Journal of refractive surgery最新文献

{"title":"Keratorefractive Lenticule Extraction for Myopia and Myopic Astigmatism With the VISUMAX 800: 6-Month Outcomes of a Prospective Multi-center Post-market Clinical Follow-up Study.","authors":"Walter Sekundo, John S M Chang, Sri Ganesh, Jesper Hjortdal, Rainer Wiltfang","doi":"10.3928/1081597X-20250204-03","DOIUrl":"https://doi.org/10.3928/1081597X-20250204-03","url":null,"abstract":"<p><strong>Purpose: </strong>To report the outcomes of small incision lenticule extraction (SMILE) using the VISUMAX 800 laser (Carl Zeiss Meditec) in a post-market clinical follow-up study.</p><p><strong>Methods: </strong>This was a prospective, non-randomized, multi-center, international, post-market clinical follow-up study. The study took place from July 2021 to March 2023 at five sites across Europe and Asia. Patients meeting all inclusion criteria including myopia up to -10.00 diopters (D) and astigmatism up to 5.00 D were enrolled to undergo SMILE using the VISUMAX 800 femtosecond laser (Carl Zeiss Meditec). Patients were examined at 1 day, 1 week, and 1, 3, and 6 months after treatment.</p><p><strong>Results: </strong>During the study period, 473 eyes (237 patients) were enrolled, treated, and analyzed. The preoperative spherical equivalent was -4.49 ± 1.87 D (range -0.25 to -10.00 D). Preoperative corrected distance visual acuity (CDVA) was 20/20 or better in 98.3% of eyes. At 6 months postoperatively, uncorrected distance visual acuity was 20/20 or better in 93.2% and 20/25 or better in 98.3% of eyes. Accuracy of spherical equivalent to intended target showed 95.1% of eyes were within ±0.50 D and 99.6% were within ±1.00 D for spherical equivalent and 90.8% of eyes were within ±0.50 D and 99.7% were within ±1.00 D for cylinder. There was a slight increase in monocular mesopic contrast sensitivity across all cycles per degree. There was one reported case of suction loss, which was not due to ocular movement. No eyes lost two or more lines of CDVA compared to baseline.</p><p><strong>Conclusions: </strong>SMILE with the VISUMAX 800 provides excellent visual and refractive outcomes for patients with myopia and myopic astigmatism. <b>[<i>J Refract Surg</i>. 2025;41(3):e264-e271.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 3","pages":"e264-e271"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605287","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 Error Prediction After Phacoemulsification Surgery: Lenstar LS 900 Versus Nidek AL-Scan.","authors":"Gülay Yalçinkaya Çakir, Ahmet Kirgiz, Ibrahim Uzar, Nilay Kandemir Beşek, Sibel Ahmet, Burcu Kemer Atik, Seda Liman Uzun, Muhittin Taşkapili","doi":"10.3928/1081597X-20250207-03","DOIUrl":"https://doi.org/10.3928/1081597X-20250207-03","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the Lenstar LS 900 (Haag-Streit AG) and the Nidek AL-Scan (Nidek Co) optical biometry devices in intraocular lens (IOL) calculation and refractive error prediction in cases with uncomplicated phacoemulsification surgery.</p><p><strong>Methods: </strong>In this study, axial length (AL), flat (K1), and steep (K2) axis, and the average (K-avg) keratometry values measured with the Lenstar LS 900 and the Nidek AL-Scan in patients who underwent uncomplicated phacoemulsification and the mean absolute error (MAE) of both devices were compared.</p><p><strong>Results: </strong>One hundred five eyes of 105 patients were examined. AL was measured shorter with the Lenstar LS 900 than with the Nidek AL-Scan, and K1, K2, and K-avg were measured steeper (<i>P</i> < .001 for all). Although there was no proportional bias in the AL, K1, and K-avg measurements of the Lenstar LS 900 and the Nidek AL-Scan devices (<i>P</i> = .83, .96, and .41 respectively), there was a proportional bias in the K2 measurements (<i>P</i> < .001, <i>R</i>² = 0.128). MAE was significantly higher in the Lenstar LS 900 (0.74 ± 0.6 D) than in the Nidek AL-Scan (0.64 ± 0.60 D) (<i>P</i> < .001). The percentage of eyes with a prediction error within the range of ±0.50 D was significantly higher with the Nidek AL-Scan (61%) than with the Lenstar LS 900 (49.5%) (<i>P</i> = .008).</p><p><strong>Conclusions: </strong>The Nidek AL-Scan produced more predictable outcomes than the Lenstar LS 900 in selecting IOL power. Despite the clinical similarity between AL, K1, and K-avg readings, there may be notable differences in choosing the IOL power between these two devices. <b>[<i>J Refract Surg</i>. 2025;41(3):e257-e263.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 3","pages":"e257-e263"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605232","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: Vector Planning and Ocular Residual Astigmatism (ORA) Source Reference and Other KLEx Studies.","authors":"Qing Su, Shuang Liang, Huazheng Cao, Mengyuan Shan, Yan Wang","doi":"10.3928/1081597X-20250224-01","DOIUrl":"https://doi.org/10.3928/1081597X-20250224-01","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 3","pages":"e288-e289"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605233","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":"Resolution of Rainbow Glare After LASIK via Mechanical Scraping and Phototherapeutic Keratectomy of Flap Undersurface.","authors":"Carla C Winter, Fabio Bondar, Ana Silvia Serrano, Roberto Pineda","doi":"10.3928/1081597X-20250207-04","DOIUrl":"https://doi.org/10.3928/1081597X-20250207-04","url":null,"abstract":"<p><strong>Purpose: </strong>To report a case of bilateral rainbow glare resolved by combined mechanical scraping and small ablation depth phototherapeutic keratectomy (PTK) of the laser in situ keratomileusis (LASIK) flap undersurface.</p><p><strong>Methods: </strong>A 42-year-old man presented with symptoms of rainbow glare in both eyes after bilateral femtosecond laser-assisted LASIK 2 years prior. The LASIK flap in the left eye was relifted and PTK of 3 µm ablation depth was performed on the back surface of the flap. Symptoms were unresolved and 16 months later the patient underwent relift of the LASIK flap in the same eye with mechanical scraping and an additional 3 µm PTK of the flap undersurface. The right eye was then similarly treated with flap undersurface mechanical scraping and 3 µm PTK.</p><p><strong>Results: </strong>The patient's rainbow glare symptoms persisted after initial LASIK flap relift and 3 µm PTK but immediately resolved after the second relift and mechanical scraping combined with 3 µm PTK polishing of left flap undersurface. Mild epithelial ingrowth occurred after the second relift of the left eye, which was managed by mechanical debridement and YAG laser epithelial lysis. Treatment of the right eye with LASIK flap relift and mechanical scraping with 3 µm PTK polishing of the flap undersurface similarly improved symptoms of rainbow glare.</p><p><strong>Conclusions: </strong>Rainbow glare symptoms were successfully treated with combined mechanical scraping and small ablation depth PTK polishing of the LASIK flap undersurface. Epithelial ingrowth may be a consequence and require management. <b>[<i>J Refract Surg</i>. 2025;41(3):e280-e287.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 3","pages":"e280-e287"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605234","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":"Spatial Variation in Ciliary Body Morphology and the Effect on Haptic Position and Peripheral Vault After ICL Implantation.","authors":"Ruoyan Wei, Zhongjun Tang, Meipan Shi, Mingrui Cheng, Chiwen Cheng, Xiaoying Wang, Xingtao Zhou, Shengtao Liu","doi":"10.3928/1081597X-20250123-01","DOIUrl":"https://doi.org/10.3928/1081597X-20250123-01","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the association of local ciliary body morphology with the haptic position and peripheral vault.</p><p><strong>Methods: </strong>This retrospective observational study included 95 eyes of 59 patients treated with the EVO Implantable Collamer Lens (ICL) (STAAR Surgical). Ciliary body morphology parameters (ciliary process length [CPL], ciliary sulcus width [CSW], and scleral spur-ciliary process distance [SCD]), the relative position of ICL haptic to the ciliary process, the haptic-related parameters (the final tip point of ICL haptic [ftICL haptic] and lowest point of ICL haptic), and peripheral vault in the location of each haptic were measured with ultrasound biomicroscopy 3 months after surgery. Factors associated with ftICL haptic and peripheral vault were evaluated.</p><p><strong>Results: </strong>The haptics were in the ciliary sulcus, on the anterior angle of the ciliary process, within the ciliary process, and under the ciliary process in 45.5%, 25.4%, 21.8%, and 7.4% of cases, respectively. The peripheral vault in the infero-temporal quadrant was significantly greater than that in the other three quadrants (all <i>P</i> < .05). Local SCD, CPL, and CSW were associated with ftICL haptic, whereas local CSW, ftICL haptic, and spherical equivalent were associated with peripheral vault (all <i>P</i> < .05).</p><p><strong>Conclusions: </strong>Local ciliary body morphology was associated with the haptic position and both factors collectively influence the peripheral vault. To achieve optimal outcomes, local ciliary body morphology should be considered when selecting ICL size and implantation orientation. <b>[<i>J Refract Surg</i>. 2025;41(3):e199-e206.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 3","pages":"e199-e206"},"PeriodicalIF":2.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143605235","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 Capsular Tension Ring on the Accuracy of Nine New-Generation IOL Formulas in Long Eyes.","authors":"Jialin Xu, Ke Feng, Er Mo, Yitong Xu, Chenyuan Zhu, Yun-E Zhao, Jin Li, Fang Huang","doi":"10.3928/1081597X-20241204-01","DOIUrl":"https://doi.org/10.3928/1081597X-20241204-01","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effect of capsular tension rings (CTRs) on the accuracy of nine new-generation intraocular lens (IOL) formulas in long eyes.</p><p><strong>Methods: </strong>A total of 106 eyes (106 patients) with CTR (CTR group) and another 106 eyes (106 patients) without CTR (NCTR group) were analyzed. The differences in mean prediction error, standard deviation, mean absolute prediction error (MAE), median absolute prediction error (MedAE), root mean square absolute prediction error (RMSAE), and percentage of eyes within ±0.25, ±0.50, ±0.75, ±1.00, and greater than ±1.00 diopter (D) were compared.</p><p><strong>Results: </strong>In the CTR group, only the Hoffer QST and VRF-G formulas showed significantly lower MedAE compared to the NCTR group. There was no statistically significant difference found among other formulas. The VRF-G and Hoffer QST formulas had lower MAE (0.351 to 0.367) than the Kane (0.469) (<i>P</i> < .05). The K6 and Pearl-DGS formulas had higher MAE (0.441 to 0.452) than the Zhu-Lu (0.351) and Emmetropia Verifying Optical (EVO) 2.0 (0.377) (<i>P</i> < .05). In the NCTR group, the Zhu-Lu and RBF 3.0 formulas had lower MAE (0.340 to 0.411) compared to the Kane (0.477) (<i>P</i> < .05). The Zhu-Lu and EVO 2.0 formulas also had lower MAE (0.340 to 0.363) than Pearl-DGS (0.429) (<i>P</i> < .05), and the EVO 2.0 had lower MedAE (0.273) than the Kane (0.433) (<i>P</i> < .05). The percentage of eyes within ±0.50 D (76 to 85, 71.70% to 80.19%) of the RBF3.0, K6, EVO 2.0, and Zhu-Lu formulas were higher than Kane (53.77%) (<i>P</i> < .02).</p><p><strong>Conclusions: </strong>CTR implantation does not improve the refractive prediction accuracy of the most new generation IOL formula. The Zhu-Lu formula is recommended for use in long eyes, regardless of CTR implantation. <b>[<i>J Refract Surg</i>. 2025;41(2):e114-e119.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 2","pages":"e114-e119"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408717","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":"Insondable (Impenetrable).","authors":"Olga Davó-Alonso","doi":"10.3928/1081597X-20241230-06","DOIUrl":"https://doi.org/10.3928/1081597X-20241230-06","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 2","pages":"90"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408723","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: Refractive Outcomes After Scleral Fixation of the Carlevale Intraocular Lens.","authors":"Nathan Courat, Clément Giraud, Nicolas Leveziel","doi":"10.3928/1081597X-20250127-01","DOIUrl":"https://doi.org/10.3928/1081597X-20250127-01","url":null,"abstract":"","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 2","pages":"e186-e187"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408158","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 the Accuracy of Toric Intraocular Lens Formulas Used by the Online Calculator of the European Society of Cataract and Refractive Surgeons.","authors":"Chang Liu, Mengyu Wang, Da Long, Ye Zhang, Yan Chen, Qiang Wu","doi":"10.3928/1081597X-20241219-01","DOIUrl":"https://doi.org/10.3928/1081597X-20241219-01","url":null,"abstract":"<p><strong>Purpose: </strong>To determine the precision of toric intraocular lens (IOL) formulas used by the online calculator of the European Society of Cataract and Refractive Surgeons (ESCRS).</p><p><strong>Methods: </strong>This retrospective study included patients undergoing phacoemulsification with toric IOL implantation from July 2021 to June 2023 in Shanghai Sixth People's Hospital, Shanghai Jiao Tong University School of Medicine. The mean absolute prediction error (PE), standard deviation of the PE, and proportion of eyes with a PE within ±0.25, ±0.50, ±0.75, and ±1.00 diopters (D) were calculated by vector analysis.</p><p><strong>Results: </strong>Among the 85 included patients, the mean and median absolute PE determined from the Barrett estimated posterior corneal astigmatism (EPCA), EVO 2.0, and Hoffer QST toric formulas varied considerably from those derived using the Kane toric formula (<i>P</i> < .001, <i>P</i> = .045, <i>P</i> < .001, respectively). For all toric formulas, the centroid of the PE deviated considerably from zero (<i>P</i> < .001). The EVO 2.0 toric formula yielded the best accuracy (61.2%) within ±0.50 D, followed by the Barrett EPCA (58.8%), Hoffer QST (58.8%), Barrett measured posterior corneal astigmatism (51.8%), and Kane toric (51.8%) formulas. However, the percentages of PEs 0.50 D or less and 0.75 D or less with all of the toric calculators did not differ significantly (<i>P</i> > .05). The Hoffer QST displayed the least mean absolute PEs in the groups with different astigmatism types, as well as in the groups with medium and long axial length and medium keratometry.</p><p><strong>Conclusions: </strong>The newly introduced ESCRS online toric calculator is a useful tool that yielded consistent results in this study. The EVO 2.0 and Hoffer QST toric formulas showed better performance, although the improved accuracy is likely to have minimal clinical importance. <b>[<i>J Refract Surg</i>. 2025;41(2):e120-e130.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 2","pages":"e120-e130"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408765","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 Comparison of Clinical Outcomes After Bilateral Implantation of Diffractive Trifocal Extended Depth-of-Focus and Diffractive Trifocal Hydrophobic Intraocular Lenses.","authors":"Zoltán Z Nagy, Peter Dorman, Szilard Szalczer, Huba Kiss","doi":"10.3928/1081597X-20241113-01","DOIUrl":"https://doi.org/10.3928/1081597X-20241113-01","url":null,"abstract":"<p><strong>Purpose: </strong>To compare clinical outcomes for patients implanted with either FineVision HP or FineVision Triumf intraocular lenses (IOL) (Beaver-Visitec International, Inc) following cataract surgery.</p><p><strong>Methods: </strong>Twenty-six patients bilaterally implanted with the HP IOL and 27 patients with the Triumf IOL were followed up for 6 months in a prospective randomized study. Refraction, uncorrected and corrected distance visual acuity (CDVA), uncorrected and distance-corrected intermediate visual acuity (DCIVA), and uncorrected and distance-corrected near visual acuity (DCNVA) were evaluated. Defocus curves and contrast sensitivity were also measured. Patient-reported outcomes were assessed using the National Eye Institute Visual Function Questionnaire 25, and adverse events were registered.</p><p><strong>Results: </strong>Ninety-four percent of the eyes in both groups were within ±1.00 diopter (D) of spherical equivalent. All of the patients had 20/20 or better binocular CDVA in both groups and 96% and 100% had 20/25 or better binocular CDIVA in the Triumf and HP IOL groups, respectively, being reduced to 32% and 91.7% for DCNVA, respectively. Differences between groups were statistically significant from -2.00 to -4.50 D with better visual acuity outcomes for the HP IOL group (<i>P</i> < .01). Better monocular photopic contrast sensitivity was found for the Triumf IOL group at 12 and 18 cycles per degree (<i>P</i> < .01). There was a statistically significant increase of the overall composite score in both groups before and after surgery (<i>P</i> < .001). Spectacle independence was similar between groups for distance and intermediate vision but higher for the HP IOL for near vision (96% versus 75%). There were no adverse events related to the IOLs.</p><p><strong>Conclusions: </strong>Both IOLs showed good and comparable distance and intermediate visual acuities but near vision was better for the HP IOL. This model provided higher spectacle independence for near vision. <b>[<i>J Refract Surg</i>. 2025;41(3):e102-e113.]</b>.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"41 2","pages":"e102-e113"},"PeriodicalIF":2.9,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143408690","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}