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Corneal and Cataract Surgery: Clinical Updates

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A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Ophthalmology".

Deadline for manuscript submissions: closed (28 January 2025) | Viewed by 8467

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Special Issue Editor

Dr. Gracia María Castro de Luna

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Guest Editor

Department of Nursing, Physiotherapy and Medicine, University of Almería, Almería, Spain
Interests: cornea; cataract surgery; keratoconus; machine learning; refractive surgery

Special Issue Information

Dear Colleagues,

The Journal of Clinical Medicine is pleased to announce a forthcoming Special Issue dedicated to showcasing the latest advancements in corneal and cataract surgery. We invite the members of the scientific community to contribute their valuable research and insights to this Special Issue, which aims to provide a comprehensive overview of cutting-edge developments in these critical fields.

We welcome original research articles, reviews, and clinical studies that explore novel techniques, technological innovations, and outcomes in cataract and cornea surgery. The topics of interest include, but are not limited to:

Surgical Techniques in Cataract and Cornea Procedures;
Advances in Intraocular Lens Technology;
Novel Pharmacological Approaches for Postoperative Care;
The Integration of Artificial Intelligence in Surgical Planning;
Outcome Assessment and Patient Satisfaction;
Complication Management and Prevention;
Emerging Trends in Corneal Transplantation.

Dr. Gracia María Castro de Luna
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

cataract surgery
intraocular lens
intraocular lens power calculation
cornea
corneal topography
corneal aberrations
keratoconus
corneal transplant

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Published Papers (6 papers)

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Research

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9 pages, 511 KiB

Open AccessArticle

Visual and Refractive Outcomes after Phacoemulsification Cataract Surgery in Nanophthalmic Eyes

by Tracy H. T. Lai, Jeffrey Y. T. Tse, Jacqueline W. T. Chan and Kenneth K. W. Li

J. Clin. Med. 2024, 13(19), 5852; https://doi.org/10.3390/jcm13195852 - 30 Sep 2024

Viewed by 1081

Abstract

Background/Objectives: The aim of this study was to report the visual and refractive outcomes of nanophthalmic eyes undergoing phacoemulsification at a tertiary cataract center. Methods: This is a prospective consecutive case series. Patients with an axial length of ≤20.5 mm who underwent phacoemulsification at a tertiary cataract center in Hong Kong were included. Eyes undergoing extracapsular cataract extraction or with a previous history of intraocular surgery including trabeculectomy were excluded. The outcome measures were the corrected distance visual acuity (CDVA) and refractive status at four months post-operation. Different intraocular lens formulas were used to compare the refractive outcomes. Results: Out of 22,847 cataract surgeries performed from May 2011 to March 2020, 14 eyes (0.06%) of 10 patients had axial lengths of ≤20.5 mm and underwent phacoemulsification. The mean axial length was 20.13 ± 0.44 mm. Out of these fourteen eyes, three (21%) had postoperative myopic shift with spherical equivalent refraction of more than or equal to 1D compared to the original target. Eleven eyes (79%) had postoperative refraction within 0.5D compared to the original target. Nine out of fourteen eyes (64%) had improvements in postoperative vision. There were no intraoperative complications. When comparing the Hoffer Q, Holladay 1, Holladay 2, Haigis and Hill-RBF 2.0 formulas, there was no significant difference in the absolute errors between the five formulas (p = 0.072). Conclusions: There was no significant difference in the mean absolute errors between the Hoffer Q, Holladay 1, Holladay 2, Haigis and Hill-RBF 2.0 formulas. Myopic shift was not uncommon, and more studies on intraocular lens (IOL) power calculation for short eyes are warranted. Full article

(This article belongs to the Special Issue Corneal and Cataract Surgery: Clinical Updates)

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14 pages, 4445 KiB

Open AccessEditor’s ChoiceArticle

Optimizing IOL Calculators with Deep Learning Prediction of Total Corneal Astigmatism

by Avi Wallerstein, Jason Fink, Chirag Shah, Damien Gatinel, Guillaume Debellemanière, Mark Cohen and Mathieu Gauvin

J. Clin. Med. 2024, 13(18), 5617; https://doi.org/10.3390/jcm13185617 - 22 Sep 2024

Viewed by 1013

Abstract

Background/Objectives: This study aims to identify the most accurate regression model for predicting total corneal astigmatism (TCA) from anterior corneal astigmatism (ACA) and to fine-tune the best model’s architecture to further optimize predictive accuracy. Methods: A retrospective review of 19,468 eyes screened for refractive surgery was conducted using electronic medical records. Corneal topography data were acquired using the Pentacam HR. Various types (7) and subtypes (21) of regression learners were tested, with a deep neural network (DNN) emerging as the most suitable. The DNN was further refined, experimenting with 23 different architectures. Model performance was evaluated using root mean squared error (RMSE), R², average residual error, and circular error. The final model only used age, ACA magnitude, and ACA axis to predict TCA magnitude and axis. Results were compared to predictions from one of the leading TCA prediction formulas. Results: Our model achieved higher performance for TCA magnitude prediction (R² = 0.9740, RMSE = 0.0963 D, and average residual error = 0.0733 D) compared to the leading formula (R² = 0.8590, RMSE = 0.2257 D, and average residual error = 0.1928 D). Axis prediction error also improved by an average of 8.1° (average axis prediction error = 4.74° versus 12.8°). The deep learning approach consistently demonstrated smaller errors and tighter clustering around actual values compared to the traditional formula. Conclusion: Deep learning techniques significantly outperformed traditional methods for TCA prediction accuracy using the Pentacam HR. This approach may lead to more precise TCA calculations and better IOL selection, potentially enhancing surgical outcomes. Full article

(This article belongs to the Special Issue Corneal and Cataract Surgery: Clinical Updates)

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15 pages, 1402 KiB

Open AccessArticle

Cataract Surgery in nAMD Patients Receiving Intravitreal Aflibercept Injections

by Małgorzata Seredyka-Burduk, Slawomir Liberski, Grażyna Malukiewicz, Jarosław Kocięcki and Bartlomiej J. Kaluzny

J. Clin. Med. 2024, 13(13), 3832; https://doi.org/10.3390/jcm13133832 - 29 Jun 2024

Cited by 1 | Viewed by 1178

Abstract

Background: To evaluate functional and anatomical outcomesof cataract surgery in neovascular age-related macular neovascularization (nAMD) eyes receiving anti-vascular endothelial growth factor (anti-VEGF) intravitreal injections in modified pro re nata (PRN) regimen. Materials and Methods: Sixty eyes of 60 nAMD patients, including 41 women (68.3%) and 19 men (31.7%) in an average age of 77.35 ± 6.41 years, under treatment with intravitreal aflibercept injections in modified PRN regimen with no signs of macular neovascularization (MNV) activity during two consecutive visits were included in this prospective, observational study. Best-corrected visual acuity (BCVA), central retinal thickness (CRT), as well as the number of anti-VEGF injections were monitored six months before and after phacoemulsification with intraocular lens (IOL) implantation. Further, the change of the abovementioned parameters was assessed during the six-month follow-up period for CRT and the number of injections, while the BCVA was monitored for 54 months. Results: BCVA measured on the first day after surgery (0.17 ± 0.19 logMAR) as well as in the six-month post-surgery (0.13 ± 0.16 logMAR) significantly improved compared to preop values (0.42 ± 0.20 logMAR). BCVA remains stable during the observational period. We found that both differences were statistically significant (p < 0.01). The mean CRT and the mean number of injections did not differ between the six-month pre- and post-surgical periods. Conclusions: We showed the beneficial effect of phacoemulsification in nAMD patients treated with anti-VEGF agents on visual outcomes in the short and long term. Cataract surgery in nAMD eyes treated with anti-VEGF injections does not increase the frequency of anti-VEGF injections and does not cause deterioration of the macular status. Full article

(This article belongs to the Special Issue Corneal and Cataract Surgery: Clinical Updates)

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8 pages, 243 KiB

Open AccessArticle

Assessment of the Retinal Ganglion Cell Layer after Uncomplicated Cataract Surgery

by Bassam Abou-Jokh Rajab, Carlos Doncel-Fernández, Noelia Sánchez-Liñan and Gracia Castro-Luna

J. Clin. Med. 2024, 13(12), 3579; https://doi.org/10.3390/jcm13123579 - 19 Jun 2024

Viewed by 952

Abstract

(1) Background: This research aimed to evaluate the changes in ganglion cell layer thickness (GCLT) after uncomplicated cataract surgery in patients without previous ocular pathology and the impact of the appearance of cystoid macular edema on the GCLT and visual acuity. (2) Methods: The evaluation of 174 patients was performed with the indication of uncomplicated cataract surgery. The variables analyzed were demographic data, best-corrected visual acuity (BCVA), cataract type and OCT (Optical Coherence Tomography) measurements of central macular thickness (CMT), and the presence of cysts and GCLT preoperatively and one day, one and three months after surgery. (3) Results: There was a relationship between the postoperative increase in retinal GCLT and BCVA after uncomplicated cataract surgery. The presence of microcysts reduced the thickness of the GCL, which is significantly related to the loss of BCVA. The appearance of cystoid macular edema one month after surgery was also related to the preoperative CMT. There was a statistically significant decrease in preoperative GCL but a statistically significant increase in preoperative CMT in patients with microcysts one-month post-surgery. (4) Conclusions: There is a relationship between postoperative retinal GCLT and BCVA after uncomplicated cataract surgery. The presence of microcysts significantly reduces the thickness of the GCL, which is significantly related to the loss of BCVA. Full article

(This article belongs to the Special Issue Corneal and Cataract Surgery: Clinical Updates)

12 pages, 1296 KiB

Open AccessArticle

Clinical Outcomes after Bilateral Implantation of a Wavefront-Shaping Extended Depth of Focus (EDOF) IOL with Mini-Monovision

by Yeo Kyoung Won, Sung Ho Choi, Tae-Young Chung and Dong Hui Lim

J. Clin. Med. 2024, 13(11), 3225; https://doi.org/10.3390/jcm13113225 - 30 May 2024

Viewed by 1703

Abstract

Background: To compare the visual outcomes and optical quality of patients who underwent bilateral implantation of EDOF (AcrySof^® IQ Vivity IOL, DFT015) for mini-monovision, trifocal (AcrySof^® IQ PanOptix, TNFT00), or monofocal (AcrySof^® IQ IOL, SN60WF) IOL. Methods: The monocular-corrected and uncorrected distance visual acuities (CDVA and UDVA, respectively) were evaluated postoperatively at 1 and 3 months. The binocular visual acuity by distance, the binocular defocus curve, contrast sensitivity, and patient satisfaction were examined 3 months postoperatively. All patients were asked to complete questionnaires regarding their satisfaction, visual symptoms, and spectacle dependency. Results: This study included 178 eyes from 89 patients. The postoperative binocular UDVA did not differ significantly among the three groups. In the defocus curve, the Vivity group showed better visual acuity over a range of far and intermediate (60 cm) than the other two IOLs groups. In near-vision, the PanOptix group showed the best near-vision, and the Vivity group showed significantly better vision than the IQ group. The Vivity group showed contrast sensitivity and optical quality comparable to the IQ group. Conclusions: The bilateral implantation of AcrySof^® IQ Vivity IOL with the mini-monovision approach provided excellent distance and intermediate visual acuity with good near-vision, resulting in high satisfaction. Full article

(This article belongs to the Special Issue Corneal and Cataract Surgery: Clinical Updates)

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15 pages, 827 KiB

Open AccessSystematic Review

Investigation of Risk Factors Predicting Cataract Surgery Complications in Patients with Pseudoexfoliation Syndrome: A Systematic Review

by Laura Denisa Preoteasa, George Baltă and Florian N. Baltă

J. Clin. Med. 2024, 13(6), 1824; https://doi.org/10.3390/jcm13061824 - 21 Mar 2024

Cited by 1 | Viewed by 1864

Abstract

(1) Background: The present review aims to identify risk factors with predictive value for differentiating between pseudoexfoliation patients at risk of developing intra- or postoperative complications and those without operative risk during cataract surgery. (2) Methods: The review protocol was registered at PROSPERO, registration no. CRD42023417721. The following databases were searched for studies between 2000 and 2023: PubMed/Medline, Scopus, Springer, Science Direct, Web of Science, Cochrane Database of Systematic Reviews, TRIP database, LILACS, Clinical Trials, and reference lists of articles. We included analytical studies of any design examining cataract surgery complications in pseudoexfoliation patients across two population groups, one who underwent uneventful cataract surgery and the other who experienced intra- or postoperative complications. The paper will follow PRISMA 2020 criteria for reporting. Effect measure was assessed using odds ratios (ORs) and corresponding 95% confidence interval (CI) for qualitative variables and means with their respective standard deviation (SD) for quantitative variables. The risk of bias was assessed using the method presented in the Cochrane Handbook for Systematic Reviews. The GRADE scale was used for quality of evidence and certainty. (3) Results: The initial search of published and gray literature databases retrieved 1435 articles, six of which were included in this report. A total of 156 intra- or postoperative incidents were reported in 999 eyes with pseudoexfoliation. The identified predictive factors were a shallow anterior chamber, cataract grade, neutrophil-to-lymphocyte ratio, preoperative intraocular pressure, and symmetry of the exfoliation material. Limitations include heterogeneity of data and limited number of studies identified in our search. (4) Conclusions: These findings suggest the potential to refine risk stratification protocols in clinical settings and assist surgeons in personalized decision-making among individuals with pseudoexfoliation syndrome. Full article

(This article belongs to the Special Issue Corneal and Cataract Surgery: Clinical Updates)

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