Corrected Distance Research Articles

Male Sex Is an Associated Factor for Delayed Bone Union Following Hybrid Closed-Wedge High Tibial Osteotomy

Background and Objectives: Although hybrid closed-wedge high tibial osteotomy (HTO) is an effective procedure for varus knee osteoarthritis, delayed bone union is a frequent occurrence. The rate of bone union and its associated factors remain unclear. This study aimed to investigate the detailed process of bone union in hybrid closed-wedge HTO using computed tomography (CT) and to examine factors associated with delayed bone union. Materials and Methods: We retrospectively reviewed 53 consecutive patients who underwent hybrid closed-wedge HTO. Cases with no bone union at any of five sites (anterior flange, posterior, lateral, hinge, and medial) on coronal and sagittal computed tomography at 3 months postoperatively were defined as delayed bone union. Regression analysis was performed with delayed bone union as the dependent variable and sex, age, height, body weight, body mass index, correction distance, smoking, and diabetes mellitus as independent variables. Results: Among 50 analyzed knees (mean age, 61.4 ± 7.8 years), 17 (34.0%) had delayed bone union at 3 months postoperatively and one knee had screw breakage. Sex was the only significant factor associated with delayed bone union (male: β = 2.1, p < 0.004). Conclusions: Delayed bone union (absence at 3 months after hybrid closed-wedge high tibial osteotomy) occurred in 34% of patients, and male sex was associated with delayed bone union.

Assessment of intraocular lens tilt and decentration after femtosecond laser-assisted and conventional cataract surgery at 12 months and beyond

PurposeTo compare long-term intraocular lens (IOL) decentration and tilt following femtosecond laser-assisted cataract surgery (FLACS) and conventional surgery using swept-source anterior segment ocular coherence tomography (SS-ASOCT).MethodsIn this retrospective cross-sectional study, all patients underwent FLACS or conventional cataract surgery. Those with a minimum of 12-months follow-up since surgery were included. Patients with surgical complications were excluded. Demographics, preoperative ocular measurements (axial length, anterior chamber depth), and postoperative measurements [corrected distance visual acuity (CDVA), autorefraction, keratometry, IOL type] were collected. Postoperative IOL tilt and decentration were compared using SS-ASOCT between patients with FLACS and conventional cataract surgery. Subgroup analysis was conducted to analyze tilt and decentration by haptic type (single-piece vs. three-piece).ResultsA total of 188 eyes were included [110 (58.5%) in the FLACS group and 78 (41.5%) in the conventional group]. No differences were observed between the FLACS and conventional groups regarding preoperative parameters. FLACS resulted in less IOL decentration compared to conventional cataract surgery (170 μm vs. 240 μm, p = 0.002). No statistically significant differences were observed between the FLACS and conventional groups in the magnitude and axis of IOL tilt. Both groups had a trend of IOL tilt toward the inferotemporal aspects. Moreover, no difference regarding postoperative CDVA, spherical equivalent, and keratometric astigmatism was observed.ConclusionsFLACS resulted in significantly better long-term IOL centration than conventional surgery with manual capsulotomy. No significant difference in IOL tilt or postoperative CDVA was observed between FLACS and conventional cataract surgery.

One-year outcomes after intraocular collamer lens implantation in hyperopic astigmatism: a retrospective single-center study

Background: Astigmatism is the most prevalent refractive error among children and adults, and it can lead to visual impairment if left uncorrected. The management of compound hyperopic astigmatism is more challenging. This study presents the 12-month outcomes of toric implantable collamer lens (ICL) implantation in eyes with hyperopic astigmatism. Methods: This interventional case series included patients with simple or compound hyperopic astigmatism who underwent toric ICL implantation. All eligible individuals underwent a detailed ocular examination. Uncorrected and corrected distance visual acuity (UDVA and CDVA, respectively), intraocular pressure, and manifest and cycloplegic refraction results were documented. Pentacam corneal tomography was performed to assess the central corneal thickness, iridocorneal angle width, and anterior chamber depth. Endothelioscopy was performed to determine endothelial cell density. The ICL V4b model was implanted in all the included eyes. Safety and efficacy indices were calculated as postoperative CDVA/preoperative CDVA and postoperative UDVA/preoperative CDVA, respectively. Results: Twenty-six eyes with low-grade simple or compound hyperopic astigmatism were included. All eyes experienced a significant improvement of four lines in postoperative UDVA (P < 0.001), and their postoperative CDVA remained stable at the 12-month follow-up (P > 0.05). The safety and efficacy indices were 1.0. None of the eyes lost two or more lines of CDVA; in 81% of the eyes, CDVA was unchanged, and the proportion of eyes with 20/30 or better postoperative UDVA was identical to that with 20/30 or better preoperative CDVA (81% for each). The mean manifest spherical equivalent at the 12-month postoperative visit had significantly improved (P < 0.001). The percentages of eyes with postoperative spherical equivalent within ± 0.50 D and ± 1.00 D were 81% and 96%, respectively. The postoperative refractive cylinder improved significantly (P < 0.05), and the percentage of eyes with refractive cylinder within ± 0.50 DC and ± 1.00 DC were 50% and 77%, respectively. Conclusions: Our outcomes indicate that toric ICL implantation is safe and effective for managing low-grade simple or compound hyperopic astigmatism. The proportion of eyes with 20/30 or better postoperative UDVA was identical to that with a 20/30 or better preoperative CDVA. The manifest spherical equivalent and refractive cylinder were significantly reduced. No serious safety concerns were observed. Further prospective large-scale studies with a wide range of ages and grades of hyperopic astigmatism are required to verify these preliminary outcomes.

Short-Term Visual and Refractive Outcomes of Single-Step Transepithelial Photorefractive Keratectomy with Amaris 750S and SmartSurfACE in Myopia and Astigmatism: A 6-Month Follow-Up Study.

Single-step transepithelial photorefractive keratectomy (TPRK) is a modern refractive surgery technique that offers a no-touch approach for correcting myopia and astigmatism. This study aims to evaluate the short-term visual and refractive outcomes of TPRK in patients with myopia and astigmatism over a 6-month follow-up period. This retrospective cohort study included patients who underwent single-step TPRK using the Amaris 750S laser platform with SmartSurfACE and SmartPulse® technologies, targeting a plano refraction. Procedures were performed with aspheric, non-wavefront-guided profiles, and outcomes were assessed postoperatively. 96% of eyes achieved 20/20 or better uncorrected distance visual acuity (UDVA), with 98% reaching 20/25 or better, and 100% achieving 20/32 or better. UDVA was the same or better than preoperative corrected distance visual acuity (CDVA) in 96% of eyes, and no eyes lost two or more Snellen lines. Refractive outcomes showed strong precision, with 93% of eyes within ±1.00 D of the target. Astigmatism correction was accurate, with 100% of eyes having ≤1.00 D of astigmatism, and 80% achieving a precise astigmatism angle of error between -5° and 5°. Single-step TPRK with SmartSurfACE and SmartPulse® technologies provides highly effective and predictable visual and refractive outcomes for myopia and astigmatism. The procedure consistently delivers precise corrections with minimal complications, making it a reliable option for refractive surgery.

Comparison Between Monofocal and Aspheric Monofocal Intraocular Lens With Higher Order Aspheric Optic in Pediatric Patients: Early Outcomes.

To retrospectively compare the visual acuity outcomes for far, intermediate, and near vision of an aspheric monofocal intraocular lens (IOL) with higher order aspheric optic with a monofocal IOL in pediatric patients. Thirty-eight eyes of 38 patients (mean age: 9.0 ± 2.3 years) affected by monolateral infantile cataract were evaluated 6 months after surgery performed with simultaneous IOL implantation. The Tecnis Eyhance ICB00 aspheric monofocal IOL (Johnson & Johnson Vision) was implanted in 17 eyes (Tecnis Eyhance group, mean age: 8.9 ± 2.5 years) and the Tecnis PCB00 monofocal IOL (Johnson & Johnson Vision) was implanted in 21 eyes (control group, mean age: 9.1 ± 2.2 years). Corrected visual acuity expressed in logarithm of the minimum angle of resolution (logMAR) was assessed for distance (CDVA) and, expressed in Jaeger standard, for intermediate (DCIVA) and near vision (CNVA). DCIVA was measured with distance correction and without addition. The Mann-Whitney test for two independent samples was performed, and a P value less than .05 was considered statistically significant. Six months postoperatively, mean CDVA was 0.20 ± 0.2 logMAR and mean DCIVA and CNVA were 5 ± 1 and 2 ± 1 Jaeger, respectively, in the Tecnis Eyhance group. In the control group, mean CDVA was 0.21 ± 0.2 logMAR and mean DCIVA and CNVA were 8 ± 1 and 3 ± 1 Jaeger, respectively. Only DCIVA showed a significant statistical difference between groups (P < .0001). In pediatric patients, the aspheric monofocal IOL with higher order aspheric optic seems to provide better intermediate distance visual acuity than a monofocal one, whereas no significant difference was observed for CDVA and CNVA. [J Refract Surg. 2024;40(10):e724-e727.].

Effectiveness and safety of a novel crosslinked hyaluronate canalicular gel occlusive device for dry eye.

To evaluate the effectiveness and safety of a crosslinked hyaluronate (HA) canalicular filler (Lacrifill Canalicular Gel) compared with a commercially available hydrogel canalicular plug (Form Fit). 5 sites in the United States. Prospective, multicenter, controlled, double-masked, randomized 2:1 (filler:plug). Adults (≥22 years) with the Schirmer test (with anesthesia) ≤10 mm/5 minutes, presence of corneal staining, ocular surface disease index (OSDI) of ≥23 with ≤3 responses of "not applicable," patent lacrimal drainage system, and bilateral corrected distance visual acuity of 20/40 or better. Filler or plugs were instilled bilaterally in the inferior canaliculi. Primary effectiveness endpoint was noninferiority of the mean within subject change from baseline to month 3 in Schirmer score for patients receiving filler compared with plugs. The key secondary effectiveness endpoint was noninferiority of the proportion of patients with filler achieving improvement from baseline to month 3 in OSDI by a minimal clinically important difference. Additional endpoints included the mean change from baseline to 3 and 6 months in tear meniscus height, OSDI, corneal staining, tear breakup time, and safety. 157 patients were randomized; 99 patients with crosslinked HA filler and 52 patients with hydrogel plugs completed the study. Filler was noninferior to plugs in the mean Schirmer score change from baseline and in the proportion of patients achieving a clinically important improvement in OSDI. Crosslinked HA filler is a safe, well-tolerated, and effective method to treat dry eye. Clinically and statistically significant improvements in signs and symptoms of dry eye were sustained through 6 months.

Compulsory Training in Post-pandemic Times - Presence, Digital, Hybrid & Co. Using the Example of the University Hospital of Würzburg

With the end of the pandemic in April 2023 the whole learning environment had run through some major changes. The act of normal teaching was not that easy anymore during the pandemic. The size of a class had to be cut down to a size that fits the hygienic guidelines. Therefore, methods like blended learning and virtual classrooms came to life stronger than before. The methods were not new but never before needed in such a strong matter. Due to the experience with these methods of education, teaching and learning stayed different. Topics like virtual reality and even augmented reality stayed and are to some point part of the educational system nowadays. Due to the pandemic, it may seem that these new kinds of methods are worse compared to the ones we are used to but several studies can prove the opposite.The University Hospital Würzburg (UKW) has adapted to these kinds of changes. Every specialist training was formed to fit the necessary changes during the pandemic. It was not easy to keep up good practical education with the correct distance measurement, open windows for fresh air every 45 minutes or an FFP2 mask for protection. The rest of the close to 190 trainings held in the rooms of the academy of the UKW had to be cancelled or cut down to a group size allowed. Most of the known digital teaching and learning system that were installed at that time remained and are in use.

Unlocking Clinical Insights and the Life-Changing Impact of Low-Vision Devices in Primary Open-Angle Glaucoma Patients.

Objective To elucidate the clinical profile of visual impairment (VI) and the effect of low-vision devices (LVD) among patients with primary open-angle glaucoma (POAG). Methodology A retrospective observational study was used. Case records of patients who reported to the low-vision care clinic with POAG were recruited for the study. Glaucoma was defined according to the International Society for Geographical and EO classification. Demographic data, visual acuity (LogMAR), clinical diagnosis, visual fields, occupation, and LVD prescribed were extracted from the records. The visual acuity pre- and post-use of LVD was compared. Visual acuity improvement while using the LVD was noted. Results Of the 200 POAG cases, 20% (n=40) had severe, 15.5% (n=31) had profound (<3/60), 20.5% (n=41) profound (<1/60), and 26.5% (n=53) had total blindness in the VI category. Significant improvement was noted for both distance and near vision (p=0.004 and p=0.000, respectively) for single-vision glasses, and significant improvement (p=0.000) was also noted for patients corrected for both distance and near correction (bifocal/progressive). Patients with severe visual field loss (p=0.004) and with a visual field defect of <10 degrees (p=0.000) both showed a significant improvement in near vision with low-vision rehabilitation. The proportion of patients earning showed improvement following LVD use compared to those who did not have self-earning (60% vs. 40.24%,p=0.0116). Conclusion LVD significantly improved near vision in POAG patients with advanced glaucoma, a visual field defect of less than 10 degrees. To effectively manage POAG patients with low vision, it is vital to understand both the ocular diseases causing VI and the patient's visual requirements and provide timely management.

Clinical Outcomes of Iris-Supported Phakic Toric Intraocular Lenses in Corneal Ectasia.

Our aim was to evaluate the visual and refractive outcomes of iris-fixated phakic toric intraocular lenses (IOLs)for visual rehabilitation in eyes with stable corneal ectasia. We conducted a study looking at the clinical outcomes of iris-fixated toric IOLs (Artisan) in 33 eyes of 27 patients diagnosed with mild-to-moderate corneal ectasia at a single center (Queen Victoria Hospital, East Grinstead, UK). The main outcome measures were functional improvement [accuracy of post-operative spherical equivalent (SE), astigmatic correction, topographic parameters, uncorrected and corrected distance visual acuity (UCVA, CDVA)] and safety of the procedure: endothelial cell count and intra- and post-operative complications. Eighteen males and nine females of mean age 38.85 were included in the study with a mean follow-up of 18months. All patients had ectasia due to keratoconus except one with post-refractive laser ectasia. Twelve patients had crosslinking, eight had intracorneal rings, and eight had previous keratoplasties. Mean pre-operative logMAR UCVA was 0.75 ± 0.35 improving to 0.02 ± 0.17 (p = 0.000). Mean pre-operative logMAR CDVA was 0.16 ± 0.17 improving to 0.02 ± 0.17 (p = 0.000). Mean pre-operative (SE) was -3.5 ± 3.9 improving to -2.75 ± 1.39 (p = 0.000) with up to 36-42months of follow-up. The mean value of endothelial cell density in the overall sample was 2252.54 ± 473.24cells/mm2 pre-operatively and 2126.75 ± 365.21cells/mm2 at 24-36months of follow-up visit. Two patients have intra-operative hyphemia secondary to iris prolapse. Implantation of iris-fixated phakic toric IOLs has shown high efficacy and safety in patients with mild-to-moderate astigmatism in corneal ectasia.

Digital versus manual axis marking for toric phakic intraocular lens alignment: a prospective randomized intraindividual trial.

This study compares visual and refractive outcomes and postoperative axis alignment for toric Implantable Collamer Lens (ICL) implantation in astigmatic myopia using manual versus digital marking techniques. Department of Ophthalmology, Medical University of Graz, Austria. Prospective randomized single-centered intraindividual comparison. Patients undergoing bilateral toric ICL implantation for myopia with astigmatism ≥ 0.5 diopters (D) were enrolled. Patients received both marking techniques and randomization was performed. Postoperative retroillumination photography assessed axis alignment, and visual and refractive parameters were evaluated. Duration of the surgeries was recorded. The study includes 20 patients and 40 eyes. Preoperative visual and refractive parameters showed no significant differences. Postoperatively, residual astigmatism (p=0.824) and spherical equivalent (p=0.309) were comparable. No notable differences between right and left eyes in terms of preoperative (p=0.371) and postoperative (p=0.824) astigmatism were observed. Although slight, corrected distance visual acuity (CDVA) increased in both groups postoperatively (p=0.381). Gain in CDVA was comparable between marking techniques (p=0.637). Safety and efficacy indices were comparable (p=0.991 and p=0.189, respectively). Postoperative axial misalignment was 2.8±3.1 degrees in the digital- and 4.4±5.1 degrees in the manual group (p=0.260). Vector analysis showed no significant differences between manual and digital marking. Duration remained uninfluenced by the marking technique (p=0.970) and side of surgery (p=0.682). In conclusion digital and manual marking techniques provided comparable results in axis alignment, surgical duration and visual and refractive outcomes. Both methods are viable for precise axis alignment, with digital marking offering a potential advantage in efficacy.

Visual Outcomes and Patient Satisfaction of Enhanced Monofocal Intraocular Lens in Phacovitrectomy for Idiopathic Epiretinal Membrane.

To evaluate the clinical outcomes and patient satisfaction after implantation of an enhanced monofocal intraocular lens (TECNIS Eyhance ICB00) in patients with idiopathic epiretinal membrane (ERM) who underwent cataract surgery with pars plana vitrectomy (PPV). This is a single-center, retrospective, comparative study. In total, 61 eyes of 61 patients with idiopathic ERM and cataracts were included. We measured the uncorrected near and intermediate visual acuity (UNVA and UIVA), uncorrected and corrected distance visual acuity (UDVA and CDVA), central macular thickness, defocus curves, and contrast sensitivity 3-6 months after the surgery. Overall patient satisfaction was assessed using a questionnaire at the 1-month follow-up visit. The ICB00 group showed better near and intermediate visual acuity than the monofocal group (TECNIS ZCB00); however, no statistically significant differences were found between the groups. The ICB00 group exhibited wider defocus curves at near to far distances (-3.0 to +2.0 D) than the ZCB00 group. There were no significant differences in the results of the contrast sensitivity test, dysphotopsia, spectacle dependence, or patient satisfaction between the two groups. In combined PPV and cataract surgery for ERM patients, ICB00 resulted in good visual acuity with a smoother defocus curve compared to the ZCB00 group.

UWB indoor localization method based on neural network multi-classification for NLOS distance correction

It is well known that ultra-wideband (UWB) is widely used in building indoor positioning systems (IPS) because of its unique advantages. However, compared with the line-of-sight environment (LOS), UWB localization on none-line-of-sight (NLOS) channels has certain limitations, which will reduce the UWB ranging accuracy and location reliability in indoor environment. In this paper, a neural network (NN)-enhanced UWB positioning method is proposed. It can improve positioning performance by using the received channel impulse response (CIR) and UWB raw ranging data to classify the channel conditions and predict the distance. By training CNN-LSTM and MLP neural networks, the proposed method can alleviate the deterioration of localization performance caused by NLOS. The experimental results showed that the average NLOS recognition accuracy of five different obstacles including wooden doors, concrete walls, metal shelves, human body and glass windows reaches up to 92.36 %. In addition, the average root mean square error (RMSE) between the predicted distance and the true distance was 0.3123 m. The indoor positioning test was carried out by weighted least squares (WLS) and the average positioning error under three trajectories was 0.1223 m, which improved the performance by 83.56 % compared with the original UWB positioning system, thus proving its ability to reduce positioning degradation.

Clinical Outcomes of Modified Manual Deep Anterior Lamellar Keratoplasty for Eyes with Previous Radial Keratotomy.

Background: The aim of this study was to evaluate the intraoperative complications and visual outcomes of manual deep anterior lamellar keratoplasty (mDALK) in patients who underwent previous radial keratotomy (RK) for myopia. Methods: The notes of patients who underwent mDALK after RK at three different hospitals-San Giovanni Addolorata Hospital (Rome, Italy), Mount Saint Joseph Hospital (Vancouver, Canada), and Tor Vergata University Hospital (Rome, Italy)-were retrospectively reviewed. We analyzed the manual dissection success rate and conversion to penetrating keratoplasty (PK), the residual recipient stromal thickness, the postoperative corrected distance visual acuity (CDVA), postoperative refraction, and topographic astigmatism. Results: Thirteen eyes of eleven patients were included in the analysis (male 7/11, 63.6%). Preoperatively, mean topographic astigmatism was 5.4 ± 3.5 D (range 1.6-14.8 D), and mean CDVA was 0.47 ± 0.2 logMAR (range 0.3-1.0 logMAR) [Snellen equivalent 20/50]. Manual dissection was performed in all cases. None of the examined eyes were converted to PK. An improvement in both topographic astigmatism (2.8 ± 0.9 D, p = 0.0135) and CDVA (0.23 ± 0.2 LogMAR, p = 0.0122) was recorded at 12-month follow-up. Conclusions: mDALK is a safe and effective surgical technique when applied to eyes previously treated with RK, with an observed improvement in CDVA and topographic astigmatism.

Refractive power profiles of commercially available soft multifocal contact lenses for myopia control.

Lens power profiles can provide valuable insights on the imposed optical defocus and visual experience of contact lens wearers, especially in the context of myopia control. This study measured the refractive power profiles of multifocal soft contact lenses (MFCLs) currently used or that have the potential for use in myopia control using high spatial resolution aberrometry. The instrument's repeatability for determining MFCLs power profiles was also assessed. The power profiles of 10 MFCLs of various designs (centre-distance, centre-near and extended depth of focus) were measured using the Lambda-X NIMOEVO, a phase shifting Schlieren-based device. Power profiles were graphically expressed as measured power at each chord position and the maximum add power was calculated. The repeatability of the NIMOEVO was expressed as the within-subject standard deviation at each chord position for a subset of five MFCLs. The measured distance powers differed from nominal powers for more than half of the MFCLs with a definable distance zone. There were variations in the chord position of the distance and near correction zones, rate of power transitions and calculated maximum add between the MFCLs which did not depend on lens design. For half of the MFCLs, the power profile shape was inconsistent between different nominal back vertex powers of the same design. The repeatability of the NIMOEVO was dependent on the lens design, with designs featuring faster rates of power change exhibiting worse repeatability. Significant differences in MFCL power profiles were found which were not adequately represented in labelling. This is likely due to the small number of parameters used to define lens power characteristics. Eye health care practitioners should be aware of potential differences in power profiles between different MFCLs, which will impact the retinal defocus introduced during lens wear and the wearer's visual experience.

Clinical Outcomes of Enhanced Monofocal (Mono-EDOF) Intraocular Lenses with the Mini-Monovision Technique versus Trifocal Intraocular Lenses: A Comparative Study.

It was aimed to compare the clinical results of the mini-monovision technique (MMV) with enhanced monofocal intraocular lens (IOL) and trifocal IOL applications and to evaluate the intereye differences in the MMV group. This retrospective observational study evaluated the results of cataract surgeries performed on 48 eyes of 24 patients. Surgeries in Group I were performed for MMV using the RayOne EMV IOL targeting emmetropia in dominant eyes (Group IA) and -0.70 diopter (D) myopia in non-dominant eyes (Group IB), while those in Group II were performed with the AcrySof® IQ PanOptixTM TNFT00 IOL targeting emmetropia. After the surgeries, uncorrected and corrected distance, intermediate, and near distance visual acuities, contrast sensitivity measurements, and defocus curves were determined. Subjective evaluation was made with the National Eye Institute Visual Function Questionnaire (NEI VFQ-25). The groups were compared statistically. Postoperative refraction mean spherical equivalent was -0.25±0.22 D, -0.67±0.33 D, and -0.16±0.31 D in the three groups, respectively. A statistical difference was identified in favor of Group IA for uncorrected distance vision and in favor of Group IB for near vision (p<0.05). There was no difference in bilateral uncorrected visions in Groups I and II (p>0.05). While contrast sensitivity was better in Group I at all spatial frequencies (p<0.05), better vision was achieved in the defocus curve at distance in Group IA and at near in Group IB. In the binocular evaluation, it was seen that Groups I and II had similar results. In the subjective evaluation, NEI-VFQ-25 scores were 94.1±4.2/100 in Group I and 91.5±3.0/100 in Group II at 6 months (p>0.05). Photic complaints were significantly more common in Group II. With the MMV technique, it was observed that enhanced monofocal lenses provided better visual acuity at all distances and less dysphotopsia than trifocal lenses, whereas trifocal lenses were better at providing independence from glasses.

Safety and Effectiveness of Laser in Situ Keratomileusis Using the Teneo 317 Model 2 for Correcting Myopia and Myopic Astigmatism: Results of the U.S. FDA Clinical Trial.

To evaluate the safety and effectiveness of a new aspheric ablation profile for correcting myopia and myopic astigmatism. This prospective, multicenter study included patients who underwent laser in situ keratomileusis (LASIK) using a new aspheric ablation profile of the Technolas Teneo 317 (Model 2) excimer laser (version 1.28 US SW) by Technolas Perfect Vision, Bausch+Lomb, Inc. No nomogram adjustments were made, and the patient's manifest refraction was entered into the laser (for treatment). Postoperative assessments included visual and refractive outcomes. Patients were asked to complete the Patient-Reported Outcomes With LASIK (PROWL) questionnaire preoperatively and postoperatively. A total of 333 eyes from 168 patients with a mean age of 33 ± 7 years were included. At postoperative 9 months, uncorrected and corrected distance visual acuities of 20/25 or better were seen in 97.8% and 100% of eyes, respectively. None of the eyes lost two or more lines of corrected distance visual acuity. The mean manifest spherical refraction improved from -5.67 ± 2.52 diopters (D) preoperatively to -0.04 ± 0.32 D postoperatively, with 92.7% of eyes achieving residual refractive error within ±0.50 D. Residual refractive cylinder within ±0.50 and ±1.00 D was seen in 93% and 99.4% eyes, respectively. The refractive outcomes were stable throughout the follow-up of 9 months. The proportion of patients satisfied with their vision rose from 27.7% preoperatively to 98.1% postoperatively. LASIK performed using a new aspheric ablation profile of the Technolas Teneo 317 (Model 2) excimer laser is safe and effective for correcting myopia and myopic astigmatism, yielding excellent visual and refractive outcomes that were stable over 9 months. [J Refract Surg. 2024;40(8):e544-e553.].

A local magnitude scale (ML) for Northern Algeria

This study presents a local magnitude scale (ML) based on the original Richter definition and designed for use within the Algerian Digital Seismic Network (ADSN). The magnitude scale is derived from the analysis of 17,377 zero-peak maximum amplitude traces extracted from the vertical component, simulated as Wood-Anderson seismograms. These traces are taken from a dataset of 1901 earthquakes recorded between January 1, 2010, and June 1, 2022, at a minimum of five stations in the ADSN network. To better account for the attenuation of direct and refracted waves in northern Algeria, amplitude decay analysis reveals the presence of two transition distances at 90 and 190 km, resulting in three segments. A distance correction term, −log10(A0), is introduced and described by the following trilinear function:−logA0=0.6747∗log10R+0.0002∗R+1.6306R≤901.7736∗log10R+0.0002∗R−0.516990<R≤1902.4580∗log10R+0.0002∗R−2.0765R>190R represents the hypocentral distance in kilometers. The derived distance correction formula provides a well-constrained ML relationship for northern Algeria that is valid over a distance range of 5 to 600 km. Compared to other local magnitude relationships, the methodology proposed in this study consistently gives ML values slightly higher than those calculated by the Southern California relationship over all distances, with an average difference of 0.2 units. We computed corrections for 72 stations by minimizing the ML residuals. These corrections range from −0.50 to 0.54, highlighting the influence of local site effects on the amplitude of the seismic signal. The magnitude residuals using our magnitude relationship and incorporating the station corrections, show that the standard deviation has improved significantly, from 0.34 to 0.24. An ML relationship specific to the northern Algerian region provides a valuable tool for seismic monitoring, hazard assessment, and earthquake research in the region.

Visual Outcomes of Cataract Surgery in Patients with Previous History of Implantable Collamer Lens.

Background/Objectives: This retrospective case series analyzed visual outcomes in patients with a prior history of implantable collamer lens (ICL) implantation who underwent cataract extraction (CE). A secondary aim was to investigate the relationship between vault height and the rate of cataract development. Methods: Visual acuity and refraction measurements were collected after CE at one week, one month and six months. Vault height measurements were correlated to the time until symptomatic cataracts were removed. Results: A total of 44 eyes were analyzed at six months after CE with efficacy and safety indexes of 1.20 ± 1.11 and 1.50 ± 1.06, respectively. In addition, 70% of eyes had a post-operative uncorrected distance visual acuity (UDVA) within one line of pre-operative corrected distance visual acuity (CDVA). Refractive predictability at six months demonstrated that 43% and 69% of eyes were within ±0.25 D and ±0.50 D of SEQ target, respectively. Astigmatism measured by refractive cylinder was ≤0.25 D in 17% and ≤0.50 D in 34% of eyes pre-operatively compared to 40% and 60% of eyes, respectively, at six months post-operatively. Vault heights one week after ICL (p < 0.0081) and one week before CE (p < 0.0154) demonstrated a positive linear regression with the time until CE. Conclusions: This sample population achieved favorable visual outcomes six months after CE, similar to six months after ICL implantation. Patients with a history of ICL implantation will similarly have a good visual prognosis after CE.

A new technique to implant intracorneal ring-segments from the perilimbal region: one-year prospective pilot study report

BackgroundRecently a new surgical technique for intracorneal ring-segments (ICRS) assisted by femtosecond laser (FSL) called ByLimB was developed, involving the creation of the incision from a paralimbic region. This study aims to evaluate the safety and efficacy of the ByLimb technique following one year of follow-up.MethodsA prospective, single-center study was conducted at the Zaldivar Institute in Buenos Aires, Argentina. Keratoconus patients with indication for ICRS-FSL assisted procedure, operated with the ByLimb technique were included. By using the ByLimb technique, the ICRS are placed without affecting the tunnel’s roof, and the end of the ICRS is always away from the incision area. Visual acuity, topographic astigmatism, and the occurrence of complications were evaluated. Safety index was the main outcome and efficacy indes was a complimentary outcome.ResultsA total of 17 eyes completed the 12-month follow-up period. The safety index was 1.10 (mean postoperative corrected distance visual acuity (CDVA) in decimal: 0.76/preoperative CDVA: 0.69), while the efficacy index was 0.89 (mean postoperative uncorrected distance visual acuity UDVA in decimal: 0.62/preoperative CDVA: 0.69). Mean preoperative astigmatism was 5.3 ± 2.3, decreasing twelve months after surgery at 2.1 ± 1.2 (p < 0.001). No eye loss lines of vision and no intraoperative complications were observed. During the first month after surgery, an improper positioning of the ICRS based on topographic assessment was detected in five cases. A second procedure was performed, which consisted of opening the incision and introducing a Sinsky hook, through which the ICRS was mobilized and placed in its correct position. No incisional alterations, signs of infection, anterior segment anomalies, or fundus alterations were observed.ConclusionFSL-assisted ICRS implantation through the perilimbal region has demonstrated an adequate safety index one year post-surgery. Additionally, this technique has facilitated accurate realignment of ICRS during secondary surgical interventions within one-month post-surgery. While the current findings are promising, continued follow-up of these cases is warranted.

Clinical and Patient Reported Outcomes of an Optimized Trifocal Intraocular Lens.

Background/Objectives: To evaluate the clinical and patient-reported outcomes (PROMs) obtained with an optimized version of a previously investigated trifocal IOL. Methods: Prospective non-comparative single-center study enrolling 29 patients (55-71 years) undergoing bilateral cataract surgery with implantation of the trifocal diffractive IOL Liberty 677CMY (Medicontur Medical Engineering Ltd., Zsámbék, Hungary). Visual and refractive outcomes as well as PROMs were evaluated during a 3-month follow-up: measurement of uncorrected and corrected distance (UDVA, CDVA), intermediate (UIVA, DCIVA) and near visual acuities (UNVA, DCNVA), defocus curve, patient satisfaction, photic phenomena perception, spectacle independence, and difficulty in performing some vision-related activities. Results: A total of 100%, 92%, and 80% of patients achieved a postoperative binocular UDVA, UIVA, and UNVA of 20/25 or better, respectively. Likewise, 100%, 80%, and 84% of patients achieved a postoperative binocular CDVA, DCIVA, and DCNVA of 20/25 or better, respectively. In the defocus curve, all mean visual acuity values were better than 0.15 logMAR for all defocus levels. A total of 95.8%, 95.8%, and 91.7% of patients referred to be satisfied with their distance, intermediate, and near visual vision, respectively. Mean overall Catquest Rasch calibrated score was -3.12 ± 0.98. Most of the patients were spectacle independent: far (95.8%), intermediate (95.8%) or near vision (91.7%). No bothersome or minimal to moderately bothersome halo, starburst, and glare was perceived by 83.3%, 83.4%, and 83.3% of patients, respectively. Conclusions: The trifocal IOL evaluated provides a visual acuity improvement, with high levels of spectacle independence, patient satisfaction, and perceived visual quality associated.