from the editor
An appreciation
Douglas D. Koch, MD, Christine Ford, Emanuel S. Rosen, FRCSE

letters
Importance of careful patient selection for LASIK
Daniel Elies, MD, Andreu Coret, PhD, Lluis Cavero, PhD

Possible case of capsular block syndrome
Javeed Khan, FRCS

Macular hemorrhage after LASIK for high myopia: a causal association?
Pierre Ellies, MD, Jean Francois Le Rouic, MD, Paul Dighiero, MD, Gilles Renard, MD

Meaningful representation of power
W.F. Harris, PhD

Cataract surgery in the nanophthalmic eye
Jose R. Villada, MRCOphth, Amr A. Osman, Jorge L. Alió, MD, PhD

Single injection of anesthetic agent
Nikhil Kaushik, FRCS, FRCOphth

correspondence
Trypan blue mixed with sodium hyaluronate for capsulorhexis
Özcan Kayikiçioglu, MD, Tansu Erakgün, MD, Cenap Güler, MD

Independent study of excimer laser ablation of the cornea
William Jory, FRCS(C), FRCOphth

Intravitreal antibiotics: the emergency kit
Luis Cordovés, Augusto Abreu, David Seal, Peter Barry

Acknowledging a surgical phenomenon
Brian Little, MA, DO, FRCS, FRCOphth

consultation section
refractive surgical problem, edited by Thomas Kohnen, MD
A 63-year-old man who reported exophoria in the right eye preoperatively had clear lens extraction and IOL implantation 15 months previously and an Nd:YAG capsulotomy 8 months later for PCO. The patient reports that the phoria in the right eye decompensated after surgery. A slitlamp examination shows that the anterior vitreous face is not intact and that the crystalline lens in the left eye is “age normal.” There are no posterior segment abnormalities. The patient reports headaches and aniseikonia. What would you suggest?
Roger F. Steinert, MD, Pietro Giardini, MD, José L.Güell, MD, Paolo Vinciguerra, MD, Jorge L. Alió, MD, PhD, Amar Agarwal, MS, FRCS, FRCOphth (Lon)

techniques
Ab externo scleral fixation of the Cionni modified capsular tension ring
Iqbal Ike K. Ahmed, MD, Alan S. Crandall, MD

Management of posterior capsule rupture during phacoemulsification using the dry technique
Junsuke Akura, MD, Shiro Hatta, MD, Shuzo Kaneda, MD, Mika Ishihara, MD, Kazuki Matsuura, MD, Akihiko Tamai, MD

Closed-system and open-sky capsulorhexis for combined cataract extraction and corneal transplantation
Aldo Caporossi, MD, Claudio Traversi, MD, Carlo Simi, MD, Gian Marco Tosi, MD

Beam-deflection method of diagnosing impaired vision
Andreas Frohn, MD, Wolfgang Fink, PhD, H. Burkhard Dick, MD, Hans-Jürgen Thiel, MD

articles
Improvement in photorefractive corneal laser surgery results using an active eye-tracking system
Michael Mrochen, PhD, Mostafa Salah Eldine, MD, Maik Kaemmerer, PhD, Theo Seiler, MD, PhD, Werner Hütz, MD
Use of an active eye tracker resulted in a smaller increase of optical aberrations than in procedures performed without an eye tracker. This improves the visual outcome after photorefractive surgery.

Stability after laser in situ keratomileusis in moderately and extremely myopic eyes
Roberto Magallanes, MD, Sujal Shah, MD, David Zadok, MD, Arturo S. Chayet, MD, Kerry K. Assil, MD, Miguel Montes, MD, Nora Robledo, OD
Eyes with myopia greater than –15.0 D have significant regression of the refractive effect. The myopic shift continued up to the second year after LASIK in patients with this level of myopia.

Laser in situ keratomileusis for residual myopia after primary LASIK
Amar Agarwal, MS, FRCS, FRCOphth, Athiya Agarwal, MD, DO, FRSH, Tahira Agarwal, OD, Anand Bagmar, MBBS, Sunita Agarwal, MS, DO
Secondary LASIK was safely and successfully performed in 50 eyes with residual myopia after primary LASIK.

Treatment of intraocular pressure elevation after photorefractive keratectomy
Zoltán Zsolt Nagy, MD, Antal Szabó, MD, Ronald R. Krueger, MD, Ildikó Süveges, MD
Timolal maleate, dorzolamide, and a combination of both were studied in eyes that had secondary IOP elevation after PRK. The combination therapy was the most effective.

Erbium:YAG laser emulsification of the cataractous lens
Sonia Durán, MD, PhD, Miguel Zato, MD, PhD
The erbium:YAG laser was used to perform cataract surgery with efficacy and minimal side effects.

Predicting sulcus size using ocular measurements
Mihai Pop, MD, Yves Payette, MSc, Magdi Mansour, MD
Sulcus size was predicted by refraction and the mean corneal power.

Effect of in-the-bag intraocular lens fixation on the prevention of posterior capsule opacification
Jagat Ram, MD, Suresh K. Pandey, MD, David J. Apple, MD, Liliana Werner, MD, PhD, Gagandeep S. Brar, MD, Ramandeep Singh, MD, Kulbhushan P. Chaudhary, MD, Amod Gupta, MD
Results show that successful capsular bag fixation of PC IOLs is mandatory to reduce the incidence of PCO after ECCE or phacoemulsification and that selecting an appropriate IOL biomaterial/design enhances PCO prevention.

Posterior capsule opacification and lens epithelial cell layer formation: Hydroview hydrogel versus AcrySof acrylic intraocular lenses
Antony Scaramuzza, MB, BS (Hons 1), Glen T. Fernando, MB, BS (Hons 1), Basil B. Crayford, MMed, FRACO
After cataract surgery, the incidence of PCO and LEC formation on the anterior IOL surface was greater in patients with Hydroview hydrogel IOLs than in those with AcrySof acrylic lenses.

Visual acuity and contrast sensitivity in different types of posterior capsule opacification
Ching-Yu Cheng, MD, MPH, May-Yung Yen, MD, Shih-Jen Chen, MD, Shu-Ching Kao, MD, Wen-Ming Hsu, MD, Jorn-Hon Liu, MD
Visual acuity and contrast sensitivity in eyes with fibrosis-type and pearl-type PCO were compared. Both test results were worse in the latter group.

Sharp-edged intraocular lens design as a cause of permanent glare
Mark F. Ellis, FRACO, FRACS, FRCOphth
In a retrospective study of long-term edge glare caused by AcrySof IOLs, 5 patients with the MA30BA model and a younger patient with the MA60BM design reported continued glare problems. Three MA30BA IOLs were removed in 2 patients, which resolved the glare symptoms.

Noninvasive Raman spectroscopic identification of intraocular lens material in the living human eye
Roel J. Erckens, MD, Wayne F. March, MD, Franciscus H. Jongsma, PhD, James P. Wicksted, PhD, Frederick Hendrikse, MD, PhD, Eefke E. Smit, MD, Massoud Motamedi, PhD
Results show that Raman spectroscopy is a noninvasive way to determine the chemical composition of implanted IOLs. It uses a safe light dose for an exposure time of 1 second.

Anterior lenticonus: histological evaluation and approach for cataract surgery
Gysbert van Setten, MD, PhD
Anterior lenticonus was detected in patients without Alport’s syndrome who were otherwise healthy. A modified 2-step CCC technique can be used to make cataract surgery in such eyes safe and relatively easy.

laboratory science
Lens epithelial cell regeneration of a capsule-like structure during postoperative healing in rabbits
Shizuya Saika, MD, PhD, Takeshi Miyamoto, MD, Iku Ishida, MD, Yuka Okada, MD, PhD, Yoshitaka Ohnishi, MD, PhD, Akira Ooshima, MD, PhD
In this histological and immunohistochemical study, a multilayered homogenous capsule-like structure was present in the equatorial region of the capsular bag 3 and 5 months after phacoemulsification and IOL implantation in rabbit eyes, indicating that LECs regenerated a capsule-like structure.

Prevention of posterior capsule opacification by intraoperative single-dose pharmacological agents
Ümit Übeyt Înan, MD, Faruk Öztürk, MD, Süleyman Kaynak, MD, Emin Kurt, MD, Levent Emiroglu, MD, Erdener Özer, MD, Süleyman Sami Ilker, MD, Cenap Güler, MD
A single dose of EDTA, EDTA + RGD peptide, dexamethasone, diclofenac, or MMC was used after phacoemulsification to prevent PCO. All except dexamethasone reduced PCO significantly. Although not as effective as the other drugs, dexamethasone reduced PCO compared with the controls.

update/review
Optics of aberroscopy and super vision
Raymond A. Applegate, OD, PhD, Larry N. Thibos, PhD, Gene Hilmantel, OD, MS
Paper reviews the limitations imposed by optical imaging and photoreceptor sampling, examines the predicted losses induced by aberrations, and discusses principles of aberration measurement.

case reports
Special Section: Late Complications of Refractive Surgery

Late partial dislocation of a laser in situ keratomileusis flap
Anthony J. Lombardo, MD, PhD, Harold R. Katz, MD

Late traumatic flap dislocation after laser in situ keratomileusis
Nader G. Iskander, MD, N. Timothy Peters, MD, Ellen Anderson Penno, MD, Howard V. Gimbel, MD

Bilateral severe keratoconus after laser in situ keratomileusis in a patient with forme fruste keratoconus
Gilles Lafond, MD, Richard Bazin, MD, Caroline Lajoie, MD

Contact lens fitting in a patient with keratectasia after laser in situ keratomileusis
Fred A.G.J. Eggink, OD, FAAO, W. Houdijn Beekhuis, MD

Late-onset interface keratitis after uneventful laser in situ keratomileusis
Louis E. Probst, MD, Linda Foley, OD

Diffuse lamellar keratitis associated with iritis 10 months after laser in situ keratomileusis
Vincent A. Keszei, MD

Corneal opacity after repeated photorefractive keratectomy
Kyu Sik Kim, MD, Ja Young Lee, MD, Sung Kun Chung, MD, Nam Ho Baek, MD

Rupture of a radial keratotomy incision after 11 years during clear corneal phacoemulsification 1132
Seema Behl, MS, Kulin Kothari, MS

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).