PURPOSE:To develop and validate a new intraocular lens (IOL) power calculation formula for cataract patients with previous myopic corneal refractive surgery (MRS). DESIGN:Retrospective, comparative analysis of lOL power calculations. PARTICIPANTS:Patients undergoing MRS were enrolled for formula development, and cataract patients with prior MRS were recruited for evaluation. METHODS:Linear regression model was used to characterize the relationship between preoperative anterior corneal radius (ARC) and postoperative posterior corneal radius (PRC) in patients undergoing MRS. A thick-lens LISA MRS formula was then developed, using predicted preoperative ARC for effective lens position estimation. Its performance was compared with existing formulas (Barrett True K, Emmetropia Verifying Optical [EVO], Haigis-L, Hoffer QST, and Shammas PL) in cataract patients with prior MRS. MAIN OUTCOME MEASURES:Arithmetic and absolute prediction errors. RESULTS:The study included 134 MRS patients (98 small incision lenticule extraction [SMILE] and 36 femtosecond laser-assisted in situ keratomileusis [FS-LASIK]) for formula development, and the changes in anterior and posterior keratometry were comparable between the two procedures. Postoperative PK was a strong predictor of preoperative ARC, with an R2 of 0.82. In 225 cataract patients from three centers for formula validation, the formula performance index (FPI) was highest for LISA MRS (with or without PRC, 0.43), followed by Hoffer QST (0.37), EVO and Hoffer QST-PRC (both 0.32), EVO-PRC and Barrett True K-PRC (both 0.30), and Barrett True K (0.26). LISA MRS-PRC and EVO-PRC yielded the lowest median absolute prediction error (0.47 D), with EVO-PRC performing relatively better in eyes with AL < 28 mm and LISA MRS-PRC maintaining favorable accuracy in eyes with AL ≥ 28 mm. Incorporating PRC significantly improved the performance of Barrett True K, LISA MRS, and Hoffer QST (all P < .05). CONCLUSIONS:The LISA MRS formula provides accurate IOL power calculation for cataract patients with prior MRS, particularly in eyes with AL ≥ 28 mm. Use of PRC is recommended whenever available.

Scars are common skin disorders that occur after trauma. They not only affect the patient’s appearance, but also cause symptoms such as pain, itching, and contracture, bringing heavy physical and mental burdens to patients. Scar classification and severity assessment are two crucial tasks in clinical practice. Recently, deep learning has facilitated the development of automatic scar classification and severity assessment methods. However, these methods still face the following two issues: (1) the lack of high-quality annotated scar data makes it difficult for deep learning models to extract effective lesion features; (2) most existing methods treat scar classification and severity assessment as independent tasks, ignoring the inherent correlations between them. To address these issues, this paper proposes a multi-task Siamese network (MT-ScarNet) for joint scar classification and severity assessment. In MT-ScarNet, an image pair construction strategy is first devised to generate a considerable number of effective image pairs. With the scar image pair as input, a Siamese network is employed to generate image embeddings which are then converted into classification and severity features through feature transformation layers. Afterward, a multi-task feature interaction module with a cross-attention mechanism is designed to explore the potential correlations between the two tasks to boost the overall multi-task performance. Besides, a multi-task metric learning loss module is developed to perform metric learning in both scar classification and severity assessment tasks to enhance the discriminative representation ability of the multi-task model. Extensive experiments on the MT-Scar dataset demonstrate the effectiveness and advantage of MT-ScarNet.

To characterize the three-dimensional lens parameters in age-related cataract patients and examine their associations with age, sex, and ocular biometrics. In this retrospective cohort study, we consecutively enrolled patients aged ≥ 40 years who underwent cataract surgery at the Aier Eye Hospital of Wuhan University (Wuhan Aier Eye Hospital) between January 2023 and December 2024. Three-dimensional lens parameters were acquired using swept-source anterior segment optical coherence tomography (SS-AS-OCT), including: anterior lens surface curvature radius (RAL), lens posterior surface curvature radius (RPL), lens thickness (LT), anterior lens thickness (LTa), lens diameter (LD), and lens volume (LV). Correlations with age, sex, and ocular biometrics were analyzed. The study included 356 patients (140 males and 216 females) with a mean ± SD age of 66.48 ± 9.60 years. No significant sex-related differences were found in any lens parameters (all p > 0.05). RAL demonstrated a significant negative linear correlation with age (r = -0.142, p = 0.007), decreasing at a rate of 0.019 mm/year. In contrast, LT, LTa, and LV showed positive linear correlations with age, increasing at rates of 0.013 mm/year, 0.007 mm/year, and 1.052 mm³/year, respectively (all p < 0.05). Age stratification showed LT increased faster in ≤ 60 years (0.022 mm/year vs. 0.010 mm/year). RAL was negatively correlated with LT and LTa, but positively with RPL and LD. RPL, LT, LTa, LD, and LV were positively intercorrelated. Ocular biometrics showed that RAL correlated positively with ACD, AL, and WTW but negatively with Km. RPL positively correlated only with AL. LT, LTa, LD, and LV exhibited negative correlations with ACD, while LD and LV positively correlated with AL (all p < 0.05). In cataract patients aged ≥ 40 years, the anterior lens surface convexity, LT, and LV increased significantly with age, with more rapid progression rates before age 60 than thereafter. Multivariable analysis revealed that smaller ACD was associated with more pronounced anterior lens surface convexity and greater lens thickness. LT, LTa, and RAL showed nonlinear relationships with AL, where RAL was maximal and LT was thinnest at approximately 25 mm AL.

Purpose: To describe the image-guided belt loop-flanged technique for knotless refixation of dislocated multifocal intraocular lens (IOL)-capsular bag complexes. Methods: This retrospective longitudinal case series included patients with late-dislocated C-haptic multifocal IOL-capsular bag complexes and fibrotic capsules. The surgical technique integrated the IOLMaster 700 biometer and Callisto Eye system for image-guided axis alignment. This was combined with a belt loop technique to secure the capsular bag and the root of the IOL haptics, along with sutureless flanged fixation using 30-gauge needles and 7-0 polypropylene sutures Outcome measures included visual acuity, surgical time for IOL fixation, IOL position (tilt and decentration), and intra- and postoperative complications Results: A total of 17 patients (17 eyes) were enrolled, with a mean age of 64.37±11.56 years (range 37–81 years). The mean surgical time for IOL fixation was 14.32±5.68 minutes. Preoperative mean uncorrected distance visual acuity (UDVA) was 0.62±0.45 logMAR, which significantly improved to 0.07±0.05 logMAR at 3 months postoperatively (t=4.99, P<0.001). Postoperative uncorrected near visual acuity (UNVA) at 40 cm was 0.07±0.06 logMAR. The mean postoperative residual spherical equivalent (SE) was -0.37±0.31 diopters (D). At 3 months postoperatively, the mean IOL tilt and decentration were 4.26±3.71° and 0.41±0.28 mm. All cases successfully underwent capsular complex preservation and fixation surgery without IOL exchange. Minor complications were observed, including anterior chamber hemorrhage (1 eye, 5.88%), mild corneal edema (2 eyes, 11.76%), hypotony (1 eye, 5.88%), and elevated intraocular pressure (IOP) (2 eyes, 11.76%). No severe vision-threatening complications occurred. Conclusions: The combined image-guided belt loop-flanged knotless refixation technique is safe, precise and effective for the management of late-dislocated multifocal IOL-capsular bag complexes.

Purpose: To evaluate the efficacy of viscoelastic-assisted patient interface docking in LenSx (Alcon Laboratories, Inc) femtosecond laser–assisted cataract surgery (FLACS). Methods: This was a randomized controlled trial. Patients undergoing FLACS from January to August 2025 at Aier Eye Hospital of Wuhan University were randomized via a random number table to receive balanced salt solution (BSS) or visoeleastic as the patient interface docking medium. The primary outcome was docking efficiency, measured by one-time docking success rate, the number of docking attempts, and mean docking time. Secondary outcomes included surgical safety (subconjunctival hemorrhage, capsulotomy completeness/tear rate), laser treatment duration (anterior capsulotomy time, nucleus pretreatment time, total laser emission time), and patient comfort (post-laser pain sensation). Results: A total of 100 patients were enrolled, 50 in each group. Suction loss occurred in 7 patients (14%) in the BSS group and 1 patient (2%) in the viscoelastic group; the one-time docking success rate was significantly higher in the viscoelastic group (98%) than in the BSS group (86%) (chi-square = 3.93, P < .05). The viscoelastic group also had fewer mean docking attempts (1.02 ± 0.14) than the BSS group (1.16 ± 0.42), showing a significant difference ( t = 2.23, P < .05). The viscoelastic group exhibited significantly shorter mean docking time (44.66 ± 4.47 seconds) compared to the BSS group (48.62 ± 3.11 seconds) ( t = 2.17, P < .05). No significant differences were observed between the groups in subconjunctival hemorrhage, capsulotomy completeness/tear rate, anterior capsulotomy time, nucleus pretreatment time, total femtosecond laser emission time, or patient-reported pain sensation (all P > .05). Conclusions: Viscoelastic-assisted patient interface docking in FLACS effectively elevates one-time docking success rate, reduces docking attempts, and shortens docking time.

Abstract Background Nanophthalmos is a rare congenital ocular disorder characterized by a short axial length (AL), which predisposes to secondary angle-closure and secondary angle-closure glaucoma. Surgical management is challenging due to high complication risks. This study aimed to evaluate the feasibility and efficacy of phacoemulsification with intraocular lens implantation and goniosynechialysis (Phaco + IOL+GSL) in nanophthalmos with secondary angle-closure or secondary angle-closure glaucoma, and to propose a stepwise complication management strategy. Methods This retrospective case series included 20 eyes of 20 patients diagnosed with nanophthalmos (AL < 20 mm) and PAC (2 eyes) or ACG (18 eyes) who underwent Phaco + IOL+GSL between January 2022 and Jun 2025. Patients were divided into three groups based on AL: Group A (14 mm ≤ AL < 16 mm, 9 eyes), Group B (16 mm ≤ AL < 18 mm, 4 eyes), and Group C (18 mm ≤ AL < 20 mm, 7 eyes). Preoperative and postoperative uncorrected visual acuity (UCVA, logMAR) and best-corrected visual acuity (BCVA, logMAR) were recorded, intraocular pressure (IOP), number of antiglaucoma medications, and intraoperative and postoperative complications were analyzed. Results At the final follow-up (6–12 months postoperatively), the median IOP significantly decreased from 25.5 [16.0, 35.0] mmHg to 16.0 [14.0, 19.0] mmHg (P < 0.05). The median number of antiglaucoma medications decreased from 2.5 [0.0, 4.0] to 0.0 [0.0, 0.0] (P < 0.05). UCVA improved from 1.30 [1.00, 1.70] to 0.40 [0.12, 1.10] (P < 0.05), and BCVA improved from 0.82 [0.40, 1.30] to 0.50 [0.30, 0.90] ( P < 0.05).The qualified success rate was 95.0% (19/20), and the complete success rate was 80.0% (16/20). The intraoperative complication rate was 25.0% (5/20), primarily shallow anterior chamber. The postoperative complication rate was 40.0% (8/20), primarily shallow anterior chamber with elevated IOP. Complications were concentrated in Groups A and B. A stepwise management strategy—initiating with medical/laser therapy, escalating to cyclophotocoagulation, and reserving pars plana vitrectomy for refractory cases—achieved successful complication management. Conclusion For nanophthalmos with secondary angle-closure glaucoma, Phaco + IOL+GSL appears to be a feasible and effective procedure, particularly when combined with a stepwise complication management strategy. It may serve as an initial surgical option before resorting to more invasive combined procedures. However, the high complication rate in eyes with AL < 16 mm warrants extreme caution and readiness for escalation. The retrospective design and small sample size limit the generalizability of our findings; larger prospective studies are needed to confirm these results.

An advanced femtosecond laser experimental platform with high precision was developed for the reconstruction of the refractive index of intraocular lenses (IOLs), and its accuracy was rigorously evaluated. Diffraction gratings were inscribed on the surface of an acrylate sample utilizing a fiber femtosecond laser operating at a wavelength of 515 nm with a repetition rate of 40 MHz. The samples were subsequently measured using an Abbe refractometer to assess the alterations in their refractive index induced by the femtosecond laser scanning process. Scanning electron microscopy, confocal Raman microscopy, and X-ray photoelectron spectroscopy were employed to examine the morphology of the diffraction grating on the sample surface following femtosecond laser scanning. Additionally, these techniques were utilized to investigate the alterations in molecular structure within the material postlaser scanning, as well as to elucidate the underlying mechanisms responsible for changes in refractive index. Furthermore, the parameters of the femtosecond laser utilized in this study were compared with those of lasers commonly employed in clinical settings.

Cataracts are the leading cause of blindness worldwide, with surgery as the only effective treatment. Accurate prediction of Best Corrected Visual Acuity (BCVA) is crucial for surgical planning. In this paper, we propose a novel Unified Multimodal Learning (UML) framework for BCVA prediction with uncertain missing modalities. Unlike existing methods that apply generic encoders and overlook critical image variability, UML leverages medical priors to enhance feature extraction through three modules: central concave region enhancement, OCT re weighting, and multi -scale attention. To manage missing modality uncertainty, we design a missing modality mask fusion network using an attentional mask for unified feature fusion. Additionally, an auxiliary diagnostic text -image contrastive learning task is introduced to further refine image features. UML achieves state-ofthe-art performance with a mean absolute error (MAE) of 0.0457 and 96.25% predictions fall within an error of 0.10 LogMAR. Codes are available at hilps://github.com/444994 I 4E4 er- BC VA.

To analyze the incidence and clinical characteristics of acute infectious endophthalmitis after approximately 2.03 million cataract surgeries in 448 hospitals in China over a 5-year period (2017–2021). Retrospective, multi-center, cross-sectional study. Eyes developing acute infectious endophthalmitis after 2,026,416 cataract surgeries in 448 Aier eye hospitals in Mainland China from January 2017 to December 2021 were collected, and surgical methods and intraocular lens (IOL) types of the patients were analyzed. There was no prophylactic antibiotic administered routinely in the anterior chamber at the end of the cataract procedures.The conjunctival capsule was disinfected with 5

Background:Surgical decision-making for highly myopic cataracts requires a high level of expertise. We, therefore, aimed to develop a preliminary artificial intelligence (AI) model for surgical decision-making in highly myopic cataracts, based on previous deep learning models. Materials and methods:We first established a highly myopic cataract decision-making AI model by integrating cataract grading and postoperative visual acuity prediction models of highly myopic eyes, which we had developed previously, with surgical decision logic. The outcomes of surgical decision-making were classified into four categories: surgery not advised, cataract surgery recommended, retinal surgery recommended, and combined cataract-retinal surgery recommended. The gold standard for surgical decision is defined as the decision jointly made by two professional ophthalmologists together (X.Z. and Y.W.). If the decision-makings regarding highly myopic cataract surgery were not fully consistent, a final judgment was made by a third expert (Y.L.). Subsequently, we evaluated the accuracy of AI model's surgical decision-making against the gold standard and doctors at different levels, using both internal (107 highly myopic eyes from Eye and ENT Hospital, Fudan University) and external (55 highly myopic eyes from Wuhan Aier Eye Hospital) test datasets. Results:In the internal and external datasets, according to the Lens Opacities Classification System (LOCS) III international standards for cataract grading, 99.07% and 87.27% of automatic nuclear grading, along with 88.79% and 61.82% of automatic cortical grading, respectively, had an absolute prediction error of ≤1.0 compared with the gold standard. The mean postoperative visual acuity prediction error was 0.1560 and 0.3057 logMAR in the internal and external datasets, respectively. Finally, the consistency of the AI model's surgical decisions with the gold standard for highly myopic cataract patients in the internal and external datasets was 96.26% and 81.82%, respectively. AI demonstrated substantial agreement with the gold standard (Kappa value = 0.811 and 0.556 in the internal and external datasets, respectively). Conclusion:The AI decision-making model for highly myopic cataracts, based on two deep learning models, demonstrated good performance and may assist doctors in complex surgical decision-making for highly myopic cataracts.

Purpose: To assess the impact of various body and head positions on intraocular pressure (IOP) in cataract patients aged over 40 years with limited mobility. Methods: This cross-sectional study was conducted between August and December 2023 at Aier Eye Hospital of Wuhan University. The IOP was measured using a handheld tonometer (iCare IC200 rebound tonometer) in various head positions (forward, tilted left, and tilted right) and body positions: supine, semirecumbent, sitting, and prone. Results: In the supine position, the IOP measurements for the head positioned forward, right, and left were (13.80 ± 3.62) mmHg, (14.25 ± 3.66) mmHg, and (13.78 ± 3.40) mmHg, respectively. In the semirecumbent position, the corresponding IOPs were (12.08 ± 3.34) mmHg, (12.12 ± 3.22) mmHg, and (12.04 ± 3.38) mmHg. In the sitting position, the IOPs were recorded as (11.73 ± 3.29) mmHg, (11.73 ± 3.22) mmHg, and (11.59 ± 3.17) mmHg. Lastly, in the prone position, the IOPs were (14.19 ± 3.73) mmHg, (14.42 ± 3.93) mmHg, and (14.74 ± 3.81) mmHg, respectively. In each position group, there was no statistically significant difference in IOP among the three head positions. Regardless of the head position, the IOP is lowest in the sitting position, followed by semirecumbent and supine positions, with the prone position having the highest IOP. The analyses revealed that central corneal thickness (CCT) was correlated with an IOP value (p < 0.05) when patients were in different positions. Conclusion: IOP is influenced by body position. As the body transitions from upright to horizontal, IOP tends to increase. The position of the head, however, has no effect on IOP.

PURPOSE:To evaluate the accuracy of modern intraocular lens (IOL) power calculation formulas in eyes with previous myopic laser vision correction (LVC), and to assess the impact of axial length (AL) on the formula performance. METHODS:A total of 108 eyes were included, with 52 eyes in the AL less than 28 mm group and 56 eyes in the AL 28 mm or greater group. Refractive prediction errors (RPEs) were compared among nine post-LVC formulas: Haigis-TK, Haigis-TKCMAL (incorporating Cooke-modified axial length [CMAL]), PEARL-DGS, Hoffer-QST TK, LISA TK, Barrett True-K TK, EVO TK, Haigis-L, and Shammas. Pearson correlation analysis was employed to evaluate the influence of AL and other biometric parameters on RPEs. RESULTS:In the AL less than 28 mm group, no significant differences were observed between all formulas (all adjusted P > .05). However, in the AL 28 mm or greater group, Haigis-TKCMAL demonstrated significantly lower root mean square absolute error (RMSAE) and mean absolute error (MAE) compared to the Hoffer-QST, Barrett True-K TK, Shammas, and Haigis-L (all adjusted P < .001). Similarly, the PEARL-DGS showed significantly lower RMSAE than the Barrett True-K TK, Shammas, and Haigis-L (both adjusted P < .001), and significantly lower MAE compared to the Barrett True-K TK and Haigis-L (both adjusted P < .001). The Haigis-TKCMAL had the highest percentage of eyes with RPEs within ±0.50 diopters (D) (73.21%), whereas the PEARL-DGS had the highest percentage of eyes with RPEs within ±1.00 D (94.64%). A significant negative correlation between AL and RPE was found in most formulas, leading to a myopic shift in eyes with extremely long AL. CONCLUSIONS:The performance of current post-LVC formulas was comparable in eyes with AL less than 28 mm, whereas the Haigis-TKCMAL and PEARL-DGS demonstrated superior accuracy in eyes with AL 28 mm or greater. A notable myopic shift occurred in post-LVC eyes with extremely long AL, highlighting the need for careful formula selection in such cases. [J Refract Surg. 2025;41(5):e435-e443.].

This paper investigates an energy-efficient distributed blocking hybrid flowshop scheduling problem, constrained by the makespan upper-bound criterion. This problem is an extension of the distributed hybrid flowshop scheduling problem and closely resembles practical production scenarios, denoted as DHF_m| block|ε( TEC/ . -C_max) . Initially, we formulate the issue into a mixed integer linear programming (MILP) model that reflects its unique characteristics and leverage the Gurobi solver for validation purposes. Building upon this groundwork, we develop a self-regulating iterative greedy (SIG) algorithm, designed to autonomously fine-tune its strategies and parameters in response to the quality of solutions derived during iterative processes. Within the SIG, we design a double-layer destruction-reconstruction, accompanied by a self-regulating variable neighborhood descent strategy, to facilitate the exploration of diverse search spaces and augment the global search capability of the algorithm. To evaluate the performance of the proposed algorithm, we implement an extensive series of simulation experiments. Based on the experimental result, the average total energy consumption and relative percentage increase obtained by SIG are 2.12 and 82 DHF_m| block|ε( TEC/ . -C_max) compared to the other algorithms, thus offering a novel reference for decision-makers.

Objective: To observe the clinical effect of piggyback multifocal intraocular lens (IOL) implantation in treating patients with high myopia complicated with cataract.Methods: This was a prospective controlled study. We compared 32 eyes of 32 patients who underwent femtosecond laser-assisted cataract surgery with piggyback IOL implantation (two IOLs were implanted into the capsule) with 32 eyes of 32 patients who also underwent the same surgery (one IOL implanted into the capsule) due to high myopia complicated with cataract at the Wuhan Aier Eye Expert Hospital between January 2019 and October 2020. All patients were followed up for three months after surgery. Uncorrected distance visual acuity (UCDVA), uncorrected intermediate visual acuity (UCIVA), uncorrected near visual acuity (UCNVA), best-corrected distance visual acuity, distance-corrected intermediate visual acuity (DCIVA), distance-corrected near visual acuity (DCNVA), postoperative spectacle independence, postoperative visual interference, equivalent spherical lens, defocus curve, and IOL tilt and eccentricity were evaluated.Results: Three months after surgery, the patients' UCIVA, UCNVA, DCIVA, and DCNVA were 0.49 +/- 0.07, 0.38 +/- 0.15, 0.47 +/- 0.09, and 0.36 +/- 0.12, respectively, in the research group and 0.56 +/- 0.18, 0.72 +/- 0.22, 0.55 +/- 0.13, and 0.69 +/- 0.15, respectively, in the control group; the differences between the two groups were statistically significant (P < .05). The spectacle independence rate was higher in the research group (93%) than in the control group (13%). The overall satisfaction regarding postoperative visual quality was also higher in the research group than in the control group. The absolute mean value of the spherical equivalents was 0.48 +/- 0.28 D in the research group and 0.62 +/- 0.33 D in the control group; the difference between the two groups was statistically significant (P < .05).Conclusion: Piggyback multifocal IOL implantation can expand the multifocal IOL application range, and satisfy the desire of patients with high myopia complicated with cataract to see both near and far.

Selecting the appropriate power for intraocular lenses (IOLs) is crucial for the success of cataract surgeries. Traditionally, ophthalmologists rely on manually designed formulas like “Barrett” and “Hoffer Q” to calculate IOL power. However, these methods exhibit limited accuracy since they primarily focus on biometric data such as axial length and corneal curvature, overlooking the rich details in preoperative images that reveal the eye’s internal anatomy. In this study, we propose a novel deep learning model that leverages multi-modal information for accurate IOL power calculation. In particular, to address the low information density in optical coherence tomography (OCT) images (i.e., most regions are with zero pixel values), we introduce a cross-layer attention module to take full advantage of hierarchical contextual information to extract comprehensive anatomical features. Additionally, the IOL powers given by traditional formulas are taken as prior knowledge to benefit model training. The proposed method is evaluated on a self-collected dataset consisting of 174 samples and compared with other approaches. The experimental results demonstrate that our approach significantly surpasses competing methods, achieving a mean absolute error of just 0.367 diopters (D). Impressively, the percentage of eyes with a prediction error within ± 0.5 D achieves 84.1 https://github.com/liyiersan/IOL .

Purpose: To compare the accuracy, safety, and consistency of asymmetric trapezoid and near-square side-port incision in cataract surgery. Setting: Aier Eye Hospital of Wuhan University, Wuhan, Hubei Province, China. Design: Prospective pilot study. Methods: This study included patients who underwent phacoemulsification between January 2022 and August 2022. They were divided into Group A and Group B using the random number table method. Group A was given a near-square side-port incision and Group B was given an asymmetric trapezoid side-port incision. We contrasted the differences in incision length, width, and shape; surgical time; and postoperative intraocular pressure (IOP) between the 2 groups. Results: 220 eyes of 220 patients were included. The mean external width of the incision in Group A was much smaller than that in Group B ( P < .01), and the consistency of the incision diameter in Group A was better than that in Group B. There was no statistically significant difference in incision length between the 2 groups ( P = .75). 1 day after surgery, there was no statistically significant difference in incision morphology between the 2 groups ( P = .72). The operating time for Group A was significantly shorter than that of Group B ( P < .01). There was no obvious incision leakage in both groups after surgery, and the IOP was generally elevated after surgery, but there was no significant statistical difference between the 2 groups ( P = .98). Conclusions: The present study suggests that a near-square side-port results in better consistency of incision width and shorter surgical time.

PurposeTo compare the visual outcomes in both eyes of patients who undergo phacoemulsification and trifocal intraocular lens (IOL) implantation and have asteroid hyalosis (AH) or synchysis scintillans (SS) in only one eye.MethodsA retrospective comparative case series was performed. We evaluated uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), predictability, safety, efficacy, and satisfaction after implantation of the same model of trifocal IOL in both eyes (PhysIOL FineVision Pod-F and Micro-F and Rayner RayOne Trifocal).ResultsA total of 164 eyes of 82 patients (41 females, 50%) met the inclusion criteria. There were no statistically significant differences in sphere, cylinder, spherical equivalent, UDVA, UIVA, or UNVA between the groups. Postoperative CDVA was slightly better in the control group (logMAR 0.03) than in the AH/SS group (logMAR 0.04) (P: 0.014). There were no statistically significant differences in predictability, safety index, or efficacy index between the groups. Overall subjective satisfaction was good (98.2%).ConclusionsVisual outcomes and satisfaction are good after implantation of trifocal IOLs in eyes with AH or SS. Therefore, trifocal IOLs should not be ruled out in these patients when no other vitreoretinal disorder is present.

The objective of this retrospective cohort study is to compare the Pacman cutting technique with the trisection cutting technique for hydrophobic acrylic intraocular lens extraction. A total of 29 eyes of 29 patients requiring IOL removal were selected and enrolled in this study. The patients in group 1 (13 cases) underwent the conventional trisection cut technique from May 2022 to Dec. 2022. The patients in group 2 (16 cases) underwent the modified partial IOL cutting technique (Pacman cutting technique) from Jan. 2023 to June 2023. Corneal endothelial cells (CECs) count, slit-lamp examination, and intraocular pressure (IOP) measurement were conducted at all preoperative and postoperative visits. Surgical time, intraoperative and postoperative complications were recorded. The mean surgical time was 3.48 ± 1.54 minutes (range: 2 to 7 minutes) for the trisection cut technique group and 2.52 ± 1.18 minutes (range: 2 to 5 minutes) for the Pacman cut technique group. There was a statistically significant difference between the two groups in terms of surgical duration (P < .05). There was no difference in the mean preoperative CEC counts (group 1: 1924 ± 462, group 2: 1876 ± 516, P > 0.05). However, three months after the operation, the count of CECs decreased by 213 ± 72 (11%) in group 1 and 142 ± 57 (8%) in group 2. The decrease in CECs in group 1 was greater than that in group 2, and the difference was statistically significant (P < .05). There were no serious complications affecting vision in either group during the follow-up period. This study showed that the Pacman cutting technique is more effective and safer than the trisection cutting technique for hydrophobic acrylic IOL removal.

To compare the accuracy of 14 formulas in calculating intraocular lens (IOL) power in extremely long eyes with axial length (AL) over 30.0 mm. In this retrospective study, 211 eyes (211 patients) with ALs > 30.0 mm were successfully treated with cataract surgery without complications. Ocular biometric parameters were obtained from IOLMaster 700. Fourteen formulas were evaluated using the optimized A constants: Barrett Universal II (BUII), Kane, Emmetropia Verifying Optical (EVO) 2.0, PEARL-DGS, T2, SRK/T, Holladay 1, Holladay 2, Haigis and Wang-Koch AL adjusted formulas (SRK/Tmodified-W/K, Holladay 1modified-W/K, Holladay 1NP-modified-W/K, Holladay 2modified-W/K, Holladay 2NP-modified-W/K). The mean prediction error (PE) and standard deviation (SD), mean absolute errors (MAE), median absolute errors (MedAE), and the percentage of prediction errors (PEs) within ± 0.25 D, ± 0.50 D, ± 1.00 D were analyzed. The Kane formula had the smallest MAE (0.43 D) and MedAE (0.34 D). The highest percentage of PE within ± 0.25 D was for EVO 2.0 (37.91

PURPOSE: To assess the influence of ocular biometric parameters on intraocular lens (IOL) tilt and decentration after cataract surgery. METHODS: Patients scheduled for cataract surgery were screened for inclusion in this prospective cohort study. Tilt and decentration of the crystalline lens and IOL were measured using the CASIA2 (Tomey). Anterior chamber depth (ACD), lens thickness (LT), and axial length (AL) were preoperatively measured by the IOLMaster 700 (Carl Zeiss Meditec AG). Multivariate regression analysis was performed to assess the influence of ocular biometric parameters on IOL tilt and decentration after cataract surgery. RESULTS: In total, 191 eyes of 120 patients were included. Age was positively correlated with IOL tilt, whereas ACD and AL were negatively correlated with IOL tilt. A strong positive correlation was found between preoperative crystalline lenses and postoperative IOLs in tilt magnitude ( r = 0.769, P < .001) and tilt direction ( r = 0.688, P < .001). A positive correlation was found between preoperative and postoperative lens decentration magnitude and decentration direction. Greater postoperative IOL tilt and decentration were significantly associated with greater preoperative crystalline lens tilt ( P < .001) and decentration ( P = .027). CONCLUSIONS: IOL tilt was greater in older patients. Shorter AL and shallower ACD contributed to greater IOL tilt. The tilt and decentration of the IOL will be greater in patients with greater tilt and decentration of the crystalline lens.