Journal of Cataract & Refractive Surgery最新文献

{"title":"Method to guide toric intraocular lens realignment based on vectorial analysis of astigmatism","authors":"Daniel Romero-Valero, Jose Juan Martínez-Toldos, Jorge L. Alió","doi":"10.1097/j.jcrs.0000000000001382","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001382","url":null,"abstract":"","PeriodicalId":15233,"journal":{"name":"Journal of Cataract & Refractive Surgery","volume":"106 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140802281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VAULT: vault accuracy using deep learning technology: new image-based artificial intelligence model for predicting implantable collamer lens postoperative vault","authors":"Taj Nasser, Matthew Hirabayashi, Gurpal Virdi, Andrew Abramson, Gregory Parkhurst","doi":"10.1097/j.jcrs.0000000000001386","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001386","url":null,"abstract":"Purpose: To develop an accurate deep learning model to predict postoperative vault of phakic implantable collamer lenses (ICLs). Setting: Parkhurst NuVision LASIK Eye Surgery, San Antonio, Texas. Design: Retrospective machine learning study. Methods: 437 eyes of 221 consecutive patients who underwent ICL implantation were included. A neural network was trained on preoperative very high–frequency digital ultrasound images, patient demographics, and postoperative vault. Results: 3059 images from 437 eyes of 221 patients were used to train the algorithm on individual ICL sizes. The 13.7 mm size was excluded because of insufficient data. A mean absolute error of 66.3 μm, 103 μm, and 91.8 μm were achieved with 100%, 99.0%, and 96.6% of predictions within 500 μm for the 12.1 mm, 12.6 mm, and 13.2 mm sizes, respectively. Conclusions: This deep learning model achieved a high level of accuracy of predicting postoperative ICL vault with the overwhelming majority of predictions successfully within a clinically acceptable margin of vault.","PeriodicalId":15233,"journal":{"name":"Journal of Cataract & Refractive Surgery","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140802240","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of scleral tunnel length on the position of IOLs in flanged intrascleral haptic fixation","authors":"Jong Hwa Jun, Joon-Ho Kwak, Chang-Hyun Park, Jiyeon Lee, Jueun Seong, Kyu Young Shim, Natalie A. Afshari","doi":"10.1097/j.jcrs.0000000000001460","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001460","url":null,"abstract":"Purpose: To investigate the effect of scleral tunnel length on the effective lens position and tilt of the intraocular lens (IOL) in flanged intrascleral haptic fixation (ISHF) using anterior segment optical coherence tomography (AS-OCT). Setting: Tertiary institution. Design: Retrospective case-control study. Methods: This study included 55 and 42 eyes that underwent ISHF with 1.0- and 2.0-mm scleral tunnels, respectively. Twenty-three eyes that underwent sutured fixation were used as a control. The anterior chamber depth (ACD), scleral tunnel length, incident angle of haptic, and tilting of optic were analyzed using AS-OCT. Results: The mean postoperative ACD, vertical tilt angle, and spherical equivalent of the 1.0-mm were 5.27 ± 0.39 mm, 6.04 ± 4.87°, and 0.38 ± 1.03 D, respectively. The ACD and vertical tilt angle of the 1.0-mm were larger than those of the others (p<0.001 and p<0.05, respectively), and the postoperative spherical equivalent was more hyperopic (p<0.05). The 2.0-mm exhibited a lower frequency of tilting greater than 7°. The inter-eye difference in ACD between in-the-bag fixation and ISHF of the1.0-mm tunnel was significantly greater than that in the 2.0-mm tunnel (p<0.05). The 1.0 mm tunnel had a significantly larger incident angle and a longer tunnel length (p<0.001, respectively) and showed a greater difference in the tunnel length on both sides (p<0.05). Conclusion: A shorter tunnel yielded a more unstable IOL position, greater variation in angle and tunnel length, and longer ACD during ISHF. An exact 2.0-mm tunnel must be created on both sides to achieve a stable and predictable IOL position.","PeriodicalId":15233,"journal":{"name":"Journal of Cataract & Refractive Surgery","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140562375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Comment on: Association between anterior chamber biometry and posterior capsular defects","authors":"Tschingis Arad, Xenia Engel, Hanns Ackermann, Ingo Schmack, Thomas Kohnen","doi":"10.1097/j.jcrs.0000000000001454","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001454","url":null,"abstract":"","PeriodicalId":15233,"journal":{"name":"Journal of Cataract & Refractive Surgery","volume":"30 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140562467","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Late Iris Cerclage Suture Cheese-Wiring","authors":"Malik S Ladki, Michael E Snyder","doi":"10.1097/j.jcrs.0000000000001459","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001459","url":null,"abstract":"Purpose: Mydriatic pupil repair by cerclage has been thought to be a permanent fix for glare, visual function and cosmesis. Iris repair can develop late cheese-wiring of cerclage sutures with resultant loss of benefits. We describe a case series of cerclage failures due to cheese-wiring. Setting: Cincinnati Eye Institute, Cincinnati, Ohio. Design: Retrospective single-surgeon case series. Methods: A retrospective chart review sought patients that underwent iris cerclage at the Cincinnati Eye Institute who later developed suture cheese-wiring. The patient symptoms, demographics, cerclage size, suture type, knot type, iris status, and suture status at final follow up were ascertained. Results: Six cases of cerclage suture cheese-wiring with loss of the original surgical benefit were identified. 10-0 polypropylene suture and a 3-1-1 knot were utilized in each case. The suture remained intact with an intact knot and suture loop in all cases. Conclusion: Cheese-wiring with return of mydriasis is a potential long-term outcome of iris cerclage suture placement, with return of pre-operative symptoms. Awareness of this potential eventuality provides physicians and patients a broader perspective when selecting between cerclage suture, iris prosthesis placement or other surgical and non-surgical options.","PeriodicalId":15233,"journal":{"name":"Journal of Cataract & Refractive Surgery","volume":"46 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140562477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Potential Role of the Light Adjustable Lens in Flanged Intrascleral Haptic Fixation","authors":"Stephen A LoBue, Nicholas Saba, Thomas M Catapano, Curtis R Martin, Christopher L Shelby, Wyche T Coleman","doi":"10.1097/j.jcrs.0000000000001455","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001455","url":null,"abstract":"Purpose: To compare maximum tensile strength between commonly used 3-piece intraocular lens (IOL) for flanged intrascleral haptic fixation (FISHF). Setting: Willis-Knight Eye Institute Design: Laboratory investigation Methods: Haptic tensile strength was compared with MA60AC, CT Lucia 602, AR40E, and the light-adjustable lens (LAL). Haptic strength with a 24D (diopter) IOL was compared across all lenses, as well as a range of 10-30D with the MA60AC. A custom device was created to hold the IOL in correct haptic orientation. The max tension (mean +/- standard deviation) was recorded in newtons (N) when the haptic lost tension or broke. Results: CT Lucia was the strongest at 1.53 +/- 0.11 N vs 1.00 +/- 0.15 (MA60AC), 0.87 +/- 0.19 (AR40E), and 0.83 +/- 0.14 N (LAL), P<0.001. The LAL and AR40E were similar to a 9-0 polypropylene suture while being significantly stronger than 10-0 polypropylene suture, P<0.001. No difference in haptic tension for the MA60AC from 10-30D, P>0.05. High magnification revealed the highest haptic fractures for MA60AC at 40% compared to LAL, AR40E, and CT Lucia at 0%. CT Lucia and AR40E had 100% of haptics disinserted from the IOL without any damage compared to 60% LAL and 60% MA60AC. CT Lucia, AR40E, and LAL have a flatter haptic angulation at 5 degrees. Conclusion: Haptic strength, durability, and angulation of the LAL may support the possibility of FISHF in the hands of experienced surgeons. However, further testing is strongly recommended to verify if physiologic conditions or light treatments may compromise long-term haptic stability.","PeriodicalId":15233,"journal":{"name":"Journal of Cataract & Refractive Surgery","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140562478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Phacoemulsification using an Active Fluidics System at Physiologic versus High IOP: Impact on Anterior and Posterior Segment Physiology","authors":"Matthew P. Rauen, Hillery Joiner, Robyn A. Kohler, Sara O’Connor","doi":"10.1097/j.jcrs.0000000000001457","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001457","url":null,"abstract":"Purpose Evaluate the impact of high vs low intraoperative IOP during phacoemulsification on anterior and posterior physiology Setting Private practice in Des Moines, Iowa. Design Prospective, randomized, paired-eye clinical trial of patients anticipating bilateral cataract surgery. Methods Twenty-seven subjects randomized at the time of their first cataract surgery to either low intraocular pressure (IOP) or high IOP group. The subsequent cataract surgery was done under the alternate condition. During phacoemulsification and cortex removal, IOP was maintained either at low (≤28 mmHg) or at high (≥55-60 mmHg) levels. The primary outcome was fluid usage, with secondary outcomes of central corneal thickness, FAZ (foveal avascular zone) area, foveal and macular thickness, endothelial cell density and post-operative inflammation. Results Surgery with low IOP settings used less fluid (40.0cc v 55.6 cc, p<0.0001). Corneal thickness changes were smaller in low IOP eyes at 1 day and 1 week (3.0% v 8.1%, p=0.01; 3.1% v 4.4%, p=0.01) but were similar by 1 and 3 months. Endothelial cell density (ECD) dropped less in low IOP eyes at 1 and 3 months (-1.7%v-12.3%, p=0.001, 2.1% vs -8.9%, p=0.0003.) IOP remained a significant predictor of ECD change when relationship was controlled for fluid use and phaco energy. Retinal parameters did not vary among all eyes or when compared by IOP setting. Visual acuity was similar at all time points. Conclusions Low IOP settings resulted in less inflammation and less corneal trauma, as evidenced by a smaller drop in endothelial cell density and less postop corneal edema, when compared to high IOP settings. Retinal parameters did not change significantly. The different outcomes did not result in a difference in visual acuity.","PeriodicalId":15233,"journal":{"name":"Journal of Cataract & Refractive Surgery","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140562760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to the comment on: Incidence and factors for pseudoaccommodation after monofocal lens implantation: the Monofocal Extended Range of Vision study","authors":"Mayank A. Nanavaty, Ritika Mukhija, Zahra Ashena, Catey Bunce, David J. Spalton","doi":"10.1097/j.jcrs.0000000000001451","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001451","url":null,"abstract":"","PeriodicalId":15233,"journal":{"name":"Journal of Cataract & Refractive Surgery","volume":"182 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140562381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Visual outcomes comparing emmetropia versus mini-monovision following bilateral implantation of a non-diffractive extended vision intraocular lens:randomized trial","authors":"Vaishali Vasavada, Shail A. Vasavada, Lajja Shastri, Vandana Nath, Abhay R. Vasavada, Samaresh Srivastava, Vaishali Vasavada","doi":"10.1097/j.jcrs.0000000000001458","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001458","url":null,"abstract":"Purpose: To compare visual outcomes and patient satisfaction following bilateral implantation of a non-diffractive extended vision intraocular lens(IOL) when targeting emmetropia versus mini-monovision Setting: Iladevi Cataract &amp; IOL Research Centre,India Design: Prospective,randomized controlled trial Methods: Patients undergoing bilateral cataract surgery with an extended vision IOL(Vivity, Alcon Laboratories, USA) randomized to: group I- IOL implantation with emmetropic target in both eyes, or group II- IOL implantation with mini-monovision of -0.5 diopters(D). Outcome measures evaluated 6 months postoperatively were: unaided and corrected near visual acuity(UNVA, CNVA) at 40 centimeters(cm), unaided and corrected distance(UDVA, CDVA) and intermediate (UIVA, CIVA) visual acuity at 66cm. Mesopic contrast sensitivity, binocular defocus curve, patient reported spectacle independence questionnaire and satisfaction on the McAlinden questionnaire were also assessed. Results: 70 patients enrolled in study. 34 and 33 patients in groups I and II completed follow-up. Binocular UNVA was significantly better in group II (0.26<jats:underline>+</jats:underline>0.05 vs 0.22<jats:underline>+</jats:underline>0.08 LogMAR, P=0.03). Reading add required in group II was significantly lower. UIVA (0.09<jats:underline>+</jats:underline>0.06 vs 0.07<jats:underline>+</jats:underline>0.08 LogMAR, P=0.15) and UDVA (0.02<jats:underline>+</jats:underline>0.04 vs 0.02<jats:underline>+</jats:underline>0.05 LogMAR, P=0.78) were not significantly different between groups. Mesopic contrast sensitivity was not significantly different between the groups. Binocular defocus curve showed significantly better mean visual acuities between -2.0 to -3.0 diopters in group II. Patients in both groups had high levels of spectacle independence, with no patient reporting dysphotopsia. Conclusion: Binocular UNVA was significantly better, with comparable UDVA and mesopic contrast sensitivity when targeting mini monovision with the non-diffractive extended vision IOL as compared to targeting binocular emmetropia.","PeriodicalId":15233,"journal":{"name":"Journal of Cataract & Refractive Surgery","volume":"47 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140562471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: Asssociation between anterior chamber biometry and posterior capsular defects","authors":"Ronald Yeoh","doi":"10.1097/j.jcrs.0000000000001453","DOIUrl":"https://doi.org/10.1097/j.jcrs.0000000000001453","url":null,"abstract":"","PeriodicalId":15233,"journal":{"name":"Journal of Cataract & Refractive Surgery","volume":"182 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140562377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}