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

Publisher: International Society of Refractive Surgery, Slack

Journal description

The Journal of Refractive Surgery, the official publication of the International Society of Refractive Surgery and its affiliated societies, is a bimonthly forum for original research, review, and evaluation of refractive and corneal surgical procedures. In addition to peer-reviewed scientific articles, regular features such as New Ideas, Case Reports, Consultations in Refractive Surgery, New Commentary, Abstracts, and Opinions help keep the surgeon abreast of this ever-changing specialty.

Current impact factor: 2.78

Impact Factor Rankings

2015 Impact Factor Available summer 2015
2013 / 2014 Impact Factor 2.781
2012 Impact Factor 2.474
2011 Impact Factor 2.541
2010 Impact Factor 2.491
2009 Impact Factor 2.32
2008 Impact Factor 1.914
2007 Impact Factor 1.696
2006 Impact Factor 2.097
2005 Impact Factor 1.948
2004 Impact Factor 2.399
2003 Impact Factor 1.877
2002 Impact Factor 2.307
2001 Impact Factor 1.995
2000 Impact Factor 2.061
1999 Impact Factor 1.847
1996 Impact Factor 1.224

Impact factor over time

Impact factor

Additional details

5-year impact 2.61
Cited half-life 5.40
Immediacy index 0.67
Eigenfactor 0.01
Article influence 0.89
Website Journal of Refractive Surgery website
Other titles Journal of refractive surgery
ISSN 1081-597X
OCLC 56970461
Material type Document, Periodical, Internet resource
Document type Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details


  • Pre-print
    • Author cannot archive a pre-print version
  • Post-print
    • Author cannot archive a post-print version
  • Restrictions
    • 12 months embargo
  • Conditions
    • On Institutional Repositories
    • Publisher's version/PDF cannot be used
    • NIH authors may deposit in PubMed Central after 12 months
    • Must link to publisher version
  • Classification
    ​ white

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: To report two cases of significant flattening after corneal cross-linking (CXL) for keratoconus and discuss its potential explanations and implications. Observational case report. One year after standard CXL protocol (3 mW/cm(2) for 30 minutes and total energy of 5.4 J/cm(2)), a 28-year-old woman presented a flattening of greater than 14 diopters and a 14-year-old boy presented a flattening of 7 diopters. Although rare, a significant flattening effect may occur during the first year after CXL, probably related to intense wound healing, increase in corneal elasticity, CXL effective depth, and central cone location. These cases suggest the necessity of a patient-specific approach and a better understanding regarding the actual mechanism behind its potent effect. [J Refract Surg. 2015;31(6):419-422.]. Copyright 2015, SLACK Incorporated.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 06/2015; 31(6):419-422. DOI:10.3928/1081597X-20150521-09
  • Journal of refractive surgery (Thorofare, N.J.: 1995) 06/2015; 31(6):423. DOI:10.3928/1081597X-20150521-10
  • [Show abstract] [Hide abstract]
    ABSTRACT: To report and document a case of successful rainbow glare correction using undersurface ablation of the LASIK flap. A 33-year-old woman was treated bilaterally for myopia using femtosecond laser-assisted LASIK with the FS200 femtosecond laser (Alcon Laboratories, Inc., Fort Worth, TX). Postoperatively, she complained of rainbow glare in her right eye, and presented some residual myopic astigmatism. Six months after the initial LASIK procedure, the right eye flap was lifted and a toric excimer correction was delivered on its stromal side. Visual symptoms related to the rainbow glare disappeared immediately after the completion of the procedure and did not reoccur. Uncorrected visual acuity improved by two lines. Rainbow glare following femtosecond laser-assisted LASIK can be successfully corrected by undersurface ablation of the flap. [J Refract Surg. 2015;31(6):406-410.]. Copyright 2015, SLACK Incorporated.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 06/2015; 31(6):406-410. DOI:10.3928/1081597X-20150521-07
  • [Show abstract] [Hide abstract]
    ABSTRACT: To assess the causes for intrastromal corneal ring segment (Intacs; Addition Technology Inc., Lombard, IL) explantation in patients with keratoconus, and technique for explantation, long-term outcomes, and secondary procedures to correct visual acuity. Ten eyes of 8 patients with a history of Intacs explantation between 2004 and 2012 were included in a retrospective study performed at the Bascom Palmer Eye Institute, Miami, Florida. Causes of Intacs removal, surgical technique, preoperative and postoperative corneal examination, and uncorrected and corrected distance visual acuity were documented. Additionally, corneal topography (Tomey, Nagoya, Japan) parameters such as average keratometry and corneal cylinder were assessed. Although the segments were well positioned, the most common cause of Intacs removal was worsening visual acuity (80%). There was no statistically significant difference between pre-Intacs placement, post-Intacs placement, and post-Intacs removal in uncorrected and corrected distance visual acuity, average keratometry, or corneal cylinder, except between 1-year post-Intacs placement corrected distance visual acuity (0.57 logMAR [20/75 Snellen]) and 1-month post-Intacs removal corrected distance visual acuity (0.25 logMAR [20/36 Snellen], P =.03). Four patients underwent penetrating keratoplasty after Intacs removal with good visual outcomes. This study demonstrates the visual and structural outcomes that returned to near baseline after Intacs explantation in keratoconic eyes. [J Refract Surg. 2015;31(6):392-397.]. Copyright 2015, SLACK Incorporated.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 06/2015; 31(6):392-397. DOI:10.3928/1081597X-20150521-05
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    ABSTRACT: To evaluate in a pilot study the visual, refractive, corneal topographic, and aberrometric changes after wavefront-guided LASIK or photorefractive keratectomy (PRK) using a high-resolution aberrometer to calculate the treatment for aberrated eyes. Twenty aberrated eyes of 18 patients undergoing wavefront-guided LASIK or PRK using the VISX STARS4IR excimer laser and the iDesign aberrometer (Abbott Medical Optics, Inc., Santa Ana, CA) were enrolled in this prospective study. Three groups were differentiated: keratoconus post-CXL group including 11 keratoconic eyes (10 patients), post-LASIK group including 5 eyes (5 patients) with previous decentered LASIK treatments, and post-RK group including 4 eyes (3 patients) with previous radial keratotomy. Visual, refractive, contrast sensitivity, corneal topographic, and ocular aberrometric changes were evaluated during a 6-month follow-up. An improvement in uncorrected (UDVA) and corrected visual acuity (CDVA) associated with a reduction in the spherical equivalent was observed in the three groups, but was only statistically significant in the keratoconus post-CXL and post-LASIK groups (P ≤ .04). All eyes gained one or more lines of CDVA after surgery. Improvements in contrast sensitivity were observed in the three groups, but they were only statistically significant in the keratoconus post-CXL and post-LASIK groups (P ≤ .04). Regarding aberrations, a reduction was observed in trefoil aberrations in the keratoconus post-CXL group (P = .05) and significant reductions in higher-order and primary coma aberrations in the post-LASIK group (P = .04). Wavefront-guided laser enhancements using the evaluated platform seem to be safe and effective to restore the visual function in aberrated eyes. [J Refract Surg. 2015;31(6):411-418.]. Copyright 2015, SLACK Incorporated.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 06/2015; 31(6):411-418. DOI:10.3928/1081597X-20150521-08
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    ABSTRACT: To evaluate the efficacy and safety of a new acrylic one-piece toric intraocular lens (IOL). This prospective multicenter clinical trial included 93 eyes of 61 patients that were implanted with a hydrophobic acrylic toric IOL from 2010 to 2012 and followed for 1 year. This IOL uses the platform of a microincision one-piece aspheric IOL, the NY-60 IOL (HOYA, Tokyo, Japan), with three increments in cylindrical power (NHT15, 1.5 diopters [D]; NHT23, 2.25 D; and NHT30, 3.0 D). The inclusion criterion was preoperative corneal astigmatism from 0.75 to 3.00 D. The primary endpoint was uncorrected distance visual acuity (UDVA) of 0.0 logMAR (20/20 Snellen) or better 6 months postoperatively. In addition to UDVA, corrected distance visual acuity (CDVA), residual astigmatism, stability of the IOL alignment, need of realignment, and the rate of Nd:YAG laser capsulotomy were evaluated up to 1 year postoperatively. Errors in astigmatic correction were assessed using Alpin's vector analysis. The primary endpoint was achieved in 54.8% of eyes. One year postoperatively, the logMAR UDVAs were 0.02 ± 0.13, 0.05 ± 0.17, and 0.09 ± 0.14 with models NHT15, NHT23, and NHT30, which corresponds to 0.96 (19/20 Snellen), 0.89 (18/20 Snellen), and 0.82 (16/20 Snellen), respectively. One year postoperatively, the residual astigmatism was 0.66 ± 0.58 D. In each evaluation, the mean absolute change in the position of the axis mark was between 1.93° and 2.32°. Three eyes required repositioning of the IOL axis and 2 eyes received Nd:YAG laser capsulotomy. The correction error showed an undercorrection with against-the-rule astigmatism and overcorrection with with-the-rule astigmatism. The new one-piece toric IOL provided desirable clinical outcomes and stability in eyes with corneal astigmatism. [J Refract Surg. 2015;31(6):358-364.]. Copyright 2015, SLACK Incorporated.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 06/2015; 31(6):358-364. DOI:10.3928/1081597X-20150521-01
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    ABSTRACT: To evaluate the effectiveness and safety of accelerated corneal collagen cross-linking for postoperative LASIK ectasia after 2 years. A prospective, single-center case series was performed with patients treated for postoperative LASIK ectasia. All eyes underwent accelerated corneal collagen cross-linking (CCL-Vario Crosslinking; Peschke Meditrade GmbH, Zurich, Switzerland) at 9 mW/cm(2) for 10 minutes. The main outcome measures were changes in uncorrected distance visual acuity, corrected distance visual acuity, central corneal thickness, corneal topography, and endothelial cell density. These parameters were assessed at baseline and at the 6-month and 1- and 2-year follow-up visit. The study enrolled 40 eyes of 24 patients (15 male and 9 female) with a mean age of 33.8 ± 7.5 years (range: 24 to 52 years) that attained at least 2 years of follow-up. The surgical procedure was uneventful in all cases. All eyes stabilized after treatment without any further signs of progression and no statistically significant changes in the mean uncorrected distance visual acuity (P = .649), corrected distance visual acuity (P = .616), mean keratometry (P =.837), steep keratometry (P = .956), ultrasonic pachymetry (P = .135), slit-scanning pachymetry (P = .276), and endothelial cell density (P = .523). In addition, 72.5% of the patients presented stable or gains of Snellen lines over time. Accelerated corneal collagen cross-linking seems to be safe and effective in halting postoperative LASIK ectasia progression after 2 years of follow-up. However, a longer follow-up period with a larger cohort is needed to validate these findings. [J Refract Surg. 2015;31(6):380-384.]. Copyright 2015, SLACK Incorporated.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 06/2015; 31(6):380-384. DOI:10.3928/1081597X-20150521-04
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    ABSTRACT: To compare the measurements of refractive errors and ocular aberrations obtained using iDesign and WaveScan (Abbott Medical Optics, Inc., Santa Ana, CA), and to compare surgical outcomes of wavefront-guided LASEK using ablation profiles based on both aberrometers. Ninety myopic eyes of 45 normal patients were evaluated using both the iDesign and WaveScan to measure spherical and cylindrical errors, spherical equivalents, and Zernike coefficients of ocular aberrations. Wavefront-guided LASEK was performed in a different group of 59 eyes of 30 patients divided into two groups, the iDesign and Wavescan groups. The clinical outcomes between the two groups including uncorrected visual acuity, refractive errors, contrast sensitivity, and ocular aberration were compared at 1, 3, and 6 months postoperatively. The iDesign produced significantly higher myopic values for refractive errors than the WaveScan, as well as significantly lower levels of total higher order, third, fourth, and fifth order root mean square values and Zernike coefficients of vertical coma and spherical aberration. At postoperative 1, 3, and 6 months, there were no statistically significant differences between the two groups in terms of uncorrected visual acuity and remaining refractive errors. The percentages of patients with spherical equivalents within ±1.00 and ±0.50 diopters of emmetropia were 100% (29 eyes) and 75.9% (22 eyes), respectively, in the iDesign group and 96.7% (29 eyes) and 70.0% (21 eyes), respectively, in the WaveScan group. Mesopic contrast sensitivity values were significantly higher, and the change in root mean square values for spherical aberration was significantly lower in the iDesign group. There were significant differences between the iDesign and the WaveScan in the measurements of refraction and ocular aberrations. Wavefront-guided LASEK based on an ablation profile from the iDesign demonstrated comparable refractive predictability with the WaveScan group, resulting in minimal physician adjustment and superior postoperative visual quality. [J Refract Surg. 2015;31(6):398-405.]. Copyright 2015, SLACK Incorporated.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 06/2015; 31(6):398-405. DOI:10.3928/1081597X-20150521-06
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    ABSTRACT: To evaluate the safety, effectiveness, stability, and predictability of implanting autologous lenticules obtained from small incision lenticule extraction for the treatment of hyperopia. Five patients (10 eyes) with one myopic eye and one hyperopic eye were enrolled. The myopic eye was treated with small incision lenticule extraction; a lenticule was extracted and subsequently implanted in the hyperopic eye. Follow-up was at 1 day, 1, 3, 6, and 9 months, and 1 year postoperatively. Patients received a complete ophthalmologic examination at each visit, including uncorrected distance visual acuity, corrected distance visual acuity, anterior segment optical coherence tomography, and corneal topography. There were no complications in any eye during follow-up. Compared with preoperative levels, at the last follow-up visit the eyes with lenticule implantation showed mean spherical equivalent reduced by 5.53 diopters (residual spherical equivalent was +1.13 to -2.63 diopters), mean uncorrected distance visual acuity increased approximately two lines (approximately 20/63 to 20/40 Snellen), and corrected distance visual acuity in 4 (80%) eyes gained one line, 2 (40%) eyes gained two lines, and 1 (20%) eye gained more than two lines. There was no significant difference (P > .05) in spherical equivalent compared with 1 day postoperatively and the last follow-up visit. Corneal topography showed that the lenticule was uniform and located well; anterior segment optical coherence tomography images showed that the lenticule was transparent and the demarcation line was visible. Implanting an autologous lenticule obtained by small incision lenticule extraction for hyperopia might be safe, effective, and stable, but its predictability should be improved in the future. [J Refract Surg. 2015;31(6):374-379.]. Copyright 2015, SLACK Incorporated.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 06/2015; 31(6):374-379. DOI:10.3928/1081597X-20150521-03
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    ABSTRACT: To report femtosecond laser-assisted cataract surgeries in patients with Marfan syndrome with mild, moderate, and severe lens subluxation. Case reports. Two patients with Marfan syndrome underwent femtosecond laser-assisted cataract surgery (Alcon LenSx Lasers Inc., Aliso Viejo, CA). One patient had a mild lens subluxation in one eye and a moderate lens subluxation in the fellow eye. The other patient had a severe lens subluxation in one eye. In all eyes, the laser was able to perform a circular and free-floating anterior capsulotomy and lens fragmentation. In two of the eyes it was also helpful in decreasing corneal astigmatism by making corneal intrastromal relaxing incisions. There were no postoperative complications. Femtosecond laser-assisted cataract surgery is an effective approach for cataract surgery in patients with Marfan syndrome with mild, moderate, and even severe lens subluxation, with the benefits of causing minimal further zonular damage and being able to treat corneal astigmatism with relaxing incisions. [J Refract Surg. 2015;31(5):338-341.]. Copyright 2015, SLACK Incorporated.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 05/2015; 31(5):338-41. DOI:10.3928/1081597X-20150424-02
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    ABSTRACT: To analyze the repeatability of keratometric and white-to-white (WTW) distance measurements with the VERION Measurement Module (Alcon Laboratories, Inc., Fort Worth, TX) and to compare the measured data to the results of the IOLMaster (Carl Zeiss Meditec, Jena, Germany). Three images were captured with the VERION and the flattest and steepest keratometric data, the astigmatism axis, and the WTW distance were recorded. Subsequently, the axial length, the keratometric data with axis, and the WTW distance were measured with an IOLMaster. The repeatability data of the keratometric value of the VERION System, converted to cross cylinder J0 and J45 vector components, were analyzed. The agreement data for keratometry obtained by the VERION System and the differences regarding keratometric data and WTW distance compared to IOLMaster were calculated. The measurements were conducted in 50 eyes of 50 healthy volunteers (median age: 50.32 years, range: 19.34 to 85.3 years). The flattest and the steepest keratometric data, the diopter of astigmatism, the J0 and J45 vector components, and WTW distance did not differ significantly between devices (P > .05). Intraclass correlation coefficients (range: 0.863 to 0.994) and Cronbach's alpha values (range: 0.950 to 0.998) were high for all parameters measured by the VERION System. The VERION System has high repeatability and agreement with the IOLMaster, making it suitable as an alternative tool in clinical practice. [J Refract Surg. 2015;31(5):333-337.]. Copyright 2015, SLACK Incorporated.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 05/2015; 31(5):333-7. DOI:10.3928/1081597X-20150424-01
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    ABSTRACT: To evaluate the visual outcome, spectacle independence, and patient satisfaction after implantation of two Acrysof ReSTOR (Alcon Laboratories, Inc., Fort Worth, TX) intraocular lenses (IOLs) with different addition power or their combination in both eyes. One hundred twenty eyes of 60 patients with bilateral multifocal IOL implantation were divided into three groups of 20 consecutive patients each: the SV25T0 (the T0 group), the SN6AD1 (the D1 group), or a combination of both the SN6AD1 and SV25T0 (the combined group). Patients were observed 18 months postoperatively for visual acuity (40, 50, and 60 cm, and 4 m), defocus curves (range: +1.0 to -4.0 diopters), and contrast sensitivity. Quality of vision, patient satisfaction, and spectacle independence were evaluated by the National Eye Institute Refractive Error Quality of Life Instrument-42 questionnaire. The D1 group achieved better results for near vision (P < .01), whereas the T0 group achieved better intermediate vision (P = .01). The combined group showed a wider range of spectacle independence at all distances evaluated (P < .05). The contrast sensitivity was similar within the groups. The incidence of glare was lower for the T0 group (P = .054). The combined group had better results in terms of expectation (P = .021) and activity limitation (P = .003). Although the bilateral implantation of the same multifocal IOL can maximize the vision for near or intermediate distances, the combination of these IOLs in both eyes can increase the range of spectacle independence without compromising the contrast sensitivity and quality of vision. [J Refract Surg. 2015;31(5):308-314.]. Copyright 2015, SLACK Incorporated.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 05/2015; 31(5):308-14. DOI:10.3928/1081597X-20150423-04
  • Journal of refractive surgery (Thorofare, N.J.: 1995) 05/2015; 31(5):349-50. DOI:10.3928/1081597X-20150424-07
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    ABSTRACT: To evaluate the clinical outcomes after cataract surgery with implantation of a new diffractive multifocal intraocular lens with a lower near addition. A prospective multicenter clinical study including 44 eyes of 44 patients (age range: 43 to 82 years) that underwent cataract surgery with implantation of the Tecnis ZLB00 multifocal intraocular lens (Abbott Medical Optics, Santa Ana, CA). Changes in uncorrected and corrected distance, intermediate, and near visual acuity, and manifest refraction were evaluated during a 3-month follow-up. Additionally, patients were asked about photic phenomena and spectacle dependence. Postoperative spherical equivalent was within 0.50 and ±1.00 diopters of emmetropia in 91.2% and 100% of eyes, respectively. Postoperative monocular uncorrected distance, near, and intermediate visual acuities were 0.10 logMAR (20/25 Snellen) or better in 82.5%, 86.5%, and 68.8% of eyes, respectively. All eyes achieved monocular corrected distance and near visual acuity of 0.10 logMAR (20/25 Snellen) or better. All patients reported to be satisfied with the outcomes of the surgery. Only 6 patients (13.6%) required the use of spectacles for some daily activities postoperatively, and 8 patients (18.2%) reported mild perception of halos. The introduction of low addition multifocal intraocular lenses follows a trend to increase intermediate visual acuity. Still, a near addition of +3.25 diopters reached satisfying near results and led to high patient satisfaction. [J Refract Surg. 2015;31(5):295-299.]. Copyright 2015, SLACK Incorporated.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 05/2015; 31(5):295-9. DOI:10.3928/1081597X-20150423-02
  • Journal of refractive surgery (Thorofare, N.J.: 1995) 05/2015; 31(5):346. DOI:10.3928/1081597X-20150424-04