Ultraviolet radiation at Mediterranean latitudes and protection efficacy of intraocular lenses.

Summary Purpose After determining the mean intensity of ultraviolet radiation to which the human eye is exposed at Mediterranean latitudes, this data is used to evaluate the efficacy of the ultraviolet filters incorporated into various intraocular lenses. Methods Ultraviolet radiation measured at Mediterranean latitudes was used as a reference for the theoretical calculation of the amount of radiation to which the human eye is exposed. The spectral transmission curve from 290 to 380 nm was measured for 10 IOLs using a UV/VIS Perkins-Elmer Lambda 800 spectrometer. Results At Mediterranean latitudes, at sea level, with a mean annual solar irradiation of 50 j/cm 2 , the human eye receives a qu…

Effect of luminance on photopic visual acuity in the presence of laser speckle

Visual acuity in coherent and incoherent light has been determined by using square-wave gratings of 100% contrast. Luminance was varied from 3 to 400 cd/m2. Coherent illumination resulted in a 40% loss of visual acuity. This is probably due to the masking effect of coherent spatial noise (speckle). However, the most interesting finding is the change in shape of the photopic visual-acuity-luminance function. With coherent illumination, the function is vertically displaced and of a different gradient. An increase in luminance produces a decrease in visual acuity. This indicates that the masking effect of the speckle is dependent on luminance. Two observers were used, and similar results were …

Effect of Color on Contrast Sensitivity with Two Different Accommodative Stimuli

We studied the influence of color and accommodation on the contrast sensitivity function (CSF). At the same time, we measured the effect of axial chromatic aberration (ACA) on the CSF. The CSF's of two observers were determined using red, green, blue, and white light, at 5- and 0.5-m viewing distances. At 5 m the CSF's were measured with natural vision and also with lenses which compensated the ACA. Results show that the effect of ACA on the CSF is to reduce the sensitivity to blue with respect to the red. The difference in sensitivity between these two colors is between 50 and 150% and varies with the frequency and the subject. When the ACA is compensated the influence of the color on the …

Optical quality of intraocular lenses after several years in the human eye

The optical quality of explanted intraocular lenses (IOLs) was analysed to verify if their quality is maintained after having been in the human eye for several years. Twenty-five explanted IOLs were studied, 10 because of intraocular luxation and 15 from corneal donors. The dioptric power and modulation transfer function (MTF) were determined to discover the image quality of the IOLs. The spectral transmission was also established to ascertain whether the filter against ultraviolet (UV) radiation was still effective. The results show that the MTF of implanted IOLs is maintained and therefore so is the image quality they provide. Only decay in the MTF of some of the explanted IOLs was observ…

Modulation transfer function: Rigid versus foldable phakic intraocular lenses

Purpose To study in a standard eye model the changes in modulation transfer function (MTF) of a monofocal intraocular lens (IOL) when a phakic IOL (pIOL) is placed in the anterior chamber, compare the MTFs of the rigid Artisan pIOL and foldable Artiflex pIOL, and evaluate the temporal evolution of the MTF of the foldable pIOL after the mechanical stress the pIOL undergoes when injected. Setting Fundacion Oftalmologica del Mediterraneo, Valencia, Spain. Methods The MTF values of the IOLs were calculated from the cross-line spread function recorded with the Opal Vector System. The measurements were taken using an eye model following the British and EN-ISO standards with 2.0 mm, 3.0 mm, 4.0 mm…

Imaging Quality of Bifocal Piggyback Intraocular Lens versus ReSTOR and TECNIS Multifocal Lenses

Purpose The imaging quality provided by a piggyback integrated by a monofocal intraocular lens (IOL) + a bifocal IOL of zero power and +3.75 diopters of addition is compared with the optics quality of a simple multifocal IOL of the same power and addition. Methods The imaging quality was evaluated by determining the modulation transfer function (MTF), using an artificial eye simulating in vivo conditions of the anterior chamber, including an artificial cornea and a wet cell containing physiologic solution where the IOL was positioned. The MTFs of the bifocal piggyback for near and distance vision were measured, with pupil diameters of 3 and 5 mm, and compared with the MTFs of an equivalent …

ATD perimetry in glaucoma and ocular hypertensive patients. A preliminar study

Purpose: The new ATD perimetry assesses contrast sentivity thresholds for the three afferent sensory pathways of the visual system. Our aim is to compare contrast sensitivity to stimuli with different spatio-temporal frequencies in glaucomatous (G) and ocular hypertensive (OHT) subjects. Methods: Twenty three G and OHT subjects were selected from the ophthalmic clinic, all subjects signed an informed consent. Inclusion criteria were diagnosis of G or OHT, normal Farnsworth-Munsell color test, ametropia less than 6 D, visual acuity over 20/30, absence of previous ocular surgery and experience in perimetry. Twenty locations and the fovea were evaluated in a 60o x 40o fovea-centered field. Eig…

Lens Opacities in Valencia, Spain

Purpose. To evaluate the most common lens opacities in Valencia (Spain), analyzed by gender, grade, and type of cataracts. The results are compared with other studies performed at other geographical latitudes and on different races. Methods. A total of 1951 eyes of patients diagnosed with cataracts, aged between 30 and 96 years, were evaluated in accordance with age, gender, type and degree of the cataract, bilaterality and symmetry of this disease. Lens Opacities Classification System III was used to classify the cataract and the degree was graded as mild or moderate to advanced. Results. The most common type of cataract is corticonuclear in the elderly and subcapsular in younger subjects.…

Correlation between optics quality of multifocal intraocular lenses and visual acuity

Purpose To study the relationship between the optics quality of multifocal intraocular lenses (IOLs) and distance-corrected near, intermediate, and distance visual acuity to determine the degree to which optics quality must change to produce a significant difference in visual acuity. Setting Fundacion Oftalmologica del Mediterraneo, Valencia, Spain. Methods Monocular distance-corrected visual acuity (decimal and logMAR) was measured at 4 m, 70 cm, and 30 cm under photopic and mesopic conditions in eyes with 1 of 3 multifocal IOL models. Visual acuity versus the “average modulation” of the IOL was assessed. Results The pupil diameter and patient age were similar between the 3 IOL groups (20 …

Spectral Transmission of the Human Crystalline Lens in Adult and Elderly Persons: Color and Total Transmission of Visible Light

Purpose To experimentally measure the spectral transmission of human crystalline lenses belonging to adult and elderly persons, and to determine the color and total transmission of visible light of such crystalline lenses. Methods The spectral transmission curve of 32 human crystalline lenses was measured using a PerkinElmer 800UV/VIS spectrometer. Total transmission of visible light and the chromatic coordinates of these crystalline lenses were determined from these curves for solar illumination. Results The crystalline lens that filters UV and its transmission in the visible spectrum decreases with age; such a decrease is greater for short wavelengths. The total transmission of visible li…

Influence of optic quality on contrast sensitivity and visual acuity in eyes with a rigid or flexible phakic intraocular lens

Purpose To determine whether the difference in optic quality between 2 types of phakic intraocular lenses (pIOLs) affects visual quality. Setting Fundacion Oftalmologica del Mediterraneo, Valencia, Spain. Methods Before implantation of a pIOL for myopia, all eyes had an examination including corrected (CDVA) and uncorrected (UDVA) distance visual acuity testing, corneal endothelial cell count (ECC), and intraocular pressure (IOP) measurement. The postoperative outcomes, determined at least 1 year after surgery, were CDVA; UDVA; contrast sensitivity function under photopic, mesopic, and mesopic with glare conditions; ECC; IOP; keratometry (Scheimpflug photography); and total ocular aberratio…

Image quality with multifocal intraocular lenses and the effect of pupil size

Purpose To analyze the image quality with a refractive and 2 hybrid refractive–diffractive multifocal intraocular lenses (IOLs) in vitro to determine the IOL modulation transfer function (MTF) following the EN-ISO international standard for distance and near vision and to study the IOLs' behavior with different pupil sizes. Setting Fundacion Oftalmologica del Mediterraneo, Valencia, Spain. Methods This study evaluated 4 IOLs: the hybrid refractive–diffractive AcrySof ReSTOR SN60D3 (Alcon) and Tecnis ZM900 (AMO), the refractive ReZoom NXG (AMO), and the monofocal AcrySof SN60WF (Alcon). The MTF was calculated from the cross-line spread function recorded with the OPAL Vector System (Image Sci…

Characterization of the human visual system threshold performance by a weighting function in the Gabor domain

Abstract As evidenced by many physiological and psychophysical reports, the receptive fields of the first-stage set of mechanisms of the visual process fit to two-dimensional (2D) compactly supported harmonic functions. The application of this set of band-pass filter functions to the input signal implies that the visual system carries out some kind of conjoint space/spatial frequency transform. Assuming that a conjoint transform is carried out, we present in this paper a new characterization of the visual system performance by means of a weighting function in the conjoint domain. We have called this weighting function (in the particular case of the Gabor transform) the Gabor stimuli Sensiti…

Influence of the contrast sensitivity function on the reaction time

The reaction time (RT) vs spatial frequency (SF) curve is determined, using gratings from 1 to 40 c/deg, at seven different contrast levels between 0.95 and 0.02. The form of the RT/SF function: (a) replicated the inverse of the contrast sensitivity function (CSF) at near threshold contrast levels; (b) behaved differently at higher contrasts, exhibiting two branches at contrast close to 1. The interpretation is that there are two factors determining this function: (1) the transition from the operation of fast transient channels at low SF to the operation of slow sustained channels at high SF, the transition taking place within a narrow SF band close to 6 or 8 c/deg (depending on the subject…

Residual astigmatism produced by toric intraocular lens rotation.

Purpose To analyze changes in the eye’s refractive properties when a toric intraocular lens (IOL) rotates. Setting Fundacion Oftalmologica del Mediterraneo, Valencia, Spain. Design Experimental study. Methods The matrix definition of astigmatism was used in this theoretical study and compared with another vector representation. Two methods were compared: (1) The cylinder, C, resulting from the addition of 2 cylinders C1 and C2 whose axes form an angle a, is obtained by the addition of 2 vectors of values C1 and C2 forming an angle 2a; (2) the power matrix, F, of a thin astigmatic dioptric system that decomposes naturally into 3 orthogonal components: the purely spherical part Fnes, the orth…

Effect of the color of the intraocular lens on optical and visual quality

Purpose: To analyze the optical quality of intraocular lenses (IOL) with an orange (PC440Y) and a yellow (SN60AT) filter, and correlate these results with the visual quality of patients with these implants. Setting: Fisabio Oftalmología Médica, Valencia, Spain. Design: Randomized prospective study. Materials and Methods: The IOL optical quality was determined using the modulation transfer function (MTF) and the spectral transmission. The visual quality of 87 eyes with cataract (51 with orange filter and 36 with yellow filter) was determined by best corrected visual acuity (BCVA) and contrast sensitivity function (CSF) under photopic and mesopic conditions. To analyze the results, we use a S…

Contrast sensitivity of the visual system in speckle imagery

The contrast sensitivity function (CSF) of the whole visual system is determined with the use of coherent diffuse illumination. This function provides supplementary data about the effect of speckle on the ability of the visual system to perceive the spatial information contained in an image. The results show that speckle not only prevents perception of the finest details (highest frequencies) but also reduces the visibility of lower frequencies (especially where contrast is low). The difference between the CSF's determined with and without speckle is quantitatively very important. And the ratio between the two CSF's is a measure of the retinal ability to perceive contrast in the presence of…

Spectral Transmittance of Intraocular Lenses under Natural and Artificial Illumination

Purpose To compare the spectral transmission of different intraocular lenses (IOLs) with either ultraviolet (UV) or blue-light filters, and to analyze the performance of these filters with artificial light sources as well as sunlight. Design Experimental study. Methods The spectral transmission curve of 10 IOLs was measured using a PerkinElmer Lambda 800 UV/VIS spectrometer (Waltham, MA). Different filtering simulations were performed using the D65 standard illuminant as daylight and standard incandescent lamp and fluorescent bulb illuminants. Main Outcomes Measures Spectral transmittance of the IOLs. Results All the IOLs studied provide good UVC (200–280 nm) and UVB (280–315 nm) protection…

Human contrast sensitivity in coherent Maxwellian view: effect of coherent noise and comparison with speckle.

Lasers have been used in vision for measuring the neural contrast sensitivity function (CSF) by forming interference fringes on the retina. We distinguish among three kinds of illumination with lasers: incoherent (without noise), Maxwellian or coherent (with coherent noise), and diffuse coherent (with speckle). The three have different characteristics and different CSF's. A coherent imaging system is designed to measure the CSF with fully coherent illumination. This is the CSF of the whole visual system, although it is measured with gratings imaged on the retina. It therefore differs from the neural CSF's measured by other authors with partially coherent illumination. However, the neural CS…

Brightness induction in a chromatic center?achromatic surround configuration

Evaluation of the performance of multifocal intraocular lenses image quality: analysis of the standard methods

Purpose: To analyze the standard methods used to describe intraocular lenses (IOL) and to suggest some improvements to make them applicable for multifocal IOLs. Methods: The EN-ISO standards and the standards of the American National Standards Institute (ANSI) for the evaluation of the performance of IOLs are tested for multifocal IOLs. The MTF of the one refractive multifocal IOL and two hybrid refractive-diffractive multifocal IOLs is measured for both distance focus and near focus and using different pupil sizes. Results: The average modulation (AM) from 0 to 100 c/mm of multifocal IOLs (for the distance focus) is about 40-50% lower than the AM of monofocal IOLs, for all pupil sizes stud…

Customized intraocular telescope implanted in high myopic patients with advanced maculopathy

Purpose To evaluate the results of intraocular personalized telescope implantation to improve distance best corrected visual acuity (BCVA) in high myopic patients having cataract surgery. Methods This prospective non randomized observational study included 16 eyes of 9 consecutive patients with advanced maculopathy associate to high myopia having cataract surgery. Bilateral implantation of the intraocular telescope was performed after phacoemulsification in patients having the requisites. The telescope consists of two lenses a positive high power lens is implanted in the anterior chamber and a negative one is implanted in the posterior chamber. The lenses power, magnification and residual r…

Spectral transmission of the pig lens: Effect of ultraviolet A+B radiation

Summary Objective To determine the spectral transmission curve of the crystalline lens of the pig. To analyse how this curve changes when the crystalline lens is irradiated with ultraviolet A + B radiation similar to that of the sun. To compare these results with literature data from the human crystalline lens. Procedures We used crystalline lenses of the common pig from a slaughterhouse, i.e. genetically similar pigs, fed with the same diet, and slaughtered at six months old. Spectral transmission was measured with a Perkin-Elmer Lambda 35 UV/VIS spectrometer. The lenses were irradiated using an Asahi Spectra Lax-C100 ultraviolet source, which made it possible to select the spectral emissi…

Influence of the gaze-stabilizing eye movements on the quality of the retinal image of the human eye

In this work we have studied the influence of the gaze stabilizing movements of the eye on the quality of the retinal image of the human eye obtained by double pass methods. The results obtained agree with the expected differences between the coherent and incoherent behaviour of the optical system of the eye. The movements-free retinal image is obtained from a typical retinal image by considering a filter function in the frequency domain which characterizes the effect of the considered movements.

Implementations of a novel algorithm for colour constancy

AbstractIn agreement with the principles of the relativistic model proposed by Creutzfeldtet al., with the photometric rule (lightness anchoring rule) and with the influence of simultaneous contrast in the appearance of a visual scene, we propose a first-stage mechanism yielding substantial colour constancy. We have defined a set of first-stage colour descriptors, and to test their utility, we have performed a simulation using a Machine Vision System (MVS). The statistical stability of the descriptors for Munsell samples under different illuminants is good.

Multichannel functional testing in normal subjects, glaucoma suspects, and glaucoma patients

Purpose.: To evaluate visual function with a novel multichannel functional test named the ATD Multichannel Functional Test. Methods.: This multicenter study had a prospective and cross-sectional design. A total of 186 eyes were included: 42 with glaucoma, 14 glaucoma suspects due to optic nerve characteristics, 25 ocular hypertensives, and 105 normal eyes. All patients performed standard visual fields (Humphrey 24-2) and ATD with eight stimuli configurations: four achromatic (A), two red-green (T), and two blue-yellow (D). To derive main outcome measures, mean sensitivity, mean defect (MD), and pattern standard deviation (PSD) were calculated and compared among groups and types of stimuli w…

Sequential visual reaction times

The reaction-time to a series of successive digits was measured on two subjects. After practice, it was found that whilst the reaction time to the onset of the series was constant at 150 ms, the response time to additional digits became less and less to asymptote to a level of about 50 ms. The time course of this ‘chorus-line’ phenomenon was studied in greater temporal detail by varying the interval in steps of 20 ms. The effect was greatest at 200 ms. Thereafter, it declined and for long intervals reached the value of a standard reaction time. On a third inexperienced subject, the learning period was established; this was about 300–400 presentations. The implications of these findings are …

Magnification of the retinal image through an intraocular Galilean telescope

The intraocular Galilean telescope is a good solution for incrementing the visual capabilities of patients with age-related macular degeneration. Nevertheless, some problems arise with the use of the intraocular telescopes available at present; these problems are originated by two main factors: the use of the same power values for the lenses in all types of eyes and the fact that the values of the distance between lenses into the eye are not the most suitable ones. As a result, a high residual refraction is produced in many implanted eyes. We propose a method for predicting outcomes in order to select patients for this technique and, moreover, for choosing the optimum power for the positive…

Modulation transfer function in refractive-diffractive multifocal intraocular lenses in vitro

Purpose: The optical quality of two types of multifocal, hybrid refractive-diffractive, intraocular lenses (IOL) is analyzed in vitro. Following the EN-ISO international standard, the IOLs’ modulation transfer functions (MTF) are determined for both distance and near vision. The behaviour of these curves when the pupil size varies is studied. Methods: The IOLs analyzed were: AcrySoft ResTor SN60D3 (Alcon) and Tecnis ZM900 (AMO). The MTF was calculated from the cross line-spread function recorded with the OPAL Vector System (Image Science Ltd. Oxford) by using fast Fourier transform techniques. The artificial eye model used simulates in vivo conditions of the anterior chamber including an ar…

A simple description of age-related changes in crystalline lens thickness.

Purpose An increase in lens thickness is often described as a linear function of age. However, contradictory opinions exist about whether the lens thickness continues to increase after 50 years of age. Differences in slope exist between this increase in younger and older people, but these findings are inconsistent with the linear behavior of an increase in the lens thickness throughout life. We investigated among different functions, including slope variation, which would be the best to show the relation between lens thickness and age. An available model portraying lens growth could be advantageous in many practical applications. The possibility of differences between sexes in lens thicknes…

Are Ocular Response Analyzer useful to measure corneal hysteresis in patients with intracorneal rings?

Purpose Corneal hysteresis is a viscoelastic property characterized by the difference in behavior under loading and unloading. The aim of the study was to determine corneal hysteresis in different eyes: healthy eyes, keratoconic eyes and keratoconic eyes after intracorneal ring implants. Methods This study comprised 95 eyes of 59 patients. The study population was divided into 3 groups. We analyze 30 healthy human eyes, 35 keratoconic eyes (Amsler grade II-III) and 30 keratoconic eyes after intracorneal rings implantation. Corneal biomechanical properties of these eyes were measured with the Ocular Response Analyser (ORA-Reichert) according to two parameters: corneal hysteresis (CH) and cor…

Clinical magnification and residual refraction after implantation of a double intraocular lens system in patients with macular degeneration

Purpose To evaluate the efficacy of a standard double intraocular lens (IOL) system (IOL-Vip) in patients with low vision and central scotoma due to macular degeneration and assess the predictability of the residual refraction and magnification. Setting Ophthalmology Department, Hospital General Universitario, Valencia, Spain. Methods This interventional prospective noncomparative case series comprised 13 consecutive surgical procedures in 10 patients with central scotoma. Follow-up was 12 months. Evaluation included the difference between preoperative and postoperative best corrected visual acuity (BCVA), refraction, position of the IOLs, endothelial cell density, and occurrence of postope…

Determination of scattering in intraocular lenses by spectrophotometric measurements.

This study presents a method for measuring scattering in explanted intraocular lenses (IOLs). Currently, determining scattering in IOLs is usually performed by Scheimpflug cameras and the results are expressed in the units used by this apparatus. The method we propose uses a spectrophotometer and this makes it possible to measure the total transmission of the IOL by using an integrating sphere; the direct transmission is determined by the double-beam mode. The difference between these two transmissions gives a value of the scattering in percentage values of light lost. In addition, by obtaining the spectral transmission curve, information about the most scattered wavelengths is also obtaine…

Modulation transfer function of a toric intraocular lens: evaluation of the changes produced by rotation and tilt.

PURPOSE: To evaluate the changes in optical quality when toric intraocular lenses (IOL) are rotated or tilted and to demonstrate that IOL rotation produces an increasing effect of aberrations. METHODS: Modulation transfer function (MTF) and average modulation were used to analyze the image quality of a toric IOL. The axis of the toric IOL was rotated 5°, 10°, 15°, 20°, 25°, and 30° in successive MTF measurements. The tilt values were 0° to 5°, in increments of 1°, plus a tilt of 15°. Pupil diameters of 3 and 5 mm were used. RESULTS: The MTF decay due to aberrations was more sensitive to rotation than tilt. The main decrement in the average modulation, of approximately 50% in both pupils, o…

Optical analysis to predict outcomes after implantation of a double intraocular lens magnification device.

Purpose To analyze the effect of different optical parameters of the eye on the outcomes of implantation of a double intraocular lens (IOL) magnification device in patients with low vision. Setting Fundacion Oftalmologica del Mediterraneo, Valencia, Spain. Methods The eye's refraction and magnification before and after surgery were evaluated using a theoretical eye model based on paraxial optics approximation. Four parameters on which refraction and magnification are dependent were evaluated: anterior chamber depth (ACD), axial length (AL), mean keratometry (Km), and the distance between the 2 implanted IOLs. The 4 variables were analyzed separately in the first stage. Next, different combi…

Influence of the type of illumination on the measurement of the modulation transfer function in the living human eye: A theoretical study

Abstract Applications such as refractive surgery demand an objective appraisal of the retinal image quality. The modulation transfer function (MTF) provides that information when measured directly. Moreover, the MTF obtained using a simple and objective method such as that described in this paper allows the neural contrast sensitivity function (CSF) to be obtained from the global CSF and the MTF. When calculating the MTF it must be borne in mind whether the applicable theory is coherent or incoherent. In the literature, the developed theory presents some approximations and incongruities. Also, it is interesting to note that the method of recording the MTF (short or long time of integration,…