SH2db, an information system for the SH2 domain.

SH2 domains are key mediators of phosphotyrosine-based signalling, and therapeutic targets for diverse, mostly oncological, disease indications. They have a highly conserved structure with a central beta sheet that divides the binding surface of the protein into two main pockets, responsible for phosphotyrosine binding (pY pocket) and substrate specificity (pY + 3 pocket). In recent years, structural databases have proven to be invaluable resources for the drug discovery community, as they contain highly relevant and up-to-date information on important protein classes. Here, we present SH2db, a comprehensive structural database and webserver for SH2 domain structures. To organize these protein structures efficiently, we introduce (i) a generic residue numbering scheme to enhance the comparability of different SH2 domains, (ii) a structure-based multiple sequence alignment of all 120 human wild-type SH2 domain sequences and their PDB and AlphaFold structures. The aligned sequences and structures can be searched, browsed and downloaded from the online interface of SH2db (http://sh2db.ttk.hu), with functions to conveniently prepare multiple structures into a Pymol session, and to export simple charts on the contents of the database. Our hope is that SH2db can assist researchers in their day-to-day work by becoming a one-stop shop for SH2 domain related research.

Medieval Gilding Technology of Historical Metal Threads Revealed by Electron Optical and Micro-Raman Spectroscopic Study of Focused Ion Beam-Milled Cross Sections.

Although gilt silver threads were widely used for decorating historical textiles, their manufacturing techniques have been elusive for centuries. Contemporary written sources give only limited, sometimes ambiguous information, and detailed cross-sectional study of the microscale soft noble metal objects has been hindered by sample preparation. In this work, to give a thorough characterization of historical gilt silver threads, nano- and microscale textural, chemical, and structural data on cross sections, prepared by focused ion beam milling, were collected, using various electron-optical methods (high-resolution scanning electron microscopy (SEM), wavelength-dispersive electron probe microanalysis (EPMA), electron backscattered diffraction (EBSD) combined with energy-dispersive electron probe microanalysis (EDX), transmission electron microscopy (TEM) combined with EDX, and micro-Raman spectroscopy. The thickness of the gold coating varied between 70-400 nm. Data reveal nano- and microscale metallurgy-related, gilding-related and corrosion-related inhomogeneities in the silver base. These inhomogeneities account for the limitations of surface analysis when tracking gilding methods of historical metal threads, and explain why chemical information has to be connected to 3D texture on submicrometre scale. The geometry and chemical composition (lack of mercury, copper) of the gold/silver interface prove that the ancient gilding technology was diffusion bonding. The observed differences in the copper content of the silver base of the different thread types suggest intentional technological choice. Among the examined textiles of different ages (13th-17th centuries) and provenances narrow technological variation has been found.

Seasonal differences in the subjective assessment of outdoor thermal conditions and the impact of analysis techniques on the obtained results.

Wide research attention has been paid in the last two decades to the thermal comfort conditions of different outdoor and semi-outdoor urban spaces. Field studies were conducted in a wide range of geographical regions in order to investigate the relationship between the thermal sensation of people and thermal comfort indices. Researchers found that the original threshold values of these indices did not describe precisely the actual thermal sensation patterns of subjects, and they reported neutral temperatures that vary among nations and with time of the year. For that reason, thresholds of some objective indices were rescaled and new thermal comfort categories were defined. This research investigates the outdoor thermal perception patterns of Hungarians regarding the Physiologically Equivalent Temperature (PET) index, based on more than 5800 questionnaires. The surveys were conducted in the city of Szeged on 78 days in spring, summer, and autumn. Various, frequently applied analysis approaches (simple descriptive technique, regression analysis, and probit models) were adopted to reveal seasonal differences in the thermal assessment of people. Thermal sensitivity and neutral temperatures were found to be significantly different, especially between summer and the two transient seasons. Challenges of international comparison are also emphasized, since the results prove that neutral temperatures obtained through different analysis techniques may be considerably different. The outcomes of this study underline the importance of the development of standard measurement and analysis methodologies in order to make future studies comprehensible, hereby facilitating the broadening of the common scientific knowledge about outdoor thermal comfort.

Evaluation of the mechanical properties of the anterior lens capsule following femtosecond laser capsulotomy at different pulse energy settings.

PURPOSE: To evaluate and compare the mechanical properties of anterior capsule opening performed with femtosecond laser capsulotomy at different energy settings in ex vivo porcine anterior lens capsule specimens. METHODS: Twenty-five fresh porcine eyes per group were included in the study. Femtosecond laser capsulotomy was performed with three different pulse energy levels: 2 µJ (low energy group), 5 µJ (intermediate energy group), and 10 µJ (high energy group). The capsule openings were stretched with universal testing equipment until they ruptured. The morphologic profile of the cut capsule edges was evaluated using scanning electron microscopy. RESULTS: The high energy group had significantly lower rupture force (108 ± 14 mN) compared to the intermediate energy group (118 ± 10 mN) (P < .05) and low energy group (119 ± 11 mN) (P < .05), but the difference between the intermediate energy and low energy groups was not significant (P = .9479). The high energy group had significantly lower circumference stretching ratio (144% ± 3%) compared to the intermediate energy group (148% ± 3%) (P < .05) and low energy group (148% ± 3%) (P < .05), but the difference between the intermediate energy group and low energy group was not significant (P = .9985). Scanning electron microscopy images showed that the edge was only serrated with low and intermediate energy, but additional signs of collagen melting and denaturation were observed at high energy. CONCLUSIONS: Anterior capsule openings created at a high energy level were slightly weaker and less extensible than those created at low or intermediate levels, possibly due to the increased thermal effect of photo-disruption.

[Results of femtosecond laser-assisted cataract surgery using the new 2.16 software and the SoftFit® Patient Interface]. / A femtoszekundumlézer-asszisztált szürkehályog-mutét eredményei az új 2.16-os szoftverrel és a módosított SoftFit® páciensi felszínnel.

INTRODUCTION: Femtosecond laser-assisted cataract surgery improved the results of cataract surgeries. AIM: Outcome analysis of femtosecond laser-assisted cataract surgery using the novel 2.16 software and the SoftFit(®) Patient Interface. METHOD: The novel software and the newly developed Patient Interface were used in 100 eyes of 100 patients. RESULTS: Length of femtosecond laser pretreatment decreased to 45-60 seconds. The smaller size of the new patient interface resulted in easier docking even on pediatric eyes. Suction force used for docking decreased from 40-50 mmHg to 16-20 mmHg. Incidence rate of subconjunctival suffusion decreased from 40% to 15-20% and its clinical severity was reduced, too. No corneal microfolds evolved, thus the incidence rate of the free-floating capsulotomies increased from 30% to 97%. The total energy of femtosecond laser pretreatment was decreased by almost 50%. Corneal wounds had the desired structure, and they were easy to open and closed precisely. CONCLUSIONS: The SoftFit(®) patient interface and the novel software widened the possible uses of the femtosecond laser-assisted cataract surgery, e.g. in pediatric ophthalmology. Innovations improved the safety and the predictability of the method.

Evaluation of femtosecond laser-assisted and manual clear corneal incisions and their effect on surgically induced astigmatism and higher-order aberrations.

PURPOSE: To evaluate femtosecond laser-assisted and manual clear corneal incisions and their effect on surgically induced astigmatism (SIA) and corneal higher-order aberrations (HOAs). METHODS: In a prospective randomized study, conventional phacoemulsification with a 2.8-mm clear corneal incision using a disposable keratome was performed in 20 eyes of 20 patients (manual group), and femtosecond laser-assisted cataract surgery with a 2.8-mm biplanar clear corneal tunnel created by a femtosecond laser (LenSx; Alcon Laboratories, Inc., Aliso Viejo, CA) was performed in 20 eyes of 20 patients (femtosecond laser group). Corneal topography readings and corneal wavefront aberrations (diameter: 9.0 mm) were obtained using a Scheimpflug camera (Pentacam HR; Oculus Optikgerate, Wetzlar, Germany) preoperatively and 3 months postoperatively. RESULTS: There was no significant difference in SIA between the groups (femtosecond laser group: 0.47 ± 0.13 vs manual group: 0.41 ± 0.14; P = .218), but the axis deviation of the SIA axis from the previously planned axis was significantly smaller in the femtosecond laser group compared to the manual group (4.47°± 2.59° vs 7.38°± 4.72°, respectively; P = .048). Corneal HOAs increased significantly in both groups (femtosecond laser group: 0.13 ± 0.09 to 0.18 ± 0.12, P = .025; manual group: 0.13 ± 0.05 to 0.15 ± 0.05, P = .002), but preoperative and postoperative values did not differ significantly between them (P = .472 and .078, respectively). Lower-order and total corneal aberration values remained stable in both groups (P > .05). CONCLUSIONS: There was no difference in SIA and induced HOAs between manual and femtosecond laser-created clear corneal incisions.

Comparison of the mechanical properties of the anterior lens capsule following manual capsulorhexis and femtosecond laser capsulotomy.

PURPOSE: To evaluate and compare the mechanical properties of anterior capsule openings performed with the continuous curvilinear capsulorhexis (CCC) technique and femtosecond laser capsulotomy (FLC) in ex vivo porcine lens capsule specimens. METHODS: Fresh porcine eyes were included in the study (CCC group, n = 50; FLC group, n = 30). The capsule openings were stretched with universal testing equipment until they ruptured. The rupture force and circumference stretching ratio were evaluated. The morphologic profile of the cut capsule edges was evaluated using scanning electron microscopy (SEM). RESULTS: The average rupture force was higher in the CCC group (median: 155 mN; interquartile range [IQR]: 129 to 201 mN; range: 71 to 294 mN) than in the FLC group (median: 119 mN; IQR: 108 to 128 mN; range: 91 to 142 mN) (P < .01, Mann-Whitney U test). The average circumference stretching ratio in the CCC group was greater (median: 150%; IQR: 146% to 156%; range: 136% to 161%) than in the FLC group (median: 148%; IQR: 145% to 150%; range: 141% to 154%) (P = .0468, Mann-Whitney U test). When less than 71 mN, no capsular tear occurred in either group. When less than 91 mN, no capsular tear occurred in the FLC group, whereas at 91 mN, the probability of capsular tears was 9% for the CCC group. SEM examination found that the CCC group had smooth edges, whereas those of the FLC group were gently serrated. CONCLUSIONS: According to the current results in a porcine eye model, FLC had less average resistance to capsule tear than CCC, but the weakest openings were seen in the CCC group.

Femtosecond laser-assisted cataract surgery in management of phacomorphic glaucoma.

PURPOSE: To report the use of femtosecond laser-assisted cataract surgery in management of phacomorphic glaucoma. METHODS: An 89-year-old patient developed acute phacomorphic glaucoma in her right eye with elevated intraocular pressure (62 mm Hg), shallow anterior chamber, and mature cataract. After conservative antiglaucoma therapy and Nd:YAG iridotomy, femtosecond laser-assisted cataract surgery was performed. A Malyugin ring was implanted for mechanical pupil dilatation and a 4.8-mm capsulorrhexis and lens fragmentation was performed using a femtosecond laser system (Alcon LenSx Inc., Aliso Viejo, CA) followed by in-the-bag intraocular lens implantation. RESULTS: Intact 4.8-mm capsulorrhexis and successful lens fragmentation could be performed using femtosecond laser. After cataract surgery, the patient's visual acuity increased from hand motions to 0.4 (Snellen 4/10) and the intraocular pressure returned to normal range without antiglaucoma drop therapy. CONCLUSIONS: The results indicate that femtosecond laser can be successfully used in certain cases of phacomorphic glaucoma, even if mechanical pupil dilatation is needed.

Anterior segment OCT imaging after femtosecond laser cataract surgery.

PURPOSE: To report the anterior segment imaging characteristics after femtosecond laser assisted cataract surgery. METHODS: Cataract surgery was performed with the LenSx femtosecond laser (Alcon-LenSx Inc., Aliso Viejo, CA) in 40 eyes of 40 patients. The laser was programmed to perform a 4.5-mm capsulorhexis, a cross-pattern fragmentation of the nucleus, a 2.8-mm main incision, and a 1.0-mm side-port incision. The anterior segment was then analyzed using the Visante OCT anterior segment program (Zeiss-Meditec AG, Jena, Germany). RESULTS: The preoperatively set treatment parameters correlated well with the achieved results. For the capsulorhexis, the femtosecond laser cut was programmed to start 350 µm behind the anterior lens capsule and OCT measured 377 ± 55.3 µm. Nucleus fragmentation was programmed to start 750 µm in front of the posterior capsule and end 550 µm behind the anterior capsule, and OCT measured 794 ± 111 and 568 ± 147 µm, respectively. The diameter of the capsulorhexis measured by OCT was 4.54 ± 0.2 mm, compared to the 4.5 mm programmed. CONCLUSIONS: Anterior segment OCT imaging was able to detect the tissue changes within the lens after femtosecond laser capsulorhexis and nucleus fragmentation. The measured values correlated well with the planned treatment parameters.

Possible COVID-19 MRNA Vaccine-Induced Case of Unilateral Central Retinal Vein Occlusion.

PURPOSE: To report a case of a patient with central retinal vein occlusion (CRVO), 2 weeks after the first dose of a COVID-19 mRNA vaccine. RESULTS: A 35-year-old man presented with decreased vision on his right eye, 2 weeks after receiving the first dose of COVID-19 mRNA vaccine. During examination, signs of right CRVO were found. We started general checkup of the patient, extended with laboratory tests specific for VIPIT. No exact cause of the thromboembolic episode could be documented. With the applied therapy, symptoms resolved completely. CONCLUSION: CRVO after COVID-19 mRNA vaccination is reported only in one case in the literature. In our case, the young age of the patient, the close onset of the symptoms to the vaccination and the negative systemic, immunologic and hematologic tests are suggesting a vaccine-induced thrombotic mechanism. We propose further investigation of vaccine-induced thrombotic mechanisms and also close follow of the reported cases.

Effect of liposomal formulation of ascorbic acid on corneal permeability.

Ascorbic acid (AA) has a pivotal role in corneal wound healing via stimulating the biosynthesis of highly organized extracellular matrix components, but its rapid degradation and low corneal permeability limits its therapeutic effects. In this paper, we present the pharmacokinetic properties of a liposomal-based formulation of AA in terms of corneal permeation. Chemical stability, shelf-life, and drug release rate of lyophilized liposome (AA-LLipo) formulation was determined in comparison to free-form of AA solution using high-performance liquid chromatography (HPLC) and rapid equilibrium dialysis. In vitro transcorneal permeability was studied using a parallel artificial membrane permeability assay (PAMPA). Ex vivo permeation was examined on AA-LLipo-treated porcine cornea by determining the AA content on the ocular surface, in the cornea as well as in the aqueous humor using HPLC, and by Raman-mapping visualizing the AA-distribution. Our results showed that the liposomal formulation improved the chemical stability of AA, while drug release was observed with the same kinetic efficiency as from the free-form of AA solution. Both corneal-PAMPA and porcine corneal permeability studies showed that AA-LLipo markedly improved the corneal absorption kinetics of AA, thus, increasing the AA content in the cornea and aqueous humor. AA-LLipo formulation could potentially increase the bioavailability of AA in corneal tissues.

Comparison of long-term visual outcome and IOL position with a single-optic accommodating IOL After 5.5- or 6.0-mm Femtosecond laser capsulotomy.

PURPOSE: To evaluate the long-term visual outcome and intraocular (IOL) position parameters with a single-optic accommodating IOL after 5.5- or 6.0-mm femtosecond laser capsulotomy. METHODS: This prospective, randomized, pilot study comprised 17 eyes from 11 patients (7 men) with a mean age of 65.82±10.64 years (range: 51 to 79 years). All patients received a Crystalens AT-50AO (Bausch & Lomb) accommodating IOL after femtosecond laser refractive cataract surgery using either a 5.5-mm capsulotomy (5.5-mm group; 9 eyes) or 6.0-mm capsulotomy (6.0-mm group; 8 eyes). Near and distance visual acuities, manifest refraction spherical equivalent (MRSE), and IOL tilt and decentration were evaluated 1 year postoperatively. RESULTS: No significant differences were noted between groups for postoperative uncorrected distance visual acuity, uncorrected near visual acuity, distance-corrected near visual acuity, and MRSE. Vertical and horizontal tilt were significantly higher in the 6.0-mm group than in the 5.5-mm group (P=.014 and P=.015, respectively). No significant difference was observed between groups regarding IOL decentration. CONCLUSIONS: A 5.5-mm capsulotomy created with a femtosecond laser is associated with less IOL tilt and therefore may be superior to a 6.0-mm capsulotomy when implanting a single-optic accommodating IOL.

Intraocular femtosecond laser use in traumatic cataracts following penetrating and blunt trauma.

PURPOSE: To investigate the use of femtosecond laser cataract surgery in traumatic cataracts of different origin. METHODS: The first case developed acute traumatic cataract due to penetrating injury of the cornea and the anterior lens capsule; the second developed traumatic cataract 11 years after a penetrating corneal injury; and the third developed a "white" cataract 12 months after blunt ocular trauma. In all cases, 4.5-mm capsulorrhexis and corneal incisions were performed using a femtosecond laser system (Alcon LenSx Inc), and nucleus liquefaction with the laser was performed additionally in the second case. RESULTS: In all patients, a capsulorrhexis could be created with the femtosecond laser. Preexisting radial tears were present in the first case, but the remaining anterior capsule could be cut with the laser. The second and third cases showed an intact 4.5-mm capsulorrhexis. Corneal incisions were stable in all cases, and nucleus liquefaction was possible in the second case (grade 1-2 nuclear density). CONCLUSIONS: Results indicate that a femtosecond laser can be used successfully in certain instances of traumatic cataract after penetrating eye injury, even if an anterior capsule laceration is present, and also after blunt trauma resulting in "white" cataracts.

Central corneal volume and endothelial cell count following femtosecond laser-assisted refractive cataract surgery compared to conventional phacoemulsification.

PURPOSE: To compare the effect of conventional phacoemulsification and femtosecond laser-assisted cataract surgery on the cornea using Scheimpflug imaging and noncontact specular microscopy. METHODS: In each group, 38 eyes (38 patients) underwent cataract surgery using either femtosecond laser-assisted (Alcon LenSx laser) (femtolaser group) or conventional phacoemulsification (phaco group). Central corneal thickness, 3-mm corneal volume, and Pentacam Nucleus Staging (PNS) were determined by a rotating Scheimpflug camera (Pentacam HR, Oculus Optikgeräte GmbH), and the volume stress index was calculated at 1 day and 1 month postoperatively. Endothelial cell count was measured by noncontact specular microscopy preoperatively, 1 day, 1 week, and 1 month postoperatively. RESULTS: Central corneal thickness was significantly higher in the phaco group (607±91 µm) than in the femtolaser group (580±42 µm) on day 1, but did not differ significantly preoperatively and at 1 week and 1 month. Volume stress index at day 1 was significantly lower in the femtolaser group than in the phaco group (P<.05) but did not differ significantly at 1 month. Multivariate regression analysis showed that the type of surgery had a significant effect on central corneal thickness. CONCLUSIONS: Femtosecond laser-assisted cataract surgery causes less corneal swelling in the early postoperative period and may cause less trauma to corneal endothelial cells than manual phacoemulsification.

Intraocular lens tilt and decentration measured by Scheimpflug camera following manual or femtosecond laser-created continuous circular capsulotomy.

PURPOSE: To compare intraocular lens (IOL) decentration and tilt following a circular capsulotomy created with a femtosecond laser (laser CCC) to a manually performed continuous curvilinear capsulorrhexis (manual CCC). METHODS: In a prospective, randomized study, a laser CCC (Alcon LenSx Inc) was performed in 20 eyes from 20 patients and a manual CCC was performed in 25 eyes from 25 patients. Intraocular lens decentration and tilt were measured using a Scheimpflug camera (Pentacam, Oculus Optikgeräte GmbH) 1 year after surgery. Uncorrected (UDVA) and corrected distance visual acuity (CDVA) and manifest refraction were also determined postoperatively. Between-group differences of IOL decentration and tilt as well as the correlation between IOL decentration and postoperative refractive changes and between IOL tilt and visual acuity were analyzed. RESULTS: Horizontal and vertical tilt were significantly higher in the manual CCC group (P=.007 and P<.001, respectively). Lenses implanted after manual CCC showed greater horizontal and total decentration (P=.034 and P=.022, respectively). Significant differences were found in the homogeneity of dichotomized IOL vertical tilt and both horizontal and total decentration distribution (P=.008, P=.036, and P=.017, respectively). Total IOL decentration showed a significant correlation with changes in manifest refraction values between 1 month and 1 year after surgery (R=0.33, P=.032). A significant correlation was noted between IOL vertical tilt and CDVA (R(2)=0.17, ß=-0.41, 95% confidence limit: -0.69 to -0.13, P=.005). CONCLUSIONS: Continuous curvilinear capsulorrhexis created with a femtosecond laser resulted in a more stable refractive result and less IOL tilt and decentration than manual CCC.

Comparison of IOL power calculation and refractive outcome after laser refractive cataract surgery with a femtosecond laser versus conventional phacoemulsification.

PURPOSE: To compare intraocular lens (IOL) power calculation and refractive outcome between patients who underwent laser refractive cataract surgery with a femtosecond laser and those with conventional cataract surgery. METHODS: In this prospective study, 77 eyes from 77 patients underwent laser refractive cataract surgery (laser group; Alcon LenSx femtosecond laser), and conventional cataract surgery with phacoemulsification was performed in 57 eyes from 57 patients (conventional group). Biometry was done with optical low coherence reflectometry (Lenstar LS900, Haag-Streit AG), and IOL calculation was performed with third-generation IOL formulas (SRK/T, Hoffer Q, and Holladay). The refractive outcome was analyzed using the mean absolute error (MAE; difference between predicted and achieved postoperative spherical equivalent refraction), and multivariable regression analysis was performed to compare the two groups. RESULTS: No significant differences were found between age, axial length, keratometry, and preoperative corrected visual acuity in the laser and conventional groups (P>.05; Mann-Whitney U test). At least 6 weeks after surgery, MAE was significantly lower in the laser group (0.38±0.28 diopters [D]) than in the conventional group (0.50±0.38 D) (P=.04). The difference was the greatest in short (axial length <22.0 mm, 0.43±0.41 vs 0.63±0.48) and long (axial length >26.0 mm, 0.33±0.24 vs 0.63±0.42) eyes. CONCLUSIONS: Laser refractive cataract surgery with a femtosecond laser resulted in a significantly better predictability of IOL power calculation than conventional phacoemulsification surgery. This difference is possibly due to a more precise capsulorrhexis, resulting in a more stable IOL position.

Corneal density with the Pentacam after photorefractive keratectomy.

PURPOSE: To measure corneal density and evaluate corneal haze in unoperated eyes and in eyes after photorefractive keratectomy (PRK). METHODS: Forty-nine patients (91 eyes) who underwent PRK and 48 control patients (76 unoperated eyes) were measured with the densitometry program of the Pentacam Scheimpflug imaging system (Oculus Optikgeräte GmbH) (0=no clouding, 100=tissue completely opaque). Eyes were categorized as myopic or hyperopic (myopia group and hyperopia group), with subgroups defined as unoperated (unoperated myopia group and unoperated hyperopia group), postoperative clear corneas (clear cornea myopia group and clear cornea hyperopia group), and postoperative with haze (myopia haze group and hyperopia haze group). The ANOVA option of the Statistica 8.1 program package (StatSoft Inc) was used to compare subgroups. RESULTS: Maximum density of postoperative corneas with haze (myopia haze group, 46.2±16.2; hyperopia haze group, 50.2±25.8) was higher than in postoperative clear corneas (clear cornea myopia group, 29.9±8.7; clear cornea hyperopia group, 22.9±3.1), but maximum corneal density in the latter subgroups showed no difference compared with unoperated controls (unoperated myopia group, 25.1±2.4; unoperated hyperopia group, 22.8±3.2). Differences among subgroups were not found outside the 6-mm diameter ablation zone. In hazy myopic corneas, there was a strong decreasing density trend from the apex to the 3-mm radius (P<.001, R=-0.5), which continued towards the periphery at 4.5 mm (P=.019, R=-0.21). Hyperopic mild hazy corneas showed a density increase from the apex to 3 mm (P<.001, R=0.4), followed by a decrease towards the periphery (P<.01, R=-0.4). CONCLUSIONS: The densitometry program of the Pentacam can provide a useful objective measure of postoperative and other mild corneal haze.

Comparison of intraocular lens decentration parameters after femtosecond and manual capsulotomies.

PURPOSE: To evaluate a laser technique and manual technique to perform capsulorrhexis in cataract eyes. METHODS: Anterior capsulotomy was performed with an intraocular femtosecond laser (LenSx Lasers Inc) in 54 eyes (FS group) and manual continuous curvilinear capsulorrhexis was performed in 57 eyes (CCC group). Circularity and area of capsulotomy and IOL decentration were measured using Photoshop CS4 Extended (Adobe Systems Inc) 1 week after surgery. Average keratometry, axial length, and preoperative anterior chamber depth were examined with the Lenstar LS 900 (Haag-Streit AG). RESULTS: No statistically significant differences were noted between groups in axial length, preoperative refractive state, and in the area of capsulotomy. Circularity values were significantly better in the FS group (P=.032). We found incomplete overlap of capsulotomies in 28% of eyes in the CCC group and 11% in the FS group (P=.033). Significant correlations were noted between axial length and area of capsulotomy, and between average keratometry and area of the capsulotomy in the CCC group (R=0.278, P=.036; and R=-0.29, P=.033, respectively), but both did not correlate in the FS group (P>.05). In the CCC group, the pupillary area correlated significantly with the area of the capsulotomy (R=0.27, P=.039). Significant correlation was noted between IOL decentration and axial length in the CCC group (R=0.30, P=.026), but there was no correlation in the FS group (P>.05). CONCLUSIONS: Femtosecond laser capsulorrhexis was more regularly shaped, showed better centration, and showed a better intraocular lens/capsule overlap than manual capsulorrhexis.

Femtosecond laser capsulotomy and manual continuous curvilinear capsulorrhexis parameters and their effects on intraocular lens centration.

PURPOSE: To measure and compare sizing and positioning parameters of femtosecond laser capsulotomy with manual continuous curvilinear capsulorrhexis (CCC). METHODS: Femtosecond capsulotomies (Alcon-LenSx Lasers Inc) and CCC were carried out in 20 eyes of 20 patients, respectively. Intraocular lens (IOL) decentration, circularity, vertical and horizontal diameters of capsulotomies, and capsule overlap were measured with Adobe Photoshop (Adobe Systems Inc) 1 week, 1 month, and 1 year after surgery. Between-group differences of parameters and predictors of IOL decentration were determined with repeated measures analysis of variance, chi-square test, and logistic regression analyses. RESULTS: Vertical diameter of CCC was statistically significantly higher in the first week and month. Significantly higher values of capsule overlap over 1 year and circularity in the first week showed more regular femtosecond capsulotomies. Horizontal IOL decentration was statistically significantly higher in the CCC group over 1 year. A significant difference was noted between the two groups in dichotomized horizontal decentration values at 0.4 mm with chi-square test after 1 week and 1 year (P=.035 and P=.016, respectively). In univariable general estimating equation models, type of capsulorrhexis (P<.01) and capsule overlap (P=.002) were significant predictors of horizontal decentration. Vertical diameter showed significant correlation to the overlap in the CCC group (1 week: r=-0.91; 1 month: r=-0.76, P<.01; 1 year: r=-0.62, P<.01), whereas no significant correlation was noted in the femtosecond group (P>.05). CONCLUSIONS: More precise capsulotomy sizing and centering can be achieved with femtosecond laser. Properly sized, shaped, and centered femtosecond laser capsulotomies resulted in better overlap parameters that help maintain proper positioning of the IOL.

Effect of femtosecond laser cataract surgery on the macula.

PURPOSE: To compare the effect of conventional and femtosecond laser-assisted (Alcon LenSx Inc) phacoemulsification on the macula using optical coherence tomography (OCT). METHODS: Twenty eyes of 20 patients underwent uneventful cataract surgery in both study groups: femtosecond laser-assisted (laser group) and conventional phacoemulsification (control group). Macular thickness and volume were evaluated by OCT preoperatively and 1 week and 1 month postoperatively. Primary outcomes were OCT retinal thickness in 3 macular areas and total macular volume at 1 week and 1 month postoperative. Secondary outcomes were changes in retinal thickness at 1 week and 1 month postoperatively, with respect to preoperative retinal thickness values and effective phacoemulsification time. RESULTS: Multivariable modeling of the effect of surgery on postoperative macular thickness showed significantly lower macular thickness in the inner retinal ring in the laser group after adjusting for age and preoperative thickness across the time course (P=.002). In the control group, the inner macular ring was significantly thicker at 1 week (mean: 21.68 µm; 95% confidence limit [CL]: 11.93-31.44 µm, P<.001). After 1 month, this difference decreased to a mean of 17.56 µm (95% CL: -3.21-38.32 µm, P=.09) and became marginally significant. CONCLUSIONS: Results of this study suggest that femtosecond laser-assisted cataract extraction does not differ in postoperative macular thickness as compared with standard ultrasound phacoemulsification.