Journal of refractive surgery最新文献

{"title":"The Use of Digital Integrated Manifest Refraction in Pseudophakic Eyes.","authors":"Pablo A Barragán-Castillo, Felix Piloto-Reyes, Erik Navas-Villar, Paula González-Palomo, Salomon Merikansky, Nora Robledo-Silva, Ivonne Curiel-Arce, Juan Mario García-Coronado, Diego Melo-Orta, Arturo Chayet","doi":"10.3928/1081597X-20260214-02","DOIUrl":"10.3928/1081597X-20260214-02","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the accuracy and efficiency of a digital integrated manifest refraction system compared with standard manifest refraction in pseudophakic eyes.</p><p><strong>Methods: </strong>This prospective, double-blind study analyzed 100 eyes from 100 pseudophakic patients; 35 eyes received monofocal intraocular lenses MA60AC (AcrySof three-piece IOL; Alcon Laboratories, Inc], MX60 (enVista; Bausch & Lomb, Inc), CNA00 (Clareon Monofocal, Alcon Laboratories, Inc), and SN60AT (AcrySof IQ Monofocal; Alcon Laboratories, Inc) and 65 eyes received trifocal IOLs TFNT00 (AcrySof IQ PanOptix; Alcon Laboratories, Inc) and ZFR00V (Synergy; Johnson & Johnson Surgical Vision, Inc). All patients underwent objective refraction with the Nidek ARK-530A autorefractor, followed by manifest refraction performed with the Topcon VT-100 (Std-MR group) and the digital integrated manifest refraction unit TS-610 (Nidek Co, Ltd) (DI-MR group). Outcomes assessed included manifest spherical equivalent, refractive cylinder, time, correlation, and agreement between methods.</p><p><strong>Results: </strong>The mean manifest spherical equivalent was -0.15 ± 0.38 diopters (D) with the TS-610 and -0.14 ± 0.38 D with standard refraction (<i>P</i> = .31). Linear regression demonstrated a strong correlation between methods (<i>R</i> = 0.914, <i>R</i>² = 0.835, <i>P</i> < .001). The mean cylinder was -0.66 ± 0.52 D (TS-610) versus -0.62 ± 0.57 D (Std-MR), with a mean difference of -0.11 ± 0.17 D and a centroid of 0.01 ± 0.20 D in vector analysis. DI-MR significantly reduced testing time (3.1 ± 1.8 minutes) compared with Std-MR (7.1 ± 7.4 minutes, <i>P</i> = .001).</p><p><strong>Conclusions: </strong>The automated TS-610 manifest refraction system demonstrated excellent agreement with Std-MR refraction in pseudophakic eyes, while significantly reducing testing time. DI-MR provides a reliable and efficient alternative for postoperative evaluation and may enhance workflow efficiency in cataract and refractive practices.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e354-e358"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633697","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":"Subjective and Objective Visual Quality Outcomes After KLEx vs KLEx Xtra: A 2-Year Prospective Randomized Trial.","authors":"Jing Cong, Xueqi Lin, Xinran Li, Jiayue Yuan, Wangyuan Liu, Xiuyu Mao, Shichu Liu, Qianhong Feng, Xianglian Li, Yingying Hu, Chenli Feng, Jinhui Dai","doi":"10.3928/1081597X-20260112-09","DOIUrl":"10.3928/1081597X-20260112-09","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the 2-year refractive correction outcomes and subjective and objective visual quality between keratorefractive lenticule extraction (KLEx) and KLEx combined with corneal cross-linking (KLEx Xtra).</p><p><strong>Methods: </strong>Patients with myopia were recruited for KLEx or KLEx Xtra surgeries. Only the right eyes were selected. The cross-linking energy was 2.4 J/cm². Visual acuity and optical quality (objective and subjective) were assessed preoperatively and at 1, 6, 12, and 24 months postoperatively.</p><p><strong>Results: </strong>A total of 150 participants were enrolled, divided into two groups: the KLEx group (75 eyes) and the KLEx Xtra group (75 eyes). At 24 months, the KLEx Xtra group showed significantly superior refractive stability (manifest refraction spherical equivalent -0.02 ± 0.33 diopters [D]) compared to the KLEx group (-0.18 ± 0.34 diopters; <i>P</i> < .05). A transient increase in higher order aberrations (HOAs) in the KLEx Xtra group was observed during early postoperative recovery, which gradually subsided without long-term adverse visual impact. The KLEx Xtra group demonstrated significantly poorer Optical Quality Analysis System II parameters at the early postoperative period compared to the KLEx group (<i>P</i> < .05), but all metrics became comparable between the groups by 12 to 24 months, Early postoperative increases in HOAs in the KLEx Xtra group resolved by 6 months postoperatively. Subjective quality of vision scores showed no significant intergroup differences at 24 months, except for glare.</p><p><strong>Conclusions: </strong>KLEx Xtra enhances long-term refractive stability without detriment to visual quality, making it a viable option for patients with borderline risk profiles.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e307-e317"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633754","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 Performance Among Two Multifocal-Extended Depth-of-Focus Intraocular Lens Types and a Trifocal Intraocular Lens.","authors":"Ken Hayashi, Koichi Uno, Shunsuke Hayashi, Motoaki Yoshida","doi":"10.3928/1081597X-20260212-01","DOIUrl":"10.3928/1081597X-20260212-01","url":null,"abstract":"<p><strong>Purpose: </strong>To compare the visual performance of a new multifocal-extended depth-of-focus (EDOF) intraocular lens (IOL) (TECNIS Odyssey, Johnson & Johnson) with that of an earlier multifocal-EDOF IOL (TECNIS Synergy; Johnson & Johnson) and a trifocal IOL (PanOptix; Alcon Laboratories, Inc).</p><p><strong>Methods: </strong>Ninety eyes of 90 patients who received one of two types of multifocal-EDOF IOLs or a trifocal IOL were enrolled. Uncorrected and corrected distance visual acuity at various distances, photopic and mesopic contrast visual acuity, and degree of photic symptoms were evaluated at 3 months postoperatively and compared among groups.</p><p><strong>Results: </strong>Mean uncorrected far and intermediate visual acuities from infinity to 1 m were generally better in the Odyssey group than in the other groups (<i>P</i> ⩽ .046), but uncorrected near visual acuity at 0.3 m and intermediate visual acuity at 0.5 m were worse (<i>P</i> ⩽ .028). However, mean distance-corrected far and intermediate visual acuities from infinity to 1 m, did not differ significantly among groups, and near visual acuity and intermediate visual acuity at 0.5 and 0.7 m were significantly worse, in the Odyssey group than in the other groups (<i>P</i> ⩽ .018). Mean mesopic contrast visual acuity at 10% contrast and glare size were significantly better in the Odyssey group than in the other groups (<i>P</i> ⩽ .040).</p><p><strong>Conclusions: </strong>The Odyssey provided better uncorrected far and intermediate visual acuities from infinity to 1 m than the other IOLs despite no significant difference in distance-corrected visual acuity. However, it showed worse uncorrected and distance-corrected near visual acuity and intermediate visual acuities at 0.5 m, suggesting that the Odyssey has far-dominant properties and greater tolerance to refractive errors.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e327-e334"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633729","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 and the Impact of Intermediate Segment Orientation on the Performance of an Asymmetric Multifocal Intraocular Lens.","authors":"Cameron McLintock, Samir Uprety, James McKelvie, Henry B Wallace","doi":"10.3928/1081597X-20260212-04","DOIUrl":"10.3928/1081597X-20260212-04","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the visual outcomes and the impact of intermediate segment orientation on the performance of an asymmetric multifocal intraocular lens (IOL) in patients who have cataract.</p><p><strong>Methods: </strong>In this retrospective single-center study, 251 eyes of 251 patients who underwent phacoemulsification with the Lentis Comfort LS-313 MF15 IOL (Oculentis BV) implantation were analyzed. Patients' data were divided into four groups: one non-toric and three toric IOL groups based on astigmatic type (with-the-rule [WTR], against-the-rule [ATR], and oblique astigmatism). Visual outcomes including uncorrected distance visual acuity (UDVA), intermediate visual acuity (UIVA), and near visual acuity (UNVA) were compared between the groups. Regression analysis was used to evaluate the relationship between visual outcomes and angle alpha, derived from Purkinje images from the ANTERION biometer (Heidelberg Engineering).</p><p><strong>Results: </strong>This study found no significant difference in uncorrected visual outcomes (UDVA, UIVA, UNVA) among the four groups: non-toric (60 eyes) and toric IOL groups comprising WTR (63 eyes), ATR (64 eyes), and oblique (64 eyes) across different intermediate segment orientations. Uncorrected visual acuity was comparable across all groups, with 90% of eyes or more achieving 20/25 UDVA, 90% or more achieving 20/40 UIVA, and 70% or more achieving 20/70 UNVA. The majority of eyes (80% or more) achieved refractive outcomes within ±0.50 and 0.50 diopters (D) or less residual cylinder. Regression analysis showed no significant relationship between angle alpha and visual outcomes.</p><p><strong>Conclusions: </strong>The Lentis MF IOL demonstrated good visual outcomes in both the non-toric and toric groups, with no significant impact of intermediate segment orientation or angle alpha on postoperative visual and refractive parameters.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e377-e386"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633695","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":"Rotational Stability and Vault Outcomes of the EVO ICL Using Oblique Implanting Orientation Compared to Horizontal/Vertical Implanting Orientation.","authors":"Zishuo Li, Hongyu Kong, Ye Yao, Zhen Li, Tian Tian, Shihao Chang, Yan Yan, Xingtao Zhou, Lingling Niu, Peijun Yao","doi":"10.3928/1081597X-20260212-02","DOIUrl":"10.3928/1081597X-20260212-02","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the outcomes of Implantable Collamer Lens (EVO ICL; STAAR Surgical) implantation using customized oblique implanting orientation, focusing on rotational stability, vault predictability, and refractive efficacy compared to horizontal and vertical implanting orientations.</p><p><strong>Methods: </strong>In this prospective case series, 219 eyes of 110 patients underwent customized EVO ICL implantation guided by ultrasound biomicroscopy (UBM) measurements of sulcus-tosulcus (STS) diameters, ciliary sulcus morphology (MCS), and routine measurement of anterior segment including anterior chamber depth (ACD). Eyes were stratified into horizontal (n = 95), vertical (n = 41), and oblique (n = 83) groups based on implanting orientation. Postoperative assessments at 1 day, 1 week, 1 month, 3 months, and 1 year included refractive outcomes, vault measurements, and rotational degree analysis using slit-lamp photography and Mediview software.</p><p><strong>Results: </strong>At 1 year, all groups maintained ideal vault ranging from 118 to 1,053 µm, with 93.8% of eyes achieving 250 to 1,000 µm. The oblique group exhibited comparable vault (562.0 ± 189.2 µm) to the horizontal (571.2 ± 206.9 µm) and vertical (533.1 ± 185.4 µm) groups, with no significant intergroup differences (<i>P</i> = .64). Rotational stability showed no statistical differences among groups (oblique: 3.56 ± 2.78°, horizontal: 3.42 ± 2.49°, vertical: 3.24 ± 2.74°; <i>P</i> = .86). The most significant ICL rotation occurred within the initial postoperative week in all groups, with subsequent stabilization observed thereafter. Haptic positioning behind the ciliary processes correlated with reduced rotation (<i>r</i> = -0.37, <i>P</i> = .004) in the oblique group. Refractive outcomes were consistent across groups, with uncorrected distance visual acuity in 96.7% of eyes achieving preoperative corrected distance visual acuity and 85.5% of eyes having astigmatism of -0.50 diopters or less.</p><p><strong>Conclusions: </strong>UBM-guided customized oblique implantation of an ICL achieved safety, efficacy, and vault predictability comparable to traditional implanting orientations, with good rotational stability, offering an alternative design to achieve optimal vault. Long-term rotational stability requires further observation.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e367-e376"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633708","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":"Corneal Endothelium and Tear Film Metrics Enhance the Accuracy of Machine Learning Prediction in Implantable Collamer Lens Surgery Outcomes.","authors":"Zeyu Meng, Jinze Zhang, Sutong Li, Mengyun Zhou, Yushuang Liu, Shang Huang, Jin Yuan, Naiyang Li, Peng Xiao","doi":"10.3928/1081597X-20260112-06","DOIUrl":"10.3928/1081597X-20260112-06","url":null,"abstract":"<p><strong>Purpose: </strong>To develop and evaluate a machine learning (ML) model to predict postoperative vault and residual refractive error following Implantable Collamer Lens (ICL) implantation by incorporating corneal functional parameters, and to investigate their influence on prediction accuracy.</p><p><strong>Methods: </strong>This study included 282 eyes implanted with ICLs from 142 patients. A Marine Predators Algorithm combined with a support vector machine (MPA-SVM) for feature selection and optimal modeling was trained to predict postoperative vault residual refractive error using preoperative ocular parameters, with and without corneal functional parameters, including tear film quality and corneal endothelium metrics. Model performance was compared using mean absolute error (MAE), median absolute error (MedAE), R-squared (<i>R</i>²), and Wilcoxon signed-rank tests.</p><p><strong>Results: </strong>Corneal endothelium metrics significantly improved MPA-SVM performance in vault prediction (<i>P</i> < .05), achieving lower MAE (138.55) and MedAE (110.41) and higher <i>R</i>² (0.26) and prediction accuracy. For refractive error prediction, combining tear film quality, endothelium metrics, and other ocular parameters yielded the best results for cylinder (MAE = 0.38; MedAE = 0.32; <i>R</i>² = 0.19), significantly outperforming models using only ocular parameters (<i>P</i> < .05). Endothelium metrics also improved sphere prediction, with numerically lower MedAE and a higher percentage of prediction errors within ±0.25, ±0.50, and ±0.75 diopters.</p><p><strong>Conclusions: </strong>In the MPA-SVM ICL prediction model, corneal endothelium metrics significantly improves vault prediction and, when combined with tear film quality parameters, enhances cylinder prediction after ICL implantation. This enhanced model offers ophthalmologists a valuable tool for improving the safety and planning of ICL procedures.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e289-e298"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633716","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 Low Laser Energy Dose in KLEx: Short-term Clinical Results, Video Analysis, and Histologic Study of Lenticules.","authors":"Sang Yoon Hyun, Tae-Hwan Moon, Thomas Magnago, Samuel Arba-Mosquera, Gyeongsoo Lim, Moon Sun Jung","doi":"10.3928/1081597X-20260212-03","DOIUrl":"10.3928/1081597X-20260212-03","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the effects of reducing pulse energy and total energy dose during keratorefractive lenticule extraction (KLEx) using the ATOS femtosecond laser (SCHWIND eye-tech-solutions GmbH) on early surgical outcomes and corneal surface roughness.</p><p><strong>Methods: </strong>This study included 80 patients (160 eyes) who underwent KLEx for myopia correction at a single clinic. Eyes were divided into three groups according to energy settings: a conventional energy group (90 nJ, spot/track distance 3 × 3 μm, 1,000 mJ/cm²; C-group, 58 eyes), a low energy group (80 nJ, 4.5 × 3 μm, 593 mJ/cm²; L-group, 52 eyes), and a very low energy group (75 nJ, 6.5 × 2.9 μm, 398 mJ/cm²; VL-group, 50 eyes). Uncorrected distance visual acuity and mean spherical equivalent were evaluated at 1 day, 1 week, 1 month, and 3 months postoperatively. Intraoperative opaque bubble layer (OBL) and black areas were assessed using surgical video analysis. Surface roughness of selected lenticules was evaluated by scanning electron microscopy (SEM).</p><p><strong>Results: </strong>Uncorrected visual acuity (logarithm of the minimum angle of resolution [logMAR]) improved with lower energy levels at 1 day (C: 0.16, L: 0.05, VL: 0.00; <i>P</i> < .001), 1 week, and 1 month (<i>P</i> < .05), with the VL-group demonstrating the fastest early visual recovery. Mean spherical equivalent showed no significant differences among groups at 1 week, 1 month, or 3 months postoperatively. Black area incidence was similar between groups. However, OBL area increased with higher energy levels. SEM analysis showed the highest lenticule surface regularity score in the L-group (13.58), followed by the VL-group (10.00) and C-group (6.50).</p><p><strong>Conclusions: </strong>When performing KLEx surgery with the ATOS device, lowering the pulse energy and applying asymmetric spacing settings led to faster early visual recovery and reduced intraoperative OBL occurrence. The smoothest lenticule surface was observed in the L-group, whereas the VL-group showed a tendency toward increased surface roughness. These findings suggest the importance of balancing early visual recovery and surface smoothness when selecting low energy settings. Further evaluation of long-term surgical outcomes and corneal effects is warranted.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e335-e342"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633759","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":"Asymptomatic Meibomian Gland Dysfunction in Refractive Surgery Candidates.","authors":"Shawn Sapir, Michael Mimouni, Tzahi Sela, Gur Munzer, Igor Kaiserman","doi":"10.3928/1081597X-20260112-08","DOIUrl":"10.3928/1081597X-20260112-08","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the association between asymptomatic meibomian gland dysfunction (MGD) and preoperative clinical parameters in candidates for refractive surgery.</p><p><strong>Methods: </strong>This retrospective case-control study was conducted at Care Vision Laser Center, Tel Aviv, Israel. A total of 3,472 eyes that underwent evaluation and subsequently proceeded to keratorefractive surgery between January 2019 and December 2024 were included. All eyes had normal tear break-up time (TBUT) and no dry eye symptoms. MGD severity was graded clinically (0 to 3) by a single examiner and categorized as low (grades 0 to 1) or high (grades 2 to 3). Preoperative parameters were compared using univariate analyses, and variables reaching significance were evaluated using multivariate logistic regression to identify independent associations with high MGD. A subgroup analysis of eyes with available low-contrast acuity (CA6%) measurements was performed to assess functional visual differences.</p><p><strong>Results: </strong>High MGD was identified in 1,731 eyes (49.9%), whereas 1,741 eyes (50.1%) were classified as low MGD. High MGD eyes were significantly older (<i>P</i> < .001), more likely to wear contact lenses (<i>P</i> < .001), and demonstrated higher myopia (<i>P</i> < .001), thinner pachymetry (<i>P</i> < .001), steeper keratometry (<i>P</i> ⩽ .001), and worse preoperative UDVA and CDVA (both <i>P</i> < .001). In the CA6% subgroup (n = 1,602), contrast acuity was significantly reduced in the high MGD group (<i>P</i> = .007). Multivariate analysis identified independent associations between high MGD severity and older age (odds ratio [OR]: 1.063; <i>P</i> < .001), contact lens wear (OR: 1.424; <i>P</i> < .001), thinner corneas (OR: 0.995/µm; <i>P</i> < .001), higher myopia (OR: 0.851/diopter; <i>P</i> < .001), and reduced CDVA (OR: 25.933; <i>P</i> = .022).</p><p><strong>Conclusions: </strong>Asymptomatic MGD in refractive surgery candidates is independently associated with older age, contact lens wear, higher myopia, thinner corneas, and reduced visual performance. Routine MGD screening is recommended even in asymptomatic patients undergoing preoperative refractive evaluation.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e299-e306"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633722","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":"Functional Classification of a New IOL Into the Category of Partial Depth of Field: Enhanced IOLs According to the ESCRS Criteria.","authors":"Giacomo Savini, Alice Galzignato, Catarina P Coutinho, Arianna Grendele, Piero Barboni, Domenico Schiano-Lomoriello","doi":"10.3928/1081597X-20260214-03","DOIUrl":"10.3928/1081597X-20260214-03","url":null,"abstract":"<p><strong>Purpose: </strong>To assess whether the Evolux (SIFI) intraocular lens (IOL) can be included in the category of partial-depth of field (DOFi) enhanced IOLs according to the functional classification of the European Society of Cataract and Refractive Surgeons.</p><p><strong>Methods: </strong>In this prospective study, a consecutive series of patients implanted with the Evolux in one eye was analyzed and compared to a control group with a monofocal IOL (AcrySof SA60WF; Alcon Laboratories, Inc). Preoperative examinations included optical biometry (IOLMaster 700; Carl Zeiss Meditec AG) and anterior segment imaging (MS-39; CSO). At 2 to 3 months postoperatively, monocular corrected distance visual acuity, distance-corrected intermediate visual acuity (DCIVA), distance-corrected near visual acuity (DCNVA), monocular DOFi in 0.2 logarithm of the minimum angle of resolution (logMAR), and the monocular defocus curve were measured in patients implanted with both IOLs.</p><p><strong>Results: </strong>The Evolux group included 32 eyes (32 patients) and the monofocal group included 27 eyes (27 patients). The mean DCIVA was, respectively, 0.19 ± 0.11 and 0.30 ± 0.13 logMAR (<i>P</i> = .0009). The mean DCNVA was 0.39 ± 0.12 logMAR in the Evolux group and 0.53 ± 0.18 logMAR in the monofocal group (<i>P</i> = .0007). The mean DOFi in 0.2 logMAR provided by the Evolux was 1.42 ± 0.56 diopters (D); the corresponding value for the monofocal IOL was 1.04 ± 0.54 D (<i>P</i> = .0091). In eyes with the Evolux, the DOFi in 0.2 logMAR DCIVA was negatively correlated with photopic pupil size (<i>r</i> = -0.3748, <i>P</i> = .0346).</p><p><strong>Conclusions: </strong>The Evolux offers better visual acuity at an intermediate distance and can be classified as a partial-DOFi enhanced IOL.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e359-e366"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633790","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":"Accuracy of Intraocular Lens Power Calculation Formulas Using Total Keratometry in Eyes With Previous Radial Keratotomy.","authors":"Yuxing Zheng, Haowen Lin, Xiaohang Xie, Xiaozhang Qiu, Xuhua Tan, Jiaqing Zhang, Lixia Luo","doi":"10.3928/1081597X-20260112-07","DOIUrl":"10.3928/1081597X-20260112-07","url":null,"abstract":"<p><strong>Purpose: </strong>To evaluate the performance of intraocular lens (IOL) power calculation using standard keratometry (SK) and total keratometry (TK) in eyes after radial keratotomy (RK) surgery.</p><p><strong>Methods: </strong>A retrospective, consecutive case series study included 49 patients with cataract (65 eyes) after RK. All implanted IOLs were monofocal in-the-bag lenses. Formulas using SK included American Society of Cataract and Refractive Surgery (ASCRS) average, Barrett True K, double-K modified Holladay 1 formula (DK-Holladay), Emmetropia Verifying Optical formula 2.0 (EVO 2.0), Holladay 1, Holladay 2, PEARL-DGS, and LISA formula for patients with cataract and prior myopic refractive surgery (LISA-MRS). Formulas using TK included Barrett True K-TK, EVO 2.0-TK, Holladay 2-TK, and LISA-MRS-TK. Holladay formulas used both Wang-Koch (Holladay-WK) and Holladay axial length (Holladay-AL) adjustment. The mean prediction error (PE), mean absolute PE (MAE), median absolute error (MedAE), root mean square absolute error (RMSAE), and the percentage of eyes within ±0.25, ±0.50, ±0.75, and ±1.00 diopters (D) of PE were evaluated.</p><p><strong>Results: </strong>In formulas using SK, the LISA-MRS formula exhibited the lowest MAE (0.71 D), lowest MedAE (0.52 D), and highest percentage of eyes within ±0.50 D of PE (49.23%). In formulas using TK, the LISA-MRS-TK formula exhibited the lowest MAE (0.78 D), lowest MedAE (0.48 D), and highest percentage of eyes within ±0.50 D of PE (52.63%). Using TK instead of SK significantly reduced the PE of both the Holladay 2 and LISA-MRS formulas. When AL was 30 mm or greater, the Holladay 1-AL formula exhibited the lowest MAE (0.68 D), lowest MedAE (0.32 D), and the highest percentage of eyes within ±0.50 D of PE (59.09%).</p><p><strong>Conclusions: </strong>In post-RK eyes, the LISA-MRS formula displayed the highest prediction accuracy. TK could improve the prediction accuracy of the Holladay 2 and LISA-MRS formulas.</p>","PeriodicalId":16951,"journal":{"name":"Journal of refractive surgery","volume":"42 4","pages":"e318-e326"},"PeriodicalIF":2.9,"publicationDate":"2026-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147633745","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}