The Netherlands Academy of Arts and Sciences has a proprietary interest in the C-Quant Straylight meter. No author has a financial or proprietary interest in any material or method mentioned.

To evaluate the quality of vision (visual acuity and straylight) in patients with Fuchs dystrophy and the improvement in visual quality after Descemet stripping endothelial keratoplasty (DSEK). Methods: There was an observational case series (Amsterdam group) and a prospective interventional case series (Mayo group). Corrected distance visual acuity (CDVA), straylight, and corneal thickness were measured in patients with phakic and pseudophakic eyes with Fuchs dystrophy recruited at the Academic Medical Center, Amsterdam, the Netherlands (99 eyes), and at Mayo Clinic, Rochester, Minnesota (48 eyes). The Mayo group was also examined at 1, 3, 6, and 12 months after DSEK; all these eyes were rendered pseudophakic during DSEK. Results: Eyes with Fuchs dystrophy had decreased CDVA (mean [SD], 0.42 [0.26] logMAR; Snellen equivalent 20/ 53) and increased straylight (mean [SD], 1.54 [0.24] logarithm of the straylight parameter) compared with normal eyes. Younger patients were affected more by increased straylight than by decreased CDVA. Corrected distance visual acuity (r=0.26; P =.003; n=135) and straylight (r = 0.26; P = .003; n = 133) were correlated with corneal thickness. Corrected distance visual acuity and straylight improved at all postoperative examinations (PϽ.001), and improvement in straylight from before DSEK to 12 months after DSEK correlated with recipient age (r =−0.43; P =.01; n=33). Improvement in straylight was more predictable than that of CDVA and was associated with preoperative straylight more than 1.33 logarithm of the straylight parameter. Conclusions: Quality of vision is severely impaired in patients with Fuchs dystrophy and improves significantly after DSEK. Straylight improves more in younger than in older eyes after DSEK. Preoperative straylight can be a useful clinical metric to predict postoperative improvement, especially in cases where preoperative visual acuity is close to 20/20.

We describe the case of an 83-year-old woman who had uneventful phacoemulsification with implantation of a tripod hydrophilic acrylic intraocular lens (IOL). Because of postoperative corneal decompensation, 2 Descemet-stripping endothelial keratoplasty (DSEK) procedures were performed within 2 years. After the second procedure, the graft was not well attached, requiring an intracameral injection of air on day 3. Approximately 9 months later, opacification was observed on the anterior surface of the IOL, with a significant decrease in visual acuity. The IOL was explanted within the capsular bag. Laboratory analyses revealed granular deposits densely distributed in a round pattern within the margins of the capsulorhexis. Granules were located at the anterior surface/subsurface of the IOL and stained positive for calcium (alizarin red and von Kossa method). Scheimpflug photography revealed high levels of light scattering from the opacified area. Surgeons should be aware of possible localized calcification following DSEK procedures in pseudophakic patients with hydrophilic acrylic IOLs.

A linear relationship exists between OCT-effective optical density of cataract and underestimation of RNFL thickness measured with OCT. This finding holds promise to correct for cataract-induced changes in RNFL measurements, but will differ for each type of OCT device.

Rigid contact lens wear leads to increased straylight during contact lens wear and after contact lens removal. This may be because of subclinical effects of contact lens wear on the cornea and is not seen in soft contact lens wearers.

Multifocal IOL implantation after corneal refractive laser surgery for myopia resulted in good visual acuity and refraction. Results were less predictable with myopia greater than 6.0 D.

IOL opacification can occur in eyes previously subjected to DSEK. The majority of patients subjected to DSEK are pseudophakic; surgeons should be aware of this possible complication. To the best of our knowledge, this has not been described in the literature to date. Further research is required to elucidate the nature of such IOL opacifications and possible ways to prevent them.

PURPOSE: To compare the accuracy of different intraocular lens (IOL) calculation formulas available on the American Society of Cataract and Refractive Surgery (ASCRS) post-refractive surgery IOL power calculator for the prediction of multifocal IOL power after previous corneal refractive laser surgery for myopia. METHODS: An analysis and comparison were performed of the accuracy of three methods using surgically induced change in refraction (ie, Masket, Modified Masket, and Barrett True-K formulas) and three methods using no previous data (ie, Shammas, Haigis-L, and Barrett True-K No History formulas). The average of all formulas was also analyzed and compared. RESULTS: Thirty-six eyes of 36 patients were included. All formulas, except for the Masket, Modified Masket, and Barrett True-K formulas, had myopic mean numerical errors that were significantly different from zero ( P ⩽ .01). The median absolute error of the Shammas formula (0.52 diopters [D]) was significantly higher compared to all of the other formulas ( P < .05), except for the Haigis-L formula ( P = .09). Comparing the formulas using no previous data, the Barrett True-K No History formula had the lowest median absolute error (0.33 D, P < .001). CONCLUSIONS: The Shammas formula showed the least accuracy in predicting IOL power in eyes with multifocal IOL implantation after previous corneal refractive laser surgery for myopia. In eyes with all available data, all formulas performed equally except for the Shammas formula, whereas in eyes lacking historical data, the Barrett True-K No History formula performed best. [ J Refract Surg . 2019;35(1):54–59.]