JCRS

Long-term ReLEX results

Femtosecond laser-assisted refractive lenticule extraction (ReLEx-FLEx) is a new treatment for myopia and myopic astigmatism. It uses the femtosecond laser to create a flap and with a second lamellar interface, a refractive lenticule for removal of corneal tissue. It has developed further and uses the laser to create just a lenticule (without a flap), which is removed through a small incision. German researchers report five-year follow-up results of a prospective clinical trial of refractive lenticule extraction. All 41 of the 108 eyes available for follow-up were within 1 D of the intended correction and 73 per cent were within ±0.50 D. No eye had lost two or more Snellen lines. One eye had lost one Snellen line. The mean regression was 0.07 D. “Several long-term studies have been published and provide evidence to support the hypothesis that the refractive lenticule extraction technique is a viable alternative treatment,” notes T Kohnen in an editorial. M Blum et al., JCRS, “Five-year results of refractive lenticule extraction”, Volume 40, Issue 9, 1425-29.

New reading evaluation tool

An electronic reading desk (Salzburg Reading Desk-Advanced) was developed to measure different aspects of reading performance under standardised conditions. Contrast and luminance levels can be preset by the examiner, and reading distance, reading acuity and reading speed are measured continuously and automatically during the examination. Any logarithmically scaled reading chart can be used in this setup. A new study compares the utility of this test with conventional methods. The first part of the study evaluated 100 eyes of 50 pseudophakic patients. Differences between the electronic reading desk and the printed version were small and not significant for reading speed, distance and print size. A second study found that reading acuity and the smallest possible read print size decreased with lower contrast and reduced luminance, whereas reading distance and reading speed did not change significantly. The researchers believe the new test could be useful for standardising results in clinical trials. N Hirnschall et al., JCRS, “Evaluation of an electronic reading desk to measure reading acuity in pseudophakic patients”, Volume 40, Issue 9, 1462-68.

Sulcus-fixated IOL exchange

Negative dysphotopsia following cataract surgery and IOL implantation can produce very unhappy patients. A new prospective study recruited patients who had developed this complication and subsequently underwent IOL exchange. Five eyes of five women with negative dysphotopsia were treated with IOL exchange and replacement with a 3-piece IOL (AcrySof MA60AC) inserted in the ciliary sulcus. The negative dysphotopsia resolved in all patients. One patient had primary insertion of a sulcus IOL in the fellow eye and did not develop negative dysphotopsia symptoms. T burke et al., JCRS, “Sulcus-fixated intraocular lens implantation for the management of negative dysphotopsia”, Volume 40, Issue 9, 1469-72.