Clinical Characteristics of Rhinogenic Optic Neuropathy Associated with Paranasal Sinus Disease

Purpose@#We describe the clinical features of patients with rhinogenic optic neuropathy caused by paranasal sinus disease. @*Methods@#Nine patients (11 eyes) diagnosed with rhinogenic optic neuropathy were retrospectively reviewed. All exhibited sphenoid or posterior ethmoid sinus lesions on magnetic resonance imaging and corresponding visual acuity or visual field defects. Patients with other causes of optic neuropathy were excluded. We recorded symptoms and symptom durations, best-corrected visual acuity, relative afferent pupillary defects, color vision test results, fundus morphology, optical coherence tomographic data, and visual field test results before and after endoscopic sinus surgery. @*Results@#The involved sinuses were the sphenoid alone (five eyes), posterior ethmoid alone (two eyes), and both (four eyes). The underlying sinus pathologies included six eyes with sinusitis and three with mucoceles. The best-corrected visual acuity exceeded 20/40 for nine eyes, the color vision test results were normal for all eyes, and relative afferent pupillary defects were noted in three eyes of unilaterally affected patients. The Humphrey visual field test revealed paracentral scotomas (three eyes, 27.3%), nasal defects related to the vertical meridian (three eyes, 27.3%), arcuate defects (two eyes, 18.2%), and a horizontal altitudinal defect (one eye, 9.1%). Six patients underwent endoscopic sinus surgery. Three patients who underwent early interventions (within 4 weeks of onset) experienced full visual recovery. @*Conclusions@#In patients with suspected optic neuropathy, a paranasal sinus lesion adjacent to the optic canal should be considered. Prompt diagnosis and early intervention (endoscopic sinus surgery) are recommended for patients with rhinogenic optic neuropathy to reduce the incidences of visual loss and visual field defects.

Clinical Characteristics of Rhinogenic Optic Neuropathy Associated with Paranasal Sinus Disease

Purpose@#We describe the clinical features of patients with rhinogenic optic neuropathy caused by paranasal sinus disease. @*Methods@#Nine patients (11 eyes) diagnosed with rhinogenic optic neuropathy were retrospectively reviewed. All exhibited sphenoid or posterior ethmoid sinus lesions on magnetic resonance imaging and corresponding visual acuity or visual field defects. Patients with other causes of optic neuropathy were excluded. We recorded symptoms and symptom durations, best-corrected visual acuity, relative afferent pupillary defects, color vision test results, fundus morphology, optical coherence tomographic data, and visual field test results before and after endoscopic sinus surgery. @*Results@#The involved sinuses were the sphenoid alone (five eyes), posterior ethmoid alone (two eyes), and both (four eyes). The underlying sinus pathologies included six eyes with sinusitis and three with mucoceles. The best-corrected visual acuity exceeded 20/40 for nine eyes, the color vision test results were normal for all eyes, and relative afferent pupillary defects were noted in three eyes of unilaterally affected patients. The Humphrey visual field test revealed paracentral scotomas (three eyes, 27.3%), nasal defects related to the vertical meridian (three eyes, 27.3%), arcuate defects (two eyes, 18.2%), and a horizontal altitudinal defect (one eye, 9.1%). Six patients underwent endoscopic sinus surgery. Three patients who underwent early interventions (within 4 weeks of onset) experienced full visual recovery. @*Conclusions@#In patients with suspected optic neuropathy, a paranasal sinus lesion adjacent to the optic canal should be considered. Prompt diagnosis and early intervention (endoscopic sinus surgery) are recommended for patients with rhinogenic optic neuropathy to reduce the incidences of visual loss and visual field defects.

Current Management of Childhood Amblyopia

Amblyopia is defined as the reduction of best-corrected visual acuity of one or both eyes caused by conditions that affect normal visual development. The basic strategy to treat amblyopia is to obtain a clear retinal image in each eye and correct ocular dominance through forced use of the amblyopic eye. Treatment modalities include correcting any underlying organic disease, prescribing appropriate optical correction, and providing occlusion/penalization therapy for the non-amblyopic eye. Given the success of amblyopia treatment declines with increasing age, the detection and management of amblyopia should begin as early as possible during the sensitive period for visual development. Proper management of amblyopia during childhood can reduce the overall prevalence and severity of visual loss. This study aims to provide an update for the management of childhood amblyopia to provide better visual outcomes.

Serial Photographic Monitoring of Spontaneous Clearance of Corneal Blood Stain in a Child with Traumatic Hyphema

No abstract available.

Astigmatic Analysis before and after Surgical Excision of Limbal Dermoid: Functional Outcome

PURPOSE: To analyze the length and area of limbal dermoid invading the cornea and to evaluate the effects on visual acuity and astigmatism before and after surgery. METHODS: This retrospective study included 20 eyes of 20 patients who underwent surgical removal of limbal dermoid. The preoperative and postoperative visual acuity and astigmatism level were measured. In addition, we evaluated the correlations of astigmatism with the length ratio (length of limbal dermoid invading the cornea/total corneal diameter), width ratio (width of limbal dermoid invading the cornea/total corneal diameter), and area ratio (area of limbal dermoid invading the cornea/total corneal area) using preoperative anterior segment photographs. RESULTS: The mean preoperative astigmatism was 0.85 ± 0.71 D in the sound eye and 3.00 ± 3.14 D in the affected eye (p = 0.004). Length, width, and area ratio of limbal dermoid have positive correlation with astigmatism (p < 0.010 for all variables), with a larger length ratio of limbal dermoid invading the cornea producing greater reduction in postoperative astigmatism (p = 0.010, r = 0.816). The amount of astigmatism was significantly higher in patients with amblyopia in the affected eye (p = 0.030). Visual acuity gain more than 2 lines was achieved in 8 among 10 patients with amblyopia under the age of 7 years through the appropriate refractive correction and occlusion 1 year after surgery. CONCLUSIONS: Astigmatism is a major cause of amblyopia in pediatric patients with limbal dermoid. The degree of astigmatism can be predicted by the size factors of the limbal dermoid. In particular, the relative length of limbal dermoid invading the cornea has a stronger correlation with preoperative astigmatism than other factors and has correlation with postoperative reduction of astigmatism. It should be emphasized that children with limbal dermoid need appropriate refractive correction and occlusion in addition to surgical excision.

Clinical Features of Patients over the Age of 60 Years Who Have Undergone Strabismus Surgery

PURPOSE: In recent years, there has been an increase in the number of strabismus operations performed on patients aged 60 years and over. This study aims to establish the characteristics and outcomes of old age strabismus. METHODS: Patients aged 60 years and over who underwent strabismus surgery between January 2011 and December 2015 were included in this study. The purpose of surgery, type of strabismus, etiology, postoperative recurrence, prevalence of general and ocular complications, and postoperative diplopia rate were reviewed. RESULTS: Ninety-eight patients aged 60 years or older were identified, and 58.2% of patients had strabismus surgery to improve diplopia, while 41.8% chose surgery for cosmetic purposes. Esotropia was the most common type of strabismus found in 40.8% of the patients, and horizontal-vertical combined type was the second highest at 29.6%. The etiology of strabismus was similarly high in both the restrictive pattern (31.6%) and neuro-paralytic pattern (30.6%). The recurrence rate after strabismus surgery was 4.1%, and the reoperation rate was 3.1%. The remnant diplopia rate after surgery in patients with diplopia was 15.8%, and the diplopia occurring rate in patients who underwent surgery for cosmetic purposes was 4.9%. No severe ocular complications such as anterior segment syndrome or eyeball rupture occurred. Anesthesia related problems did not occur in any of the patients who underwent general anesthesia. CONCLUSIONS: Strabismus in patients aged 60 years and over is an effective and safe way to improve diplopia and cosmetic status by restoring ocular alignment.

Prevalence and Factors Associated with the Use of Eye Care Services in South Korea: Korea National Health and Nutrition Examination Survey 2010–2012

PURPOSE: To estimate the factors and prevalence of eye care service utilization in the South Korean population. METHODS: This cross-sectional, population-based study included data from 22,550 Koreans aged ≥5 years who participated in the Korea National Health and Nutrition Examination Survey from 2010 to 2012. For people aged 5 to 11 years (young children), information was based on self-reports of contact with eye care service in the past year; for people aged ≥12 years (older population), the information was based on the self-reported lifetime contact with eye care service. Univariate and multivariate logistic regression analyses of the complex sample survey data were performed. RESULTS: The prevalence of eye care service use in young children during the past year was 61.1% (95% confidence interval, 58.1%–64.1%), while that in the older population during their lifetime was 73.5%. Subjects aged 7 to 11 years were more likely to have had an eye examination in the past year than subjects aged 5 to 6 years (odds ratio, 3.83; 95% confidence interval, 2.37–6.19). Multivariate logistic regression analysis indicated that higher monthly household income, being a National Health Insurance holder, and having private health insurance were related to more frequent use of eye care services in young children. For the older population and women, those living in an urban area and those with a best-corrected visual acuity less than 20 / 40 in the worse-seeing eye were more likely to have had an eye examination during their lifetime. Low education level was associated with low lifetime use of eye care services in the older population. CONCLUSIONS: There are sociodemographic disparities with use of eye care services in South Korea. This population-based study provides information that is useful for determining different intervention programs based on sociodemographic disparities to promote eye care service utilization in South Korea.

Identification of a Fibrillin-1 Gene Mutation in a Monozygotic Twin Presenting with Bilateral Juvenile-onset Ectopia Lentis

No abstract available.

The Effect of Colored Filters in Patients with Meares-Irlen Syndrome

PURPOSE: To evaluate the benefit of colored filters in Meares-Irlen Syndrome patients with reading difficulties. METHODS: Twenty-five patients were selected through a brief questionnaire aimed to determine symptoms of eyestrain or visual distortion after thorough eye examinations. The cutoff value of the questionnaire was 2.13. The rates of Korean reading and writing were measured using the RWSM (Reading Writing Speed Meter) test with and without the use of colored filters. Two months after wearing the individually prescribed colored filters, a questionnaire on the patient's subjective satisfaction with the colored filters were completed and evaluated. RESULTS: The blue (n = 8, 32%) and gray (n = 4, 16%) colors were the most frequently selected filters. The mean score of the questionnaire on reading difficulties was 2.72. The mean reading rate improved from 82.72 wpm (words per minute) to 101.84 wpm with the colored filters, a statistically significant change (p = 0.019). The mean writing rate did not improve. The overall satisfaction score with the colored lenses was 3.6, with the highest score given to ease of reading (4.08) and the lowest to writing (2.92). CONCLUSIONS: In cases of reading difficulty, colored filters were effective for alleviating visual symptoms and improving reading speed. It is important to achieve an adequate understanding of the specific symptoms of Meares-Irlen Syndrome and to perform a thorough eye examination to differentiate this from other ocular disorders.

The Changes in the Cornea and Anterior Chamber after Lateral Rectus Muscle Recession in Intermittent Extropia

PURPOSE: To investigate changes in corneal keratometry and the anterior chamber in intermittent exotropia after lateral rectus recession using Pentacam. METHODS: Corneal keratometry, anterior chamber depth, and anterior chamber volumes were evaluated preoperatively and at 1 week, 1 month, and 2 months postoperatively using Pentacam in 20 patients (40 eyes) who underwent lateral rectus muscle recession. The IOP was measured before and after lateral rectus muscle detachment during the surgery. According to the change in IOP, the patients were divided into 2 groups; Group 1 (DeltaIOP or = 3 mm Hg), and the results of the 2 groups were compared. RESULTS: The horizontal keratometry and anterior chamber volumes significantly decreased 1 week postoperatively, although there were no significant differences in vertical keratometry, mean keratometry, or anterior chamber depth. Additionally, there were no significant changes in any measurement parameters at 1 month or 2 months postoperatively. In Group 2, horizontal keratometry, mean keratometry, and anterior chamber volumes showed significant reduction compared with those in Group 1. There were no significant differences between the 2 groups at 1 month postoperatively. CONCLUSIONS: Postoperative corneal keratometry and anterior chamber volumes did not change significantly compared to preoperative values in intermittent exotropia after performing lateral rectus muscle recession. However, the higher the ocular muscle tension, the greater were the changes in corneal astigmatism and anterior volumes.

Clinical Findings and Results of Low Vision Devices in Pediatric Patients with Albinism

PURPOSE: To assess clinical features and efficacy of spectacles and low vision devices in pediatric patients with albinism. METHODS: A retrospective study was performed of 15 pediatric patients with albinism for whom glasses and low vision devices had been prescribed to determine subjective satisfaction and objective improvement in visual acuity (VA), strabismus, contrast sensitivity, number of reading letters during 1 minute with refractive correction and low vision devices. RESULTS: The median refractive correction was +0.12 +/- 5.45 diopter (D) spherical equivalent with -0.71 +/- 3.62 D astigmatism. Most patients complained of reading difficulty and photophobia. Hand-held magnifier and Keplerian telescope were commonly prescribed low vision devices. In addition, VA, strabismic deviation, contrast sensitivity and number of reading letters during 1 minute significantly improved after wearing glasses and low vision devices. CONCLUSIONS: The present study showed a significant improvement in corrected VA, alignment and subjective symptoms in pediatric patients with albinism by wearing glasses and low vision devices. Additionally, high compliance can improve final patients' satisfaction through using training of low vision devices.

Clinical Features of Korean Patients with Congenital Aniridia

PURPOSE: To investigate the clinical features of Korean patients with congenital aniridia. METHODS: This retrospective study focused on 60 eyes from 31 patients who were diagnosed with congenital aniridia at Kangnam St. Mary's Hospital from 1996 to 2007. Patient age, gender, visual acuity (VA), family history, and previous ocular history were recorded. The presence of keratopathy, glaucoma, cataract, foveal hypoplasia, and other ocular or systemic anomalies were evaluated for each patient. RESULTS: The proportion of sporadic cases was 29.0%. Cataract (82.5%), glaucoma (51.6%), keratopathy (71.6%), and foveal hypoplasia (81.8%) commonly accompanied aniridia. Thirty-four (60.7%) eyes had VAs less than 20/200 and 20 eyes (35.7%) had VAs between 20/200 and 20/60. In patients without a past history of ocular surgery, the mean central corneal thickness was 643.05 +/- 37.67 microm and the mean endothelial cell count was 3,349.44 +/- 408.17 cells/mm2. Ocular surface surgeries were performed in 6 eyes. The clarity of the transplanted corneal graft vanished in 5 eyes with the progression of peripheral neovascularization and subepithelial fibrosis. The mean age of cataract surgery in 8 eyes was 29.8 +/- 5.9 years. Postoperative worsening of corneal clouding and glaucomatous damage were observed in 4 eyes. Two infants had bilateral congenital glaucoma. Two children with sporadic aniridia were identified to have Wilm's tumors. CONCLUSIONS: Congenital aniridia is a progressive congenital disorder that is commonly accompanied by complications that can lead to impaired vision. Regular, careful examinations for these accompanying complications should be performed in all patients with congenital aniridia.

Comparison of Keratometric Values Measured by the Handheld Autokeratometer, On-table Autokeratometer and Manual Keratometer

PURPOSE: To compare the keratometry measurements by the handheld Nikon Retinomax K-plus2, the on-table Canon RK-5 autokeratometer, and the manual Topcon OM-4 keratometer and to evaluate the degree of agreement among the three instruments. METHODS: Adults (n=30) and children (n=40) presenting toa tertiary eye hospital clinic were examined by an optometrist. Topcon OM-4 keratometer, Nikon Retinomax and the on-table Canon RK-5 autokeratometer analyses were performed in order. The horizontal and vertical keratometry data were measured. The vector components of astigmatism, mean bias and agreement among the three types of measurements were evaluated. RESULTS: There were no significant differences among the three keratometers in horizontal or vertical keratometry or in central corneal astigmatism in both the adult and child groups (p-value>0.05). The keratometers which were estimated with Retinomax K-plus2 were highly correlated with those by on-table RK-5 autokeratometer (min. 0.89, max. 0.97) and Topcon OM-4 keratometer (min. 0.67, max. 0.94) in the adult group, while in the child group, the three instruments showed slightly decreased correlation (min. 0.45, max. 0.97 on RK-5, min. 0.36, max. 0.92 on OM-4), especially in the left eyes. CONCLUSIONS: The handheld Retinomax K-plus2 provided comparable data to that of the conventional on-table Topcon and manual keratometers. This instrument will beuseful in the clinic to measure keratometry in children or immobilized patients who have difficulty sitting during the examination.

Multiple Myeloma Manifesting as a Fluctuating Sixth Nerve Palsy

We report a case of multiple myeloma that presented as a fluctuating sixth cranial nerve palsy in the absence of widespread signs of systemic disease. A 63-year-old woman presented with horizontal diplopia of two weeks duration that subjectively changed over time. Ocular examination showed a fluctuating sixth nerve palsy. A computed tomography (CT) scan of the brain showed multiple, enhancing, soft tissue, mass-like lesions involving the left cavernous sinus and the apex of both petrous bones. Based on bone marrow biopsy and hematologic findings, she was diagnosed with multiple myeloma. Multiple myeloma may be included in the differential diagnosis of a fluctuating sixth nerve palsy, and although ophthalmic signs are rare and generally occur late in the course of multiple myeloma, they can still be its first signs.

Consecutive Exotropia After Bilateral Medial Rectus Recession for Infantile Esotropia

PURPOSE: To evaluate associated factors by comparing the patients with consecutive exotropia to the patients with orthophoria after undergoing surgery for infantile esotropia. METHODS: The study consisted of 50 patients who underwent bilateral medial rectus recession and attended follow-ups until eight years of age. The authors retrospectively investigated the clinical characteristics ofage at operation, duration between diagnosis and operation, the spherical equivalent of both eyes, the deviated angle at the first visit and immediately before the operation, the recession amount, and the total follow-up period. RESULTS: During the mean follow-up period of 78.51+/-54.70 months, 13 patients (26%) had consecutive exotropia, 27 patients (54%) had orthophoria and 10 patients (20%) had remnant esotropia. As the result of comparing orthophoric patients to consecutive exotropic patients, there were no significant differences in the birth weights, the deviated angles at the first visit and immediately before the operation, the spherical equivalents of both eyes, the ages at operation, the recession amounts, and the durations between diagnosis and operation. However, in consecutive exotropia, inferior oblique muscle overaction was 46.5%, dissociated vertical deviation was 46.5% in orthophoric patients, inferior oblique muscle overaction was 19.24%, and dissociated vertical deviation was 8.7%. CONCLUSIONS: A thorough follow-up is necessary when inferior oblique muscle overaction and dissociated vertical deviation occur after undergoing a bilateral medial rectus operation.

The First Survey Report on the Current Trends in Prescription of Orthokeratologic Lenses in Korea

PURPOSE: To investigate the current trends in the prescription of orthokeratologic lenses in Korea. METHODS: We sent out an online survey to the members of the Korean ophthalmological Society in December 2007 and March 2008. We received responses from 139 ophthalmologists and analyzed the results of each question. RESULTS: Easy fitting (34.5%) was selected as a major factor in the selection of orthokeratologic lenses. Children between the ages of 10 and 15 years with myopia less than 5 diopter, astigmatism less than 1.5 diopter, and 42 to 45-diopter keratometric value were preferred by most respondents. Decentration (n=74, 59%), corneal erosion (n=35, 25.2%), undercorrection (n=18, 12.9%), and allergy (n=11, 7.9%) were the most frequently encountered problems. 54.7% (n=76) of respondents needed to be fitted twice for trial lenses. The time required for the lens prescription in one patient was more than 30 minutes in 83.5% (n=116) of respondents. 59.7% of the respondents agreed that the lenses had an inhibitory potential on myopic progression, and 81.3% of the respondents said that orthokeratology could substitute for refractive surgery. CONCLUSIONS: There is a possibility of future growth in the use of orthokeratology. It is necessary to provide guidelines and teaching programs for the safe and effective fitting of orthokeratologic lenses.

Comparison Between Bimanual Microincisional Cataract Surgery and Conventional Coaxial Phacoemulsification

PURPOSE: To evaluate corneal endothelial cell changes after conventional coaxial phacoemulsification and bimanual microincision cataract surgery (MICS). METHODS: Forty patients were divided into 2 groups, coaxial phacoemulsification (Group 1, n=20), and MICS (Group 2, n=20). To evaluate corneal endothelial cell changes after coaxial phacoemulsification and bimanual MICS, intraoperative phacoemulsification power and volume of intraoperative irrigation solution (balanced salt solution, BSS(R), Alcon, U.S.A) were measured. Central corneal thickness and endothelial cell count were also evaluated, preoperatively and at 1 week, and 2 months postoperatively. RESULTS: Between the 2 groups, there was no statistically significant difference in intraoperative phacoemulsification power and volume of intraoperative irrigation solution (balanced salt solution, BSS(R), Alcon, U.S.A.) (p>0.05). In addition, there was no statistically significant difference between the 2 groups in endothelial cell count and central corneal thickness (p>0.05). CONCLUSIONS: When comparing bimanual MICS and conventional coaxial phacoemulsification, bimanual MICS appears to have similar endothelial cell changes. In conclusion, MICS has the same safety as compared to coaxial phacoemulsification.

Clinical Results of Rollable IOL Implantation After Bimanual Microincision Phacoemulsification

PURPOSE: To retrospectively evaluate the clinical results of insertion of a hydrophilic acrylic plate posterior chamber intraocular lens (ThinOptX) after bimanual microincision phacoemulsification. METHODS: Thirty-four eyes of 30 patients who underwent bimanual phacoemulsification and ThinOptX implantation through a 2.0 mm incision between July 2004 and May 2006 were followed-up for more than 12 months. We examined best corrected visual acuity (BCVA), refractive errors, corneal endothelial cell density, halo and contrast sensitivity, posterior capsule opacification (PCO), and intraoperative and postoperative complications. RESULTS: The preoperative mean logMAR BCVA was 0.43+/-0.24, and the postoperative BCVA was 0.04+/-0.09 after 6 months and 0.14+/-0.12 after 12 months. The preoperative corneal endothelial cell density was 2562+/-347.90 cells/mm2, and decreased to 2241+/-294.88 (cells/mm2) at 12 months postoperative. Postoperative contrast sensitivity at 6 months was increased in both photopic and mesopic condition. Halo was noted in all examined eyes. A PCO of 29% was evaluated at 6 months postoperative and a PCO of 52% was evaluated at 12 months postoperative. CONCLUSIONS: Bimanual phacoemulsification and ThinOptX implantation through a 2.0 mm incision resulted in good initial visual outcome and correction of refractive errors. However, problems such as halo and PCO associated with IOL design were noted. Therefore, further evaluation and correction of the IOL are needed.

Clinical Results and Some Problems of Multifocal Apodized Diffractive Intraocular Lens Implantation

PURPOSE: To evaluate near and far visual outcomes, subjective visual symptoms, and patient satisfaction with AcrySof(R) ReSTOR(R) diffractive multifocal intraocular lenses (IOL), and to study the reasons for postoperative dissatisfaction. METHODS: Twenty-three eyes of 19 patients received phacoemulsifications and implantation of AcrySof(R) ReSTOR(R) IOL. The main outcome measures, taken at postoperative 1 day, 1 week, 1 month, and 3 months, were uncorrected and corrected near and distant visual acuity, refractory errors, subjective visual symptoms (glare, halo, and night vision), and satisfaction. RESULTS: At the 3-month postoperative visit, the mean uncorrected near and distant visual acuities were 0.59+/-0.24 (0.25+/-0.22 LogMAR unit) and 0.78+/-0.27 (0.13+/-0.10 LogMAR unit), respectively. In addition, patients' satisfaction with uncorrected near vision, intermediate vision, far vision, and general visual performance were better than their satisfaction with night vision. Glare and halos were reported as severe by only 10.2% and 5.3% of patients, respectively. The seven eyes with poor patient satisfaction included eyes with a high incidence of preoperative ocular diseases or preoperative and postoperative high corneal astigmatisms of more than 1.0 diopter. CONCLUSIONS: The AcrySof(R) ReSTOR(R) IOL demonstrated good near and distant visual acuity with good patient satisfaction. Previous ocular disease, corneal astigmatism less than 1.0 diopter, and patient lifestyle should be considered to enhance patient satisfaction.

A Comparison of the Efficacy of Cataract Surgery Using Aqualase(R) with Phacoemulsification Using MicroFlow(R) System

PURPOSE: To compare the outcomes after phacoemulsification performed with the AquaLase(R) and phacoemulsification in MicroFlow(R) system, including surgically induced astigmatism (SIA), corneal endothelial cell damage and postoperative recovery of visual acuity. METHODS: The cataracts of Lens Opacities Classification System, version III (LOCS III) nuclear grade below 2 were subjected in this study. Nineteen eyes underwent cataract operation using AquaLase(R) (Alcon Laboratories, Fort Worth, Texas, U.S.A.). A control group (19 eyes) used the MicroFlow(R) system (Millenium, Stortz, U.S.A.) and was selected by matching age, sex, systemic disease, corneal astigmatism and corneal endothelial cell density. All the surgeries were performed by the same operator. SIA, corneal endothelial cell loss, visual acuity, and corneal thickness were evaluated postoperatively. RESULTS: SIA in the group using AquaLase(R) was less than that of the group using MicroFlow(R) system (P=0.022) at 2 months postoperatively. Evaluation of corneal endothelial cell loss, recovery of visual acuity and corneal thickness found no statistically significant differences between the two groups. CONCLUSIONS: Cataract surgery using AquaLase(R) induces less surgically induced astigmatism in mild to moderate cataracts.