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JCRS Highlights

Vol 42 Issue 6, June 2016

Thomas Kohnen

Posted: Thursday, September 1, 2016

JCRS_v42_i6_COVER.indd

INTRAOPERATIVE ABERROMETRY VS ASTIGMATISM
The use of intraoperative aberrometry during toric intraocular lens (IOL) implantation surgery appears to be more effective that conventional methods in achieving less than 0.50D residual postoperative refractive astigmatism. A prospective cohort study conducted in 12 centres in the USA randomised eyes of 130 patients to intraoperative aberrometry measurement in one eye, and standard preoperative biometry and use of a toric calculator in the contralateral eye. The eyes that underwent intraoperative aberrometry had significantly better outcomes at one month in terms of lower astigmatism, with 89 per cent having 0.5 dioptre or less, compared with 76 per cent in the traditional preoperative assessment group. The researchers conclude that intraoperative aberrometry offers a reliable method for calculating the power and position of toric IOLs in astigmatic cataractous eyes that have not had previous refractive surgery. MG Woodcock et al, JCRS, “Intraoperative aberrometry versus standard preoperative biometry and a toric IOL calculator for bilateral toric IOL implantation with a femtosecond laser: One-month results”, Volume 42, Issue 6, 17–825.

IOL GLISTENINGS IN THE LONGER-TERM
Refractive microvacuoles or glistenings are found in all IOL materials, with the most significant glistening reported in hydrophobic acrylic IOLs. While it has been observed that the prevalence and intensity of glistenings in hydrophobic acrylic IOLs increase over time up to at least 10 years postoperatively, the effect on visual function has been debated. Swedish researchers looked at these questions in a prospective longitudinal case series of 90 patients. The study confirmed that the glistenings continued to increase in hydrophobic acrylic IOLs from 10 to 15 years after surgery. At 15 years, most patients had severe glistenings with a high level of light scattering from the IOL. However, the study found no clinically significant effect on everyday visual function associated with the glistenings. E Mönestam et al, JCRS, “Change in light scattering caused by glistenings in hydrophobic acrylic intraocular lenses from 10 to 15 years after surgery”, Volume 42, Issue 6, 864–869.

LONG-TERM PATIENT SATISFACTION WITH LASIK
Patient-reported quality-of-life and satisfaction rates remain high five years after LASIK, suggests a retrospective study of 2,530 patients. Patients had been treated with the VISX Star S4 IR excimer laser for preoperative manifest spherical equivalents ranging from -11.0 dioptres to +4.88 dioptres. Some 91.0 per cent were satisfied with their vision and 94.9 per cent did not wear distance correction. Less than two per cent of patients noticed visual phenomena. Among patients reporting dissatisfaction, poor visual outcome and difficulties with various activities such as night driving, outdoor activities, and reading were cited. S Schallhorn et al, JCRS, “Patient-reported outcomes 5 years after laser in situ keratomileusis”, Volume 42, Issue 6, 879–889.