JCRS HIGHLIGHTS

Cost efficacy of same-day bilateral surgery

Same-day bilateral cataract surgery can provide both visual and economic benefits, suggest the results of a new prospective controlled non-randomised clinical trial. The trial compared the outcomes of 42 same-day patients and a matched set of separate-day bilateral surgery. Benefits for same-day patients included less travel time, fewer office visits and quicker visual recovery. Overall reimbursement for physician and the ambulatory surgical centre were lower for the same-day cohort, while physician time was the same for both groups. SW Rush et al, JCRS, “Prospective analysis of outcomes and economic factors of same-day bilateral cataract surgery in the United States”, Volume 41, Issue 4, 732-739.

Cataract and herpes zoster

Cataract surgery in eyes with previous herpes zoster ophthalmicus can be compromised by a number of chronic factors, a recent review indicates. The study evaluated 24 eyes with a history of herpes zoster ophthalmicus that had undergone phacoemulsification and intraocular lens (IOL) implantation. The mean CDVA improved from 20/112 preoperatively to 20/53 at one month postoperatively, improved to 20/44 at one year, but decreased to 20/71 at later visits. Eleven patients (45.8 per cent) had recurrent keratouveitis after the first episode, five before cataract surgery and six after cataract surgery. Three had penetrating keratoplasty for worsening corneal opacification. Two patients had tractional retinal detachment from chronic uveitis and required vitrectomy and retinal repair. Y He et al, JCRS, “Outcomes of cataract surgery in eyes with previous herpes zoster ophthalmicus”, Volume 41, Issue 4, 771-777.

Corneal asphericity

Does anterior corneal surface asphericity affect the refractive outcomes in eyes having intraocular lens implantation after cataract surgery? Italian researchers believe so, suggesting that third-generation IOL power formulas be used to factor this in. Prior to surgery, IOL power was calculated using the Haigis, Hoffer Q, Holladay 1 and SRK/T formulas in 115 eyes. Asphericity (Q-value) was measured at 8.0mm with a Placido-disk corneal topographer (Keratron), a rotating Scheimpflug camera (Pentacam) and a rotating Scheimpflug camera combined with Placido-disk corneal topography (Sirius). All eyes received an Acrysof SA60AT IOL. Regression analysis showed a statistically significant relationship between the error in refraction prediction and the Q-value with all formulas and all devices. In all cases, a more negative Q-value (prolate cornea) was associated with a myopic outcome, whereas a more positive Q-value (oblate cornea) was associated with a hyperopic outcome. The researchers call for formulas to be updated. G Savini et al, JCRS, “Influence of corneal asphericity on the refractive outcome of intraocular lens implantation in cataract surgery”, Volume 41, Issue 4, 785-789.