from the editor
Quality of vision
Nick Mamalis, MD

letters
Effect of accommodation on the cornea
Changes in the posterior corneal surface after LASIK
Deep venous thrombosis and cataract surgery
Where do the missed diopters of CBS hide?

consultation section
refractive surgical problem, edited by Thomas Kohnen, MD
After superonasal and superotemporal trabeculectomy with mitomycin-C, a patient developed high astigmatism (central astigmatism to 18.7 D) and mild cataract. How would you manage this case?
Salomon Esquenazi, MD, Giuseppe Ravalico, MD, Holger Mietz, MD, Thomas Neuhann, MD, Samuel Cady, MD, Robert Ritch, MD, Paul Rafuse, PhD, MD, FRCSC, Jacqueline T. Koo, MD, MPH, Thomas W. Samuelson, MD, Alan Crandall, MD

techniques
Phototherapeutic keratectomy with an epithelial flap for recurrent erosion syndrome
Navid Ardjomand, MD, Peter Fellner, MD, Bertram Vidic, MD

Revised Miyake-Apple technique for postmortem eye preparation
Brandon L. Davis, MD, Christian D. Nilson, MD, Nick Mamalis, MD

Optimizing refractive lens exchange with bimanual microincision phacoemulsification
I. Howard Fine, MD, Richard S. Hoffman, MD, Mark Packer, MD

Human cataractous lens nucleus implanted in a sheep eye lens as a model for phacoemulsification training
Özcan Kayikçioglu, MD, Sait Egrilmez, MD, Sinan Emre, MD, Tansu Erakgün, MD

articles

Early visual results with the rollable ThinOptX intraocular lens  
Murat Dogru, MD, Rie Honda, MD, Masahiro Omoto, MD, Hiroshi Fujishima, MD, Yukiko Yagi, CO, Kazuo Tsubota, MD
Eyes with a ThinOptX IOL had best corrected near and distance visual acuities comparable to those in eyes with an AcrySof IOL. However, the ThinOptX IOL provided significantly higher contrast acuities, perhaps because of its ultrathin properties.

Viscocanalostomy in patients with glaucoma secondary to uveitis:
Preliminary report
Elisabetta Miserocchi, MD, Roberto G. Carassa, MD, Paolo Bettin, MD, Rosario Brancato, MD
Results of a preliminary study suggest that viscocanalostomy is safe and effective for treating glaucoma in patients with uveitis and can be used as an alternative to conventional filtering surgery with antimetabolites and implant devices.

High-order aberrations in pseudophakia with different intraocular lenses
Lucas Vilarrodona, MD, Graham D. Barrett, MD, Bradley Johnson, MD
In a prospective study of pseudophakic eyes with different types of IOLs, postoperative highorder aberrations were significantly greater in patients with IOLs having a high refractive index.

Corneal endothelial assessment after ICL implantation
Henry F. Edelhauser, PhD, Donald R. Sanders, MD, PhD, Ramzy Azar, MPH, Helene Lamielle, MD, ICL in Treatment of Myopia Study Group
No ongoing change in endothelial cell density was observed after the third year following implantation of the ICL for myopia.

Cataract surgery in patients with nanophthalmos: Results and complications  
Wayne Wu, MD, Daniel G. Dawson, MD, Alan Sugar, MD, Susan G. Elner, MD, Kathy A. Meyer, RDMS, Jesse B. McKey, Sayoko E. Moroi, MD, PhD
The surgical results in eyes with nanophthalmos improved when current cataract, glaucoma, and uveal effusion treatments were used.

Surgeons' perceptions of their patients' priorities
Chet K. Pager, BMed (Hons), DipEd, MA, Peter J. McCluskey, MD, FRACO
When considering cataract surgery, surgeons were poor predictors of their patients' priorities, a finding compounded by surgeon stereotypes of public versus private patients.

Improvement in cognitive impairment after cataract surgery in elderly patients  
Hiroki Tamura, MD, Hidetoshi Tsukamoto, MD, Satoshi Mukai, MD, Tomoko Kato, MD, Atsushi Minamoto, MD, Yuko Ohno, PhD, Hidetoshi Yamashita, MD, PhD, Hiromu K. Mishima, MD, PhD
Quality-of-vision and quality-of-life scores improved after cataract surgery. Thus, cataract surgery improved cognitive impairment in a cohort of elderly Japanese patients.

Early postoperative refractive outcomes of pediatric intraocular lens implantation
Eedy Mezer, MD, David S. Rootman, MD, FRCSC, Mohamed Abdolell, MSc, Alex V. Levin, MD, MHSc, FRCSC
Prediction of short-term refractive error in children using 5 IOL power calculation formulas (SRK, SRK II, Holladay 1, Hoffer Q, SRK/T) was fair to good at best.

Surgery in unilateral congenital cataract caused by persistent fetal vasculature or minimal fetal vascular remnants: Age-related findings and management challenges  
Andrea Müllner-Eidenböck, MD, Michael Amon, MD, Wolfgang Hauff, MD, Nina Klebermass, MD, Claudette Abela, MD, Elisabeth Moser, MD
Special surgical procedures in addition to age-related standard pediatric cataract surgery techniques were necessary in all patients with unilateral cataract because all had varying degrees of PFV.

Hyperthermic treatment of post-LASIK corneal striae
Eric D. Donnenfeld, MD, Henry D. Perry, MD, Sima J. Doshi, MD, Seth A. Biser, MD, Renée Solomon, MD
Hyperthermic treatment of corneal striae produced collagen relaxation and return of normal architecture with improvement in corneal anatomy and visual acuity.

Influence of spectacle-related changes in retinal image size on contrast sensitivity function after laser in situ keratomileusis  
Birgit Lackner, MD, Stefan Pieh, MD, Martin A. Funovics, MD, Gerald Schmidinger, MD, Carmen Franz, MD, Christian Simader, MD, PhD, Christian Skorpik, MD
Small changes in contrast sensitivity after LASIK can be documented using a dedicated computer program displaying optotypes on a monitor. Contrast sensitivity is impaired at 1 and 3 months, while complete recovery is observed after 6 months. This course is partly concealed if the spectacle refraction is not taken into account.

Cyclotorsional eye motion occurring between wavefront measurement and refractive surgery
Dimitri A. Chernyak, PhD
Low to moderate cyclotorsional eye movement occurred between measurements with the wavefront device and laser refractive surgery. Adjusting the laser ablation algorithm to compensate for this movement may produce better visual results.

Day to day variability of the dark-adapted pupil diameter
Sandra M. Brown, MD, Arshad M. Khanani, MA, Ke Tom Xu, PhD
The dark-adapted pupil diameter varied by ≤0.2 mm in 75% of normal individuals tested on 2 occasions using a consistent dark-adaptation protocol.

Effect of posture and artificial tears on corneal power measurements with a handheld automated keratometer
Andrew K.C. Lam, PhD, FAAO, Rufina Chan, MOptom, FAAO, Roger Chiu, HCert(Optom)
A study of the effect of patient posture and artificial tears on corneal power measurements found different results between handheld keratometry and topographic keratometry. The difference was greatest with the use of artificial tears. Results show that the power vector method is best for studying corneal shape.

Comparison of higher-order aberrations after LASEK with a 6.0 mm ablation zone and a 6.5 mm ablation zone with blend zone
Kyoung Yul Seo, MD, Jae Bum Lee, MD, Jimmy Jaeyoung Kang, Eun Suk Lee, MD, Eung Kweon Kim, MD
In scotopic conditions, HOAs were significantly smaller with larger optical and blend zone treatment than with conventional ablation zone treatment. Larger and blend zone treatment can be an alternative surgical technique for preventing deterioration in optical performance in low light.

Influence of optic edge design and anterior capsule polishing on posterior capsule fibrosis
Stefan Sacu, MD, Rupert Menapace, MD, Oliver Findl, MD, Michael Georgopoulos, MD, Wolf Buehl, MD, Katharina Kriechbaum, MD, Georg Rainer, MD
An acrylic IOL with a sharp edge led to significantly less fibrotic PCO than an acrylic IOL with a round edge. Anterior capsule polishing had no significant influence on fibrotic PCO in eyes with a truncated-edged silicone IOL.

Comparison of Nagahara phaco-chop and stop-and-chop phacoemulsification nucleotomy techniques
Ízzet Can, MD, Tamer Takmaz, MD, Ferda Çakici, MD, Meltem Özgül, MD
In a comparison of the intraoperative and postoperative effects of the phaco-chop and stop-and-chop nucleotomy techniques, phaco-chop decreased the phaco time and power and shortened the postoperative healing time.

Comparison of the handheld Retinomax K-Plus2 and on-table autokeratometers in children with and without cycloplegia
Chung-Ling Liang, MD, Kuo-Sheng Hung, MD, Naeun Park, Patrick Chan, Suh-Hang H. Juo, MD, PhD
In keratometry using the Retinomax and Topcon in children with and without cycloplegia, the mean difference was clinically acceptable: ~80% within 0.5D. The measurement agreement was higher without cycloplegia.

Chronic dry eye and regression after laser in situ keratomileusis for myopia
Julie M. Albietz, PhD, Lee M. Lenton, FRANZCO, FRACS, Suzanne G. McLennan
After LASIK for myopia, the risk for refractive regression was increased in patients with chronic dry eye. Dry eye treatment may improve the refractive outcome.

Refractive outcomes after bilateral multifocal intraocular lens implantation
Angel Pineda-Fernández, MD, Jorge Jaramillo, MD, Vanessa Celis, MD, José Vargas, MD, Mauro DiStacio, MD, Alicia Gal&iAcute;ndez, MD, Mercedes Del Valle, MD
Bilateral AMO Array multifocal IOL implantation gave excellent uncorrected distance and near visual acuities. However, halos and glare remained a problem in some patients.

laboratory science

Collagen crosslinking of human and porcine sclera
Gregor Wollensak, MD, Eberhard Spoerl, PhD
Collagen crosslinking with riboflavin/UVA, glyceraldehyde, and glutaraldehyde led to an increase in biomechanical strength in human and porcine sclera. This might be used as a treatment for progressive myopia.

case reports
Anterior chamber optical coherence tomography study of human natural accommodation in a 19-year-old albino
Georges Baikoff, MD, Eric Lutun, Jay Wei, Caroline Ferraz, MD

Laser in situ keratomileusis after conductive keratoplasty
Shawn Klein, MD, Kristen Fry, OD, Peter S. Hersh, MD

Laser in situ keratomileusis flap tear during lifting for enhancement in the presence of post-photorefractive keratectomy corneal haze
Michael G. Gressel, MD, Vickie L. Belsole, LPN

Treatment of dense subepithelial corneal haze after laser-assisted subepithelial keratectomy
M. Azim Mirza, MD, Mujtaba A. Qazi, MD, Jay S. Pepose, MD, PhD

Combined trabeculectomy and vitrectomy for pseudophakic malignant glaucoma and extensive peripheral anterior synechia-induced secondary glaucoma
Yi-Yu Tsai, MD, Sung Huei Tseng, MD

Surgical management of crystalline lens dislocation into the anterior chamber with corneal touch and secondary glaucoma
Dong-Youk Choi, MD, June-Gone Kim, MD, PhD, Byung-Joo Song, MD, PhD

Orbital varix rupture during cataract surgery
Miwako Yoshimoto, MD, PhD, Shun Matsumoto

Repair of a ruptured globe using topical anesthesia
Gerd U. Auffarth, MD, Luis G. Vargas, MD, Jens Klett, MD, Hans E. Völcker, MD

information for authors

assignment 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 5 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 provide continuing medical education for physicians. ASCRS takes responsibility for the content, quality, and scientific integrity of this CME activity.

The American Society of Cataract and Refractive Surgery designates this educational activity for a maximum of 5 category 1 credits toward the AMA Physician’s Recognition Award. Each physician should claim only those credits that he/she actually spent in the activity.