JCRS Highlights

THOMAS KOHNEN European Editor of JCRS

NEVER TOO LATE TO LIFT

The time between initial laser-assisted in situ keratomileusis (LASIK) procedures and enhancement procedures does not influence the success of re-lifting the LASIK flap, according to the findings of a retrospective observational case series. The study included 73 eyes of 68 patients who underwent LASIK enhancement procedures with flap re-lifting between January 1, 1997, and July 31, 2019. The mean interval between primary LASIK to re-lift was 8.6 years (range 0.2 to 22.2 years). The study showed the flap re-lifting was successful in 71 eyes (97.3%). Among the eyes with successfully re-lifted flaps, 12 (16.9%) developed epithelial ingrowth (EI), which was clinically significant in three (4.2%) eyes. However, none of those eyes lost lines of best-corrected visual acuity following the ingrowth removal. There was no significantly significant association with re-lift success or EI development and factors such as the interval between the primary and enhancement procedures and primary LASIK flap creation method (microkeratome versus femtosecond laser). J Chang et al., “Effect of time since primary laser-assisted in situ keratomileusis on flap re-lift success and epithelial ingrowth risk”, 48(6): 705–709.

LESS VISUAL IMPROVEMENT IN EYES WITH RETINAL VEIN OCCLUSION

Patients with retinal vein occlusion have poorer visual outcomes after cataract surgery than patients without the condition, as well as a higher risk of postoperative cystoid macular oedema (CME). A retrospective, multicentre cohort study compared cataract surgery outcomes of 1,796 eyes with RVO preoperatively and 177,060 eyes without RVO. The study found 55.1% of eyes with RVO achieved a postoperative gain in visual acuity of 0.35 logMAR or more at four to 12 weeks postoperatively, compared to 64.55% in eyes without the condition. In addition, the RVO group had a significantly higher rate of postoperative CME (3.02% versus 0.87%). C M Ponder et al., “Intraoperative complications and visual outcomes of cataract surgery in patients with retinal vein occlusion: multicentre database study”, 48(6): 697–704.

ICLS OKAY FOR SOLDIERS

Implantation of the implantable collamer lens (ICL) appears to be a safe and effective option for active-duty military personnel, according to a new study. The retrospective longitudinal observational study involved 1,485 patients with a median age of 25 years (range 22–29) who underwent ICL implantation between 2007 and 2019. All were unsuitable for LASIK because of high myopia or topographic abnormalities. The study showed the proportion achieving the targeted refractive correction was 97% at one year and 90% at eight years. In addition, at one year postoperatively, 80.3% of patients (663 eyes) achieved an uncorrected visual acuity of 20/20 or better, and 79.2% of patients had a UDVA of 20/25 or better at eight years. Complications included visually significant anterior subcapsular cataracts requiring ICL removal and cataract extraction in 36 eyes, glaucoma in two eyes, and retinal detachments in three eyes. K T Packer et al., “U.S. military implantable collamer lens surgical outcomes: 11-year retrospective review”, 48(6): 649–656.