from the editor
Lamellar or surface?
Thomas Kohnen, MD

letters
Topical corticosteroids after keratorefractive surgery
Frances W. Price, Jr., MD

Striae and opacities with the AcrySof lens
Mayank S. Pangtey, MD, Sudarshan Khokhar, MD, Ambarish Soni, MD

Outcomes of IOL implantation in the first year of life
Rajeev Sudan, MD, Sudarshan Khokhar, MD, Parul Sony, MD

Accommodative effect of an IOL
Klaus D. Teichmann, MD

Risk factors for and management of dropped nucleus after phacoemulsification
Sudarshan Khokhar, MD, Ambarish Soni, MD, Mayank S. Pangtey, MD

Visual outcome after pars plana vitrectomy
Rajat Agrawal, MD, Rajiv Raman, MD

consultation section
cataract surgical problem, edited by Samuel Masket, MD
A 57-year-old woman requests cataract surgery in an eye with previous filtering surgery. After the mitomycin-assisted trabeculectomy, she experienced prolonged partial chamber shallowing and modest elevation of IOP.
Dan Eisenberg, MD, Detlef Uthoff, MD, Linda J. Greff, MD, Leif Corydon, MD, Bradford J. Shingleton, MD, Stuart A. Terry, MD, Rupert Menapace, MD, James P. Gills, MD, J. Pitzer Gills III, MD, Alan S. Crandall, MD

techniques
Warm balanced salt solution for clearing tear film precipitation during cataract surgery
Clifton S. Otto, MD, Michael A. McMann, MD, Vernon C. Parmley, MD, Keith F. Dahlhauser, MD, D. Matthew Bushley, MD, Robert B. Carroll, MD

Forceps-guided nuclear cleavage cataract extraction
Xiuqin Dong, MD, Wei Chen, MD, Hongmei Wang, MD, Per Söderberg, MD, PhD

Phaco one-chop nucleotomy
Ilan Sebban, FRACO, FRACS

articles
Laser-assisted subepithelial keratectomy versus photorefractive keratectomy for the correction of myopia: A prospective comparative study
Sergio Litwak, MD, David Zadok, MD, Valente Garcia-de Quevedo, MD, Nora Robledo, OD, Arturo S. Chayet, MD
Discomfort and worse vision were more common in the immediate postoperative period in eyes that had LASEK than in eyes that had PRK. At 1 month, the results in the 2 groups were similar.

Laser-assisted subepithelial keratectomy for low to high myopia and astigmatism  
Lee Shahinian, Jr., MD
Laser-assisted subepithelial keratectomy was safe and effective in treating a wide range of myopia and may have advantages over LASIK in safety and patient selection.

Epi-LASEK for the correction of myopia and myopic astigmatism
Nicole J. Anderson, MD, Robin F. Beran, MD, Timothy L. Schneider, MD
The Epi-LASEK appeared safe and effective in the correction of myopia and myopic astigmatism. There was a low incidence of haze and postoperative pain.

Outcomes of cataract extraction in functionally monocular patients: Case-control study  
William L. Trotter, MD, Kevin M. Miller, MD
Monocular patients who had cataract surgery had significantly more ocular comorbidity and required more additional planned and unplanned surgery than binocular patients. There was no difference in surgical complications.

Prediction of macular edema exacerbation after phacoemulsification in patients with nonproliferative diabetic retinopathy  
Hideharu Funatsu, MD, Hidetoshi Yamashita, MD, Hidetaka Noma, MD, Erika Shimizu, MD, Tatsuya Mimura, MD, Sadao Hori, MD

Factors affecting visual outcomes after small-incision phacoemulsification in diabetic patients
Mamta D. Somaiya, MD, Jason D. Burns, MD, Roni Mintz, MD, Robert E. Warren, MD, Tatsuo Uchida, MS, Bernard F. Godley, MD, PhD
Visual potential measurement provided a reasonable estimate of postoperative visual acuity in diabetic patients. The coexistence of diabetes and the preoperative level of retinopathy were important predictors of visual outcome.

Phacoemulsification in patients with Fuchs' heterochromic uveitis
Jagat Ram, MD, Sushmita Kaushik, MD, Gagandeep Singh Brar, MD, Amit Gupta, MD, Amod Gupta, MD
Capsular bag fixation of IOLs yielded good results in patients with complicated cataract resulting from Fuchs' heterochromic uveitis irrespective of IOL material or design.

Cataract surgery combined with ocular surface reconstruction in patients with severe cicatricial keratoconjunctivitis
Hiroko Bissen-Miyajima, MD, Yu Monden, MD, Jun Shimazaki, MD, Kazuo Tsubota, MD
Combined phacoemulsification and transplantation of limbal allograft and amniotic membrane in 4 eyes with severe cicatricial keratoconjunctivitis led to no intraoperative complications and improved visual acuity.

Outcomes of phacoemulsification in patients with dry eye
Jagat Ram, MD, Amit Gupta, MD, Gagandeep S. Brar, MD, Sushmita Kaushik, MD, Amod Gupta, MD
Phacoemulsification appears to be the procedure of choice in patients with age-related dry eye as well as dry eye associated with connective tissue disorder.

Confocal microscopic characteristics of stage 1 to 4 diffuse lamellar keratitis after laser in situ keratomileusis
Jens Bühren, MD, Martin Baumeister, MD, Magdalena Cichocki, MD, Thomas Kohnen, MD
Confocal microscopic examination of DLK after LASIK shows that stages 1 and 2 represent the active inflammation, whereas stages 3 and 4 show the results of accumulation and decay of the inflammatory cells in the lamellar flap interface.

Interface fungal infection after laser in situ keratomileusis presenting as diffuse lamellar keratitis: A clinicopathological report
Qun Peng, MD, Mike P. Holzer, MD, Peter H. Kaufer, MD, David J. Apple, MD, Kerry D. Solomon, MD
Clinicopathological findings in 3 cases of interface fungal infection after LASIK are presented. Early flap lifting, culture, and treatment are recommended to prevent this complication.

Diffuse lamellar keratitis associated with carboxymethylcellulose sodium 1% after laser in situ keratomileusis
Michael A. Samuel, MD, Stephen C. Kaufman, MD, PhD, Jason A. Ahee, MD, Curtis Wee, OD, David Bogorad, MD
Use of carboxymethylcellulose sodium 1.0%, which has been advocated to decrease epithelial defects during flap construction in LASIK, resulted in a high incidence of DLK.

Ray tracing for intraocular lens calculation
Paul-Rolf Preussner, MD, Jochen Wahl, MD, Hedro Lahdo, MD, Burkhard Dick, MD, Oliver Findl, MD
State-of-the-art numerical methods improved the accuracy of IOL calculations and made the various error contributions more transparent.

Effect of hyaluronidase on ocular motility in sub-Tenon’s anesthesia: Randomized controlled trial
Amar Alwitry, MRCS, MRCSEd, MRCOphth, Sanjay Chaudhary, FRCOphth, Keshkar Gopee, FRCOphth, Tom K.H. Butler, FRCOphth, Roger Holden, FRCOphth
The addition of hyaluronidase to sub-Tenon’s anesthetic solution increased the rapidity of onset of akinesia; however, the final degree of immobility was unaffected.

Arcuate keratotomy for asymmetrical steep islands after laser in situ keratomileusis and automated lamellar keratoplasty
James P. Pulaski, MD
Asymmetrical steep islands occurred unexpectedly after LASIK and ALK, causing irregular astigmatism with reduced visual acuity and unwanted optical effects. The islands were successfully reduced or eliminated by arcuate keratotomy on the steep refractive axis.

Use of a digital infrared pupillometer to assess patient suitability for refractive surgery
Emanuel S. Rosen, MD, Christa L. Gore, MSc, Daniel Taylor, PhD, Deepak Chitkara, Frank Howes, Elizabeth Kowalewski
When assessing potential patients for refractive surgery, dynamic pupillometry will provide quantitative pupil data and a record of the examination under varied lighting conditions.

Monovision pseudophakia
Scott Greenbaum, MD
Sequential implantation of IOLs calculated to produce emmetropia in the dominant eye and a –2.75 D spherical equivalent in the nondominant eye resulted in a high level of uncorrected postoperative acuity and patient satisfaction.

Corneal-wetting property of lignocaine 2% jelly
Thandalam S. Kalyanasundaram, FRCSOph, Mahmood Hasan, FRCOphth
Application of lignocaine 2% jelly on the cornea just before the corneal incision is made for cataract surgery maintained clarity of the surgical field for a long duration. A second intraoperative application of jelly may be needed when surgery is prolonged.

laboratory science
Corneal haze after photorefractive keratectomy for myopia: Role of collagen IV mRNA typing as a predictor of haze
Christoph Winkler von Mohrenfels, MD, Udo Reischl, PhD, Chris P. Lohmann, MD, PhD
A quantitative PCR test showed that collagen type IV α3 is an important factor in the development of corneal haze after PRK.

Lens epithelial cell death after cataract surgery
Shizuya Saika, MD, PhD, Takeshi Miyamoto, MD, Iku Ishida, MD, PhD, Yoshitaka Ohnishi, MD, PhD, Akira Ooshima, MD, PhD
Human LECs undergo apoptosis during the early phase of healing after cataract/IOL surgery and are rarely seen during the later phase. Transforming growth factor-β2 may be a factor in inducing apoptosis in the lens epithelium.

Use of caffeic acid phenethyl ester to prevent sodium-selenite-induced cataract in rat eyes
Selim Doganay, MD, Yusuf Turkoz, PhD, Cem Evereklioglu, MD, Hamdi Er, MD, Mehmet Bozaran, MD, Elif Ozerol, MD
Caffeic acid phenethyl acid ester effectively prevented cataract formation in the selenite-induced cataract model. This effect was associated with high GSH and low MDA levels in rats treated with CAPE.

case reports
Epithelial defect, diffuse lamellar keratitis, and epithelial ingrowth following post-LASIK epithelial toxicity
Nisha Sachdev, MBChB, Charles N. McGhee, PhD, FRCS, FRCOphth, FRACO, Jennifer P. Craig, PhD, MCOptom, Kathryn H. Weed, MSc, MCOptom, J. Jane McGhee, BSc

Confocal microscopic findings in a case of delayed-onset bilateral diffuse lamellar keratitis after laser in situ keratomileusis  
Moonyoung S. Chung, MD, Jay S. Pepose, MD, PhD, Sameh Al-Agha, MD, H. Dwight Cavanagh, MD, PhD

Phototherapeutic keratectomy for the treatment of diffuse lamellar keratitis
Grace Leu, MD, Peter S. Hersh, MD

Chronic endophthalmitis mimicking an endothelial immune reaction after penetrating keratoplasty
Thomas Reinhard, MD, Alfred B&0uml;cking, MD, FIAC, Rainer Sundmacher, MD, FRCOphth

Dislocated laser in situ keratomileusis flap visualized by cross-polarized filtration
Chris J. Barry, MMedSci, Geoffrey J. Crawford, FRACO, FRACS

Late complications with intraocular lens dislocation after capsulorhexis in pseudoexfoliation syndrome  
Samuel Masket, MD, Robert H. Osher, MD

Intraocular lens power calculation after macular hole surgery
David B. Cohen, MD

Capsular block syndrome associated with horizontal jerk nystagmus
Daniele Tognetto, MD, Lisa Toto, MD, Cinzia Michieli, MD, Giuseppe Ravalico, MD

correspondence
Cortex removal after CTR insertion
Srinivas K. Rao, MD, Prema Padmanabhan, MD

Forceps capsulorhexis
Tanuj Dada, MD, Harinder Sethi, MD

Change in corneal refractive power induced by penetrating keratoplasty
Jost B. Jonas, MD, Philipp Hugger, MD, Wido M. Budde, MD

Tearing of intact capsulorhexis during hydrodissection by poorly polished hydrodissection cannula
Harinder Singh Sethi, MD, Prasant Bhartiya, MD, Harsh Kumar, MD, Namrata Sharma, MD

Subjective visual perception of a dislocated intraocular lens
Vernon K.Y. Yong, FRCSEd, Hung-Ming Lee, FRCSEd, Kah-Guan Au Eong, FRCSEd, FRCS(Glasg), DRCOphth, Victor S.H. Yong, FRCSEd, FRCOphth

Information for Authors

Assigment of Copyright Form

Continuing Medical Education
CME Coordinator: David E. Silverstone, MD

Ophthalmologists who read the Journal of Cataract & Refractive Surgery can now earn 5 CME credits in Category 1 of the Physician's Recognition Award of the American Medical Association. Questions have been developed for five articles in this issue, marked with a symbol () in the table of contents. Detailed instructions and a copy of the CME quiz can be obtained from the ASCRS web site (http://www.ascrs.org) or ASCRS Fax-on-demand (732-578-4472).