JCRS

Best approach to correcting astigmatism?

Approximately 40 per cent of patients having cataract surgery have astigmatism of more than 1.0 D. Surgeons know that optimising refractive outcomes following cataract surgery requires good management of pre-existing corneal astigmatism. But how best to accomplish this? Researchers at Moorfields Eye Hospital conducted a prospective masked bilateral randomised study comparing the two standard approaches now used to reduce preoperative corneal astigmatism during cataract surgery, toric IOLs and peripheral corneal relaxing incisions. The study enrolled 60 eyes of 30 patients with preoperative corneal astigmatism of 1.0 to 2.5 D. Toric IOLs and relaxing incisions both reduced astigmatism. However, toric IOLs reduced astigmatism to a higher extent and were more predictable.

N Hirnschal et al., JCRS, “Correction of moderate corneal astigmatism during cataract surgery: Toric intraocular lens versus peripheral corneal relaxing incisions,” Volume 40, Issue 3, 345-361.

Physician see thyself

How do physicians feel about laser vision correction when they themselves undergo it? A 12-question survey of 132 physicians who underwent refractive surgery suggested a positive overall experience. The mixed group of surgeons and non-surgeons reported an overall satisfaction rate of 95.3 per cent. Most, 84.8 per cent reported an improvement in the quality of vision, with 39.0 per cent reporting an improvement in the ability to perform procedures accurately.

Theodore A. Pasquali et al., JCRS, “Long-term follow-up after laser vision correction in physicians: Quality of life and patient satisfaction,” Volume 40, Issue 3, 395-402.

Ancient ophthalmology

Contrary to oft heard claims, primitive cataract surgery was not performed in ancient Egypt. A recently conducted review of the available sources from that time concludes that ophthalmology was indeed one of the most important specialties in the time of the Pharaohs. However, it appears to have been of a purely noninvasive nature, with no example of cataract surgery or of any other invasive ophthalmologic procedure found in the original sources. Indeed, the first clear mention of cataract surgery comes from the Greek stoic Chrysippus in the third century BC. The true origin of cataract surgery remains unknown.

P Blomstedt, JCRS, “Cataract Surgery in Ancient Egypt,” Volume 40, Issue 3, 485-489.