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Advances in Anterior Segment Surgery
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Advances in Anterior Segment Surgery

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

Deadline for manuscript submissions: closed (20 February 2025) | Viewed by 6199

Special Issue Editor

Dr. Mayank A. Nanavaty

E-Mail Website
Guest Editor
Sussex Eye Hospital, University Hospitals Sussex NHS Foundation Trust, Brighton, UK
Interests: laser refractive surgery; refractive lens exchange; complex cataract surgeries; vision correction surgeries; corneal transplants; keratoconus management
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The aim of this Special Issue is to highlight the current themes in modern laser-, corneal- and lens-based refractive surgery. This issue will feature three articles from world-renowned refractive surgeons on the latest trends and themes relating refractive surgery.

We will be delighted if you are able to submit a full-length article or review on a topic of your choice in refractive, corneal and cataract surgery. The possible areas of interests for this issue are lenticule-based surgery, surface ablations, blended vision treatments with laser refractive surgery, corneal inlay procedures, presbyopia management with monovision laser vsion correction, refractive lens exchange, premium presbyopia-correcting intraocular lens, refractive solutions for keratoconics, complex cataract surgery, biometry, cataract surgery outcomes, modern lamellar corneal transplants, etc.

We will be grateful if you can let us know whether this is something you are interested to contribute to.

Dr. Mayank A. Nanavaty
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

  • lenticule-based surgery
  • surface ablations
  • blended vision treatments with laser refractive surgery
  • corneal inlay procedures
  • presbyopia management with monovision laser vsion correction
  • refractive lens exchange
  • premium presbyopia-correcting intraocular lens
  • refractive solutions for keratoconics
  • cataract surgery
  • corneal transplant
  • biometry

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Related Special Issue

Published Papers (5 papers)

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Research

15 pages, 669 KiB  
Article
Corneal Characteristics After Small-Diameter DMEK Graft for Fuchs Corneal Dystrophy—Long-Term Observation
by Anna Machalińska, Monika Kuśmierz-Wojtasik, Krzysztof Safranow and Magda Kossmann
J. Clin. Med. 2025, 14(7), 2185; https://doi.org/10.3390/jcm14072185 - 23 Mar 2025
Viewed by 256
Abstract
Background/Objectives: This study aimed to evaluate long-term postoperative outcomes following the use of small-diameter grafts in Descemet Membrane Endothelial Keratoplasty (DMEK) procedures. Methods: Thirty-four eyes were evaluated after DMEK surgery. Best-corrected visual acuity (BCVA), endothelial cell density (ECD), endothelial cell loss [...] Read more.
Background/Objectives: This study aimed to evaluate long-term postoperative outcomes following the use of small-diameter grafts in Descemet Membrane Endothelial Keratoplasty (DMEK) procedures. Methods: Thirty-four eyes were evaluated after DMEK surgery. Best-corrected visual acuity (BCVA), endothelial cell density (ECD), endothelial cell loss (ECL), central corneal thickness (CCT), mean keratometry (MK), mean astigmatism (MA), astigmatism asymmetry (AA), and higher-order aberrations (HOA) were assessed at baseline and 12, 24 and 36 months after surgery using anterior segment swept-source OCT (CASIA2, Tomey, Japan). Results: BCVA gradually improved during the 12-month follow-up, after which the stabilisation of this parameter was documented. Compared with the donor values, the cumulative median ECL reached approximately 63.95% over 36 months. No significant changes in total keratometry between baseline recordings and 36-month data were observed. Total astigmatism power significantly decreased between baseline and the 12th month and subsequently between the 12th and 24th month, with consecutive stabilisation of astigmatism power from the 24th month to the 36th month of follow-up. Significant reductions in HOA were observed until the 12th month, followed by the stabilisation of these parameters. Conclusions: The use of smaller grafts in DMEK demonstrates high effectiveness in maintaining high visual and refractive quality while offering potential advantages in tissues. Full article
(This article belongs to the Special Issue Advances in Anterior Segment Surgery)
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10 pages, 557 KiB  
Article
Modified Transepithelial Phototherapeutic Keratectomy for Band Keratopathy
by Rachana Prashant Shah and Mayank A. Nanavaty
J. Clin. Med. 2024, 13(19), 5717; https://doi.org/10.3390/jcm13195717 - 25 Sep 2024
Viewed by 1105
Abstract
Objectives: To report the outcomes of novel modified transepithelial phototherapeutic keratectomy (PTK) in treating band keratopathy (BK). Methods: A retrospective analysis was performed on patients who underwent PTK for BK at the Sussex Eye Laser Clinic, Nuffield Health, Brighton. Patients with BK obscuring [...] Read more.
Objectives: To report the outcomes of novel modified transepithelial phototherapeutic keratectomy (PTK) in treating band keratopathy (BK). Methods: A retrospective analysis was performed on patients who underwent PTK for BK at the Sussex Eye Laser Clinic, Nuffield Health, Brighton. Patients with BK obscuring the visual axis, affecting visual acuity, or causing discomfort were considered for PTK. All the patients underwent preoperative evaluation, including preoperative corneal topography and optical coherence tomography. Modified transepithelial PTK was performed without using EDTA for chelation or alcohol for epithelium debridement. Patients were followed up for one week and then every two weeks after that until two months. Preoperative and postoperative best corrected visual acuities (BCVA) were compared using a paired t-test. Results: We studied 15 eyes of nine patients undergoing novel PTK for BK. The mean age was 80 ± 5.73 years. The mean pre-treatment visual acuity was 0.68 ± 0.17 logMAR (range: 0.6 logMAR to 1 logMAR) and improved to 0.22 ± 0.09 logMAR (p < 0.05), ranging from 0.18 to 0.48 logMAR at two months following PTK. None of the patients complained of ocular discomfort following the procedure. A repeat procedure was not required for any of these patients. Conclusions: Modified transepithelial PTK is an effective procedure for improving visual outcomes in patients with band keratopathy and should be considered for the treatment of band keratopathy. Full article
(This article belongs to the Special Issue Advances in Anterior Segment Surgery)
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13 pages, 1630 KiB  
Article
Clinical Impact of the Use of Ologen in Filtering Surgery Performed in Uncontrolled Glaucoma
by José-Manuel Navero-Rodríguez, Júlia Boldú-Roig, Laura Pinilla, María Vidal-Martí and Alfonso Antón
J. Clin. Med. 2024, 13(15), 4463; https://doi.org/10.3390/jcm13154463 - 30 Jul 2024
Viewed by 1044
Abstract
Introduction: To compare the efficacy and safety of trabeculectomy with a collagen matrix implant (Ologen®) versus trabeculectomy with mitomycin C (MMC) versus trabeculectomy with both Ologen® and MMC (OLO + MMC). Methods: This non-randomized study included 119 eyes of [...] Read more.
Introduction: To compare the efficacy and safety of trabeculectomy with a collagen matrix implant (Ologen®) versus trabeculectomy with mitomycin C (MMC) versus trabeculectomy with both Ologen® and MMC (OLO + MMC). Methods: This non-randomized study included 119 eyes of 101 patients with uncontrolled open-angle glaucoma who underwent trabeculectomy, either alone or combined with phacoemulsification. The data were initially recorded following a standard surgical protocol, using an electronic database with structured fields. The patients were divided into three groups: 44 received trabeculectomy with adjunctive MMC (MMC group), 34 received surgery with Ologen® (OLO group), and 41 received surgery with both Ologen® and MMC (OLO + MMC group). The main outcome measures were the change in intraocular pressure (IOP), change in number of medications needed, complete success rate (defined as IOP ≤ 20 mmHg and at least 20% IOP reduction without hypotensive medications), rate of complications, and rate of postoperative interventions. The follow-up period was 36 months. Results: IOPs significantly decreased (p = 0.01) in all groups across all study visits, decreasing from 19.8 ± 4.6 mmHg to 12.7 ± 4.2 mmHg in the MMC group, from 20.5 ± 4.7 mmHg to 13.9 ± 3.5 mmHg in the OLO group, and from 23.5 ± 6.1 mmHg to 13.1 ± 3.5 mmHg in the OLO + MMC group. After correcting for the baseline IOP, only the first two postoperative visits (first week and first month) showed a significantly greater IOP reduction in the OLO + MMC group. The number of hypotensive medications was significantly reduced from 3.1 ± 0.6 to 0.56 ± 1.1 in the MMC group, from 2.9 ± 0.4 to 0.83 ± 1.1 in the OLO group, and from 3.0 ± 0.6 to 0.45 ± 0.95 in OLO + MMC group, with no statistically significant differences among the groups (p = 0.57). The complete success rates were 63.6% in the MMC group, 67.6% in the OLO group, and 80.5% in the OLO +MMC group, with no statistically significant differences between the groups (p = 0.21). Suture release was significantly more frequent in the MMC group (86.1%) than in the OLO group (62.1%) and in the OLO + MMC group (45.9%; p = 0.02). Bleb needling, with (33.3%; p = 0.005) or without (66.7%; p = 0.0001) 5-fluorouracil injection (5-FU), was significantly more common in the MMC group. The highest complete success rate (61%) was observed in the OLO + MMC group. Conclusions: The use of Ologen® and mitomycin C provided similar surgical IOP reduction in glaucoma surgery compared with either MMC or Ologen® alone, but significantly reduced the need for postoperative interventions. Full article
(This article belongs to the Special Issue Advances in Anterior Segment Surgery)
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14 pages, 2654 KiB  
Article
Clinical and Patient Reported Outcomes of an Optimized Trifocal Intraocular Lens
by Antonio Cano-Ortiz, Álvaro Sánchez-Ventosa, Marta Villalba-González, Timoteo González-Cruces, Juan José Prados-Carmona, Vanesa Díaz-Mesa, David P. Piñero and Alberto Villarrubia-Cuadrado
J. Clin. Med. 2024, 13(14), 4133; https://doi.org/10.3390/jcm13144133 - 15 Jul 2024
Cited by 1 | Viewed by 1473
Abstract
Background/Objectives: To evaluate the clinical and patient-reported outcomes (PROMs) obtained with an optimized version of a previously investigated trifocal IOL. Methods: Prospective non-comparative single-center study enrolling 29 patients (55–71 years) undergoing bilateral cataract surgery with implantation of the trifocal diffractive IOL [...] Read more.
Background/Objectives: To evaluate the clinical and patient-reported outcomes (PROMs) obtained with an optimized version of a previously investigated trifocal IOL. Methods: Prospective non-comparative single-center study enrolling 29 patients (55–71 years) undergoing bilateral cataract surgery with implantation of the trifocal diffractive IOL Liberty 677CMY (Medicontur Medical Engineering Ltd., Zsámbék, Hungary). Visual and refractive outcomes as well as PROMs were evaluated during a 3-month follow-up: measurement of uncorrected and corrected distance (UDVA, CDVA), intermediate (UIVA, DCIVA) and near visual acuities (UNVA, DCNVA), defocus curve, patient satisfaction, photic phenomena perception, spectacle independence, and difficulty in performing some vision-related activities. Results: A total of 100%, 92%, and 80% of patients achieved a postoperative binocular UDVA, UIVA, and UNVA of 20/25 or better, respectively. Likewise, 100%, 80%, and 84% of patients achieved a postoperative binocular CDVA, DCIVA, and DCNVA of 20/25 or better, respectively. In the defocus curve, all mean visual acuity values were better than 0.15 logMAR for all defocus levels. A total of 95.8%, 95.8%, and 91.7% of patients referred to be satisfied with their distance, intermediate, and near visual vision, respectively. Mean overall Catquest Rasch calibrated score was −3.12 ± 0.98. Most of the patients were spectacle independent: far (95.8%), intermediate (95.8%) or near vision (91.7%). No bothersome or minimal to moderately bothersome halo, starburst, and glare was perceived by 83.3%, 83.4%, and 83.3% of patients, respectively. Conclusions: The trifocal IOL evaluated provides a visual acuity improvement, with high levels of spectacle independence, patient satisfaction, and perceived visual quality associated. Full article
(This article belongs to the Special Issue Advances in Anterior Segment Surgery)
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8 pages, 820 KiB  
Article
Direct Intraocular Lens Extraction Using a Newly Developed Lens-Grabbing Forceps
by Santaro Noguchi, Shunsuke Nakakura, Hitoshi Tabuchi and Asuka Noguchi
J. Clin. Med. 2024, 13(10), 2938; https://doi.org/10.3390/jcm13102938 - 16 May 2024
Viewed by 1595
Abstract
Background: Due to lower age thresholds for cataract surgery and increased longevity, cases with intraocular lens (IOL) dislocation requiring removal have increased. Traditional methods, such as cutting or folding the IOL within the eye, pose a high risk of complications, including corneal endothelial [...] Read more.
Background: Due to lower age thresholds for cataract surgery and increased longevity, cases with intraocular lens (IOL) dislocation requiring removal have increased. Traditional methods, such as cutting or folding the IOL within the eye, pose a high risk of complications, including corneal endothelial and iris damage. Methods: We developed a new minimally invasive technique for direct IOL removal using specially designed lens-grabbing forceps. These forceps can grasp and remove the IOL through a small incision in a single motion, significantly reducing intraocular manipulations compared to conventional methods. Results: In our test cases, IOL removal through a 2.2 mm corneal incision was completed in approximately 95 s, with minimal incision enlargement (about 0.16 mm) and a slight decrease in corneal endothelial cells. Conclusions: Our findings suggest that this technique is minimally invasive and safe for IOL removal, offering a promising alternative to existing methods. Full article
(This article belongs to the Special Issue Advances in Anterior Segment Surgery)
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