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Purpose: To assess a new polynomial regression formula integrating the refractive prediction error of the first-operated eye to improve the intraocular lens power calculation of the second eye in cataract surgery., Setting: Centre Hospitalier Universitaire, Toulouse, France., Design: Retrospective multicentric dataset study., Methods: A polynomial regression formula, WeOptimeye2nd (WO2nd), was developed using a machine-learning algorithm trained on a dataset of 534 patients who underwent sequential bilateral cataract surgery. A separate multicentric dataset was used to retrospectively calculate predicted refraction with WO2nd, SRK/T and Barrett Universal II formulas, and 3 other methods of constant factors (CFs) second-eye refinement (CF0.38, CF0.35, and CF0.5). Mean absolute errors (MAEs) and percentage of eyes within ±0.25, ±0.5, and ±1.0 diopter (D) from predicted spherical equivalent were compared between formulas., Results: The study comprised data on 722 patients. In the overall population, WO2nd had the lowest MAE: 0.339 vs 0.347 (P = .137), 0.340 (P = .956), 0.350 (P = .066), 0.399 (P < .001), and 0.410 (P < .001), with CF0.38, CF0.5, and CF0.35, Barrett II, and SRK/T, respectively. WO2nd had the highest percentage of eyes within ±0.5 D of the predicted refraction, and the difference was statistically significant vs SRK/T and Barrett II formulas but not vs CF0.38, CF0.5, and CF0.35. WO2nd performed the best in axial length (AL) < 22 mm with the lowest MAE and a statistically significant difference vs any other formula., Conclusions: WO2nd improved the refractive outcome of the second-operated eye and performed well in extreme AL and mean keratometry subgroups., (Copyright © 2021 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.)

Purpose: The goal of our retrospective, single-center study of a case series was to compare the total, corneal, and internal astigmatism, and the visual acuity at one year after combined or stand-alone surgery consisting of iris fixation of an iris-claw intraocular lens (ARTISAN aphakia) in aphakic patients, according to whether the lens was fixated to the anterior (n=21) or posterior (n=51) surface of the iris., Results: We did not find a significant difference between these two types of fixation for any of the studied variables. The surgically induced astigmatism was 1.67 D at 176° in group A versus 1.19 D at 11° in group P., Conclusion: Although this surgery creates additional corneal astigmatism, it has not been proven that it differs depending on the type of fixation of the iris-claw. If we adhere to the notion that the posterior fixated iris-claw decreases the risk of endothelial decompensation in case the implant becomes disenclavated, then reverse iris fixation of the iris-claw makes sense., (Copyright © 2018 Elsevier Masson SAS. All rights reserved.)

Objectives: To evaluate the success rate, efficacy, and safety of the ICD 16.5 mini-scleral gas permeable (GP) contact lens., Methods: This prospective study included referred consecutive patients with irregular corneas and severe ocular surface disease (OSD) in treatment failure. All patients were fitted with the ICD 16.5 mini-scleral GP lens. Even though we had some limited experience with scleral lenses, it was our first experience with the ICD 16.5 mini-scleral GP lens. Efficacy was assessed by comparing best-corrected visual acuity (BCVA) with the mini-scleral lens to baseline BCVA. A subjective visual functioning questionnaire (comfort score, visual quality score, handling rating, and wearing time) was administered in a face-to-face structured interview., Results: Thirty-nine eyes of 23 patients with a mean age of 43±16 years were included. Fitting indications were keratoconus (46%), post-penetrating keratoplasty (21%), other irregular astigmatism (15%), and severe OSD (18%). Twenty-five eyes (64%) were successfully fitted with an 18-month follow-up. The mini-scleral GP lens BCVA was 0.16 logarithm of the minimum angle of resolution (logMAR; 20/25) versus a baseline BCVA of 0.44 logMAR (20/63; P<0.001). Comfort and visual quality scores were 8.5/10 and 7.5/10, respectively. No complications were detected in 96% of the eyes (95% confidence interval, 76.1%-99.4%). One eye experienced corneal graft swelling., Conclusions: The present findings suggest that the ICD 16.5 mini-scleral GP lens is an effective and safe alternative for managing challenging corneas in a therapeutic impasse.

Introduction: A new foldable version of an anterior chamber phakic lens designed to surgically correct high myopia was evaluated., Patients and Methods: A prospective study on the efficacy and tolerance of a foldable phakic intraocular iris-supported lens, designed to correct moderately high myopia, is presented in this article. Twenty-five eyes of 25 patients were implanted uneventfully using this lens, newly designed and called the Artiflex lens. This phakic intraocular lens is an upgraded foldable version of the Artisan (or Verisyse) lens. The follow-up was complete (24 months) for all Artiflex-treated eyes and the targeted postoperative refraction was emmetropia. Inclusion criteria were moderately high myopia ranging from -8 to -14 D, unchanged refraction for 2 years, total contact lenses wearing intolerance, refractive cylinder power no greater than 1.5 D, anterior chamber depth greater than 3 mm, and endothelial cell count greater than 2,200 cells/mm2., Results: The preoperative spherical equivalent was -9.70+/-2.37 D. The spherical equivalent was -1.07+/-0.84 D at 2 years postoperatively. The surgically induced astigmatism was 0.42 D x 67.4-degree axis. The percentage of eyes with an uncorrected visual acuity greater than or equal to 0.5 and 0.8 was 66.6% and 33.3%, respectively. Neither intra- nor postoperative complications were noted during the entire follow-up period. The mean endothelial cell count value was 2267+/-352 at 2 years postoperatively. The objective and subjective quality of vision was acceptable, associated with a high level of patient satisfaction., Discussion: The refractive results and tolerance of the Artiflex lens are satisfactory and seem to be as good as other phakic intraocular lens outcomes., Conclusion: To correct moderately high myopia, the Artiflex lens seems to provide a suitable refractive efficacy and a quick visual recovery, secondary to a lowering of induced astigmatism. Furthermore, this phakic intraocular lens is associated with satisfactory safety and quality of vision at each milestone of the entire follow-up period.

Purpose: To compare refractive performance of Artisan (Ophtec, Groningen, The Netherlands) or Verisyse phakic intraocular lens and its foldable version, Artiflex (Ophtec), for the correction of moderately high myopia., Design: Randomized pilot study., Methods: setting: Institutional practice. patient population: Thirty-one patients with myopia that ranged from -6 to -14 diopters (D). interventional procedure: One eye was implanted with an Artisan phakic intraocular lens (PIOL) and the other with an Artiflex PIOLs. main outcome measures: Primary outcome measure was the percentage of eyes with uncorrected visual acuity (UCVA) of >20/40 at one year after the operation. Main secondary outcome measures were the safety index, the change of two lines or more of best spectacle-corrected visual acuity (BSCVA) and the endothelial cell count., Results: No intraoperative complications were noticed. One year after surgery, the percentage of eyes with UCVA of >20/40 was 51.6% (16/31 patients) for Artisan-treated eyes and 77.4% (24/31 patients) for Artiflex-treated eyes (P = .033). One month after surgery, this same percentage was 42.9% (13/31 patients) and 77.4% (24/31 patients), respectively (P = .004). The safety index at one year was 1.13 +/- 0.24 for Artisan-treated eyes and 1.12 +/- 0.21 for Artiflex-treated eyes, which is a difference that was not statistically significant (P = 0.742). At one year after surgery, the changes of two lines or more of BSCVA and the endothelial cell loss were similar for both groups., Conclusion: To correct moderately high myopia, the Artiflex lens provides a faster visual recovery and a better UCVA than does the Artisan lens. The safety of the lens should be supported by an enlarged sample size and a longer follow-up period.

Purpose: To evaluate efficacy, predictability and safety of Artisan-Verysise intraocular lens (IOL) secondary implantation for aphakia correction., Setting: Instituto de Microcirugía Ocular, and Autonoma University of Barcelona, Barcelona, Spain., Methods: Uncorrected visual acuity, best spectacle-corrected visual acuity (BSCVA), manifest refraction, endothelial cell count, and clinical complications were evaluated. Sixteen consecutive eyes of 14 patients with aphakia were submitted to surgery. Postoperative examinations were done at 6 weeks, 6 months, 1 year, and every year for at least 3 years. An iris-supported Artisan-Verysise IOL was implanted for aphakia correction., Results: Thirty-six months after Artisan-Verysise lens implantation, BSCVA was 20/40 or better in 6 eyes (37.5%). Preoperatively, 5 eyes had the same BSCVA (31.25%). Mean postoperative spherical equivalent (SE) was 0.46 diopter (D). Mean endothelial cell loss was 10.9% 36 months postoperatively. The cell loss occurred predominantly during the first year (7.78%). Cystoid macular edema was observed in 2 cases, 1 of them associated with chronic unresponsive low intraocular pressure. No other serious complications were observed., Conclusion: Artisan-Verysise IOL implantation seems a safe, predictable, and effective option for aphakic eyes without capsule support.

Purpose: To evaluate efficacy, predictability, and safety of Artisan toric phakic intraocular lens (Ophtec, Groningen, The Netherlands) implantation for the correction of astigmatism higher than 2 diopters., Design: Interventional case series., Methods: This prospective study included 27 eyes of 16 patients with a mean preoperative spherical equivalent of -11.78 +/- 6.24 diopters and a mean preoperative astigmatism of -3.43 +/- 0.81. The Artisan phakic intraocular lens was inserted in the anterior chamber through a posterior corneal incision; the technique is similar to the implantation of the classical Artisan lens, but in these cases it is particularly important to secure the lens accurately in the correct axis. The main parameters evaluated in this study were uncorrected visual acuity, best-corrected visual acuity, refraction, and endothelial cell count., Results: Twelve months after the implantation of the Artisan toric phakic intraocular lens, 62.90% of the eyes were within +/-0.50 diopters. of emmetropia and 96.20% within +/-1.0 diopters. Seventy percent of the eyes gained 1 or more Snellen lines from their preoperative best-corrected visual acuity, and 11.11% lost 1 Snellen line. Mean endothelial cell count increased 2.9%. Mean of the parallel and orthogonal components of cylinder correction were 1.97 diopters and 0.10 diopters, respectively, of the intended cylinder change. The mean of axis alignment error was 10.53 degrees. No serious complications were observed., Conclusion: Artisan toric phakic intraocular lens implantation appears to be a safe and predictable method for the correction of high levels of astigmatism.

Purpose: To assess the safety and efficacy of the iris claw phakic (6mm Artisan lens) in patients with high myopia., Methods: Twenty-five eyes with myopia of -7.50 to 16D were implanted with a 6mm artisan lens and followed for 24 months., Results: The mean preoperative spherical equivalent refraction was 13.08+/-3.44D at one year. Mean operative spherical equivalent refraction was 0. 77+/-0.57D and 81.8% of eyes had a spherical equivalent refraction within +/-1.00D. Best spectacle-corrected visual acuity was maintained or improved in 62.5% of cases. No iritis or cataract or glaucoma was observed., Conclusion: Implantation with the 6mm Artisan lens is an effective method for reducing or correcting myopia up to -16D. Gains in spectacle corrected visual acuity were common, and results suggested good predictability. Because of the incomplete follow up, we cannot draw conclusions about the long term safety of the 6mm Artisan lens.

Purpose: To assess whether annexin V-coated poly(methyl methacrylate) (PMMA) intraocular lenses (IOLs) prevent postoperative inflammation in rabbit eyes., Setting: Department of Ophthalmology, Hôpital Purpan, Toulouse, France., Methods: Thirteen IOLs coated with annexin V were implanted in 13 rabbit eyes; the contralateral eyes received uncoated IOLs. Postoperative fibrin was quantitated by daily slitlamp examination until the anterior chamber was completely clear. Results were analyzed using a Wilcoxon test. Ocular toxicity was evaluated by light and electron microscopy., Results: Eyes with the annexin V-coated IOLs had less severe inflammation on the first postoperative day, and the inflammation resolved more quickly than in eyes with uncoated IOLs (P < .05). No annexin V was released postoperatively, nor were there signs of ocular toxicity., Conclusion: Annexin V-coated lenses effectively reduced postoperative inflammation in rabbit eyes.

Examination of the extreme periphery of the fundus of patients with pseudophakic retinal detachment is difficult due to poor pupil dilatation, optical aberrations from the intraocular lens, opacification of the posterior capsule or peripheral capsular remnants. Fifty-one patients with pseudophakic retinal detachment were operated on with using the wide angle panfunduscope of Rodenstock. It allows a very satisfactory pre- or intraoperative view of the extreme periphery of the fundus using the slit-lamp of the operative microscope combined with a scleral indentation. In only 3 cases no break was found in spite of pre- and intraoperative examination of the fundus periphery with the panfunduscope. Anatomic success was achieved in 47 out of 48 patients with a minimum of 6 months of follow-up; 3 patients were lost to follow-up. The mean postoperative visual acuity was 0.5. Unlike other methods of fundus examination, such the 3 mirror Goldmann lens or the indirect binocular ophthalmoscope, the panfunduscope allows good visualization of the peripheral retina of patients with pseudophakic retinal detachment using the slit-lamp of the operative microscope combined with a scleral indentation. Thus, small peripheral retinal breaks, often associated with pseudophakic retinal detachment, can be identified.