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Total keratometry in intraocular lens power calculations in eyes with previous laser refractive surgery
摘要： Importance: Intraocular lens (IOL) calculations in post-refractive cases remain a concern. Our study identifies improved options for surgeons. Background: To evaluate and compare the prediction accuracy of IOL power calculation methods after previous laser refractive surgery using standard keratometry (SK), measured posterior corneal astigmatism (PCA) and total keratometry (TK). Design: Retrospective consecutive cohort Participants: 50 consecutive patients (72 eyes) at a private institution who underwent cataract surgery with prior laser refractive procedures Methods: Methods using SK included ASCRS mean, Barrett True K no history, Haigis-L and Shammas IOL formulae. Barrett True K using posterior values (True K TK), Haigis and Holladay 1 Double-K methods using TK were also assessed. Post-surgery refraction was undertaken at minimum 3 weeks following surgery. Main outcome measures: Arithmetic and absolute IOL refractive prediction errors, variances in mean arithmetic IOL prediction error, and percentage of eyes within ± 0.25D, ± 0.50D, ± 0.75D and ± 1.00D of refractive prediction errors were compared. Results: The Barrett True K (TK) provided the lowest mean refractive prediction error and variance for both prior myopes and hyperopes undergoing cataract surgery. The Barrett True K (TK) exhibited the highest percentages of eyes within ± 0.50D, ± 0.75D and ± 1.00D of the refractive prediction error compared to other formulae for prior myopic patients. Conclusions and relevance: Accuracy of IOL power calculations in post-laser eyes can be improved by the addition of posterior corneal values as measured by the IOLMaster 700. The use of total keratometry may supplement outcomes when no prior refraction history is known.
关键词： Cataract,Refractive surgery,Surgery,Intraocular lenses
更新于2025-09-19 17:13:59
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Success of combined cataract extraction plus excimer laser trabeculotomy exceeds that of combined ab interno trabeculectomy with the trabectome or cataract extraction alone
摘要： Purpose To determine the efficacy of cataract surgery alone and combined with two minimally invasive glaucoma surgery (MIGS) procedures (phaco-ELT and phaco-aiT). Methods Data was collected from 12/2007 to 02/2012 in this retrospective, non-randomized, comparative single surgery center study. Reduction in IOP and hypotensive medication (AGD), change in visual acuity, success rates, and complications were computed by comparing preoperative data with data at 1 year postoperatively. Results A total of 245 eyes of 245 subjects were included. Study eyes underwent phaco alone (38 eye) or combined phaco-ELT (105 eye) and phaco-aiT (102 eye). Phaco alone, combined phaco-ELT, and combined phaco-aiT lowered IOP by 1.5 ± 4.0 mmHg, 4.3 ± 5.6, and 5.3 ± 4.5 mmHg, respectively (P < 0.01). Survival time of phaco-ELT outreached survival time of phaco alone and combined phaco-aiT (20.6 ± 1.0 vs. 13.2 ± 0.4 and 12.9 ± 0.6 month, respectively). No serious complications or adverse events occurred. None of the cases required a subsequent procedure within the first year to lower IOP further. Conclusions All three surgical procedures lowered IOP and reduced medication. However, the IOP-lowering efficacy of the two combined MIGS procedures exceeded the effect of phaco alone. A combined phaco and MIGS procedures seem reasonable to consider whenever a cataract surgery in an eye with glaucoma or ocular hypertension is considered. In addition, the combined MIGS procedure effectively lowers IOP whenever a target IOP in the mid-teens is sufficient. In this study, the nonthermal phaco-ELT procedure showed superior efficacy at 1 year over phaco alone and phaco-aiT in the Kaplan–Meier statistics.
关键词： Cataract,Excimer laser trabeculostomy,Glaucoma,Excimer laser trabeculotomy,Ab interno trabeculotomy with the trabectome,Minimally invasive glaucoma surgery
更新于2025-09-16 10:30:52
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CO2 Laser-assisted Deep Sclerectomy Combined With Phacoemulsification in Patients With Primary Open-angle Glaucoma and Cataract
摘要： To assess the safety and efficacy of CO2 laser-assisted sclerectomy surgery (CLASS) combined with phacoemulsification in patients with primary open-angle glaucoma (POAG) and visually significant cataracts. This was a prospective, uncontrolled, interventional case series. Seventeen patients (17 eyes) diagnosed with POAG and cataracts were enrolled starting from November 2015. All subjects underwent CLASS combined with phacoemulsification surgery by the same surgeon. After the surgery, all patients were followed for 12 months. The preoperative to postoperative changes in intraocular pressure (IOP), glaucoma medication requirements, best-corrected visual acuity and adverse events were recorded. The results of 17 eyes of 17 patients were included in the statistical analysis. The baseline mean IOP was 23.94 ± 8.57 mm Hg (mean ± SD), and patients used 2.18 ± 0.88 types of antiglaucoma medication. At 12 months postsurgery, the mean IOP was 14.67 ± 2.97 mm Hg, and patients used 0.59 ± 0.87 types of antiglaucoma medication (both P < 0.001). The logarithm of the minimal angle of resolution of the best-corrected visual acuity improved from 0.77 ± 0.42 preoperatively to 0.33 ± 0.47 postoperatively (P < 0.05). Two patients experienced intraoperative perforation accompanied by iris prolapse. One patient exhibited postoperative choroidal detachment. CLASS with phacoemulsification may become a safe and effective intervention for patients with POAG and visually significant cataracts.
关键词： cataract,primary open-angle glaucoma,phacoemulsification,CLASS,laser surgery
更新于2025-09-16 10:30:52
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Comparison of the selected parameters of the anterior segment of the eye between femtosecond laser-assisted cataract surgery, microincision cataract surgery, and conventional phacoemulsification
摘要： The purpose of our study was to compare the selected parameters of the anterior segment of the eye in patients after femtosecond laser-assisted cataract surgery (FLACS) with the results of microincision cataract surgery (MICS) and conventional phacoemulsi?cation surgery (CPS). This single-center prospective randomized comparative observational study included 87 patients. Patients were randomly selected into group A (FLACS), group B (MICS) and group C (control group). All the surgeries were performed by the same experienced surgeon. Preoperative and postoperative parameters were evaluated: best-corrected visual acuity (BCVA), endothelial cell density (ECD), endothelial cell loss percentage (ECL%), central corneal thickness (CCT), central anterior and posterior corneal astigmatism induction, posterior corneal elevation map were measured. Intraoperative parameters: effective phacoemulsi?cation time (EPT), balanced salt solution use (BSS use), total surgical time and suction time were analyzed. Examination was performed preoperatively and on the ?rst, seventh day, one and six months postoperatively. The follow up period was 6 months. There was no statistically signi?cant difference in BCVA, central anterior and posterior astigmatism induction between studied groups. The ECL% was statistically signi?cant lower in the group A on the 7th day, 1 month and 6-months postoperatively (P < .05). The CCT was statistically signi?cant lower in the group A and in the group B than in the group C on the 7th postoperative day (P = .002). However, in the 6 months follow-up there was no statistically signi?cant difference in the CCT between studied groups (P = .133). We observed statistically signi?cant difference in change of the posterior corneal elevation map at the periphery assessed within the 90° to 120°meridian range between group A, group B and group C at every timepoint postoperatively (P < .05). The EPT and BSS use were statistically signi?cant lower whilst total surgery time was statistically signi?cant higher in the FLACS group (P < .05). To conclude in the 6 months follow-up there was statistically signi?cant difference found between eyes undergoing FLACS, MICS and CPS with respect to the posterior corneal elevation map assessed within the studied range, ECL%, EPT, BSS use and total surgery time. Postoperative BCVA, central anterior and posterior astigmatism induction, CCT were comparable between studied groups.
关键词： conventional phacoemulsi?cation surgery,femtosecond laser-assisted cataract surgery,clinical outcomes,manual phacoemulsi?cation,intraoperative parameters,microincision cataract surgery
更新于2025-09-12 10:27:22
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Intraocular Pressure Changes during Femtosecond Laser-Assisted Cataract Surgery: A Comparison between Two Different Patient Interfaces
摘要： Purpose. The aim of this retrospective cohort study was to evaluate intraocular pressure (IOP) changes during femtosecond laser-assisted cataract surgery (FLACS) using two di?erent patient interface systems. Methods. 116 eyes of 116 patients scheduled for cataract surgery were divided into 2 groups: group 1 (61 eyes) and group 2 (55 eyes) underwent FLACS using Catalys Laser with ?uid interface (liquid optics interface, LOI) and LenSx Laser with curved interface and soft contact lens (SoftFit), respectively. IOP was assessed using a portable rebound tonometer (Icare?) preoperatively, after docking, immediately after surgery, at one and seven days postoperatively. Results. In group 1, the mean IOP (±SD) was 14.1 ± 0.4 mmHg before surgery, 33.2 ± 1.1 mmHg after docking, and 21.4 ± 0.9 mmHg immediately after surgery. In group 2, the mean IOP was 13.8 ± 0.4 mmHg before surgery, 24.2 ± 1.4 mmHg after docking, and 20.2 ± 1.2 mmHg immediately after surgery. After the docking procedure, a statistically signi?cant increase in IOP from the baseline was found in both groups (p < 0.001). Moreover, no statistically signi?cant di?erence in IOP measured at 1 and 7 days postoperatively was observed compared with the preoperative values (p > 0.05) using both laser platforms. No intraoperative and postoperative complications were observed. Conclusions. FLACS suction phase resulted in a transient increase of IOP in both groups, especially with the LOI system, and it is probably related to the greater pressure of a suction ring and suction generated through the vacuum, independently from the e?ect of femtosecond laser itself.
关键词： femtosecond laser-assisted cataract surgery,LenSx Laser,intraocular pressure,Catalys Laser,patient interface systems
更新于2025-09-12 10:27:22
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Tomographic analysis of anterior and posterior surgically induced astigmatism after 2.2?mm temporal clear corneal incisions in femtosecond laser–assisted cataract surgery
摘要： To evaluate surgically induced astigmatism (SIA) of temporal clear corneal incisions (CCIs) on anterior and posterior corneal curvature after femtosecond laser–assisted cataract surgery (FLACS) using Scheimpflug tomographic measurements.
关键词： clear corneal incisions,Scheimpflug tomography,femtosecond laser–assisted cataract surgery,surgically induced astigmatism
更新于2025-09-12 10:27:22
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Comparison of Perioperative Parameters in Femtosecond Laser-assisted Cataract Surgery using Three Nuclear Fragmentation Patterns
摘要： Purpose: To compare the perioperative parameters of quadrant, sextant, and grid lens fragmentation patterns in femtosecond laser-assisted cataract surgery (FLACS). Design: Prospective randomized clinical trial. Methods: Setting: Eye Center of the Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China. Patient or Study Population: A total of 894 eyes in 661 patients with cataracts were enrolled. Intervention or Observation Procedures: The nuclear density was graded according to the Emery-Little classification. Patients received lens fragmentation using a quadrant, sextant, or grid pattern after random allocation. Evaluations included intraoperative parameters, complications, and postoperative outcomes. Main Outcome Measure(s): Effective phacoemulsification time (EPT), intraoperative complications, visual acuity and intraocular pressure (IOP) at one day postoperatively, as well as endothelial cell density (ECD), endothelial cell loss (ECL) and central corneal thickness (CCT) at one week postoperatively. Results: In grade 1 nuclei, the mean EPT in the grid group was the shortest compared to those in the quadrant (P = 0.011) and sextant (P = 0.001) groups. In grade 2 nuclei, all three patterns showed no significant difference in the mean EPT (p > 0.05). In grade 3 nuclei, the sextant group revealed shorter mean EPT compared to the grid (P = 0.017) and quadrant (P > 0.05) groups. In grade 4 & 5 nuclei, the quadrant pattern had the shortest mean EPT among all three patterns (P < 0.05). The grid pattern is associated with higher IOP in hard nuclei (grade 4 & 5) than the other two patterns (P < 0.05). Conclusions: The grid and quadrant patterns allow for shorter EPT in soft (grade 1) and hard (grade 4 & 5) nuclei, respectively. All three patterns can be selected for treating grade 2 nuclei. The sextant pattern may be the best option when treating grade 3 nuclei. The grid pattern should be avoided in hard nuclei combined with glaucoma or glaucoma suspect.
关键词： nuclear fragmentation patterns,Femtosecond laser-assisted cataract surgery,Emery-Little classification,perioperative parameters,FLACS
更新于2025-09-12 10:27:22
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Comparison of Different Corneal Power Readings From Pentacam in Post-laser In Situ Keratomileusis Eyes
摘要： To compare the various Pentacam-measured K-readings with the clinical history method (CHM) in eyes that have undergone myopic laser in situ keratomileusis (LASIK). Methods: In this prospective study, Pentacam examination was performed in 71 eyes 1 month after myopic LASIK. The true net power (TNP) 4 mm, total corneal refractive power (TCRP) 4 mm, equivalent K-reading (EKR) 4.0 mm, and EKR 4.5 mm obtained from the same scan were compared with the K derived from CHM. Results: The average baseline spherical equivalence was 25.4462.38 D. the mean KCHM was 37.6762.13 D, TCRP4mm was After LASIK, 37.1461.79 D, TNP4mm was 36.8861.76 D, EKR4.0mm was 37.5861.94 D, and EKR4.5mm was 37.5161.94 D. TCRP4mm, TNP4mm, and EKR4.5mm showed a statistically signi?cant deviation from the KCHM, with the mean error being 0.53 D, 0.79 D, and 0.16 D, respectively (P,0.05). Only the EKR4.0mm showed no statistically signi?cant difference from the KCHM (mean error 0.09 D, P?0.23). The EKR4.0mm also had the narrowest 95% limits of agreement (LoA) (21.10 to +1.28 D), whereas both TCRP4mm and TNP4mm had a wider LoA (20.88 to +1.95 D and 20.62 to +2.20 D, respectively). All four Pentacam K-readings had a strong and statistically signi?cant correlation with the KCHM. Conclusions: Using the CHM as reference, the EKR4.0mm demonstrated the closest agreement when compared with the EKR4.5mm, TNP4mm, and TCRP4mm obtained from the same scan.
关键词： surgery,Scheimp?ug imaging,Refractive,Cataract,Corneal power,Pentacam,Biometry
更新于2025-09-12 10:27:22
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Femtosecond Laser Surgery in Ophthalmology
摘要： This comprehensive, well-organized text encompasses the numerous applications of femtosecond lasers to anterior segment surgery. From the use of laser-assisted in situ keratomileusis flap creation, cataract surgery, and even femtosecond-assisted keratopigmentation, this text thoroughly reviews all aspects of technology, leaving no application uncovered, highlighting the great versatility and potential of this technology. Each of the chapters is written by 1 to 3 experienced ophthalmic surgeons, and the text is well edited to assure completeness and prevent redundancy.
关键词： anterior segment surgery,femtosecond laser,laser-assisted in situ keratomileusis,ophthalmology,cataract surgery
更新于2025-09-12 10:27:22
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Femtosecond laser–assisted cataract surgery: A review
摘要： Purpose: Review scientific literature concerning femtosecond laser–assisted cataract surgery. Methods: Following databases were searched: CENTRAL (Cochrane Eyes and Vision Trials Register; Cochrane Library: Issue 2 of 12, June 2019), Ovid MEDLINE? without Revisions (1996 to June 2019), Ovid MEDLINE? (1946 to June 2019), Ovid MEDLINE? Daily Update June 2019, MEDLINE and MEDLINE Non-Indexed Items, Embase (1980–2019), Embase (1974 to June 2019), Ovid MEDLINE? and Epub Ahead of Print, in-Process & Other Non-Indexed Citations and Daily (1946 to June 2019), Web of Science (all years), the metaRegister of Controlled Trials (www.controlled-trials.com), ClinicalTrials.gov (www.clinicaltrial.gov) and World Health Organization International Clinical Trials Registry Platform (www.who.int/ictrp/search/en). Search terms/keywords included ‘Femtosecond laser’ combined with ‘cataract’, ‘cataract surgery’. Results: Based on quality of their methodology and their originality, 121 articles were reviewed, including randomised controlled trials, cohort studies, case-controlled studies, case series, case reports and laboratory studies. Each step of the femtosecond laser–assisted cataract surgery procedure (corneal incisions, arcuate keratotomies, capsulotomy and lens fragmentation) has been discussed with relevance to published outcomes, as well as complication rates of femtosecond laser–assisted cataract surgery, and what we can learn from the larger studies/meta-analyses and the economics of femtosecond laser–assisted cataract surgery within different healthcare settings. Conclusion: Studies suggest that the current clinical outcomes of femtosecond laser–assisted cataract surgery are not different to conventional phacoemulsification surgery and it is not cost effective when compared with conventional phacoemulsification surgery. In its current technological form, it is a useful surgical tool in specific complex cataract scenarios, but its usage has not been shown to translate into better clinical outcomes.
关键词： Cataract,phacoemulsification,femtosecond laser–assisted cataract surgery
更新于2025-09-11 14:15:04