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Macular segmentation after femtosecond laser–assisted cataract surgery Zoltán Z. Nagy, M.D., D.S.C., Monika Ecsedy, M.D., Ph.D., Illés Kovács, M.D., Ph.D., Ágnes Takács, M.D., Erika Tátrai, M.D., Gábor Márk Somfai, M.D., Ph.D., Delia Cabrera DeBuc, Ph.D.
In this case-controlled study, investigators considered how the various retinal layers of the cornea compared when using the femtosecond laser together with phacoemulsification versus in cases involving traditional phacoemulsification. They determined that between those that underwent femtosecond phacoemulsification versus traditional, when it came to the outer nuclear layer thickness and the relative outer nuclear layer thickness in the inner and outer macular rings, there were statistically significant differences. While both groups had detectable macular edema particularly in the outer nuclear layer, when the femtosecond laser was used this was found to be significantly less than with the traditional approach. After cataract surgery, macular edema was detectable mainly in the outer nuclear layer in both groups but was found to be significantly less in cases using the femtosecond laser platform.
Bac-assisted transepithelial crosslinking
Carina Koppen, M.D., Kristien Wouters, Ph.D., Danny Mathysen, M.Sc., Jos Rozema, Ph.D., Marie-José Tassignon, M.D., Ph.D.
Investigators here set out to determine whether progressive keratoconus patients undergoing transepithelial collagen crosslinking without epithelial debridement fared better or worse when proparacaine 0.5% drops preserved with benzalkonium chloride–assisted (BAC) were used prior to irradiation. When the 53 eyes that had undergone the transepithelial crosslinking procedure with proparacaine preserved BAC were evaluated, investigators found that the only statistically significant improvement was in distance visual acuity at the 6- and 12-month marks. There was significant progression during the 18 months of the study of maximum K and pachymetry. Meanwhile, during the study sphere, cylinder, maximum keratometry, simulated steep K, flat K, and astigmatism all remained stable here. Investigators concluded that when it came to stabilizing progressive keratoconus it was more effective to perform standard crosslinking than to use proparacaine drops preserved with BAC 0.005%.
Visual quality after phakic IOL implantation in keratoconus
Mathew Kurian, M.S., Somshekar Nagappa, M.D., Ridhima Bhagali, M.S., Rohit Shetty, F.R.C.S., Bhujang K. Shetty, M.S.
The aim in this case series was to consider just how those with keratoconus that is stable or stabilized fare after posterior chamber phakic IOL implantation for refractive correction, with regard to quantifiable image quality. In the series the V4 Visian PC pIOL was implanted in 10 eyes of 7 patients, with a pre-op mean spherical equivalent of -7.21 D. At the 6-week mark the refractive error had decreased to -0.55 D and at 6 months was at -0.44 D. However, when it came to the mean modulation transfer function this was at just 18.96 on a scale where 30 cycles per degree is considered good. Likewise the Strehl ratio, in which a 1 is considered perfect, was just 0.11 here. When it came to the objective scatter index this was significant at 4.45. Investigators found that secondary coma, secondary trefoil, total aberrations, and higher-order aberrations all directly corrected with the objective scatter index. They concluded that while the pIOL could be used to correct refractive errors in keratoconus cases the visual quality was hampered by associated aberrations, which needed attention.
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