Researchers say there may be a connection between undergoing LASIK and needing cataract surgery at an earlier age than patients who didn’t have the refractive surgery.

The investigators conducted a matched, case-control study. Cases were otherwise healthy adults with a history of LASIK. Groups were paired according to corrected-distance visual acuity, axial length and cataract grade.

A total of 213 patients were included; 85 patients were classified as post-LASIK group, and 128 were identified as controls. Here are some of the findings:

• The mean age at the time of LASIK was 42.32 ±9.24 years. 

• The mean CDVA before phaco was 0.29 ±0.19 logMAR in the post-LASIK group and 0.34 ±0.22 logMAR in controls (p=0.07). 

• The mean axial length was 23.99 ±1.78 mm in the post-LASIK group and 23.62 ±0.98 mm in controls (p=0.085). 

• The mean nuclear cataract grading was 1.36 in the post-LASIK group and 1.47 in controls (p=0.34). 

• The mean age at the time of phaco was 60.18 ±7.46 years in the post-LASIK group and 67.35 ±9.28 in controls (p<0.0005). 

• The difference between the mean age of LASIK and the mean age of phaco was 17.85 ±5.72 years. 

• Scientists found a positive association between the post-LASIK group and the age of phaco ≤55 years (OR: 4.917; CI, 2.21 to 10.90; p<0.001).

Scientists concluded that LASIK was associated with early phacoemulsification surgery. Patients with LASIK had a seven-year earlier phacoemulsification surgery vs. the matched control group.


Int Ophthalmol 2024;3;44:1:125.

Ortiz-Morales G, Ramos-Davila EM, Elizondo-Fernández B, et al.


Risk for Impairments in Wet AMD Patients

Investigators assessed the prevalence and correlates of impaired activities of daily living (ADLs) in patients with neovascular age-related macular degeneration (nAMD) who present for anti-vascular endothelial growth factor therapy.

In a clinic-based cohort of 437 patients with nAMD who presented for anti-VEGF therapy, the Older
American Resources and Services Scale (OARS) was administered to assess for impairments in basic, instrumental and total ADL. Logistic regression analyses were conducted to determine odds ratios (OR) and 95 percent confidence intervals for factors associated with ADL impairment.

Here are some of the findings:

• The prevalence of impaired basic, instrumental and total ADL was 37.76, 67.82 and 39.59 percent, respectively. 

• In multivariate-adjusted models, moderate visual impairment (OR: 5.65; CI, 2.31 to 13.83) and blindness (OR: 5.43; CI, 2.09 to 14.12) were associated with greater odds of impaired total ADL. 

• Depressive symptoms (OR: 2.08; CI, 1.08 to 4.00), the presence of any disability (OR: 3.16; CI, 1.64 to 0.07) and never driving (OR: 4.00; CI, 1.60 to 10.00) were also positively associated with total ADL impairment. 

• Better vision-related quality of life was inversely associated with impaired instrumental ADL while higher health-related QoL scores were associated with decreased odds of total ADL impairment.

Investigators found a high prevalence rate of activities of daily living impairment among neovascular age-related macular degeneration patients presenting for therapy. They found that visual impairment, never driving, and poor physical and mental health increased the odds of experiencing activities of daily living impairment while better vision- and health-related quality of life reduced the odds of impairment.


Eye (Lond) 2024; Feb 19. [Epub ahead of print].

Van Vu K, Mitchell P, Detaram HD, et al. 


Could Nanothin be “In”?

Scientists aimed to describe a method to achieve a high success rate for nanothin (NT, ≤50 µm) Descemet’s stripping automated endothelial keratoplasty graft preparation using an anterior chamber pressurizer (ACP) with a modified setting and evaluate its postoperative efficacy.

A prospective cohort (study group) of 24 patients with corneal endothelial dysfunction was consecutively enrolled and received DSAEK grafts using the modified ACP method from December 2021 to May 2022. The control group included 24 historical patients who received DSAEK grafts using a conventional ACP procedure. Central graft thickness (CGT), graft regularity (3-mm and 5-mm diameter zones), best spectacle-corrected visual acuity and endothelial cell density were compared between the two groups.

Here are some of the findings from the study:

• A 100 percent ultrathin (UT, ≤100 µm) DSAEK rate and 62.5 percent NT-DSAEK rate was achieved at three months post-surgery in the study group, with a 51.3 ±14.8 µm CGT, while a 70.8 percent UT-DSAEK rate and 4.2 percent NT-DSAEK rate was achieved in the control group, with an 89 ±15.4 µm CGT (p<0.001). 

• At three-month postoperative follow-up, the regularity of graft thickness was significantly better in the study group:

— central-to-peripheral thickness difference: p=0.044 and 0.014 for 3 mm and 5 mm diameter zones, respectively; and 

— graft thickness uniformity: p<0.001 and 0.012, respectively. 

• No statistical difference was reported in the best spectacle-corrected visual acuity (p=0.170) or ECD (p=0.833) between the two groups at the three-month postoperative follow-up time point.

The researchers determined that Descemet’s stripping automated endothelial keratoplasty grafts harvested using a modified anterior chamber pressurizer method were thinner and more regular compared with the conventional anterior chamber pressurizer method.


Cornea 2024; Feb 21. [Epub ahead of print].

Zhao Z, Lin L, Zhou W, et al.


Long-term Results of Treat and Extend with Faricimab

Researchers evaluated the two-year efficacy, durability and safety of the bispecific antibody, faricimab, which inhibits both angiopoietin-2 and vascular endothelial growth factor-A, as part of the TENAYA and LUCERNE identically designed, randomized, double-masked, active comparator-controlled Phase III noninferiority trials across 271 sites worldwide.

Participants included treatment-naïve patients with neovascular age-related macular degeneration (nAMD) ages ≥50 years randomized (1:1) to intravitreal faricimab 6 mg up to every 16 weeks (Q16W) or aflibercept 2 mg every eight weeks (Q8W). 

Faricimab fixed dosing was based on protocol-defined disease activity at weeks 20 and 24 up to week 60, followed up to week 108 by a treat-and-extend−based personalized treatment interval regimen.

Efficacy analyses included change in best-corrected visual acuity (BCVA) from baseline at two years (averaged over weeks 104, 108 and 112) and proportion of patients on Q16W, every 12 weeks (Q12W) and Q8W dosing at week 112 in the intention-to-treat population. Safety analyses included ocular adverse events (AEs) in the study eye through study end at week 112 in patients who received ≥ one dose of study treatment.

Of 1,326 patients treated across the trials, 1,113 (83.9 percent) completed study treatment (n=555 faricimab and n=558 aflibercept). Here are some of the findings:

• BCVA change from baseline at two years was comparable between faricimab and aflibercept in the trials, as demonstrated by the following findings:

— TENAYA adjusted mean change: +3.7 letters; CI, +2.1 to +5.4 with faricimab and +3.3 letters; CI, +1.7 to +4.9 with aflibercept; mean difference: 0.4 letters; CI, -1.9 to +2.8; and 

— LUCERNE adjusted mean change: +5 letters; CI, +3.4 to +6.6 with faricimab and +5.2; CI, +3.6 to +6.8 with aflibercept; mean difference: -0.2 letters; CI, -2.4 to +2.1. 

• At week 112 in TENAYA and LUCERNE 59 percent with faricimab and 66.9 percent with aflibercept achieved Q16W faricimab dosing, increasing from year one; and 74.1 with faricimab and 81.2 percent with aflibercept achieved ≥Q12W dosing. 

• Ocular AEs in the study eye were comparable between faricimab and aflibercept in TENAYA (55 and 56.5 percent, respectively, of patients) and LUCERNE (52.9 and 47.5 percent, respectively, of patients) through week 112.

Researchers wrote that treat-and-extend-based faricimab treatment based on neovascular age-related macular degeneration disease activity maintained vision gains through year two with most patients achieving extended dosing intervals. 


Ophthalmology 2024; Feb 19. [Epub ahead of print].

Khanani AM, Kotecha A, Chang A, et al. 


Optic Disc Hemorrhage Size And Glaucoma Progression

Researchers investigated the correlation between optic disc hemorrhage size and glaucoma progression, as part of a retrospective observational cohort study at a tertiary hospital in South Korea.

A total of 250 open-angle glaucoma patients with DH were included. Participants were followed for five years or longer, with a minimum of five visual field tests.

The DH area was calculated by comparing the pixel numbers of the DH area with the disc area based on optical coherence tomography. For recurrent DH cases, researchers calculated the average DH area. DH size was classified as large or small based on the median value. Rates of mean deviation (MD) loss were determined using Guided Progression Analysis. Univariable and multivariable regression analyses were performed to identify significant predictors of MD loss. Main outcome measures included DH size and longitudinal VF progression. 

Here are some of the findings:

• The mean follow-up period was 11.1 ±3.6 years. 

• The group with large DH showed faster global MD loss relative to the group with small DH (-0.51 ±0.48 dB/y vs. -0.36±0.42 dB/y, p=0.01). 

• In the multivariable model, mean DH size, maximum DH size and initial MD were all significantly associated with the overall rate of MD loss (all p<0.05).

Researchers found that optic disc hemorrhage size was associated with the rate of visual field deterioration; eyes with larger disc hemorrhages showed more pronounced visual field progression.


Am J Ophthalmol 2024; Feb 21. [Epub ahead of print].

Jeong Y, Bak E, Jang M, et al. 


Biomarkers May Help Predict Non-exudative MNV Conversion to Exudative 

Investigators evaluated the incidence and morphological biomarkers to predict the exudative conversion in eyes with type 1 nonexudative macular neovascularization (MNV) using swept-source optical coherence tomography angiography.

MNV was detected using the retinal pigment epithelium-to-RPE-fit slab of SS-OCTA scans. Depending on whether exudation developed within a year, the eyes were divided into two groups: active and silent. Qualitative and quantitative OCTA parameters of the two groups were evaluated to discriminate the biomarkers associated with exudative conversion.

Here are some of the findings: 

• Of the 40 eyes, nine developed exudation within one year (incidence rate 22.5 percent). 

• The active group exhibited significantly higher “anastomosis and loop” patterns, greater “vessel density,” increased “junction density,” fewer “number of endpoints” and lower “lacunarity” compared to silent group. 

• Anastomosis and loops and higher vessel density were correlated with the active group in multivariate analyses. 

• A predictive model combining these biomarkers achieved 95-percent accuracy in predicting exudative conversion.

Investigators found, at 12 months, the risk of exudation was 22.5 percent, and anastomosis and loops and vessel density were useful optical coherence tomography angiography biomarkers for predicting exudative conversion in eyes with type 1 nonexudative MNV. They suggested, for eyes with a high risk of exudative conversion, more frequent follow-up is recommended.


Retina 2024; Feb 12. [Epub ahead of print].

Bae SH, Bae K, Yoon CK, et al.