Clinical and Aberrometric Evaluation of a New Monofocal IOL with Intermediate Vision Improvement.

Purpose: The aim of the study was to evaluate the visual outcomes, aberrometric results, and subjective and objective optical qualities 12 months after implantation of a new monofocal intraocular lens (Physiol IsoPure 1.2.3) in comparison with a standard monofocal intraocular lens (Tecnis PCB00). Materials and Methods: Cataract patients without ocular comorbidities had bilateral implantation of the IsoPure IOL or the PCB00 IOL. One month after eye surgery, the visual acuity and monocular defocus curve were assessed. Twelve months after surgery, the visual acuity, binocular defocus curve, contrast sensitivity, and subjective/objective optical quality were assessed. Furthermore, wavefront analysis was performed. The primary endpoint was the best distance correct/uncorrected visual acuity at intermediate and far distances. The secondary endpoint was an aberration evaluation of the IOLs and contrast sensitivity. Results: The study comprised a total of 42 patients (84 eyes). Monocular and binocular uncorrected and corrected distance were similar between groups, and uncorrected intermediate visual acuity was significantly higher in the IsoPure group. There was no difference in contrast sensitivity and subjective and objective optical qualities. The optical aberrations at 3.0 and 5.0 mm aperture diameters were similar in both groups. Conclusion: The IsoPure IOL, based on greater depth of focus than the aspheric monofocal IOL, may offer a good option for the distance and intermediate vision without increasing optical aberrations and any photic phenomena.

Intraocular Pressure Changes during Femtosecond Laser-Assisted Cataract Surgery: A Comparison between Two Different Patient Interfaces.

PURPOSE: The aim of this retrospective cohort study was to evaluate intraocular pressure (IOP) changes during femtosecond laser-assisted cataract surgery (FLACS) using two different 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 fluid 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 significant increase in IOP from the baseline was found in both groups (p < 0.001). Moreover, no statistically significant difference 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 effect of femtosecond laser itself.

Scanning Electron Microscopy Analysis of the Anterior Capsulotomy Edge: A Comparative Study between Femtosecond Laser-Assisted Capsulotomy and Manual Capsulorhexis.

PURPOSE: To compare the capsule edges ultrastructure obtained by two femtosecond laser-assisted cataract surgery (FLACS) platforms and manual continuous curvilinear capsulorhexis (CCC) using scanning electron microscopy (SEM). SETTING: Eye Clinic, University of Trieste, Italy. DESIGN: Experimental comparative study. METHODS: 150 anterior capsules were collected and divided into three groups as follows: Group 1 (50 capsules) obtained with manual CCC, Groups 2 and 3 (each with 50 capsules) obtained with the Catalys Laser and the LenSx Laser, respectively. All samples were imaged by means of SEM and regularity of the cut surface, and thickness of the capsule edge were evaluated and compared. RESULTS: All femtosecond laser (FSL) capsules were perfectly circular, whereas some alteration of the circular shape was observed in the manual ones. Group 1 showed a smooth and regular capsule edge without any surface irregularity, conversely Groups 2 and 3 showed postage-stamp perforations on the capsule edge. The cut surface irregularity value in Group 2 was 1.4 ± 0.63, while it was 0.7 ± 0.49 in Group 3 (p < 0.05). Group 1 had a significantly lower thickness of the capsule edge than the FSL groups (p < 0.05). No statistically significant difference in the capsule edge thickness between the FSL groups was found (p=0.244). CONCLUSIONS: Despite the presence of slight cut surface irregularities, both FSL capsulotomies showed a better geometry and circularity than the manual ones. Capsulotomy specimens obtained using both FSL capsulotomies showed laser-induced alterations of the capsule edge when compared with smooth and regular edges obtained using manual CCC.

Etiopathogenesis and therapy of epithelial ingrowth after Descemet's stripping automated endothelial keratoplasty.

Descemet's stripping endothelial keratoplasty is an emerging technique finalized to treat endothelial dysfunction replacing only the pathological portion of cornea. The advent of any new technique puts us in front of new complications. The epithelial ingrowth is a well-known complication already studied in case of ocular trauma and more recently in refractive surgery. This job analyzed the potential etiopathogenesis of epithelial ingrowth after DSAEK, reviewing the cases described in literature, and suggests the potential therapy.

Evaluation of the efficacy of 50% autologous serum eye drops in different ocular surface pathologies.

PURPOSE: This study evaluated the efficacy of 50% autologous serum eye drops in ocular surface diseases not improved by conventional therapy. METHODS: We analyzed two groups: (1) acute eye pathologies (e.g., chemical burns) and (2) chronic eye pathologies (e.g., recurrent corneal erosion, neurotropic keratitis, and keratoconjunctivitis sicca). The patients were treated for surface instability after conventional therapy. The patients received therapy 5 times a day until stabilization of the framework; they then reduced therapy to 3 times a day for at least 3 months. We analyzed the best corrected visual acuity, epithelial defects, inflammation, corneal opacity, and corneal neovascularization. We also analyzed symptoms such as tearing, burning, sense of foreign body or sand, photophobia, blurred vision, and difficulty opening the eyelids. RESULTS: We enrolled 15 eyes in group 1 and 11 eyes in group 2. The average therapy period was 16 ± 5.86 weeks in group 1 and 30.54 ± 20.33 weeks in group 2. The epithelial defects all resolved. Signs and symptoms improved in both groups. In group 2, the defect recurred after the suspension of therapy in 2 (18%) patients; in group 1, no defects recurred. CONCLUSIONS: Autologous serum eye drops effectively stabilize and improve signs and symptoms in eyes previously treated with conventional therapy.