JCRS HIGHLIGHTS VOL: 41 ISSUE: 6 MONTH: JUNE 2015

IOL glistenings and visual quality

The effect of glistenings, fluid-filled microvacuoles that form within some hydrophobic IOLs, on visual function is controversial. US researchers report a retrospective cohort study looking at the effects of glistenings on light scatter and visual function. The study of 79 pseudophakic patients stratified two groups, those with glistenings of 6 µm to 25 µm in diameter, and those with larger glistenings. Glistening size correlated with light scatter. They found significant correlations between IOL age and glistening size, as well as IOL age and contrast visual acuity with glare. They also call for larger clinical studies to further examine the effects of glistening size and area on visual function parameters. BS Henriksen et al., JCRS, “IOL glistening size and visual quality”, in press, June 2015.

Post-op endophthalmitis prophylaxis

The use of intracameral antibiotic injection prophylaxis is catching on the US, a 2014 online survey of the American Society of Cataract and Refractive Surgery members indicates. Nearly half of respondents already used or planned to adopt this measure. Many of those using this approach continue to have concerns about the lack of a commercially available antibiotic approved in the US for intracameral injection. The majority used topical perioperative antibiotic prophylaxis, and gatifloxacin and moxifloxacin were still the most popular agents. However, there was a trend toward declining use of fourth-generation fluoroquinolones and a greater use of topical ofloxacin and ciprofloxacin. D Chang et al., JCRS, “Antibiotic prophylaxis of postoperative endophthalmitis after cataract surgery: Results of the 2014 ASCRS member survey”, in press, June 2015.

Intrastromal corneal ring segments and keratoconus progression

Intrastromal corneal ring segments (ICRS) are one treatment option for keratoconus patients. In the short term they induce a geometric change in the central curvature to improve the visual acuity and reduce the refractive error and the mean keratometry. In addition, the corneal remodelling improves the optical quality of the cornea and reduces the potential for optical aberrations. Spanish investigators followed 15 keratoconus patients for five years following ICRS implantation. All were 30 years or younger at the time of surgery, with confirmed progressive disease. At six months patients showed significant improvement in uncorrected and corrected distance visual acuities and all refractive measurements, and the mean keratometry was reduced by 4.48 dioptres. However, at five years these values worsened, with mean K values regressing to 3.36 dioptres. A Vega-Estrada et al., JCRS, “Keratoconus progression after intrastromal corneal ring segment implantation in young patients: Five-year follow-up”, in press, June 2015.