Double-pass microkeratome technique for ultra-thin graft preparation in Descemet's stripping automated endothelial keratoplasty

Journal ArticleEndothelial keratoplasty is evolving with increased attention placed on the optical qualities of the posterior donor lenticule. In efforts to improve visual outcomes, the effects of the thickness, smoothness, and planar profile are being studied. This paper describes a double-pass microkeratome technique to create ultra-thin (less than 100 μm) Descemet's stripping automated endothelial keratoplasty grafts

The effect of preoperative keratometry on visual outcomes after moderate myopic LASIK

Journal ArticleThe relationship between preoperative keratometry (K) and visual outcomes in laser-assisted in situ keratomileusis (LASIK) has been studied in high myopia and hyperopia, but not in moderate myopia. Rao et al report increased undercorrection in eyes with preoperative spherical equivalent (SE) of −10.0 to −11.9 diopters (D), and in eyes with flat corneas compared with steeper corneas.1 Williams et al, conversely, reported undercorrection and loss of best spectacle corrected visual acuity (BSCVA) following hyperopic LASIK in eyes with steep corneas, compared with flat corneas.2 To our knowledge, to date no study has analyzed visual prognosis based on preoperative keratometry in moderately myopic LASIK. In this retrospective analysis, we studied the relationship between preoperative keratometry and postoperative visual outcomes in flat and steep corneas treated with LASIK for the correction of moderate myopia (−2.00 to −5.99 D)

Softec HD hydrophilic acrylic intraocular lens: biocompatibility and precision

Intraocular lens development is driven by higher patient expectations for ideal visual outcomes. The recently US Food and Drug Administration-approved Softec HD™ lens is an aspheric, hydrophilic acrylic intraocular lens (IOL). The hydrophilic design of the lens is optimized to address dysphotopsia while maintaining biocompatibility, optical clarity, resistance to damage, and resistance to biocontamination. Aspheric lenses decrease postoperative spherical aberration. The addition of the Softec lens provides clinicians with another option for IOL placement; however, randomized comparative studies of this lens to others already on the market remain to be completed

Evaluation of the American Society of Cataract and Refractive Surgery intraocular lens calculator for eyes with prior radial keratotomy

David L DeMill, Maylon Hsu, Majid MoshirfarJohn A Moran Eye Center, University of Utah, Salt Lake City, UT, USABackground: The purpose of this study was to evaluate the American Society of Cataract and Refractive Surgery (ASCRS) intraocular lens (IOL) calculator for eyes with prior radial keratotomy and assess the accuracy of its methods in predicting IOL power in patients with previous radial keratotomy.Methods: This retrospective study included data from 15 eyes with previous radial keratotomy and subsequent cataract surgery. The average central power and Humphrey Atlas methods from the ASCRS IOL calculator, along with an average IOL power produced from an average of these two methods (ASCRS average), were compared. Primary outcome measures for each method were mean arithmetic and absolute IOL prediction error, variance in mean arithmetic IOL prediction error, and the percentage of refractive outcomes within ±0.50, ±1.00, ±1.50, and ±2.00 diopters (D).Results: The average central power method and the ASCRS average were significantly more accurate than the Humphrey Atlas method in terms of mean absolute IOL prediction error (1.03 D and 1.02 D versus 1.53; P = 0.04 and P = 0.01, respectively). In addition, the average central power method and ASCRS average produced a higher percentage of refractive outcomes within ±0.50 D when compared with the Humphrey Atlas method (60% and 46.67% versus 0%, respectively). A comparison of the average central power method and the ASCRS average demonstrated a smaller variance and higher percentage of patients within ±1.00 D when using the ASCRS average.Conclusion: The ASCRS calculator for eyes with prior radial keratotomy is an easily accessible and valuable online tool for calculating IOL power in patients with previous radial keratotomy. We found that the ASCRS average produced by the calculator provided the best IOL prediction. We recommend using it with the addition of 1.00 to 1.50 D to its IOL power prediction.Keywords: radial keratotomy, cataract, intraocular lens calculator, American Society of Cataract and Refractive Surger

Management of a Traumatic Flap Dislocation Seven Years after LASIK

Seven years after uneventful laser in situ keratomileusis (LASIK), a 48-year-old woman presented one week after being hit with an iron cord with blurry vision, pain, and irritation. The injury resulted in traumatic flap dislocation, epithelial ingrowth, and macrostriae. Following epithelial removal, the flap was refloated and repositioned. Nine interrupted sutures were used to secure the flap. Three-weeks after surgery with no sutures remaining, the epithelial ingrowth and macrostriae had resolved with a visual acuity of 20/20

Safety of the Excimer Laser in LASIK and PRK for Patients with Implantable Cardiac Devices: Our Clinical Experience in the Past Two Decades

This is a Letter to the Editor and does not have an abstrac

Surgical technique: coupling of intrastromal corneal ring segments for ectatic corneal disorders in eye bank corneas

The management of corneal ectasia is evolving, with intrastromal corneal ring segments playing an important role in delaying or eliminating the need for penetrating keratoplasty. This paper describes a modification in the implantation technique of intrastromal corneal ring segments that allows for coupling of the two segments with suture, affording more structural support

Epithelial growth over the optic surface of the type 1 Boston Keratoprosthesis: histopathology and implications for biointegration

We report the histopathology of epithelial overgrowth in the Boston type I keratoprosthesis. The epithelium shows an inconsistent number of layers and basement membrane and goblet cells are absent. Epithelialization of the keratoprosthesis optic would have multiple advantages, but the limitation of vision makes tolerating the overgrowth difficult

Choroidal Neovascularization Following Implantation of Verisyse™ Iris-Supported Phakic Intraocular Lens in a Pregnant Myopic Patient

Both choroidal neovascularization during pregnancy, and choroidal neovascularization following implantation of phakic intraocular lenses have been reported in the literature. To our knowledge, this is the first case reported of a gravid woman developing choroidal neovascularization in an eye with a phakic intraocular lens. A 31-year-old woman became aware of her pregnancy three weeks after placement of the Verisyse™ iris-supported phakic intraocular lens. She was at 15 weeks gestation when she developed a Fuch’s spot consistent with choroidal neovascularization. By eight months gestation, her symptoms nearly resolved. While the development of choroidal neovascularization in this patient may appear incidental, women of childbearing age considering phakic intraocular lenses warrant additional discussion on the possible increased likelihood of choroidal neovascularization