Purpose To compare prediction errors of the Barrett True K No History (Barrett TKNH) formula and intraoperative aberrometry (IA) in eyes with prior radial keratotomy (RK). Methods A retrospective, non‐randomized study of all patients with RK who underwent cataract surgery using IA at the UCHealth Sue Anschutz‐Rodgers Eye Center from 2014 to 2019 was conducted. Refraction prediction error (RPE) for IA and Barrett TKNH was compared. General linear modelling accounting for the correlation between eyes was used to determine whether absolute RPE differed significantly between Barrett TKNH and IA. Outcome by number of RK cuts was also compared between the two methods. Results Forty‐seven eyes (31 patients) were included. The mean RPEs for Barrett TKNH and IA were 0.04 ± 0.92D and 0.01 ± 0.92D, respectively, neither was significantly different than zero (p = 0.77, p = 0.91). The median absolute RPEs were 0.50D and 0.48D, respectively (p = 0.70). The refractive outcome fell within ± 0.50D of prediction for 51.1% of eyes with Barrett TKNH and 55.3% with IA, and 80.8% were within ± 1.00D for both techniques. Mean absolute RPE increased with a higher number of RK cuts (grouped into < 8 cuts and ≥ 8 cuts) for both Barrett TKNH (0.35D and 0.74D, p = 0.008) and IA (0.30D and 0.80D, p = 0.0001). Conclusions There is no statistically significant difference between Barrett TKNH and IA in predicting postoperative refractive error in eyes with prior RK. Both are reasonable methods for choosing intraocular lens power. Eyes with more RK cuts have higher prediction errors.

Preventable causes of ophthalmology surgical case cancellations were identified, and interventions were implemented to improve operating room utilization at our Veterans Affairs (VA) Medical Center. A retrospective review of 269 patients with cancellations from 2013 to 2015 was performed. Interventions implemented from September 2014 to March 2015 were evaluated followed by in-depth chart reviews to identify demographics and wait-time intervals. Interventions included scheduling surgeries electronically, by specialty, and with predetermined attending coverage. In addition, the preoperative templates and technology to obtain preoperative measurements were updated. Cancellation rates dropped significantly from 35% to 7% (p = .014). Preventable causes of cancellations decreased from 28% to 5% (p = .005). Operating room utilization increased significantly with 264 more scheduled cases in 2015 than in 2013 (485 vs. 749, p < .001), and surgery wait time trended downward. These findings may support the use of similar interventions at other VA medical centers or similar hospitals with the goal of improving quality of care through decreased cancellations and cost.

Background/Aims: Alpha-carotene is a provitamin A carotenoid present in fruits and vegetables. Higher serum concentrations of α-carotene have been associated with lower risk of cancer and all-cause mortality. Previous studies have suggested that genetic variants influence serum concentrations of provitamin A carotenoids, but to date no variants have been robustly associated with serum α-carotene concentrations. The aim of this study was to identify genetic associations with serum α-carotene concentrations using the genome-wide association study (GWAS) approach. Methods: A GWAS of serum α-carotene concentrations was conducted in 433 Old Order Amish adults who had consumed a 6-day controlled diet. Linear regression models adjusting for age, gender, and family structure were utilized to evaluate associations between genetic variants and serum α-carotene concentrations. Results: Genome-wide significant associations with α-carotene concentrations were observed for loci on chromosome 1q41 between the genes CAPN2 and CAPN8 (rs12137025, p = 3.55 × 10^-8), chromosome 2p21 in PRKCE (rs2594495, p = 1.01 × 10^-8), and chromosome 4q34 (rs17830069, p = 2.89 × 10^-8). Conclusions: We identified 3 novel loci associated with serum α-carotene concentrations among a population that consumed a controlled diet. While replication is necessary, the CAPN2/CAPN8 locus provides compelling evidence for an association with serum α-carotene concentrations and may suggest a relationship with the development and progression of cancers.

Purpose: To determine whether type 2 diabetes mellitus (T2DM) with and without diabetic retinopathy (DR) is independent risk factor for posterior capsular rupture (PCR) during cataract surgery. Methods: A retrospective study was conducted from 2014 to 2019. Patients from the University of Colorado Cataract Outcomes Database who had undergone phacoemulsification cataract surgery were included. Patients with traumatic, congenital or polar cataracts, type 1 diabetes or less than 18 years old were excluded. The primary outcome was incidence of PCR during surgery in patients with T2DM with and without DR, accounting for previous intravitreal anti-VEGF injections (IVI). Results: A total of 6636 patients were included. A PCR occurred in 59 (0.5%) of 10 893 eyes studied: 35 (0.4%) eyes in patients without diabetes, comparatively to 13 (0.7%) eyes with T2DM without DR (p = 0.142) and 11 (1.8%) eyes with DR (p < 0.0001). All groups with previous IVI demonstrated a significant increase in PCR compared with eyes without IVI or T2DM. In the absence of IVI, T2DM without DR was not significant (p = 0.520), but T2DM with DR had a significantly increased risk of PCR in univariate analysis (OR 3.55, 95% CI: 1.49,8.50, p = 0.004) and an increased risk of borderline significance in multivariate analysis (AOR 2.33, 95% CI: 0.98, 5.56, p = 0.056). Conclusion: Previous IVI is an independent risk factor for PCR. Diabetic retinopathy without previous IVI is likely a risk factor but was of borderline significance due to small sample size. Consideration of PCR risk should be given during surgical planning for patients with DR and/or previous IVI.