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This article presents the findings of a long-term study on the clinical outcomes, safety, and efficacy of the Visian implantable collamer lens (ICL) for myopia correction. The study followed patients for a mean duration of 17.52 years and found that the ICL procedure resulted in favorable visual outcomes with a low risk of complications. The study also found that the ICL did not cause a significant loss of endothelial cell density and had an optimal vaulting range to minimize complications. However, a small number of cases experienced complications such as angle-closure glaucoma and cataracts. The study concludes that the Visian ICL is a safe and effective long-term solution for myopia correction. [Extracted from the article]

Background/Objectives: To evaluate the clinical and patient-reported outcomes (PROMs) obtained with an optimized version of a previously investigated trifocal IOL. Methods: Prospective non-comparative single-center study enrolling 29 patients (55–71 years) undergoing bilateral cataract surgery with implantation of the trifocal diffractive IOL Liberty 677CMY (Medicontur Medical Engineering Ltd., Zsámbék, Hungary). Visual and refractive outcomes as well as PROMs were evaluated during a 3-month follow-up: measurement of uncorrected and corrected distance (UDVA, CDVA), intermediate (UIVA, DCIVA) and near visual acuities (UNVA, DCNVA), defocus curve, patient satisfaction, photic phenomena perception, spectacle independence, and difficulty in performing some vision-related activities. Results: A total of 100%, 92%, and 80% of patients achieved a postoperative binocular UDVA, UIVA, and UNVA of 20/25 or better, respectively. Likewise, 100%, 80%, and 84% of patients achieved a postoperative binocular CDVA, DCIVA, and DCNVA of 20/25 or better, respectively. In the defocus curve, all mean visual acuity values were better than 0.15 logMAR for all defocus levels. A total of 95.8%, 95.8%, and 91.7% of patients referred to be satisfied with their distance, intermediate, and near visual vision, respectively. Mean overall Catquest Rasch calibrated score was −3.12 ± 0.98. Most of the patients were spectacle independent: far (95.8%), intermediate (95.8%) or near vision (91.7%). No bothersome or minimal to moderately bothersome halo, starburst, and glare was perceived by 83.3%, 83.4%, and 83.3% of patients, respectively. Conclusions: The trifocal IOL evaluated provides a visual acuity improvement, with high levels of spectacle independence, patient satisfaction, and perceived visual quality associated. [ABSTRACT FROM AUTHOR]

Highlights: What is known? The 3D visualization system allows the surgeon to operate in a more comfortable position than a conventional microscope. Looking at the surgical field on a large, high-definition 3D screen has advantages for surgical assistance and instructional purposes. What is new? The 3D visualization system can be successfully used for DSO procedures. Learning curve is short, as there is no training time required for successful use of 3D visualization system. (1) Purpose: The aim was to analyze the outcomes of Descemet's membrane endothelial keratoplasty (DMEK) and Descemet stripping only (DSO) surgeries using a glasses-assisted NGENUITY® 3D visualization system (Alcon Laboratories, Fort Worth, TX, USA). (2) Methods: Five consecutive cases of DMEK surgery and four consecutive cases of DSO were performed using the NGENUITY® system in this prospective study carried out at the Arruzafa Hospital, Córdoba, Spain. Only one eye from each patient received surgery. Best corrected distance visual acuity (CDVA) using EDTRS charts, central corneal thickness using the Casia II optical coherence tomograph (Tomey Co., Nagoya, Japan), and endothelial cell count using the Tomey EM-4000 (Tomey Co., Nagoya, Japan) for DMEK cases or the Nidek CEM-530 (Nidek Co., Ltd., Gamagori, Japan) specular microscopes for DSO cases were recorded preoperatively and at 1 and 3 months postsurgery. (3) Results: DMEK cases included one male and four female subjects, with a mean age of 73.6 ± 9.5 years. Average improvement in CDVA 3 months after surgery was 0.46 ± 0.16 decimal. Average change in cell count between 1 and 3 months postsurgery was 360.75 ± 289.38 cells/mm2. DSO cases included four female subjects, with a mean age of 64.2 ± 9.7 years. The average improvement in CDVA 3 months after surgery was 0.09 ± 0.17 decimal. All cases also had phacoemulsification carried out. He average change in cell count between 1 and 3 months after surgery was 460 ± 515.69 cells/mm2. There were no associated complications during surgery or the follow-up period in any of the cases. (4) Conclusions: In addition to the known benefits of the use of a 3D visualization system during surgery, the present study shows that the system can be successfully used in both DMEK and DSO procedures with a very short learning curve for the surgeon. [ABSTRACT FROM AUTHOR]

Purpose: This systematic review aims to compare corneal astigmatism correction in cataract surgery through corneal relaxing incision, manually and femtosecond laser assisted. Methods: The study was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement recommendations. We used PubMed, Scopus, and Web of Science (WOS) as databases from January 2010 to March 30, 2021. Patients with keratoconus, corneal ectasia, and a previous history of eye surgery were excluded because our aim was to analyze only healthy eyes. Results: A total of 1025 eyes were evaluated from 946 patients (mean age was 68.90 ± 5.12) in manual incision group articles, while 1905 eyes of 1483 patients (mean age was 65.05 ± 4.57) were evaluated in femtosecond laser arcuate keratotomy (FLAK) articles. The mean uncorrected distance visual acuity (UDVA) was 0.19 ± 0.12 and 0.15 ± 0.05 logMAR for manual incision and FLAK articles, respectively (p = 0.39). The mean correction index (CI) was similar in both groups: 0.77 ± 0.18 in manual incision and 0.79 ± 0.17 in femtosecond laser assisted incision (p = 0.70). Refractive stability was found after 3 months and no serious complications were reported during the follow-up in any group. Conclusion: Both techniques are safe and moderately effective in corneal astigmatism correction in cataract surgery. FLAK represents a more precise and predictable approach. However, since visual and refractive outcomes appear to be similar in both cases, the cost-benefit analysis is controversial. [ABSTRACT FROM AUTHOR]

PURPOSE: To compare two aspheric ablation profiles in myopic refractive surgery using different asphericity targets. METHODS: Patients underwent laser in situ keratomileusis (LASIK) with the WaveLight EX500 laser platform (Alcon, WaveLight Laser Technologie). Asymmetric surgery was performed, programming the wavefront-optimized (WFO) ablation profile in one eye and the custom-Q (CQ) profile in the contralateral eye. The patients were divided into two groups following a systematic randomization method. The Q-target programmed for the preoperative Q group was equal to the preoperative asphericity of the CQ profile, and for the −0.6 Q-target group, the Q-target was set to −0.6. RESULTS: The study included 100 patients (200 eyes). Both groups had comparable safety and efficacy indexes greater than 1. A similar oblate shift in postoperative asphericity was seen in both groups regardless of the ablation profile and programmed Q-target. Asphericity was 0.33 ± 0.34 and 0.35 ± 0.29 (P =.18) in the preoperative Q group and 0.26 ± 0.28 and 0.26 ± 0.27 (P =.89) in the −0.6 Q-target group for WFO and CQ, respectively. A lower spherical aberration was found with CQ compared to WFO when the Q-target was set to −0.6: 0.211 ± 0.121 versus 0.144 ± 0.114 (P <.01). However, no statistically significant differences were found when the preoperative Q-target was used. CONCLUSIONS: WFO and CQ treatments are similar in terms of refractive and visual outcomes. CQ offers greater control over the increase in positive spherical aberration after myopic refractive surgery, but it does not represent an advantage over WFO in the oblate shift in postoperative asphericity regardless of the Q-target programmed. [J Refract Surg. 2022;38(11):698–707.] [ABSTRACT FROM AUTHOR]

The main objective was to evaluate distance, intermediate, and near vision in patients who have undergone cataract extraction with bilateral implantation of a new trifocal diffractive intraocular lens (IOL), along with patient-reported outcomes (PRO). A total of 50 eyes from 25 patients after AsqelioTM Trifocal IOL (AST Products, Inc., Billerica MA, USA) implantation were assessed in this study. At 3 months after surgery, the photopic visual acuity (VA) at distance, intermediate, and near distances was measured. Binocular photopic defocus curves were also obtained. Three questionnaires to assess patients' visual satisfaction and spectacle dependence, among other items, were completed: the Catquest-9SF, the patient-reported spectacle independence questionnaire (PRSIQ), and the patient-reported visual symptoms questionnaire (PRVSQ). The average spherical equivalent was 0.21 ± 0.37 D at 3 months post-operation, and the average absolute tolerance to defocus was 3.64 ± 0.70 D. The mean binocular uncorrected VAs for distance, intermediate, and near vision were −0.02 ± 0.09, 0.06 ± 0.08, and 0.11 ± 0.07 logMAR, respectively. The best-corrected VA was better than 0.1 logMAR for the whole range from distance to near. PROs revealed spectacle independence and general satisfaction with vision, and the incidence of photic phenomena were low. This study shows that the new bi-aspheric diffractive trifocal IOL provides a good visual performance at different distances under photopic conditions, accompanied by patient satisfaction and spectacle independence. [ABSTRACT FROM AUTHOR]

aime Beltrán,7 Alberto Villarrubia11Instituto de Oftalmología la Arruzafa, Córdoba, Spain; 2Department of Cataract and Refractive Surgery, Clínica Baviera, Málaga, Spain; 3Hospital Regional Universitario de Málaga, Málaga, Spain; 4Istituto de Biomedicina de Málaga (IBIMA), Málaga, Spain; 5Universidad de Córdoba, Córdoba, Spain; 6University Medical Center Hamburg Eppendorf, Hamburg, Germany; 7Department of Research & Development, Clínica Baviera, Valencia, Spain; 8Department of Physics of Condensed Matter, Optics Area University of Seville, Seville, SpainCorrespondence: Pablo Morales; Isabel Leiva-Gea Málaga, SpainTel +34 669 232 767; Tel +34 677254051Email [email protected] ; [email protected] Purpose: To assess the safety, aberrometric and keratometric changes, and stability of trans-epithelial topography-guided phototherapeutic keratectomy (TE-TG-PTK) with mitomycin C (MMC) using the ALLEGRO Topolyzer platform for the treatment of irregular astigmatism. Methods: This is a retrospective case series including 57 eyes that underwent TE-TG-PTK + MMC using the ALLEGRO Topolyzer platform for the treatment of irregular astigmatism. CDVA, manifest refraction (MR), keratometry readings, and aberrometry readings were analyzed at 1, 3, 6, and 12 months. Results: Causes of corneal irregularity included non-infectious leucoma (n=23), infectious leucoma (n=7), adenoviral keratitis (n=20), corneal haze (n=2), post-penetrant keratoplasty (PKP) (n=1), and others (n=4). Overall, 76% of the eyes (n=40) gained lines of vision; patients gained 1, and 2 or more lines of vision in 76%, and 38% of cases, respectively. Only 1 patient (2%) lost 5 lines of vision. Mean preoperative CDVA (LogMAR) was 0.37 ± 0.31 and improved to 0.14 ± 0.18 (p< 0.001) at final follow-up (12 months). CDVA remained unchanged in 10 eyes (21%). No significant changes were observed in mean keratometry (Kmean) and keratometric astigmatism readings. Regarding aberrometry, only changes in coma proved to be significant 6 months after surgery (P< 0.01). No intraoperative/postoperative complications were reported. Conclusion: At final follow-up, significant improvements were observed in CDVA and coma. TE-TG-PTK + MMC proved to be an effective and safe procedure for the treatment of corneal irregular astigmatism due to several causes. [ABSTRACT FROM AUTHOR]

The aims of this study were to explore intestinal microbial composition and functionality in primary Sjögren's syndrome (pSS) and to relate these findings to inflammation, permeability and the transcription factor Forkhead box protein P3 (FOXP3) gene expression in peripheral blood. The study included 19 pSS patients and 19 healthy controls matched for age, sex, and body mass index. Fecal bacterial DNA was extracted and analyzed by 16S rRNA sequencing using an Ion S5 platform followed by a bioinformatics analysis using Quantitative Insights into Microbial Ecology (QIIME II) and Phylogenetic Investigation of Communities by Reconstruction of Unobserved States (PICRUSt). Our data suggest that the gut microbiota of pSS patients differs at both the taxonomic and functional levels with respect to healthy controls. The gut microbiota profile of our pSS patients was characterized by a lower diversity and richness and with Bacteroidetes dominating at the phylum level. The pSS patients had less beneficial or commensal butyrate-producing bacteria and a higher proportion of opportunistic pathogens with proinflammatory activity, which may impair intestinal barrier function and therefore contribute to inflammatory processes associated with pSS by increasing the production of proinflammatory cytokines and decreasing the release of the anti-inflammatory cytokine IL-10 and the peripheral FOXP3 mRNA expression, implicated in the development and function of regulatory T cells (Treg) cells. Further studies are needed to better understand the real impact of dysbiosis on the course of pSS and to conceive preventive or therapeutic strategies to counteract microbiome-driven inflammation. [ABSTRACT FROM AUTHOR]