Journal of cataract and refractive surgery最新文献

{"title":"Reply: Comment on: Intravenous vs nonintravenous sedation for cataract surgery: systematic review and meta-analysis.","authors":"Angelica Hanna, James Jacob Armstrong, Efstathia Tsioros-Kiatos, Guillermo Rocha, Cindy M L Hutnik, Iqbal Ike K Ahmed","doi":"10.1097/j.jcrs.0000000000001775","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001775","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":"145069656","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: Intravenous vs nonintravenous sedation for cataract surgery: systematic review and meta-analysis.","authors":"Lucas M Barbosa, Lara Guedes, Jhonattan Rodrigues Garcia Costa, Vinícius Martins Rodrigues Oliveira, Marcelo Ramos","doi":"10.1097/j.jcrs.0000000000001774","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001774","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":"145069602","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":"A forgotten study with the Ridley lens.","authors":"Richard Packard","doi":"10.1097/j.jcrs.0000000000001771","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001771","url":null,"abstract":"","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955518","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":"Institutional comparison of methods of intraoperative cataract surgery complication reporting.","authors":"Allie Simpson, Marshall Henrie, ChaoRong Wu, Benjamin Brintz, Stephen Christiansen, Michael S Jensen, Brian Stagg, Judith Warner","doi":"10.1097/j.jcrs.0000000000001769","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001769","url":null,"abstract":"<p><p>This study evaluated the effectiveness of surgeon self-reporting and anterior vitrector equipment billing in identifying intraoperative posterior capsular tears (PCT) with vitreous loss during cataract surgery. A total of 19,258 cataract surgeries performed over six years at the John A. Moran Eye Center were analyzed, with 343 potential complications identified through billing or self-reporting, and 193 confirmed PCT cases based on chart review. Billing data captured 83.9% of PCTs but lacked specificity, including many non-PCT uses of anterior vitrectomy. Surgeon self-reporting was highly specific, with 100% accuracy according to operative reports, but detected only 58.5% of total PCT cases. The findings highlight the strengths and limitations of both methods-billing is sensitive but overinclusive, while self-reporting is accurate but underutilized. Neither method alone was sufficient to identify all complications, emphasizing the need for a standardized, comprehensive approach to intraoperative complication monitoring to enhance patient safety and quality assurance in ophthalmic surgery.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955671","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":"Intrastromal Corneal Ring Segments in Previously Cross-Linked versus Virgin Keratoconic Corneas: A Multi-Parameter Propensity Score Matched Analysis.","authors":"Karim Kozhaya, Jad F Assaf, Nasrine Anais El Salloukh, Nour Nasser, Shady T Awwad","doi":"10.1097/j.jcrs.0000000000001768","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001768","url":null,"abstract":"<p><strong>Purpose: </strong>To compare outcomes of intrastromal corneal ring segments (ICRS) insertion in crosslinked (CXL) versus non-CXL keratoconic eyes, using a multi-parameter propensity score matching (PSM).</p><p><strong>Setting: </strong>American University of Beirut Medical Center, Beirut, Lebanon.</p><p><strong>Design: </strong>Retrospective case series.</p><p><strong>Methods: </strong>A total of 198 eyes with mild to moderate keratoconus who underwent ICRS insertion were included. Our data were divided into two groups, based on whether CXL was performed before ICRS insertion. A PSM was used to balance the following covariates: age, gender, ICRS segment thickness, arc size, optical zone, topographic data and total corneal coma. Visual, refractive, topographic and total corneal aberrometric data were measured preoperatively and at 6 months post-ICRS implantation.</p><p><strong>Results: </strong>After 1:1 PSM, 32 eyes from 27 patients with prior CXL were matched to 32 untreated eyes from 30 patients. Preoperative parameters were not statistically different between the groups (ps>.05). Both groups displayed a statistically significant improvement in visual, refractive, and topographic (simulated keratometry, maximum axial keratometry, and keratometric astigmatism) and total corneal aberrometric (total higher order aberrations and coma) outcomes 6 months after ICRS insertion (all ps<.05). The changes in all reported visual, refractive, topographic and total corneal aberrometric outcomes were not statistically different between CXL and non-CXL eyes (all ps>.05).</p><p><strong>Conclusions: </strong>When properly matched for preoperative disease type and severity, ICRS insertion had a similar improvement in eyes with and without CXL.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955585","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":"Tilt and Decentration of the Crystalline Lens and Intraocular Lens After Femtosecond Laser-Assisted Cataract Surgery.","authors":"Felix Gonzalez-Lopez, Santiago Delgado-Tirado, Ricardo Perez-Izquierdo, Daniel Gonzalez-Gonzalez, David Medel, Alba Saez-Corrales, Enelia Cristina Pelaez-Gutierrez","doi":"10.1097/j.jcrs.0000000000001770","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001770","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate crystalline lens (CL) and intraocular lens (IOL) tilt and decentration after uneventful femtosecond laser-assisted cataract surgery (FLACS) in Caucasian eyes.</p><p><strong>Setting: </strong>Clínica Miranza Madrid, Spain.</p><p><strong>Design: </strong>Retrospective, observational, interventional, non-randomized, single-center study.</p><p><strong>Methods: </strong>This study included 125 consecutive eyes from 125 patients undergoing FLACS. CL and IOL tilt and decentration were assessed using the built-in analysis software of the CASIA2 anterior segment optical coherence tomography (AS-OCT) system. Univariate and multivariate regression analyses identified associations between biometric parameters and both CL and IOL tilt and decentration. Pearson's correlation coefficient evaluated the relationship between CL and IOL values. Differences across IOL platforms in relation to preoperative CL tilt and decentration were explored.</p><p><strong>Results: </strong>Mean preoperative CL tilt was 5.20 ± 1.35 degrees and decentration was 0.16 ± 0.09 mm. At 1 month postoperatively, mean IOL tilt was 5.08 ± 1.33 degrees and decentration was 0.23 ± 0.12 mm. CL tilt strongly correlated with IOL tilt (R = 0.80, P < 0.0001), while CL and IOL decentration showed a moderate correlation (R = 0.38, P < 0.0001). No significant correlation was found between IOL tilt and decentration (R = 0.07, P = 0.439). Axial length was a significant predictor of both CL and IOL tilt. Age significantly predicted CL decentration and showed a modest association with IOL decentration.</p><p><strong>Conclusions: </strong>In Caucasian eyes undergoing FLACS, preoperative CL position correlates with postoperative IOL alignment. AS-OCT analysis of CL geometry may aid in predicting IOL behavior prior to cataract surgery.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955608","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 suction angle on zonular fibers during residual cortex removal in phacoemulsification using finite element modeling.","authors":"Seyed Hashem Daryabari, Seyyed Morteza Hosseini Imeni, Mojtaba Ghouhestani","doi":"10.1097/j.jcrs.0000000000001767","DOIUrl":"10.1097/j.jcrs.0000000000001767","url":null,"abstract":"<p><strong>Purpose: </strong>The suction of the eye lens cortex is an integral step of cataract surgery. Two conventional angles of cortex removal, including suction in the tangential or normal direction to the cortex surface, have different resulting stress and the risk of failure. However, there is no study about the effect of suction angle on the risk of zonules failure. So, this investigation aimed to evaluate the effect of suction direction on zonules' mechanical behavior using finite element modeling.</p><p><strong>Setting: </strong>In-silico Study.</p><p><strong>Design: </strong>3D finite element model experimental study.</p><p><strong>Methods: </strong>A 3D finite element model was developed, including nucleus covered by cortex and capsule. Similar to cataract surgery, a circular rapture was considered at the top of the capsule to apply suction pressure. Finally, Zonular fibers were modeled as a continuum body using 3D solid elements (C3D8R). A custom FORTRAN subroutine was implemented to enforce tension-only behavior, mimicking the physiological characteristics of the zonules, which are resistant to tensile but not compressive loads. This method allows for a realistic simulation of zonular mechanics during cortical aspiration.</p><p><strong>Results: </strong>The suction processes in tangential and normal angles were simulated; The resulting relative displacements between the cortex and capsule, as a criterion of cortex separation, versus the resulting maximum zonule displacements, were recorded in each model. The cortex-capsule relative displacement versus maximum zonule displacement indicated a diagram slope of 0.09 for tangential applying pressure and 0.02 in the case of applying normal pressure.</p><p><strong>Conclusion: </strong>The results illustrated that zonules were less tensile in a specific magnitude of cortex-capsule relative displacement under tangential applying pressure, which means eye zonules have a lower risk of failure until the separation of the lens cortex.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882889","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":"Accuracy of new-generation and traditional IOL power calculation formulas in pediatric primary implantation.","authors":"Jiaxin Jin, Yanyu Shen, Yiwen Qu, Hui Chen, Xiaohang Wu, Ling Jin, Yizhi Liu, Haotian Lin, Zhenzhen Liu","doi":"10.1097/j.jcrs.0000000000001766","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001766","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the prediction accuracy of new-generation and traditional intraocular lens (IOL) power calculation formulas in pediatric primary IOL implantation and identify factors influencing refractive prediction errors.</p><p><strong>Setting: </strong>Zhongshan Ophthalmic Center, Guangzhou, China.</p><p><strong>Design: </strong>Retrospective consecutive case-series study.</p><p><strong>Methods: </strong>We calculated the prediction error (PE) for Holladay 1, SRK/T, Hoffer Q, Haigis, Barrett Universal II (BUII), Kane, Emmetropia Verifying Optical (EVO) 2.0 and Ladas Super Formula (LSF) in pediatric primary IOL implantation. Subgroup analyses were conducted based on age, axial length (AL), average keratometry (K), surgical procedures and IOL type. Multivariable regression analysis was used to identify factors associated with significant refractive surprise.</p><p><strong>Results: </strong>A total of 83 patients (108 eyes) were included in the study. Significant differences in both PE and absolute PE were observed among formulas (P <0.001). The SRK/T and Kane formulas demonstrated lower mean predicted error (ME) and median absolute error (MedAE), whereas LSF and Haigis formulas showed higher ME and MedAE respectively. Patients who were older age and had longer AL exhibited improved predictive accuracy. No significant differences in prediction accuracy were found between eyes with different surgical procedures or different IOL types. Multivariable regression analysis showed that younger age and shorter preoperative AL were predictors of significant refractive surprise across formulas.</p><p><strong>Conclusions: </strong>The predictive accuracy of IOL formulas in pediatric primary IOL implantation remains suboptimal, with the SRK/T and Kane formulas performing relatively better. Younger age and shorter AL remain major predictors of refractive surprise, while surgical procedures and IOL type show no significant association. Further development of pediatric-specific IOL power formulas is warranted.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955588","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":"Precision refraction methodology for LASIK enhancement after trifocal IOL implantation: Clinical outcomes and technique.","authors":"Mitsuoshi Ito, Miyuki Watabe, Keitaro Obikane, Takahiro Yamamoto, Satoshi Yukawa","doi":"10.1097/j.jcrs.0000000000001765","DOIUrl":"10.1097/j.jcrs.0000000000001765","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the postoperative outcomes of LASIK enhancements performed on eyes implanted with trifocal intraocular lenses.</p><p><strong>Setting: </strong>Shinagawa LASIK Center, Tokyo, Japan.</p><p><strong>Design: </strong>Retrospective, consecutive case series.</p><p><strong>Methods: </strong>A total of 59 cases (89 eyes) underwent femtosecond laser-assisted cataract surgery with trifocal IOL implantation between October 2014 and May 2021 and were followed for a minimum of 3 months after LASIK enhancements. A novel systematic five-step refraction methodology was employed to accurately identify multiple focal points created by trifocal IOLs and determine optimal enhancement targets. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), and uncorrected near visual acuity (UNVA) were evaluated at distance (5 m), intermediate (70 cm), and near (30 cm) at pre-cataract surgery, pre-enhancement, and 3 months, 6 months, and 1 year post-enhancement.</p><p><strong>Results: </strong>At 1 year post-LASIK enhancement, the mean manifest refraction spherical equivalent improved from +0.35 diopters (D) ± 0.75 D to -0.05 ± 0.36 D (P < .0001), with 80.9% of eyes achieving ±0.50 D of emmetropia. The percentage of eyes with ≤0.50 D cylinder increased from 37.1% to 83.3%. UDVA of 20/20 or better was achieved in 83.3% of eyes, with 56.3% achieving J1 UNVA.</p><p><strong>Conclusions: </strong>LASIK enhancements following trifocal intraocular lens implantation demonstrated both safety and efficacy in improving visual outcomes. A systematic approach to measuring refractive error, accounting for the multifocal nature of these IOLs, is crucial for optimal outcomes. This methodology can be applied to various trifocal IOL designs to enhance visual results and patient satisfaction.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873363","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":"Validation of a new Implantable Collamer Lens sizing algorithm based on the Anterion swept source OCT images.","authors":"Pierre Zéboulon, Nicole Mechleb, Maria Rizk, Roxane Flamant, Tobias Duncker, Raphael Neuhann, Damien Gatinel, Alain Saad","doi":"10.1097/j.jcrs.0000000000001764","DOIUrl":"10.1097/j.jcrs.0000000000001764","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the performance of a novel deep learning-based Implantable Collamer Lens (ICL) sizing model that uses raw Swept-Source OCT images as input.</p><p><strong>Setting: </strong>Multicentric European study.</p><p><strong>Design: </strong>Retrospective external validation study. Preoperative images were evaluated blinded from the post operative results.</p><p><strong>Methods: </strong>Patients implanted with EVO ICL V4 at two European clinics between October 2019 and April 2024 were analyzed. Preoperative OCT images and implanted ICL data were processed by our model, which predicted vault, confidence levels, and the probability of achieving a postoperative vault within 250-750 μm (P250-750). Predictions were compared with actual postoperative vaults, and performance metrics such as mean absolute error (MAE), P250-750 accuracy, and postoperative vault distribution were assessed.</p><p><strong>Results: </strong>A total of 848 eyes from 429 patients were included. The mean postoperative vault was 476 ± 235 μm, with a model MAE of 146 ± 113 μm, significantly outperforming the STAAR nomogram (186 ± 149 μm; p < 0.001). The model correctly predicted vaults within ±250 μm in 81.7% of cases and ±300 μm in 90.7%. Among cases outside the 250-750 μm range (28.9%), the model recommended more appropriate sizes in 70.6%. P250-750 was comparable to the actual proportion of eyes achieving a satisfactory vault for P250-750 > 60%. In cases requiring lens exchange, the model's suggested size aligned with the final implanted size in 81.8%.</p><p><strong>Conclusions: </strong>Our deep learning-based model, using raw OCT images, provides accurate ICL sizing predictions and valuable metrics such as P250-750 to assist clinical decision-making. This approach may reduce sizing errors and improve patient outcomes. The model is available for ANTERION users at safevaulticl.com.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144873364","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}