Journal of cataract and refractive surgery最新文献

{"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}

{"title":"Novel Software Program to Improve Biometry Measurements Obtained by an Optical Low Coherence Reflectometry Biometer.","authors":"David L Cooke, Tim L Cooke, Raj Patel, Michael T Heath, Mason Gardiner, David A Murphy, Kamran M Riaz","doi":"10.1097/j.jcrs.0000000000001630","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001630","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate a novel software program (SpikeFinder) that improves quality of measurements obtained by optical low coherence reflectometry (OLCR) biometry (Lenstar).</p><p><strong>Setting: </strong>Tertiary care academic center.</p><p><strong>Design: </strong>Retrospective case series.</p><p><strong>Method: </strong>ology: After applying inclusion criteria, 12,988 eyes scanned with OLCR biometry and swept-source OCT (SS-OCT) biometry (IOLMaster700) were analyzed. Measurements, including axial length (AL), anterior chamber depth (ACD), and lens thickness (LT), were compared. SpikeFinder was applied to eyes with the most prominent ACD and LT measurement differences. Statistical testing was performed using Wilcoxon (two variables) and Kruskal-Wallis ANOVA tests (multiple variables) with Tukey post-hoc adjustments. Heteroscedastic testing (WHWK Statistics Package) was used to assess differences after software application.</p><p><strong>Results: </strong>99.1% of AL measurements were within 0.01 mm between the two biometers. SS-OCT LT was significantly longer than the OLCR LT: 33% differed by ≥ 0.50 mm (p<0.001). Correspondingly, SS-OCT ACD was significantly shorter than OLCR ACD: 14% differed by ≥ 0.50 mm (p<0.001). SS-OCT biometer - OLCR biometer values for ACD and LT before applying SpikeFinder were -0.64 ± 0.31 mm and 1.15 ± 0.38 mm, respectively (p<0.001). After applying SpikeFinder to a subgroup of 337 eyes, these differences were -0.02 ± 0.03 mm and 0.01 ± 0.11 mm, respectively. SpikeFinder ACD and LT values were similar to SS-OCT biometer-measured ACD (p=0.872) and LT (p=0.987) values.</p><p><strong>Conclusion: </strong>The SpikeFinder program can help improve the accuracy of ACD and LT measurements obtained by the OLCR biometer, which may enhance the performance of formulas that utilize these measurements.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399200","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 evaluation of the effectiveness of asymmetric intrastromal corneal ring segments with progressive base width for management of keratoconus.","authors":"Quentin Hays, Sofiene Kallel, Thibaud Garcin, Clémentine David, Raphaël Barugel, Marie Borderie, Roxane Cuyaubère, Isabelle Goemaere, Vincent Borderie, Nacim Bouheraoua","doi":"10.1097/j.jcrs.0000000000001629","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001629","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate visual, refractive, corneal topographic, and aberrometric results of asymmetric intracorneal ring segments (AS ICRS) with variable width to manage asymmetric keratoconus.</p><p><strong>Setting: </strong>Quinze-Vingts National Ophthalmology Hospital, Paris, France.</p><p><strong>Design: </strong>Prospective observational study.</p><p><strong>Methods: </strong>According to their tomographic pattern, patients receiving one AS ICRS (INTRASEG asymmetric; Gamma Vision) were included. AS INTRASEG features an arc length of 150 degrees and asymmetric width (800 to 1200 µm). Anterior segment optical coherence tomography (AS-OCT) combined with Placido disc MS-39 (CSO, Firenze, Italy) were performed before, 1, and 6 months after surgery to assess keratometric, aberrometric outcomes, and epithelial remodeling. Refractive outcomes were also evaluated. Analysis of the correction profile according to the width of the base of the ICRS was performed.</p><p><strong>Results: </strong>43 keratoconic eyes were analyzed. Significant improvement of corrected distance visual acuity was observed (LogMAR): from 0.34 ± 0.23 to 0.08 ± 0.10 (p<0.001). The flattening effect was higher at the widest end than the narrowest end (-10.59D ± 2.59 versus -4.54D ± 1.30, p<0.001), contributing to reduce the Symmetry Index Front from 9.06 ± 4.02 to 2.21 ± 3.81. Total higher orders aberrations reduced from 2.13 ± 0.94 µm to 1.77 ± 0.59 µm (p<0.001) with a halving of the coma aberration from 1.84 ± 0.87 µm to 0.89 ± 0.50 µm (p<0.001).</p><p><strong>Conclusion: </strong>Implantation of AS INTRASEG in asymmetric keratoconus improves refractive, topographic, and aberrometric parameters. The progressive width of the base is efficient for reducing vertical asymmetry and higher-order aberrations of asymmetric keratoconus phenotype.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399267","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 - EPR 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":"https://doi.org/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>Three 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. 3. A surgery-comparable system that closely mimics a realistic setup.Porcine lenses were incubated for 1.25h 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-emulsified compared to 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>Conclusion: </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. Also, we show that air-bubbles should be avoided during cataract surgery, as 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":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-11","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":"In vivo capsular bag size in children with congenital cataract: Implications for placement of Intraocular Lens.","authors":"Jaspreet Sukhija, Savleen Kaur, Kajree Gupta, Kiran Kumari, Sameer Sethi","doi":"10.1097/j.jcrs.0000000000001631","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001631","url":null,"abstract":"<p><strong>Purpose: </strong>To measure the equatorial lens diameter in vivo and correlate it with other biometric variables in children undergoing cataract surgery.</p><p><strong>Setting: </strong>Tertiary care institution.</p><p><strong>Design: </strong>Prospective case series.</p><p><strong>Methods: </strong>Children < 5 years with cataracts were included. Those with corneal opacities, previous ocular surgery, traumatic cataracts, and or any coexisting corneal or retinal ocular pathology were excluded.In addition to routine investigations, all patients underwent Ultrasound biomicroscopy (UBM) of both eyes. Correlation between the measured value of axial length, corneal diameter, age, and bag diameters and their effect on Intraocular Lens (IOL) implantation (Aphakia/Pseudophakia) were observed.</p><p><strong>Results: </strong>We included 112 eyes of 68 children with a mean age of 11.42 + 11.34 months ( 1 month - 4 years). Mean capsular bag diameter(CBD) in the eyes where IOL was placed successfully in the bag was 8.27 ± 0.6 mm (7.1 - 9.39 mm). The eyes in which IOL placement was difficult in the bag and who were either left aphakic or bicapsular capture IOL was performed had a mean diameter of 7.09 ±0.99 mm (5.23 - 9.09 mm) (p<0.05). A significant and positive correlation was found between CBD and age, axial length, and corneal diameter (p=0.00; 0.00; 0.001 and r=0.4,0.4 and 0.8, respectively). Bag diameter had the highest association(odds ratio 4) with successful IOL placement.</p><p><strong>Conclusions: </strong>Bag diameters should be measured preoperatively in children with cataracts along with other biometric variables as it is the most important measurement that helps in making a decision regarding implantation and positioning of IOL.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399176","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":"Late refractive change after cataract extraction and toric intraocular lens implantation.","authors":"Sydney Roston, J Erik Kulenkamp, Abdurahman Ahmed, Ryan Scheurer, Karen R Armbrust","doi":"10.1097/j.jcrs.0000000000001634","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001634","url":null,"abstract":"<p><strong>Purpose: </strong>To report rates of change and identify factors associated with late change in refractive outcome after toric intraocular lens (IOL) implantation.</p><p><strong>Setting: </strong>Single-site study at the Minneapolis Veterans Affairs Health Care System, Minneapolis, MN, USA.</p><p><strong>Design: </strong>Retrospective cohort study.</p><p><strong>Methods: </strong>Study inclusion required uncomplicated posterior chamber Alcon SN6ATT toric IOL implantation from 2010 -2017 and refractions 1 month and 5 years after surgery. Exclusion criteria were sulcus IOL placement, subsequent intraocular or refractive surgery in the operative eye, and 5-year Snellen visual acuity of 20/60 or worse. Outcomes of interest were change in spherical equivalent and change in magnitude of the astigmatism vector between the postoperative month 1 and postoperative year 5 refractions. Refractive stability was defined as ≤0.5D change in spherical equivalent and ≤1D change in magnitude of the astigmatism vector. Predictive factors analyzed included age, sex, race, pseudoexfoliation (PXF) syndrome, axial length (AL), pre-operative keratometry measurements (∆K), IOL power, neodymium:yttrium-aluminum-garnet capsulotomy, and intravitreal injections.</p><p><strong>Results: </strong>Of the 320 eyes meeting study criteria, spherical equivalent was stable in 241 (75%) eyes, astigmatism was stable in 266 (83%) eyes, and 205 (64%) eyes met criteria for refractive stability with both measures. Multivariable regression analysis identified shorter AL (p=0.018) and larger ∆K (p=0.002) as significant predictors of change in refractive astigmatism and PXF syndrome (p=0.006) as a predictor of hyperopic shift >0.5D.</p><p><strong>Conclusions: </strong>A minority of eyes exhibit late refractive change after toric IOL implantation. AL, ∆K, and PXF syndrome are independent predictors of late refractive change.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399179","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 Outcomes following implantation of a non-diffractive extended depth of focus Intraocular Lens in patients with early dry macular degeneration.","authors":"Shail Vasavada, Lajja Shastri, Vandana Nath, Shyamal Dwivedi, Asav Patel, Vaishali Vasavada, Samaresh Srivastava, Abhay R Vasavada","doi":"10.1097/j.jcrs.0000000000001627","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001627","url":null,"abstract":"<p><strong>Purpose: </strong>Evaluate visual outcomes following implantation of a non-diffractive extended deapth of focus (EDOF) intraocular lens (IOL) in patients with early dry age-related macular degeneration (AMD).</p><p><strong>Setting: </strong>Iladevi Cataract & IOL Research Centre, Ahmedabad, India.</p><p><strong>Design: </strong>Prospective, interventional series.</p><p><strong>Methods: </strong>Patients undergoing cataract surgery with the EDOF Acrysof Vivity IOL and having early dry AMD were included. Primary outcome measures were monocular unaided and corrected distance visual acuity (UDVA, CDVA) 3 months postoperatively. Secondary outcome measures were: monocular unaided and distance corrected intermediate (UIVA, DCIVA) (66cm) and near (UNVA, DCNVA) (40cm) visual acuity as well as mesopic contrast sensitivity (CS).</p><p><strong>Results: </strong>40 eyes (40 patients) with a mean age of 68.5 + 8.38 (standard deviation, SD) years were included. UDVA and CDVA at 3 months follow up were 0.12 + 0.07 and 0.10 + 0.10 (SD) LogMAR. UIVA, DCIVA were 0.25 + 0.09, 0.12 + 0.09 LogMAR. UNVA, DCNVA were 0.23 + 0.10, 0.19 + 0.15 LogMAR. Mesopic CS values without glare were 1.50 + 0.10, 1.69 + 0.26, 1.40 + 0.30 and 0.84 + 0.5 units at 3, 6, 12 and 18 cycles per degree (CPD). Mesopic CS with glare was 1.53 + 0.16, 1.63 + 0.21, 1.21 + 0.45 and 0.75 + 0.42 units.</p><p><strong>Conclusion: </strong>The Acrysof Vivity IOL gives very good distance visual acuity with improved intermediate and near visual acuity without significant compromise in contrast sensitivity in eyes with early dry AMD.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399207","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 Predicted Refraction Using Two Swept-Source Optical Coherence Biometers and an Intraoperative Aberrometer.","authors":"Keizo Watanabe","doi":"10.1097/j.jcrs.0000000000001628","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001628","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the refractive accuracy of Optiwave Refractive Analysis (ORA) using biometric measurements of ARGOS and OA-2000 in the same patient planned for a monofocal intraocular lens (IOL) insertion.</p><p><strong>Setting: </strong>Single center.</p><p><strong>Design: </strong>Prospective, observational study.</p><p><strong>Methods: </strong>Patients scheduled for cataract surgery between January 2021 and March 2022 (expected corrected distance visual acuity of ≥0.8 postoperatively at 1-3 months) underwent preoperative ocular measurements using ARGOS and OA-2000 biometers on the same day, which were entered into the intraoperative aberrometer ORA system to assess the refractive accuracy of the IOL implant and postoperative spherical equivalent at 1-3 months. The refractive accuracy was compared between ORA using ARGOS (ORA-AR) and ORA using OA-2000 (ORA-OA). The primary endpoint was the comparison of the mean absolute refractive prediction error (MAE) between the ORA-AR and ORA-OA methods.</p><p><strong>Results: </strong>A total of 117 eyes of 81 patients were evaluated (mean ± standard deviation [SD] age, 72.8 ± 7.4 years; male, 65.4%). The criteria for noninferiority were met between the ORA-AR and ORA-OA methods, as the upper boundary of the confidence interval (CI) was lower than the noninferiority margin of 0.10 D for the difference in MAE (-0.03 D; 95% CI: -0.061 to 0.001). MAE was numerically smaller with ORA-AR (0.243 ± 0.215 D) but not significantly different from that with ORA-OA (0.269 ± 0.246 D).</p><p><strong>Conclusions: </strong>Postoperative MAE obtained using ORA-AR was noninferior to that of ORA-OA. However, the MAE and SD of refractive prediction errors with ORA-AR were numerically lower compared with ORA-OA.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523595","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":"Impact of Postoperative Walking vs. Lying Down on IOL Rotation After Lens Surgery: A Prospective Comparative Study.","authors":"Tyll Jandewerth, Klemens Paul Kaiser, Eva Hemkeppler, Christoph Lwowski, Thomas Kohnen","doi":"10.1097/j.jcrs.0000000000001632","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001632","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the intraocular lens (IOL) rotational stability depending on patient position in the first postoperative hour after femtosecond laser assisted cataract or refractive surgery with implantation of a non-toric IOL in the capsular bag.</p><p><strong>Setting: </strong>Department of Ophthalmology, Goethe-University, Frankfurt, Germany.</p><p><strong>Design: </strong>Prospective, randomized clinical trial.</p><p><strong>Methods: </strong>In this study, 38 eyes of 36 patients received femtosecond laser assisted phacoemulsification and implantation of a non-toric IOL in the capsular bag. Patients were randomized into two groups: patients laid down for one hour after surgery due to the clinical standard (LD group), patients walked around in the first postoperative hour (W group). No miotic eye drops were applied at the end of operation. A retroilluminated slit lamp picture was taken at the end of the operation (baseline), one hour and one day postoperative. Changes in IOL position were measured by an axis between two episcleral landmarks and the haptics of the IOL. Measurements were performed by an image processing application specified for medical and scientific purpose. If not normally distributed, the paired t-test was used. Otherwise, the Mann-Whitney-U-Test was used if data was not normally distributed.</p><p><strong>Results: </strong>IOL rotation in the first hour was 1.80° ± 1.80° in the LD group and 1.21° ± 2.11° in the W group (p=0.123). One day after operation, IOL position differed from the baseline measurement with 1.52° ± 1.89° in the LD group and 1.51° ± 1.69° in the W group (p=0.773).</p><p><strong>Conclusion: </strong>Early postoperative patient position does not seem to influence IOL rotational stability.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399272","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}