Purpose: To assess the impact of intravitreal injections (IVTI) on ocular surface of patients treated with multiple injections. Methods: Prospective, tricentric study conducted in patients treated with unilateral IVTI. An asepsis protocol with povidone-iodine was used for all patients during IVTI. The primary endpoint was the difference between the pre-IVTI Ocular Surface Disease Index (OSDI 1) score and that measured on day one (D1) post-IVTI (OSDI 2). Secondary endpoints were the evaluation of predictive factors for OSDI scores, pain assessment on D1, and the Lacrydiagâ analysis of tears from the injected eye versus contralateral eye before IVTI. Results: Two hundred and nineteen patients with a mean age of 75.9 AE 10 years were included. The mean OSDI2-OSDI1 difference was 19.2 AE 20.6 (p < 0.001). The mean noninvasive tear break-up time was 6.41 AE 4.59 seconds in the injected eye versus 7.36 AE 4.36 seconds in the contralateral eye (p < 0.001). In the multivariate analysis, the factors significantly associated with the OSDI 2 score were the OSDI 1 score (p < 0.001), the pain score on D1 (p < 0.001) the number of instilled glaucoma eye drop (p = 0.01) and a centre effect (centres 2 and 3 versus centre 1, p < 0.001). Conclusion: Our results confirm the impairment of the ocular surface and quality of life immediately after an IVTI. These results suggest 3 levels of action to improve the immediate tolerance: improving the basal status of the ocular surface, reducing the contact time with povidone-iodine that might be toxic to the surface, and improving immediate post-IVTI treatment.

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PURPOSE: To assess the impact of the use of artificial tears during the preoperative work-up performed before age-related cataract surgery, when a toric intraocular lens (IOL) was indicated. METHODS: This was a monocentric prospective study assessing 73 eyes of 51 patients, included consecutively after a preoperative work-up performed without artificial tears (no artificial tears group), when a toric IOL was indicated. Each included patient underwent a second series of examinations: biometry using the IOLMaster 700 (Carl Zeiss Meditec AG) and topography using the OPD-Scan II (Nidek), 1 minute after artificial tears instillation (artificial tears group; hyaluronate de sodium 0.15%, threalose 3% [Théalose; Théa]). Changes in anterior corneal astigmatism and subsequent changes in toric IOL calculation were analyzed. The error in predicted residual astigmatism was calculated. RESULTS: Anterior corneal astigmatism and total corneal astigmatism measured with the IOLMaster 700 were significantly modified when artificial tears were instilled before the examinations (1.51 ± 0.57 diopters [D], range: 0.75 to −3.55 vs 1.42 ± 0.63 D, range: 0.42 to 3.35 D; P = .043 and 1.59 ± 0.54 D, range: 0.87 to 3.48 vs 1.51 ± 0.59 D, range: 0.56 to 3.27 D, P = .038, respectively). This modification led to a change in IOL cylinder calculation in 43.8% of cases and to a change in implantation axis greater than 10° in 17.7% of cases. These changes were significantly greater in patients with a breakup time (BUT) less than 5 seconds (57.5% and 27.8%, with P = .009 and .029, respectively). In the subgroup of patients with a BUT of less than 5 seconds, the mean absolute error in predicted astigmatism was significantly lower after artificial tears instillation (0.48 ± 0.50 D, range: 0.00 to 2.79 vs 0.37 ± 0.25 D, range: 0.00 to 1.10 D, P = .048). CONCLUSIONS: Dry eye significantly impacted toric IOL calculations and should be taken into account during the preoperative assessments. Using artificial tears reduced the number of refractive errors. [ J Refract Surg . 2021;37(11):759–766.]

Purpose: To compare the impact of total corneal astigmatism (TCA) estimated with the Abulafia-Koch formula (TCA ABU ) versus measured by Total Keratometry (TK), swept-source optical coherence tomography (OCT) coupled with telecentric keratometry (TCA TK ) on the refractive outcomes after cataract surgery with toric intraocular lens (IOL) implantation. Methods: Two hundred one eyes of 146 patients who underwent cataract surgery with toric IOL implantation (XY1AT; HOYA Corporation) were included in this single-center, retrospective study. For each eye, TCA ABU (estimated from the anterior keratometry values measured with the IOLMaster 700 [Carl Zeiss Meditec AG]) and TCA TK (measured using TK IOLMaster 700) were entered into the HOYA Toric Calculator. Patients were operated on based on TCA ABU . For each eye, centroid and mean absolute error in predicted residual astigmatism (EPA) were calculated according to TCA used (TCA ABU or TCA TK ). The cylinder power and the axis of the posterior chamber IOL were compared. Results: The mean uncorrected distance visual acuity was 0.07 ± 0.12 logMAR, the mean spherical equivalent was 0.11 ± 0.40 D, and mean residual astigmatism was 0.35 ± 0.36 D. Mean centroid EPA was 0.28 D at 132° with TCA ABU and 0.35 D at 148° with TCA TK ( P (x) < .001; P (y) < .01). Mean absolute EPA was 0.46 ± 0.32 D with TCA ABU and 0.50 ± 0.37 D with TCA TK ( P < .01). In the with-the-rule astigmatism subgroup, a deviation from the target of less than 0.50 D was achieved in 68% of eyes with TCA ABU versus 50% of eyes with TCA TK . The proposed posterior chamber IOL was different depending on the calculation methods used in 86% of cases. Conclusions: Both calculation methods showed excellent results. However, the predictability error was significantly reduced when TCA ABU was used compared to TCA TK measured with the IOLMaster 700 in the whole cohort. Finally, TCA was overestimated by TK in the with-the-rule astigmatism subgroup. [ J Refract Surg. 2023;39(3):171–179.]

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