Journal of cataract and refractive surgery最新文献

{"title":"Modern cataract surgery with simplified technology: new trend?","authors":"Liliana Werner","doi":"10.1097/j.jcrs.0000000000001657","DOIUrl":"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":"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":"Reply : Comparison of axial length measurements in silicone oil-filled eyes using SS-OCT and partial coherence interferometry.","authors":"Jiaqing Zhang, Xiaotong Han, Miao Zhang, Xuhua Tan, Lixia Luo","doi":"10.1097/j.jcrs.0000000000001203","DOIUrl":"10.1097/j.jcrs.0000000000001203","url":null,"abstract":"","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"438"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9357157","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":"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}

{"title":"Efficiency of venturi vs peristaltic-based phacoemulsification in femtosecond laser cataract surgery.","authors":"Rachel A Scott, Caleb J Holtmeyer, Travis M Parker, Jessica K Willis, Wendell J Scott, Randall J Olson","doi":"10.1097/j.jcrs.0000000000001618","DOIUrl":"10.1097/j.jcrs.0000000000001618","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the efficiency of peristaltic vs venturi vacuum platforms when applied to femtosecond-treated cataract.</p><p><strong>Setting: </strong>Outpatient Eye Center, Mercy Health System, Springfield, Missouri.</p><p><strong>Design: </strong>This is a prospective randomized controlled trial of 111 patients with moderate nuclear sclerosis scheduled for bilateral routine laser cataract surgery (LCS) ( ClinicalTrials.gov ; NCT03970525).</p><p><strong>Methods: </strong>Patients were randomized to receive surgery in 1 eye with a peristaltic system and the other with a venturi system. The vacuum and phacoemulsification power were the same for both systems. The primary outcomes were phacoemulsification energy (EFX), ultrasound time (UST), phacoemulsification in/out time (PIOT), surgery time (speculum in/out time), and endothelial cell count (ECC).</p><p><strong>Results: </strong>The type of vacuum/phacoemulsification system used during LCS had a significant impact on the 4 procedural outcomes. Specifically, EFX, UST, PIOT, and total microscope time (speculum in/out case time) were lower when the venturi system was used compared with the peristaltic system ( t (100) = -4.28, P < .001). The vacuum system used did not affect the uncorrected distance visual acuity, corrected distance visual acuity, or central cornea thickness. ECC decreased by 6.38% with venturi and 8.32% with peristaltic ( t (87) = 1.19, P = .235). There were no complications.</p><p><strong>Conclusions: </strong>Venturi-based phacoemulsification was more efficient than peristaltic, based on energy and time, when used for removal of femtosecond-treated cataract.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"382-387"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033198","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":"Quantification of physiological tilt of the phakic eye using biometry parameters and AS-OCT.","authors":"Haidar Khalil, Theresa Höftberger, Peter Laubichler, Klemens Waser, Leon Pomberger, Paul Jirak, Nino Hirnschall, Matthias Bolz","doi":"10.1097/j.jcrs.0000000000001614","DOIUrl":"10.1097/j.jcrs.0000000000001614","url":null,"abstract":"<p><strong>Purpose: </strong>To comprehensively evaluate the tilt of the crystalline lens in phakic eyes and its relationship with optical biometry parameters.</p><p><strong>Setting: </strong>The retrospective analysis was conducted at the Department for Ophthalmology and Optometry, Kepler University Clinic, in Linz, Austria.</p><p><strong>Design: </strong>Lens tilt assessment was performed through a combined analysis of optical biometry (IOLMaster 700) and anterior segment optical coherence tomography (AS-OCT) data to understand its relationship.</p><p><strong>Methods: </strong>The study analyzed preoperative biometry data and AS-OCT images from 4689 eyes of 2489 patients before cataract surgery. The optical biometry parameters were correlated with the degree of lens tilt using logistic regression and machine learning techniques.</p><p><strong>Results: </strong>The mean lens tilt was 4.9 degrees, with 6.7% of eyes showing a tilt greater than 7 degrees. Significant associations were found with specific biometry parameters, such as anterior chamber depth, axial length, equator thickness, and lens decentration. The developed predictive model for assessing tilt risk demonstrated a high accuracy with an area under the curve of 0.862.</p><p><strong>Conclusions: </strong>The findings highlight the mean lens tilt of 4.9 degrees in a cataract patient cohort. This analysis contributes to a broader understanding of lens orientation and its interactions with biometric parameters.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"366-370"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033055","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 vs povidone-iodine alone on conjunctival flora:systematic review and meta-analysis.","authors":"Amelia Charlotte Rees, Mohammad Saleki","doi":"10.1097/j.jcrs.0000000000001626","DOIUrl":"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 (eg, cataract, keratoplasty, and 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 postintervention rate of positive conjunctival bacterial cultures before 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. Although PVI is widely recognized 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 health care. The current standard of care varies globally, with PVI commonly used alone in many regions, such as the United Kingdom.</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>7 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 (odds ratio [OR], 0.77; 95% CI, 0.42-1.42; P = .41). Subgroup analysis showed that levofloxacin combined with PVI significantly reduced positive culture rates (OR, 0.48; 95% CI, 0.29-0.81; P = .006), whereas moxifloxacin and gatifloxacin did not show similar benefits. Moderate heterogeneity was observed across studies ( I2 = 58%; P = .04).</p><p><strong>Conclusions: </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><p><strong>Prospero registration number: </strong>CRD42024603822.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"427-435"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","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":"Meibomian gland structure and function in patients with Demodex blepharitis.","authors":"Elizabeth Yeu, Cecelia Koetting","doi":"10.1097/j.jcrs.0000000000001619","DOIUrl":"10.1097/j.jcrs.0000000000001619","url":null,"abstract":"<p><strong>Purpose: </strong>To compare structural and functional measures of meibomian gland disease (MGD) in eyes with moderate to severe Demodex blepharitis (collarette grades 2 to 4) compared with those with collarette grade 0 (0 to 2 collarettes).</p><p><strong>Setting: </strong>Private clinical practice.</p><p><strong>Design: </strong>Retrospective, single-center, noninterventional, observational study.</p><p><strong>Methods: </strong>In this study, case records of patients aged ≥18 years with data available for collarettes and MGD signs (telangiectasia, meibum expressibility, meibum quality, and meibography) were included. Outcome measures were the comparison of the mean telangiectasia score, meibum expressibility score, meibum quality score, and meibomian gland (MG) atrophy score between eyes with moderate to severe Demodex blepharitis (collarette grades 2 to 4, or >10 collarettes) and those with collarette grade 0 (0 to 2 collarettes). Right and left eyes were analyzed separately.</p><p><strong>Results: </strong>The mean telangiectasia, meibum quality, and MG atrophy scores were statistically significantly worse in the collarette grade 2 to 4 group than in those in the collarette grade 0 group for both right and left eyes (even after adjusting for age). There was a positive correlation between collarette grade and telangiectasia, meibum quality, and MG atrophy scores.</p><p><strong>Conclusions: </strong>Structural and functional measures of MGD were significantly worse in eyes with collarette grades 2 to 4 than in those with collarette grade 0. Clinicians should routinely examine their patients for Demodex infestation and signs of MGD and treat both conditions as needed, especially in the perioperative setting.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"359-365"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143033053","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, contrast sensitivity, and defocus profile with an aspheric monofocal intraocular lens using positive spherical aberration.","authors":"Elizabeth M Law, Rajesh K Aggarwal, Phillip J Buckhurst","doi":"10.1097/j.jcrs.0000000000001612","DOIUrl":"10.1097/j.jcrs.0000000000001612","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate visual outcomes after bilateral implantation of the RayOne EMV intraocular lens with targeted micromonovision.</p><p><strong>Setting: </strong>Southend Private Hospital, Westcliff on Sea, United Kingdom.</p><p><strong>Design: </strong>Retrospective cohort.</p><p><strong>Methods: </strong>50 patients (100 eyes) were assessed at 12 to 18 months postoperatively. Emmetropia was targeted in the dominant eye and myopia of -0.50 to -1.00 diopter (D) in the nondominant eye. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity was assessed monocularly and binocularly at distance (6 m), intermediate (70 cm), and near (40 cm). Defocus was assessed from +1.50 to -4.00 D monocularly and binocularly. Contrast sensitivity was assessed using a computerized Pelli-Robson chart.</p><p><strong>Results: </strong>Mean spherical equivalent was -0.05 ± 0.34 D and -0.91 ± 0.60 D in the dominant and nondominant eyes, respectively. UDVA was significantly different in the dominant (0.09 ± 0.10 logMAR) and nondominant (0.31 ± 0.18 logMAR) eyes ( P < .01). CDVA, distance corrected intermediate VA (DCIVA), and distance corrected near VA (DCNVA) were similar between eyes. However, significant differences were found between binocular uncorrected intermediate VA (UIVA) (0.16 ± 0.11 logMAR) and DCIVA (0.31 ± 0.11 logMAR) ( P < .01) and between binocular uncorrected near VA (UNVA) (0.30 ± 0.17 logMAR) and DCNVA (0.50 ± 0.19 logMAR) also ( P < .01). The nondominant eye shows superior acuity eye in both UIVA ( P < .01) and UNVA ( P < .01). Contrast sensitivity showed no significant difference between eyes ( P = .06). Significant improvement binocularly compared with monocularly was seen through imposed defocus -0.50 to -2.50 D.</p><p><strong>Conclusions: </strong>The RayOne EMV with micromonovision is a reliable method for improving intermediate and near VA, by increasing the range of focus without compromise of distance acuity or contrast sensitivity.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"394-398"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143023652","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 Nd:YAG capsulotomy on the light-adjustable intraocular lens.","authors":"Ashley A Abing, Jimmy K Lee, Dan B Tran, Amir H Marvasti","doi":"10.1097/j.jcrs.0000000000001621","DOIUrl":"10.1097/j.jcrs.0000000000001621","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the safety and refractive outcomes of Nd:YAG capsulotomy in pseudophakic eyes with the light-adjustable intraocular lens (LAL) both before and after completing the light delivery device lock-in treatments.</p><p><strong>Setting: </strong>Private practice in Orange, California.</p><p><strong>Design: </strong>Retrospective, comparative study.</p><p><strong>Methods: </strong>Patients were divided into 2 groups according to the timing of their YAG capsulotomy (Group I underwent YAG capsulotomy before lock-in treatments and Group II underwent YAG capsulotomy on completion of lock-in treatments). Sphere, cylinder, axis, spherical equivalent (SE), uncorrected distance visual acuity (UDVA), and corrected distance visual acuity (CDVA) were compared preoperatively and postoperatively using 2-tailed paired t tests. Postoperative data were measured 1 month after Nd:YAG capsulotomy. The α level (type I error) was set at 0.05.</p><p><strong>Results: </strong>The LAL was successfully implanted in 485 eyes from January 2020 to March 2023. 10 eyes (0.02%) needed YAG capsulotomy before the completion of lock-in treatments (Group I), and 28 eyes (5.77%) needed YAG capsulotomy after the lock-in was completed (Group II). Postoperative CDVA significantly improved compared with preoperative values in both groups. Changes in sphere, cylinder, axis, SE, and UDVA preoperative and postoperative measurements were not statistically significant ( P > .05) in both groups.</p><p><strong>Conclusions: </strong>YAG capsulotomy can be safe and effective for patients with the LAL who develop posterior capsular opacification during the adjustment period. There were no significant changes in sphere, cylinder, axis, or spherical equivalence after YAG capsulotomy in both groups.</p>","PeriodicalId":15214,"journal":{"name":"Journal of cataract and refractive surgery","volume":" ","pages":"406-411"},"PeriodicalIF":2.6,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143065788","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}