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These retrospective data suggest that besifloxacin ophthalmic suspension 0.6% was well tolerated when included in the treatment of bacterial keratitis; no serious AEs were reported. A prospective clinical trial is needed to better isolate the contribution of besifloxacin to the therapeutic outcome and to confirm these observations.

The refractive outcome after cataract surgery depends on several factors. According to Norrby, 1 the sources of error in the refractive outcome after cataract surgery include postoperative anterior chamber depth (ACD), 35.47%; postoperative refraction, 26.98%; axial length of the eye, 17.03%; corneal curvatures, asphericity, thickness, and refractive index, 10.19%; pupil size, 8.11%; refractive index of the intraocular lens (IOL), 1.19%; vitreous refractive indices, 0.54%; aqueous refractive index, 0.36%; retinal thickness, 0.14%; and eye chart distance, 0.01%.Per the above, the postoperative refraction, second to only postoperative ACD, is crucial in determining the error from the preoperative intended refractive target. 1,2 Since the corrected distance visual acuity (CDVA) is the endpoint of manifest refraction, we investigated whether the CDVA after cataract surgery affects the assessment of refractive outcome.Two hundred ninety-five patients had uneventful phacoemulsification with implantation of a posterior chamber IOL. The same surgeon (S.L.) performed all procedures through a 2.4 mm temporal limbal incision and implanted a 3-piece IOL with an acrylic optic and poly(methyl methacrylate) haptics (iSert, Hoya Corp.) in all cases.Preoperatively, the biometry was obtained with optical low coherence reflectometry (Lenstar 900, Haag-Streit AG). The IOL power was calculated with the Holladay 2 formula. 3 Eyes with corneal pathology or previous corneal surgery were excluded. Postoperatively, the CDVA was obtained with manifest refraction 3 weeks after surgery or later. There were no postoperative complications. Eyes with a CDVA worse than 20/40 were excluded.One eye from each patient was included in the study. The eyes were divided into 2 groups, 1 with a postoperative CDVA of 20/20 or better and the other, of 20/25 to 20/40. For each group, the mean error and the mean absolute error (MAE) from the intended refractive target were calculated. The statistical comparison was performed with the Student t test. Significant difference was defined as a P value less than 0.05. cause manifest refraction can be refined more easily in eyes with better visual acuity potential. More refined manifest refraction should lead to more accurate assessment of the error from the intended refractive target.With modern IOL power formulas, the mean error and the MAE are used for adjusting the lens constant of the IOL in calculating the IOL power. 2 By continually adjusting the lens constant, the surgeon can improve the refractive accuracy in future cases. The present study indicates that one should be able to obtain more accurate assessment of the refractive outcome by using the postoperative manifest refraction from eyes with a CDVA of 20/20 or better. REFERENCES1. Norrby S. Sources of error in intraocular lens power calculation.

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