from the editor
Need for intraoperative measurement of corneal thickness during LASIK
Thomas Kohnen

letters
Longitudinal folds in the posterior capsule
Srinivas K. Rao, Prema Padmanabhan

Extending the standard temporal incision
Randy J. Epstein

Repeating a good idea
Philip Bloom, Vincent Lee
Clinical note concerning Regional anesthesia for cataract surgery
Martin Livingston

Personal experience with anterior chamber lenses
Ronald D. Miller

MVR knife with a hole at the tip for secondary IOL implantation
Tansu Erakgun, Ozcan Kayikcioglu, Cezmi Akkin

Pseudoaccommodation and oscillopsia in pseudophakia
Karen B. Lauer, Dawn V. Herzig

consultation section
cataract surgical problem, edited by Samuel Masket, MD
A healthy 51-year-old woman with life-long history of diminished visual capacity has noted significantly reduced functional vision over the past several years. A long-standing high hyperope, she had prophylactic laser iridotomies for narrow angles. She has been warned "never to have cataract surgery." Although corneal diameters are 11.2 mm, she has visibly small eyes, clear corneas, and shallow anterior chambers with imperforate prior laser iridotomies and extraordinarily dense nuclear cataracts in both eyes. The optic nerve in the right eye is apparently healthy, but no structures are visible in the left eye's posterior segment. Confrontation visual field analysis is seemingly normal. A-Scan ultrasonography reveals extremely short eyes. How would you manage this patient?
Warren E. Hill, Luis W. Lu, Ana Claudia Arenas, Jack M. Dodick, Julia Hsu, Abhay R. Vasavada, Thomas A. Oetting, Gerd U. Auffarth, Kenneth J. Hoffer, Alan S. Crandall, Joel K. Shugar

techniques
Hydrodissection after nucleus fracture
Gustavo Cremona, Maria A. Carrasco

Electric double-sleeved vacuuming microtrephine for lens refilling
Tsutomu Hara, Yuji Sakka, Fumihiko Hayashi

articles
Outcome of corneal and laser astigmatic refractive axis alignment in photoastigmatic refractive keratectomy
Samir G. Farah, Eric Olaffson, David G. Gwynn, Dimitri T. Azar
This study demonstrated the advantage of limbal marking and astigmatic axis alignment in PARK when cylindrical correction was 1.25 D. The Alpins vector analysis method was used in 143 eyes.

Reproducibility of corneal flap thickness in laser in situ keratomileusis using the Hansatome microkeratome
Rengin Yildirim, Cengiz Aras, Akif Ozdamar, Halil Bahcecioglu, Sehirbay Ozkan
The accuracy and reproducibility of the flap thickness created with the Hansatome microkeratome were evaluated, and the correlation between central corneal thickness and corneal curvature with flap thickness was studied.

Laser in situ keratomileusis after intracorneal rings: Report of 5 cases
Elizabeth A. Davis, David R. Hardten, Richard L. Lindstrom
Intracorneal rings can induce astigmatism that persists after explanation. Careful wound handling may reduce this complication. Furthermore, LASIK following ICR removal is safe and effective.

Large optical ablation zone using the VISX S2 Smoothscan excimer laser
Weldon W. Haw, Edward E. Manche
The potential benefits of large-zone ablations with broad-beam excimer laser systems must be weighed against the potential risks such as topographic steep central islands.

Manual keratometry and videokeratography after photorefractive keratectomy
Roland Peter, Mehrnaz Hazeghi, Oliver Job, Lucy Wienecke, Isaak Schipper
This study demonstrated a disparity between the change in refraction and the reduction in corneal power as measured with the TMS-1 and with the manual keratometer 6 months after PRK.

Multifocal phototherapeutic keratectomy for the treatment of persistent epithelial defect
Man Soo Kim, Sang Wroul Song, Jae Ho Kim, Heung Myong Woo
Excimer laser PTK provided symptomatic relief and fast corneal epithelial healing of persistent epithelial defects unresponsive to conventional therapy.

Visual outcome and complications of bilateral intraocular lens implantation in children
Michael O'Keefe, Alan Mulvihill, Phee Liang Yeoh
A retrospective study evaluated the outcome of bilateral intraocular lens implantation in children aged 1 to 93 months. Visual outcomes and complications are reported.

Incision sizes with 5.5 mm total optic, 3-piece foldable intraocular lenses
Thomas Kohnen
In a prospective randomized clinical studym the postimplantation incision sizes for 5.5 mm total optic foldable IOLs made of silicone and hydrophobic acrylic ranged between 2.8 and 3.4 mm. The Allergan SI-55NB IOL implanted with the Unfolder system provided the smallest post implantation incision.

Postoperative sterile endophthalmitis (TASS) associated with the MemoryLens
Faisal S. Jehan, Nick Mamalis, Terrence S. Spencer, Luther L. Fry, Richard S. Kerstine, Randall J. Olson
Ten patients had a delayed onset, acute anterior segment intraocular inflammation following uneventful cataract surgery with implantation of the MemoryLens.

Effect of large positioning holes on capsule fixation of plate-haptic intraocular lenses
Oliver Schwenn, Ulrike Kottler, Frank Krummenauer, Burkhard Dick, Norbert Pfeiffer
Lens decentration and rotation were not prevented by the use of plate-haptic silicone IOLs with larger positioning holes. In most cases, ultrasound biomicroscopy showed no tissue growth or capsule adhesion through the enlarged holes during a 5-month follow-up.

Intraocular bacterial contamination during sutureless, small incision, single-port phacoemulsification
Thomas John, Michelle Sims, Carol Hoffman
The incidence of anterior chamber bacterial contaminations during no-stitch, single-port, small incision phacoemulsification was low.

laboratory Science
Adhesion of fibronectin, vitronectin, laminin, and collagen type IV to intraocular lens materials in pseudophakic human autopsy eyes. Part 1: Histological sections
Reijo J. Linnola, Liliana Werner, Suresh K. Pandey, Marcela Escobar-Gomez, Sergey L. Znoiko, David J. Apple
Immunohistochemical analyses of histologic sections from pseudophakic human eyes obtained postmortem with different IOLS suggested that fibronectin is the major mediator of adhesion of hydrophobic soft acrylate lenses to the capsule.

Adhesion of fibronectin, vitronectin, laminin, and collagen type IV to intraocular lens materials in pseudophakic human autopsy eyes. Part 2: Explanted intraocular lenses
Reijo J. Linnola, Liliana Werner, Suresh K. Pandey, Marcela Escobar-Gomez, Sergey L. Znoiko, David J. Apple
Immunohistochemical analyses of intraocular lenses explanted from peudophakic human eyes obtained post mortem showed that fibronectin and possibly vitronectin are the major mediators at the interface between hydrophobic soft acrylate lenses and the capsule.

Protecting the retina during MemoryLens insertion
Rajiv Kumar, D. Luprice Reeves, David Brodstein, Randall J. Olson
The MemoryLens when folded, dry, or below its glass-transition temperature of 27°C will diffuse and defocus the light source as read using an optical bench. When the MemoryLens is unfolded, hydrated, and at body temperature, resolution is acceptable.

case reports
Paradoxical hypotony after laser in situ keratomileusis
Uri Rehany, Valery Bersudsky, Shimon Rumelt

Delayed posterior dislocation of silicone plate-haptic lenses after neodymium:YAG capsulotomy
Aaron M. Petersen, L. Lothaire Bluth, Michael Campion

Keratographic analysis of a family with keratoconus in identical twins
Clair-Florent Schmitt-Bernard, Christelle D. Schneider, Dominique Blanc, Bernard Arnaud

Early capsular distension syndrome after sulcus implantation of intraocular lenses
Kouros Nouri-Mahdavi

Role of ultrasound biomicroscopy in managing pseudophakic pupillary block glaucoma
Srinivasan sathish, Jane R. MacKinnon, Hatem R. Atta

Our Appreciation

2000 Index [PDF]
(To view the PDF, download the free Adobe Acrobat Reader.)

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).