><strong>Setting: </strong>Rothschild Foundation Hospital, Paris, France.</p><p><strong>Design: </strong>Theoretical study.</p><p><strong>Methods: </strong>The theoretical changes in dP required for desired variations in dR and influencing variables were computed using a paraxial pseudophakic eye model. This formulation was subsequently validated against the Haigis formula, using half-diopter power increments for comparison. Various eye models, covering a range of axial lengths, keratometry readings, and effective implant positions, were analyzed. Additionally, the impact of keratometry and effective lens position on the IOL power-refraction change ratio was evaluated.</p><p><strong>Results: </strong>The findings highlight the significant roles of keratometric power and effective lens position in determining the theoretical magnitude of IOL power increment required for a specific dioptric change in refraction. The study extended beyond standard keratometry values to include a wider range of clinical scenarios.</p><p><strong>Conclusion: </strong>Our model provides theoretical trends for guiding clinicians in predicting the necessary IOL power adjustments for desired refractive changes in pseudophakic eyes.Our work also suggests potential applications in the fine-tuning of adjustable IOLs and more customized IOL power selection for a range of refractive surgeries.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143575859","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}