IntroductionThe accuracy of intraocular lens (IOL) power calculation has undergone remarkable improvements over the last decade, thanks to technological advancements of optical biometers and the introduction of new formulas. Nevertheless, more than 10% of eyes still experience unpleasant refractive surprises and researchers are called to minimize this percentage.Areas coveredThis article investigates the limitations of current methods of IOL power calculation and suggests possible improvements in several areas: 1) the prediction of the postoperative IOL position, 2) the calculation of the corneal power, 3) the calculation of the axial length, 4) constant optimization, 5) the role of pupil diameter, 6) the importance of exact-power-labeled IOLs, and 7) IOL tilting. Each of these areas offers a large variety of opportunities to obtain more accurate calculations.Expert commentaryAlthough most surgeons feel sufficiently confident to perform clear lens extraction for refractive purposes, unwanted surprises still have an unacceptably high incidence. The efforts of many experts have recently improved the accuracy of IOL power calculation, but the target has not yet been reached and further research is required to enhance the satisfaction of our patients.
To evaluate the clinical efficacy and safety of prostatic artery embolization (PAE) using glue (n-butyl cyanoacrylate, NBCA) in patients with benign prostatic hyperplasia (BPH) presenting with lower urinary tract symptoms (LUTS) due to obstruction or chronic urinary retention managed with an indwelling catheter (IUC). A total of 101 patients (median age 79 years) were included, of whom 67 had LUTS and 34 had an IUC. All were treated with PAE with glue between 2021 and 2024. Clinical success was defined as either a ≥ 25
To evaluate morbidity and mortality after minimally invasive (MIG) versus open gastrectomy (OG) for gastric cancer (GC) in a large European population, with a subgroup analysis comparing total and subtotal gastrectomy. Real-world European studies comparing postoperative outcomes between MIG and OG are lacking. This retrospective study included GC patients undergoing curative-intent gastrectomy between 2017 and 2021 at 24 high-volume European centers participating in the GASTRODATA registry. The primary outcome was the perioperative complication rate after MIG versus OG. Propensity score matching (PSM) was performed to adjust for potential confounders. Of 2430 patients, 1,800 (74%) underwent OG and 630 (26%) MIG. MIG was performed in patients with smaller tumors, earlier stages, and less frequently receiving neoadjuvant treatment (P<0.001). MIG was associated with higher R0 resection rate (96.5% vs. 92.4% in OG), shorter hospital stay, lower perioperative complication rate (23.0% vs. 31.6%, P<0.001), and reduced 30-day and 90-day mortality rates (1.6% vs. 3.3%, [P=0.026] and 1.9% vs. 4.7%, [P=0.001], respectively). In sub-group analysis, MIG had fewer perioperative complications in subtotal (17.9% vs. 25.3%, P=0.005), but not total gastrectomy (31.5% vs. 36.1%, P=0.201). After PSM, MIG remaind significantly associated with lower perioperative complication rates compared to OG only in subtotal (OR=0.49, 95% CI, 0.30-0.80; P=0.005), but not in total gastrectomy (OR=1.15, 95% CI, 0.62-2.17; P=0.645). Minimally invasive subtotal gastrectomy was associated with fewer perioperative complications than OG, while this association was not observed for total gastrectomy. Minimally invasive subtotal gastrectomy should be considered a viable option in specialized European centers.
