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The median ocular damage area was 3.55 mm (interquartile range [IQR], 1.21-5.88 mm) with normal stereopsis, increasing to 6.10 mm (IQR, 3.96-12.47 mm) with stereopsis reduced to 150 seconds of an arc and to 9.25 mm (IQR, 4.93-18.70 mm) with no stereopsis. Time taken to complete the task increased and overall score decreased as stereopsis was reduced. The overall score decreased from 53% (IQR, 22.5-82%) under normal stereopsis to 0% (IQR, 0-43.5%) with absent stereopsis. CONCLUSIONS Impaired stereopsis was associated with worse microsurgical performance, which may have implications for surgical training. The absence of stereopsis resulted in worse performance than partial reduction in stereopsis.PURPOSE To evaluate the outcome of toric intraocular lens (IOL) implantation in eyes with previous laser in situ keratomileusis/photorefractive keratectomy (LASIK/PRK). SETTING Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA. DESIGN Retrospective case series. METHODS Consecutive cases that had previous myopic or hyperopic LASIK/PRK and had undergone cataract surgery with toric IOL implantation were retrospectively reviewed. Included were eyes that had (1) preoperative ocular biometry measurements with the Lenstar, (2) no intraoperative or postoperative complications, and (3) available postoperative manifest refraction at ≥3 weeks with corrected distance visual acuity of 20/30 or better. Vector analysis was used to assess the preoperative corneal and postoperative refractive astigmatism. RESULTS In 56 eyes with previous myopic LASIK/PRK and 19 eyes with previous hyperopic LASIK/PRK, respectively, the mean magnitudes of corneal astigmatism were 1.34 ± 0.62 diopters (D) and 1.66 ± 0.80 D, 5% and 0% of eyes had anterior corneal astigmatism ≤0.50 D, and the centroid values were 0.31 D at 19 degrees ± 1.45 D and 0.74 D at 92 degrees ± 1.72 D preoperatively. Postoperatively, the mean magnitudes of refractive astigmatism were 0.36 ± 0.31 D and 0.34 ± 0.34 D, 80% and 84% of eyes had refractive astigmatism of ≤0.50 D, and the centroid values were 0.12 D at 152 degrees ± 0.46 D and 0.05 D at 172 degrees ± 0.48 D (all P less then .05). CONCLUSIONS Toric IOLs were effective to correct preexisting corneal astigmatism in eyes with previous excimer laser corneal refractive surgery.PURPOSE To investigate whether postoperative-induced refractive astigmatism after small-incision lenticule extraction (SMILE) could be predicted by preoperative objective astigmatism measured with autorefraction, keratometry, and Scheimpflug tomography. SETTING University eye clinic. DESIGN Retrospective case series. METHODS Only eyes without preoperative subjective astigmatism treated with SMILE for myopia were included. Postoperative subjective astigmatism was compared with preoperative objective astigmatism. Examinations were performed before SMILE and 3 months postoperatively and included subjective refraction, keratometry, autorefraction, and Scheimpflug tomographer measurements. Astigmatism was analyzed using double-angle plots and multivariate statistics. RESULTS A total of 358 eyes of 358 patients were included. The mean preoperative sphere was -7.33 diopter (D) ± 1.46 (SD). The postoperative spherical equivalent was -0.30 ± 0.49 D. Postoperatively, 79.6% and 98.9% of patients had a subjective cylinder ≤0.50 D and ≤1.00 D, respectively. Preoperative objective astigmatism measured with keratometry, autorefraction, and Scheimpflug tomography was significantly different (P less then .05) from postoperative subjective refraction when all patients were analyzed; for patients with postoperative refractive astigmatism ≥0.50 D, preoperative astigmatism with keratometry and Scheimpflug tomography was not significantly different from postoperative refractive astigmatism. Preoperative objective astigmatism ≥0.50 D increased the risk ratio of postoperative subjective astigmatism ≥0.50 D by 2.2 (P less then .001). CONCLUSIONS Preoperative objective astigmatism could not be directly interchanged with postoperative subjective astigmatism, but the presence of preoperative astigmatism ≥0.50 D doubled the risk of inducing a postoperative subjective astigmatism ≥0.50 D. Extra care when performing subjective refraction should be taken in the presence of high objective astigmatism.A technique of diagonal haptic capture of a plate intraocular lens (IOL) with 4 haptics for cases with insufficient posterior capsular support is presented. The diagonal haptics were captured through the capsulorhexis by sequentially depressing each side of the haptic beneath the rim of the capsulorhexis with a gentle pressure. The IOL is fixated by pure IOL-capsule capture without sulcus fixation of haptics. The technique was used in 12 eyes (12 patients). The IOLs were well centered within the follow-up period. No IOL malposition, pseudophacodonesis, pupil capture, pigmental dispersion, or high intraocular tension was observed postoperatively. Ultrasound biomicroscopy revealed that there was no chafing of the IOL with the posterior iris. The technique provided an instant and definitive fixation with high adaptability to different sizes of capsulorhexis, and thereby could reduce the risk for complications related to haptic-sulcus fixation.GOAL To investigate associations of prediagnosis and postdiagnosis use of statins and metformin on overall survival of patients with diabetes who later developed HCC. BACKGROUND Statins and metformin have received considerable interest as potential chemopreventive agents against hepatocellular carcinoma (HCC) development in individuals with type 2 diabetes mellitus (T2DM); however, their impact on overall survival of patients with T2DM who later develop HCC (diabetic HCC patients) is unclear. STUDY Data on 2499 elderly diabetic HCC patients obtained from the SEER-Medicare program (2009 to 2013) were analyzed. Patients were categorized based on use of statins only, metformin only, both, or neither (reference for all comparisons). Necrostatin-1 molecular weight The patients were further categorized based on (1) metformin dose ≤1500 or >1500 mg/d; (2) statins functional form hydrophilic (pravastatin and rosuvastatin) or lipophilic (atorvastatin, fluvastatin, lovastatin, and simvastatin); (3) statins potency high (atorvastatin, rosuvastatin, and simvastatin) or low (fluvastatin, lovastatin, and pravastatin); and (4) individual statins type.
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