from the editor
An optical journey
Emanuel S. Rosen, FRCS

letters

Cell destruction from intraocular use of benzalkonium chloride

Incision burns

Transparent irrigation cannula

Why mix trypan blue with viscoelastic agents?

consultation section
cataract surgical problem,edited by Samuel Masket, MD
Loss of iris tissue temporally at cataract surgery induced glare in an 81-year-old man.
I. Howard Fine, MD, H. Burkhard Dick, MD, Mana Tehrani, MD, Leon D. Solomon, MD, FRCSC, Rupert Menapace, MD, Tobias H. Neuhann, MD, Robert H. Osher, MD, Kenneth J. Rosenthal, MD

techniques
Phacoemulsification in eyes with corneal opacification
Ayad A. Farjo, MD, Roger F. Meyer, MD, Qais A. Farjo, MD

Single-action implantation of a 3-piece acrylic intraocular lens with an injector
Tetsuji Takeshita, MD, Kazuhiro Yamada, MD, Hidenobu Tanihara, MD

articles

Histopathology of corneal melting associated with diclofenac use after refractive surgery  
Joseph K.W. Hsu, MD, W. Todd Johnston, MD, Russell W. Read, MD, Peter J. McDonnell, MD, Rey Pangalinan, MD, Narsing Rao, MD, Ronald E. Smith, MD
The histopathology and clinical course in 3 cases suggests that in the presence of a dislodged flap after LASIK, corneal melting can occur with topical diclofenac.

Maximum permissible lateral decentration in aberration-sensing and wavefront-guided corneal ablation
Michael Bueeler, MSE, Michael Mrochen, PhD, Theo Seiler, MD
The maximum permissible decentration to improve the optical performance to the level of the best 10% of a normal, untreated population was on the order of 0.2 mm for 7.0 mm pupils.

Laser in situ keratomileusis flap suturing to treat recalcitrant flap striae
David W. Jackson, MD, M. Bowes Hamill, MD, Douglas D. Koch, MD
Laser in situ keratomileusis flap suturing was an effective technique for treating recalcitrant flap striae.

Choroidal neovascularization in phakic eyes with anterior chamber intraocular lenses to correct high myopia
José M^a Ruiz-Moreno, MD, Concepción de la Vega, MD, Oscar Ruiz-Moreno, MD, Jorge L. Alió, MD
The incidence of CNV after phakic IOL implantation was low, but CNV was followed by a significant decrease in BSCVA.

Effect of pupil size on visual function under monocular and binocular conditions in LASIK and non-LASIK patients
Brian S. Boxer Wachler, MD
Visual acuity and contrast sensitivity were greater when tested under binocular conditions than under monocular conditions. Vision improvement was more pronounced in the post-LASIK group than the non-LASIK group.

Amniotic membrane transplantation for bullous keratopathy in eyes with poor visual potential  
Edgar M. Espana, MD, Martin Grueterich, MD, Helga Sandoval, MD, Abraham Solomon, MD, Eduardo Alfonso, MD, Carol L. Karp, MD, Francisco Fantes, MD, Scheffer C.G. Tseng, MD, PhD
Amniotic membrane transplantation relieved the pain and discomfort in eyes with symptomatic bullous keratopathy and poor visual potential.

Morphological and functional results of AcrySof intraocular lens implantation in children: Prospective randomized study of age-related surgical management  
Andrea Müllner-Eidenböck, MD, Michael Amon, MD, Elisabeth Moser, MD, Andreas Kruger, MD, Claudette Abela, MD, Yasmin Schlemmer, MD, Thomas Zidek, MD
The AcrySof IOL was well tolerated in pediatric eyes when age-related surgical techniques were used. Posterior optic capture is not necessary. Leaving the posterior capsule intact is an acceptable method for school-age children and juveniles with isolated developmental cataract.

Four-point fixation of posterior chamber intraocular lenses in children with unilateral aphakia
Ashraf Sewelam, MD
Four-point scleral fixation of a PC IOL in children with unilateral aphakia produced encouraging results. Immediate postoperative anterior uveitis was the most common treatable complication.

Comparison of secondary implantation of flexible open-loop anterior chamber and scleral-fixated posterior chamber intraocular lenses
Cem Evereklioglu, MD, Hamdi Er, MD, Necdet A. Bekir, MD, Mehmet Borazan, MD, Ferhat Zorlu, MD
Although there was no difference in postoperative mean visual acuity, secondary implantation of flexible open-loop AC IOLs led to a higher complication rate than scleral-fixated PC IOLs in aphakic eyes with insufficient capsule support after complicated primary cataract surgery.

Corticocapsular adhesions and their effect during cataract surgery
Abhay R. Vasavada, MS, FRCS, Deepa Goyal, MS, Lajja Shastri, MS, Raminder Singh, MS
Corticocapsular adhesions identified on slitlamp examination were associated with difficulty in nucleus rotation after single-site hydrodissection. Additional multiquadrant and focal hydrodissection overcame this problem.

Efficacy of a capsular tension ring for phacoemulsification in eyes with zonular dialysis
Soosan Jacob, MS(Oph), DNB, FERC, Amar Agarwal, MS(Oph), FRCS, FRCOphth, Athiya Agarwal, MD, FRSH, DO, Sunita Agarwal, MS, FSVH, FRSH, DO, Nishant Patel, DO, FERC, Vikas Lal, MBBS, FERC
Use of a capsular tension ring made phacoemulsification with in-the-bag IOL implantation safe in eyes with zonular dialysis of up to 150 degrees.

Intrastromal corneal ring implantation for the correction of myopia: 12-month follow-up
Magda Rau, MD, Dieter Dausch, MD
Intrastromal corneal ring segment implantation for low to moderate myopia provided good visual recovery and efficacy. Corneal infiltrates can occur and must be treated immediately.

Advanced glycation end-products in anterior chamber aqueous of cataractous patients
Sybille Franke, PhD, Friederike Stein, MD, Jens Dawczynski, MD, Marcus Blum, MD, Ulrich Kubetschka, MD, Günter Stein, MD, Jürgen Strobel, MD
Advanced glycation end-products were present in the aqueous of cataractous eyes, occurring mainly in an albumin-bound form. This provides evidence that they may originate from the blood. Their role in cataractogenesis is still unclear.

laboratory science

Intraocular lens surfaces and their relationship to postoperative glare  
Jay C. Erie, MD, Mark H. Bandhauer, MS
Internal and external surface reflections from an IOL can be minimized by using an optic design with an anterior radius of curvature of approximately 17.0 mm or less.

Computerized analysis of the effects of intraocular lens edge design on the quality of vision in pseudophakic patients
Alessandro Franchini, MD, Barbara Zamma Gallarati, MD, Eleonora Vaccari, MD
Computerized analysis of the interaction of light rays as a function of edge design showed different intensities of the reflected glare images in 3 IOL models.

Effect of the optic size of a single-piece acrylic intraocular lens on posterior capsule opacification
Okihiro Nishi, MD, Kayo Nishi, MD
Implantation of the single-piece AcrySof IOL in the rabbit showed more PCO with a 7.0 mm optic than with a 5.5 mm optic. In addition, the bulky haptic of this IOL may hamper capsular adhesion and bend formation.

Effect of tenascin and fibronectin on the migration of human corneal fibroblasts
Gerald Schmidinger, MD, Georg Hanselmayer, MD, Stefan Pieh, MD, Birgit Lackner, MD, Stephan Kaminski, MD, Irene Ruhswurm, MD, Christian Skorpik, MD
In vitro assays demonstrate the effects of ECM proteins and growth factors on the migration of human corneal fibroblasts in early corneal wound healing.

Bacterial adhesion to rigid and foldable posterior chamber intraocular lenses: In vitro study
Jörg Schauersberger, MD, Michael Amon, MD, Doris Aichinger, MD, Apostoulos Georgopoulos, MD
Based on the hypothesis that inoculation of bacteria during cataract surgery is primarily caused by contaminated IOLs, IOLs with hydrophilic surfaces may help reduce the risk of endophthalmitis.

Surface roughness of intraocular lenses and inflammatory cell adhesion to lens surfaces
Naoyuki Yamakawa, MD, Takao Tanaka, MD, Mari Shigeta, MD, Migio Hamano, Masahiko Usui, MD
The average surface roughness of the surface of PMMA IOLs significantly affected endogenous immunoreactive cell adhesion to their surface and is proposed as an important index of IOL biocompatibility.

In vitro study of bacterial adherence to processed dura mater, processed pericardium, pericardium in saline, and human sclera
Thomas John, MD, Olivia C. John, Roberta B. Carey, PhD
Bacteria adhered to dura mater, pericardium, and human sclera in vitro. Surgical use of such materials should be followed by adequate antibiotic coverage to prevent potential infections.

update/review

Current surgical options for keratoconus  
Joseph Colin, MD, Sylvie Velou, MD
Keratoconus treatment is partly dependent on the severity of the disease. Treatment options include keratoplasty, ablative, and additive procedures.

case reports

Aberrant regeneration of corneal nerves after laser in situ keratomileusis
Sanjay V. Patel, MD, Jay C. Erie, MD

Prophylactic use of mitomycin-C in the management of a buttonholed LASIK flap
Howard A. Lane, MD, Jerome A. Swale, MD, Parag A. Majmudar, MD

Tissue adhesive to treat 2-site corneal melting associated with topical ketorolac use
Alexandre S. Marcon, MD, Christopher J. Rapuano, MD, Janine G. Tabas, MD

Corneal wedge resection to treat progressive keratoconus in the host cornea after penetrating keratoplasty
Luca Ilari, MD, Sheraz M. Daya, FRCS(Ed), FACS

Sutured piggyback toric intraocular lenses to correct high astigmatism
James P. Gills, MD

Congenital double crystalline lenses
Hansa H. Thakkar, MS, Raminder Singh, MS

Late bacterial keratitis after implantation of intrastromal corneal ring segments
Tristan Bourcier, MD, PhD, Vincent Borderie, MD, PhD, Laurent Laroche, MD

Spontaneous posterior dislocation of an intraocular lens presenting as pupillary block glaucoma
Jai Shankar, FRCOphth, Mark Halliwell, FRCOphth

correspondence

Using nylon hooks during small-pupil phacoemulsification
Tanuj Dada, MD, Harinder Singh Sethi, MD, Namrata Sharma, MD, Vijay K. Dada, MS

Delayed opacification of PMMA intraocular lens
David F. Gilmour, MBChB, Abdel Taguri, FRCS(Ed), MRCOphth, Harry G.B. Bennett, MRCP(UK), FRCOpht

Induced astigmatism after laser in situ keratomileusis
Jose Rodríguez-Prats, MD, Ahmed Galal Ahmed, MD, Ma-Jose Ayala, MD, Jorge L. Alió, MD, PhD

Recurrent capsule opacity and erythropoietin
James S. Kelly, MD

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 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).