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PURPOSE: To compare differences in visual acuity, contrast sensitivity, higher order ocular aberrations, quality of life, and patient-reported outcomes at 3 and 6 months postoperatively in eyes with stable myopia undergoing thin-fl ap (intended fl ap thicknesses of 120 or 90 µm) LASIK using the VISX Star S4 CustomVue excimer laser (VISX Inc), with fl aps created by the IntraLase FS60 femtosecond laser (Abbott Medical Optics). METHODS: In this prospective study, thin-fl ap LASIK was performed contralaterally on 94 eyes: 47 eyes with 120-µm intended fl ap thickness and 47 eyes with 90-µm intended fl ap thickness. Primary outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), contrast sensitivity, and higher order aberrations. RESULTS: At 6 months, mean values for UDVA (logMAR) were -0.064±0.077 and -0.051±0.070 in the 120-µm and 90-µm groups, respectively (n=40, P=.431). Visual acuity of 20/20 was achieved in 98% of eyes with 120- µm fl aps and 95% of eyes with 90-µm fl aps, whereas 20/15 vision was achieved in 50% of eyes with 120-µm fl aps and 45% of eyes with 90-µm fl aps (P>.454). Both groups had significant increases in total higher order aberrations (P<.003). Significant differences were not found between groups in contrast sensitivity (P>.258), CDVA (P<.726), total higher order aberrations (P>.477), or patient-reported outcomes (P>.132). Patients in both groups reported increased quality of life postoperatively (P<.002). CONCLUSIONS: Under well-controlled surgical conditions, thin-fl ap LASIK achieved similar results in visual acuity, contrast sensitivity, and low induction of higher order aberrations in eyes with intended fl ap thicknesses of either 120 or 90 µm. [ABSTRACT FROM AUTHOR]

Purpose of Review: To review the most recent literature regarding the incidence and pathophysiology of phakic intraocular lens (pIOL) associated cataracts, surgical issues and outcomes of combined pIOL explantation/cataract surgery, and the prevention of cataract formation secondary to pIOLs., Recent Findings: The overall rate of cataracts secondary to pIOLs is low, but a disproportionate number is associated with posterior chamber pIOLs. All combination pIOL explantation/cataract surgeries resulted in the successful implantation of a posterior chamber intraocular lens in the capsular bag. We present several theories regarding the pathophysiology of anterior subcapsular cataracts secondary to posterior chamber pIOLs. In addition, we present general strategies in performing combination pIOL explantation/cataract surgery. Several methods of preoperative assessment show promise in helping prevent cataracts secondary to pIOLs, including new ultrasound methods for sulcus imaging and preoperative simulations., Summary: Although the incidence of cataracts secondary to pIOLs is low, more studies regarding the pathophysiology of this phenomenon and improvement of preoperative assessment are needed, especially for posterior chamber pIOLs.