from the editor
Evolution of a journal
Stephen A. Obstbaum, MD

letters
Pupil management during phacoemulsification in patients with iridoschisis
Jorge Castanera, MD

Popperian falsification of methods of assessing astigmatism
William F. Harris, PhD

Ballooning of the conjunctiva during phacoemulsification
André R. Ismail, MB BS, Haralabos Eleftheriadis, MD, Athanasios Vakalis, MD,Christopher S.C. Liu, FRCOphth

Gas sandwich technique for IOL support in combined cataract and vitreoretinal surgery
Holger Mietz, MD, Philipp C. Jacobi, MD, Ralf Krott, MD, Peter Walter, MD

Delayed reappearance of a dislocated lens
Abdel H. Taguri, FRCSEd, Jaswinder Singh, FRCSEd, Mushtaq A. Khan, FRCSEd

consultation section
cataract surgical problem, edited by Samuel Masket, MD
A 78-year-old woman with a 3 year history of post herpes zoster sclerouveitis seeks cataract management in the left eye. She lost the right eye to injury at 2 years. Recently, she reports significant difficulty with daily visual activities. Intermittent noncompliance with medications has led to several ocular complications. The inflammation has been quiescent for 6 months. The left eye has extensive posterior synechias, 4/6 nuclear sclerosis and brunescence, cortical and posterior subcapsular opacities, and a prominent inferior iridociliary staphyloma, which is in communication with a posterior chamber staphyloma. What cataract management would you suggest?
Irving M. Raber, MD, James A. Davison, MD, Ehud I. Assia, MD, Michael L. Nordlund, MD, PhD, Edward J. Holland, MD, Robert H. Osher, MD, I. Howard Fine, MD, Virgílio Centurion, MD, Leif Corydon, MD, PhD, Alan S. Crandall, MD, Gerrit R.J. Melles, MD, PhD

techniques
Translimbal approach for intravitreal injection in endophthalmitis after phacoemulsification
Hyoung J. Koh, MD, Chan Y. Kim, MD, Oh W. Kwon, MD

Teaching continuous curvilinear capsulorhexis using a postmortem pig eye with simulated cataract
Chigusa Hashimoto, MD, Daijiro Kurosaka, MD, Yasushi Uetsuki, PhD

articles
Changes in posterior capsule opacification after poly(methyl methacrylate), silicone, and acrylic intraocular lens implantation
Ken Hayashi, MD, Hideyuki Hayashi, MD, Fuminori Nakao, MD, Fumihiko Hayashi, MD
The progression of PCO with PMMA IOLs was significantly more pronounced than with silicone or acrylic IOLs and led to impairment of visual acuity.

Posterior continuous curvilinear capsulorhexis with hydrogel and silicone intraocular lens implantation: development of capsulorhexis size and capsule opacification
Michael Georgopoulos, MD, Rupert Menapace, MD, Oliver Findl, MD, Georg Rainer, MD, Vanessa Petternel, MD, Barbara Kiss, MD
Anterior capsulorhexis shrinkage and concomitant posterior capsulorhexis enlargement were observed in eyes with a silicone IOL. Eyes with a hydrogel IOL showed no capsule movement but developed anterior and posterior ongrowth.

Collamer intraocular lens: clinical results from the U.S. FDA core study
David C. Brown, MD, Steven L. Ziémba, for the Collamer IOL FDA Study Group
A 2-phase FDA clinical study of Staar CC-4203VF Collamer plate-haptic IOL implantation after phacoemulsification comprised 686 cases enrolled by 15 investigators. Results in the first 502 cases completing the 12 month postoperative follow-up showed that the IOL produces excellent visual acuity results with few reported complications.

Piggyback foldable intraocular lens implantation in patients with microphthalmos
Tetsuro Oshika, MD, Asuka Imamura, MD, Shiro Amano, MD, Shuichiro Eguchi, MD, Miyuki Nakayama, MD, Kazuyuki Emi, MD
Phacoemulsification with implantation of 2 piggyback IOLs was beneficial in microphthalmic eyes. However, precise prediction of postoperative refraction was difficult. In-the-bag placement of 2 foldable lenses is questioned.

Surface abnormalities on hydrophilic acrylic intraocular lenses implanted by an injector
Christoph W. Faschinger, MD
Changes in the surface of hydrophilic acrylic IOLs with a water content of 26% were found after implantation with an injector system. Anterior surface changes remained, but posterior surface changes disappeared within several weeks.

Lens epithelial cell outgrowth on 3 types of intraocular lenses
Jörg Schauersberger, MD, Michael Amon, MD, Andreas Kruger, MD, Claudette Abela, MD, Gebtraud Schild, MD, Julia Kolodjaschna, MD
In regard to PCO, lens material appears to have a greater influence on LEC migration onto the anterior IOL surface than a sharp optic edge design.

Aqueous flare induced by heparin-surface-modified poly(methyl methacrylate) and acrylic lenses implanted through the same-size incision in patients with diabetes
Damien Gatinel, MD, Thierry Lebrun, MD, Philippe Le Toumelin, MD, MS, Gilles Chaine, MD
No significant difference was observed in postoperative inflammation and clinical evolution after insertion of HSM PMMA and hydrophobic acrylic IOLs implanted through the same-size incision in diabetic patients.

Improved prediction of intraocular lens power using partial coherence interferometry
Oliver Findl, MD, Wolfgang Drexler, PhD, Rupert Menapace, MD, Harald Heinzl, PhD, Christoph K. Hitzenberger, PhD, Adolf F. Fercher, PhD
Dual-beam partial coherence interferometry applied to several IOL power calculation formulas enhanced power prediction and improved the refractive outcome of cataract surgery.

Corneal surface changes after pars plana vitrectomy and scleral buckling surgery
Yuval Yhoshua Domniz, MD, Michael Cahana, MD, Izhak Avni, MD
Pars plana vitrectomy, scleral buckling surgery, and a combination of the procedures caused significant corneal surface measurement changes during the first month postoperatively. The measurements returned to baseline by 1 month.

Topical versus sub-Tenon’s anesthesia without sedation in cataract surgery
Panayotis Zafirakis, MD, Adamantia Voudouri, MD, Susannah Rowe, MD, Gerasimos Livir-Rallatos, MD, Charalampos Livir-Rallatos, MD, Christina Canakis, MD, Stefanos Kokolakis, MD, Stefanos Baltatzis, MD, George Theodossiadis, MD
Although patients having cataract surgery under topical anesthesia reported more intraoperative and postoperative discomfort, those receiving sub-Tenon’s anesthesia reported more discomfort during its administration and had more complications.

Patient pain during different stages of phacoemulsification using topical anesthesia
Paul D. O’Brien, FRCSI, Tim Fulcher, FRCOphth, David Wallace, FRCOphth, William Power, FRCS
The pain experienced at different stages of phacoemulsification cataract surgery was no more than that experienced after the instillation of amethocaine eyedrops.

Effects of hand massage on anxiety in cataract surgery using local anesthesia
Man Soo Kim, MD, Kyung Sook Cho, DNS, Heung-Myong Woo, PhD, Jae Ho Kim, MD
Hand massage performed 5 minutes before cataract surgery appeared to decrease patients’ psychological and physiological anxiety levels.

Customized ablation for asymmetrical corneal astigmatism
Carlos Argento, MD, María José Costentino, MD
In a study of asymmetrical corneas treated with customized ablation, the results were satisfactory and safe although features of the algorithm for corneal-topography-assisted customized ablations should be modified.

Clear lens phacoemulsification for correction of high myopia
Vincenzo Pucci, MD, Simonetta Morselli, MD, Federica Romanelli, MD, Silvia Pignatto, MD, Fiona Scandellari, MD, Robert Bellucci, MD
In eyes with myopia greater than 12.0 D, clear lens extraction by phacoemulsification and IOL implantation was effective and predictable and had a low complication rate. The retinal periphery should be carefully evaluated by indirect ophthalmoscopy to avoid postoperative retinal detachment.

Laser in situ keratomileusis for residual myopia after radial keratotomy and photorefractive keratectomy
Amar Agarwal, MS, FRCS, FRCOphth, Athiya Agarwal, MD, DO, FRSH, Tahira Agarwal, DO, Anand Bagmar, MBBS, Sunita Agarwal, MS, DO
Secondary LASIK can be performed for residual myopia after RK and PRK. In this study, the residual myopia in 20 eyes that had primary LASIK was corrected by retreatment with LASIK.

Effect of preoperative pupil measurements on glare, halos, and visual function after photoastigmatic refractive keratectomy
Weldon W. Haw, MD, Edward E. Manche, MD
Preoperative spherical equivalent, astigmatism, and pupil diameter may be important variables in predicting postoperative symptoms and poor visual performance following keratorefractive surgery.

laboratory science
Diffuse lamellar keratitis: isolation of endotoxin and demonstration of the inflammatory potential in a rabbit laser in situ keratomileusis model
N. Timothy Peters, MD, Nader G. Iskander, MD, Ellen E. Anderson Penno, MD, MS, FRCSC, Donald E. Woods, PhD, Richard A. Moore, PhD, Howard V. Gimbel, MD, MPH, FRCSC
Bacterial endotoxin was isolated at multiple stages of the LASIK process in significant concentrations that were then shown to cause DLK-like interface inflammation in a rabbit model.

Direct measurement of microkeratome gap width by electron microscopy
King-yu Liu, FRCOphth, PhD, Dennis S.C. Lam, FRCS, FRCOphth
Electron microscopy was used to measure the gap width of a microkeratome directly and accurately. Results indicate that it is desirable to validate gap widths of new microkeratomes and blades from other manufacturers before use.

special report
Practice styles and preferences of ASCRS members - 2000 survey
David V. Leaming, MD

case reports
Ciliary body tumor and cataract: local resection combined with phacoemulsification
Carlos Argento, MD, María A. Carrasco, MD, Jorge O. Zárate, MD, Martina L. Zilli, MD, Lucas Vilarrodona, MD

Respiratory arrest and convulsions after peribulbar anesthesia
Vsevolod Rozentsveig, MD, Ronit Yagev, MD, Natan Wecksler, MD, Gabriel Gurman, MD, Tova Lifshitz, 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 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).