Journal of refractive surgery最新文献

{"title":"Accuracy of Modern IOL Power Calculation Formulas in Eyes After Myopic Laser Vision Correction: A Stratified Axial Length Analysis.","authors":"Jianheng Liang, Qian Tan, Zheming Wu, Yun Chen, Ruihong Ju, Haisong Chen, Qiongyan Tang, Yanxue Xu, Li Xu, Julio Ortega-Usobiaga, Danmin Cao, Yong Wang","doi":"10.3928/1081597X-20250328-01","DOIUrl":"https://doi.org/10.3928/1081597X-20250328-01","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the accuracy of modern intraocular lens (IOL) power calculation formulas in eyes with previous myopic laser vision correction (LVC), and to assess the impact of axial length (AL) on the formula performance.</p><p><strong>Methods: </strong>A total of 108 eyes were included, with 52 eyes in the AL less than 28 mm group and 56 eyes in the AL 28 mm or greater group. Refractive prediction errors (RPEs) were compared among nine post-LVC formulas: Haigis-TK, Haigis-TK_CMAL (incorporating Cooke-modified axial length [CMAL]), PEARL-DGS, Hoffer-QST TK, LISA TK, Barrett True-K TK, EVO TK, Haigis-L, and Shammas. Pearson correlation analysis was employed to evaluate the influence of AL and other biometric parameters on RPEs.</p><p><strong>Results: </strong>In the AL less than 28 mm group, no significant differences were observed between all formulas (all adjusted <i>P</i> > .05). However, in the AL 28 mm or greater group, Haigis-TK_CMAL demonstrated significantly lower root mean square absolute error (RMSAE) and mean absolute error (MAE) compared to the Hoffer-QST, Barrett True-K TK, Shammas, and Haigis-L (all adjusted <i>P</i> < .001). Similarly, the PEARL-DGS showed significantly lower RMSAE than the Barrett True-K TK, Shammas, and Haigis-L (both adjusted <i>P</i> < .001), and significantly lower MAE compared to the Barrett True-K TK and Haigis-L (both adjusted <i>P</i> < .001). The Haigis-TK_CMAL had the highest percentage of eyes with RPEs within ±0.50 diopters (D) (73.21%), whereas the PEARL-DGS had the highest percentage of eyes with RPEs within ±1.00 D (94.64%). A significant negative correlation between AL and RPE was found in most formulas, leading to a myopic shift in eyes with extremely long AL.</p><p><strong>Conclusions: </strong>The performance of current post-LVC formulas was comparable in eyes with AL less than 28 mm, whereas the Haigis-TK_CMAL and PEARL-DGS demonstrated superior accuracy in eyes with AL 28 mm or greater. A notable myopic shift occurred in post-LVC eyes with extremely long AL, highlighting the need for careful formula selection in such cases. <b>[<i>J Refract Surg</i>. 2025;41(5):e435-e443.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 5","pages":"e435-e443"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015081","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 Posterior Staphyloma and Peripheral Refraction on Intraocular Lens Power Calculation in Highly Myopic Eyes.","authors":"Zhiwen Yao, Yingyan Qin, Lu Qin, Yan Ni, Liangping Liu, Mingxing Wu","doi":"10.3928/1081597X-20250403-01","DOIUrl":"https://doi.org/10.3928/1081597X-20250403-01","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the impact of posterior staphyloma and peripheral refraction on the calculation of intraocular lens (IOL) power in eyes with highly myopic cataracts.</p><p><strong>Methods: </strong>Multispectral refraction topography (MRT) was used to categorize posterior staphyloma types and detect the refraction difference value (RDV) across different fundus regions. The Barrett Universal II formula was employed for IOL power calculation. Refractive outcomes were assessed through the calculation of standard deviation (SD), mean absolute error (MAE), median absolute error (MedAE), and the proportion of eyes with prediction error (PE) within ±0.25, ±0.50, ±0.75, and ±1.00 diopters (D). The associations between PE and peripheral refraction were analyzed using Pearson correlation analysis.</p><p><strong>Results: </strong>A total of 65 patients (84 eyes) were included in the study and were categorized into groups based on staphyloma types (non-posterior staphyloma, wide macular staphyloma, narrow macular staphyloma, peripapillary staphyloma) using MRT. The patients with wide macular staphyloma exhibited significantly higher SD (0.465) in comparison to those without staphyloma (0.23). Among patients with posterior staphyloma, peripapillary staphyloma had the least effect on IOL power calculation with the lowest SD (0.325), MAE (0.25), and MedAE (0.25), and highest percentage of cases with a PE within ±0.50 D (90%). According to multivariate analysis, RDV-Superior was significantly correlated with PE (B = -0.471, <i>P</i> = .001).</p><p><strong>Conclusions: </strong>Patients with wide macular staphyloma present challenges for accurate IOL power calculation. In addition, superior retinal peripheral myopic defocus in patients with posterior staphyloma may lead to greater hyperopic shifts after cataract surgery. Consideration of staphyloma types and RDV-Superior is recommended for more precise IOL power calculation. <b>[<i>J Refract Surg</i>. 2025;41(5):e472-e480.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 5","pages":"e472-e480"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144005647","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":"The Influence of the Epithelium Removal Method on the Outcomes of Photorefractive Keratectomy.","authors":"Barbara A L Dutra, Valeria Villabona-Martinez, Steven E Wilson","doi":"10.3928/1081597X-20250320-01","DOIUrl":"https://doi.org/10.3928/1081597X-20250320-01","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the outcomes and complications reported for alternative methods of removal of the corneal epithelium during photorefractive keratectomy (PRK).</p><p><strong>Methods: </strong>Literature review.</p><p><strong>Results: </strong>Excimer laser-based refractive surgery treatments are safe and effective, and PRK is one of the most common methods used to treat refractive errors. Conventional PRK methods involve removing the corneal epithelium overlying the intended stromal ablation with mechanical debridement, dilute ethanol exposure, or a rotating brush, and each method is associated with potential complications. An alternative method in which the corneal epithelium overlying the intended stromal ablation is removed with the excimer laser followed by refractive stromal ablation (a single-step, \"no-touch\" method) termed transepithelial PRK (transPRK) continues to evolve and has advantages and disadvantages compared to the other methods.</p><p><strong>Conclusions: </strong>Mechanical blade scrape PRK and alcohol-assisted PRK techniques have been most used and yield excellent results. However, alcohol-assisted epithelial removal triggers increased keratocyte death at the time of surgery that is hypothesized to underlie the development of breakthrough haze after PRK with mitomycin C. TransPRK continues to have limitations but as the technique evolves it appears to potentially be a more precise method. <b>[<i>J Refract Surg</i>. 2025;41(5):e510-e518.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 5","pages":"e510-e518"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143968811","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 Anterior Segment Measurements With a New Swept-source Optical Coherence Tomography Biometer and a Scheimpflug-Placido Topographer.","authors":"Chak Seng Lei, Xin Li, Huilin Xu, Rui Ning, Yiran Wang, Giacomo Savini, Domenico Schiano-Lomoriello, Xingtao Zhou, Kexin Li, Jinhai Huang","doi":"10.3928/1081597X-20250317-03","DOIUrl":"https://doi.org/10.3928/1081597X-20250317-03","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the agreement of anterior segment measurements between a new swept-source optical coherence tomography biometer (ZW-30; TowardPi Medical Technology) and a Scheimpflug-Placido topographer (Sirius; Costruzione Strumenti Oftalmici) in normal eyes.</p><p><strong>Methods: </strong>In this prospective study, measurement agreement was assessed in 56 right eyes of 56 healthy patients. One experienced operator obtained three consecutive measurements with both devices randomly. The comparative parameters were central corneal thickness (CCT), anterior aqueous depth (AQD), anterior chamber depth (ACD), mean keratometry, astigmatism magnitude (AST), J₀ and J₄₅ power vectors, and corneal diameter (CD). The paired <i>t</i>-test was used to compare the difference between the two devices. Pearson's correlation analysis and Bland-Altman plots with 95% limits of agreement (LoA) were calculated to evaluate agreement.</p><p><strong>Results: </strong>The paired <i>t</i>-test showed statistically significant differences in all parameters (<i>P</i> < .05). Correlation analysis showed high correlation, Bland-Altman plots indicated moderate to high agreement between the two devices. The 95% LoA of CCT, AQD, ACD, mean keratometry, AST, J₀ and J₄₅ power vectors, and CD ranged from -4.36 to 19.83 µm, -0.11 to 0.04 mm, -0.12 to 0.03 mm, -0.50 to 0.12 D, -0.29 to 0.39 D, -0.20 to 0.14 D, -0.17 to 0.13 D, and 0.18 to 0.80 mm, respectively.</p><p><strong>Conclusions: </strong>Anterior segment measurements from the new SS-OCT biometer and the Scheimpflug-Placido topographer demonstrated high agreement in AQD, ACD, AST, and J₀ and J₄₅ power vectors. However, for CCT, mean keratometry, and CD, the moderate inter-device agreement suggests that results should be interpreted with caution when making comparisons. <b>[<i>J Refract Surg</i>. 2025;41(5):e413-e420.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 5","pages":"e413-e420"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998341","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":"Refractive Prediction Error Following Phacoemulsification Cataract Surgery in Patients With Uveitis.","authors":"Yujia Gui, Nan Guo, Ying Chen, Hong Yan","doi":"10.3928/1081597X-20250317-05","DOIUrl":"https://doi.org/10.3928/1081597X-20250317-05","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the refractive prediction error (PE) following phacoemulsification cataract surgery in patients with and without uveitis, and identify the factors associated with PE in patients with uveitis.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted on the data obtained from patients who underwent uncomplicated phacoemulsification cataract surgery, which was performed by a single surgeon at Xi'an People's Hospital between January 2021 and February 2024. The patients were divided into two cohorts based on the operated eyes' history of uveitis. PE was analyzed before and after propensity score matching based on confounding variables, which included patient gender and age, procedure laterality, anterior chamber depth (ACD), axial length (AL), and keratometry. Then the factors associated with PE in the uveitis cohort were identified.</p><p><strong>Results: </strong>The PE significantly differed between the matched uveitis and non-uveitis cohorts (0.16 ± 0.65 vs -0.19 ± 0.50 diopters [D], <i>P</i> < .001), with a shift toward hyperopia in the uveitis cohort. However, the absolute PE did not significantly differ between the matched cohorts (0.49 ± 0.45 and 0.42 ± 0.33, <i>P</i> = .081). For patients with uveitis, PE was positively associated with the course of uveitis (β = 0.027, 95% CI = 0.003 to 0.052, <i>P</i> = .027), preoperative posterior synechiae (β = 0.226, 95% CI = 0.027 to 0.425, <i>P</i> = .026), and preoperative ACD (β = 0.417, 95% CI = 0.089 to 0.746, <i>P</i> = .013) and AL (β = 0.068, 95% CI = 0.009 to 0.128, <i>P</i> = .025).</p><p><strong>Conclusions: </strong>For patients with uveitis who underwent phacoemulsification cataract surgery, postoperative PE presented with a hyperopic shift relative to that in patients without uveitis. This was associated with the course of uveitis, preoperative posterior synechiae, and preoperative ACD and AL. <b>[<i>J Refract Surg</i>. 2025;41(5):e427-e434.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 5","pages":"e427-e434"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143978060","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 of Corneal Aberrometric Measurements With a New Hybrid Device and Comparison With a Scheimpflug/Placido Topography in Different Grades of Keratoconus.","authors":"Rui Ning, Yizhou Yang, Huilin Xu, Kexin Li, Zheng Li, Yue Li, Giacomo Savini, Domenico Schiano-Lomoriello, Xingtao Zhou, Xiaoying Wang, Jinhai Huang","doi":"10.3928/1081597X-20250401-03","DOIUrl":"https://doi.org/10.3928/1081597X-20250401-03","url":null,"abstract":"<p><strong>Purpose: </strong>To assess the precision of corneal higher order aberration (HOA) measurements obtained by an anterior segment optical coherence tomographer combined with Placido-disk topography (MS-39) in different grades of keratoconus and compare them with a Scheimpflug/Placido topographer (Sirius).</p><p><strong>Methods: </strong>Anterior, posterior, and total corneal aberrations were analyzed. Within-subject standard deviation (S_w), test-retest repeatability (TRT), and intraclass correlation coefficient (ICC) were used to assess the intraobserver repeatability and interobserver reproducibility. The differences between the two devices were evaluated using the paired <i>t</i>-test. Bland-Altman plots and 95% limits of agreement (95% LoA) were applied for agreement analysis.</p><p><strong>Results: </strong>This prospective study included 99 eyes of 99 patients with keratoconus. Regarding intraobserver repeatability, all S_w values were 0.16 µm or less, TRT 0.44 µm or less, and ICCs 0.874 or greater for anterior and total corneal parameters. For posterior corneal aberrations, all S_w values for high-order Zernike terms were 0.04 µm or less and ICCs varied from 0.739 to 0.991. Regarding interobserver reproducibility, all S_w values were 0.17 µm or less and TRT 0.29 µm or less. ICCs ranged from 0.956 to 0.998, from 0.84 to 0.997, and from 0.923 to 0.997 for anterior, posterior, and total corneal aberrations, respectively. The TRT of the Zernike coefficients tended to improve with increasing keratoconus stage. All parameters showed a narrow 95% LoA and varied according to the keratoconus stages.</p><p><strong>Conclusions: </strong>The new hybrid MS-39 device provides precise measurements for almost all corneal aberrations in different grades of keratoconus. The MS-39 and Sirius can be used interchangeably for measuring corneal aberrations. <b>[<i>J Refract Surg</i>. 2025;41(5):e460-e471.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 5","pages":"e460-e471"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016151","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 Customized and Standard Corneal Cross-linking for Ectasia After Laser in Situ Keratomileusis.","authors":"Elina M Utti, Kari M Krootila Md","doi":"10.3928/1081597X-20250401-02","DOIUrl":"https://doi.org/10.3928/1081597X-20250401-02","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the effect of customized corneal cross-linking (CXL) in ectasia after laser in situ keratomileusis (LASIK).</p><p><strong>Methods: </strong>Thirty-two eyes of 24 patients with post-LASIK ectasia treated with customized CXL were included in this study. Treatment zones with different ultraviolet energy levels were planned according to corneal tomography. A control group of 19 eyes of 14 patients with post-LASIK ectasia received conventional CXL. Patients were prospectively followed up at 1 month, 6 months, and 1 year after the procedure. Subsequent follow-up 2 to 4 years after CXL was obtained from 22 eyes of 18 patients. Corrected distance visual acuity, refraction, and anterior segment optical coherence tomography parameters were compared to preoperative values.</p><p><strong>Results: </strong>After a transient deterioration at 1 month, visual acuity and keratometry stabilized at 6 months in both groups. One year after customized CXL, the visual acuity was significantly better (P< .01), corneal inferior-superior asymmetry decreased (<i>P</i> = .02), and corneal thickness increased (<i>P</i> < .01). These effects were maintained during the 2- to 4-year follow-up. There were no statistically significant changes in refractive outcomes or keratometry at 1 or 2 to 4 years. Decrease in higher order irregularities was seen only after customized CXL, but it did not reach statistical significance. In 1 patient the ectasia continued progressing after customized CXL, giving a failure rate of 4.2%.</p><p><strong>Conclusions: </strong>Customized CXL seems to be as safe as standard CXL in treating progressive post-LASIK ectasia. The results suggest that customized CXL could have a better effect on visual acuity and corneal asymmetry. More studies are needed to verify the advantages of customized method over standard CXL.the <b>[<i>J Refract Surg</i>. 2025;41(5):e451-e459.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 5","pages":"e451-e459"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998108","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 Vitro Comparison of an Aspherical Monofocal Lens Inducing Positive Spherical Aberrations With a Spherical Lens.","authors":"Benjamin Stern, Alain Saad, Damien Gatinel","doi":"10.3928/1081597X-20250403-02","DOIUrl":"https://doi.org/10.3928/1081597X-20250403-02","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the in vitro performance of a monofocal intraocular lens (IOL) with an aspherical design inducing positive spherical aberrations (APSA IOL, RayOne EMV; Rayner), and a spherical lens (RayOne Spheric; Rayner).</p><p><strong>Methods: </strong>In vitro wavefront measurements were conducted on 10.00, 20.00, and 30.00 diopter (D) lenses. The average through-focus modulation transfer function (MTF) (0 to 50 lp/mm) was generated for 168 synthetic numerical eye models with varying aperture sizes (2.0 to 5.5 mm) and corneal spherical aberration values (-0.49 to 0.91 µm). Evaluated metrics included MTFmax (peak MTF value) and depth of focus (DOF), defined as half of the dioptric range in the spectacle plane where the MTF exceeds 0.3.</p><p><strong>Results: </strong>In physiological corneal models, APSA IOLs demonstrated enhanced MTFmax and DOF in larger apertures in high power lenses (30.00 D); a similar, although less pronounced, pattern was observed at 20.00 D. For low-power (10.00 D) lenses, APSA IOLs provided superior MTFmax in large apertures but exhibited a moderate trade-off in mid-sized apertures. In non-physiological corneal models with high SA, both APSA IOLs and spherical lenses showed reduced MTFmax in larger apertures. Conversely, in negative spherical aberration models, they provided excellent MTF-max but limited DOF.</p><p><strong>Conclusions: </strong>In normal eyes, APSA IOLs offer better contrast rendering and DOF in high-power lenses due to the controlled induction of positive spherical aberration. However, in medium-power and low-power lenses, the benefits are less evident, with low-power lenses showing reduced contrast in mid-sized pupils. Caution is advised for both models following myopic corneal refractive surgery, although they perform well after hyperopic treatment. <b>[<i>J Refract Surg</i>. 2025;41(5):e481-e491.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 5","pages":"e481-e491"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143998142","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":"The Visual Impact of Induced Astigmatism of a Violet Light-Filtering Diffractive Extended Depth of Focus Intraocular Lens.","authors":"Marcela Feltrin de Barros, Karolinne Maia Rocha, George O Waring, Marcony R Santhiago, Rupal H Trivedi","doi":"10.3928/1081597X-20250317-04","DOIUrl":"https://doi.org/10.3928/1081597X-20250317-04","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate tolerance to simulated astigmatism on distance visual acuity in pseudophakic eyes implanted with an extended depth of focus (EDOF) diffractive intraocular lens (IOL) with violet light filter.</p><p><strong>Methods: </strong>This prospective observational study enrolled consecutive patients who underwent cataract surgery with violet light-filtering diffractive EDOF IOL implantation. Cylinder defocus was induced with plus cylinder lenses from +0.50 to +2.00 diopters (D) in 0.50-D steps for each astigmatic orientation (against-the-rule [ATR], oblique, and with-the-rule [WTR]). The monocular distance visual acuity was measured after induced astigmatism was added to the patient's corrected distance manifest refraction. The magnitude of astigmatic tolerance was assessed by taking the difference between distance visual acuity at each defocus relative to corrected distance visual acuity without defocus. Quality of vision was evaluated using the National Eye Institute Visual Function Questionnaire (VFQ-25).</p><p><strong>Results: </strong>Most patients maintained 20/40 or better distance visual acuity with up to 1.00 D WTR astigmatism and 0.50 D ATR and oblique astigmatism. The median astigmatic defocus to maintain distance visual acuity within one-line reduction was 1.00 D with WTR and 0.50 D with ATR and oblique astigmatism. Within a two-line reduction, it was 1.50 D for WTR and 1.00 D for oblique and ATR. All patients reported excellent outcomes on the VFQ-25 questionnaire.</p><p><strong>Conclusions: </strong>The diffractive EDOF IOL with violet light filter demonstrated satisfactory distance vision tolerance to induced astigmatism. WTR astigmatism was better tolerated for distance vision than oblique and ATR astigmatism. <b>[<i>J Refract Surg</i>. 2025;41(5):e421-e426.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 5","pages":"e421-e426"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144016170","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":"The Eye That Sees.","authors":"Leandro Portella","doi":"10.3928/1081597X-20250401-01","DOIUrl":"https://doi.org/10.3928/1081597X-20250401-01","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 5","pages":"412"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144023135","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}