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Current Challenges and Advances in Cataract Surgery
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Current Challenges and Advances in Cataract Surgery

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: closed (20 July 2022) | Viewed by 22288

Printed Edition Available!
A printed edition of this Special Issue is available here.

Special Issue Editor

Prof. Dr. Nobuyuki Shoji

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Guest Editor
Department of Ophthalmology, Kitasato University School of Medicine, Kanagawa, Japan
Interests: multifocal IOL; EDOF IOL; toric IOL; MIGS; glaucoma surgery

Special Issue Information

Dear Colleagues,

Cataract surgery has achieved rapidly advancing development for several years. It is no longer enough to simply remove the lens opacity and insert an intraocular lens with a good focus somewhere; we are now in an era where strict predictive accuracy and a high quality of vision is required. In addition, there are more and more situations where cataract surgery must be performed on patients who have already undergone other ophthalmic surgeries in the past—in other words, after refractive surgery, after corneal endothelial surgery, and after glaucoma filtration surgery. High-quality cataract surgery is required even in these complicated cases. In this Special Issue, we would like to discuss the appropriate formulas, the appropriateness of multifocal IOL or extended depth of fucus (EDOF) IOL, and the indications for toric IOLs in previously operated eyes such as refractive surgery, corneal endothelial transplantation, and glaucoma filtering surgery. Furthermore, intrascleral IOL fixation for aphakic eyes will also be discussed.

Prof. Dr. Nobuyuki Shoji
Guest Editor

Manuscript Submission Information

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Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • multifocal IOL
  • EDOF IOL
  • toric IOL
  • refractive surgery
  • DSAEK
  • glaucoma filtering surgery

Published Papers (15 papers)

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Research

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17 pages, 4901 KiB  
Article
Dry Eye Following Femtosecond Laser-Assisted Cataract Surgery: A Meta-Analysis
by Wei-Tsun Chen, Yu-Yen Chen and Man-Chen Hung
J. Clin. Med. 2022, 11(21), 6228; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11216228 - 22 Oct 2022
Cited by 2 | Viewed by 1662
Abstract
This study investigates the dry eye effect after femtosecond laser-assisted cataract surgery (FLACS) and also compares the risk of postoperative dry eye between FLACS and manual cataract surgery (MCS). We searched various databases between 1 January 2000 and 15 October 2022 and included [...] Read more.
This study investigates the dry eye effect after femtosecond laser-assisted cataract surgery (FLACS) and also compares the risk of postoperative dry eye between FLACS and manual cataract surgery (MCS). We searched various databases between 1 January 2000 and 15 October 2022 and included peer-reviewed clinical studies in our review. Dry eye parameters were extracted at baseline and postoperative day one, week one, one month, and three months. Parameters included were the ocular surface discomfort index (OSDI), tear secretion (tear meniscus height, Schirmer’s test), microscopic ocular surface damage (fluorescein staining), and tear stability (first and average tear breakup time). Additionally, the differences of each parameter at each time point were compared between FLACS and MCS. In total, six studies of 611 eyes were included. On postoperative day one, increased, pooled standardised mean differences (SMDs) were noted in the OSDI, tear secretion, tear film instability, and microscopic damage. During postoperative week one, dry eye worsened. Fortunately, dry eye achieved resolution afterwards and nearly returned to the baseline level at postoperative three months. When the parameters were compared between FLACS and MCS, those of FLACS had higher severities, but most were not statistically significant. Dry eye impact was approximately the same in FLACS and MCS at postoperative three months. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Cataract Surgery)
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10 pages, 727 KiB  
Article
Accuracy of Six Intraocular Lens Power Calculations in Eyes with Axial Lengths Greater than 28.0 mm
by Majid Moshirfar, Kathryn M. Durnford, Jenna L. Jensen, Daniel P. Beesley, Telyn S. Peterson, Ines M. Darquea, Yasmyne C. Ronquillo and Phillip C. Hoopes
J. Clin. Med. 2022, 11(19), 5947; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11195947 - 08 Oct 2022
Cited by 7 | Viewed by 1644
Abstract
The purpose of this study was to compare the accuracy of several intraocular (IOL) lens power calculation formulas in long eyes. This was a single-site retrospective consecutive case series that reviewed patients with axial lengths (AL) > 28.0 mm who underwent phacoemulsification. The [...] Read more.
The purpose of this study was to compare the accuracy of several intraocular (IOL) lens power calculation formulas in long eyes. This was a single-site retrospective consecutive case series that reviewed patients with axial lengths (AL) > 28.0 mm who underwent phacoemulsification. The Wang–Koch (WK) adjustment and Cooke-modified axial length (CMAL) adjustment were applied to Holladay 1 and SRK/T. The median absolute error (MedAE) and the percentage of eyes with prediction errors ±0.25 diopters (D), ±0.50 D, ±0.75 D, and ±1.00 D were used to analyze the formula’s accuracy. This study comprised a total of 35 eyes from 25 patients. The Kane formula had the lowest MedAE of all the formulas, but all were comparable except Holladay 1, which had a significantly lower prediction accuracy with either AL adjustment. The SRK/T formula with the CMAL adjustment had the highest accuracy in predicting the formula outcome within ±0.50 D. The newer formulas (BU-II, EVO, Hill-RBF version 3.0, and Kane) were all equally predictable in long eyes. The SRK/T formula with the CMAL adjustment was comparable to these newer formulas with better outcomes than the WK adjustment. The Holladay 1 with either AL adjustment had the lowest predictive accuracy. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Cataract Surgery)
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13 pages, 275 KiB  
Article
Evaluation of Visual and Patient—Reported Outcomes, Spectacle Dependence after Bilateral Implantation with a Non-Diffractive Extended Depth of Focus Intraocular Lens Compared to Other Intraocular Lenses
by Anna Dołowiec-Kwapisz, Halina Piotrowska and Marta Misiuk-Hojło
J. Clin. Med. 2022, 11(17), 5246; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11175246 - 05 Sep 2022
Cited by 2 | Viewed by 1668
Abstract
Purpose: To evaluate postoperative outcomes, spectacle dependance and the occurrence of the photic phenomena in patients after cataract surgery following the implantation of a non-diffractive extended depth of focus (EDOF) intraocular lens was compared to monofocal and multifocal lenses. Methods: We [...] Read more.
Purpose: To evaluate postoperative outcomes, spectacle dependance and the occurrence of the photic phenomena in patients after cataract surgery following the implantation of a non-diffractive extended depth of focus (EDOF) intraocular lens was compared to monofocal and multifocal lenses. Methods: We enrolled patients with bilateral cataracts who wanted to reduce their dependence on glasses in the study. They were followed for 6 months. The study group in which the EDOF lens was implanted consisted of 70 eyes in 35 patients. The control groups consisted of: 52 eyes in 26 patients in whom a multifocal was implanted and 52 eyes in 26 patients with implanted monofocal lens. After a total of 2 weeks, 2 months and 6 months post-surgery the following were evaluated: uncorrected and corrected visual acuity at 4 m, 80 cm, 40 cm, manifest refraction expressed as mean refractive spherical equivalent (MRSE), contrast sensitivity, intraocular pressure. A questionnaire on independence from ocular correction, the occurrence of photic phenomena, and patient satisfaction was also completed. Results: Monocular and binocular visual acuity and MRSE 6 months after the procedure were compared between three groups. All of the main analyses, except for comparisons of uncorrected distance visual acuity (both monocular and binocular) level, were significant. Contrast sensitivity was lower among patients with multifocal lens than among patients with EDOF lens. Halo and glare after 6 months were seen more often among patients with multifocal lens than among patients with the other lens (65% of eyes with multifocal lens vs. 6% of eyes with EDOF lens and 0% of eyes with monofocal lens). Glasses were needed by 35% of patients with EDOF lens, and by 96% of patients with monofocal lens and in none of the patients with multifocal lens. Conclusions: Most patients qualify for the implantation of a non-diffractive EDOF lens. Post-operative visual acuity improves at any distance. The best monocular visual acuity for intermediate distances is provided by an EDOF lens, and for near distance by a multifocal lens. The EDOF lens definitely increases independence from spectacle correction compared to monofocal lenses; however, the greatest degree of independence from spectacles is provided by multifocal lenses. The incidence of photic phenomena is slightly higher than that of a monofocal lens, and much lower for a multifocal lens. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Cataract Surgery)
7 pages, 1191 KiB  
Article
Investigating the Prediction Accuracy of Recently Updated Intraocular Lens Power Formulas with Artificial Intelligence for High Myopia
by Miki Omoto, Kaoruko Sugawara, Hidemasa Torii, Erisa Yotsukura, Sachiko Masui, Yuta Shigeno, Yasuyo Nishi and Kazuno Negishi
J. Clin. Med. 2022, 11(16), 4848; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11164848 - 18 Aug 2022
Cited by 8 | Viewed by 1247
Abstract
The aim of this study was to investigate the prediction accuracy of intraocular lens (IOL) power formulas with artificial intelligence (AI) for high myopia. Cases of highly myopic patients (axial length [AL], >26.0 mm) undergoing uncomplicated cataract surgery with at least 1-month follow-up [...] Read more.
The aim of this study was to investigate the prediction accuracy of intraocular lens (IOL) power formulas with artificial intelligence (AI) for high myopia. Cases of highly myopic patients (axial length [AL], >26.0 mm) undergoing uncomplicated cataract surgery with at least 1-month follow-up were included. Prediction errors, absolute errors, and percentages of eyes with prediction errors within ±0.25, ±0.50, and ±1.00 diopters (D) were compared using five formulas: Hill-RBF3.0, Kane, Barrett Universal II (BUII), Haigis, and SRK/T. Seventy eyes (mean patient age at surgery, 64.0 ± 9.0 years; mean AL, 27.8 ± 1.3 mm) were included. The prediction errors with the Hill-RBF3.0 and Kane formulas were statistically different from the BUII, Haigis, and SRK/T formulas, whereas there was not a statistically significant difference between those with the Hill-RBF3.0 and Kane. The absolute errors with the Hill-RBF3.0 and Kane formulas were smaller than that with the BUII formula, whereas there was not a statistically significant difference between the other formulas. The percentage within ±0.25 D with the Hill-RBF3.0 formula was larger than that with the BUII formula. The prediction accuracy using AI (Hill-RBF3.0 and Kane) showed excellent prediction accuracy. No significant difference was observed in the prediction accuracy between the Hill-RBF3.0 and Kane formulas. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Cataract Surgery)
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10 pages, 769 KiB  
Article
IOL Power Calculations and Cataract Surgery in Eyes with Previous Small Incision Lenticule Extraction
by Roman Lischke, Walter Sekundo, Rainer Wiltfang, Martin Bechmann, Thomas C. Kreutzer, Siegfried G. Priglinger, Martin Dirisamer and Nikolaus Luft
J. Clin. Med. 2022, 11(15), 4418; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11154418 - 29 Jul 2022
Cited by 9 | Viewed by 1812
Abstract
Small incision lenticule extraction (SMILE), with over 5 million procedures globally performed, will challenge ophthalmologists in the foreseeable future with accurate intraocular lens power calculations in an ageing population. After more than one decade since the introduction of SMILE, only one case report [...] Read more.
Small incision lenticule extraction (SMILE), with over 5 million procedures globally performed, will challenge ophthalmologists in the foreseeable future with accurate intraocular lens power calculations in an ageing population. After more than one decade since the introduction of SMILE, only one case report of cataract surgery with IOL implantation after SMILE is present in the peer-reviewed literature. Hence, the scope of the present multicenter study was to compare the IOL power calculation accuracy in post-SMILE eyes between ray tracing and a range of empirically optimized formulae available in the ASCRS post-keratorefractive surgery IOL power online calculator. In our study of 11 post-SMILE eyes undergoing cataract surgery, ray tracing showed the smallest mean absolute error (0.40 D) and yielded the largest percentage of eyes within ±0.50/±1.00 D (82/91%). The next best conventional formula was the Potvin–Hill formula with a mean absolute error of 0.66 D and an ±0.50/±1.00 D accuracy of 45 and 73%, respectively. Analyzing this first cohort of post-SMILE eyes undergoing cataract surgery and IOL implantation, ray tracing showed superior predictability in IOL power calculation over empirically optimized IOL power calculation formulae that were originally intended for use after Excimer-based keratorefractive procedures. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Cataract Surgery)
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9 pages, 600 KiB  
Article
A Comparison of Visual Quality and Contrast Sensitivity between Patients with Scleral-Fixated and In-Bag Intraocular Lenses
by Yueh-Ling Chen, Christy Pu, Ken-Kuo Lin, Jiahn-Shing Lee, Laura Liu and Chiun-Ho Hou
J. Clin. Med. 2022, 11(10), 2917; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11102917 - 22 May 2022
Cited by 1 | Viewed by 1439
Abstract
Purpose: To analyze visual quality and contrast sensitivity in patients after intraocular lens (IOL) implantation with sutured scleral fixation. Setting: Chang Gung Memorial Hospital, Taoyuan, Taiwan. Design: Retrospective observational study. Methods: Data on the refractive outcome, visual acuity, and subjective visual symptoms in [...] Read more.
Purpose: To analyze visual quality and contrast sensitivity in patients after intraocular lens (IOL) implantation with sutured scleral fixation. Setting: Chang Gung Memorial Hospital, Taoyuan, Taiwan. Design: Retrospective observational study. Methods: Data on the refractive outcome, visual acuity, and subjective visual symptoms in patients with scleral-fixated or in-bag IOL implantation were collected from September 2019 to March 2020. We also investigated patients’ postoperative higher-order aberrations (HOAs) and dysphotopsia using a wavefront aberrometer and glaretester, respectively. The following values were compared: corrected distance visual acuity, spherical equivalent, root mean square values for aberrations, and contrast sensitivity. Results: A total of 23 eyes implanted with scleral-fixated IOL and 74 eyes with in-bag IOL were studied. The mean postoperative spherical equivalent and logarithm of the minimum angle of resolution after scleral fixation were −1.09 ± 3.32 D and 0.20 ± 0.17, respectively. The ocular HOAs were higher in the scleral-fixation group than in the in-bag group (p = 0.001). Contrast sensitivity was negatively associated with age, and it was similar between the two groups after controlling for the age effect. Conclusions: Ocular HOAs and refractive errors were higher in the scleral-fixation group than in the in-bag group. However, no significant difference was noted in contrast sensitivity between advanced scleral fixation and in-bag IOL implantation. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Cataract Surgery)
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7 pages, 1058 KiB  
Article
Saving of Time Using a Software-Based versus a Manual Workflow for Toric Intraocular Lens Calculation and Implantation
by Barbara S. Brunner, Nikolaus Luft, Siegfried G. Priglinger, Mehdi Shajari, Wolfgang J. Mayer and Stefan Kassumeh
J. Clin. Med. 2022, 11(10), 2907; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11102907 - 20 May 2022
Cited by 1 | Viewed by 1532
Abstract
Background: To determine whether there is a significant saving of time when using a digital cataract workflow for digital data transfer compared to a manual approach of biometry assessment, data export, intraocular lens calculation, and surgery time. Methods: In total, 48 eyes of [...] Read more.
Background: To determine whether there is a significant saving of time when using a digital cataract workflow for digital data transfer compared to a manual approach of biometry assessment, data export, intraocular lens calculation, and surgery time. Methods: In total, 48 eyes of 24 patients were divided into two groups: 24 eyes were evaluated using a manual approach, whereas another 24 eyes underwent a full digital lens surgery workflow. The primary variables for comparison between both groups were the overall time as well as several time steps starting at optical biometry acquisition until the end of the surgical lens implantation. Other outcomes, such as toric intraocular lens misalignment, reduction of cylinder, surgically induced astigmatism, prediction error, and distance visual acuity were measured. Results: Overall, the total diagnostic and surgical time was reduced from 1364.1 ± 202.6 s in the manual group to 1125.8 ± 183.2 s in the digital group (p < 0.001). The complete time of surgery declined from 756.5 ± 82.3 s to 667.3 ± 56.3 (p < 0.0005). Compared to the manual approach of biometric data export and intraocular lens calculation (76.7 ± 12.3 s) as well as the manual export of the reference image to a portable external storage device (26.8 ± 5.5 s), a highly significant saving of time was achieved (p < 0.0001). Conclusions: Using a software-based digital approach to toric intraocular lens implantation is convenient, more efficient, and thus more economical than a manual workflow in surgery practice. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Cataract Surgery)
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11 pages, 1628 KiB  
Article
Conditional Process Analysis for Effective Lens Position According to Preoperative Axial Length
by Young-Sik Yoo and Woong-Joo Whang
J. Clin. Med. 2022, 11(6), 1469; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11061469 - 08 Mar 2022
Cited by 3 | Viewed by 1374
Abstract
Purpose: To predict the effective lens position (ELP) using conditional process analysis according to preoperative axial length. Setting: Yeouido St. Mary hospital. Design: A retrospective case series. Methods: This study included 621 eyes from 621 patients who underwent conventional cataract surgery at Yeouido [...] Read more.
Purpose: To predict the effective lens position (ELP) using conditional process analysis according to preoperative axial length. Setting: Yeouido St. Mary hospital. Design: A retrospective case series. Methods: This study included 621 eyes from 621 patients who underwent conventional cataract surgery at Yeouido St. Mary Hospital. Preoperative axial length (AL), mean corneal power (K), and anterior chamber depth (ACD) were measured by partial coherence interferometry. AL was used as an independent variable for the prediction of ELP, and 621 eyes were classified into four groups according to AL. Using conditional process analysis, we developed 24 structural equation models, with ACD and K acting as mediator, moderator or not included as variables, and investigated the model that best predicted ELP. Results: When AL was 23.0 mm or shorter, the predictability for ELP was highest when ACD and K acted as moderating variables (R2 = 0.217). When AL was between 23.0 mm and 24.5 mm or longer than 26.0 mm, the predictability was highest when K acted as a mediating variable and ACD acted as a moderating variable (R2 = 0.217 and R2 = 0.401). On the other hand, when AL ranged from 24.5 mm to 26.0 mm, the model with ACD as a mediating variable and K as a moderating variable was the most accurate (R2 = 0.220). Conclusions: The optimal structural equation model for ELP prediction in each group varied according to AL. Conditional process analysis can be an alternative to conventional multiple linear regression analysis in ELP prediction. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Cataract Surgery)
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9 pages, 825 KiB  
Article
Development of a New Method for Calculating Intraocular Lens Power after Myopic Laser In Situ Keratomileusis by Combining the Anterior–Posterior Ratio of the Corneal Radius of the Curvature with the Double-K Method
by Yoshihiko Iida, Kimiya Shimizu and Nobuyuki Shoji
J. Clin. Med. 2022, 11(3), 522; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11030522 - 20 Jan 2022
Cited by 4 | Viewed by 1921
Abstract
Background: A new method, the Iida–Shimizu–Shoji (ISS) method, is proposed for calculating intraocular lens (IOL) power that combines the anterior–posterior ratio of the corneal radius of the curvature after laser in situ keratomileusis (LASIK) and to compare the predictability of the method with [...] Read more.
Background: A new method, the Iida–Shimizu–Shoji (ISS) method, is proposed for calculating intraocular lens (IOL) power that combines the anterior–posterior ratio of the corneal radius of the curvature after laser in situ keratomileusis (LASIK) and to compare the predictability of the method with that of other IOL formulas after LASIK. Methods: The estimated corneal power before LASIK (Kpre) in the double-K method was 43.86 D according to the American Society of Cataract and Refractive Surgery calculator, and the K readings of the IOL master were used as the K values after LASIK (Kpost). The factor for correcting the target refractive value (correcting factor [C-factor]) was calculated from the correlation between the anterior–posterior ratio of the corneal radius of the curvature and the refractive error obtained using this method for 30 eyes of 30 patients. Results: Fifty-nine eyes of 59 patients were included. The mean values of the numerical and absolute prediction errors obtained using the ISS method were −0.02 ± 0.45 diopter (D) and 0.35 ± 0.27 D, respectively. The prediction errors using the ISS method were within ±0.25, ±0.50, and ±1.00 D in 49.2%, 76.3%, and 96.6% of the eyes, respectively. The predictability of the ISS method was comparable to or better than some of the other formulas. Conclusions: The ISS method is useful for calculating the IOL power in eyes treated with cataract surgery after LASIK. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Cataract Surgery)
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16 pages, 2945 KiB  
Article
Proteomic Analysis of Aqueous Humor Proteins in Association with Cataract Risks: Diabetes and Smoking
by Wei-Cheng Chang, Cho-Hao Lee, Shih-Hwa Chiou, Chen-Chung Liao and Chao-Wen Cheng
J. Clin. Med. 2021, 10(24), 5731; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm10245731 - 07 Dec 2021
Cited by 2 | Viewed by 2146
Abstract
Cataracts are one of the most common eye diseases that can cause blindness. Discovering susceptibility factors in the proteome that contribute to cataract development would be helpful in gaining new insights in the molecular mechanisms of the cataract process. We used label-free nanoflow [...] Read more.
Cataracts are one of the most common eye diseases that can cause blindness. Discovering susceptibility factors in the proteome that contribute to cataract development would be helpful in gaining new insights in the molecular mechanisms of the cataract process. We used label-free nanoflow ultra-high-performance liquid chromatography–tandem mass spectrometry to compare aqueous humor protein expressions in cataract patients with different cataract risk factors such as diabetes mellitus (DM) and smoking and in controls (with cataract) without risk exposure. Eight patients with diabetes and who smoked (with double risk factors), five patients with diabetes and five patients who smoked (both with a single risk factor), and nine aged-matched cataract controls patients (non-risk exposure) were enrolled. In total, 136 aqueous humor proteins were identified, of which only alpha-2-Heremans–Schmid (HS)-glycoprotein was considered to be significantly risk-associated because it was differentially expressed in these three groups and exhibited increased expression with increasing risk factors. Significant changes in the aqueous humor level of alpha-2-HS-glycoprotein between DM and control samples and between smoking and control samples were confirmed using ELISA. The alpha-2-HS-glycoprotein, called fetuin-a, could be a potential aqueous biomarker associated with DM and smoking, which were cataract risk factors. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Cataract Surgery)
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Review

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13 pages, 569 KiB  
Review
Intraoperative Anterior Segment Optical Coherence Tomography in the Management of Cataract Surgery: State of the Art
by Mario Damiano Toro, Serena Milan, Daniele Tognetto, Robert Rejdak, Ciro Costagliola, Sandrine Anne Zweifel, Chiara Posarelli, Michele Figus, Magdalena Rejdak, Teresio Avitabile, Adriano Carnevali and Rosa Giglio
J. Clin. Med. 2022, 11(13), 3867; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11133867 - 04 Jul 2022
Cited by 4 | Viewed by 1495
Abstract
Background: The introduction of non-invasive diagnostic tools in ophthalmology has significantly reshaped current clinical practice in different settings. Recently, different anterior segment (AS) intraoperative optical coherence tomography (i-OCT) systems have been employed for different interventional procedures including cataract surgery. Materials and Methods: A [...] Read more.
Background: The introduction of non-invasive diagnostic tools in ophthalmology has significantly reshaped current clinical practice in different settings. Recently, different anterior segment (AS) intraoperative optical coherence tomography (i-OCT) systems have been employed for different interventional procedures including cataract surgery. Materials and Methods: A review on the use of AS i-OCT in the management of cataract surgery, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines (PRISMA). The level of evidence according to the Oxford Centre for Evidence-Based Medicine (OCEM) 2011 guidelines, and the quality of evidence according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system were assessed for all included articles. Results: Out of 6302 articles initially extracted, 6302 abstracts were identified for screening and 32 of these met the inclusion/exclusion criteria for full-text review; 19 articles were excluded. Conclusions: The use of AS i-OCT in cataract surgery, even if only a few studies have a high level or grade of evidence, may represent a useful tool for novel surgeons approaching phacoemulsification but also for expert ones for teaching purposes and to plan and manage complicated cases. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Cataract Surgery)
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Other

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2 pages, 180 KiB  
Reply
Reply to Cione et al. Comment on “Moshirfar et al. Accuracy of Six Intraocular Lens Power Calculations in Eyes with Axial Lengths Greater than 28.0 mm. J. Clin. Med. 2022, 11, 5947”
by Majid Moshirfar, Kathryn M. Durnford, Jenna L. Jensen, Daniel P. Beesley, Telyn S. Peterson, Ines M. Darquea, Yasmyne Castillo Ronquillo and Phillip C. Hoopes
J. Clin. Med. 2023, 12(9), 3268; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12093268 - 04 May 2023
Viewed by 526
Abstract
We thank Cioni et al. for their suggestions and comments [...] Full article
(This article belongs to the Special Issue Current Challenges and Advances in Cataract Surgery)
2 pages, 180 KiB  
Comment
Comment on Moshirfar et al. Accuracy of Six Intraocular Lens Power Calculations in Eyes with Axial Lengths Greater than 28.0 mm. J. Clin. Med. 2022, 11, 5947
by Ferdinando Cione, Margherita Di Stasi and Ciro Sannino
J. Clin. Med. 2023, 12(8), 2911; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm12082911 - 17 Apr 2023
Cited by 2 | Viewed by 537
Abstract
With great interest, we read the article by Moshirfar et al. [...] Full article
(This article belongs to the Special Issue Current Challenges and Advances in Cataract Surgery)
3 pages, 187 KiB  
Reply
Reply to Cione et al. Comment on “Iida et al. Development of a New Method for Calculating Intraocular Lens Power after Myopic Laser In Situ Keratomileusis by Combining the Anterior–Posterior Ratio of the Corneal Radius of the Curvature with the Double-K Method. J. Clin. Med. 2022, 11, 522”
by Yoshihiko Iida, Kimiya Shimizu and Nobuyuki Shoji
J. Clin. Med. 2022, 11(10), 2708; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11102708 - 11 May 2022
Cited by 1 | Viewed by 763
Abstract
We appreciate the insightful comments [...] Full article
(This article belongs to the Special Issue Current Challenges and Advances in Cataract Surgery)
5 pages, 783 KiB  
Brief Report
Facilitating Role of the 3D Viewing System in Tilted Microscope Positions for Cataract Surgery in Patients Unable to Lie Flat
by Otman Sandali, Rachid Tahiri Joutei Hassani, Ashraf Armia Balamoun, Mohamed El Sanharawi and Vincent Borderie
J. Clin. Med. 2022, 11(7), 1865; https://0-doi-org.brum.beds.ac.uk/10.3390/jcm11071865 - 28 Mar 2022
Cited by 4 | Viewed by 1237
Abstract
Purpose: To assess the utility of the 3D viewing system in tilted microscope positions for the performance of cataract surgery in challenging positions, for patients with difficulty remaining supine. Methods: Prospective, single-center, single-surgeon, consecutive case series of patients undergoing surgery in an inclined [...] Read more.
Purpose: To assess the utility of the 3D viewing system in tilted microscope positions for the performance of cataract surgery in challenging positions, for patients with difficulty remaining supine. Methods: Prospective, single-center, single-surgeon, consecutive case series of patients undergoing surgery in an inclined position. Results: 21 eyes of 15 patients who had undergone surgery at inclined positions at angles of 20° to 80°, with a mean angle of 47.62°. Surgeon comfort was considered to be globally good. The surgeon rated red reflex perception and the impression of depth as good and stable in all cases. The operating time was slightly longer for patients inclined at angles of more than 50°. On the first day after surgery, BSCVA was 20/25 or better in all cases. No ocular complications occurred in any of the interventions. Conclusions: Due to the ocular-free design of the 3D system, the surgical procedure and the positioning of the surgeon remained almost identical to that for patients undergoing surgery in a supine position, maintaining the safety of the standard surgical approach. Full article
(This article belongs to the Special Issue Current Challenges and Advances in Cataract Surgery)
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