Retropupillary fixation of an iris-claw IOL provides early visual recovery, has a low risk of postoperative increase in IOP, and is a time-saving method compared with transscleral suturing fixation for aphakic eyes without sufficient capsular support.

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Theoretical thin-lens formulas were as accurate as the ray-tracing method in IOL power calculations in normal eyes and eyes after refractive surgery.

Purpose A new class of enhanced range of vision intraocular lenses (IOLs) has been introduced recently to cope with compromises of diffractive optics in patients aiming for spectacle independence. Few information is available about their optical function. We aimed to analyze higher order aberrations of four of these new wavefront-shaped IOLs under standardized conditions. Methods Two recently developed enhanced monofocal and two recently developed enhanced depth of focus IOLs (power 22 D) were analyzed by a Shack-Hartmann sensor in an in-situ model eye according to ISO 11,979 in NaCl with 546 nm. We determined the Zernike polynomials up to the 10th order. Results Only spherical aberration (SA) of different orders was considerably modified. Whereas RaySof EMV showed a moderate increase in Z 4-0, Eyhance and Vivity produced a considerable increase of negative Z 4-0. A combination of Z 4-0 and Z 6-0 with an opposite sign was found in LuxSmart. Conclusion SAs of different orders are the only relevant Zernike polynomials in this new class of wavefront-shaped IOLs. RaySof EMV proved to be a monofocal IOL with increased positive SA. The central change in radial power and the resulting increase in negative SA in Eyhance IOL might produce some depth of field. The magnitude of SA modification of Vivity and LuxSmart is expected to extend the depth of focus considerably. Surgeons can select among these novel IOLs depending on corneal asphericity and the patient's wish for spectacle independence.

Ophthalmic viscoelastic devices (OVDs) are currently used in cataract surgery and have significantly improved the safety and effectiveness of this surgical procedure. OVDs are classified according to the zero-shear viscosity and the cohesion-dispersion index in cohesive, dispersive, and viscoadaptives. OVDs create and maintain anterior chamber depth and visibility, protecting the corneal endothelium and other intraocular tissues during surgery. The selection of the most adequate OVD is especially relevant when performing cataract surgery in challenging cases, such as in hard, mature cataracts, flat anterior chamber, pseudoexfoliation syndrome, intraoperative floppy iris syndrome, or glaucoma surgery. In such cases, OVD is crucial for facilitating the surgical procedure and the associated minimal complication rate. The use of a combination of OVDs (soft-shell technique and modifications), the use of blue-colored OVDs, and the combination of sodium hyaluronate with lidocaine have also been described as useful tools in some of these challenging cases.