August 2020


Journal of Cataract & Refractive Surgery
In the journal: August 2020

Review: Prevention and management of refractive prediction errors following cataract surgery

Jeremy Kieval, MD, Saba Al-Hashimi, MD, Richard Davidson, MD, D. Rex Hamilton, MD,Mitchell Jackson, MD, Scott LaBorwit, MD, Larry Patterson, MD, Karl Stonecipher, MD, and Kendall Donaldson, MD, for the ASCRS Refractive Cataract Surgery Subcommittee
In recent years there have been numerous advances in diagnostics, refractive planning, and other technologies to help meet target refraction and patient expectations in cataract surgery. This review paper takes a look at the potential pitfalls that are still a source of residual refractive error and future technologies that could limit it as well. Things that could cause residual refractive error include inability to correctly predict effective lens position, IOL power calculations, inaccuracies in biometric measurements, the ocular surface, IOL decentration, surgically induced astigmatism, and more. Management of residual refractive error includes laser vision correction, IOL repositioning, piggyback IOLs, or in some cases IOL exchange. Future technologies may further improve diagnostic and technological abilities to prevent residual refractive error or correct it within the implanted IOL postop.

Results 5 to 10 years after cataract surgery with primary IOL implantation in juvenile idiopathic arthritis-related uveitis

Sanna Leinonen, MD, Kaisu Kotaniemi, MD, Tero Kivelä, MD, Kari Krootila, MD
A study out of the Helsinki University Hospital in Finland evaluated long-term results of cataract surgery on patients with juvenile idiopathic arthritis (JIA) and uveitis-related cataract surgery. The retrospective case series included 26 eyes of 20 patients who were 20 years old or younger with JIA-uveitis-related cataracts. The preop median BCVA was 0.05 in decimal notation; median BCVA was 1.0 at 5 years postop and 0.9 at 10 years postop. Two eyes did not reach a BCVA of 0.5 after cataract surgery and two decreased below 0.5 3–5 years postop. According to the study authors, active uveitis 3–12 months preoperatively was a risk factor for a postop BCVA of less than 0.5 at 5 years. With these findings the study authors concluded that cataract surgery with primary lens implantation provided good long-term visual acuity for patients with well-controlled JIA-related uveitis.

Comparison of femtosecond laser-assisted cataract surgery and conventional cataract surgery: a meta-analysis and
systematic review

Carolin Kolb, Mehdi Shajari, MD, Lisa Mathys, Eva Herrmann, PhD, Kerstin Petermann, MSc, Wolfgang Mayer, MD, Siegfried Priglinger, MD, Thomas Kohnen, MD
Seventy-three studies (25 randomized, controlled studies and 48 observational) were included in a meta-analysis and systematic review to compare safety and efficacy of femtosecond laser-assisted cataract surgery (FLACS) and conventional phaco-cataract surgery. The studies totaled 12,769 that had FLACS and 12,274 treated conventionally. The authors found better uncorrected and corrected distance visual acuity and spherical equivalent 1–3 months postop in the FLACS group. They also found lower phacoemulsification times, lower cumulative dissipated energy, more accurate circularity, thinner central corneal thickness at 1 day postop and at 1–3 months postop, and less endothelial cell loss between 3–6 weeks and at 3 months in the FLACS group. Anterior capsule ruptures were more common with FLACS. The study authors observed no significant difference between the two groups in visual acuity at 1 week or after 6 months and no difference in posture capsule rupture rates or endothelial cell loss at 6 months postop.

Journal of Cataract & Refractive Surgery In the journal: August 2020 Journal of Cataract & Refractive Surgery In the journal: August 2020
Ophthalmology News - EyeWorld Magazine
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