Pseudoexfoliation and Cataract Syndrome Associated with Genetic and Epidemiological Factors in a Mayan Cohort of Guatemala.

The Mayan population of Guatemala is understudied within eye and vision research. Studying an observational homogenous, geographically isolated population of individuals seeking eye care may identify unique clinical, demographic, environmental and genetic risk factors for blinding eye disease that can inform targeted and effective screening strategies to achieve better and improved health care distribution. This study served to: (a) identify the ocular health needs within this population; and (b) identify any possible modifiable risk factors contributing to disease pathophysiology within this population.

Systemic Disease and Ocular Comorbidity Analysis of Geographically Isolated Federally Recognized American Indian Tribes of the Intermountain West.

Background: The American Indian Navajo and Goshute peoples are underserved patient populations residing in the Four Corners area of the United States and Ibupah, Utah, respectively.

Methods: We conducted a cross-sectional study of epidemiological factors and lipid biomarkers that may be associated with type II diabetes, hypertension and retinal manifestations in tribal and non-tribal members in the study areas (n = 146 participants). We performed multivariate analyses to determine which, if any, risk factors were unique at the tribal level.

Visual function, digital behavior and the vision performance index.

Historically, visual acuity has been the benchmark for visual function. It is used to measure therapeutic outcomes for vision-related services, products and interventions. Quantitative measurement of suboptimal visual acuity can potentially be corrected optically with proper refraction in some cases, but in many cases of reduced vision there is something else more serious that can potentially impact other aspects of visual function such as contrast sensitivity, color discrimination, peripheral field of view and higher-order visual processing.

Exfoliation Syndrome and Cataract Surgery.

Cataract extraction in exfoliation syndrome requires careful preoperative assessment and planning. Knowledge of the degree of pupil dilation and zonular integrity are essential for safely perform cataract surgery in these eyes. Capsule rhexis should be 5.

A Schlemm Canal Microstent for Intraocular Pressure Reduction in Primary Open-Angle Glaucoma and Cataract: The HORIZON Study.

Objective: To compare cataract surgery with implantation of a Schlemm canal microstent with cataract surgery alone for the reduction of intraocular pressure (IOP) and medication use after 24 months.

Design: Prospective, multicenter, single-masked, randomized controlled trial.

Participants: Subjects with concomitant primary open-angle glaucoma (POAG), visually significant cataract, and washed-out modified diurnal IOP (MDIOP) between 22 and 34 mmHg.

Long-term outcomes for pediatric patients having transscleral fixation of the capsular bag with intraocular lens for ectopia lentis.

Purpose: To report the long-term outcomes of transscleral fixation of capsular tension rings (CTR) with intraocular lens (IOL) placement in pediatric patients with ectopia lentis.

Setting: John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, USA.

New capsular tension segment with 2-point fixation for zonular weakness.

We describe clinical applications and surgical techniques for a new type of capsular tension segment (CTS) for use during cataract surgery. The Ambati CTS is distinguished from other CTS devices by having 2 eyelets close to each other, which allows it to distribute tension to 2 points, avoiding too much stress at a single point on the anterior capsulotomy, which prevents peaking of the capsulorhexis, and potentially reducing the risk for anterior capsule tear. Two of these CTS devices could possibly be used to provide 4-point fixation of a capsular bag in eyes with near-complete zonular instability.

Adherence to Glaucoma Medications Over 12 Months in Two US Community Pharmacy Chains.

Unlabelled: This study determined the degree of adherence to medications for glaucoma among patients refilling prescriptions in community pharmacies.

Methods: Data abstracted from the dispensing records for 3615 adult patients (18 years or older, predominantly over 45) receiving glaucoma medications from two retail pharmacy chains (64 stores in total) were analyzed. From a 24-month historic data capture period, the 12-month levels of adherence were determined using standard metrics, the proportion of days covered (PDC) and the medication possession ratio (MPR).

Minimally invasive external mini-glaucoma shunt implantation without conjunctival dissection.

The current method for implantation of the Ex-PRESS Glaucoma Filtration Device requires a conjunctival peritomy and shunt insertion under the guarded protection of a scleral flap. This technique requires suture closure of the flap and conjunctiva. A new minimally invasive technique for Ex-PRESS shunt implantation allows for insertion through a scleral tunnel originating from a grooved clear corneal incision.

Ab externo scleral fixation of intraocular lens.

Unlabelled: We describe an ab externo technique that facilitates IOL scleral fixation and reduces the risk associated with previous ab externo scleral fixation techniques. This technique uses a microvitreoretinal blade and an internal limiting membrane forceps to create sclerotomies and retrieve the suture, respectively.

Financial Disclosure: Dr.

Glaucoma diagnostic accuracy of ganglion cell-inner plexiform layer thickness: comparison with nerve fiber layer and optic nerve head.

Purpose: To determine the diagnostic performance of macular ganglion cell-inner plexiform layer (GCIPL) thickness measured with the Cirrus high-definition optical coherence tomography (HD-OCT) ganglion cell analysis (GCA) algorithm (Carl Zeiss Meditec, Dublin, CA) to discriminate normal eyes and eyes with early glaucoma and to compare it with that of peripapillary retinal nerve fiber layer (RNFL) thickness and optic nerve head (ONH) measurements.

Design: Evaluation of diagnostic test or technology.

Participants: Fifty-eight patients with early glaucoma and 99 age-matched normal subjects.

Length and frequency of intraoperative occlusive events with new torsional phacoemulsification software.

Purpose: To evaluate the efficiency profile of new torsional phacoemulsification software.

Setting: Eye Institute of Utah, Salt Lake City, Utah, USA.

Design: Comparative case series.

Randomized comparison of postoperative use of hydrogel ocular bandage and collagen corneal shield for wound protection and patient tolerability after cataract surgery.

Purpose: To compare the safety and efficacy of a hydrogel bandage and a collagen corneal shield in providing wound protection and relief of pain/discomfort in the acute period after uneventful unilateral clear corneal phacoemulsification cataract surgery with foldable intraocular lens (IOL) implantation.

Setting: Seventeen investigational sites in the United States.

Design: Prospective randomized single-masked parallel study.

Pseudoexfoliation and the cataract surgeon: preoperative, intraoperative, and postoperative issues related to intraocular pressure, cataract, and intraocular lenses.

This review provides a comprehensive assessment of intraocular pressure (IOP), phacoemulsification techniques, and intraocular lenses (IOLs) in pseudoexfoliation (PXF) eyes having cataract surgery. Pseudoexfoliation is ubiquitous and the most common cause for open-angle glaucoma worldwide. Cataracts occur with increased frequency in PXF eyes, and surgery is potentially complicated by the presence of small pupils and zonule laxity and significantly affects IOP in these eyes.

Intraoperative performance and postoperative outcomes of endocapsular ring implantation in pediatric eyes.

Purpose: To study the intraoperative performance and postoperative outcomes of Cionni modified capsule tension ring (CTR) and intraocular lens (IOL) implantation in the capsular bag in pediatric eyes with ectopia lentis.

Setting: John A. Moran Eye Center, Salt Lake City, Utah, USA.

Corticocapsular cleavage during phacoemulsification: Viscodissection versus hydrodissection. Miyake-Apple view analysis.

Purpose: To compare the corticocapsular separation created by viscodissection and by hydrodissection using Miyake-Apple video-photographic analysis.

Setting: University-based center.

Methods: Fourteen cadaver eyes were randomized to hydrodissection (Group 1, n=7) or viscodissection (Group 2, n=7).

Laser in situ keratomileusis versus lens-based surgery for correcting residual refractive error after cataract surgery.

Purpose: To evaluate and compare the efficacy and safety of laser in situ keratomileusis (LASIK) versus lens-based surgery (intraocular lens [IOL] exchange or piggyback IOL) for correcting residual refractive error after cataract surgery.

Setting: Private eye center, Salt Lake City, Utah, USA.

Methods: This retrospective study included 57 eyes of 48 patients who had LASIK (28 eyes) or lens-based correction (29 eyes) for residual refractive error after cataract surgery.

Small-incision iris fixation of foldable intraocular lenses in the absence of capsule support.

Purpose: To report visual outcomes and complications of modified McCannel iris suture fixation of small-incision foldable acrylic intraocular lenses (IOLs) for aphakia in the absence of capsule support.

Design: Retrospective interventional case series.

Participants: Forty-six patients who underwent foldable acrylic IOL implantation using peripheral iris suture fixation for aphakia in the absence of capsule support.

Phacotrabeculectomy: assessment of outcomes and surgical improvements.

Purpose: To evaluate the outcomes and progress after phacotrabeculectomy at the same clinical setting and/or performed by the same surgeon over the past decade.

Setting: Eye Institute of Utah, Salt Lake City, Utah, USA.

Methods: This retrospective study included 60 eyes of 43 patients who had phacotrabeculectomy at a single institute between 1999 and 2005.

Intraocular lens exchange due to incorrect lens power.

Purpose: To evaluate patients who had intraocular lens (IOL) exchange for unexpected postoperative refractive errors, determine the sources associated with the errors, and derive an empiric approach to estimating the power for IOL exchange.

Design: Retrospective review of interventional case series.

Participants: Twenty-two eyes that underwent IOL exchange for correcting unexpected refractive errors after cataract surgery with IOL implantation were reviewed.

Analysis of intraocular lens power calculation for eyes with previous myopic LASIK.

Purpose: To evaluate the effectiveness of a manual keratometry (K) adjusted value for intraocular lens (IOL) power calculation in patients who underwent cataract surgery following previous myopic LASIK.

Methods: Sixteen eyes of 14 consecutive patients who underwent cataract surgery after previous LASIK were evaluated retrospectively. All IOL powers were calculated using an adjusted K value (K minus 1.