JCRS Highlights – selected by Thomas Kohnen, European Editor, JCRS

Vol: 45 Issue: 10 Month: October 2019

Thomas Kohnen

Posted: Friday, November 29, 2019

Bag-in-the-lens calculation in paediatric patients
Cataract surgery in paediatric patients presents many challenges, not least of which is calculating the correct IOL power for a growing eye. While the bag-in-the-lens (BIL) technique has been shown to significantly reduce postoperative PCO rates in these patients, little is known about predicting postoperative outcomes. A new consecutive case series study looked at the precision of BIL IOL power calculation in 87 eyes of 56 patients who were divided into four groups based on age. The researchers calculated IOL power using the SRK/T formula. The mean prediction error (PE) for the entire group was 1.79 dioptres. This ranged from 3.43D in the youngest patients (0-3 months) to 1.33 in the oldest patients (3-17 years). The PE after IOL implantation correlated inversely with age group and axial length, but not with corneal radii and corneal astigmatism. LM Lytvynchuk et al., JCRS, “Precision of bag-in-the-lens intraocular lens power calculation in different age groups of paediatric cataract patients: Report of the Giessen Pediatric Cataract Study Group”, Vol. 45, #10, 1372-79.

PCO in paediatric cataract

Posterior capsule opacification (PCO) is the most common complication of paediatric cataract surgery. Does the IOL type make a difference? A case series study compared outcomes in 103 eyes of 80 children who received either a hydrophilic IOL (Ocular ANU6 IOL) or a hydrophobic IOL (AcrySof SA60AT) and were followed for more than three years. When the posterior capsule was left intact, 39.3% of eyes in the hydrophilic group and 13.4% of eyes in the hydrophobic group developed PCO. When primary posterior capsulotomy and anterior vitrectomy were performed, 4.3% and 6.8%, respectively, developed PCO. Follow-up analysis showed a survival (i.e., no PCO formation at five-year follow-up) rate of 95.4% in the hydrophobic group and 88.8% in the hydrophilic group.
P Sen et al., JCRS, “Posterior capsule opacification rate after in pediatric cataract: Hydrophilic versus hydrophobic intraocular lenses”, Vol. 45, #10, 1380-85.

Blue versus violet filter IOL comparison
Violet light-filtering IOLs were developed to reduce exposure to the violet wavelength (400-to-440nm). Although these IOLs have been available for some time, clinical outcomes have not been reported. Japanese researchers conducted a prospective study of 55 patients with bilateral cataract who were randomly allocated to a blue light-filtering IOL (AcrySof IQ SN60WF) in one eye and to a violet light-filtering IOL (OptiBlue ZCB00V) in the fellow eye.
Postoperative contrast sensitivity under photopic condition at one week and three months and contrast sensitivity under mesopic conditions at three months were significantly better with the violet light-filtering IOL than with the blue light-filtering IOL.
S Nakano et al., JCRS, “Blue light–filtering and violet light–filtering hydrophobic acrylic foldable intraocular lenses: Intraindividual comparison”, Vol. 45, #10, 1393-97.