from the editor
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Emanuel S. Rosen, FRCSE

letters
Secondary LASIK
Tanuj Dada, MD

Trypan blue with a viscoelastic agent
Vijay K. Dada, MBBS, MS, Rajev Sudan, MD, Namrata Sharma, MD, Tanuj Dada, MD

Correcting astigmatism
Kristian Naeser, MD

Treating a hyperopic shift after refractive surgery
Tanuj Dada, MD

Effect of optic size on PCO
John C. Merriam, MD, Joanna Urbanowicz, MD, PhD, Lei Zheng, MD

consultation section
cataract surgical problem, edited by Samuel Masket, MD
A 63-year-old woman had a suprachoroidal hemorrhage during phacoemulsification in the left eye. Vitrectomy removed a vitreous hemorrhage and repaired a retinal detachment. The eye is aphakic and the patient contact lens intolerant. She has a significant cataract in the right eye. The left eye has an unresponsive irregular pupil with posterior synechias, a superotemporal iridectomy, and anterior synechias. The cornea is thickened in the area of the iridocorneal adhesions. No posterior lens capsule is visible, and the vitreous cavity is optically empty. There is a healthy optic nerve, moderate epimacular membrane, attached retina, and fibrotic scar in the inferotemporal periphery. How would you proceed?
Stephen Bylsma, MD, Rupert Menapace, MD, William J. Fishkind, MD, Marie-José Tassignon, MD, Gerd U. Auffarth, MD, Abhay R. Vasavada, FRCS, Garry P. Condon, MD, Matteo Piovella, MD, Fabrizio I. Camesasca, MD, Dan Eisenberg, MD

techniques
Managing anterior capsule contraction by mechanical widening with vitrector-cut capsulotomy
Patrick C. Yeh, MD, Kenneth M. Goins, MD, Wico W. Lai, MD

Transparent irrigation cannula for bimanual lens cortex removal
Yoshiaki Shimada, MD, Masayuki Horiguchi, MD, Yoshihisa Kojima, MD, Hiromitsu Suzuki, MD

articles
Biometry of cataractus eyes using partial coherence interferometry: Clinical feasibility study of a commericial prototype I
Barbara Kiss, MD, Oliver Findl, MD, Rupert Menapace, MD, Matthias Wirtitsch, MD, Wolfgang Drexler, MD, Christoph K. Hitzenberger, MD, Adolf F. Fercher, MD
Axial length measurements with commercial and laboratory PCI prototypes did not differ significantly, but the measurements were longer than those with immersion ultrasound.

Refractive outcome of cataract surgery using partial coherence interferometry and ultrasound biometry: Clinical feasibility study of a commericial prototype II
Barbara Kiss, MD, Oliver Findl, MD, Rupert Menapace, MD, Matthias Wirtitsch, MD, Vanessa Petternel, MD, Wolfgang Drexler, MD, Georg Rainer, MD, Michael Georgopoulos, MD, Christoph K. Hitzenberger, MD, Adolf F. Fercher, MD
Refractive outcomes in cataract patients measured with a commercial PCI instrument as well as with immersion ultrasound were not significantly different. The axial length measurements with the 2 instruments were different.

Accuracy and reproducibility of biometry using partial coherence interferometry
Rafe Connors III, Peter Boseman III, Randall J. Olson, MD
Partial coherence interferometry resulted in more accuracy and consistency than contact A-scan and was less technician-experience dependent. It will not work in all patients.

Immersion A-scan compared with partial coherence interferometry: Outcomes analysis
Mark Packer, MD, I. Howard Fine, MD, Richard S. Hoffman, MD, Peggy G. Coffman, COT, Laurie K. Brown, COMT, COE
Excellent surgical results may be obtained with the use of immersion ultrasonography, Axial length measurements performed with immersion correlated highly with those performed with PCI.

Anterior chamber depth measurement: A-scan versus optical methods
Gabor Koranyi, MD, Eva Lydahi, MD, Sveerker Norrby, PhD, Mikaela Taube
Methods based on optical principles provided more reliable results than A-scan for measuring anterior chamber depth.

Comparison of corneal pachymetry using ultrasound and Orbscan II
Mohamed A. Fakhry, MD, Alberto Artola, MD, PhD, José I. Belda, MD, PhD, M^a José Ayala, MD, PhD, Jorge L. Alió, MD, PhD
Orbscan is a precise pachymetry tool when no media opacity exists. The presence of haze decreases the Orbscan II readings.

Accuracy of Orbscan optical pachymetry in corneas with haze
Francesco Boscia, MD, Maria Gabriella La Tegola, MD, Giovanni Alessio, MD Carlo Sborgia, MD
Orbscan measured lower corneal thickness than ultrasonic pachymetry in corneas with haze. The cause of this error is the assumption by Orbscan that the interface between hazy and clear stroma is the back corneal surface.

Accuracy and predictablility of the compensatory function of Orbscan II in intraocular pressure measurements after laser in situ keratomileusis
Do-Hyung Lee, MD, PhD, Sejung Seo, MD, Soo-Cheol Shin, OD, Eui-Hong Chung, MD, PhD, Tim T. Turner, PhD
The function of the Orbscan II in correcting postoperative IOP values is useful in understanding the relationship between preoperative and postoperative IOPs and in evaluating the inaccuracy of the measured postoperative IOP.

Reproducibility of standardized retroillumination photography for quantification of posterior capsule opacification
Wolf Buehl, MD, Oliver Findl, MD, Rupert Menapace, MD, Michael Georgopoulos, MD, Georg Rainer, MD, Matthais Wirtitsch, MD, Hannes Siegl, MSc, Axel Pinz, PhD
Standardized coaxial retroillumination photography provided a highly reproducible basis for objective assessment of regeneratory capsule opacification. It would be useful in clinical trials of the genesis and prevention of PCO.

Assessment of anterior capsule opacification: Photographic technique and quantification
Stefan Sacu, MD, Oliver Findl, MD, Rupert Menapace, MD, Michael Georgopoulos, MD, Wolf Buehl, MD, Georg Rainer, MD
The standardized acquisition of slitlamp images of the anterior capsule produced reliable and valid data for analysis of ACO.

Comparison of a ray-tracing refractometer, autorefractor, and computerized videokeratography in measuring pseudophakic eyes
Li Wang, MD, Manjula Misra, MD, Ioannis G. Pallikaris, MD, Douglas D. Koch, MD
Using manifest refraction as the standard, the Tracey-1 ray-tracing refractometer had a mean error in measuring spherical equivalent of just over 1.0 D; however, it measured astigmatism accurately and had excellent reproducibility for both spherical equivalent and astigmatism.

Comparison of the pupil card and pupilometer in measuring pupil size
Mihai Pop, MD, Yves Payette, MSc, Emma Santoriello, RN, COA
The bias between examiners was the source of greatest measurement variation when assessing the reliability of the Colvard pupillometer and Rosenbaum pupil card.

Analysis of anterior and posterior corneal curvature changes using Orbscan technology in radial keratotomy eyes exposed to hypoxia
Michael A. McMann, MD, Vernon C. Parmley, MD, Steven M. Brady, DO, Lawrence J. White, MD, William R. Raymond IV, MD, Robert A. Mazzoli, MD, Elizabeth A. Hansen, MD, Thomas H. Mader, MD
The hyperopic shift seen in RK eyes exposed to surface hypoxia was due to a flattening of anterior and posterior corneal curvature.

Toric intraocular lens implantation: 100 consecutive cases
Jonathan Stanwood Till, MD, Paul R. Yoder, Jr., MD, Thomas K. Wilcox, OD, Jeffrey L. Spielman, PhD
Toric IOLs achieved good vision and reduced the need for distance correction in eyes with astigmatism. In most cases, IOL rotation occurred during the first postoperative week and repositioning could be performed after 1 week.

Risk factors for secondary membrane formation after removal of pediatric cataract
Banu M. Hosal, MD, Albert W. Biglan, MD
Secondary membrane formation occurred less frequently after cataract removal in children when a posterior capsulectomy was combined with an anterior vitrectomy.

Retained intravitreal lens fragments after phacoemulsification: Complications and visual outcome in vitrectomized and nonvitrectomized eyes
Alberto Rossetti, MD, Daniele Doro, MD
Results indicate that visual rehabilitation is faster and vision of better quality in eyes that had vitrectomy for retained intravitreal lens fragments after phacoemulsification than in nonvitrectomized eyes.

Cataract surgery in patients with Behçet’s' disease
Sibel Kadayifçilar, MD, Sansal Gedik, MD, Bora Eldem, MD, Murat Irkeç, MD
The visual outcome of extracapsular cataract surgery in patients with ocular Behçet’s' disease mainly depended on the preoperative status of the posterior segment.

Naproxen ophthalmic solution to manage inflammation after phacoemulsification
Vincento Papa, MD, PhD, Giovanni Milazzo, MD, PhD, Marcello Santocono, MD, Valerie Servolle, Philippe Sourdille, MD, Pierre-Yves Santiago, MD, Jacques Darondeau, MD, Nathalie Cassoux, MD, Phuc LeHoang, MD
After cataract surgery, 0.2% naproxen eyedrops were effective and safe in treating inflammation. A large-scale study is needed to confirm these results.

laboratory science
Scanning electron microscopic evaluation of the surface characteristics of 4 microkeratome systems in human corneas
M. Bowes Hamill, MD, Thomas Kohnen, MD
The cut surface of keratectomy specimens created with 4 microkeratomes were examined using scanning electron microscopy. Corneal surface irregularities were noted in all specimens.

Anterior capsule dyes and labeled viscoelastic solutions to enhance contrast in EAS-1000 Scheimpflug images
Jörgen B. Holmén, MSc
Labeled viscoelastic solutions and anterior lens capsule dyeing enhanced the evaluation of rheological properties of viscoelastic solutions by anterior chamber depth measurements using an EAS-1000 instrument.

special report

Refractive surgery survey 2001
Kerry D. Solomon, MD, Mike P. Holzer, MD, Helga P. Sandoval, MD, Luis G. Vargas, MD, Liliana Werner, MD, PhD, David T. Vroman, MD, Terrance J. Kasper, MD, David J. Apple, MD

case reports

Progression to end-stage glaucoma after laser in situ keratomileusis
Naazli M. Shaikh, MD, Saad Shaikh, MD, Kuldev Singh, MD, Edward Manche, MD

Imaging of posterior chamber phakic intraocular lens by optical coherence tomography
Martin Bechmann, MD, Stephanie Ullrich, MD, Martin J. Thiel, MD, Kenneth R. Kenyon, MD, Klaus Ludwig, MD

Acanthamoeba keratitis after photorefractive keratectomy
Roger M. Kaldawy, MD, John E. Sutphin, MD, Michael D. Wagoner, MD

Correction of the Pulfrich phenomenon by surgery and laser
Charles J.M. Diaper, FRCS(Ed), FRCOphth, Gordon Heron, PhD, Ewen S. MacMillan, PhD

Acute comitant esotropia after cataract surgery
Panayotis Zafirakis, MD, Adamantia Voudouri, MD, Gerasimos Livir-Rallatos, MD, Charalampos Livir-Rallatos, MD, Panagiotis Theodossiadis, MD, Ioannis Vergados, MD, Stefanos Baltatzis, MD

Histopathology of anterior lens capsules in vitrectomized eyes with tamponade by silicone oil
Shizuya Saika, MD, PhD, Takeshi Miyamoto, MD, Takeshi Tanaka, MD, Yoshitaka Ohnishi, MD, PhD, Akira Ooshima, MD, PhD, Wataru Kimura, MD, PhD

Our Appreciation

2002 Index

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).

The American Society of Cataract and Refractive Surgery is accredited by the Accreditation Council for Continuing Medical Education to sponsor continuing medical education for physicians. ASCRS takes responsibility for the content, quality, and scientific integrity of the CME activity.

The American Society of Cataract and Refractive Surgery designates this continuing medical education activity for a maximum of 5 credit hours in Category 1 of the Physician’s Recognition Award of the American Medical Association.