JCRS February 2021
Intraocular lenses have undergone a remarkable evolution since first being imagined by Harold Ridley. The Journal of Cataract and Refractive Surgery, now celebrating its 25th anniversary, has reported developments in lens design for this period, and continues to do so today. Noted researchers Prof Liliana Werner, who began her career working with the legendary David Apple, discusses the long arc of IOL development in a special editorial. She also worked with Dr David Leaming, who she credits for his valuable annual practice surveys, which show how trends in lens design are adopted in the clinic. She explains how IOL designs have evolved to deal with problems such as posterior capsule opacification, glistenings, and potential UV light risk. She also discussed attempts to develop a lens for presbyopia treatment, including the recent development of extended depth of focus technology.
L Werner, “Intraocular lens evolution in the past 25 years as told by the Journal of Cataract and Refractive Surgery”, Vol. 47, #2, 147-149.
ESCRS INTRACAMERAL CEFUROXIME DEBATE
Appearing in the JCRS15 years ago, the ESCRS Intracameral cefuroxime study remains the single most important study of antibiotic prophylaxis for ophthalmic surgery, says guest editorialist Dr David Chang. Spearheaded by Dr Peter Barry in Dublin, the study (
J Cataract Refract Surg2006;32:407–410) continues to stir debate. In 2006 the common practice for intraoperative antibiotic prophylaxis was a topical approach. The study instead looked at using cefuroxime in an intracameral approach. The result was a remarkably low incidence of endophthalmitis. While initially met with some resistance, the use of intracameral prophylaxis has now been widely, but not universally, adopted.
DF Chang, “The ESCRS Intracameral cefuroxime study: the debate continues”,Vol. 47, #2, 150-152.
NEW ENHANCED MONOFOCAL IOL
The conventional monofocal IOLs effectively restore distance vision, but typically fall short at other distances. The TECNIS Eyhance IOL, Model ICB00 appears to be the first monofocal IOL to demonstrate an improvement in intermediate vision with comparable distance vision and photic phenomena as a standard monofocal IOL. Researchers report results from a multi-centre prospective randomised controlled study in which 139 patients received the new lens or the standard Tecnis ZCB00 monofocal IOL. At six months’ follow-up, patients receiving the enhanced IOL showed significantly better mean distance corrected and uncorrected intermediate visual acuity compared with those that received the standard lens. Distance vision, contrast sensitivity and photic effects were similar for the two groups. The investigators explain that the design of the new IOL resembles the standard lens in most ways but has a higher-order aspheric anterior surface. GU Auffarth,“Clinical evaluation of a new monofocal IOL with enhanced intermediate function in patients with cataract”, Vol. 47, #2, 184-191.
