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(searched for: doi:10.1111/j.1442-9071.2006.01240.x)
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, Jie Zhang, Dipika V. Patel
Journal of the Royal Society of New Zealand, Volume 50, pp 245-262; https://doi.org/10.1080/03036758.2020.1714673

Abstract:
Cataract is the most common, reversible cause of visual impairment and blindness in the world. Cataract surgery in primitive form has been around for millennia but the last 50 years have witnessed a monumental revolution in cataract surgery making it the most common, and one of the most successful, operations world-wide. Major advances have included the development of phacoemulsification techniques, refinement of small incision approaches, foldable and injectable specialised intraocular lenses (IOLs), day-case local anaesthetic approaches and a better understanding of risks and benefits. Clinicians and scientists in New Zealand / Aotearoa have contributed significantly to the global knowledge of cataract surgery, including aspects of indications for surgery, assessment and use of specialised IOLs including aspheric, toric and secondary IOLs, effect of surgical techniques on corneal structure and performance, training of cataract surgeons, intraoperative and post-operative complications, strategies to minimise complications, and visual outcomes following phacoemulsification surgery. These studies also reveal disparities in health care, with the indigenous Māori population demonstrating more advanced cataract at an earlier age, associated with greater risk of intra-operative complications, yet accessing cataract services disproportionally less. This review highlights key research contributions from a New Zealand perspective, in the light of contemporary knowledge and practice.
Eye & Contact Lens: Science & Clinical Practice, Volume 44; https://doi.org/10.1097/icl.0000000000000360

Abstract:
To determine the demographic and refractive characteristics of excimer laser refractive surgery candidates in Iran. This was a cross-sectional study between 2010 and 2014. All information was collected from 28 centers randomly selected from 12 provinces. Then, for each season of the year, one week was chosen through simple random selection, and within each week, 3 days were again chosen randomly. All excimer laser surgical procedures performed during these 3 days were identified by training staff, and data were extracted from patient charts. A total of 14,569 charts were reviewed; 67.5% of the subjects were female and the rest were male. Of the total surgeries, 18.6% had been done in 2010 which reached to 19.1% in 2014. The mean age of people receiving refractive surgery showed an upward trend (P<0.001) and female patients were significantly younger than male patients (P<0.001). The 25 to 39 years age group received the highest number of surgeries (31.9% of the total) and there was a significant association with gender (P<0.001). The most common refractive error was compound myopic astigmatism with a prevalence of 79.3%. In 2010, 33.3% of the performed surgeries were covered by insurance policies, and this decreased to 30.2% in 2014 (P<0.001). Women with compound myopic astigmatism in the age range of 25 and 35 years are the most frequent users of excimer laser refractive surgery. Less than one-third of laser refractive surgeries are covered by insurance policies. Therefore, proper planning for improving services to this group must be given priority.
, , Motoaki Yoshida, Koichi Yoshimura
Published: 18 May 2018
by BMJ
British Journal of Ophthalmology, Volume 103, pp 181-185; https://doi.org/10.1136/bjophthalmol-2017-311710

Abstract:
Aim: To compare changes in the shape and astigmatism of the total and posterior cornea between eyes with a nasal clear corneal incision (CCI) and eyes with a temporal CCI in cataract surgery.Methods: The left eyes of 100 patients undergoing phacoemulsification were randomly assigned to undergo a 2.4 mm nasal (nasal CCI group) or temporal CCI (temporal CCI group). Corneal astigmatic changes were compared between groups using power vector analysis, and corneal shape changes were compared using videokeratography maps at 2 days, and at 2, 4 and 8 weeks postoperatively.Results: The mean J0 and J45 values of the total cornea were significantly greater in the nasal CCI group than in the temporal CCI group at 2 and 4 weeks postoperatively (p≤0.0392), but did not differ significantly between groups at 2 days and 8 weeks. The videokeratography maps revealed a wedge-shaped flattening in the total cornea and a steepening in the posterior cornea around the CCIs in both groups at 2 days postoperatively; those were more prominent in the nasal CCI group than in the temporal CCI group. The wound-related changes diminished by 8 weeks postoperatively in the total and posterior cornea, and were not markedly different between groups at 8 weeks postoperatively.Conclusion: Corneal shape and astigmatic changes were comparable between groups at 8 weeks postoperatively, although the changes were greater after nasal CCI than after temporal CCI in the early postoperative periods, indicating that nasal or temporal CCI can be selected based on the surgeon’s preference.
, Akihito Igarashi, , , Masaki Sato, , Survey Working Group of the Japanese Society of Cataract and Refractive Surgery
Published: 1 September 2017
Journal of Refractive Surgery, Volume 33, pp 598-602; https://doi.org/10.3928/1081597x-20170621-01

Abstract:
PURPOSE: To retrospectively evaluate the current practice, trends, and outcomes of refractive surgery in Japan. METHODS: This multicenter survey comprised 78,248 eyes of 39,727 consecutive patients who underwent refractive surgery at 45 major institutions in Japan. The corresponding ophthalmologists responded to a selfadministered questionnaire. The authors especially evaluated the safety, efficacy, predictability, stability, and adverse events of LASIK and phakic intraocular lens (IOL) implantation 3 months postoperatively. RESULTS: The most common refractive surgery was LASIK (90.9%), followed by corneal inlay (5.0%), posterior chamber phakic IOL implantation (1.3%), laser-assisted subepithelial keratomileusis (1.0%), refractive lens exchange (0.9%), photorefractive keratectomy (0.3%), and refractive lenticule extraction (0.2%). For subgroup analysis, 69,987 eyes (99.5%) and 67,512 eyes (95.9%) achieved corrected and uncorrected distance visual acuity of 20/20 or better, respectively, after LASIK, and 935 eyes (98.8%) and 890 eyes (94.1%), respectively, after phakic IOL implantation. There were 69,176 eyes (98.3%) and 908 eyes (96.0%) within ±1.00 diopter (D) of the attempted correction after LASIK and phakic IOL implantation, respectively. There were 1,926 eyes (2.7%) and 1 eye (0.1%) with changes in refraction of 1.00 D or less from 1 week to 3 months after LASIK and phakic IOL implantation, respectively. No vision-threatening complications occurred in any case. CONCLUSIONS: According to this survey, LASIK remains the most prevalent surgical technique in Japan. Both LASIK and phakic IOL implantation offered good safety and efficacy outcomes, yielding predictable and stable results. [J Refract Surg. 2017;33(9):598–602.]
Sharif Hashmani, , Sham Kumar, Sanjay Kumar, Vishal Dhomeja, Sufyan Razak, Hina Rajani, Azfar N Hanfi, Idrees Adhi
Published: 25 June 2017
Abstract:
Purpose To study and analyze the reasons for not performing laser-assisted in-situ keratomileusis (LASIK) surgery in Pakistan. Methods This is a retrospective observational review of the patients who presented for LASIK surgery during January 2014 to September 2016 at the Hashmanis Hospital refractive surgery facility in Karachi, Pakistan. Results A total of 6005 eyes in 3512 patients presented for LASIK surgery. Out of these, a total of 1795 eyes (29.9%) of 899 patients (25.6%) were rejected. The most common cause for not performing LASIK surgery was found to be increased risk of postoperative ectasia seen in 534 (29.75%) eyes. In 275 (15.32%) eyes, the surgery could not be performed because of affordability of procedure or unscientific apprehensions of the patient. Keratoconus was seen in 268 (14.93%) eyes. Conclusion The patients presenting for LASIK surgery need extensive screening as the large proportion of patients may have corneal structural for not performing this procedure. The cost of the procedure plays its role as does the unscientific beliefs amongst the patients.
, Akihito Igarashi, , , Masaki Sato,
American Journal of Ophthalmology, Volume 175, pp 159-168; https://doi.org/10.1016/j.ajo.2016.12.009

Abstract:
To assess the clinical outcomes of currently used refractive surgery procedures performed in 2015. Prospective, multicenter cohort study. This prospective study included 15 011 eyes of 7622 consecutive patients who underwent laser in situ keratomileusis (LASIK), surface ablation, refractive lenticule extraction (ReLEx), or phakic intraocular lens (IOL) implantation at 42 major institutions. We determined the safety, efficacy, predictability, stability, and adverse events of these surgeries preoperatively and at 1 week and 1 and 3 months postoperatively. Mean logMAR corrected distance visual acuity 3 months after LASIK, surface ablation, ReLEx, posterior chamber phakic IOL, or iris-supported phakic IOL implantation was -0.18 ± 0.07, -0.16 ± 0.08, -0.17 ± 0.09, -0.21 ± 0.08, and -0.10 ± 0.12, respectively; the corresponding values for logMAR uncorrected distance visual acuity were -0.15 ± 0.11, -0.12 ± 0.12, -0.12 ± 0.13, -0.15 ± 0.12, and 0.01 ± 0.21, respectively. The percentages within ±1.0 diopter (D) of the attempted correction were 96%, 93%, 97%, 99%, and 84% after LASIK, surface ablation, ReLEx, posterior chamber phakic IOL, and iris-supported phakic IOL implantation, respectively. Refractive change from 1 week to 3 months was -0.08 ± 0.07, 0.21 ± 0.63, -0.04 ± 0.41, 0.01 ± 0.31, and 0.01 ± 0.46 D, respectively. No vision-threatening complications occurred during the observation period. Although more prolonged follow-up is still necessary, currently used refractive surgery procedures have good safety and efficacy outcomes, yielding predictable and stable results. Contemporary LASIK, surface ablation, ReLEx, and phakic IOL implantation appear to be feasible options for the treatment of refractive errors.
Published: 10 December 2014
Eye and Vision, Volume 1, pp 1-13; https://doi.org/10.1186/s40662-014-0010-2

Abstract:
Cataract surgery due to advances in small incision surgery evolved from a procedure concerned with the primary focus on the safe removal of cataractous lens to a procedure focused on the best possible postoperative refractive result. As the outcomes of cataract surgery became better, the use of lens surgery as a refractive modality in patients without cataracts has increased in interest and in popularity. Removal of the crystalline lens for refractive purposes or refractive lens exchange (RLE) presents several advantages over corneal refractive surgery. Patients with high degrees of myopia, hyperopia and astigmatism are still not good candidates for laser surgery. Moreover, presbyopia can currently only be corrected with monovision or reading spectacles. RLE supplemented with multifocal or accommodating intraocular lenses (IOLs) in combination with corneal astigmatic procedures might address all refractive errors including presbyopia, and eliminate the future need for cataract surgery.
, , Amr El Aswad, Dorota Romaniuk
Published: 8 May 2014
Survey of Ophthalmology, Volume 59, pp 579-598; https://doi.org/10.1016/j.survophthal.2014.04.004

Abstract:
Advances in small incision surgery have enabled cataract surgery to evolve from being concerned primarily with the safe removal of the opaque crystalline lens to a procedure refined to yield the best possible postoperative refractive result. As the outcomes of cataract surgery have improved, the use of lens surgery as a refractive modality in patients without cataracts (clear lens extraction) has increased in popularity. The removal of the crystalline lens for refractive purposes, or so-called refractive lens exchange (RLE), offers distinct advantages over corneal refractive surgery in selected cases. Nevertheless, in some middle-aged patients with high refractive errors, corneal refractive surgery can be a safe and effective treatment. In addition, the use of multifocal lenses offers an alternative for the correction of presbyopia. A further advantage of RLE is that it simultaneously eliminates the need for cataract surgery in the future. The keys for success in RLE are effectiveness and consistency in the refractive outcome, providing at the same time surgical and postoperative safety. To achieve these goals, adequate indications following strict risk/benefit criteria and refractive precision based on accurate preoperative protocols for IOL calculation and selection are mandatory, together with an appropriate choice of surgical procedure based on the surgeon's skills, minimizing complications.
Carl W. Baker
JAMA Ophthalmology, Volume 131, pp 870-879; https://doi.org/10.1001/jamaophthalmol.2013.2313

Abstract:
Diabetes mellitus increases the probability of developing cataract and may increase the risk of reduced visual outcomes after cataract surgery.1,2 As approximately 250 000 people with diabetes in the United States undergo cataract surgery each year, improvements in understanding the prognosis and management of these cases could confer a substantial benefit to many people.3
Ingo Schmack, , Daniel Epstein, Mike P. Holzer
Published: 1 January 2010
Journal of Refractive Surgery, Volume 26, pp 202-208; https://doi.org/10.3928/1081597x-20090515-05

Abstract:
To study the current practice styles and preferences of refractive surgeons in Germany. In February 2008, a seven-item questionnaire regarding the practice of refractive surgery was mailed to 282 members of the German Society of Intra-ocular Lens Implantation, Interventional, and Refractive Surgery (DGII) and the Commission of Refractive Surgery (KRC). Most questions were identical to our 2005 German refractive surgery survey. All data were analyzed in a masked fashion. The response rate was 42.2%. The majority (68%) of respondents reported that they perform refractive surgery in laser centers (exclusively or partially) followed by general hospitals (19.4%) and universities (12.6%). Although LASIK was the predominant type of refractive surgery performed (80.6%), other refractive procedures included refractive lens exchange (60.2%), photorefractive keratectomy (47.6%), phakic intraocular lens implants (45.6%), laser-assisted subepithelial keratectomy (36.9%), epithelial laser in situ keratomileusis (15.5%), intracorneal rings (5.8%), and limbal relaxing incisions (2.9%). The volume of refractive surgery procedures and the preferred type of excimer laser systems, microkeratomes, and diagnostic devices varied at different institutions. Most respondents performed either wavefront-guided custom ablation or wavefront-optimized ablation (63.1%) compared with conventional excimer laser correction (36.9%). Refractive surgery practice styles and preferences in Germany are comparable to trends in other European countries. Although LASIK is the most commonly performed refractive procedure, the numbers of various surface ablation techniques and refractive intraocular lens procedures are increasing.
Sang Chul Yoon, Jee Woong Jung, Hee Jin Sohn,
Korean Journal of Ophthalmology, Volume 23, pp 142-147; https://doi.org/10.3341/kjo.2009.23.3.142

Abstract:
This purpose of this report was to study trends in cataract and refractive surgeries conducted during the past twelve years and to compare results to previous reports from the ASCRS and New Zealand (NZ) in order to forecast future medical services. We surveyed members of the Korean Society of Cataract and Refractive Surgery (KSCRS) every year from 1995 to 2006, and studied changes in cataract and refractive surgeries (RS). The duration of hospitalization has been gradually decreasing to the point that a one day hospitalization following surgery has become common. The rate of topical anesthesia use has significantly increased since 1998. Sutureless incision methods are now commonly practiced. The use of acryl IOL as an optic material has been gradually increasing for cataract surgeries. KSCRS members showed an interest in the special intraocular lenses as multifocal IOL. While Excimer laser PRK was the most popular refractive surgery during the first stage, KSCRS members increasingly prefer LASIK to the Excimer laser PRK. Regression of the corrected visual acuity, dry eye, night halo, and flashes were the most common complications following refractive surgeries. Medical disputes related to PRK and LASIK have been gradually increasing throughout the study period. We confirm that the KSCRS practice styles for cataract and RS are similar to those of the ASCRS and NZ. We infer a world-wide trend from the comparison of these three societies.
Zelda S Pick, David V Leaming,
Clinical & Experimental Ophthalmology, Volume 36, pp 604-619; https://doi.org/10.1111/j.1442-9071.2008.01869.x

The publisher has not yet granted permission to display this abstract.
, Ikuko Toda, Yoshiko Hori-Komai, Chikako Sakai, Kazuo Tsubota
Published: 31 May 2008
Ophthalmology, Volume 115, pp 839-844.e2; https://doi.org/10.1016/j.ophtha.2007.07.012

The publisher has not yet granted permission to display this abstract.
Saurabh Jain, M Ragoussi, Waheeda Rahman, Dawn Grosvenor
Clinical & Experimental Ophthalmology, Volume 35, pp 784-784; https://doi.org/10.1111/j.1442-9071.2007.01590.x

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