Eyeworld

clear corneal incision versus a scleral tunnel incision. Patients, overall, did quite well. "All patients from both groups achieved uncorrected visual acuity of 20/16 or better," Dr. Lee noted in a 2015 ESCRS Winter Meeting post- er. "Predictability at 6 months was 96% in the sclera group, and in the cornea group it was 94%. Spherical equivalents improved significantly in both groups. Preoperative astig- matism decreased significantly in [the] cornea group at postoperative [month] 6." That said, some aberrations that could interfere with quality of vision occurred. "The HOAs increased signifi- cantly at postoperative 6 months compared to the preoperative values in both groups," Dr. Lee reported. "The total RMS and trefoil wave- front aberration at postoperative 6 months of the cornea group was significantly higher [than] that of the sclera group." The Artisan phakic IOL led to great vision in terms of Snellen lines. Due to incisions themselves, there still may be some lingering visual quality compromise. "Although corneal incision sig- nificantly reduces preexisting astig- matism, the total RMS and trefoil aberration of postoperative corneal change may be deteriorated in the visual quality after Artisan PIOL im- plantation," Dr. Lee noted. EW Editors' note: The sources have no financial interests related to their comments. Contact information Szaflik: szaflik@ophthalmology.pl Lee: jiel75@hanmail.net Perera: sumith.perera@royalberkshire.nhs.uk "It is assumed that a small corneal incision causes flattening in the axis of the incision and corre- sponding steepening at 90 degrees, keeping the average corneal power the same," said Sumith Perera, FRCS, Surrey and Sussex Healthcare NHS Trust, Surrey, U.K., in a 2015 ESCRS Winter Meeting poster. "This study is meant to assess the validity of these assumptions." Thirty patients underwent cat- aract surgery by 1 surgeon with the same technique. A clear corneal in- cision was made and enlarged to 3.0 mm for lens implantation. Automat- ed keratometry readings were taken preoperatively and postoperatively. Keratometry readings of the operat- ed eye were taken 1 year later. The mean change in spherical equivalent turned out to be 0.24 +/–0.174 D. "In 16% of cases, the change in spherical equivalent from preoper- atively to postoperatively was more than 0.50 D," Dr. Perera reported. "This study shows that the net spherical equivalent change follow- ing small incision cataract surgery is not zero as assumed in IOL power calculations. In 16% of cases, the difference was more than 0.50 D, which will affect the refractive out- come by about the same amount." Case study: Artisan phakic IOL incisions In South Korea, Professor Ji Eun Lee, Department of Ophthalmology, School of Medicine, Pusan National University, and colleagues studied the effects of Artisan phakic IOL (Ophtec, Groningen, the Nether- lands) implantation on higher-order aberrations, bearing in mind inci- sion location. The researchers analyzed 38 eyes of 38 patients who underwent implantation. The groups were divided into those that underwent a A F R E S H P E R S P E C T I V E ™ © 2015 Lacrivera, a division of Stephens Instruments. All rights reserved. 2500 Sandersville Rd ■ Lexington KY 40511 USA lacrivera.com ( 855 ) 857-0518 Effective dry eye treatment meets unprecedented comfort in the VeraPlug. ™ Your patients won't feel anything but relief. Visit lacrivera.com/challenge for your free sample It's all about comfort.

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