Journal of refractive surgery最新文献

{"title":"First Discoveries.","authors":"Raquel Ruiz Birlanga","doi":"10.3928/1081597X-20250305-03","DOIUrl":"https://doi.org/10.3928/1081597X-20250305-03","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 4","pages":"290"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803239","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":"Comparison of Visual Acuity Outcomes of Enhanced Monofocal Versus Standard Monofocal Intraocular Lenses from a Randomized, Multicenter, Active-Controlled Trial.","authors":"Robert Edward T Ang, Ramin Khoramnia, Harvey S Uy, Peter Hoffmann, Robert D Anello, Dominik Zalewski, Kai Januschowski, Pablo de Arriba Palomero, Daniel Böhringer, Marta Ibarz Barberá, Eckart Bertelmann, Slawomir Cisiecki, H Burkhard Dick, Katrin Lorenz, Gerd U Auffarth, Ramón Ruiz-Mesa, Alvin S Relucio","doi":"10.3928/1081597X-20250218-01","DOIUrl":"10.3928/1081597X-20250218-01","url":null,"abstract":"<p><strong>Purpose: </strong>To compare visual performance of the Vivinex Impress enhanced monofocal intraocular lens (IOL) (HOYA Surgical Optics) with the Acrysof IQ monofocal IOL (Alcon Laboratories, Inc).</p><p><strong>Methods: </strong>In this multicenter, active-controlled trial, participants were randomized 2:1 to bilateral implantation with the enhanced monofocal (test) or standard monofocal (control) IOL and examined through 12 months postoperatively for visual acuities, refractive outcomes, defocus curves, and pupil diameters.</p><p><strong>Results: </strong>Ninety-eight test and 46 control participants completed testing for the first implanted eye. The test arm demonstrated a statistically significant benefit in monocular distance-corrected intermediate visual acuity (DCIVA) (photopic: 1.2 lines, <i>P</i> < .001; mesopic: 0.7 lines, <i>P</i> = .01) and uncorrected intermediate visual acuity (0.8 lines; <i>P</i> < .001) but no significant difference in monocular corrected distance visual acuity (<i>P</i> = .07). Using a stepwise regression analysis for DCIVA, the final model (adjusted R-square, 0.31) identified three significant predictor variables (age, pupil diameter, and treatment arm). Photopic defocus curves showed the test arm produced better monocular visual acuity from -1.00 through -2.50 D than the control arm. The intermediate vision benefit of the test IOL is independent of pupil size and axial length. Cumulative and persistent adverse events for the test IOL did not exceed the Safety and Performance Endpoint rates per International Organization for Standardization 11979-7.</p><p><strong>Conclusions: </strong>Compared to a standard monofocal IOL, the Vivinex Impress enhanced monofocal IOL offers an extended range of vision, with significant improvements in intermediate vision and a DCIVA benefit unaffected by pupil size and axial length. This IOL is safe and effective for patients seeking improved intermediate vision following cataract surgery. <b>[<i>J Refract Surg</i>. 2025;41(4):e300-e309.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 4","pages":"e300-e309"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803235","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":"To Dose or Not to Dose, Is That the Question?","authors":"Kishore Raj Pradhan, Victor Derhartunian, Samuel Arba-Mosquera","doi":"10.3928/1081597X-20250306-01","DOIUrl":"https://doi.org/10.3928/1081597X-20250306-01","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 4","pages":"e409-e410"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803507","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":"Prospective Fellow-Eye Comparison of a Spherical Monofocal and an Enhanced Monofocal Intraocular Lens in Intermediate and Near Vision.","authors":"Victor Danzinger, Daniel Schartmüller, Marcus Lisy, Markus Schranz, Claudette Abela-Formanek, Rupert Menapace, Christina Leydolt","doi":"10.3928/1081597X-20250307-01","DOIUrl":"10.3928/1081597X-20250307-01","url":null,"abstract":"<p><strong>Purpose: </strong>To compare monocular visual performance of a spherical and an enhanced monofocal intraocular lens (IOL) after combined implantation.</p><p><strong>Methods: </strong>This prospective study comprised 50 patients (100 eyes) with bilateral cataract surgery and implantation of the spherical Sensar AAB00 IOL (Johnson & Johnson Vision) in the dominant eye and the enhanced monofocal Eyhance ICB00 IOL (Johnson & Johnson Vision) in the non-dominant eye. Postoperative assessment compared monocular CDVA, CNVA, DCIVA, DCNVA, low contrast visual acuities, defocus curves, wavefront aberrometry, decentration, tilt, and the 7-item Visual Function Index (VF-7) questionnaire.</p><p><strong>Results: </strong>Monocular DCIVA at 66 cm (spherical: 0.33 ± 0.13 vs enhanced monofocal: 0.37 ± 0.13 logarithm of the minimum angle of resolution (logMAR), <i>P</i> = .007), DCIVA at 80 cm (spherical: 0.24 ± 0.12 vs enhanced monofocal: 0.31 ± 0.11 logMAR, <i>P</i> < .001), and DCNVA at 40 cm (spherical: 0.49 ± 0.17 vs enhanced monofocal: 0.56 ± 0.13, <i>P</i> = .003) increased significantly with the enhanced monofocal IOL. Similarly, monocular low contrast intermediate (<i>P</i> = .048) and corrected (<i>P</i> = .006) near vision were better in the enhanced monofocal group. Defocus curves from -0.25 to -1.50 D (<i>P</i> < .05) and internal spherical aberrations Z(4,0) (<i>P</i> < .001) differed between the two IOLs. CDVA, decentration, and tilt were comparable (<i>P</i> > .05).</p><p><strong>Conclusions: </strong>This fellow-eye study demonstrated significant differences between the enhanced monofocal IOL and the spherical IOL. Visual improvements with the enhanced monofocal IOL were modest for both intermediate and near vision. There was no significant difference in distance vision, decentration, or tilt, and higher order aberrations were low. <b>[<i>J Refract Surg</i>. 2025;41(4):e382-e390.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 4","pages":"e382-e390"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803350","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":"Using 3D Convolutional Neural Network and Corvis ST Corneal Dynamic Video for Detecting Forme Fruste Keratoconus.","authors":"Hua Rong, Guihua Liu, Yanling Wang, Jiamei Hu, Ziwen Sun, Nan Gao, Chea-Su Kee, Bei Du, Ruihua Wei","doi":"10.3928/1081597X-20250226-01","DOIUrl":"10.3928/1081597X-20250226-01","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the performance of a three-dimensional convolutional neural network (3D CNN) in detecting forme fruste keratoconus (FFKC).</p><p><strong>Methods: </strong>A total of 415 anonymized corneal dynamic videos were collected for this study. The video dataset consisted of 150 patients with FFKC (150 videos) and 265 normal patients (265 videos). These patients underwent comprehensive ocular examinations, including slit lamp, Pentacam (Oculus Optikgeräte GmbH), and Corvis ST (Oculus Optikgeräte GmbH), and were classified by corneal experts. A 3D CNN-based algorithm was developed to establish a FFKC detection model. The performance of the model was evaluated using metrics such as accuracy, area under the receiver operating characteristic curve (AUC), confusion matrices, and F1 score. Gradient-weighted class activation mapping (Grad-CAM) was used to observe the regions that the model attended to.</p><p><strong>Results: </strong>In the test dataset, the model achieved an accuracy of 87.95% in identifying FFKC. The ResNet3D-AUC was 0.95 with a cut-off value of 0.49, and the F1 value was 0.85. The sensitivity was 83.33% and the specificity was 90.57%.</p><p><strong>Conclusions: </strong>Combining 3D CNN with Corvis ST corneal dynamic videos provides a new method for distinguishing between FFKC and normal corneas. This could offer valuable clinical insights and recommendations for detecting FFKC. Nevertheless, the generalizability of the model is still a concern, and external validation is required prior to its clinical implementation. <b>[<i>J Refract Surg</i>. 2025;41(4):e356-e364.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 4","pages":"e356-e364"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803519","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":"Anterior Segment Characteristics Changes After Implantable Collamer Lens V4c in Low Anterior Chamber Depth Eyes: An Optical Coherence Tomography Study.","authors":"Zhanyu Su, Shanshan Wang, Siya Li, Ruiwen Wang, Yaxin Li, Shuli Di, Yaqian Xu, Jinwei Hu, Julio Ortega-Usobiaga, Zheng Wang, Ming X Wang, Kangjun Li","doi":"10.3928/1081597X-20250225-01","DOIUrl":"10.3928/1081597X-20250225-01","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate anterior segment changes after implantable collamer lens V4c (ICL-V4c; STAAR Surgical) implantation in eyes with low anterior chamber depth (ACD) and compare them with eyes with normal ACD.</p><p><strong>Methods: </strong>This prospective, interventional case-control study included 96 eyes of 48 patients with a low ACD (< 2.8 mm) and 44 eyes of 22 patients with normal ACD (≥ 2.8 mm) receiving a 12.1-mm ICL. All patients underwent follow-up and comprehensive ophthalmic examinations preoperatively and at 1, 3, and 6 months after surgery. Anterior segment parameters, including ACD, anterior chamber width, crystalline lens rise, anterior chamber angle, trabecular-iris angle (TIA), angle opening distance, trabecular-iris space area, the distance from cornea to ICL, and vault were all conducted by optical coherence tomography. These parameters from the last follow-up (6 months postoperatively) were used for statistical analysis to assess changes in anterior segment structure and their relationship with vault height.</p><p><strong>Results: </strong>The mean safety and efficacy index in eyes with low ACD were 1.23 ± 0.22 and 1.21 ± 0.08 respectively. In both groups, anterior chamber structure parameters become narrower compared to preoperatively (all <i>P</i> < .05). Preoperative ACD and C-ICL demonstrated significant correlations with ICL vault in eyes with low ACD (<i>P</i> < .001). Compared with eyes with normal ACD preoperatively, eyes with low ACD are more prone to have low vault (<i>P</i> < .01). There is a correlation between normal vault and corneal horizontal white-to-white distance (<i>P</i> = .032), ACD (<i>P</i> = .046), and temporal TIA₅₀₀ (<i>P</i> = .016).</p><p><strong>Conclusions: </strong>ICL-V4c surgery in eyes with low ACD is safe and efficacious. In patients with low ACD, the normal vault could be better anticipated by considering preoperative anterior chamber angle, white-to-white distance, and ACD. <b>[<i>J Refract Surg</i>. 2025;41(4):e342-e355.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 4","pages":"e342-e355"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803697","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":"Clarifying Laser Dose Terminology in Ophthalmology.","authors":"Juan Arbelaez, Maria C Arbelaez","doi":"10.3928/1081597X-20250211-01","DOIUrl":"https://doi.org/10.3928/1081597X-20250211-01","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 4","pages":"e404"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803234","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":"Objective Versus Subjective Depth of Focus Correlation in Pseudophakic Eyes.","authors":"Mayank A Nanavaty, Margarita Safir, Muhanned Alwindi","doi":"10.3928/1081597X-20250207-01","DOIUrl":"10.3928/1081597X-20250207-01","url":null,"abstract":"<p><strong>Purpose: </strong>To develop a method for quantifying objective depth of focus (DOF) from the visual Strehl ratio based on the optical transfer function (VSOTF), measured on a ray-tracing aberrometer (iTrace; Tracey Technologies) and to compare it to the subjective clinical DOF in two groups of pseudophakic eyes with varying asphericity of the intraocular lenses (IOLs).</p><p><strong>Methods: </strong>In this cross-sectional study, two groups with negatively aspheric (Eyhance; Johnson & Johnson) and aspherically neutral (RayOne; Rayner) IOLs were assessed 3 to 9 months postoperatively. The patient assessments included: logarithm of the minimum angle of resolution visual acuity, refraction, defocus curves, and iTrace assessments. The primary outcome was to determine the threshold of VSOTF (%) corresponding to subjective DOF. Secondary outcomes were uncorrected (UDVA) and corrected (CDVA) distance visual acuities, manifest refraction, keratometry, and wavefront aberrometry. The specific threshold of VSOTF matching the subjective DOF was determined.</p><p><strong>Results: </strong>Forty-two eyes (21 patients in each IOL group) were analyzed. For the primary outcome, in the Eyhance versus the RayOne IOL group and all eyes together there was no significant difference between 25% (<i>P</i> = .10 vs .28; <i>P</i> = .07) and 30% (<i>P</i> = .55 vs .73; <i>P</i> = .58) VSOTF and subjective DOF, respectively. For secondary outcomes, UDVA was better in the Eyhance group (<i>P</i> = .02). There was no difference in CDVA, manifest refraction, and keratometry. There was a significant difference in total and internal spherical aberration between the two groups, although it was not clinically significant.</p><p><strong>Conclusions: </strong>This study showed that a 25% to 30% threshold of VSOTF values on iTrace measurements (Nanavaty Threshold) gives an objective DOF estimate, equivalent to clinical DOF derived from the defocus curve irrespective of the IOL's optical profiles. <b>[<i>J Refract Surg</i>. 2025;41(4):e310-e317.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 4","pages":"e310-e317"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply: To Dose or Not to Dose, Is That the Question?","authors":"Holger Lubatschowski, Jodhbir S Mehta","doi":"10.3928/1081597X-20250317-02","DOIUrl":"https://doi.org/10.3928/1081597X-20250317-02","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 4","pages":"e410"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803497","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":"Changes in Corneal Densitometry Values of 50 Corneal Layers After Keratorefractive Lenticule Extraction (KLEx): A 6-Year Follow-Up.","authors":"Li Li, Wenjing Gao, Fuqi Deng, Huazheng Cao, Xiaomei Zhen, Yan Wang","doi":"10.3928/1081597X-20250305-01","DOIUrl":"10.3928/1081597X-20250305-01","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the changes in the corneal densitometry (CD) values after keratorefractive lenticule extraction (KLEx) and their influencing factors.</p><p><strong>Methods: </strong>CD values of 50 layers of the right corneas of the participants, measured using a Pentacam (Oculus Optikgeräte GmbH) at different points after KLEx, were obtained from a database and analyzed. Repeated-measures analysis of variance was used to compare CDs between postoperative time, regions, and corneal depths.</p><p><strong>Results: </strong>Fifty-two participants were included. At 1 week after surgery, CDs of the corneal center, para-center, and non-incised periphery increased by 24.23%, 24.49%, and 11.42% at the superior and inferior 20 μm and 14.54%, 13.39%, and 7.82% at the superior and inferior 40 μm of the junctions of the corneal cap and stromal bed, respectively, from their preoperative values. No significant differences were observed in maximum CD values between the corneal center, para-center, and non-incised periphery groups between preoperative and 6-year postoperative measurements (<i>P</i> = .07, .81, and .96, respectively).</p><p><strong>Conclusions: </strong>There was an initial significant increase in CD, particularly near the junctions of the corneal cap and stromal bed. Maximum CDs returned to preoperative values after 6 years. <b>[<i>J Refract Surg</i>. 2025;41(4):e365-e373.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 4","pages":"e365-e373"},"PeriodicalIF":2.9,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143803232","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}