Clinical use of the ocular point spread function for retinal image quality assessment

The purpose of this study is to demonstrate the clinical use of the point spread function (PSF) as metric for the assessment of retinal image quality in eyes with different ocular conditions. The PSF was computed from the wavefront aberrations obtained in seven eyes with different ocular conditions: emmetropia, myopia, hyperopia, post-myopic laser in situ keratomileusis (LASIK), post-hyperopic LASIK, keratoconus, Intacs ® in keratoconus, radial keratotomy (RK), LASIK after RK, cataract, phacoemulsification after cataract surgery, and LASIK after astigmatic keratotomy. The Strehl intensity ratio was calculated for all the PSFs computed. The PSF was correlated with the change in the optical e…

Amplitude, Latency, and Peak Velocity in Accommodation and Disaccommodation Dynamics

The aim of this work was to ascertain whether there are differences in amplitude, latency, and peak velocity of accommodation and disaccommodation responses when different analysis strategies are used to compute them, such as fitting different functions to the responses or for smoothing them prior to computing the parameters. Accommodation and disaccommodation responses from four subjects to pulse changes in demand were recorded by means of aberrometry. Three different strategies were followed to analyze such responses: fitting an exponential function to the experimental data; fitting a Boltzmann sigmoid function to the data; and smoothing the data. Amplitude, latency, and peak velocity of …

Lens-vault analysis and its correlation with other biometric parameters using swept-source OCT

Purpose To measure lens vault (LV) and to assess its correlation with various ocular parameters in healthy eyes, using for all measurements the same high-resolution swept-source optical coherence tomographer (SS-OCT). Methods We prospectively recruited 67 Caucasian healthy patients whose mean age was 41.9 ± 12.4 years; only their right eye was included in the study. Data were all recorded with the ANTERION SS-OCT and comprised, for each patient, 5 consecutive measurements of LV, anterior chamber depth (ACD), lens thickness (LT), axial length (AL), white-to-white (WTW) distance, central corneal thickness (CCT), anterior chamber volume (ACV) and spur-to-spur (STS) distance. Results Mean LV wa…

Evaluation of the iridocorneal angle with accommodation using optical coherence tomography

The changes in the iridocorneal angle structure during accommodation are assessed by means of anterior segment optical coherence tomography. Thirteen right eyes were included in the study. The device used for the measurement was the Visante® omni system. The stimuli were set up at different vergences (0.0 D, -1.5 D, and -3.0 D). The angle opening distance 500 and 750, the trabecular iris space area 500 and 750, and the scleral spur angle parameters were assessed at the nasal and temporal regions. The results in the iridotrabecular angle comparing the three accommodative states of the eye did not yield any statistically significant difference at nasal or temporal angle sections. In light of …

Optical and visual quality comparison of implantable Collamer lens and laser in situ keratomileusis for myopia using an adaptive optics visual simulator.

Purpose. To compare optical and visual quality of the implantable Collamer lens (ICL) and laser in situ keratomileusis (LASIK) for myopia. Methods. An adaptive optics visual simulator (CRX1, Imagine Eyes, France) was used to simulate the vision after ICL implantation and LASIK procedure from the wavefront aberration pattern for -3 and -6 D. Monocular visual acuity (VA) at different contrasts and contrast sensitivity (CS) at 10, 20, and 25 cycles/degree (cpd) were measured for 3- and 5-mm pupils. Modulation transfer function (MTF) and point spread function (PSF) were calculated for a 5-mm pupil. Results. The ICL showed a MTF near of diffraction-limited MTF, but the post-LASIK of MTF worsened…

Foldable toric intraocular lens for astigmatism correction in cataract patients.

PURPOSE: To evaluate the results of AcrySof toric intraocular lens (IOL) (Alcon) implantation to correct preexisting astigmatism in patients having cataract surgery. SETTING: Ophthalmology Service, Donostia Hospital, San Sebastian, Spain. METHODS: This prospective observational study included 30 eyes of 15 consecutive patients with more than 1.00 diopter (D) of preexisting corneal astigmatism having cataract surgery. Bilateral implantation of the AcrySof toric IOL was performed after phacoemulsification. The uncorrected visual acuity (UCVA), best corrected visual acuity (BCVA), residual refractive sphere, residual keratometric and refractive cylinders, and toric IOL axis were measured. RESU…

Effect of Phenylephrine on the Accommodative System

Accommodation is controlled by the action of the ciliary muscle and mediated primarily by parasympathetic input through postganglionic fibers that originate from neurons in the ciliary and pterygopalatine ganglia. During accommodation the pupil constricts to increase the depth of focus of the eye and improve retinal image quality. Researchers have traditionally faced the challenge of measuring the accommodative properties of the eye through a small pupil and thus have relied on pharmacological agents to dilate the pupil. Achieving pupil dilation (mydriasis) without affecting the accommodative ability of the eye (cycloplegia) could be useful in many clinical and research contexts. Phenylephr…

Accommodative Stimulus-Response Curve with Emoji Symbols

Purpose. To evaluate the static measurement of the accommodative stimulus-response curve with emoji symbols. Methods. The accommodative stimulus-response curve was measured in 18 subjects using a Hartmann-Shack sensor to obtain the objective accommodative response from the Zernike defocus term. Measurements were acquired at different accommodative demands, from 0 to 3 D with a step of 0.5 D. Detailed and nondetailed emoji targets were used with two different sizes, corresponding to the two most common visual angles used in smartphones. Results. A regression analysis was performed to fit the mean results obtained for each target. The determination coefficient was R2≥0.988 for all targets. Fo…

Intraocular lens centration and stability: efficacy of current technique and technology

Purpose of review The manuscript presents a review of recently published studies analyzing different methodologies to assess centration and stability of intraocular lenses after implantation. Recent findings Considering that there is no current gold standard for centration and stability of intraocular lenses after implantation, we have summarized the different techniques used clinically for intraocular lenses centration and stability estimation. We have described the use of Scheimpflug imaging, the anterior segment optical coherence tomography and photography analysis used for lens position estimation. Techniques used to assess lens rotation are based on image analysis on digital retroillum…

Visual Comparison of an Artificial Pupil Contact Lens to Monovision

PURPOSE To assess and compare the effects of contact-lens based artificial pupil design and monovision correction on visual performance. METHODS In a cross-over study design, 22 presbyopic patients (age range 50 to 64 years) were evaluated using artificial pupil contact lens on the non-dominant eye and monovision. After 1 month, binocular distance visual acuity (BDVA), binocular near visual acuity (BNVA), defocus curve, binocular distance contrast sensitivity, binocular near contrast sensitivity, and stereoacuity were measured, under photopic conditions (85 cd/m2), in each patient after contact lens fitting. Moreover, BDVA and binocular distance contrast sensitivity were examined under meso…

Refractive lens exchange with a multifocal diffractive aspheric intraocular lens

PURPOSE: To evaluate the safety, efficacy and predictability after refractive lens exchange with multifocal diffractive aspheric intraocular lens implantation. METHODS: Sixty eyes of 30 patients underwent bilateral implantation with AcrySof® ReSTOR® SN6AD3 intraocular lens with +4.00 D near addition. Patients were divided into myopic and hyperopic groups. Monocular best corrected visual acuity at distance and near and monocular uncorrected visual acuity at distance and near were measured before and 6 months postoperatively. RESULTS: After surgery, uncorrected visual acuity was 0.08 ± 0.15 and 0.11 ± 0.14 logMAR for the myopic and hyperopic groups, respectively (50% and 46.67% of patients ha…

Optical quality of hyperopic and myopic phakic intraocular lenses

Aims: To assess and compare the optical quality of the myopic and hyperopic implantable collamer lens (ICL) from its wavefront aberrations for different powers and pupil diameters. Settings and Design: Prospective study. Material and Methods: The wavefront aberrations of two myopic (−3 and −6 diopters (D)) and two hyperopic V4b ICLs (+3 and +6D) were measured in vitro . To assess and compare the optical quality of different powers of ICLs, we analyzed the root mean square (RMS) of total higher order aberrations (HOAs), trefoil, coma, tetrafoil, secondary astigmatism, and spherical aberration at 3- and 4.5-mm pupil. In addition, the point spread functions (PSFs) of each ICL evaluated were ca…

The tear film and the optical quality of the eye

The stability of the tear film plays an important role in the optical quality of the eye. Various methods have been developed to quantify the contribution of the tear film to optical quality, including the double-pass optical method, Hartmann-Shack wavefront sensing, videokeratoscopy, retroillumination analysis, and interferometry. In addition to assessing the effect of tear film irregularities, these methods can aid in the diagnosis of dry-eye related conditions and the monitoring of therapy. This review describes the methodologies used to assess the relationship between the tear film and optical quality of the eye and summarizes the most important findings obtained with these methods with…

Clear Lens Extraction with Multifocal Apodized Diffractive Intraocular Lens Implantation

Purpose To assess efficacy, safety, predictability, and stability after clear lens extraction (CLE) with multifocal diffractive intraocular lens (IOL) implantation. Design Prospective, nonrandomized, masked observational case series (self-controlled). Participants Two hundred twenty-four eyes of 112 consecutive patients after CLE with bilateral AcrySof ReSTOR Natural IOL implantation. Eyes were divided into myopic (mean spherical equivalent [SE], −6.01±2.71 diopters [D]) and hyperopic (mean SE, +3.86±2.52 D) groups. Methods Monocular and binocular uncorrected distance visual acuity (VA), best-corrected distance VA, uncorrected distance near VA, and best distance-corrected near VA were recor…

Efficacy and Safety of Mass Cataract Surgery Campaign in a Developing Country

To determine the visual outcomes achieved in terms of efficacy and safety during a mass eye surgery campaign in a low-income developing country.Three hundred fifteen eyes of 305 patients underwent extracapsular cataract extraction with intraocular lens implantation in a prospective, analytical, experimental, and nonrandomized study on patients who underwent cataract surgery during the campaign that two Spanish nongovernmental organizations conducted in December 2008 in a district hospital in Bobo-Dioulasso (Burkina Faso).Mean age was 61.97 ± 14.39 years. The mean uncorrected distance visual acuity before surgery was 2.17 ± 0.7 (20/3000), which improved to 0.86 ± 0.64 logMAR (20/150) 3 month…

Agreement between 2 swept-source OCT biometers and a Scheimpflug partial coherence interferometer

PURPOSE To evaluate the agreement between different parameters obtained with 2 swept-source optical coherence tomography (SS-OCT)-based biometers and 1 Scheimpflug camera with partial coherence interferometry (PCI). SETTING Single center, Oftalvist, Alicante, Spain. DESIGN Prospective case series. METHODS Biometry was performed in 49 eyes using 3 optical biometers: ANTERION SS-OCT, IOLMaster 700 SS-OCT, and Pentacam AXL PCI. Keratometry (K), J0 and J45 vectors, anterior chamber depth (ACD), central corneal thickness (CCT), white-to-white (WTW), lens thickness (LT), and axial length (AL) were measured with each device. Bland-Altman analysis was applied. RESULTS This study comprises 49 eyes o…

Evaluation of Physiological Parameters on Discomfort Glare Thresholds Using LUMIZ 100 Tool

Purpose To assess the links between discomfort glare sensitivity and physiological factors such as eye biometry, refraction, skin phototype, age, and gender among a large sample of healthy human subjects. Methods A total of 489 participants who were 20 to 70 years old (241 men, 248 women) underwent discomfort glare threshold measurements via the LUMIZ 100. Eye biometry and optical quality were measured using a Zeiss IOLMaster 700 biometer and i.Profiler aberrometer. Iris color, skin tone, age, gender, eyeglasses use, chronotype, fatigue level, self-evaluation of light sensitivity, and time spent outdoors were determined. Statistical analysis was carried out using nonparametric Mann–Whitney …

Avaliação por OCT in vivo do comprimentos axiais centrais do segmento anterior

ABSTRACT Purpose: To assess changes in anatomic structures in the anterior eye segment in terms of axial lengths with accommodation via optical coherence tomography. Methods: In this observational study, 25 eyes of 25 healthy adults were examined using the Visante® omni optical coherence tomography system. Central corneal thickness, anterior chamber depth, central lens thickness, and anterior segment length were assessed. The evaluated parameters were obtained with accommodation using different stimulus vergences, namely 0.0, -1.0, -2.0, and -3.0 D. Variation of these parameters was compared among different levels of accommodation. Results: Central corneal thickness was not altered at any s…

Accommodation Responds to Optical Vergence and Not Defocus Blur Alone.

Purpose To determine whether changes in wavefront spherical curvature (optical vergence) are a directional cue for accommodation. Methods Nine subjects participated in this experiment. The accommodation response to a monochromatic target was measured continuously with a custom-made adaptive optics system while astigmatism and higher-order aberrations were corrected in real time. There were two experimental open-loop conditions: vergence-driven condition, where the deformable mirror provided sinusoidal changes in defocus at the retina between -1 and +1 diopters (D) at 0.2 Hz; and blur-driven condition, in which the level of defocus at the retina was always 0 D, but a sinusoidal defocus blur …

Optical and Visual Quality of the Visian Implantable Collamer Lens Using an Adaptive-Optics Visual Simulator

To evaluate visual and optical quality of the implantable collamer lens for different powers and sizes of incision surgery.Prospective study in humans.An adaptive optics visual simulator was used to measure 3 powers of implantable collamer lenses and simulate the implantable collamer lens wavefront aberration's pattern for small- and large-incision surgery. Visual acuity (VA) and contrast sensitivity were measured in 11 observers for 3- and 5-mm pupils. Modulation transfer function, point spread function, and Strehl ratio were calculated.At 3 mm pupil, no statistically significant differences were found between both incision sizes for any implantable collamer lens power, except for -15 diop…

Accommodative Functions with Multifocal Contact Lenses: A Pilot Study

PURPOSE: To evaluate accommodative response and facility in presbyopic patients fitted with several types of simultaneous-image multifocal contact lenses (CLs). METHODS: Six presbyopic patients, unadapted wearers of simultaneous-image bifocals, were fitted with the Focus Progressives and the low- and high-addition Pure Vision simultaneous vision multifocal CLs. Each individual wore each of the three types of lenses in successive random order. Accommodative response, accommodative facility, visual acuity, and contrast sensitivity at distance and near were evaluated in all cases. A control group of eight non-presbyopic patients was also studied. RESULTS: The mean age was 28.6 +/- 2.72 and 51.…

Changes in accommodative responses with multifocal contact lenses: a pilot study.

Our aim was to evaluate induced changes in pupil and accommodative response for different accommodative stimuli with three different multifocal contact lenses (CLs). Accommodative and pupil responses with three aspheric multifocal CLs of simultaneous focus center near (PureVision Low Add, PureVision High Add and Focus Progressives) for two accommodative stimuli of -2.5 and -4.00 D were recorded in 10 young subjects. Accommodative response, peak velocity, and time constant of accommodation and pupil constriction were assessed. The measurements were evaluated in all the participants with distance-single vision CLs and with the three multifocal CLs. The monocular measurements were performed in…

In vitro optical performance of a new aberration-free intraocular lens

To assess the optical performance of the new EnVista intraocular lens (IOL). Four aspheric IOLs were evaluated; the new EnVista is one amoung them. This IOL, similarly to the Z-Flex HB and the Bi-Flex 1.8 667AB ones, has a neutral aspheric design, whereas the fourth IOL under test (AcrySof IQ IOL SN60WF) presents a negative spherical aberration (SA). The IOL’s aberration patterns were measured in vitro, by setting them up on an optical bench. From these aberration-pattern data, the modulation transfer function (MTF), the average modulation values, and the points spread function (PSF) were calculated. Furthermore, in order to assess the potential optical quality that these IOLs would yield o…

There is more to accommodation of the eye than simply minimizing retinal blur

Eyes of children and young adults change their optical power to focus nearby objects at the retina. But does accommodation function by trial and error to minimize blur and maximize contrast as is generally accepted? Three experiments in monocular and monochromatic vision were performed under two conditions while aberrations were being corrected. In the first condition, feedback was available to the eye from both optical vergence and optical blur. In the second, feedback was only available from target blur. Accommodation was less precise for the second condition, suggesting that it is more than a trial-and-error function. Optical vergence itself seems to be an important cue for accommodation.

Refractive lens exchange with the Acri. Twin asymmetric diffractive bifocal intraocular lens system

PURPOSE To evaluate efficacy, safety, and predictability after refractive lens exchange (RLE) in patients who had implantation of asymmetric Acri.Twin bifocal diffractive intraocular lenses. METHODS The study comprised 130 eyes of 65 consecutive patients after RLE who had bilateral implantation of the Acri.Twin system. Eyes were divided into myopic and hyperopic groups. Binocular uncorrected distance visual acuity, best-corrected distance visual acuity (BCVA), uncorrected distance near visual acuity, and best distance-corrected near visual acuity (BCNVA) were recorded preoperatively and 6 months after surgery. RESULTS Efficacy indexes were 0.99 for myopic and 0.93 for hyperopic patients at …

Depth-of-Field of the Accommodating Eye

Our eyes project information from a three-dimensional world to a basically two-dimensional surface, corresponding to the photoreceptor plane in the retina. In theory, only one plane or surface of world can be in focus at one time. However, the eye exhibits a certain tolerance to out-of-focus images, a feature that is known as depth-of-focus (DOF). The corresponding distance range in which the objects are seen “clearly” is known as depth-of-field (DOFi). Although DOF and DOFi refer to an interval of distances or a dioptric range in the image and object space, respectively, both parameters define a similar concept and are usually interchangeable. This article will mainly refer to DOFi because…

Prospective visual evaluation of apodized diffractive intraocular lenses

To evaluate distance, intermediate, and near visual performance in patients who had multifocal apodized diffractive intraocular lens (IOL) implantation.Fernández-Vega Ophthalmological Institute, Oviedo, Spain.The best corrected distance visual acuity, best distance-corrected near visual acuity, intermediate visual acuity, distance contrast sensitivity under photopic and mesopic conditions, and patient satisfaction were measured in 325 patients and 335 patients who had bilateral implantation of the model SA60D3 IOL (AcrySof ReSTOR, Alcon) and model SN60D3 IOL (AcrySof Natural ReSTOR), respectively.At the 6-month postoperative visit, binocular best corrected distance acuity with the ReSTOR IO…

Choice of spatial frequency for contrast sensitivity evaluation after corneal refractive surgery.

ABSTRACT PURPOSE: To study the utility of measurements of contrast sensitivity at different spatial frequencies as an index of visual recovery following refractive surgery. METHODS: Contrast sensitivity at 1.5, 3, 6, 12, and 18 c/deg was measured with the Stereo Optical FACT chart in 20 patients after photorefractive keratectomy (PRK) using the Nidek EC-5000 excimer laser system, and in 18 patients following laser in situ keratomileusis (LASER). Contrast sensitivity was measured preoperatively and 1, 3, 6, and 12 months after surgery. RESULTS: Results showed a statistically significant reduction (P<01) in contrast sensitivity at all spatial frequencies in PRR patients during the first an…

Ocular biometric repeatability using a new high-resolution swept-source optical coherence tomographer.

To assess the repeatability of ocular biometric parameters using a high-resolution imaging device.74 healthy right eyes were included in this study. Five-repeated measurements were taken with ANTERION high-resolution swept-source optical coherence tomographer (SS-OCT) to measure: corneal thickness (central and at 2, 4 and 6-mm diameters), aqueous depth (AD), lens thickness (LT), anterior chamber volume (ACV), axial length (AL), and pupil (diameter and position). The intrasubject standard deviation (SWe have not found statistically significant differences between repeated measurements (p  0.05). The mean difference for corneal thickness was between -0.08 and 0.28 μm. For AD and LT was 0.004 …

Assessment of corneal morphological changes induced by the use of daily disposable contact lenses.

To assess the effect of different disposable soft contact lenses upon corneal thickness, and upon anterior and posterior corneal curvatures using a dual-Scheimpflug imaging based device.Twenty-eight young, healthy subjects wore four different types of daily disposable soft contact lenses on four different days: Dailies Total1, Proclear 1 Day, Clariti 1-Day and 1-Day Acuvue Moist. The lenses had different material and water content. Pachymetry maps and keratometry values were obtained using the Galilei G4 twice a day: one before putting the lens on and one after an eight-hour period of contact-lens wear. Measurements were also recorded without any contact lenses being worn during a day.Clari…

Comparison of Immersion Ultrasound, Partial Coherence Interferometry, and Low Coherence Reflectometry for Ocular Biometry in Cataract Patients

PURPOSE: To compare ocular biometry parameters measured with immersion ultrasound, partial coherence interferometry, and low coherence reflectometry in cataract patients. METHODS: Measurements of axial length and anterior chamber depth were analyzed and compared using immersion ultrasound, partial coherence interferometry, and low coherence reflectometry. Keratometry (K), flattest axis, and white-to-white measurements were compared between partial coherence interferometry and low coherence reflectometry. Seventy-eight cataract (LOCS II range: 1 to 3) eyes of 45 patients aged between 42 and 90 years were evaluated. A subanalysis as a function of cataract degree was done for axial length and…

Visual performance of the Akreos Adapt AO intraocular lens in patients with different corneal profiles measured with an adaptive optics visual simulator

AIMS: To evaluate the visual performance of an aberration-free intraocular lens (IOL) in patients with different corneal profiles using adaptive optics visual simulation. METHODS: A crx1 adaptive optics visual simulator was used to simulate the aberration pattern of an aberration-free IOL combined with five corneal profiles: virgin corneas and corneas with low and high myopic ablations and low and high hyperopic ablations. Ten eyes of 10 subjects were evaluated, and monocular distance visual acuity (VA) at 100%, 50% and 10% of contrast was measured. RESULTS: At 100% of contrast, no differences were found in VA values among virgin corneas, low and high myopic ablations and low hyperopic abla…

Effect of sport-tinted contact lenses for contrast enhancement on retinal straylight measurements

PURPOSE: To investigate the effect of two tinted contact lenses (CL) designed for outdoor sports activity on the psychometric determination of retinal straylight using the compensation comparison method. METHODS: Thirteen emmetropic subjects were randomly fitted with two different tinted Nike Maxsight (Bausch & Lomb, Rochester, NY, USA) CL in one eye, while the contralateral eye was fitted with a clear lens made of the same material (Optima 38, Bausch & Lomb). Three valid straylight measurements were taken on each eye before and a few minutes after lens insertion, when lens stabilization had occurred. RESULTS: The subjects' mean straylight values were 0.90 +/- 0.09 at baseline and 0.95 +/- …

VisuMax®femtosecond laser for corneal refractive surgery

Femtosecond lasers are increasingly present in ophthalmologic surgical theaters for a variety of reasons. These include faster and better visual outcomes, increased accuracy and predictability for corneal flap thickness in laser in situ keratomileusis procedures. Recent applications of modern femtosecond lasers have broadened the range of uses: keratoplasty, intrastromal segment insertion and even glaucoma and presbyopia surgery. This device profile provides an overview of the advantages of femtosecond lasers in ophthalmic surgery, paying special attention to the new VisuMax® femtosecond laser from Zeiss/Meditec.

Refractive Lens Exchange with Foldable Toric Intraocular Lens

To assess visual and refractive outcomes, and rotational stability after refractive lens exchange (RLE) with toric intraocular lens (IOL) implantation to correct ametropia and preexisting astigmatism.Prospective, nonrandomized, observational case series (self-controlled).This prospective, nonrandomized, and self-controlled study included 32 eyes of 19 consecutive patients with more than 1.00 diopter (D) of preexisting corneal astigmatism having RLE with AcrySof Toric IOL implantation (Alcon Laboratories Inc, Fort Worth, Texas, USA). Uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), refractive sphere, and keratometric and refractive cylinder were recorded preoperatively …

Repeatability of in vitro power profile measurements for multifocal contact lenses

Abstract Purpose To evaluate the repeatability of an optical device (NIMO TR1504, Lambda-X, Belgium) for measuring multifocal contact lens power profiles. Methods The NIMO TR1504 was used to measure power profiles 30 times for each of 10 different contact lenses from 4 major companies. All contact lenses were labelled as −3 D for distance vision; half were for high addition and half for low addition. The optical zone in all measurements was set to 3-mm radius. For each lens, the median power profile and the residuals of the 30 measurements were calculated. The 95% confidence bands and two indices that summarize measurement errors were calculated: the repeatability limit and an index of repe…

Ocular biometry with swept-source optical coherence tomography

This study aimed to summarize the outcomes reported when swept-source optical coherence tomography (SS-OCT) is used for ocular biometry. A literature search was performed to identify publications reporting clinical outcomes of patients measured with commercial SS-OCT. Twenty-nine studies were included in this review. A comprehensive analysis of the available data was performed, focusing on parameters used for intraocular lens (IOL) power calculation in cataract surgery, including keratometry, central corneal thickness, white-to-white distance, anterior chamber depth, lens thickness, axial length, IOL power, and pupil diameter. Different metrics for repeatability, reproducibility, and agreem…

Visual performance comparison between contact lens-based pinhole and simultaneous vision contact lenses.

Background The aim was to evaluate the visual performance provided with a contact lens-based pinhole design against a simultaneous vision multifocal contact lens. Methods In a cross-over study at the University of Valencia, 22 presbyopic patients were evaluated using an artificial pupil fitted on the non-dominant eye and the simultaneous vision PureVision Multifocal contact lenses. After one month of contact lens wear, binocular distance visual acuity (BDVA), binocular near visual acuity (BNVA), defocus curve, binocular distance contrast sensitivity, binocular near contrast sensitivity, and stereoacuity were measured, under photopic conditions (85 cd/m2). In addition, binocular distance vis…

Influence of contrast polarity on the accommodative response☆

espanolObjetivo Evaluar los cambios de la respuesta acomodativa del ojo al leer un texto en diferentes condiciones de polaridad de contraste: letras negras sobre fondo blanco (condicion BoW) y letras blancas sobre fondo negro (condicion WoB). Metodos En este estudio experimental participaron dieciocho sujetos de edades comprendidas entre 21 y 41 anos. Se obtuvo objetivamente la respuesta acomodativa (AR) del ojo al leer un texto con polaridad de contraste BoW o WoB con un sistema de optica adaptativa que corregia todas las aberraciones salvo las propias del sujeto. Se estudiaron dos tamanos de letra diferentes (condiciones de agudeza visual), mostrados en una micropantalla. Se midio la AR d…

Evaluating tear clearance rate with optical coherence tomography

Purpose: To assess the early-phase of tear clearance rate (TCR) with anterior segment optical coherence tomography (OCT) and to determine the association between TCR and other clinical measures of the tear film in a group of young subjects with different levels of tear film quality. Methods: TCR was classified as the percentage decrease of the inferior tear meniscus height 30s after instillation of 5uL 0.9% saline solution. Fifty subjects (32F and 18M) aged (mean +/- standard deviation) 25.5 +/- 4.3 years volunteered for the study. It consisted of a review of medical history, Ocular Surface Disease Index (OSDI) questionnaire, tear film osmolarity measurements, slit lamp examination and TCR …

Sensibilidad al contraste tras cirugía de cristalino transparente con lente intraocular multifocal asférica difractiva

PURPOSE: To evaluate distance and near contrast sensitivity (CS) under photopic and mesopic conditions before and after refractive lens exchange (RLE) and implantation of the aspheric AcrySof®ReSTOR® (SN6AD3 model) intraocular lens (IOL). METHODS:Seventy-four eyes of 37 patients after RLE underwent bilateral implantation with the aspheric AcrySof ReSTOR IOL. The patient sample was divided into myopic and hyperopic groups. Monocular uncorrected visual acuity at distance and near (UCVA and UCNVA, respectively) and monocular best corrected visual acuity at distance and near (BCVA and BCNVA, respectively) were measured before and 6 months postoperatively. Monocular CS function was measured at t…

Intrastromal corneal ring segment implantation in paracentral keratoconus with coincident topographic and coma axis.

To evaluate the efficacy, predictability, and safety of implantation of Ferrara-type intrastromal corneal ring segments (ICRS) for refractive correction of paracentral keratoconus.Fernández-Vega Ophthalmological Institute, Oviedo, Spain.Cohort study.Snellen uncorrected (UDVA) and corrected (CDVA) distance visual acuities and residual refractive errors were recorded before and 6 months after ICRS implantation for keratoconus. The tunnels for ICRS implantation were created with a femtosecond laser. The power vector and the Alpins method were used to analyze postoperative refractive outcomes.The study evaluated 56 eyes of 49 patients. The mean UDVA was 0.17 ± 0.14 (SD) preoperatively and 0.41 …

Influence of the luminance level on visual performance with a disposable soft cosmetic tinted contact lens.

The purpose of the present work was to study the effect on visual performance of wearing disposable soft tinted contact lenses for cosmetic purposes. Parameters such as contrast sensitivity (Vistech 6000), colour vision (Farnsworth-Munsell 100-Hue colour test), visual fields (static Goldmann perimetry) and subjective vision (what the wearer feels while wearing the lenses) were studied under different illumination levels in order to check for possible vision losses while wearing these contact lenses at low illumination levels. Sixteen emmetropic subjects were fitted consecutively with seven pairs of different colour lenses (Optima Colors lenses by BauschLomb), and the experimental parameters…

Agreement of predicted intraocular lens power using swept-source optical coherence tomography and partial coherence interferometry

PURPOSE To analyze the agreement of the predicted intraocular lens (IOL) power obtained with ANTERION, IOLMaster 700 and Pentacam AXL biometers. METHODS We calculated the monofocal and trifocal IOL power using the SRK/T, Haigis, Barrett Universal II and Hoffer Q formulas for 106 eyes. IOL power agreement between devices was evaluated using the Bland-Altman method. RESULTS We found significant differences between biometers comparisons (p  0.05), with the same outcomes for medium- and long-eyes. No significant differences were found using the SRK/T, Haigis, or Hoffer Q formulas for short-eyes (p > 0.1). However, Barrett Universal II formula produced significant differences (p < 0.05) and thes…

Visual Acuity and Contrast Sensitivity in Eyes Implanted with Aspheric and Spherical Intraocular Lenses

Purpose To compare visual acuity and contrast sensitivity (CS) in eyes implanted with aspheric and spherical intraocular lenses (IOLs) after cataract surgery. Design Randomized, prospective study. Participants Five hundred twenty-four eyes from 262 cataract surgery patients implanted with 2 IOL models: the AcrySof IQ (262 eyes) and AcrySof SN60AT (262 eyes; Alcon Laboratories, Fort Worth, TX). Methods High-contrast photopic best-corrected distance visual acuity (BCVA) and CS under photopic (85 cd/m 2 ) and mesopic (6 cd/m 2 ) conditions were measured. Pupil diameter was analyzed for distance vision under both lighting conditions. Follow-up was carried out for 6 months in all patients. Main …

Medida da profundidade da câmara anterior, distância branco a branco, ângulo da câmara anterior e diâmetro pupilar usando dois dispositivos de imagens de Scheimpflug

Purpose: To compare the ocular anterior chamber depth, white-to-white distance, anterior chamber angle, and pupil diameter, as measured with two different Scheimpflug imaging devices. Methods: This transversal study included 80 right eyes from 80 subjects aged from 20 to 40 years. Their spherical equivalents ranged from -4.25 to +1.00 diopters (D). Each eye's anterior chamber depth, white-to-white distance, anterior chamber angle, and pupil diameter, were measured for far vision using both the Galilei G4 (double Scheimpflug camera) and the Pentacam HR (single Scheimpflug camera) systems. Results: Mean anterior chamber depths were calculated as 3.12 ± 0.23 mm and 3.19 ± 0.24 mm when measured…

Differences in visual performance of AcrySof ReSTOR IOL in high and low myopic eyes.

PURPOSE To determine the differences in refractive and visual results obtained in eyes with high and low myopia after multifocal intraocular lens (IOL) implantation. METHODS Monocular visual acuity for distance and near, with and without distance correction, and photopic and mesopic contrast sensitivity were measured at 6 months after surgery in 152 myopic eyes implanted with the AcrySof ReSTOR Natural (SN60D3) IOL. Two groups were created: high and low myopia (76 eyes in each). RESULTS Monocular best distance-corrected visual acuity was 0.02+/-0.06 logMAR for low myopes and 0.05+/-0.09 logMAR for high myopes. Monocular best distance-corrected near visual acuity was 0.04+/-0.05 and 0.07+/-0…

New intraocular lens for achromatizing the human eye.

To describe the design of a new intraocular lens (IOL) capable of correcting spherical and chromatic aberrations when implanted in the human eye.University of Murcia, Murcia, and University of Valencia, Valencia, Spain.A hybrid singlet achromatic IOL was designed. The IOL has a combination of a refractive and a diffractive surface, with 1 of the surfaces being aspherical. Optical simulations were used to model the polychromatic modulation transfer function (MTF) in pseudophakic eyes to explain the differences in optical quality afforded by the achromatic IOL. Parameters such as focus shift, optical path difference, through-focus, and robustness to tilt and decentering of achromatic IOLs wer…

Collagen copolymer posterior chamber phakic intraocular lens supported by the ciliary sulcus to treat myopia: One-year follow-up

Purpose To evaluate the predictability, stability, safety, and efficacy of Visian V4b Implantable Collamer Lens phakic intraocular lens (pIOL) implantation to treat varying degrees of myopia. Setting Fernandez-Vega Ophthalmological Institute, Oviedo, Spain. Design Prospective nonrandomized clinical study. Methods The uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, pIOL vault, and adverse effects were evaluated 12 months postoperatively. Results The study enrolled 121 eyes (68 patients). The mean spherical equivalent decreased from −8.61 diopters (D) ± 3.41 (SD) (range −18.75 to −2.25 D) preoperatively to −0.18 ± 0.29 D (range −1.25 to 0.50 D) 12 months postoper…

Performance of the compensation comparison method for retinal straylight measurement: effect of patient's age on repeatability

Aim: The assessment of repeatability and reproducibility of retinal straylight measurements with the C-Quant straylight meter (Oculus AG, Germany) and the effect of patient’s age on the instrument performance are tested with a series of experiments. Methods: First, 20 eyes from 20 subjects (mean age 26.9 (SD 2.7) years, mean refractive error −1.34 (2.72) D) were examined with the C-Quant straylightmeter, taking 10 consecutive readings. Five subjects were also examined on five consecutive days to assess reproducibility. Additionally, repeated measures of straylight from 84 subjects of ages ranging from 19 to 86 years (mean (SD): 42.4 (24.0) years) were retrospectively analysed to assess the …

Assessment of modifications in thickness, curvatures, and volume upon the cornea caused by disposable soft contact lens wear.

Purpose To assess the effect of different disposable soft contact lenses on several corneal parameters–-thickness, anterior and posterior curvature, and volume–-by means of a Scheimpflug imaging-based device (Pentacam HR). Diurnal variations of these parameters were taken into account. Methods Twenty-one young, healthy subjects wore 4 different types of daily disposable soft contact lenses on 4 different days: Dailies AquaComfort Plus, SofLens, Dailies Total1, and Acuvue TruEye. The lenses had different material and water content. Pachymetry and curvature maps and corneal volume values were obtained using the Pentacam HR twice a day: one before putting the lens on and one after an 8-hour pe…

Role of the tear film in the optical quality of the human eye.

This paper reviews recent studies of the role of the tear film in the optical quality of the eye. Recent investigations focus on the dynamics of the tear film after a blink and its important role in the optical quality of the eye. The results in this review were used in an attempt to understand the optical and visual impact of tear-film breakup in normal eyes and dry eyes. It was noted that patients with dry-eye syndrome have large optical aberrations compared with those in normal eyes, which may be the cause of blurry vision associated with the syndrome. In addition, instillation of artificial tears reduces optical aberrations and thus improves the optical quality of vision in these patien…

Antibacterial and antifungal effects of soft contact lens disinfection solutions.

To study the antibacterial and antifungal effects of soft contact lens disinfection solutions.Eight contact lens disinfection solutions containing hydrogen peroxide or biguanides or polyquad compounds were evaluated with respect to their ability to disinfect a saline solution experimentally contaminated with different bacteria and with a fungus. We used cultures in blood Agar, MuellerHinton agar and Saboureaud's agar to identify the bacterial and fungal growth following 14 h of exposure to the disinfection solutions.Hydrogen peroxide, DYMED and polyhexamide solutions prevented the growth of the four bacteria studied. The solution containing biguanide prevented the growth of Escherichia coli…

Changes of the eye optics after iris constriction☆

Purpose: To evaluate the possible change in the optics of the human eye after iris constriction. Methods: Ocular aberrations were measured under natural viewing conditions in 26 eyes. The measured eyes fixated on a dim target while the contralateral eye was either occluded (so the measured eye had a large pupil) or highly illuminated (so the measured eye had a small pupil). The measured eyes fixated to a dim target placed 0.5 D beyond the subject’s far point. Zernike values obtained in both situations were compared within the same pupil diameter corresponding to the one obtained under the high illumination condition. Results: Significant variation in some aberration coefficients were found …

Visual simulation through different intraocular lenses using adaptive optics: Effect of tilt and decentration

Purpose To analyze visual quality differences between intraocular lenses (IOLs) and assess the impact of IOL decentration and tilt on visual quality. Setting University of Valencia, Valencia, Spain. Design Cohort study. Methods The crx1 adaptive optics visual simulator was used to simulate the wavefront aberration pattern of 2 commercially available aspheric aberration-correcting IOLs (Acrysof IQ SN60WF and Tecnis ZA9003) and 2 spherical IOLs (Akreos Adapt and Triplato) in 5 situations: centered, decentered 0.2 mm and 0.4 mm, and tilted 2 degrees and 4 degrees. Monocular distance visual acuity at 100%, 50%, and 10% contrast and the depth of focus were measured. Results Ten eyes of 10 patien…

Opto-mechanical artificial eye with accommodative ability.

The purpose of this study was to describe the design and characterization of a new opto-mechanical artificial eye (OMAE) with accommodative ability. The OMAE design is based on a second-pass configuration where a small source of light is used at the artificial retina plane. A lens whose focal length can be changed electronically was used to add the accommodation capability. The changes in the OMAE's aberrations with the lens focal length, which effectively changes the accommodative state of the OMAE, were measured with a commercial aberrometer. Changes in power and aberrations with room temperature were also measured. The OMAE's higher-order aberrations (HOAs) were similar to the ones of th…

The effect of aberrations on objectively assessed image quality and depth of focus

The effects of aberrations on image quality and the objectively assessed depth of focus (DoF) were studied. Aberrometry data from 80 young subjects with a range of refractive errors was used for computing the visual Strehl ratio based on the optical transfer function (VSOTF), and then, through-focus simulations were performed in order to calculate the objective DoF (using two different relative thresholds of 50% and 80%; and two different pupil diameters) and the image quality (the peak VSOTF). Both lower order astigmatism and higher order aberration (HOA) terms up to the fifth radial order were considered. The results revealed that, of the HOAs, the comatic terms (third and fifth order) ex…

Posterior‐chamber phakic implantable collamer lenses with a central port: a review

Abstract We aimed to summarize the outcomes reported following the implantation of the V4c implantable collamer lens with a central port (ICL, STAAR Surgical Inc) for myopia correction. A literature search in PubMed, Web of Science and Scopus was carried out to identify publications reporting clinical outcomes of patients who were implanted with the V4c ICL model and had a follow‐up period of at least 6 months. A total of 35 clinical studies published between 2012 and 2020 were included in the present review. A comprehensive analysis of the available data was performed, focusing on visual and refractive outcomes at different time‐points post‐surgery. In addition, adverse events and other pa…

Artificial pupil versus contralateral balanced contact lens fit for presbyopia correction.

Purpose: To assess and compare the effects of contact lens-based artificial pupil design and contralateral balanced multifocal contact lens combination (CBMCLC) on visual performance. Methods: This randomized crossover study conducted at the University of Valencia, Spain included 38 presbyopic patients using an artificial pupil contact lens in the nondominant eye and a CBMCLC. After a month of lens wear, the binocular distance visual acuity (BDVA), binocular near visual acuity (BNVA), defocus curve, binocular distance, and near contrast sensitivity and near stereoacuity (NSA) were measured under photopic conditions (85 cd/m2). Moreover, BDVA and binocular distance contrast sensitivity were …

Myopic astigmatism correction: comparison of a Toric Implantable Collamer Lens and a bioptics technique by an adaptive optics visual simulator.

Purpose To compare the optical and visual quality of a simulated Toric Implantable Collamer Lens (TICL) and a bioptics technique to treat high myopic astigmatism. Methods An adaptive optics visual simulator was used to simulate the vision after TICL implantation and a bioptics procedure from the wavefront aberration pattern for moderate and high-myopic astigmatism. Visual acuity (VA) at different contrasts and contrast sensitivity (CS) at 10, 20 and 25 cycles degree−1 were measured for 3 and 5-mm pupils. Modulation Transfer Function (MTF) and Point Spread Function (PSF) were calculated for a 5-mm pupil. Results At a 3-mm pupil we only found statistically significant differences in VA betwee…

Age-related changes in the human visual system and prevalence of refractive conditions in patients attending an eye clinic.

PURPOSE: To retrospectively report the trends of change in several parameters of the human visualsystem over a wide age range in patients attending an eye clinic. SETTING: University of Valencia, Valencia, Spain. METHODS: The clinical records of 2654 patients were retrospectively reviewed, and the age, sex, spherocylindrical refraction, visual acuity, keratometry, and intraocular pressure were obtained. Descriptive values for each parameter and the correlations with age and between different parameters were calculated. Vectorial components of refraction, including blur, were also derived from clinical refractive data and then analyzed. RESULTS: Several parameters changed significantly with …

Optical quality after instillation of eyedrops in dry-eye syndrome

Purpose To study the effect of eyedrop instillation on the optical quality of the air–tear film interface at the anterior cornea in cases of dry eye. Setting University of Valencia, Valencia, Spain. Methods Corneal aberrations (total, spherical-like, and coma-like) were determined from corneal elevation maps and purpose-designed software in cases of dry eye before, immediately after, and 10 minutes after lubricating eyedrop instillation (Blink Intensive Tears). All data were decomposed using Zernike polynomials to yield the root-mean-square wavefront deviations for pupil diameters of 3.0 mm and 5.5 mm. Outcome measures included comparison with clinical tear breakup time (TBUT). Results Wave…

Determination of corneal volume from anterior topography and topographic pachymetry: application to healthy and keratoconic eyes

Purpose: To describe a method to measure corneal volume from topography and pachymetry, and test its clinical use on a sample of healthy human subjects and a case of circumscribed posterior keratoconus. Methods: Corneal curvature (PCT 200® corneal topography system; Optopol Technology SA, Zawiercie, Poland) and ultrasonic topographic pachometry on 25 points (Ophthasonic ® A-Scan/Pachometer III; Teknar Inc., St Louis, MO, USA) were measured on each of 12 young healthy corneas and one cornea suffering from circumscribed posterior keratoconus. Topography and pachymetry data were used to calculate the coordinates for the corresponding points on the posterior surface of the cornea. TableCurve 3D…

Human eyes do not need monochromatic aberrations for dynamic accommodation

Purpose To determine if human accommodation uses the eye's own monochromatic aberrations to track dynamic accommodative stimuli. Methods Wavefront aberrations were measured while subjects monocularly viewed a monochromatic Maltese cross moving sinusoidally around 2D of accommodative demand with 1D amplitude at 0.2 Hz. The amplitude and phase (delay) of the accommodation response were compared to the actual vergence of the stimulus to obtain gain and temporal phase, calculated from wavefront aberrations recorded over time during experimental trials. The tested conditions were as follows: Correction of all the subject's aberrations except defocus (C); Correction of all the subject's aberratio…

Astigmatism in infancy and childhood.

ABSTRACT Purpose: To evaluate the prevalence of astigmatism In infancy and childhood In a Spanish population. Methods: A total of 478 children with astigmatism from Valencia Province, Spain were examined. The patients, ranging in age from 2-1 2 years, were classified into groups according to age. Astigmatism error and axis orientation were determined using noncyclopeglc retlnoscopy over each eye. Results: The overall prevalence of astigmatism (5=1.00 diopter of cylinder) decreased In relation to increasing age from 44.3% to 5.2%. The prevalence of against-the-rule astigmatism decreased from 61.5% (at 2 years) to 33.4% (at 12 years), with-the-rule astigmatism increased In prevalence from 23.…

Toric intraocular lens versus opposite clear corneal incisions to correct astigmatism in eyes having cataract surgery.

To compare toric intraocular lens (IOL) implantation with paired opposite clear corneal incisions (OCCIs) for astigmatism correction in patients having cataract surgery.Ophthalmology Service, Donostia Hospital, San Sebastián, Spain.This randomized prospective clinical study comprised eyes with more than 1.00 diopter (D) of preexisting corneal astigmatism. One group had AcrySof toric IOL implantation and the other, paired 2.75 mm/3.20 mm OCCIs in the steep axis with spherical IOL implantation. Uncorrected (UCVA) and best corrected (BCVA) visual acuity, refraction, corneal and total higher-order aberrations (HOAs), photopic and mesopic contrast sensitivity, and toric IOL axis were measured 3 …

Trifocal toric intraocular lenses in eyes with low amount of corneal astigmatism.

Aim To evaluate the refractive and visual outcomes following cataract surgery and implantation of a trifocal toric intraocular lens (IOL) in eyes with low degrees of corneal astigmatism. Methods Twenty-six eyes of 22 patients who underwent implantation a trifocal toric IOL (FineVision PODFT, PhysIOL s.a., Liege, Belgium) were enrolled. Phacoemulsification with femtosecond laser, capsular tension ring insertion and intraoperative aberrometry were performed in all cases. All IOLs used showed a cylinder power of 1.00 D. Main outcome measures were refractive error and corrected-distance visual acuity (CDVA) and uncorrected-distance visual acuity (UDVA) values. Eyes were evaluated at 4mo post-su…

Clinical Implications in Perimetry After Photorefractive Keratectomy

Through refractive surgery, it is now possible to correct various ametropias using new techniques such as photorefractive keratectomy (PRK). We hypothesized that patients submitting to PRK show higher peripheral thresholds attributable to poorer retinal quality than normal patients. However, no difference were found when comparing glaucoma with PRK patients. Thus, early glaucoma following PRK may be masked by the previous surgery.

Multifocal intraocular lenses for unilateral cataract in children.

Purpose To evaluate the implantation of apodized diffractive multifocal intraocular lenses (IOLs) in children with unilateral cataract. Setting Ophthalmology Service, Hospital Clinico Lozano Blesa, Zaragoza, Spain. Design Prospective clinical study. Methods Five children between 4 and 6 years of age with unilateral cataract had cataract extraction and implantation of an apodized diffractive multifocal IOL (AcrySof Restor SN60D3). Phacoaspiration was accompanied by posterior capsulorhexis followed by an anterior vitrectomy. Uncorrected distance (UDVA), corrected distance (CDVA), and corrected near (CNVA) visual acuities; binocular function using the Worth 4-dot test and the TNO stereotest; a…

Intraocular pressure after excimer laser myopic refractive surgery

The aim of this study was to determine whether intraocular pressure (IOP), as measured by Goldmann applanation or non-contact tonometry, shows systematic changes in patients who have undergone photorefractive keratectomy (PRK) or laser in situ keratomileusis (LASIK). IOP was measured by central Goldmann and non-contact tonometry in 54 patients pre and post-PRK, and in 43 patients pre- and post-LASIK. An interval of 12 months was allowed after surgery. Patients were selected to have one of four specific initial values of refractive error (-2.5, -5.0, -7.5 and -10.0 D). Fellow unoperated eyes were used as controls. A paired Student's t-test and a one-way ANOVA test were used for statistical a…

Analysis of the possible benefits of aspheric intraocular lenses: review of the literature.

We reviewed recently published studies that analyzed the visual and optical quality in eyes with different spherical and aspheric intraocular lenses (IOLs). Recent studies focused on visual quality metrics, such as visual acuity and contrast sensitivity, under photopic and mesopic lighting conditions and optical metrics, such as wavefront aberrations, especially spherical aberration. The results in this review were used in an attempt to understand whether there is a visual and/or optical benefit of implanting aspheric IOLs over implanting spherical IOLs.

Prevalence of corneal astigmatism before cataract surgery.

To analyze the prevalence and presentation patterns of corneal astigmatism in cataract surgery candidates.University of Valencia, Valencia, Spain.Refractive and keratometric values were measured before surgery in patients having cataract extraction. Descriptive statistics of refractive and keratometric cylinder data were analyzed and correlated by age ranges.Refractive and keratometric data from 4,540 eyes of 2,415 patients (mean age 60.59 years +/- 9.87 [SD]; range 32 to 87 years) differed significantly when the patients were divided into 10-year subsets. There was a trend toward less negative corneal astigmatism values, except the steepest corneal radius and the J(45) vector component, in…

Accommodation-related changes in monochromatic aberrations of the human eye as a function of age.

PURPOSE. To investigate the relationship between accommodation and the optical aberrations of the whole human eye, as a function of age. METHODS. Sixty healthy subjects with spherical ametropia in the range 3 D, astigmatism less than 1 D, corrected visual acuity of 20/18 or better, and normal findings in an ophthalmic examination were enrolled. Subjects were divided into four groups, with age ranges of 19 to 29, 30 to 39, 40 to 49, and 50 to 60 years. Monochromatic optical aberrations and pupil size were measured with a Hartmann-Shack wavefront sensor under monocular viewing conditions, without pharmacological dilation or cycloplegia. Stimulus vergences were in the range of 0 to 5 D, with a…

Diurnal variations in visual performance for disposable contact lenses.

The purpose of this study is to compare the visual performance provided by different daily disposable contact lenses and to analyze its variation over time.Visual performance was evaluated in terms of visual acuity (VA) and contrast sensitivity (CS) in 15 myopic subjects (-0.50 to -4.00 diopters) who had been previously fitted with each one of the following seven types of soft contact lenses: DAILIES TOTAL1 (Alcon, Forth Worth, TX), DAILIES AquaComfort Plus (Alcon), 1-DAY ACUVUE TruEye (JohnsonJohnson Vision Care, Jacksonville, FL), 1-DAY ACUVUE MOIST (JohnsonJohnson Vision Care), SofLens daily disposable (BauschLomb, Rochester, NY), Proclear 1 Day (CooperVision, Fairport, NY), and Clariti …

Visual Performance of a Multifocal Toric Soft Contact Lens

PURPOSE To evaluate the visual performance of the Proclear multifocal toric contact lens (CL; CooperVision, US) for both presbyopia and astigmatism correction. METHODS In this crossover study design, 20 presbyopic subjects with astigmatism were fitted in a random order with either Proclear multifocal toric CL or Proclear toric single vision distance CL (DCL) combined with reading spectacles. After 1 month, high-contrast distance visual acuity, near high-contrast visual acuity, distance contrast sensitivity (CS) under photopic and mesopic conditions without and with glare, near CS, defocus curve, and stereopsis were measured. Subjects were then refitted with the alternative correction, and t…

Contrast sensitivity after refractive lens exchange with a multifocal diffractive aspheric intraocular lens

Purpose: To evaluate distance and near contrast sensitivity (CS) under photopic and mesopic conditions before and after refractive lens exchange (RLE) and implantation of the aspheric AcrySof ReSTOR (SN6AD3 model) intraocular lens (IOL) Methods: Sixty eyes of 30 consecutive patients after RLE underwent bilateral implantation with the aspheric AcrySof ReSTOR IOL. The patients sample was divided into myopic [n=15, mean spherical equivalent (SE) -6.87± 2.03 diopters (D)] and hyperopic (n=15, mean SE +4.52±1.14 D) groups. Monocular uncorrected visual acuity at distance and near (UCVA and UCNVA, respectively) and monocular best corrected visual acuity at distance and near (BCVA and BCNVA, respec…

Measurements of anterior chamber depth, white-to-white distance, anterior chamber angle, and pupil diameter using two Scheimpflug imaging devices.

Purpose: To compare the ocular anterior chamber depth, white-to-white distance, anterior chamber angle, and pupil diameter, as measured with two different Scheimpflug imaging devices. Methods: This transversal study included 80 right eyes from 80 subjects aged from 20 to 40 years. Their spherical equivalents ranged from -4.25 to +1.00 diopters (D). Each eye's anterior chamber depth, white-to-white distance, anterior chamber angle, and pupil diameter, were measured for far vision using both the Galilei G4 (double Scheimpflug camera) and the Pentacam HR (single Scheimpflug camera) systems. Results: Mean anterior chamber depths were calculated as 3.12 ± 0.23 mm and 3.19 ± 0.24 mm when measured…

Visual and refractive outcomes in hyperopic pseudophakic patients implanted with a trifocal intraocular lens

Jos&amp;eacute; F Alfonso,1,2 Andr&amp;eacute;s Fern&amp;aacute;ndez-Vega-Cueto,1 Bel&amp;eacute;n Alfonso-Bartolozzi,1 Ignacio Rodr&amp;iacute;guez-U&amp;ntilde;a,1 Robert Mont&amp;eacute;s-Mic&amp;oacute;3 1Corneal and Lens Surgery Department, Fern&amp;aacute;ndez-Vega Ophthalmological Institute, Oviedo, Spain; 2Surgery Department, School of Medicine, University of Oviedo, Oviedo, Spain; 3Optics and Optometry and Vision Sciences Department, Faculty of Physics, University of Valencia, Valencia, SpainCorrespondence: Jos&amp;eacute; F AlfonsoInstituto Oftalmol&amp;oacute;gico Fern&amp;aacute;ndez-Vega, Avda. Dres. Fern&amp;aacute;ndez-Vega 114, Oviedo 33012, SpainTel +34 985 245533Fax +34 98…

Dynamic accommodation without feedback does not respond to isolated blur cues

Highlights • A new methodology is used to study a potential cue for dynamic accommodation. • We show that human accommodation is not driven correctly by defocus alone. • Accommodation is most efficient using changes in stimulus vergence with feedback.

A pilot study on the differences in wavefront aberrations between two ethnic groups of young generally myopic subjects

A comparative population-based cross-sectional study design was used to examine the prevalence of wavefront patterns in two different ethnic groups, and the relationship of these patterns with ocular biometrics and gender. The Shin–Nippon SRW5000 open field autorefractor, the Wavefront Analysis Supported Customized Ablation (WASCA) wavefront analyser and the IOLMaster were used to determine wavefront aberrations, mean spherical equivalent (SE) refractive error and axial length (AL). Seventy-four eyes from 74 young healthy subjects (44 British Asians, 30 Caucasians; 36 men, 38 women; mean age 22.51 ± 3.89 years) with mean SE averaging )1.90 ± 2.76 D (range )10.88 to +2.19 D) were examined. R…

Femtosecond laser versus mechanical keratome LASIK for myopia.

To assess efficacy, safety, predictability, stability, and changes in corneal higher-order aberrations (CHOAs) and contrast sensitivity (CS) after a femtosecond laser for LASIK and standard LASIK for myopia.Prospective, randomized, comparative clinical study.Two hundred eyes of 100 consecutive patients who underwent LASIK treatment using the VISX S2 laser system. A femtosecond laser for flap creation was used in 100 eyes (50 patients; spherical equivalent [SE], -2.85+/-1.79 diopters [D]), and a mechanical microkeratome was used in 100 eyes (50 patients; SE, -2.90+/-1.63 D).Uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction, CS by means of t…

Effect of phenylephrine on static and dynamic accommodation

Purpose We tested the hypothesis that changes in accommodation after instillation of Phenylephrine Hydrochloride (PHCl) observed in some studies could be caused by changes in optics. Methods We performed two experiments to test the effects of PHCl on static and on dynamic accommodation in 8 and 6 subjects, respectively. Objective wavefront measurements were recorded of the static accommodation response to a stimulus at different distances or dynamic accommodation response to a sinusoidally moving stimulus (between 1 and 3 D of accommodative demand at 0.2 Hz). The responses were characterized using two methods: one that takes into account the mydriatic optical effects on the accommodation pr…

Multisectorial changes in the ciliary muscle during accommodation measured with high-resolution optical coherence tomography

ABSTRACT Purpose: To measure changes in the anterior ciliary muscle during accommodation at the nasal, superior, temporal, and inferior sectors by means of an anterior chamber optical coherence tomographer, and correlate them with vergence changes. Methods: Twenty-four subjects with healthy, phakic eyes, whose mean age was 27.1 ± 8.9 years, underwent measurement with an anterior chamber optical coherence tomographer. The anterior ciliary muscle was measured at the nasal, temporal, superior, and inferior sectors for 0, -1, -2, and -3 D of vergence. A linear model was used to assess the correlation of each eye parameter with the accommodative demand. Results: The anterior ciliary muscle area …

Visual quality after diffractive intraocular lens implantation in eyes with previous hyperopic laser in situ keratomileusis

To evaluate distance, intermediate, and near visual quality in eyes with diffractive intraocular lens (IOL) implantation after previous hyperopic laser in situ keratomileusis (LASIK).Fernández-Vega Ophthalmological Institute, Oviedo, Spain.Cohort study.Corrected distance visual acuity (CDVA) at 12.5%, 25.0%, and 100% contrast levels under photopic and mesopic conditions; uncorrected (UNVA) and distance-corrected (DCNVA) near visual acuity, defocus curves, and corneal higher-order aberrations (HOAs) were measured in eyes that had AcrySof Restor SN60D3 spherical IOL implantation (study group) and in phakic eyes (control group) after hyperopic LASIK.Under photopic conditions at 100% contrast, …

Optical and Visual Simulation of Standard and Modified Spherical Aberration Implantable Collamer Lens Post Myopic LASIK Surgery

To evaluate the visual quality achieved in patients undergoing standard or modified implantable Collamer lens (ICL) to correct residual myopic error after laser-assisted in situ keratomileusis (LASIK) surgery.The adaptive optics visual simulator was used to simulate LASIK surgery of moderate and high myopia with a myopic regression corrected by a standard and modified ICL. Visual acuity (VA) and contrast sensitivity (CS) were measured in 14 subjects at 3- and 4.5-mm pupil. Point spread function and simulated retinal images were calculated.Comparing LASIK plus standard ICL and LASIK plus modified ICL simulations, for moderate myopia, VA improvement was less than 1 line in all VA contrasts an…

Estimation of the mechanical properties of the eye through the study of its vibrational modes.

Measuring the eye's mechanical properties in vivo and with minimally invasive techniques can be the key for individualized solutions to a number of eye pathologies. The development of such techniques largely relies on a computational modelling of the eyeball and, it optimally requires the synergic interplay between experimentation and numerical simulation. In Astrophysics and Geophysics the remote measurement of structural properties of the systems of their realm is performed on the basis of (helio-)seismic techniques. As a biomechanical system, the eyeball possesses normal vibrational modes encompassing rich information about its structure and mechanical properties. However, the integral a…

Changes in Accommodation and Ocular Aberration With Simultaneous Vision Multifocal Contact Lenses

Objective: The aim of this study was to evaluate ocular aberration changes through different simultaneous vision multifocal contact lenses (CLs). Methods: Eighteen young-adult subjects with a mean age of 29.8 +/- 2.11 years took part. Changes in accommodative response, spherical aberration (C-4(0)), horizontal coma (C-3(1)), vertical coma (C-3(-1)), and root mean square (RMS) of higher-order aberrations (HOAs, third to sixth orders) were evaluated. Measurements were obtained with a distance-single vision CL and 2 aspheric multifocal CLs of simultaneous focus center-near design (PureVision Low Add and PureVision High Add) for 2 accommodative stimuli (-2.50 and -4.00 D). All measurements were…

Optical Quality Comparison of Conventional and Hole-Visian Implantable Collamer Lens at Different Degrees of Decentering

To compare the optical quality of implantable Collamer lens (ICL) with and without central hole (Hole ICL and conventional ICL) at different degrees of decentering.Experimental laboratory investigation.Wavefront aberrations of the -3, -6, and -12 diopter (D) V4b and -3, -6, and -12 D V4c ICLs were measured in 3 conditions-centered and decentered 0.3 and 0.6 mm-at 3-mm and 4.5-mm pupils. The root mean square of total higher order aberrations, trefoil, coma, tetrafoil, secondary astigmatism, and spherical aberration were evaluated. In addition, point spread function and simulated retinal images of ICLs were calculated from the wavefront aberrations for each ICL and all conditions of decenteri…

Visual acuity tolerance to residual refractive errors in patients with an apodized diffractive intraocular lens.

To assess visual acuity tolerance to defocus caused by residual refractive errors after clear lens extraction (CLE) with apodized diffractive intraocular lens (IOL) implantation.Fernández-Vega Ophthalmological Institute, Oviedo, Spain.In this prospective study, 150 eyes of 75 consecutive patients who had bilateral CLE with implantation of an AcrySof ReSTOR Natural IOL (Alcon) were evaluated. The eyes were divided into 2 groups: myopia and hyperopia. Residual refractive errors were analyzed using vector analysis. Monocular and binocular uncorrected distance visual acuity, best corrected distance visual acuity, uncorrected distance near visual acuity, and best distance-corrected near visual a…

Posterior chamber phakic intraocular lenses to improve visual outcomes in keratoconus patients

The aim of this review is to summarize the results of using posterior chamber phakic intraocular lenses (pIOLs) to restore quality of vision in keratoconus patients. These pIOLs can correct the refractive errors associated with keratoconus and can also be combined with other surgical techniques to improve the results.

Prevalence of cataract after collagen copolymer phakic intraocular lens implantation for myopia, hyperopia, and astigmatism

Purpose To evaluate the prevalence of cataract after Implantable Collamer Lens phakic intraocular lens (pIOL) implantation with different models at different ages and for different refractive powers. Setting Fernandez-Vega Ophthalmological Institute, Oviedo, Spain. Design Retrospective nonrandomized clinical study. Methods The pIOL (models V4, V4b, or V4c) was implanted in all cases. Results The study included 3420 eyes (1898 patients). The mean patient age at surgery was 31.2 years ± 6.4 (SD) (range 18 to 50 years) and the mean spherical refractive error, −7.27 ± 5.24 diopters (D) (range −26.5 to 12.5 D). Twenty-one eyes (0.61%) of 15 patients had pIOL explantation (all model V4) because c…

Accommodative stimulus-response curves to low-pass filtered natural images

To assess how the monocular steady-state accommodative stimulus-response curve is modified when viewing low-pass filtered natural images. Eighteen adult subjects participated in the study. The accommodative stimulus-response curve was objectively assessed by means of a Hartmann-Shack wavefront sensor. Measurements were taken at different accommodative demands. Target images were low-pass filtered versions of a natural image that were obtained applying different digital spatial filters that limited the spatial frequency content of the natural image. Cutoff spatial frequencies were set at 30, 21, and 15 cycles per degree (cy/deg). Mean data obtained for each target were fitted to linear model…

Visual acuity comparison of 2 models of bifocal aspheric intraocular lenses.

Purpose To compare visual acuity after bilateral implantation of 2 models of multifocal aspheric intraocular lenses (IOLs). Setting Fernandez-Vega Ophthalmological Institute, Oviedo, and University of Valencia, Valencia, Spain. Methods Prospective study of patients who had bilateral implantation of an AcrySof ReSTOR SN6AD3 IOL (Group 1) or an Acri.LISA 366D IOL (Group 2). Six months postoperatively, binocular uncorrected and best corrected distance visual acuity, uncorrected-distance and best distance-corrected near visual acuity, best corrected intermediate visual acuity, and the defocus curve were measured in both IOL groups. Results Group 1 comprised 36 eyes (18 patients) and Group 2, 40…

Quality of vision with the Acri. Twin asymmetric diffractive bifocal intraocular lens system.

To assess the quality of vision in patients who had implantation of asymmetric Acri. Twin bifocal diffractive intraocular lenses (IOLs) by evaluating distance and near visual acuities and photopic and mesopic contrast sensitivity under monocular and binocular conditions.Fernández-Vega Ophthalmological Institute, Oviedo, Spain.The study comprised 343 consecutive patients who had bilateral implantation of the Acri. Twin system: a distance-weighted 737D IOL and a near-weighted 733D IOL. Monocular and binocular best corrected distance visual acuities, best distance corrected near visual acuity, and distance contrast sensitivity under photopic (85 cd/m(2)) and mesopic (5 cd/m(2)) conditions were…

Effect of even and odd-order aberrations on the accommodation response

Aim To investigate the potential effect that odd and even-order monochromatic aberrations may have on the accommodation response of the human eye. Methods Eight healthy subjects with astigmatism below 1 D, best corrected visual acuity 20/20 or better and normal findings in an ophthalmic examination were enrolled. An adaptive optics system was used in order to measure the accommodation response of the subjects' eyes under different conditions: with the natural aberrations being present, and with the odd and even-order aberrations being corrected. Three measurements of accommodation response were monocularly acquired at accommodation demands ranging from 0 to 4 D (0.5 D step). Results The acc…

Depth of focus through different intraocular lenses in patients with different corneal profiles using adaptive optics visual simulation

PURPOSE: To evaluate the depth of focus with monofocal intraocular lenses (IOLs) in patients with different corneal profiles using adaptive optics (AO) visual simulation. METHODS: An AO visual simulator (crx1, Imagine Eyes) was used to simulate the aberration pattern of three monofocal IOLs (Acrysof IQ SN60WF [Alcon Laboratories Inc]; Akreos Adapt AO [Bausch &amp; Lomb]; and Triplato [AJL Ophthalmic]) of different optic designs. Five groups were considered: patients without any corneal refractive surgery (normal cornea group) and with prior low and high myopic and hyperopic ablations (low myopic ablation, high myopic ablation, low hyperopic ablation, and high hyperopic ablation groups). De…

Agreement between intraoperative anterior segment spectral-domain OCT and 2 swept-source OCT biometers.

Purpose: To evaluate the agreement of different biometric parameters obtained using intraoperative spectral-domain optical coherence tomography (SD-OCT) and two swept-source optical coherence tomog...

Evaluation of 6 biometers based on different optical technologies

This study shows that optical biometers based on different technologies provide repeatable measurements for different ocular parameters and, when compared, statistically significant differences between them were found when measuring most parameters.

Effect of contact lenses on ocular biometric measurements based on swept-source optical coherence tomography

ABSTRACT Purpose: To determine the reliability of swept- source optical coherence tomography in cases in which soft contact lenses cannot be removed when acquiring biometric measurements. Methods: Eight subjects were included and only one eye per participant was analyzed. Each eye was measured six times by swept-source optical coherence tomography with the IOLMaster 700 instrument (Carl Zeiss Meditec, Jena, Germany). Axial length, central corneal thickness, anterior chamber depth, lens thickness, and keratometric measurements were evaluated for the naked eye and while wearing soft contact lenses of three different powers (-1.5, -3.0, and +2.0 D). Results: There were statistically significan…

On-eye optical quality of daily disposable contact lenses for different wearing times

Purpose To quantify the optical quality of various daily disposable contact lenses in vivo and to ascertain its variation in terms of wearing time by means of objective non-invasive determination of wavefront patterns. Methods The crx1 adaptive-optics system was used to measure the wavefront aberrations in 15 myopic eyes before and at 2-h intervals after contact lens fitting, over a 12-h wearing period. Seven types of contact lenses having different material, water content and lens design were evaluated in this study: Dailies Total1, Dailies AquaComfort Plus, Proclear 1 Day, 1-Day Acuvue TruEye, 1-Day Acuvue moist, SofLens daily disposable and Clariti 1-Day. The aberration data were analyse…

Comparison of two artificial tear formulations for dry eye through high‐resolution optical coherence tomography

Purpose:  The aim was to determine the efficacy of two artificial eye-drop formulations by analysing the lower tear film meniscus volume through a commercial high-resolution spectral-domain optical coherence tomographer. Methods:  Twenty dry eye patients (12 men, eight women, aged 57.5 ± 8.4 years) with refractive errors from -2.50 to +0.75 D (mean -1.34 ± 1.02 D) and cylinders lower than 1.00 D were examined. Tear meniscus volume was measured before, immediately after and 10, 30 and 60 minutes after instillation using the Copernicus high-resolution spectral-domain optical coherence tomographer (Optopol Tech SA, Zawiercie, Poland). Volume was calculated from the local area obtained from tom…

Visual function after implantation of a diffractive aspheric trifocal intraocular lens

Purpose To evaluate distance, intermediate, and near vision after bilateral implantation of a diffractive aspheric trifocal intraocular lens (IOL). Methods This study enrolled 204 eyes of 102 patients who had bilateral implantation of the AT LISA tri 839MP IOL. Monocular and binocular uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA) (4 meters), monocular and binocular uncorrected near visual acuity (UNVA) and distance-corrected near visual acuity (DCNVA) (30, 40 centimeters), binocular uncorrected intermediate visual acuity (UIVA) and distance-corrected intermediate visual acuity (DCIVA) (50, 60, 70 centimeters), the defocus curve, and binocular photopic…

Visual and optical performance with hybrid multifocal intraocular lenses

During the past years, the wish to become independent of spectacles has been growing among cataract and presbyopic patients due to many factors, such as the increase in near visual demands, the aesthetic need for a spectacle-free image and ageing of refractive surgery patients, among others. This review assesses recently published studies that analyse visual and optical performance through different metrics of eyes implanted with multifocal intraocular lenses (IOLs), particularly hybrid IOL designs. The published evidence suggests that hybrid multifocal IOLs provide very good outcomes in a number of visual and optical performance parameters. Patients implanted with this type of IOL obtain a…

Optical performance of two new trifocal intraocular lenses: through-focus modulation transfer function and influence of pupil size

Background To compare the in vitro optical quality of two new trifocal intraocular lenses at different focal points as a function of pupil size. Methods Two intraocular lenses having different design approaches were evaluated: the AT LISA tri 839MP with a trifocal diffractive design, and the FineVision, which combines two distinct apodized bifocal diffractive profiles resulting in three foci. A PMTF optical bench was used to assess the intraocular lenses' performance, and as optical quality metrics, the through-focus modulation transfer function was selected; that is, it was measured at 10 focal points and for four different apertures (2.0, 3.0, 3.75 and 4.5 mm). Results For both lenses, th…

Mesopic contrast sensitivity function after excimer laser photorefractive keratectomy.

ABSTRACT PURPOSE: To evaluate contrast sensitivity under mesopic conditions in patients who had undergone uncomplicated excimer laser photorefractive keratectomy (PRK) for myopia. METHODS: Monocular contrast sensitivity function was measured with the Stereo Optical ?A.C.T. chart in 26 patients who had received PRK using the Nidek EC-5000 excimer laser system. Mean preoperative refractive error was -6.23 ? 1.69 D (range, -4.00 to -8.25 D); postoperatively, mean refractive error was -0.36 ? 0.58 D (range, -0.75 to +0.50 D). Contrast sensitivity function was measured 6 months after surgery using four different chart luminances: 85, 5.0, 2.5, and 0.1 cd/m2, the first being a photopic level and …

Optical power distribution of refractive and aspheric multifocal contact lenses: Effect of pupil size

Abstract Purpose To evaluate the power profile within the optic zone of different designs of multifocal contact lenses (CLs) and to analyze how the effect of pupil size could impact on their optical performance. Methods The optical power distribution within the optic zones of multifocal CLs was measured by the Nimo TR1504 (LAMBDA-X, Belgium). The multifocal CLs under study were the Acuvue Bifocal, the Acuvue Oasys for Presbyopia, the PureVision Multifocal and the PureVision 2 for Presbyopia. Each design was considered in all their available addition powers. All lenses had a nominal power of −3.0D. At the same time, three lenses of each model were considered and five consecutive readings of …

Refractive and Visual Results after Implantation of the AcrySof ReSTOR IOL in High and Low Hyperopic Eyes

To assess the differences in refractive and visual results obtained in eyes with high and low hyperopia after implantation of a multifocal intraocular lens (IOL).A prospective study was performed on 172 hyperopic eyes implanted with the AcrySof Re-STOR Natural (SN60D3) IOL. Two groups were created, high and low hyperopes (86 eyes in both cases). We analyzed monocular visual acuity for distance and near, with and without distance correction. Photopic and mesopic contrast sensitivity (CS) were also assessed. All measurements were performed at 6 months after surgery.Monocular best distance-corrected visual acuity was 0.01+/-0.03 logMAR for low hyperopes and 0.04+/-0.10 logMAR for high hyperope…

Stereoacuity After Refractive Lens Exchange With AcrySof ReSTOR Intraocular Lens Implantation

Purpose: To evaluate stereoacuity before and after refractive lens exchange (RLE) with AcrySof ReSTOR intraocular lens (IOL) implantation. Methods: Stereoacuity was measured using the Titmus stereotest at 40 cm under photopic conditions (85 cd/m 2 ) before and after RLE with bilateral AcrySof ReSTOR Natural (SN60D3 model) implantation in 30 hyperopic eyes of presbyopes with low astigmatism (⩽1.00 diopter [D]). Stereoacuity measurements after implantation were compared with those found before surgery. Results: Stereoacuity was unchanged after RLE with pseudoaccommodative IOL implantation. In this population of non-cataractous hyperopes with excellent preoperative stereoacuity (46.42±1.36 se…

Schematic eye models to mimic the behavior of the accommodating human eye

A simplified version of the human eye is known as schematic eye model. Since the first attempts in the middle of the 19th century, numerous approaches describing new schematic eye models have been introduced. Some of them are able to describe the accommodation ability of the human eye. Accommodative schematic eyes could be of great interest since they are able to explain the functionality of the human eye and they can be easily used for different research purposes. Some of these include the design and testing of multifocal ophthalmic solutions, evaluation of the effect of optical aberrations on the retinal image quality, and study of the optical performance of the eye at different distances…

Clinical outcomes after implantation of a posterior chamber collagen copolymer phakic intraocular lens with a central hole for myopic correction.

Purpose To evaluate the efficacy, predictability, safety, and stability of a new-model posterior chamber Implantable Collamer Lens phakic intraocular lens (pIOL) (V4c Visian) to correct myopia. Setting Private practice, Oviedo, Spain. Design Case series. Methods This study enrolled patients who had implantation of a new pIOL design with a central hole for more natural aqueous flow, eliminating the need for neodymium:YAG iridotomy or peripheral iridectomy. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refractive error, intraocular pressure (IOP), endothelial cell count, central vault, and adverse events were evaluated 6 months postoperatively. Results The study enroll…

Collagen copolymer posterior chamber phakic intraocular lens for hyperopia correction: three-year follow-up.

Purpose To assess the efficacy, predictability, safety, and stability of the Visian V3 Implantable Collamer Lens posterior chamber phakic intraocular lens (PC pIOL) for moderate to high hyperopia. Setting Private clinic, Oviedo, Spain. Design Prospective nonrandomized clinical study. Methods The uncorrected (UDVA) and corrected (CDVA) distance visual acuities, manifest refraction, endothelial cell density, intraocular pressure (IOP), central vault, and adverse events were evaluated for 3 years postoperatively. Results The study comprised 73 eyes of 44 patients. The mean spherical equivalent decreased from +4.84 diopters (D) ± 1.6 (SD) (range +1.00 to +7.75 D) preoperatively to −0.13 ± 0.39 …

Visual performance of two simultaneous vision multifocal contact lenses

Purpose To evaluate and compare the visual performance of two simultaneous vision multifocal contact lenses (CLs). Methods In this cross-over study design 20 presbyopic subjects were fitted with two different simultaneous vision multifocal CLs (the PureVision Multifocal Low Add and Acuvue Oasys for Presbyopia) in random order. After 1 month, binocular distance visual acuity (BDVA) under photopic (85 cd/m2) and mesopic (3 cd/m2) conditions, binocular near visual acuity (BNVA), binocular distance contrast sensitivity function (CSF) under photopic and mesopic conditions, binocular near CSF and defocus curve were measured. Subjects were then refitted with the alternative correction and the proc…

Aspheric intraocular lenses enhance contrast sensitivity

Evaluation of: Pandita D, Raj SM, Vasavada VA, Vasavada VA, Kazi NS, Vasavada AR. Contrast sensitivity and glare disability after implantation of AcrySof IQ natural aspherical intraocular lens: pro...

Contrast sensitivity after LASIK flap creation with a femtosecond laser and a mechanical microkeratome

ABSTRACT PURPOSE: To compare the effects on contrast sensitivity of the IntraLase femtosecond laser for flap creation (IntraLASIK) and standard LASIK for myopia. METHODS: Two hundred eyes of 100 consecutive patients underwent LASIK treatment using the VISX S2 laser system. The femtosecond laser (15 kHz IntraLase) was used for flap creation in 100 eyes (50 patients) and a mechanical microkeratome (Carriazo-Barraquer) was used in 100 eyes (50 patients). Best spectacle-corrected contrast sensitivity was measured before and 6 months postoperatively in the IntraLASIK and mechanical LASIK groups. The IntraLASIK and mechanical LASIKinduced changes in contrast sensitivity were compared under photop…

Cataract surgery in West Africa: is couching still a choice?

Objective measurement of intraocular forward light scatter using Hartmann-Shack spot patterns from clinical aberrometers. Model-eye and human-eye study.

Purpose To apply software-based image-analysis tools to objectively determine intraocular scatter determined from clinically derived Hartmann-Shack patterns. Setting Aston Academy of Life Sciences, Aston University, Birmingham, United Kingdom, and Department of Optics, University of Valencia, Valencia, Spain. Methods Purpose-designed image-analysis software was used to quantify scatter from centroid patterns obtained using a clinical Hartmann-Shack analyzer (WASCA, Zeiss/Meditec). Three scatter values, as the maximum standard deviation within a lenslet for all lenslets in the pattern, were obtained in 6 model eyes and 10 human eyes. In the model-eye sample, patterns were obtained in 4 sessi…

Agreement of white-to-white measurements with the IOLMaster 700, Atlas 9000, and Sirius systems

Current advances in ocular surgery require the evaluation of differences in automated white-to-white (WTW) measurements between systems. We aim to analyze three different commonly used devices in clinical practice: the IOLMaster 700, the Atlas 9000, and the Sirius.Ninety right eyes of ninety healthy subjects were included. Measurements of WTW distances were taken with each device for all subjects in the same session and by the same observer. Statistical comparison was carried out by means of the rANOVA procedure and the Bonferroni post-hoc test. In addition, the Bland-Altman analysis was applied in order to perform pairwise comparisons.Average WTW values obtained by the IOLMaster 700, the A…

Femtosecond laser versus mechanical microkeratome laser in situ keratomileusis for myopia: Metaanalysis of randomized controlled trials.

Purpose To examine differences in efficacy, accuracy, safety, and changes in aberrations between femtosecond and mechanical microkeratome laser in situ keratomileusis (LASIK) for myopia. Setting Department of Ophthalmology, Shanghai First People's Hospital Affiliated to Shanghai Jiaotong University, Shanghai, China. Design Evidence-based manuscript. Methods Data sources, including PubMed, Medline, EMBASE, and Cochrane Controlled Trials Register, were searched to identify potentially relevant prospective randomized controlled trials. Primary outcome measures were efficacy (uncorrected distance visual acuity ≥20/20), accuracy (±0.50 diopter mean spherical equivalent), and safety (loss of ≥2 l…

Refractive lens exchange with Acri.LISA bifocal intraocular lens implantation.

PURPOSE To assess efficacy, safety, and predictability after refractive lens exchange (RLE) in patients who had bilateral implantation of an Acri.LISA 366D diffractive bifocal intraocular lens (IOL). METHODS Sixty-six eyes of 33 consecutive patients were examined after RLE who had bilateral implantation of an Acri.LISA bifocal 366D IOL. Eyes were divided into myopic and hyperopic groups. Monocular uncorrected distance visual acuity, best-corrected distance visual acuity (BCVA), uncorrected distance near visual acuity, and best distance-corrected near visual acuity (BCNVA) were recorded preoperatively and 6 months after surgery. RESULTS Efficacy indexes were 0.73 for myopic and 0.85 for hype…

Symmetric bilateral implantation of a distance-dominant diffractive bifocal intraocular lens

To assess visual results after symmetrical bilateral implantation of a distance-dominant bifocal diffractive intraocular lens (IOL).Fernández-Vega Ophthalmological Institute, Oviedo, Spain.Fifty patients had bilateral implantation of a distance-dominant diffractive bifocal 447D IOL (Acri.Tec GmbH) in a prospective study. Monocular and binocular best corrected distance visual acuities and best distance-corrected near visual acuity, binocular best distance-corrected intermediate visual acuity, and distance contrast sensitivity under photopic (85 cd/m(2)) and mesopic (5 cd/m(2)) conditions were determined.At the 6-month postoperative visit, the mean binocular best corrected distance acuity and…

Optical quality of the eye after lens replacement with a pseudoaccommodating intraocular lens

To examine the optical quality of healthy presbyopic eyes before and after implantation of the pseudoaccommodating AcrySof ReSTOR Natural intraocular lens (IOL) (Alcon Laboratories) by measuring visual acuity and wavefront aberrations.University of Valencia, Fernández-Vega Ophthalmological Institute, Valencia, Spain.Monocular refraction and photopic distance (6 m) and near (0.33 m) visual acuities were determined before and after clear lens extraction with bilateral AcrySof ReSTOR Natural IOL implantation in 30 hyperopic eyes (+0.50 to +4.00 diopters [D]) of presbyopic patients with low astigmatism (or = 1.00 D). Postsurgical binocular visual acuity was measured over a range of effective di…

Optical quality comparison among different Boston contact lens materials.

BACKGROUND The aim was to assess the optical quality of four Boston contact lens materials with an optical device based on Schlieren interferometry. METHODS The NIMO TR1504 (Lambda-X, Nivelles, Belgium) was used to measure higher-order aberrations and their corresponding root mean square values of four different rigid gas permeable contact lenses made from four different Boston materials: EO, ES, XO and XO2 . For each lens, 30 measurements were performed with two optical apertures: 3.0 mm and 6.0 mm. The modulation transfer function, point spread function, Strehl ratio and a simulation of the image provided by the lens were computed from the Zernike coefficients measured up to the fourth or…

Reliability results of straylight measurements using the C-Quant

Purpose Assessment of repeatability and reproducibility of straylight measures with the C-Quant straylightmeter (Oculus AG, Germany), effect of age on reliability measures and correlation of measures determined with new methods of scatter determination. Methods Results from different studies will be presented. For repeatability assessment, 20 eyes (age 26.9±2.7 years) were examined with the C-Quant, taking 10 consecutive readings. 5 subjects were also examined on 5 consecutive days to assess reproducibility. Repeated measures from 84 subjects, age range 19-86 years, were analysed to assess the effect of patient’s age. Software was developed to quantify scatter from centroid patterns obtaine…

In vitro optical performance of nonrotational symmetric and refractive-diffractive aspheric multifocal intraocular lenses: impact of tilt and decentration.

Purpose To evaluate the optical quality of Acrysof Restor SN6AD1 refractive–diffractive +3.00 D and Lentis Mplus LS-312 nonrotational symmetric +3.00 D aspheric multifocal intraocular lenses (IOLs) and analyze the effect of tilt and decentration. Setting University of Valencia, Valencia, and University of Murcia, Murcia, Spain. Design Experimental study. Methods An artificial model eye was used to measure wavefront aberrations of both IOL models. The modulation transfer function (MTF) and point-spread function (PSF) were calculated for a 5.0 mm pupil and under 5 situations: centered, 0.2 mm and 0.4 mm decentered, and 2 degrees and 4 degrees tilted. Results The refractive–diffractive IOL had…

Visual quality differences between orthokeratology and LASIK to compensate low-moderate myopia.

PURPOSE: To assess the differences in visual performance between orthokeratology (ortho-k) and laser in situ keratomileusis (LASIK) for the treatment of low-to-moderate myopia. METHODS: An adaptive optics visual simulator (Imagine Eyes) was used to simulate the wavefront aberration patterns induced by ortho-k and LASIK for low and moderate myopia on 10 healthy eyes. Visual acuity (VA) at 100%, 50%, and 10% contrast levels and contrast sensitivity (CS) at 10, 20 and 25 cycles per degree (cpd) were then measured for 3- and 6-mm pupil sizes. RESULTS: Differences in VA for 3-mm pupil diameter were not found between ortho-k and LASIK. For 6-mm pupil size, LASIK provided significantly better VA v…

Assessment of anterior segment measurements using a high-resolution imaging device

To assess the repeatability of several anterior segment parameters obtained with swept-source optical coherence tomography (SS-OCT).We measured 5-times consequently several parameters in 69 eyes using the ANTERION SS-OCT. White-to-white (WTW), angle-to-angle (ATA), spur-to-spur (STS), and lens vault distances were measured in the horizontal- and vertical-meridian. Anterior-chamber-angle (ACA), scleral-spur-angle (SSA), angle-opening-distance (AOD), and trabecular-iris-space-area (TISA) were measured at 500 and 750 μm for the superior-, nasal-,inferior-, and temporal-quadrants. Intrasubject standard deviation (Sw),coefficient of variation (CoV), coefficient of repeatability (CoR), and intrac…

Accommodation in human eye models: a comparison between the optical designs of Navarro, Arizona and Liou-Brennan.

Aim To simulate and compare accommodation in accommodative and non-accommodative human eye models. Methods Ray tracing and optical design program was used. Three eye models were designed and studied: the Navarro, the Arizona and the Liou-Brennan. In order to make the Navarro and Liou-Brennan models to accommodate, specific geometric parameters of the models were altered with values that were chosen from the literature. For the Arizona model, its' mathematical functions for accommodation were used for the same accommodative demands. The simulation included four distances of accommodation for each model: at infinity, 3, 1 and 0.5 m.The results were diffraction images of a "letter F" for graph…

Retinal straylight in patients with monofocal and multifocal intraocular lenses

Purpose To determine the differences in retinal straylight perceived by patients with monofocal intraocular lenses (IOLs) and patients with multifocal IOLs. Setting Vissum-Instituto de Oftalmologico de Alicante, Alicante, Spain. Methods In this prospective study, contrast sensitivity and retinal straylight were measured prospectively 6 months postoperatively in 67 eyes of 40 patients with a monofocal or multifocal IOL. In the monofocal group, a ThinOptX IOL (ThinOptX, Inc.) was implanted in 12 eyes and an Acri.Smart 48 S IOL (Acri.Tec) in 20 eyes. In the multifocal IOL group, a ReZoom IOL (Advanced Medical Optics) was implanted in 13 eyes and a ReSTOR IOL (Alcon Laboratories) in 22 eyes. Re…

Assessing the in vitro optical quality of presbyopic solutions based on the axial modulation transfer function.

Purpose To present a metric for assessing the in vitro optical quality of rotationally symmetrical optical elements based on volume calculation under the surface defined by the axial modulation transfer function (MTF). Setting University of Valencia, Valencia, Spain. Design Experimental study. Methods The metric volume under the axial MTF was used to assess the optical quality of 2 rotationally symmetrical multifocal intraocular lenses (IOLs) within various defocus intervals (0.50 diopter [D], 0.75 D, and 1.00 D) and at various spatial frequency intervals (7.5 cycles per degree [cpd], 15.0 cpd, and 30.0 cpd). Results The far focus of the bifocal IOL yielded higher volume values at all spati…

Prospective study of the Acri.LISA bifocal intraocular lens

To assess the visual results after bilateral implantation of the bifocal Acri.LISA 366D intraocular lens (IOL) (Acri.Tec AG).Fernández-Vega Ophthalmological Institute, Oviedo, Spain.Eighty-one patients had bilateral implantation of the distance-dominant bifocal Acri.LISA 366D IOL in a prospective study. Monocular and binocular best corrected distance visual acuity and best distance-corrected near visual acuity, binocular best distance-corrected intermediate visual acuity, and distance contrast sensitivity under photopic (85 cd/m(2)) and mesopic (5 cd/m(2)) conditions were determined.At the 3-month postoperative visit, the mean binocular best corrected distance acuity was 0.048 +/- 0.111 log…

Changes in anterior chamber eye during accommodation as assessed using a Dual Scheimpflug system

Purpose: To study the changes in anterior chamber depth (ACD), anterior chamber angle (ACA), and pupil diameter (PD) during accommodation. Methods: Eighty eyes of 80 subjects, aged 22 to 40 years, were included. The rotating Dual Scheimpflug and a Placido disc system (Galilei G4, Ziemer Ophthalmic Systems AG, Switzerland) was used to measure the changes in ACD, ACA, and PD during accommodation. ACD measurement was taken for the central zone and for 4 more positions, each in different orientation (nasal, superior, temporal and inferior), 4 mm away from the centre. ACA was measured for the whole eye as well for the nasal, superior, temporal, and inferior quadrants. These metrics were obtained…

Effect of Simulated IOL Tilt and Decentration on Spherical Aberration After Hyperopic LASIK for Different Intraocular Lenses

PURPOSE: To evaluate visual quality differences among intraocular lenses (IOLs) in patients with previous hyperopic laser ablations and to assess the impact of decentration and tilt of IOLs on visual quality. METHODS: An adaptive optics visual simulator was used to simulate the wavefront aberration pattern of one aberration-correcting IOL (AcrySof IQ SN60WF, Alcon Laboratories Inc) and two spherical IOLs with different amounts of positive spherical aberration (Akreos Adapt [Bausch &amp; Lomb] and Triplato [AJL Ophthalmic]) in five situations—centered, 0.2 mm and 0.4 mm of decentration, and 2° and 4° of tilt—in two groups: simulated low hyperopic laser corneal ablation (low hyperopia group)…

Mesopic Contrast Sensitivity Function After Laser in situ Keratomileusis

ABSTRACT PURPOSE: To evaluate contrast sensitivity under mesopic conditions in patients who have undergone uncomplicated bilateral laser in situ keratomileusis (LASIK) for myopia. METHODS: Best-corrected monocular contrast sensitivity was measured with the Stereo Optical F.A.C.T. chart at 1.5, 3, 6, 12, and 18 c/deg in 20 patients (20 left eyes) before and after bilateral LASIK (with the Nidek EC-5000 excimer laser and the Automated Corneal Shaper). Mean preoperative refractive error was -6.40 ± 1.28 D (range -4.00 to -8.00 D) and postoperative mean refractive error was -0.41 ± 0.45 D (range -0.75 to +0.50 D). Contrast sensitivity function was measured before and 6 months after surgery usin…

Contrast sensitivity after refractive lens exchange with diffractive multifocal intraocular lens implantation in hyperopic eyes

Contrast Test chart at distance and near under 3 luminance levels (85.0 cd/m 2 , 5.0 cd/m 2 , and 2.5 cd/m 2 ) before and after RLE with bilateral AcrySof ReSTOR IOL implantation in 30 hyperopic eyes with presbyopia and low astigmatism (%1.0 diopter). Results after surgery were compared with those before surgery. RESULTS: Six months postoperatively, the mean residual spherical equivalent refractive error was 0.21 diopter G 0.19 (SD). The best corrected distance and near visual acuities were comparable to those before surgery. For distance vision, the safety index was 1.02 and the efficacy index was 0.91. For near vision, the values were 1.04 and 1.02, respectively. There were no statistical…

Effect of 3rd-order aberrations on human vision

To investigate the effect of 3rd-order aberrations on human vision.Grupo de Ciencias de la Visión, University of Murcia, Murcia, Spain.The 3rd-order aberrations coma and trefoil were induced with purpose-designed soft contact lenses, 3 inducing coma (low [0.05 microm], medium [0.13 microm], high [1.03 microm]) and 3 inducing trefoil (low [0.07 microm], medium [0.17 microm], high [0.96 microm]). Monocular high-contrast (HCVA) and low-contrast (LCVA) visual acuities and contrast sensitivity were measured in 11 subjects wearing contact lenses with a 5.0 mm artificial pupil.The reduction in HCVA and LCVA was statistically significant only for the highest coma and trefoil values (P.0001). For co…

Intermediate visual function with different multifocal intraocular lens models

Purpose To compare visual acuity at different distances after bilateral implantation of 1 of 4 multifocal intraocular lenses (IOLs). Setting Fernandez-Vega Ophthalmological Institute, Oviedo, Spain. Methods This study evaluated consecutive patients who had bilateral implantation of a spherical multifocal IOL with a +4.00 diopter (D) addition (add) (AcrySof ReSTOR SN60D3) or an aspheric multifocal IOL with a +4.00 D add (AcrySof ReSTOR SN6AD3), +3.75 D add (Acri.LISA 366D), or +3.00 D add (AcrySof ReSTOR SN6AD1). Six months postoperatively, binocular measurement of corrected distance visual acuity (CDVA) at 4 m, corrected near visual acuity (CNVA) at 40 cm, and corrected intermediate visual …

In vitro power profiles of daily disposable contact lenses

Abstract Purpose To evaluate and compare the distribution of refractive power within the optic zone of different soft contact lenses and to investigate the effect of lens decentration on the power profiles. Methods The Nimo TR1504 instrument was used to measure the optical power across different aperture diameters (from 1.5 mm to 5.5 mm in steps of 0.5 mm) of four daily disposable contact lenses: DAILIES TOTAL1, Proclear 1-Day, SofLens daily disposable and 1-DAY ACUVUE MOIST. Measurements were performed using a wet cell. Power data were evaluated when contact lenses were in its centered position and after inducing different amounts of lens decentration (from 0.2 mm to 1.0 mm in steps of 0.2…

Long-term follow-up of a multifocal apodized diffractive intraocular lens after cataract surgery.

Purpose To report the long-term performance of the AcrySof ReSTOR SA60D3 intraocular lens (IOL) after cataract surgery. Setting University Hospital Maastricht, Maastricht, The Netherlands. Methods This prospective clinical trial comprised 44 eyes (22 consecutive patients) having cataract surgery with implantation of the ReSTOR IOL. Monocular and binocular uncorrected distance visual acuity, best corrected distance visual acuity, uncorrected near visual acuity, best distance-corrected near visual acuity, spectacle dependence, undesired visual symptoms, patient satisfaction, and incidence of posterior capsule opacification were analyzed 6 months and 3 years postoperatively. Results The mean u…

Changes in the anterior chamber during accommodation assessed with a Scheimpflug system.

Purpose To study changes in the anterior chamber depth (ACD), anterior chamber angle, and pupil diameter with accommodation. Setting University of Valencia, Valencia, Spain. Design Evaluation of diagnostic technology. Methods A rotating Scheimpflug camera (Pentacam HR) was used to measure changes in the ACD, anterior chamber angle, and pupil diameter with accommodation. Peripheral ACD was measured at the corneal center and 2.0 mm away from it in the nasal, superior, temporal, and inferior directions. The anterior chamber angle was computed as the mean anterior chamber angle of the entire eye. All measurements were obtained with accommodation stimuli ranging from +1.0 to −4.0 diopters (D) in…

In vitro power profiles of multifocal simultaneous vision contact lenses.

Abstract Purpose To evaluate the power profile of multifocal contact lenses (CLs) using a new technology based on quantitative deflectometry. Methods The Nimo TR1504 was used to analyze the power distribution of multifocal CLs. The CLs under study were: Air Optix Aqua Multifocal Low, Medium and High Addition and Focus Progressives. Three lenses of each model were considered. Results All multifocal CLs showed a power profile characterized by a change toward more positive power values when aperture sizes become smaller. The near refractive addition of the lenses under study was +2.61 D, +1.44 D, +1.30 D and +0.30 D for the Focus Progressives, the Air Optix Aqua Multifocal High, Medium Add and…

Repeatability of whole-cornea measurements using a new swept-source optical coherence tomographer

Purpose: The aim of this study was to evaluate the repeatability of several corneal parameters provided by a high-resolution swept-source optical coherence tomographer (SS-OCT). Methods: One eye from each of 74 patients was measured five times consequently using the ANTERION SS-OCT. The following corneal parameters were analyzed: average, steep and flat keratometry (K), astigmatism for anterior, posterior and total at 3-mm, average K and astigmatism at 6-mm, anterior and posterior eccentricity, higher-order aberrations (HOA) and spherical aberration ([Formula: see text]), and anterior and posterior best-fit sphere at 8-mm. The intrasubject standard deviation (Sw), coefficient of variation (…

Visual Performance after AcrySof ReSTOR Aspheric Intraocular Lens Implantation

Purpose: To evaluate distance, intermediate and near visual performance in patients who had undergone implantation of the multifocal aspheric AcrySof ReSTOR intraocular lens (IOL). Methods: Binocular best distance corrected visual acuity (BCVA) at high and low contrast [4 m], best distance corrected near visual acuity (BCNVA) [40 cm], intermediate visual acuity [80 and 60 cm], and distance contrast sensitivity (CS) under photopic [85 cd/m2] and mesopic [3 cd/m2] conditions, were measured in 36 eyes that underwent implantation of the AcrySof ReSTOR Aspheric IOL (SN6AD3). Results: At the 3-month postoperative visit, binocular BCVA was -0.058±0.091, 0.200±0.079, and 0.258±0.071 logMAR, for 100…

Device interchangeability on anterior chamber depth and white-to-white measurements: a thorough literature review

We have reviewed a set of recently published studies that compared the anterior chamber depth (ACD) and/or white-to-white (WTW) distance obtained by means of different measuring devices. Since some of those studies reached contradictory conclusions regarding device interchangeability, this review was carried out in attempting to clarify which clinical devices can or cannot be considered as interchangeable in clinical practice to measure ACD and/or WTW distance, among these devices: A-scan, ultrasound biomicroscopy, Orbscan and Orbscan II (Bausch&Lomb Surgical Inc., San Dimas, California, USA), Pentacam and Pentacam HR (Oculus, Wetzlar, Germany), Galilei (Ziemer, Switzerland), Visante optica…

Bilateral implantation of the Acri.LISA bifocal intraocular lens in myopic eyes.

Purpose To asses visual quality after bilateral implantation of the Acri.LISA 366D intraocular lens (IOL) (Carl Zeiss Meditec) in patients with high and low–moderate myopia. Methods A total of 304 eyes of 152 patients had bilateral implantation of the Acri.LISA 366D IOL. The patients were divided into 2 groups: low–moderate myopia (IOL power from 15 to 20.5 D) and high myopia (IOL power from 0 to 14.5 D). Monocular and binocular best-corrected distance visual acuity (BCVA) and best distance-corrected near visual acuity (BCNVA), binocular best distance-corrected intermediate visual acuity (BCIVA), and distance contrast sensitivity (OS) under photopic (85 cd/m2) and mesopic (5 cd/m2) conditio…

OCT for Assessing Artificial Tears Effectiveness in Contact Lens Wearers

PURPOSE: To apply a commercially available high-resolution spectral domain optical coherence tomographer (SOCT) to assess the change in tear volume after application of a new artificial tears formulation specifically developed for contact lens (CL) users. METHODS: Twenty OD from young healthy CL wearers (mean age, 24.7 ± 3.5 years) with refractive errors ranging from -0.75 to -2.50 D (mean, -1.56 ± 0.69 D) were examined. All subjects were fitted with Focus Dailies CL (Ciba Vision), and two drops of Blink Contacts (AMO), lubricating formulation specifically developed for CL wearers, were instilled after baseline measures. Tear meniscus volume (TMV) was measured immediately after and 1 min, 1…

In vitro optical quality differences between multifocal apodized diffractive intraocular lenses.

Purpose To compare the in vitro optical quality of multifocal apodized intraocular lenses (IOLs) at different focal points. Setting University of Valencia, Valencia, Spain. Design Experimental study. Methods The Acrysof Restor +3.0 diopter (D) multifocal IOL with 2 main foci (bifocal IOL) and the Finevision multifocal IOL with 3 main foci (trifocal IOL) were evaluated. The optical quality was quantified using the modulation transfer function (MTF) at 7 focal points and for 3.0 mm and 4.5 mm apertures. The through-focus MTF at 10 focal points of the IOLs was also recorded. Results For the 0.0 D and −2.5 D focal points, the bifocal IOL showed the highest MTF values for pupil sizes as well as …

Implantable collamer lens and femtosecond laser for myopia: comparison using an adaptive optics visual simulator.

Purpose: To compare optical and visual quality of implantable collamer lens (ICL) implantation and femtosecond laser in situ keratomileusis (F-LASIK) for myopia. Methods: The CRX1 adaptive optics visual simulator (Imagine Eyes, Orsay, France) was used to simulate the wavefront aberration pattern after the two surgical procedures for -3-diopter (D) and -6-D myopia. Visual acuity at different contrasts and contrast sensitivities at 10, 20, and 25 cycles/degree (cpd) were measured for 3-mm and 5-mm pupils. The modulation transfer function (MTF) and point spread function (PSF) were calculated for 5-mm pupils. Results: F-LASIK MTF was worse than ICL MTF, which was close to diffraction-limited MT…

Pseudoaccommodating intraocular lens implantation in patients with irregular nonreactive pupils.

We report 3 patients implanted with the AcrySof ReSTOR pseudoaccommodating intraocular lens (IOL) who had irregular nonreactive pupils as a consequence of pupil stretching during phacoemulsification. Despite the pupils, the visual acuity at distance and near was not compromised. The outcome in these cases suggests that an irregular nonreactive pupil is not an exclusion criterion for pseudoaccommodating IOL implantation.

Five-year functional outcomes and vault of -20 diopter myopic phakic intraocular lens implantation.

Purpose To evaluate refractive and visual outcomes and complications associated with phakic intraocular lens (pIOL) implantation to correct high myopia. Settings Fernandez-Vega Ophthalmological Institute, Oviedo, Spain. Design Retrospective observational case series. Methods Uncorrected distance visual acuity (UDVA) and corrected distance visual acuity (CDVA), refraction, vault, and adverse effects were evaluated after 5 years with Visian ICMV4 pIOL. Results Mean spherical equivalent (SE) dropped from −18.32 ± 2.37 diopters (D) preoperatively to −0.88 ± 0.52D 5 years postoperatively; 61% of eyes were within ±0.75 D of the target. The mean Snellen decimal CDVA and UDVA were 0.73 ± 0.23 and 0…

Posterior chamber phakic intraocular lenses after penetrating keratoplasty.

Purpose To evaluate the efficacy, predictability, and safety of a phakic posterior chamber intraocular Collamer lens (ICL) after penetrating keratoplasty (PKP). Setting Fernandez-Vega Ophthalmological Institute, Oviedo, Spain. Methods A myopic or toric ICL was implanted after PKP in eyes unable to wear glasses or contact lenses and for which corneal laser surgery was contraindicated. The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive error, and endothelial cell count were recorded preoperatively and 24 months postoperatively. Results Preoperatively, the 15 eyes had myopia from −2.00 to −17.00 diopters (D) or astigmatism from −1.50 to −7.00 D. …

Technical note: a comparison of central and peripheral intraocular pressure using rebound tonometry

Purpose: To compare central and peripheral intraocular pressure (IOP) readings obtained with rebound tonometry.Methods: Intraocular pressure was measured on the right eye of 153 patients (65 males, 88 females), aged from 21 to 85 years (mean +/- S.D., 55.5 +/- 15.2 years) with the ICare rebound tonometer at centre, and 2 mm from the limbus (in the nasal and temporal regions along the 0-180O corneal meridian).Results: Intraocular pressure values obtained with the ICare were 14.9 +/- 2.8; 14.1 +/- 2.5 and 14.5 +/- 2.7 mmHg at centre, nasal and temporal corneal locations, respectively. On average, nasal and temporal IOP readings were 0.75 and 0.37 mmHg lower than the central reading (p 0.05, r…

Objective Amplitude of Accommodation Computed from Optical Quality Metrics Applied to Wavefront Outcomes

Purpose: We studied the accuracy and precision of 32 objective wavefront methods for finding the amplitude of accommodation obtained in 180 eyes. Methods: Ocular accommodation was stimulated with 0.5 D steps in target vergence spanning the full range of accommodation for each subject. Subjective monocular amplitude of accommodation was measured using two clinical methods, using negative lenses and with a custom Badal optometer. Results: Both subjective methods gave similar results. Results obtained from the Badal optometer where used to test the accuracy of the objective methods. All objective methods showed lower amplitude of accommodation that the subjective ones by an amount that varied …

Two-year retrospective analysis of the international impact of Journal of Optometry: part II

The Journal of Optometry – Peer-reviewed Journal of the Spanish General Council of Optometrists- was launched in March 2008 publishing the first issue by September 2008. It is now reaching 2.5 years of activity in spreading clinical and scientific knowledge in the field of Optometry and Visual Science and related areas. Despite this short path within the international scientific publication scenario, it is appropriate to stop and reflect about the challenges, achievements and the numbers that are making J Optom a reference in this competitive area. In this editorial we will discuss the steps followed to setup the journal and the actual international impact in terms of audience from the read…

Optical quality comparison between 2 collagen copolymer posterior chamber phakic intraocular lens designs

Purpose To compare the optical quality in vitro of 2 designs of the Visian Implantable Collamer Lens phakic intraocular lens (pIOL) for different powers and optical apertures. Setting University of Valencia, Valencia, Spain. Design Experimental study. Methods The Nimo TR1504 deflectometry device was used to measure the V4c pIOL, which has a smaller optic diameter, and the V5 pIOL, which has a larger optic diameter. The pIOLs were measured for −3.00 diopters (D), −6.00 D, −9.50 D, and −10.50 D at different optical apertures from 3.00 to 6.00 mm depending on the IOL power and model. The root mean square of higher-order aberrations (RMS HOAs) was analyzed. The Strehl ratio, point-spread functi…

Femtosecond laser for residual refractive error correction after refractive lens exchange with multifocal intraocular lens implantation.

Purpose To assess visual and refractive outcomes of femtosecond laser for residual refractive error correction after refractive lens exchange (RLE) with multifocal intraocular lens (IOL) implantation. Design Prospective, nonrandomized, masked observational case series (self-controlled). Methods Fifty-three eyes of 31 consecutive patients were submitted to femtosecond laser surgery after RLE with multifocal IOL implantation. Patients showed an average manifest refractive error (D) of M , 0.200 ± 0.490; J 0 , −0.051 ± 0.532; and J 45 , −0.007 ± 0.371. Visual acuity (VA) was measured at distance and near vision before and six months after the surgery. Results At six months after surgery, mean …

Performance of a new device for the clinical determination of light discomfort

PURPOSE To assess the performance of a new device for the clinical determination of light discomfort on a large sample of healthy human subjects. METHODS A total of 489 subjects ranging from 20 to 70 years old (241 men, 248 women) were evaluated with the LUMIZ™ 100 to determine light discomfort. Repeatability was assessed by means of within-subject standard deviation, coefficient of variation (CoV), and intraclass correlation coefficient (ICC). Repeated measures ANOVA, Kruskal-Wallis, and correlation analysis were applied to test for differences between repeated measures, and effect of age on reliability. RESULTS Discomfort thresholds obtained are well distributed across the light intensity…

Implantable collamer lens with central hole: 3-year follow-up.

Luis Fern&amp;aacute;ndez-Vega-Cueto,1 Carlos Lisa,1 Jos&amp;eacute; J Esteve-Taboada,2 Robert Mont&amp;eacute;s-Mic&amp;oacute;,2 Jos&amp;eacute; F Alfonso1,3 1Department of Surgery, Fern&amp;aacute;ndez-Vega Ophthalmological Institute, Oviedo, Spain; 2Department of Optics and Optometry and Visual Sciences, University of Valencia, Valencia, Spain; 3School of Medicine, University of Oviedo, Oviedo, Spain Purpose: To evaluate the long-term predictability, stability, safety, and efficacy of the V4c Visian implantable collamer lens (ICL) with central hole to correct myopia.Patients and methods: One hundred and eighty-four eyes of 92 patients were evaluated during 3 years after implantation of …

Correlation of pupil size with visual acuity and contrast sensitivity after implantation of an apodized diffractive intraocular lens

To determine whether pupil size is correlated with visual acuity and contrast sensitivity at all distances in eyes with an apodized diffractive intraocular lens (IOL).Private Clinic, Oviedo, Spain.Six months after surgery, the best corrected distance visual acuity, best distance-corrected near visual acuity, intermediate visual acuity, and distance contrast sensitivity under photopic (85 cd/m2) and mesopic (5 cd/m2) conditions were measured in 670 eyes of 335 consecutive patients who had implantation of the AcrySof ReSTOR Natural IOL (SN60D3, Alcon). Pupil diameters in distance vision were measured using a pupillometer.The logMAR best corrected distance acuity was significantly better with …

The effect of simulated normal and amblyopic higher-order aberrations on visual performance.

Purpose To study the effect of simulated amblyopic and normal higher-order aberrations on visual performance of normal eyes. Methods To assess visual function, an adaptive optics visual simulator was used to compensate volunteers' ocular aberrations and simulate the wavefront aberration patterns found in healthy and amblyopic eyes in 7 healthy individuals. Visual acuity for high (100%), medium (50%), and low (10%) contrast and contrast sensitivity at 10, 20, and 25 cycles per degree (cpd) were measured after simulation of both pattern aberrations. The modulation transfer function and the point spread function were computed based on the aberration data. All measures were taken for 3 and 5.5 …

Visual function comparison of 2 aspheric multifocal intraocular lenses

To compare visual function after bilateral implantation of the multifocal Lentis Mplus LS-312 with a nonrotational symmetrical design (copolymer aspheric) or the Acrysof Restor SN6AD1 +3.0 D (hybrid aspheric) intraocular lens (IOL).Fernández-Vega Ophthalmological Institute, Oviedo, Spain.Comparative case series.Six months postoperatively, corrected distance visual acuity (CDVA), distance-corrected near visual acuity (DCNVA), the defocus curve, and photopic and mesopic contrast sensitivity with and without glare were measured.The mean CDVA was 0.02 ± 0.06 (SD) with the copolymer aspheric IOL and -0.06 ± 0.05 logMAR with the hybrid aspheric IOL (P=.07) and the mean DCNVA, 0.10 ± 0.06 and -0.0…

Optical quality in eyes with aspheric intraocular lenses and in younger and older adult phakic eyes: comparative study.

To compare ocular higher-order aberrations (HOAs) in eyes with aspheric intraocular lenses (IOL) and in phakic eyes.Department of Ophthalmology, Military Health Service Institute, Warsaw, Poland.Higher-order aberrations with a 5.0 mm pupil and best spectacle-corrected visual acuity (BSCVA) were analyzed in a young phakic group (age 20 to 40 years), older phakic group (age 40 to 60 years), and a pseudophakic group (age 62 to 84 years; SN60WF aspheric IOL).The mean coma was 0.13 microm+/-0.07 (SD) in the younger phakic group, 0.18+/-0.08 microm in the older phakic group, and 0.16+/-0.08 microm in the pseudophakic group; the difference between the 2 phakic groups was statistically significant …

Contrast sensitivity loss in the peripheral visual field following laser in situ keratomileusis.

We report a case of contrast sensitivity loss in the peripheral visual field following laser in situ keratomileusis (LASIK). A 50-year-old white man was referred to us for differences in visual perception in the peripheral field between the right eye, which had had LASIK, and the left eye, which was emmetropic. Linear meridional static perimetry was carried out in the 0- to 180-degree meridian using a Goldmann perimeter to assess the peripheral perimetric thresholds. There was a statistically significantly marked increased threshold in contrast sensitivity in the nasal and temporal fields from 40 degrees of eccentricity in the LASIK eye compared with that in the emmetropic eye. Eyes treated…

Repeatability assessment of biometric measurements with different refractive states and age using a swept-source biometer

Background We aim to assess if refractive error or age may influence the repeatability of measurements using a swept-source biometer. Methods A total of 61 subjects were evaluated with IOLMaster 700 acquiring measurements of axial length (AL), central corneal thickness (CCT), white-to-white distance (WTW), anterior aqueous depth (AQD), lens thickness (LT), and keratometry (K) readings. Repeatability was evaluated classifying the sample according to the refractive state and age by the calculation of the within-subject standard deviation (Sw), coefficient of repeatability, and intraclass correlation coefficient. Results Very similar Sw was acquired among groups for AL, CCT, and WTW. Differenc…

Visual function after implantation of an aspheric bifocal intraocular lens.

Purpose To evaluate distance, intermediate, and near vision after bifocal aspheric AcrySof ReSTOR SN6AD1 intraocular lens (IOL) implantation. Setting Fernandez-Vega Ophthalmological Institute, Oviedo, Spain. Methods Binocular distance best corrected visual acuity (BCVA) (4.0 m), best distance-corrected near (40.0 cm) and intermediate (70.0, 60.0, 50.0 cm) acuities, and contrast sensitivity under photopic (85.0 candelas [cd]/m 2 ) and mesopic (3.0 cd/m 2 ) conditions with and without glare were measured postoperatively. A patient-satisfaction and visual phenomena questionnaire was administered. Results Six months postoperatively, the mean acuities (logMAR) were binocular BCVA, −0.064 ± 0.049…

Visual performance with multifocal intraocular lenses

Abstract Objective To evaluate distance and near visual performance under bright (photopic) and dim (mesopic) conditions in patients who had undergone uncomplicated cataract extraction with multifocal or monofocal intraocular lens (IOL) implantation. Design Prospective, nonrandomized, masked, comparative, observational case series. Participants Thirty-two eyes of 32 patients after zonal-progressive multifocal IOL implantation (Allergan Medical Optics Array SA-40N) and 32 eyes of 32 age-matched patients after monofocal IOL implantation (Allergan Medical Optics SI-40NB). Intervention All eyes underwent phacoemulsification and IOL implantation. Main outcome measures At 18 months after surgery,…

Objective vs Subjective Vault Measurement After Myopic Implantable Collamer Lens Implantation

PURPOSE: To evaluate the relationship between subjective measurements of vault and objective values measured with Visante optical coherence tomography (OCT) in eyes receiving an implantable contact lens (ICL) for myopia correction. DESIGN: Observational cross-sectional study. METHODS: SETTING: Fernández-Vega Ophthalmological Institute, Oviedo, Spain. PATIENTS: Four hundred and fifty-two eyes from 246 patients were elected to be implanted with a Visian ICL V4 (STAAR Surgical Inc, Monrovia, California, USA). OBSERVATION PROCEDURES: Subjective and objective measurements of vault after implantation of ICL. MAIN OUTCOME MEASURES: Subjective vault classified in 5 levels assessed using an optical …

Image quality and visual performance in the peripheral visual field following photorefractive keratectomy.

ABSTRACT PURPOSE: A theoretical and experimental study was performed to assess the possible effects of photorefractive keratectomy (PRK) on retinal image quality and thresholds in the peripheral visual field. METHODS: Simple optical calculations suggest that although the quality of the retinal image at the fovea of the postoperative PRK eye may be comparable to that in an emmetropic eye, images in the peripheral field may be markedly worse, since peripheral ray bundles may pass partly through ablated and partly through unablated cornea, giving a simultaneous-vision bifocal effect. This would be expected to create an annular zone of confusion, so that light from two different directions in o…

Avaliação da resposta de acomodação após tarefas visuais próximas usando diferentes dispositivos eletrônicos portáteis

ABSTRACT Purpose: To assess the accommodation response after short reading periods using a tablet and a smartphone as well as determine potential differences in the accommodation response at various stimulus vergences using a Hartmann- Shack aberrometer. Methods: Eighteen healthy subjects with astigmatism of less than 1 D, corrected visual acuity of 20/20 or better, and normal findings in an ophthalmic examination were enrolled. Accommodation responses were obtained under three different conditions: accommodation system of the eye relaxed and visually stressed with a tablet and an smartphone for 10 min, at a distance of 0.25 m from the subject's eyes. Three measurements of accommodation res…

Visual Function after Implantation of a Presbyopia-Correcting Trifocal Intraocular Lens

&lt;b&gt;&lt;i&gt;Purpose:&lt;/i&gt;&lt;/b&gt; To evaluate distance, intermediate, and near visual performance in patients implanted with a trifocal aspheric presbyopia-correcting intraocular lens (IOL). &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; Forty patients were bilaterally implanted with the AcrySofIQ PanOptix IOL after femtosecond laser-assisted lens surgery. Binocular best corrected distance visual acuity (CDVA) (4 m), best distance-corrected near visual acuity (DCNVA) (40 and 30 cm), best corrected distance intermediate visual acuity (DCIVA) (70, 60, and 50 cm), binocular distance contrast sensitivity under photopic conditions (85 cd/m&lt;sup&gt;2&lt;/sup&gt;), and defocus curve…

Crystalens HD Intraocular Lens Analysis Using an Adaptive Optics Visual Simulator

PURPOSE To compare visual and optical quality of the Crystalens HD intraocular lens (IOL) with that of a monofocal IOL. METHODS The wavefront aberration patterns of the monocular Akreos Adapt AO IOL and the single-optic accommodating Crystalens HD IOL were measured in a model eye. The Crystalens IOL was measured in its nonaccommodative state and then, after flexing the haptic to produce 1.4 mm of movement, in its accommodative state. Using an adaptive optics system, subjects' aberrations were removed and replaced with those of pseudophakes viewing with either lens. Monocular distance visual acuity (DVA) at high (100%), medium (50%), and low (10%) contrast and contrast sensitivity (CS) were …

Interchangeability among five devices that measure anterior eye distances.

The aim was to study the interchangeability of various devices that measure anterior chamber depth (ACD) and white-to-white (WTW) distance.Eighty right eyes of eighty patients aged 20 to 40 years were included. Their spherical equivalent ranged from -4.25 to +1.00 dioptres. Each eye's ACD and the WTW distance were measured using the following devices: a Castroviejo surgical calliper, CA-200F Corneal Analyser, Orbscan II, Pentacam HR and IOLMaster 500.The Pentacam HR measured significantly greater ACD (p0.01) than the other two devices, whereas IOLMaster 500 and Orbscan II yielded comparable (p0.01) distances. Nonetheless, in every device comparison, the mean difference was within clinically…

Comparison of partial coherence interferometry and ultrasound for anterior segment biometry.

To assess the performance of a partial coherence interferometry (PCI)-based device for the determination of anterior segment biometry.Clinica Centrofama, Cartagena, Murcia, Spain.Central corneal thickness (CCT), anterior chamber depth (ACD), and lens thickness (LT) were measured with the ACMaster PCI anterior segment biometer and an Echoscan US-1800 ultrasound (US) biometer/pachymeter with and without cycloplegia. To determine the precision of the instruments, the same examiner took 30 consecutive CCT, ACD, and LT measurements in a single subject under the same conditions and with and without cycloplegia. The same measurements were performed in additional subjects.Twenty-one eyes (16 subjec…

Repeatability of whole-cornea measurements using an anterior segment imaging device based on OCT and Placido-disk

Current advances in refractive surgery require high accuracy of corneal measurements. We aim to evaluate the repeatability of topographic measurements using an integrated Placido disk - OCT device.Thirty right eyes of thirty healthy and young subjects were included. The topographic parameters of simulated keratometry, asphericity, minimum pachymetry, white-to-white distance, spherical aberration and corneal elevation were studied. Three measurements were taken by the same observer using the Visante omni device. The coefficient of repeatability (CoR), coefficient of variation (CoV) and intraclass correlation coefficient (ICC) were calculated to assess the repeatability. The Bland-Altman grap…

Visual quality comparison of conventional and Hole-Visian implantable collamer lens at different degrees of decentering

Purpose To compare the visual quality of implantable collamer lens (ICL) with and without central hole (Hole ICL and conventional ICL) at different degrees of decentering. Methods An adaptive optics visual simulator (crx1, Imagine Eyes, Orsay, France) was used to simulate the –3, –6 and –12 dioptres (D) conventional and Hole ICLs in three conditions: centred and decentred 0.3 and 0.6 mm. Visual acuity (VA) at high-contrast, medium-contrast and low-contrast and contrast sensitivity (CS) were measured in 15 observers for 3 and 4.5 mm pupils. Results No statistically significant differences in VA and CS were found between conventional and Hole ICLs for any ICL powers and pupil sizes evaluated …

Assessment of corneal thickness and tear meniscus during contact-lens wear

To assess the effect of seven different daily disposable contact lenses upon corneal thickness, as well as upon tear meniscus volume, by using optical coherence tomography (OCT).Thirty-four young healthy subjects wore seven different types of daily disposable soft contact lenses, each for a period of 12h: Delefilcon A, Nelfilcon A, Omafilcon A, Filcon II3, Narafilcon A, Etafilcon A and Hilafilcon B. Central and mid-peripheral corneal thickness and lower tear meniscus volume (TMV) were measured using an OCT device during contact-lens wear at 4-h intervals throughout a 12-h period. Measurements were also recorded without any contact lenses being worn during a day.In the no-lens scenario a sma…

Simulated prototype of posterior chamber phakic intraocular lens for presbyopia correction.

Purpose To evaluate the visual impact of adding different spherical aberration values to an Implantable Collamer Lens phakic intraocular lens (pIOL) to increase the depth of focus using an adaptive optics visual simulator. Setting University of Valencia, Valencia, Spain. Design Experimental study. Methods Wavefront aberrations in −3.00 D and −6.00 diopter (D) pIOLs were measured in vitro. Afterward, different simulated pIOL experimental prototypes were created along with variances in the spherical aberration. An adaptive optics visual simulator was used to simulate vision after the implantation of the different pIOL prototypes from their wavefront aberrations. The corrected distance visual …

Comparison of higher order aberrations measured by NIDEK OPD-Scan dynamic skiascopy and Zeiss WASCA Hartmann-Shack aberrometers.

&lt;h4&gt;PURPOSE&lt;/h4&gt;&lt;p&gt;To compare the measurement of wavefront aberrations in non-cyclopleged human eyes with Hartmann-Shack and dynamic skiascopy wavefront analyzers.&lt;/p&gt; &lt;h4&gt;METHODS&lt;/h4&gt;&lt;p&gt;Eighty eyes of 40 healthy young adults (19 men, 21 women; mean age 20.8±2.5 years) with refractive errors ranging from +1.50 to –9.75 diopters (D) sphere and up to 1.75 D cylinder (mean spherical equivalent refraction –2.12±2.69 D) were examined with the Zeiss/Meditec WASCA and NIDEK OPD-Scan wavefront analyzers and with the Nippon SRW5000 binocular, open-field autorefractor without the instillation of antimuscarinic agents. Three measurements were taken with each s…

Visual Performance of Four Simultaneous-Image Multifocal Contact Lenses Under Dim and Glare Conditions

To assess and compare the effects of four simultaneous-image multifocal contact lenses (SIMCLs), and those with distant-vision-only contact lenses on visual performance in early presbyopes, under dim conditions, including the effects of induced glare.In this double-masked crossover study design, 28 presbyopic subjects aged 40 to 46 years were included. All participants were fitted with the four different SIMCLs (Air Optix Aqua Multifocal [AOAM; Alcon], PureVision Multifocal [PM; BauschLomb], Acuvue Oasys for Presbyopia [AOP; JohnsonJohnson Vision], and Biofinity Multifocal [BM; CooperVision]) and with monofocal contact lenses (Air Optix Aqua, Alcon). After 1 month of daily contact lens wear…

Optical Quality Comparison between Spherical and Aspheric Toric Intraocular Lenses

Purpose To measure and compare the optical quality of spherical and aspheric toric intraocular lenses (IOLs). Methods Wavefront aberrations of AcrySof Toric and IQ Toric IOLs (Alcon Laboratories) for different powers were measured at 3- and 5-mm pupils by Nimo TR0805 instrument. The Zernike coefficients of trefoil, coma, tetrafoil, secondary astigmatism, and spherical aberration were evaluated. The point spread functions (PSFs) of each IOL evaluated were calculated from the wavefront aberrations. The PSF images also were calculated from the IOL wavefront aberrations, adding the cornea's aberrations to simulate the optical quality after their implantation. Results Spherical toric IOLs showed…

In vitro optical quality comparison of 2 trifocal intraocular lenses and 1 progressive multifocal intraocular lens.

Purpose To evaluate the optical quality of 3 multifocal intraocular lenses (IOLs): the Mini Well Ready progressive multifocal aspheric IOL, the AT LISA trifocal diffractive IOL, and the Finevision full diffractive trifocal IOL. Setting University of Valencia, Valencia, Spain. Design Experimental study. Methods An instrument designed for measuring real-time modulation transfer function (MTF) and IOL power was used to measure the optical quality of each IOL for 3.0 mm and 4.5 mm apertures. This instrument measures both sagittal and tangential MTFs. The optical quality of each IOL was evaluated with the MTF, through-focus MTF, defocus tolerance, Strehl ratio MTF, and relative percentage of lig…

Optical and visual performance of diffractive intraocular lens implantation after myopic laser in situ keratomileusis

To evaluate the optical and visual quality in eyes with diffractive intraocular lenses (IOLs) after myopic laser in situ keratomileusis (LASIK).Fernández-Vega Ophthalmological Institute, Oviedo, Spain.The best corrected visual acuity (BCVA [distance]) at 12.5%, 25.0%, and 100% contrasts under photopic and mesopic conditions; best distance-corrected near acuity; corneal total higher-order aberrations (HOAs); and optical quality by modulation transfer function (MTF) were measured after myopic LASIK in eyes with a spherical AcrySof ReSTOR SN60D3 IOL or an aspheric Acri.LISA 366D IOL and phakic eyes (control).Under photopic conditions at 100% contrast, the BCVA was 0.1 logMAR or better in all g…

Visual and Refractive Outcomes in Hyperopic Pseudophakic Patients Implanted with the Acri.LISA 366D Multifocal Intraocular Lens

Our purpose was to assess the visual quality after bilateral implantation of the Acri.LISA 366D intraocular lens (IOL; Carl Zeiss Meditec, Jena, Germany) in patients with hyperopia. We did a prospective and nonrandomized study. One hundred and seventy eyes of 85 patients had bilateral implantation of the Acri.LISA 366D IOL. The patients were divided into 2 groups: low to moderate hyperopia (IOL power, 21 to 24.5 diopters [D]) and high hyperopia (IOL power, 25 to 36 D). Monocular and binocular best spectacle-corrected visual acuity (BSCVA), best distance-corrected near visual acuity (BCNVA), binocular best distance-corrected intermediate visual acuity (VA), and distance contrast sensitivity …

Effect of age in the ciliary muscle during accommodation: Sectorial analysis

Abstract Purpose To compare changes in the ciliary muscle area at different sectors between pre-presbyopic and presbyopic eyes during accommodation by means of an anterior segment optical coherence tomographer (OCT). Methods The anterior ciliary muscle area was measured in 20 healthy and phakic pre-presbyopic eyes, whose mean age was 23.3 ± 4.4 years, and in 20 healthy and phakic presbyopic eyes, whose mean age was 46.5 ± 5.2 years. The relative change in the cross-sectional area of the ciliary muscle was measured at the nasal, inferior, and temporal sectors between 0 and −3 D of vergence, in −1 D step. A linear model was used to assess the correlation of each eye parameter with the accommo…

&lt;p&gt;Visual And Refractive Outcomes In Hyperopic Pseudophakic Patients Implanted With A Trifocal Intraocular Lens&lt;/p&gt;

Purpose To assess visual and refractive results after bilateral implantation of a trifocal intraocular lens (IOL) in patients with hyperopia. Methods In a retrospective nonrandomized study, 196 eyes of 98 patients had bilateral implantation of a trifocal IOL. The Barrett Universal II formula was used for IOL power calculation. Eyes were divided into two groups for their analysis: low-moderate, with IOL power ranging from 22 to 26 D, and high, with IOL power ranging from 25 to 34 D. Refractive error was used to assess predictability, and corrected distance visual acuity (CDVA) and uncorrected distance visual acuity values were used to assess efficacy and safety of the surgery. Results Six mo…

Effect of Phenylephrine on the Accommodative System

Accommodation is controlled by the action of the ciliary muscle and mediated primarily by parasympathetic input through postganglionic fibers that originate from neurons in the ciliary and pterygopalatine ganglia. During accommodation the pupil constricts to increase the depth of focus of the eye and improve retinal image quality. Researchers have traditionally faced the challenge of measuring the accommodative properties of the eye through a small pupil and thus have relied on pharmacological agents to dilate the pupil. Achieving pupil dilation (mydriasis) without affecting the accommodative ability of the eye (cycloplegia) could be useful in many clinical and research contexts. Phenylephr…

Assessing the accommodation response after near visual tasks using different handheld electronic devices

ABSTRACT Purpose: To assess the accommodation response after short reading periods using a tablet and a smartphone as well as determine potential differences in the accommodation response at various stimulus vergences using a Hartmann- Shack aberrometer. Methods: Eighteen healthy subjects with astigmatism of less than 1 D, corrected visual acuity of 20/20 or better, and normal findings in an ophthalmic examination were enrolled. Accommodation responses were obtained under three different conditions: accommodation system of the eye relaxed and visually stressed with a tablet and an smartphone for 10 min, at a distance of 0.25 m from the subject's eyes. Three measurements of accommodation res…

Effect of contact lenses on ocular biometric measurements based on swept-source optical coherence tomography

ABSTRACT Purpose: To determine the reliability of swept- source optical coherence tomography in cases in which soft contact lenses cannot be removed when acquiring biometric measurements. Methods: Eight subjects were included and only one eye per participant was analyzed. Each eye was measured six times by swept-source optical coherence tomography with the IOLMaster 700 instrument (Carl Zeiss Meditec, Jena, Germany). Axial length, central corneal thickness, anterior chamber depth, lens thickness, and keratometric measurements were evaluated for the naked eye and while wearing soft contact lenses of three different powers (-1.5, -3.0, and +2.0 D). Results: There were statistically significan…

Measurements of anterior chamber depth, white-to-white distance, anterior chamber angle, and pupil diameter using two Scheimpflug imaging devices

Purpose: To compare the ocular anterior chamber depth, white-to-white distance, anterior chamber angle, and pupil diameter, as measured with two different Scheimpflug imaging devices. Methods: This transversal study included 80 right eyes from 80 subjects aged from 20 to 40 years. Their spherical equivalents ranged from -4.25 to +1.00 diopters (D). Each eye's anterior chamber depth, white-to-white distance, anterior chamber angle, and pupil diameter, were measured for far vision using both the Galilei G4 (double Scheimpflug camera) and the Pentacam HR (single Scheimpflug camera) systems. Results: Mean anterior chamber depths were calculated as 3.12 ± 0.23 mm and 3.19 ± 0.24 mm when measured…

Changes in anterior chamber eye during accommodation as assessed using a Dual Scheimpflug system

Purpose: To study the changes in anterior chamber depth (ACD), anterior chamber angle (ACA), and pupil diameter (PD) during accommodation. Methods: Eighty eyes of 80 subjects, aged 22 to 40 years, were included. The rotating Dual Scheimpflug and a Placido disc system (Galilei G4, Ziemer Ophthalmic Systems AG, Switzerland) was used to measure the changes in ACD, ACA, and PD during accommodation. ACD measurement was taken for the central zone and for 4 more positions, each in different orientation (nasal, superior, temporal and inferior), 4 mm away from the centre. ACA was measured for the whole eye as well for the nasal, superior, temporal, and inferior quadrants. These metrics were obtained…

In vivo OCT assessment of anterior segment central axial lengths with accommodation

ABSTRACT Purpose: To assess changes in anatomic structures in the anterior eye segment in terms of axial lengths with accommodation via optical coherence tomography. Methods: In this observational study, 25 eyes of 25 healthy adults were examined using the Visante® omni optical coherence tomography system. Central corneal thickness, anterior chamber depth, central lens thickness, and anterior segment length were assessed. The evaluated parameters were obtained with accommodation using different stimulus vergences, namely 0.0, -1.0, -2.0, and -3.0 D. Variation of these parameters was compared among different levels of accommodation. Results: Central corneal thickness was not altered at any s…

Multisectorial changes in the ciliary muscle during accommodation measured with high-resolution optical coherence tomography

ABSTRACT Purpose: To measure changes in the anterior ciliary muscle during accommodation at the nasal, superior, temporal, and inferior sectors by means of an anterior chamber optical coherence tomographer, and correlate them with vergence changes. Methods: Twenty-four subjects with healthy, phakic eyes, whose mean age was 27.1 ± 8.9 years, underwent measurement with an anterior chamber optical coherence tomographer. The anterior ciliary muscle was measured at the nasal, temporal, superior, and inferior sectors for 0, -1, -2, and -3 D of vergence. A linear model was used to assess the correlation of each eye parameter with the accommodative demand. Results: The anterior ciliary muscle area …

Artificial pupil versus contralateral balanced contact lens fit for presbyopia correction

Purpose: To assess and compare the effects of contact lens-based artificial pupil design and contralateral balanced multifocal contact lens combination (CBMCLC) on visual performance. Methods: This randomized crossover study conducted at the University of Valencia, Spain included 38 presbyopic patients using an artificial pupil contact lens in the nondominant eye and a CBMCLC. After a month of lens wear, the binocular distance visual acuity (BDVA), binocular near visual acuity (BNVA), defocus curve, binocular distance, and near contrast sensitivity and near stereoacuity (NSA) were measured under photopic conditions (85 cd/m2). Moreover, BDVA and binocular distance contrast sensitivity were …

Implantable collamer lens and femtosecond laser for myopia: comparison using an adaptive optics visual simulator

Purpose: To compare optical and visual quality of implantable collamer lens (ICL) implantation and femtosecond laser in situ keratomileusis (F-LASIK) for myopia. Methods: The CRX1 adaptive optics visual simulator (Imagine Eyes, Orsay, France) was used to simulate the wavefront aberration pattern after the two surgical procedures for -3-diopter (D) and -6-D myopia. Visual acuity at different contrasts and contrast sensitivities at 10, 20, and 25 cycles/degree (cpd) were measured for 3-mm and 5-mm pupils. The modulation transfer function (MTF) and point spread function (PSF) were calculated for 5-mm pupils. Results: F-LASIK MTF was worse than ICL MTF, which was close to diffraction-limited MT…