Eyeworld

UPDATE 15 • Jeff Pettey, MD • Mitchell Porias, DO • Kristopher Pugh, MD • William Quayle, MD • Vadrevu Raju, MD • Matthew Ralstin, MD • Wade Reardon, MD • Robert Reuther, MD • Robert Rice, MD • Trent Richards, MD • Grover Robinson, MD • Brandon Rodriguez, MD • Justin Roman, MD • Steven Sarkisian Jr., MD • Leslie Scarlette, MD • Gary Schwartz, MD • Stephen Scoper, MD • Maria Scott, MD • Samir Shah, MD • John Shin, MD • David Shoemaker, MD • Cary Silverman, MD • Snow Slade, MD • Kerry Solomon, MD • William Soscia, MD • W. Colby Stewart, MD • Glenn Strauss, MD • Tom Sun, MD • John Sutphin, MD • John Swan, MD • Russell Swan, MD • Justus Thomas, MD • Elaine Thung, MD • Christopher Tortora, MD • Da-Thuy Van, DO • Jesse Vislisel, MD • Mark Vital, MD • Aaron Waite, MD • L. Andrew Watkins, MD • Charles Weber, MD • Mark Weiner, MD • Matthew Weiss, MD • Damon Welch, MD • Daniel Welch, MD • Lisa West, MD • Abraham White, MD • Jeffrey Whitman, MD • Bradley Williams Sr., MD • Steven Williams, MD • Jeffrey Wipfli, MD • Darcy Wolsey, MD • Elizabeth Yeu-Lin, MD • Sing Your Li, MD • Fiaz Zaman, MD • Zachary Zavodni, MD • Stewart Zuckerbrod, MD EW • Joseph Harman, MD • Thomas Harvey, MD • Kurt Heitman, MD • Jason Hendrix, MD • Paul Herring, MD • Ralph Hester, MD • Brian Hunter, MD • Shawn Iverson, DO • Adrian Jachens, MD • David Jackson, MD • Vivek Jain, MD • James Jochum, MD • Carol Johnston, MD • Thomas Joly, MD • Kevin Jong, MD • Elliott Kanner, MD • Mahmoud Khaimi, MD • Sherif Khalil, MD • Jennifer Kim, MD • Joshua Kim, MD • Daniel Kim, MD • Judith Kirby, MD • Daniel Kline, MD • Robert Knape, MD • Peter Knowlton, MD • Douglas Kohl, MD • Timmy Kovoor, MD • Chris Kurz, MD • Byron Ladd, MD • William Lahners, MD • Marissa Larochelle, MD • Bryan Lee, MD • James Lehmann, MD • Jeffrey Levenson, MD • John Lim, MD • Jeffrey Liu, MD • David Loewy, MD • Jeffrey Maltzman, MD • Nick Mamalis, MD • Esther Manolarakis, MD • Bethany Bray Markowitz, MD • Terrence McCanna, MD • Frank McDonald, MD • Brandon Menke, MD • Kenneth Miller, MD • Bernard Milstein, MD • Jason Much, MD • Paul Munden, MD • Heather Nesti, MD • Thomas Newland, MD • Myhanh Nguyen, MD • Constance Okeke, MD • Richard Ou, MD • David Park, MD • Reena Patel, MD • Larry Patterson, MD • John Peters, MD In the journal Changes in shape and astigmatism of total, anterior, and posterior cornea after long versus short clear corneal incision cataract surgery Ken Hayashi, MD, Motoaki Yoshida, MD, Akira Hirata, MD, Koichi Yoshimura, MD In this prospective case series, investigators compared how the use of long length clear corneal incisions and short length clear corneal incisions affected the total anterior and posterior cornea in terms of shape and astigmatism. In the study, the 120 patients undergoing phaco with temporal clear corneal incisions had both eyes randomized to either have the procedure with a short length clear corneal incision of less than 1.75 mm or a long length incision of equal to or greater than 1.75 mm. Investigators found that the mean vertical, horizontal, and oblique changes in corneal astigmatism were significantly greater in eyes that underwent long clear corneal incisions than in the short clear corneal incision group. At 2 days postoperatively, in both groups investigators saw a wedge-shaped flattening in the total and anterior cornea. In the posterior cornea there was a steepening around the clear corneal incision. This steepening of the posterior cornea was gone within 4 weeks. Likewise, after 8 weeks the flattening of the total and ante- rior cornea related to the wound disappeared. In the long clear corneal incision group these extended closer to the central cornea. Investigators concluded that the long clear corneal incisions caused significantly greater corneal astigmatic changes than the short. While immediately postoperatively there were wound- related shape changes, these rapidly diminished. The changes were closer to the central cornea in the long clear corneal group than in the short one. Racial/ethnic differences in rates of complex cataract surgery among United States Medicare beneficiaries Michael Mahr, David Hodge, MS, Jay Erie, MD Investigators in this retrospective case series set out to determine whether rates of complex cataract surgery among United States Medicare beneficiaries were influenced by racial or ethnic differences. They determined that for African Americans, Asians, and Hispanics there was a significantly higher chance of un- dergoing complex cataract surgery after age and sex were taken into account than for whites. Likewise, men were more likely to undergo complex cataract surgery procedures than women. Those older than age 84 were more likely to have com- plex cataract surgery than those in the 65- to 69-year-old age group. Investigators concluded that among fee-for-service Medicare beneficiaries, racial minorities were 42–90% more likely than whites to undergo complex cataract procedures. Factors influencing the outcome of astigmatic correction by intrastromal astigmatic keratotomy performed during femtosecond laser-assisted cataract surgery Yong-Soo Byun, MD, Seonjoo Kim, Marjorie Lazo, MD, Mi-Hyun Choi, Min-Jee Kang, Ji-Hye Lee, Young-Sik Yoo, Woong-Joo Whang, Choun-Ki Joo, MD What are the factors affecting the 6-month outcomes of femtosecond laser astigmatic keratotomy when combined with femtosecond laser-assisted cataract surgery? In this retrospective case series, when investigators examined this in 89 eyes they determined that there was a significant difference in the correction index. However, they also found that there was no difference in keratometric astigmatism in the with-the-rule astigmatism cases as well as the against-the-rule and oblique cases. They found that the keratometric astigmatism (0.66 D) was significantly lower than the refractive cylinder (0.92 D and 0.78 D) in against- the-rule and oblique astigmatism. The conclusion reached was that the astigma- tism type and the biomechanical properties of the cornea affected the efficacy of femtosecond laser astigmatic keratotomy. More studies including total corneal astigmatism in the nomogram as well as individual biomechanical properties of the cornea are needed. EW February 2018

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