A Decrease in Quality and Quantity of Vision

Surgeons discuss the next steps for a patient who has developed haze after a PRK enhancement.

Karl G. Stonecipher, MD; Michael D. Greenwood, MD; Mark A. Kontos, MD; William B. Trattler, MD; and Steven E. Wilson, MD

Cataract and Refractive Surgery Today

CASE PRESENTATION A 25-year-old woman is referred for a decrease in the quality and quantity of vision in her right eye. The patient’s history is significant for bilateral LASIK performed 4 years ago, followed by a PRK enhancement in the right eye only. Her BCVA is 20/25 OD with a manifest refraction of -0.25 D sphere and 20/20 OS with a plano manifest refraction. Her UCVA is 20/25 OD and 20/20 OS. Pachymetry is 409 µm OD. Grade 2 to 3 corneal haze is evident in the right eye (Figure 1). An analysis with the Pentacam (Oculus Optikgeräte) shows normal surface topography (Figure 2) but also reduced contrast sensitivity and haze in the right eye (Figure 3).

Nomograms to Predict Lens Vault

Efforts to avoid ICL exchange and explantation continue.

Tariq Mohammad, MBBS, PGCert, FRCOphth, and Artemis Matsou, MD, MRCP(UK), FEBO, PgDip CRS

Cataract and Refractive Surgery Today

Prediction of Implantable Collamer Lens Vault Based on Preoperative Biometric Factors and Lens Parameters Di Y, Li Y, Luo Y1Industry support: None ABSTRACT SUMMARY A retrospective study of 300 patients (300 eyes) who underwent implantation of a Visian ICL V4c (STAAR Surgical) analyzed a range of anterior segment parameters to correlate them with postoperative vault size. The goal was to establish and validate a predictive formula. Study in Brief A retrospective study analyzed a large sample of Chinese patients who underwent implantation of an ICL V4c (STAAR Surgical). The research aimed to establish and validate a formula to predict the postoperative ICL vault at 1 week by examining the correlation between preoperative anterior segment parameters and the actual vault achieved. WHY IT MATTERS Inappropriate vault is the most common reason for ICL exchange or explantation, especially in nonaverage eyes where the standard manufacturer’s calculator may fall short. This study provides surgeons with a predictive formula to refine the prediction of postoperative ICL vault. Patients were randomly and evenly divided into two groups: one for formula development and one for formula validation. Using the IOLMaster 700 (Carl Zeiss Meditec), investigators meticulously measured axial length, central corneal thickness, white-to-white distance, and lens thickness. Using anterior segment OCT, they measured anterior chamber depth (ACD), anterior chamber width, crystalline lens rise, angle-to-angle (ATA) distance, pupillary distance, angle open distance at 500 µm and 700 μm, trabecular iris space area at 500 µm and 700 μm, anterior chamber angle, and 1-week postoperative vault in the horizontal position. All measured parameters except crystalline lens rise positively correlated with the 1-week postoperative vault.

GA Options in Clinical Therapy, Part 2: Real-world Cases in GA

David RP Almeida, MD, PhD, MBA; Lisa Faia, MD; and Chris Riemann, MD

Eyetube

David RP Almeida, MD, PhD, MBA; Lisa Faia, MD; and Chris Riemann, MD, return for the second episode in this podcast miniseries, in which they review a trio of real-world GA cases, explore what early responses to treatment look like, and ask how to address GA in the presence of wet AMD.