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Article: [PUBLICATION TRENDS AND IMPACT OF OPHTHALMOLOGY DEPARTMENTS IN ISRAEL: SUMMARIZING OVER A DECADE OF RESEARCH WITH AN INTERNATIONAL PERSPECTIVE (2011-2021)].

Assayag, Elishai / Mimouni, Michael / Bettach, Emmanuel / Zadok, David / Abulafia, Adi / Weill, Yishay

2024 Volume 163, Issue 3, Page(s) 145–150

Abstract: Background: A focused bibliographic analysis of Israel's ophthalmology research productivity has never been performed.: Objectives: To assess the research output of Israeli ophthalmology departments between the years 2011-2021 and compare to leading ... ...

Abstract	Background: A focused bibliographic analysis of Israel's ophthalmology research productivity has never been performed. Objectives: To assess the research output of Israeli ophthalmology departments between the years 2011-2021 and compare to leading countries in the discipline. Methods: The PubMed search engine was used to detect all medical articles published between the years 2011 and 2021, with at least one author from an Israeli ophthalmology department. Each entry was reviewed for: year of publication, journal, department, sub-specialty, and study design. Journals were ranked according to Scopus Cite Score. Research output and population data of 7 top-ranked countries in ophthalmology (USA, UK, Japan, Germany, Australia, Canada, China) were documented for comparisons. Results: Overall, 1,919 publications were included. Total research output of Israeli ophthalmology departments significantly increased throughout the study period (R2=0.85, P<0.0001). Medical retina publications were the most prevalent (493 articles, 25.6%), and the most commonly utilized design was cohort (536 articles, 28%). Over a third of all articles (669) were published in Q1 ophthalmology journals, and 16% were published in the top-10 journals. Israel was ranked (1/8) and (3/8) in publications per population and physician, respectively, compared to the other assessed countries. Conclusions: Between 2011-2021, the research productivity of the Israeli ophthalmological community has constantly increased across all sub-specialties and in high-impact journals. Israel's relative contribution to the ophthalmic medical literature is noteworthy internationally.
MeSH term(s)	Humans ; Bibliometrics ; Germany ; Internationality ; Israel ; Ophthalmology
Language	Hebrew
Publishing date	2024-03-20
Publishing country	Israel
Document type	English Abstract ; Journal Article ; Review
ZDB-ID	953872-0
ISSN	0017-7768
ISSN	0017-7768
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Article ; Online: In vivo assessment of antimicrobial activity and toxicity of repeated 1% povidone-iodine applications versus a single 5% povidone-iodine application.

Teren, David / Neuman, Gil / Abulafia, Adi / Gelman, Evgeny / Assayag, Elishai / Hajj, Abeer / Shwartz, Orna / Zadok, David

Journal of cataract and refractive surgery

2024

Abstract: Purpose: To demonstrate the non-inferiority in antimicrobial effectiveness of thrice-repeated applications of 1% povidone-iodine (PI) compared to a single application of 5% PI on the ocular surface in vivo and to evaluate potential toxicity of PI to the ...

Abstract	Purpose: To demonstrate the non-inferiority in antimicrobial effectiveness of thrice-repeated applications of 1% povidone-iodine (PI) compared to a single application of 5% PI on the ocular surface in vivo and to evaluate potential toxicity of PI to the corneal epithelium. Setting: Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel. Design: Prospective randomized, double-blind study. Methods: Patients randomly received either a single application of 5% PI or repeated irrigations of 1% PI on the ocular surface before surgery. Bacterial colony counts were quantitatively analyzed by taking standardized conjunctival swabs before and after irrigation, and differences in bacterial colony counts were compared between the 2 groups. The presence of superficial punctate keratopathy was evaluated in all patients by the National Eye Institute grading system. Results: The study comprised 102 eyes of 102 patients. Both 1% and 5% PI yielded a marked decrease in bacterial colonies compared to pre-application (P<.001). The repeated application of 1% PI showed a significantly lower bacterial count compared to the single application of 5% PI (P<.05) and resulted in significantly less damage to the corneal epithelium compared to a single 5% PI application (P<.001). Conclusion: Preoperative repeated applications of 1% PI effectively eradicated ocular surface bacteria equal to that of 5% PI with less deleterious impact on the corneal epithelium. Our findings suggest that 1% PI may be a promising alternative to 5% PI.
Language	English
Publishing date	2024-02-28
Publishing country	United States
Document type	Journal Article
ZDB-ID	632744-8
ISSN	1873-4502 ; 0886-3350
ISSN (online)	1873-4502
ISSN	0886-3350
DOI	10.1097/j.jcrs.0000000000001436
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Article ; Online: Refining Glaucoma Diagnosis and Treatment in Cataract Surgery Candidates: The Contribution of Preoperative OCT RNFL.

Goldberg, Mordechai / Zadok, David / Assayag, Elishai / Ziv-On, Elad / Zaitar, Rand / Porat-Rein, Adi / Brosh, Kobi / Weill, Yishay / Abulafia, Adi

Journal of cataract and refractive surgery

2024

Abstract: Purpose: To evaluate the clinical significance of preoperative spectral domain optical coherence tomography (OCT) of the retinal nerve fiber layer (RNFL) thickness in identifying glaucoma and better managing patients scheduled for routine cataract ... ...

Abstract	Purpose: To evaluate the clinical significance of preoperative spectral domain optical coherence tomography (OCT) of the retinal nerve fiber layer (RNFL) thickness in identifying glaucoma and better managing patients scheduled for routine cataract surgery. Setting: Department of Ophthalmology, Shaare Zedek Medical Center, Jerusalem, Israel.Design: retrospective cohort study. Methods: Consecutive patients scheduled for cataract surgery were enrolled from February 2022 to August 2022. Participants underwent routine OCT RNFL studies which were evaluated by a glaucoma specialist. Findings were compared with those of preoperative fundus biomicroscopic examinations conducted by the referring ophthalmologist. The main outcomes were the incidence of newly detected glaucoma based upon OCT RNFL findings and the consequent changes in patient management. Results: In total, 486 patients met the inclusion criteria, of whom 112 (23%) had abnormal RNFL. Thirty-one patients (6.4%) had abnormal OCT RNFL findings attributed to comorbidities other than glaucoma, and 81 patients (16.7%) were suspected to have glaucoma based upon their OCT RNFL findings, from which 44 patients (9%) were newly diagnosed with glaucoma or as glaucoma suspects, resulting in management modifications that included routine glaucoma follow-up (25 patients, 5.1%), initiation of intraocular pressure-lowering treatment (12 patients, 2.5%), and conversion to combined cataract-glaucoma surgery (7 patients, 1.4%). Conclusions: OCT RNFL for cataract surgery candidates proved valuable in detecting glaucoma that had not been revealed by standard fundus biomicroscopic examination. The additional information provided by OCT RNFL can potentially enhance patient management and optimize outcomes.
Language	English
Publishing date	2024-04-24
Publishing country	United States
Document type	Journal Article
ZDB-ID	632744-8
ISSN	1873-4502 ; 0886-3350
ISSN (online)	1873-4502
ISSN	0886-3350
DOI	10.1097/j.jcrs.0000000000001465
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Article ; Online: Comparison of IOL Power Prediction Accuracy between Two Swept-Source OCT Biometry Devices.

Sorkin, Nir / Zadok, Rotem / Giacomo, Savini / Kan-Tor, Yoav / Benjamini, Yuval / Levinger, Eliya / Bardugo, Judith / Abulafia, Adi

American journal of ophthalmology

2024

Abstract: Purpose: To compare intraocular lens (IOL) power prediction accuracy of the Eyestar 900 (EyeS900) and the IOLMaster 700 (IOLM700) based on estimated and measured posterior corneal power DESIGN: Retrospective, inter-instrument reliability study METHODS: ... ...

Abstract	Purpose: To compare intraocular lens (IOL) power prediction accuracy of the Eyestar 900 (EyeS900) and the IOLMaster 700 (IOLM700) based on estimated and measured posterior corneal power DESIGN: Retrospective, inter-instrument reliability study METHODS: Setting: Institutional. Participants: 225 eyes of 225 cataract surgery patients. Measurements: Patients underwent measurements by both devices preoperatively. Main outcome measures: Spherical Equivalent Prediction Error (SEQ-PE), spread of the SEQ-PE (Precision) and the absolute SEQ-PE (accuracy) of each device using Barrett Universal II (BUII) formula with either estimated posterior keratometry (E-PK) or measured posterior keratometry (M-PK). Results: Trimmed mean SEQ-PEs of EyeS900 E-PK, EyeS900 M-PK, IOLM700 E-PK and IOLM700 M-PK were 0.03, 0.08, 0.02 and 0.08 D, respectively with no significant differences between EyeS900 E-PK and IOLM700 E-PK (p=0.31) as well as between EyeS900 M-PK and IOLM700 M-PK (p=0.31). Statistically significant SEQ-PE differences were found when E-PK and M-PK were compared, regardless of the device used, showing hyperopic SEQ-PE in M-PK calculations. Excellent correlation and agreement in SEQ-PE were found between the devices for both E-PK (p<0.001,r=0.848, mean bias:+0.01 D, 95% LOA of -0.32 to +0.34 D) and M-PK (p<0.001,r=0.776, mean bias:-0.01 D, 95% LOA of -0.42 to +0.39 D). No significant differences were found comparing absolute SEQ-PE and precision of the devices. Conclusion: The Eyestar 900 and the IOLMaster 700 show comparable IOL power prediction accuracy by the BUII formula using either estimated or measured posterior keratometry. An adjusted lens factor may be required for BUII when utilizing measured posterior keratometry in both devices.
Language	English
Publishing date	2024-04-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	80030-2
ISSN	1879-1891 ; 0002-9394
ISSN (online)	1879-1891
ISSN	0002-9394
DOI	10.1016/j.ajo.2024.04.013
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Article: Early Impact of Laser Vision Correction (LVC) on the Stability and Quality of the Retinal Image.

Smadja, David / Erdinest, Nir / Wajnsztajn, Denise / Weill, Yishay / Abulafia, Adi / Zadok, David / Lavy, Itay

Journal of clinical medicine

2023 Volume 12, Issue 5

Abstract: This retrospective comparative study analyzes the early postoperative impact of laser vision correction for myopia on the optical quality and stability of functional vision using a double-pass aberrometer. Retinal image quality and visual function ... ...

Abstract	This retrospective comparative study analyzes the early postoperative impact of laser vision correction for myopia on the optical quality and stability of functional vision using a double-pass aberrometer. Retinal image quality and visual function stability were assessed preoperatively, one and three months after myopic laser in situ keratomileuses (LASIK) and photorefractive keratectomy (PRK) using double-pass aberrometry (HD Analyzer, Visiometrics S.L, Terrassa, Spain). The parameters analyzed included vision break-up time (VBUT), objective scattering index (OSI), modulation transfer function (MTF), and Strehl ratio (SR). The study included 141 eyes of 141 patients, of whom 89 underwent PRK and 52 underwent LASIK. No statistically significant differences were noted between the two techniques in any analyzed parameters at three months postoperatively. However, a significant drop was observed in all parameters one month after PRK. Only the OSI and VBUT remained significantly altered from baseline at the three months follow-up visit, with an increased OSI by 0.14 +/- 0.36 (
Language	English
Publishing date	2023-02-23
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2662592-1
ISSN	2077-0383
ISSN	2077-0383
DOI	10.3390/jcm12051779
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Article ; Online: Comprehensive approach for capsular bag fixation in subluxated crystalline lens: preserving the anterior/posterior anatomical segment barrier.

Porat Rein, Adi / Abulafia, Adi / Assayag, Elishai / Goldberg, Mordechai / Zadok, David

Journal of cataract and refractive surgery

2023 Volume 49, Issue 12, Page(s) 1236–1241

Abstract: Purpose: To report the intraoperative performance and postoperative outcomes of crystalline lens removal and in-the-bag intraocular lens (IOL) implantation with scleral-bag fixation by means of capsular tension segments (CTSs) and a capsular tension ... ...

Abstract	Purpose: To report the intraoperative performance and postoperative outcomes of crystalline lens removal and in-the-bag intraocular lens (IOL) implantation with scleral-bag fixation by means of capsular tension segments (CTSs) and a capsular tension ring (CTR) in patients with a subluxated lens. Setting: Department of Ophthalmology, Shaare-Zedek Medical Center, Jerusalem, Israel. Design: Retrospective, consecutive case series. Methods: This study included patients with subluxated crystalline lens who underwent lensectomy or cataract extraction using an anterior chamber maintainer (ACM), a CTR, transscleral capsular-bag fixation by polytetrafluoroethylene suture with 2 CTSs, and in-the-bag IOL implantation. Outcome measures included intra- and postoperative complications, corrected distance visual acuity (CDVA), target and postoperative refraction, and IOL tilt. Results: 17 eyes (9 patients) were included, with a mean follow-up of 22.06 ± 14.88 months. There was a significant improvement in mean logMAR CDVA ( P < .001), with 15 eyes (88.24%) achieving a Snellen CDVA of 20/30 or better and all eyes achieving 20/40 or better. The mean refractive spherical-equivalent prediction error was 0.07 ± 1.10 diopters (D), with 10 (58.82%) and 15 (88.24%) of eyes within ±0.50 D and 1.00 D, respectively, from the intended refraction. The mean horizontal and vertical tilts were 1.9 ± 2.6 degrees and 2.6 ± 2.1 degrees, respectively. No complications were observed except for 1 case of an intraoperative posterior-capsular tear. Conclusions: A comprehensive surgical approach for scleral-bag fixation that combines the use of an ACM, CTR, polytetrafluoroethylene sutures, 2 CTSs with in-the-bag IOL implantation, offers an effective strategy for achieving favorable visual outcomes and a low incidence of complications in patients with subluxated crystalline lenses.
MeSH term(s)	Humans ; Lenses, Intraocular ; Lens Implantation, Intraocular ; Retrospective Studies ; Lens, Crystalline ; Refractive Errors ; Polytetrafluoroethylene
Chemical Substances	Polytetrafluoroethylene (9002-84-0)
Language	English
Publishing date	2023-08-22
Publishing country	United States
Document type	Journal Article
ZDB-ID	632744-8
ISSN	1873-4502 ; 0886-3350
ISSN (online)	1873-4502
ISSN	0886-3350
DOI	10.1097/j.jcrs.0000000000001293
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Article ; Online: Differences in retinal images quality between normal and subclinical keratoconus and its association to posterior corneal asymmetry.

Smadja, David / Krauthammer, Mark / Wajnsztajn, Denise / Abulafia, Adi / Zadok, David / Lavy, Itay

European journal of ophthalmology

2023 Volume 33, Issue 4, Page(s) 1567–1575

Abstract: Purpose: To compare retinal image quality in subclinical keratoconus and normal eyes using a double-pass aberrometer and to correlate it with posterior surface deformation.: Methods: Sixty normal corneas were compared to 20 subclinical keratoconus ( ... ...

Abstract	Purpose: To compare retinal image quality in subclinical keratoconus and normal eyes using a double-pass aberrometer and to correlate it with posterior surface deformation. Methods: Sixty normal corneas were compared to 20 subclinical keratoconus (SKC) corneas. Retinal image quality was assessed using a double-pass system in all the eyes. The objective scatter index (OSI) modulation transfer function (MTF) cutoff, Strehl ratio (SR), and Predicted Visual Acuity (PVA) values at 100%, 20%, and 9% were calculated and compared between the groups. Posterior corneal asymmetry was measured using a combined Placido Dual Scheimpflug Analyzer, and correlations were tested with all optical quality parameters. Results: Significant decrease in optical quality parameters was observed in SKC eyes compared with that in normal eyes. Subclinical KC eyes expressed greater scattering (OSI = 0.66 ± 0.36 vs 0.47 ± 0.26) and reduced contrast images (MTF and SR) than normal eyes, with 38.82 ± 9.4 and 0.22 ± 0.04, and 44.35 ± 7.1 and 0.24 ± 0.04, respectively. The reduction in the image contrast parameters (MTF and SR) was strongly correlated to the level of posterior corneal asymmetry in SKC. The greater the posterior asymmetry, the more affected was the image contrast, with r = -0.63 and -0.59, respectively for MTF and SR. Conclusion: Retinal image quality was significantly more affected in eyes with subclinical keratoconus than in normal eyes. The reduction in optical quality observed in subclinical keratoconus was strongly associated with the increased asymmetry of the posterior cornea.
MeSH term(s)	Humans ; Keratoconus/diagnosis ; Corneal Topography/methods ; Sensitivity and Specificity ; ROC Curve ; Cornea
Language	English
Publishing date	2023-04-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	1089461-5
ISSN	1724-6016 ; 1120-6721
ISSN (online)	1724-6016
ISSN	1120-6721
DOI	10.1177/11206721231166559
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Article: Influence of the Reference Center on the Calculation of Corneal Higher Order Aberrations.

Smadja, David / Greenbaum, Assaf / Shoshani, Avi / Abulafia, Adi / Zadok, David / Lavy, Itay

Journal of refractive surgery (Thorofare, N.J. : 1995)

2023 Volume 39, Issue 5, Page(s) 340–346

Abstract: Purpose: To evaluate the differences in corneal wavefront measurements in myopic and hyperopic eyes when calculated using three different reference centers and explore possible influencing factors for such differences.: Methods: Corneal wavefront ... ...

Abstract	Purpose: To evaluate the differences in corneal wavefront measurements in myopic and hyperopic eyes when calculated using three different reference centers and explore possible influencing factors for such differences. Methods: Corneal wavefront measurements were performed in myopic and hyperopic eyes using a GALILEI Placido Dual Scheimpflug Analyzer (Ziemer Ophthalmic Systems AG). Corneal higher order aberrations (HOAs), including total, vertical, and horizontal coma-like aberrations, spherical aberrations, and total corneal HOAs through a 6-mm pupil size, were calculated over three different reference center positions: pupil center, corneal vertex, and limbus to limbus. Values were then compared between the myopic and hyper-opic eyes, and correlations with kappa distance and spherical equivalent were tested. Results: A significant decrease in the level of total corneal HOAs (-0.04 ± 0.05 and -0.12 ± 0.09), total corneal coma (-0.07 ± 0.09 and -0.18 ± 0.12), and horizontal coma (-0.07 ± 0.11 and -0.22 ± 0.11) in myopic and hyperopic eyes, respectively, was found when recalculating from pupil center to corneal vertex centration, whereas a significant increase in the same aberrations was observed from pupil center or corneal vertex to limbus to limbus. Significant correlations were found between the kappa distance and changes in total corneal HOAs, total corneal coma, and horizontal coma from the pupil center to the corneal vertex in both groups. Conclusions: Corneal vertex centration generated the lowest level of corneal wavefront error in both groups. The differences in corneal aberrations between the reference centers for calculation were highly correlated with the kappa distance in hyperopic eyes.
MeSH term(s)	Humans ; Coma ; Corneal Wavefront Aberration/diagnosis ; Cornea ; Refraction, Ocular ; Myopia ; Hyperopia ; Corneal Topography
Language	English
Publishing date	2023-05-01
Publishing country	United States
Document type	Journal Article
ISSN	1081-597X
ISSN	1081-597X
DOI	10.3928/1081597X-20230310-01
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Article ; Online: Comparison of biometry measurements and intraocular lens power prediction between 2 SS-OCT-based biometers.

Sorkin, Nir / Zadok, Tal / Barrett, Graham D / Chasid, Otzem / Abulafia, Adi

Journal of cataract and refractive surgery

2022 Volume 49, Issue 5, Page(s) 460–466

Abstract: Purpose: To evaluate the agreement in biometry measurements and intraocular lens (IOL) power prediction between the Eyestar 900 and the IOLMaster 700.: Setting: Institutional.: Design: Retrospective comparative study.: Methods: Patients were ... ...

Abstract	Purpose: To evaluate the agreement in biometry measurements and intraocular lens (IOL) power prediction between the Eyestar 900 and the IOLMaster 700. Setting: Institutional. Design: Retrospective comparative study. Methods: Patients were evaluated before cataract surgery using both devices on the same visit. Axial length, anterior and posterior keratometry, anterior chamber depth, corneal diameter (CD), central corneal thickness, and lens thickness were recorded by both devices. The agreement in measurements and in IOL power calculations was evaluated using the Barrett Universal II (BU-II) formula with either predicted or measured posterior keratometry. Results: In total, 402 eyes of 402 consecutive patients were included. The mean age was 72.0 ± 9.2 years. Clinically, mean differences in measured variables were small, albeit slightly larger for posterior flat and steep keratometry (0.43 diopters [D] and 0.42 D, respectively). The measurement correlation and agreement between the devices were good for all variables with slightly lower agreement in CD measurements. Consistent bias was seen in measurements of posterior flat and steep keratometry. Good agreement was also found in anterior and posterior astigmatism measurements. Good IOL power calculation agreement was found using either predicted posterior keratometry (95% limits of agreement [LoA] of -0.40 to +0.30 D) or measured posterior keratometry (95% LoA of -0.45 to +0.40 D). The agreement was within ±0.5 D in 394 eyes (98.0%) using predicted posterior keratometry and in 386 eyes (96.0%) using measured posterior keratometry. Conclusions: The Eyestar 900 and the IOLMaster 700 show strong agreement in biometry measurements and IOL power prediction by the BU-II formula using either standard or total corneal keratometry and can be used interchangeably.
MeSH term(s)	Aged ; Aged, 80 and over ; Humans ; Middle Aged ; Axial Length, Eye ; Biometry ; Cornea ; Lenses, Intraocular ; Reproducibility of Results ; Retrospective Studies ; Tomography, Optical Coherence
Language	English
Publishing date	2022-11-29
Publishing country	United States
Document type	Comparative Study ; Journal Article
ZDB-ID	632744-8
ISSN	1873-4502 ; 0886-3350
ISSN (online)	1873-4502
ISSN	0886-3350
DOI	10.1097/j.jcrs.0000000000001146
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Article ; Online: Advantageous effect of pupil dilation on the quality of optical biometry axial length measurement in individuals with dense cataract.

Bettach, Emmanuel / Weill, Yishay / Aronovitz, Yocheved / Zadok, David / Gelman, Evegeny / Abulafia, Adi

Journal of cataract and refractive surgery

2022 Volume 48, Issue 11, Page(s) 1248–1252

Abstract: Purpose: To evaluate the effect of pharmacologic pupil dilation on the quality of axial length (AL) measurement in patients with dense cataracts and previous low-quality AL measurements performed without dilation.: Setting: Shaare-Zedek Medical ... ...

Abstract	Purpose: To evaluate the effect of pharmacologic pupil dilation on the quality of axial length (AL) measurement in patients with dense cataracts and previous low-quality AL measurements performed without dilation. Setting: Shaare-Zedek Medical Center, Jerusalem, Israel. Design: Retrospective case series. Methods: All participants underwent swept-source optical coherence tomographic (SS-OCT) biometry. Those with low-quality AL measurements due to dense cataract underwent an additional SS-OCT biometric evaluation after pupil dilation, and the AL measurement of the same eye was recorded. Results: 2076 patients underwent SS-OCT during the study period, and 177 (8.52%) had low-quality AL measurements because of dense cataract. 79 (44.63%, mean age 72.53 ± 13.27 years, 43 females) of those 177 patients underwent repeat SS-OCT biometric imaging after pharmacologic pupil dilation, and formed the study group. After pupil dilation, high-quality AL measurements were successfully obtained in 60 (75.95%) of the 79 eyes. The mean SD of the AL measurements decreased significantly ( P < .001), and the number of successful OCT scans per measurement increased significantly ( P < .001) after pupil dilation. The mean difference of the AL before and after pupil dilation was 0.03 ± 0.07 mm ( P < .001). Conclusions: Pharmacologic pupil dilation improved the quality of SS-OCT biometrically measured AL in patients with low-quality AL measurement due to dense cataract. These results could potentially improve postoperative refractive outcomes after cataract surgery and reduce the need of additional AL measurements by more complicated alternative means in this group.
MeSH term(s)	Female ; Humans ; Middle Aged ; Aged ; Aged, 80 and over ; Axial Length, Eye/anatomy & histology ; Pupil ; Retrospective Studies ; Cataract/diagnosis ; Biometry/methods ; Tomography, Optical Coherence/methods ; Reproducibility of Results
Language	English
Publishing date	2022-04-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	632744-8
ISSN	1873-4502 ; 0886-3350
ISSN (online)	1873-4502
ISSN	0886-3350
DOI	10.1097/j.jcrs.0000000000000964
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