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: 3.47

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

  • Journal of refractive surgery (Thorofare, N.J.: 1995) 08/2015; 31(8):566. DOI:10.3928/1081597X-20150728-04
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    ABSTRACT: To evaluate corneal power distribution using the ray tracing method (corneal power) in eyes undergoing small incision lenticule extraction (SMILE) surgery and compare the functional optical zone with two lenticular sizes. This retrospective study evaluated 128 patients who underwent SMILE for the correction of myopia and astigmatism with a lenticular diameter of 6.5 mm (the 6.5-mm group) and 6.2 mm (the 6.2-mm group). The data include refraction, correction, and corneal power obtained via a Scheimpflug camera from the pupil center to 8 mm. The surgically induced changes in corneal power (Δcorneal power) were compared to correction and Δrefraction. The functional optical zone was defined as the largest ring diameter when the difference between the ring power and the pupil center power was 1.50 diopters or less. The functional optical zone was compared between two lenticular diameter groups. Corneal power distribution was measured by the ray tracing method. In the 6.5-mm group (n = 100), Δcorneal power at 5 mm showed the smallest difference from Δrefraction and Δcorneal power at 0 mm exhibited the smallest difference from correction. In the 6.2-mm group (n = 28), Δcorneal power at 2 mm displayed the lowest dissimilarity from Δrefraction and Δcorneal power at 4 mm demonstrated the lowest dissimilarity from correction. There was no significant difference between the mean postoperative functional optical zones in either group when their spherical equivalents were matched. Total corneal refactive power can be used in the evaluation of surgically induced changes following SMILE. A lenticular diameter of 6.2 mm should be recommended for patients with high myopia because there is no functional difference in the optical zone. [J Refract Surg. 2015;31(8):532-538.]. Copyright 2015, SLACK Incorporated.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 08/2015; 31(8):532-8. DOI:10.3928/1081597X-20150727-03
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    ABSTRACT: To present two cases of spontaneous haptic flexion and misalignment of a new single-piece microincisional aspheric intraocular lens (IOL) following uneventful microincisional phacoemulsification surgery and IOL implantation. Case reports. Both patients had decreased visual acuity and significant myopia and astigmatism in their operated eye at the postoperative first month visit. On dilated biomicroscopic examination, flexion of one haptic was observed in both cases. In one of the cases, the misaligned IOL was explanted and a different posterior chamber IOL was implanted. In the other case, the misaligned IOL was repositioned. Cataract surgeons should be aware of the risk for haptic flexion and misalignment of this new IOL, causing decreased visual acuity and significant refractive error in the early postoperative period. Satisfactory results can be achieved by either IOL exchange or repositioning the IOL. [J Refract Surg. 2015;31(8):558-560.]. Copyright 2015, SLACK Incorporated.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 08/2015; 31(8):558-60. DOI:10.3928/1081597X-20150728-01
  • Journal of refractive surgery (Thorofare, N.J.: 1995) 08/2015; 31(8):565. DOI:10.3928/1081597X-20150728-03
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    ABSTRACT: To evaluate the long-term refractive and visual stability and the risks related to the implantation of Implantable Collamer Lens (ICL; STAAR Surgical, Monrovia, CA) phakic intraocular lens (PIOL) for myopia. This retrospective, consecutive, cumulative clinical study was performed in a group of 144 eyes implanted with ICL PIOL for myopia. Only the cases with clinical data available 12 years after the implantation were included in the series. Corrected distance visual acuity (CDVA), uncorrected distance visual acuity, spherical equivalent, refractive astigmatism, endothelial cell density, ICL vaulting, and postoperative complications were analyzed. Mean spherical equivalent refraction was -16.90 ± 4.26 diopters (D) preoperatively and -1.77 ± 1.93 D 12 years postoperatively. Mean CDVA at the first and last visit were 0.31 ± 0.19 logMAR and 0.22 ± 0.22 logMAR, respectively (Mann-Whitney U test, P < .001). Twelve years postoperatively, 8.9% of eyes had lost more than two lines of CDVA. The incidence of clinically relevant cataracts (13.88%) was significantly linked to the use of the V3 model ICL (chi-square test, P = .007). During the follow-up period, a significant reduction in PIOL vaulting was observed (Kruskal-Wallis test, P < .05), and the mean endothelial cell density decreased by 19.75%. The ICL PIOL provided good refractive outcomes and stability in the long term. The incidence of cataracts is low when the latest models of this PIOL are used. [J Refract Surg. 2015;31(8):548-556.]. Copyright 2015, SLACK Incorporated.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 08/2015; 31(8):548-56. DOI:10.3928/1081597X-20150727-05
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    ABSTRACT: To analyze the refractive outcomes and satisfaction of presbyopic hyperopes treated with central presbyopicLASIK (presbyLASIK) with induced micro-monovision. This retrospective study included 74 eyes of 37 patients treated with central presbyLASIK with micro-monovision using the Technolas 217P excimer laser (Technolas Perfect Vision GmbH, Munich, Germany) between June 2011 and March 2014. Study parameters included uncorrected distance visual acuity (UDVA) and uncorrected near visual acuity (UNVA), aberrometry, the central steep zone, and patient satisfaction. Median age was 54.3 ± 4 years (range: 46 to 63 years). Mean postoperative spherical equivalent refraction was 0.00 ± 0.58 diopters (D) for dominant eyes and -0.51 ± 0.54 D for non-dominant eyes. Mean binocular UDVA was 0.01 ± 0.10 logMAR (Snellen 20/20) at 6 months and -0.01 ± 0.05 logMAR (Snellen 20/19) at 1 year postoperatively. Mean binocular UNVA was 0.18 ± 0.14 logMAR (Parinaud 2) (Jaeger 1) at 6 months and 0.18 ± 0.12 logMAR (Parinaud 2) (Jaeger 1) at 1 year postoperatively. At 6 months, 79.31% of patients achieved 20/25 and could read Parinaud 2 (Jaeger 1) binocularly. At 1 year, 84.21% of patients achieved 20/25 and could read Parinaud 2 (Jaeger 1) binocularly. The mean central steep zone was 2.35 ± 1.00 D. There were significantly more negative spherical aberration and vertical coma in the central 5 mm postoperatively (P < .05). The re-treatment rate was 6.75%. Eighty-three percent of these patients did not need any glasses for distance and near vision. This procedure may improve functional near, intermediate, and distance vision in presbyopic patients with low and moderate hyperopia. [J Refract Surg. 2015;31(8):540-546.]. Copyright 2015, SLACK Incorporated.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 08/2015; 31(8):540-6. DOI:10.3928/1081597X-20150727-04
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    ABSTRACT: To evaluate intraocular lens (IOL) axial movements and refractive changes during a 6-month follow-up period after femtosecond laser-assisted cataract surgery and conventional cataract surgery, investigate the influence of capsulorhexis features on postoperative IOL axial changes, and assess the prediction error for both techniques. Eighty eyes of 80 candidates for cataract extraction were randomized into two groups: femtosecond laser (40 eyes) and manual (40 eyes). The overall anterior chamber depth variation was significantly lower in the femtosecond laser group compared to the manual group during follow-up (P < .001). At 30 and 180 days postoperatively, the mean spherical equivalent showed a hyperopic shift (0.09 ± 0.28 diopters [D]) in the femtosecond laser group and a myopic shift in the manual group (-0.25 ± 0.18 D). Median absolute error was not significantly different between the two groups with standard formulas ranging between 0.29 and 0.64 (Hoffer Q) in the femtosecond laser group and between 0.24 (SRK-T) and 0.55 D (Hoffer Q) in the manual group. There was a significant lower deviation from intended versus achieved capsulotomy/capsulorhexis area in the femtosecond laser group (P < .001) compared to the manual group. The femtosecond laser group showed better IOL centration compared to the manual group at all time periods (P < .001). Femtosecond laser-assisted cataract surgery was related to a lower overall variability of anterior chamber depth compared to conventional cataract surgery with more stable postoperative refraction. The two techniques did not show significant differences of prediction error. [J Refract Surg. 2015;31(8):524-530.]. Copyright 2015, SLACK Incorporated.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 08/2015; 31(8):524-30. DOI:10.3928/1081597X-20150727-02
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    ABSTRACT: To evaluate vector analysis, rotational stability, and refractive and visual outcome of a new toric intraocular lens (IOL) for correction of preexisting corneal astigmatism during routine cataract surgery. In this prospective, interventional case series, 30 toric, aspheric Bi-Flex T toric IOLs (Medicontur Medical Engineering Ltd., Inc., Zsámbék, Hungary) were implanted in 20 consecutive patients with topographic corneal astigmatism between 1.50 and 4.00 diopters (D) and evaluated within the first year after implantation. Appropriate IOL-toric alignment was facilitated by combined imaging/eye tracking technology. Postoperative evaluation included refraction and uncorrected and corrected distance visual acuities (UDVA, CDVA). For each visit, photodocumentation in retroillumination was performed to evaluate toric alignment and potential toric IOL rotation. Vector analysis of refractive astigmatism was performed using the Alpins method. At 12 months postoperatively, a reduction of the refractive astigmatism from 1.93 ± 0.90 D (range: 0.50 to 4.00 D) to 0.28 ± 0.61 D (range: 0.00 to 1.50 D) could be found, with patients achieving a mean UDVA of 0.06 ± 0.16 logMAR (range: -0.18 to 0.40 logMAR; Snellen 20/20). Intraoperative to 12-month postoperative comparison of IOL axis alignment showed low levels of rotation (0.2° ± 2.41°; range: +4° to -5°). Vector analysis showed target induced astigmatism of 0.60 D @180°, surgically induced astigmatism of 0.80 D @177°, correction index of 1.02 ± 0.25, and a difference vector of 0.30 D @82°. Implantation of the new Bi-Flex T IOL was a safe, stable, and effective method to correct preexisting regular corneal astigmatism during cataract surgery. [J Refract Surg. 2015;31(8):513-520.]. Copyright 2015, SLACK Incorporated.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 08/2015; 31(8):513-520. DOI:10.3928/1081597X-20150727-01
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    ABSTRACT: To evaluate the visual, refractive, and contrast sensitivity outcomes, as well as the level of photic phenomena, after cataract surgery with implantation of a trifocal diffractive toric intraocular lens (IOL). This prospective study included 56 eyes with corneal astigmatism of 1.00 diopters (D) or greater of 28 patients (age: 23 to 78 years) undergoing cataract surgery with implantation of the trifocal toric IOL AT LISA tri toric 939MP (Carl Zeiss Meditec, Jena, Germany). Monocular and binocular visual outcomes, refractive changes, contrast sensitivity, and photic phenomena perception (Halo & Glare Simulator; Eyeland-Design Network GmbH, Vreden, Germany) were evaluated at 3 months postoperatively. Mean 3-month postoperative monocular uncorrected distance (UDVA), intermediate (UIVA), and near (UNVA) visual acuities were 0.13 ± 0.15, 0.08 ± 0.15, and 0.13 ± 0.18 logMAR, respectively. Binocular postoperative CDVA, DCIVA, and DCNVA values were 0.10 logMAR or better in all cases. A total of 88.2%, 88.2%, and 95.5% of eyes achieved binocular UDVA, UIVA, and UNVA values of 0.20 logMAR or better, respectively. Postoperative refractive cylinder was 0.50 D or less and 1.00 D or less in 78.6% and 98.2% of eyes, respectively. Photopic contrast sensitivity was significantly better than mesopic values for the spatial frequencies of 6 (P = .007), 12 (P = .005), and 18 cycles/degree (P = .011). Mean size and intensity of halos were 50.67 ± 15.69 and 54.89 ± 17.86, respectively. Mean glare size and intensity were 39.67 ± 3.51 and 44.67 ± 15.01, respectively. The evaluated trifocal diffractive toric IOL provides an effective restoration of the distance, intermediate, and near vision after cataract surgery with good levels of visual quality and minimal photic phenomena. [J Refract Surg. 2015;31(8):504-510.]. Copyright 2015, SLACK Incorporated.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 08/2015; 31(8):504-510. DOI:10.3928/1081597X-20150622-01
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    ABSTRACT: To report a modified surgical technique as an alternative procedure for sutureless fibrin glue-assisted transscleral intraocular lens (IOL) fixation. Description of the modified surgical technique with an accompanying video. In the standard glued IOL fixation technique, the leading haptic is externalized using a forceps through the sclerotomy and an assistant holds the haptic while the second IOL haptic is bimanually externalized, using the handshake technique, through the other sclerotomy site. In the author's technique, called the suture-assisted sutureless technique, IOL haptics were tied with a looped 9-0 polypropylene suture with an attached curved needle. The suture needle was fastened to the haptic, passed through the sclerotomy site, and pulled out to externalize the haptic through the sclerotomy site. This technique is an easy, feasible, and assistant-free procedure for glued IOL implantation in aphakic eyes. [J Refract Surg. 2015;31(7):488-491.]. Copyright 2015, SLACK Incorporated.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 07/2015; 31(7):488-91. DOI:10.3928/1081597X-20150623-08
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    ABSTRACT: To evaluate changes in visual performance and ocular optical quality after implantation of a corneal hydrogel inlay as a treatment for presbyopia. A Raindrop Near Vision Inlay (ReVision Optics, Lake Forest, CA) was implanted monocularly on the stromal bed of a femtosecond laser-assisted generated corneal flap of non-dominant eyes of 22 patients with emmetropic presbyopia (preoperative spherical equivalent range: -0.50 to 1.00 diopters). Efficacy was determined by measuring near and distance visual acuities and ocular aberrations, and satisfaction was assessed by a patient questionnaire. The preoperative monocular uncorrected near visual acuity of the inlay inserted eye was 20/129 ± 1 Snellen (range: 20/135 to 20/61 Snellen) and improved to 20/35 ± 2 Snellen (range: 20/61 to 20/20 Snellen) (P < .01) at 6 months postoperatively. The monocular uncorrected distance visual acuity of the eye receiving the inlay was 20/25 ± 2 Snellen (range: 20/50 to 20/20 Snellen) preoperatively and 20/25 ± 1 Snellen (range: 20/50 to 20/20 Snellen) at 6 months postoperatively (P =.257). According to the questionnaire responses, 82% of patients were satisfied. This was despite near glasses needs remaining in 13.6% of the cohort and the presence of glare and a decrease in night vision in approximately 40% of patients. The primary spherical aberration coefficient Z4(0) changed from positive to negative values in all patients (P < .01). However, the point spread function showed no significant change. Hydrogel corneal inlays improve uncorrected near visual acuity in patients with presbyopia with only moderate effect on visual quality. However, the satisfaction with this therapy was relatively lower in these Korean patients than that reported previously in Western patients. [J Refract Surg. 2015;31(7):454-460.]. Copyright 2015, SLACK Incorporated.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 07/2015; 31(7):454-60. DOI:10.3928/1081597X-20150623-03
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    ABSTRACT: To correlate the efficacy of femtosecond laser-assisted intrastromal relaxing incisions after penetrating keratoplasty with the posterior depth of corneal incisions. Twenty eyes of 20 patients were treated for regular postoperative penetrating keratoplasty astigmatism. Sutures had been removed and refraction had stabilized. Ultrasound pachymetry was used to calculate incisional depth. Femtosecond laser-assisted paired arcuate incisions were made inside the graft stroma, leaving 90 µm of intact anterior cornea including epithelium. The intact posterior corneal margin was 10% of the measured corneal thickness for 10 patients (10% group) and 125 µm for the remaining 10 patients (125-µm group). Follow-up visits consisted of biomicroscopy, intraocular pressure measurement, fundus examination, and topographic evaluation using anterior segment optical coherence tomography at 1 and 3 months. Postoperative corneal thickness and the depth of incisions were measured with optical coherence tomography. Corrected distance visual acuity improved from 0.5 to 0.3 logMAR (Snellen: 20/63 to 20/40, P < .05) in the 10% group and remained constant in the 125-µm group. The refractive cylinder decreased by 34% in the 10% group (range: 0% to 60%), but did not change in the 125-µm group. The topographic anterior cylinder decreased in both groups by 48% (range: 0% to 67%) and 13% (range: 0% to 38%), respectively. The smaller the posterior intact corneal margin, the higher the surgically induced astigmatism (P < .05). Efficacy of femtosecond laser-assisted intrastromal relaxing incisions is correlated with the posterior depth of the incisions. The deeper incisions were more effective. [J Refract Surg. 2015;31(7):474-479.]. Copyright 2015, SLACK Incorporated.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 07/2015; 31(7):474-9. DOI:10.3928/1081597X-20150623-06
  • Journal of refractive surgery (Thorofare, N.J.: 1995) 07/2015; 31(7):493-4. DOI:10.3928/1081597X-20150623-09
  • Journal of refractive surgery (Thorofare, N.J.: 1995) 07/2015; 31(7):495. DOI:10.3928/1081597X-20150623-10
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    ABSTRACT: To evaluate the visual, refractive, and aberrometric outcomes of a bitoric intraocular lens (IOL) and its stability and alignment within the capsular bag. A retrospective study including 41 eyes of 24 patients with preexisting corneal astigmatism of 0.75 diopters or greater undergoing cataract surgery with implantation of the bitoric IOL AT TORBI 709M (Carl Zeiss Meditec, Jena, Germany). Visual and refractive outcomes were evaluated during a 3-month follow-up period. The misalignment between intended and real axis and the levels of corneal, internal, and ocular aberrations (KR-1W; Topcon, Tokyo, Japan) were also evaluated. A total of 76% and 97% of eyes had a postoperative spherical equivalent within ±0.50 and ±1.00 diopters of emmetropia, respectively. Likewise, a total of 86% and 95% of eyes had a postoperative absolute value of refractive cylinder of 0.50 or less and 1.00 or less diopters, respectively. Mean postoperative corrected distance visual acuity was 0.00 logMAR (20/20 Snellen). Mean values of postoperative monocular and binocular uncorrected distance visual acuity were 0.10 and 0.00 logMAR (20/25 and 20/20 Snellen), respectively. The aberrometric analysis confirmed that the magnitude of ocular higher-order aberrations was mainly due to corneal optics and that the corneal astigmatism correction was sufficient with the toric IOL. Mean absolute IOL misalignment was 3.5° with values ranging from 0° to 10°. The bitoric IOL AT TORBI 709M is able to provide a predictable correction of corneal astigmatism with low postoperative levels of ocular higher-order aberrations. [J Refract Surg. 2015;31(7):431-436.]. Copyright 2015, SLACK Incorporated.
    Journal of refractive surgery (Thorofare, N.J.: 1995) 07/2015; 31(7):431-436. DOI:10.3928/1081597X-20150518-11
  • Journal of refractive surgery (Thorofare, N.J.: 1995) 07/2015; 31(7):496.