JCRS Highlights

Spherical effects of astigmatic treatments

Coupling, a term used to describe the relative corneal steepening that occurs 90 degrees from the primary corneal flattening induced by corneal incisions, is a clinically significant phenomenon that affects the visual outcomes of incisional and ablative procedures. Better quantification of coupling would help a surgeon better anticipate the spherical effect of astigmatic effects of surgery. To this end, Alpins and colleagues developed a coupling paradigm that is valid for all forms of incisional and ablative astigmatism treatments. They have created a calculator that determines the coupling effect when sphero-cylindrical treatments are performed. They report that, by using this approach, they are able to reliably estimate the amount of coupling caused by any type of astigmatism treatment. In the case of laser ablation, the resulting coupling adjustment can be incorporated into future surgical plans for sphere to improve the accuracy of visual outcomes. N Alpins et al, JCRS, “Corneal coupling of astigmatism applied to incisional and ablative surgery”, Volume 40, Issue 11, 1813-27.

Poor eyedrop technique common

The inability of patients to instil eyedrops properly after cataract surgery is well known, and has implications for postoperative recovery. Just how bad are patients when it comes to eyedrop use? Canadian researchers conducted a prospective, cross-sectional study to find out. They collected data from 54 eyedrop-naïve patients after cataract surgery. This included questionnaires, chart reviews and videos of patients. The vast majority of patients demonstrated poor instillation technique, failing to wash hands, contaminating bottle tips, missing the eye, and using an incorrect amount of drops. Most patients tended to overestimate how well they were doing. JA An et al, JCRS, “Evaluation of eye drop administration by inexperienced patients after cataract surgery”, Volume 40, Issue 11, 1857-61.

MRSA challenges

Ophthalmologists are in the front lines in the war against Methicillin-resistant Staphylococcus aureus (MRSA). Mah and colleagues did a comprehensive review of the current medical literature and describe many of the challenges of ocular MRSA infections, and also recommend ways to identify, treat and reduce the overall problems associated with MRSA. They emphasise that clinicians must remove transient microorganisms from hands by using hand washing or hand antisepsis between all patient contacts. Eye-lane surfaces and hand instruments should be cleaned periodically. They also emphasise the importance of working with local infectious disease specialists to plan treatment. F Mah et al, JCRS, “Current knowledge about and recommendations for ocular methicillin-resistant Staphylococcus aureus”, Volume 40, Issue 11, 1894-1908.