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Thomas Kohnen,1 Ruth Lapid-Gortzak,2 Dandapani Ramamurthy,3 Hiroko Bissen-Miyajima,4 Andrew Maxwell,5 Tae-Im Kim,6 Satish Modi7 1Department of Ophthalmology, Goethe-University, Frankfurt, Germany; 2Department of Ophthalmology, Amsterdam University Medical Centers, Amsterdam, Netherlands; 3The Eye Foundation, Coimbatore, Tamil Nadu, India; 4Department of Ophthalmology, Tokyo Dental College Suidobashi Hospital, Tokyo, Japan; 5The California Eye Institute, Fresno, CA, USA; 6Department of Ophthalmology, Yonsei University College of Medicine, Seoul, South Korea; 7Seeta Eye Centers, Poughkeepsie, NY, USACorrespondence: Thomas Kohnen, Department of Ophthalmology, Goethe University, Theodor‑Stern-Kai 7, Frankfurt, 60590, Germany, Tel +49 69 6301 6739/ 3945, Fax +49 69 6301 3893, Email thomas.Kohnen@kgu.dePurpose: To investigate visual and safety outcomes of AcrySof® IQ PanOptix® (model TFNT00), a trifocal, presbyopia-correcting intraocular lens (IOL), in patients of different ethnicities across multiple countries, based on a pooled analysis of six prospective multicenter studies.Patients and Methods: This pooled analysis included adult patients from six prospective clinical studies performed across 56 centers worldwide. After cataract removal by phacoemulsification, all patients were implanted with TFNT00; follow-up duration varied from 3 to 12 months according to the studies’ design. Binocular defocus curve; absolute manifest refraction spherical equivalent (MRSE); and binocular photopic uncorrected and corrected visual acuities at distance (UCDVA, BCDVA; 4– 5 m), intermediate (UCIVA, DCIVA; 60– 66 cm), and near (UCNVA, DCNVA; 40 cm) were measured.Results: The study included 557 patients, 547 of whom were implanted bilaterally with the TFNT00 IOL (n = 1094 eyes). Binocular visual data at 1 month and 3– 6 months after implantation were available for up to 546 and 542 bilaterally implanted patients, respectively. A continuous range of 0.1 logarithm of the minimum angle of resolution (logMAR) or better vision from distance (0.00 diopter [D], 4– 5 m) to near (– 3.00 D; optically equivalent to 33 cm) was observed 3– 6 months after TFNT00 implantation. At 3– 6 months, 88.2% of first eyes achieved an MRSE ≤ 0.50 D and 88.7% of second eyes achieved an MRSE ≤ 0.50 D. Overall, 99.3%, 92.3%, and 94.6% of patients bilaterally implanted with TFNT00 achieved binocular photopic BCDVA, DCIVA, and DCNVA of 0.14 logMAR or better, respectively. Ocular adverse device effects and secondary surgical interventions (SSIs) were infrequent.Conclusion: This global pooled analysis showed that TFNT00 provided a continuous range of 0.1 logMAR (~20/25 Snellen) or better vision from distance to 33 cm, with a low incidence of ocular adverse device effects and SSIs.Keywords: PanOptix, intraocular lens, presbyopia, trifocal lens, diffractive lens, pooled analysis

Purpose: The purpose of this study was to report the safety and efficacy results of an artificial lamellar implant for the treatment of chronic corneal edema., Methods: The EndoArt (EyeYon Medical, Ness Ziona, Israel), an artificial endothelial replacement membrane designed to treat corneal edema, was implanted in 24 eyes of 24 patients with low-to-normal visual potential. We present the safety and efficacy results from a prospective, open-label, single-arm, multicenter study conducted over a 12-month period., Results: Twenty-four patients were enrolled, with no device-related serious adverse events reported. Seventeen patients completed 12-month follow-up, showing a reduction in average central corneal thickness from 759 ± 116 μm to 613 ± 135 μm. Best-corrected distance visual acuity improved from 1.88 ± 0.79 logarithmic minimum angle of resolution (logMAR) to 1.34 ± 0.57 logMAR. Sixty percent gained at least 3 early treatment diabetic retinopathy study (ETDRS) lines. The EndoArt was removed in 5 cases due to incomplete attachment and replaced by corneal transplants; 1 patient was lost to follow-up, and 1 had a procedure failure. No device-related long-term complications, infections, or inflammations were reported. The implants remained transparent throughout the study., Conclusions: The first-in-human results of EndoArt implantation demonstrated the device's potential to treat patients suffering from corneal edema with a favorable safety profile and effective edema reduction in most subjects, with no device-related serious adverse event. The EndoArt may offer a viable solution in regions facing a shortage of donor corneas, as well as for patients who have poor prognosis with human tissue., (Copyright © 2025 The Author(s). Published by Wolters Kluwer Health, Inc.)

Presbyopia is farsightedness of old-age. Due to lenticular stiffness, decreased accommodative range, and decreased ciliary muscle function, the ability to see up close diminishes with age. Clinically this means people will need reading glasses. Cataract surgery is the most performed and successful surgery to improve patients' visual acuity. Currently there are many possibilities of solving presbyopia during cataract surgery. This can be achieved by using premium implant lenses, which are lenses that have more than one focus, enabling freedom from spectacles postoperatively. These premium lenses allow vision at the near, intermediate and distance foci, decreasing dependence on optical aids. In this article we will explain the options, and patients' suitability for these solutions and will briefly outline the ins and outs of presbyopia correcting surgery.

Purpose: To evaluate the feasibility of new adjustable intraocular lens (IOL) technology., Methods: The foldable adjustable IOL consists of a nitinol mechanism placed in a haptic-optic cradle. Heating actuators on the nitinol mechanism with a continuous green laser achieve controlled movement of the mechanism and optic. Activation occurs in controlled steps: rotation in 1-degree steps over 360 degrees, and anterior posterior movement in 0.25-diopter (D) steps with a range of +1.50 D. The IOL was tested in vitro and in vivo in a rabbit eye. Foldability and unfolding were demonstrated through a 2.6-mm cartridge., Results: The adjustable lens mechanism was successfully tested in vitro and in vivo. Activation resulted in a change in optic position relative to the haptics and the capsular bag. Activation of the lever and ratchet mechanism showed radial advancement of the IOL clockwise and counterclockwise. In vivo rotatory movement was achieved after activation by the argon laser at 1 week after implantation. Anterior to posterior movement was accomplished by activating the circular spring actuator mechanism in the laboratory model. Uneventful folding and unfolding were performed., Conclusions: A new adjustable IOL with a mechanism that responds in measured steps had been shown to move as planned after activation by argon laser. This was successful in the laboratory in both radial and anterior posterior movement. The radial movement was also proven in vivo in an animal model. Further refinement of the prototype is currently being undertaken. [ J Refract Surg . 2023;39(10):662-667.] .

A 27-year-old woman who wants to get rid of contact lenses and spectacles was seen at our clinic. She had strabismus surgery as a child and was patched for the right eye but now shows mild nondisturbing exophoria. Infrequently, she likes to box in the sports school. Her corrected distance visual acuity at presentation in the right eye was 20/16 with -3.75 -0.75 × 50 and in the left eye 20/16 with -3.75 -1.25 × 142. Her cycloplegic refraction in the right eye was -3.75 -0.75 × 44 and in the left eye was -3.25 -1.25 × 147. The left eye is the dominant eye. The tear break-up time was 8 seconds in both eyes, and the Schirmer tear test was 7 to 10 mm in right and left eyes, respectively. Pupil sizes under mesopic conditions were 6.62 mm and 6.68 mm. The anterior chamber depth (ACD) (measured from the epithelium) in the right eye was 3.89 mm and in the left eye was 3.87 mm. The corneal thickness was 503 μm and 493 μm of the right and left eye, respectively. Corneal endothelial cell density was on average 2700 cells/mm2 for both eyes. Slitlamp biomicroscopy showed clear corneas and a normal flat iris configuration. Supplemental Figures 1 to 4 (available at http://links.lww.com/JRS/A818, http://links.lww.com/JRS/A819, http://links.lww.com/JRS/A820, and http://links.lww.com/JRS/A821) show the corneal topography and Belin-Ambrósio deviation (BAD) maps at presentation of the right eye and left eye, respectively. Would you consider this patient a candidate for corneal refractive surgery (eg, laser-assisted subepithelial keratectomy, laser in situ keratomileusis [LASIK], or small-incision lenticule extraction [SMILE] procedure)? Has your opinion changed given the recent opinion of the U.S. Food and Drug Administration (FDA) regarding LASIK?1 The patient herself is slightly favoring an implantation of a phakic intraocular lens (pIOL), as she prefers something reversible. Would you implant a pIOL, and which type of IOL, for this level of myopia? What is your diagnosis or are additional diagnostic methodologies needed to establish a diagnosis? What is your treatment advice for this patient? REFERENCES 1. U.S. Food and Drug Administration, HHS. Laser-assisted in situ keratomileusis (LASIK) lasers-patient labeling recommendations; draft guidance for industry and food and drug administration staff; availability. July 28, 2022, Federal Register; 87 FR 45334. Available at: https://www.fda.gov/regulatory-information/search-fda-guidance-documents/laser-assisted-situ-keratomileusis-lasik-lasers-patient-labeling-recommendations Accessed January 25, 2023., (Copyright © 2023 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.)

Purpose: To compare standard and total corneal astigmatism measurements to the predicted pseudophakic (nontoric) refractive astigmatism in candidates for cataract surgery., Design: A retrospective, cross-sectional study., Methods: A single-center analysis of consecutive eyes measured with a swept-source optical coherence tomography biometer at a large tertiary medical center between February 2018 and June 2020. Corneal astigmatism was calculated based on standard keratometry astigmatism (KA), total corneal astigmatism (TCA), and predicted refractive astigmatism (PRA) for a monofocal nontoric intraocular lens (IOL) implantation calculated by the Barrett toric calculator using the predicted posterior corneal astigmatism (PRA (Predicted-PCA) ) and the measured posterior corneal astigmatism (PRA (Measured-PCA) ) options. Separate analyses were performed for each eye., Setting: Ophthalmology Department, Shaare Zedek Medical Center, Jerusalem, Israel., Results: In total, 8152 eyes of 5320 patients (4221 right eyes [OD] and 3931 left eyes [OS], mean age 70.6±12.2 years, 54.2% females) were included in the study. The mean vector values (centroid) for KA, TCA, PRA (Predicted-PCA) , and PRA (Measured-PCA) were 0.07 diopters [D] at 19.5°, 0.27 D at 7.5°, 0.44 D at 2.9°, and 0.43 D at 179.3°, respectively (P < .01), for OD and 0.02 D at 150.3°, 0.23 D at 169.7°, 0.40 D at 179.4°, and 0.42 D at 169.5°, respectively (P < .01), for OS. More than 73% of eyes had a PRA >0.5 D., Conclusions: Standard and total corneal astigmatism measurements differ significantly from the PRA by the Barrett toric calculator. The PRA, rather than the KA or TCA, should be used as the reference guide for astigmatism correction with toric IOL implantation., (Copyright © 2022 Elsevier Inc. All rights reserved.)

Purpose: To assess visual results (including the Lapid-Kushlin defocus coefficient), and satisfaction, following the implantation of PanOptix® a trifocal intraocular lens., Methods: Observational, retrospective cohort study. 130 eyes of 65 subjects with bilateral implantation were included. Binocular uncorrected visual acuities [distance (Binocular UDVA), intermediate (Binocular UIVA) and near (Binocular UNVA)] were measured. Also, the manifest refraction, binocular defocus curve and binocular contrast sensitivity were determined. The Lapid-Kushlin defocus coefficient, a new single numerical parameter based on the area under the curve of the defocus curve, was calculated. The validated Spanish CATQUEST-9SF satisfaction survey was applied., Results: Postoperative visual acuity ranges were: binocular UDVA 0.18 to 0.0 LogMAR, binocular UIVA 0.30 to 0.0 LogMAR and Binocular UNVA 0.18 to 0.0 LogMAR. The levels of contrast sensitivity both in bright light conditions (with and without glare) and low light conditions with glare, remained within the limits of normality. Under scotopic conditions without glare values below normality were found at lower spatial frequencies. The binocular defocus curve showed a plateau without a clearly evident peak. The Lapid-Kushlin defocus coefficient was 0.199. Two patients (3.1%) needed glasses after the procedure for near and intermediate vision. No patient manifested great visual difficulties or was dissatisfied with the results., Conclusions: The trifocal platform showed very good results in this series of patients. 96.9% of the patients achieved independence of the glasses and expressed a high degree of satisfaction. The Lapid-Kushlin defocus coefficient was better than those calculated from literature, for other multifocal intraocular lenses., (Copyright © 2021 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.)

Purpose: To compare calculated corneal surgically induced astigmatism (SIA) by means of anterior-based keratometry (K) and total keratometry (TK) measurements made by 2 biometric devices., Setting: Ophthalmology Department, Shaare Zedek Medical Center, Jerusalem, Israel., Design: Retrospective, consecutive case series., Methods: The medical records of patients who had undergone cataract surgery through a 2.4 mm temporal clear corneal incision by a single surgeon between March 2018 and November 2020 were retrospectively reviewed. Patients for whom there were preoperative and postoperative K measurements assessed by 2 biometric devices, optical low-coherence reflectometry (OLCR) (Lenstar LS900, Haag-Streit, software v. eye suite i/9.1.0.0) and swept-source optical coherence tomography (SS-OCT) (IOLMaster700, Carl Zeiss Meditec AG, software v. 1.80.6.60340), were identified. Corneal SIA (mean vector value) was calculated by vector analysis for 3 groups: SS-OCT(K), SS-OCT(TK), and OLCR(K). Bivariate analyses were applied for comparisons., Results: 147 eyes of 123 patients (73 right eyes and 74 left eyes) were enrolled in the study. The right eye corneal SIA values were 0.09 diopters (D) @ 136 degrees, 0.09 D @ 141 degrees, and 0.07 D @ 123 degrees for the SS-OCT(K), SS-OCT(TK), and OLCR, respectively. The corresponding left eye corneal SIA values were 0.13 D @ 120 degrees, 0.11 D @ 123 degrees, and 0.08 D @ 120 degrees. There were no statistically significant differences between the mean vector value and variance of the corneal SIA for the right (P = .78 and P = .65) and the left (P = .75 and P = .37) eyes of the 3 groups., Conclusions: Corneal SIA values were low (0.07 to 0.13 D) and similar for the SS-OCT and the OLCR biometric devices with standard K measurements. TK measurements yielded similar corneal SIA values compared with anterior corneal-based measurements., (Copyright © 2021 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.)

Purpose: To validate a new methodology of intraocular lens (IOL) assessment using acuity reserve analysis via area under the curve (AUC) to assess intermediate vision., Setting: Study 1 was conducted at 17 sites in Australia, Chile, and Europe. Study 2 was conducted at 15 sites in Australia, Brazil, and Europe., Design: Post hoc analyses of defocus curve results from 2 clinical trials (study 1: single-arm investigation of the AcrySof IQ PanOptix Trifocal IOL [model TFNT00; Alcon Research LLC]; study 2: comparative investigation of AcrySof PanOptix Trifocal IOL vs the AT LISA Trifocal IOL [model 839MP; Carl Zeiss Meditec AG])., Methods: Acuity reserve was calculated using AUC compared with visual demand (logMAR) at various distances. Study 1 validated the model; study 2 compared acuity reserve, for a range of defocus levels, for the 2 IOLs., Results: The defocus curve (study 1 [149 patients; 298 eyes]) showed good visual acuity (ie, >20/25) at all defocus levels; the AUC estimate showed 2 lines or more of reserve at -2.50 diopters. Comparative post hoc analysis (study 2 [182 patients]) demonstrated significantly improved acuity reserve with PanOptix IOL vs AT LISA IOL at 20 to 40 days postoperatively (P < .001) and 120 to 180 days postoperatively (P < .001)., Conclusions: Acuity reserve analysis using AUC represents a new methodology for comparative IOL assessment, providing additional detail beyond defocus curve analysis. This method demonstrated that the PanOptix Trifocal IOL was superior to the AT LISA Trifocal IOL (model 839MP) for visual acuity at near to intermediate distances with visual acuity reserve analysis., (Copyright © 2020 Published by Wolters Kluwer on behalf of ASCRS and ESCRS.)

Disturbing binocular problems can be too complex to be treated in such a way that comfortable binocular single vision is restored. The grey filter contact lens could offer a safe and clinically useful way to help these patients., Background: In unilateral acquired reduced visual performance or intractable diplopia the binocular performance often is less than the performance of the better eye, possibly leading to complaints of binocular visual functioning. The hypothesis is to use a grey filter contact lens on the affected eye to obtain more binocular visual comfort. The grey filter changes the binocular central visual image in the brain through delaying the image of the affected eye and has minimal effect on the peripheral vision. The purpose of this study was to evaluate the effect of the grey filter contact lens on the reduction of patients' binocular complaints in daily life., Methods: In 19 consecutive patients with unilateral acquired reduced visual performance or intractable diplopia a grey filter contact lens was fitted. The contact lens was chosen from six available filters with different transmissions, based on patient preference. The chosen filter contact lens was fitted according to the normal practice of contact lens fitting., Results: The results of 18 patients are reported, one patient was lost to follow-up. Twelve patients (67%) reported good results when wearing the grey filter contact lens. Five patients (28%) discontinued wear of the grey filter contact lens because their binocular visual complaints disappeared during filter contact lens wear and remained absent after contact lens wear was terminated., Conclusion: The grey filter contact lens is a clinically useful, safe, and easily reversible treatment option for patients with binocular visual complaints due to an acquired monocular reduction in visual quality., Competing Interests: The authors have no competing interests to declare., (Copyright: © 2021 The Author(s).)

Purpose: To clinically evaluate visual performance of the AcrySof IQ PanOptix TFNT00 and AT LISA tri 839MP intraocular lenses (IOLs) in binocular visual acuity (VA) and to characterize low-contrast visual performance at 6 months postimplantation., Setting: Multicenter, 15 sites., Design: Prospective, parallel-group, randomized, double-masked, postmarketing clinical study., Methods: Binocular uncorrected distance (UDVA, 4 m), intermediate (UIVA, 60 cm), and near (UNVA, 40 cm) visual acuities and binocular defocus curves were evaluated under photopic lighting conditions. Photopic and mesopic contrast sensitivities with and without glare were assessed., Results: The study included 182 subjects (62% women; mean age, 66 ± 9.4 years) who were implanted bilaterally with the TFNT00 IOL (n = 93) or 839MP IOL (n = 89), and binocular VA was evaluated 4 to 6 months (120-180 days) postimplantation. The TFNT00 IOL group showed superior visual outcomes compared with the 839MP IOL group in binocular UIVA (P = .001) and UNVA (P = .003) and noninferior outcomes in UDVA (95% CI, -0.023 to 0.041; upper limit <0.1 logarithm of the minimum angle of resolution [logMAR] [margin of noninferiority]). Mean defocus curve from 0.00 to -3.00 diopter (D) ranged from 0.1 to 0.0 logMAR for both IOLs; better mean VA values (logMAR) were observed in the TFNT00 IOL group between -1.50 and -2.50 D compared with those of the 839MP IOL group. Contrast sensitivity values were similar between the 2 groups in all conditions., Conclusions: The results of this study showed improved visual performance at near and intermediate distances with the TFNT00 IOL compared with that of the 839MP IOL.

Purpose: To evaluate the accuracy of different intraocular lens (IOL) power calculation formulas available on the American Society of Cataract and Refractive Surgery calculator in calculating multifocal IOL power in eyes with previous hyperopic corneal refractive laser surgery., Design: Retrospective case series., Setting: Amsterdam University Medical Center, University of Amsterdam, and Retina Total Eye Care, Driebergen, the Netherlands., Methods: This study compared the accuracy of 3 formulas using historical refractive data (ie, Masket, modified Masket, and Barrett True-K) and 3 formulas using no previous refractive data (ie, Shammas, Haigis-L, and Barrett True-K no-history)., Results: Sixty-four eyes were included. The variance of the prediction error of the various formulas was similar and ranged from 0.27 D 2 to 0.33 D 2 (P = .99). The modified Masket formula had a significantly higher median absolute prediction error than the Masket formula, Barrett True-K formula, and mean value of all formulas (P < .001)., Conclusion: All formulas showed comparable accuracy in predicting IOL power in eyes after hyperopic corneal refractive laser surgery except for the modified Masket formula, which performed less accurately than the Masket formula, Barrett True-K formula, and mean value of all formulas., (Copyright © 2018 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

Purpose: To compare the accuracy of different intraocular lens (IOL) calculation formulas available on the American Society of Cataract and Refractive Surgery (ASCRS) post-refractive surgery IOL power calculator for the prediction of multifocal IOL power after previous corneal refractive laser surgery for myopia., Methods: An analysis and comparison were performed of the accuracy of three methods using surgically induced change in refraction (ie, Masket, Modified Masket, and Barrett True-K formulas) and three methods using no previous data (ie, Shammas, Haigis-L, and Barrett True-K No History formulas). The average of all formulas was also analyzed and compared., Results: Thirty-six eyes of 36 patients were included. All formulas, except for the Masket, Modified Masket, and Barrett True-K formulas, had myopic mean numerical errors that were significantly different from zero (P ⩽ .01). The median absolute error of the Shammas formula (0.52 diopters [D]) was significantly higher compared to all of the other formulas (P < .05), except for the Haigis-L formula (P = .09). Comparing the formulas using no previous data, the Barrett True-K No History formula had the lowest median absolute error (0.33 D, P < .001)., Conclusions: The Shammas formula showed the least accuracy in predicting IOL power in eyes with multifocal IOL implantation after previous corneal refractive laser surgery for myopia. In eyes with all available data, all formulas performed equally except for the Shammas formula, whereas in eyes lacking historical data, the Barrett True-K No History formula performed best. [J Refract Surg. 2019;35(1):54-59.]., (Copyright 2019, SLACK Incorporated.)

Purpose: To study straylight before and after posterior polar cataract removal., Setting: Academic Medical Center, Amsterdam, the Netherlands., Design: Prospective case series., Methods: Patients diagnosed with posterior polar cataract who agreed to cataract surgery were included in the study. Intraocular straylight was measured before and after surgery with the compensation comparison method using a straylight meter (C-Quant)., Results: Measurements were performed on 8 eyes of 4 patients. The mean preoperative corrected distance visual acuity was relatively good (0.15 logarithm of the minimum angle of resolution [logMAR] ± 0.18 (SD). The mean postoperative CDVA was -0.08 ± 0.09 logMAR (P < .01). The mean preoperative straylight was extreme (2.01 ± 0.38 log[s]), 13 times that of a young normal eye; however, it improved postoperatively to 1.04 ± 0.26 log(s) (P < .01)., Conclusions: Straylight in eyes with posterior polar cataract patients can be extremely bothersome, while visual acuity is relatively well preserved. Surgery was effective in lowering straylight levels. For these patients, straylight measurements can help objectively measure the quality of vision complaints, and elevated straylight levels can be an indication for surgery independent of visual acuity., (Copyright © 2018 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)

Objectives: To study the effects of corneal scars and the treatment of these scars with rigid gas-permeable (RGP) contact lenses on quality of vision including straylight. Visual effects were related to scar characteristics such as size and grade., Methods: Straylight and best-corrected visual acuity were measured in 23 patients with corneal scars during and after RGP contact lens wear. Contralateral eyes were used as controls, and age-normal values in case of bilateral scars. Straylight measurements were performed using the compensation comparison method of the Oculus C-Quant instrument., Results: Scarred eye straylight values were 1.53 log(s) without contact lens and 1.60 log(s) with contact lens (P=0.043). Healthy eyes without contact lens had a mean straylight value of 1.13 log(s), corresponding to age-normal values. Contact lens wear increased straylight in healthy eyes to 1.26 log(s) (P<0.001). Visual acuity improved from 0.66 logarithm of minimal angle of resolution (logMAR) to 0.19 logMAR with contact lens wear in eyes with a corneal scar (P<0.001)., Conclusions: Corneal scars can have a strong effect on quality of vision by diminishing visual acuity and increasing straylight. The increase in straylight from corneal scars on its own can lead to a serious visual handicap. Contact lens treatment did not improve straylight, but showed a slight worsening. As the recovery of visual acuity with contact lens wear far exceeded straylight increase, contact lenses remain a clinically useful treatment option in most patients with corneal scars.

Purpose: To report the results of long-term topical treatment with bevacizumab (Avastin) 5 mg/mL eyedrops in a case of aniridia-related neovacularization of the cornea., Methods: Interventional case report. A female patient with aniridia had a decrease in the best corrected visual acuity from 0.32 to 0.02 in the OS over the course of 4 years, secondary to central corneal neovascularization and epithelial breakdown. Vision in the OD was 0.2. In 2008, at age 28, a shared decision was made to start off-label treatment with bevacizumab eyedrops 0.5% in both eyes. After 9 years, the visual acuity in the OD remained stable, with stability of the macropannus and maintenance of central corneal clarity. In the OS, the central corneal neovascularization regressed, the epithelium regained its clarity, and after cataract surgery visual acuity was regained to 0.32., Results: After 9 years of treatment with topical bevacizumab, vision acuity is comparable to the situation of 12 years previously: Visual acuity remained stable in the ODS., Conclusion: In a young patient with progressive corneal neovascularization secondary to aniridia, stability of central corneal neovascularization was obtained and corneal clarity was preserved by adding a daily drop of bevacizumab 5 mg/mL. No adverse events occurred. Vessel growth was inhibited, and as such, the progression of the natural history of the patient's disease was halted. More clinical study with longer follow-up is needed to investigate the applicability of treatment with topical VEGF inhibitors in aniridia.

Purpose: To describe the outcomes in terms of the refraction and visual acuity of multifocal intraocular lens (IOL) implantation in patients with previous hyperopic corneal refractive laser surgery., Setting: Academic Medical Center, University of Amsterdam, Amsterdam, and Retina Total Eye Care, Driebergen, the Netherlands., Design: Retrospective case series., Methods: Results were analyzed 3 months after implantation of a multifocal IOL (Acrysof Restor SN6AD1) in patients after previous corneal refractive laser surgery for hyperopia. The primary outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and refraction. The secondary outcome measures were the number of laser enhancements and posterior capsule opacification (PCO) rates., Results: Forty eyes of 40 patients were included. Sixteen eyes (40.0%) had lens extraction because of cataract, and 24 eyes (60.0%) had refractive lens exchange. The mean postoperative UDVA was 0.16 logarithm of the minimum angle of resolution (logMAR) ± 0.18 (SD), and the mean postoperative CDVA was 0.01 ± 0.08 logMAR. The mean postoperative spherical equivalent was 0.04 ± 0.92 diopter (D). Twenty-five eyes (62.5%) were within ±0.50 D of emmetropia, and 35 eyes (87.5%) were within ±1.0 D of emmetropia. Nine eyes (22.5%) had a laser enhancement because of a residual refraction error. Eleven eyes (27.5%) had a neodymium:YAG laser capsulotomy because of PCO., Conclusions: In general, multifocal IOL implantation after corneal refractive laser surgery for hyperopia resulted in good visual acuity and refraction. The magnitude of previous hyperopia did not influence the refractive predictability., (Copyright © 2018 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)