Eyeworld

111 EW RESIDENTS March 2018 impact amblyopia, visual function, and quality of life will help clarify the optimal timing of surgical inter- vention among these patients. EW References 1. Atchison DA, et al. Anterior corneal, pos- terior corneal, and lenticular contributions to ocular aberrations. Invest Ophthalmol Vis Sci. 2016;57:5263–5270. 2. Stem MS, et al. Scleral-fixated intraocular lenses: past and present. J Vitreoretin Dis. 2017;1:144–152. 3. Srivastava S, et al. Comparison of ocular wavefront aberrations in subluxated lenses before and after lens extraction with intraocu- lar lens implantation. J Cataract Refract Surg. 2018;44. Article in press. 4. Agarwal A, et al. Aberropia: a new refractive entity. J Cataract Refract Surg. 2007;33:1835–6; author reply 1836–7. 5. Applegate RA, et al. Interaction between aberrations to improve or reduce visu- al performance. J Cataract Refract Surg. 2003;29:1487–95. 6. Asadi R, et al. Long-term results of scleral fixation of posterior chamber intraocular lenses in children. Ophthalmology. 2008;115: 67–72. 7. Walsh MK, et al. Sutureless scleral tunnel intraocular lens fixation in the pediatric popu- lation. Retina. 2014;34:807–11. 8. Wagoner MD, et al. Intraocular lens implan- tation in the absence of capsular support: a report by the American Academy of Ophthal- mology. Ophthalmology. 2003;110:840–59. Contact information Mian: smian@med.umich.edu and surgeon-dependent. Although studies of the aforementioned surgical techniques have shown good long-term improvement in visual acuity, 8 it is unclear whether similar reductions in HOAs would be achieved when a broader range of surgeons performed these surger- ies. Securing the capsular bag or the IOL to the sclera can result in tilt or decentration of the IOL, increasing postoperative HOA in some cases. More research is needed before we can extrapolate the results of this single center, single surgeon study to other settings. The long-term clinical implica- tions of this study, whether in terms of amblyopia reduction or improved quality of life, are intriguing but still unclear. Without evidence clearly linking HOAs to either of these out- come metrics independent of visual acuity, it is difficult to justify using HOAs as a standalone indication for surgery. Nevertheless, Srivastava et al. are to be commended for stim- ulating a new discussion regard- ing the potential merits of earlier surgical treatment for patients with mild to moderate crystalline lens subluxation and decent preoperative visual acuity, particularly among younger patients who may be at risk for developing amblyopia. Further studies of the extent to which HOAs aberrations in subluxated intraocular lens implantation" University of Michigan residents; front row: Lev Prasov, MD, Joseph Grubbs, MD, Sarah Michelson, MD, Rohan Jalalizadeh, MD, Jason Miller, MD, Michael Huvard, MD; back row: Sean Hansen, MD, Nathan Liles, MD, Nakul Shekawat, MD, Eric Weinlander, MD, Tatiana Deveney, MD Source: University of Michigan

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