JCRS highlights chosen by Professor Thomas Kohnen, European Editor, JCRS

ROTATIONALLY ASYMMETRIC MULTIFOCAL IOLS While rotationally asymmetric refractive multifocal intraocular lenses (IOLs) have been found to provide a good range of vision from near to intermediate to distance, there has been no consensus on the best choice for position and power of the near add reading segment. Researchers looked at this question in a retrospective comparative case series that compared the postoperative quality of vision between different bilateral placements of the near segments in these types of IOLs. The study of 180 patients (360 eyes) indicated that a combination of superotemporal placement of the near segment (+2.00D add) in the dominant eye with inferonasal placement of the near segment (+3.00D add) in the fellow eye yielded the most consistent, high overall quality of vision and uncorrected visual acuity. RN McNeely et al, JCRS, “Comparison of the visual performance and quality of vision with combined symmetrical inferonasal near addition versus inferonasal and superotemporal placement of rotationally asymmetric refractive multifocal intraocular lenses”; Volume 42, Issue 12, 1721-1729. VISUAL FUNCTION AFTER TRIFOCAL IOLS Patients receiving trifocal IOLs report better visual function than those receiving monofocal IOLs, according to data gathered from a new Spanish language version of the Catquest-9SF survey instrument. Some 300 patients completed the questionnaire before and three months after the surgery. Patients were asked about changes in visual function and satisfaction with vision after surgery. Patient-reported improvement in visual function was statistically significantly better for those with trifocal IOLs. M Lundström et al, JCRS, “Validation of the Spanish Catquest-9SF in patients with a monofocal or trifocal intraocular lens”; Volume 42, Issue 12, 1791-1796. ACCELERATED CXL Corneal crosslinking (CXL) is now widely used to halt the progression of ectatic diseases. Newer protocols attempt to increase the speed of the procedure by reducing the illumination time and increasing the irradiation intensity. In a review article, researchers discuss the new accelerated CXL protocols and compare the efficacy and safety of accelerated CXL with conventional methods. The reviewers report that, although the follow-up is short, accelerated CXL does appear to be a safe and effective method for halting the progression of ectasia. The shortest exposure time used to halt keratoconus progression was three minutes at 30mW/cm2. Corneal shape responses to accelerated CXL varied considerably, as did the demarcation line at different irradiance settings and elevation changes. They conclude that by altering stroma farthest from the endothelium, accelerated CXL could be a safe option for treating thin corneas. CS Medeiros et al, JCRS, “Accelerated corneal collagen crosslinking: Technique, efficacy, safety, and applications”; Volume 42, Issue 12, 1826-1835.