Accuracy of newer intraocular lens power formulas in short and long eyes using sum-of-segments biometry

Purpose: To analyze the accuracy of newer intraocular lens power formulas in long and short eyes measured using the sum-of-segments biometry.Setting: Private practice, Lynwood, California.Design: Retrospective observational study.Methods: 595 patients scheduled for cataract surgery had their eyes measured using the sum-of-segments biometry. The expected residual refractions were calculated using Barrett Universal II (B II), Barrett True Axial Length (BTAL), Emmetropia Verifying Optical (EVO), Hill-RBF, Hoffer QST, Holladay 2, Holladay 2-NLR, K6, Kane, Olsen, PEARL-DGS, T2, and VRF formulas and compared with the traditional Haigis, Hoffer Q, Holladay 1, and SRK/T formulas.Results: In the 102 long eyes, all new formulas had a mean absolute error (MAE) equal or lower than the traditional formulas, ranging from 0.29 to 0.32 diopter (D). In the 78 short eyes, BTAL, EVO, Hoffer QST, K6, Olsen, and PEARL-DGS formulas had the lowest MAE (0.33 D, 0.33 D, 0.31 D, 0.36 D, 0.32 D, and 0.32 D, respectively), whereas all traditional formulas exceeded 0.36 D.Conclusions: All new formulas performed equal or better than the traditional formulas with the sum-of-segments biometry. The best overall results in the short and long eyes as well as in the very short and very long eyes were noted with the BTAL, EVO, Hoffer QST, K6, Olsen, and PEARL-DGS formulas, closely followed by the B II and Kane formulas. Copyright (c) 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of ASCRS and ESCR

The current burden and future solutions for preoperative cataract-refractive evaluation diagnostic devices: A modified Delphi study

Purpose: To obtain consensus on the key areas of burden associated with existing devices and to understand the requirements for a comprehensive next-generation diagnostic device to be able to solve current challenges and provide more accurate prediction of intraocular lens (IOL) power and presbyopia correction IOL success. Patients and methods: Thirteen expert refractive cataract surgeons including three steering committee (SC) members constituted the voting panel. Three rounds of voting included a Round 1 structured electronic questionnaire, Round 2 virtual face-to-face meeting, and Round 3 electronic questionnaire to obtain consensus on topics related to current limitations and future solutions for preoperative cataract-refractive diagnostic devices. Results: Forty statements reached consensus including current limitations (n = 17) and potential solutions (n = 23) associated with preoperative diagnostic devices. Consistent with existing evidence, the panel reported unmet needs in measurement accuracy and validation, IOL power prediction, workflow, training, and surgical planning. A device that facilitates more accurate corneal measurement, effective IOL power prediction formulas for atypical eyes, simplified staff training, and improved decision-making process for surgeons regarding IOL selection is expected to help alleviate current burdens. Conclusion: Using a modified Delphi process, consensus was achieved on key unmet needs of existing preoperative diagnostic devices and requirements for a comprehensive next-generation device to provide better objective and subjective outcomes for surgeons, technicians, and patients

Dysfunctional T regulatory cells in multiple myeloma

Multiple myeloma (MM) is characterized by the production of monoclonal immunoglobulin and is associated with suppressed uninvolved immunoglobulins and dysfunctional T-cell responses. The biologic basis of this dysfunction remains ill defined. Because T regulatory (Treg) cells play an important role in suppressing normal immune responses, we evaluated the potential role of Treg cells in immune dysfunction in MM. We observed a significant increase in CD4+CD25+ T cells in patients with monoclonal gammopathy of undetermined significance (MGUS) and in patients with MM compared with healthy donors (25% and 26%, respectively, vs 14%); however, Treg cells as measured by FOXP3 expression are significantly decreased in patients with MGUS and MM compared with healthy donors. Moreover, even when they are added in higher proportions, Treg cells in patients with MM and MGUS are unable to suppress anti-CD3–mediated T-cell proliferation. This decreased number and function of Treg cells in MGUS and in MM may account, at least in part, for the nonspecific increase in CD4+CD25+ T cells, thereby contributing to dysfunctional T-cell responses