Effect of multizone refractive multifocal contact lenses on the Cirrus HD OCT retinal measurements

Background Simultaneous vision multifocal contact lenses are widely used to alleviate the symptoms of presbyopia. These contact lenses create simultaneous retinal images due to the incoming light distribution being divided into two or more focuses. Our aim was to evaluate whether the multizone refractive multifocal contact lenses affect the measurements of the retinal nerve fibre layer (RNFL) and macular thickness using optical coherence tomography (OCT). Methods In this cross-over study, 30 eyes of 30 subjects with a mean age of 50.42 ± 7.82 years were fitted with multizone refractive multifocal contact lenses. Using the RNFL Thickness Analysis mode of the Cirrus HD (Carl Zeiss, Meditec, D…

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…

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…

Impact of contact lens material and design on the ocular surface.

BACKGROUND: To evaluate the impact on the ocular surface of a daily disposable hydrogel contact lens with high water content compared with two silicone hydrogel daily disposable lenses of lower water content. METHODS: The hydrogel lens assessed was made from nesofilcon A and the silicone hydrogel lenses were made of delefilcon A and stenfilcon A. Contact lens thickness was measured to assess material stability during daily wear, and ocular surface parameters such as tear film osmolarity, tear meniscus area and central corneal thickness were also assessed. Optical quality was analysed for all cases by means of wavefront aberrometry. RESULTS: The nesofilcon A was shown to be the thinnest lens…

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…

Medium-term visual, refractive, and intraocular stability after implantation of a posterior chamber phakic intraocular lens to correct moderate to high myopia.

To evaluate the medium-term refractive and visual outcomes and the complications after implantation of a silicone posterior chamber phakic intraocular lens (PC pIOL) for moderate to high myopia.Oftalmar, Medimar International Hospital, Alicante, Spain.Retrospective case series.Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, and intraocular pressure were evaluated during a medium-term follow-up. Postoperative complications were also studied.The study enrolled 35 eyes (mean preoperative spherical equivalent [SE] -10.25 diopters [D] ± 3.19 [SD]) of 20 patients with a mean age of 31.83 ± 8.87 years and a mean follow-up of 57.34 ± 9.24 months. The mean UDVA improved…

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…

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…

The Effect of Anesthetic Eye Drop Instillation on the Distribution of Corneal Thickness

PURPOSE To address the effect of topical instillation of oxybuprocaine on the relative distribution of corneal thickness (CT) in young healthy subjects. METHODS Prospective study involving 30 eyes of 30 emmetropic subjects (24 ± 3 years). Corneal thickness measurements were carried out before and 3 minutes after the instillation of oxybuprocaine 4% using slit-scanning corneal topography (Orbscan topography system II). No acoustic correction factor was applied. The mean of 5 consecutive Orbscan measurements was obtained at the center and 3 mm from the visual axis in the temporal, superior, nasal, and inferior hemimeridians. RESULTS No significant mean differences were found at any corneal lo…

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…

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…

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…

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, …

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…

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 & 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…

Objective assessment of the effect of pupil size upon the power distribution of multifocal contact lenses

AIM: To analytically assess the effect of pupil size upon the refractive power distributions of different designs of multifocal contact lenses. METHODS: Two multifocal contact lenses of center-near design and one multifocal contact lens of center-distance design were used in this study. Their power profiles were measured using the NIMO TR1504 device (LAMBDA-X, Belgium). Based on their power profiles, the power distribution was assessed as a function of pupil size. For the high addition lenses, the resulting refractive power as a function of viewing distance (far, intermediate, and near) and pupil size was also analyzed. RESULTS: The power distribution of the lenses was affected by pupil siz…

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…

“In situ” corneal and contact lens thickness changes with high resolution OCT

Purpose: To show the utility of high resolution spectral domain optical coherence tomography (HR SOCT) for the in situ evaluation of epithelial, stromal and contact lens (CL) thickness changes under closed-eye conditions without lens removal. Settings: Clinical and Experimental Optometry Research Lab, University of Minho, Portugal. Methods: Eight young healthy patients wore a thick soft CL during 90 minutes under closed-eye conditions and measures of epithelial and stromal corneal thickness were obtained at regular intervals using a HR SOCT (Copernicus HR, Optopol Tech. SA, Poland). Results: Minimal changes in epithelial thickness were detected with a transient statistically significant inc…

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…

Effect of Multizone Refractive Multifocal Contact Lenses on Standard Automated Perimetry

PURPOSE The aim of this study was to evaluate whether the creation of 2 foci (distance and near) provided by multizone refractive multifocal contact lenses (CLs) for presbyopia correction affects the measurements on Humphreys 24-2 Swedish interactive threshold algorithm (SITA) standard automated perimetry (SAP). METHODS In this crossover study, 30 subjects were fitted in random order with either a multifocal CL or a monofocal CL. After 1 month, a Humphrey 24-2 SITA standard strategy was performed. The visual field global indices (the mean deviation [MD] and pattern standard deviation [PSD]), reliability indices, test duration, and number of depressed points deviating at P<5%, P<2%, P<1%, an…

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 …

Visual acuity changes in presbyopic patients fitted with 3 multifocal contact lenses

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…

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…

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…

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…

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…

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)…

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…

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…

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 …

Stereoacuity with balanced presbyopic contact lenses.

Our aim was to evaluate near stereoacuity with the balanced Proclear Multifocal simultaneous vision contact lens. Twenty-five presbyopic subjects were fitted binocularly with the Proclear Multifocal contact lens and with distance contact lenses combined with reading spectacles, which served as controls. After one month, stereoacuity was measured using the vectographic Titmus and Random dot stereotests and the Howard-Dolman (HD) apparatus under photopic conditions (85 cd/m(2) ) at 40 cm. Binocular high-contrast visual acuities (BHCVA) at distance and near were examined. For the multifocal group, mean stereoacuity with the Howard-Dolman method was 22.40 ± 8.23 seconds of arc. Using the Titmus…

Femtosecond laser–assisted intrastromal corneal ring segment implantation for high astigmatism correction after penetrating keratoplasty

PURPOSE: To assess the visual and refractive outcomes of femtosecond laser-assisted implanta- tion of Ferrara-type intrastromal corneal ring segments (ICRS) in post-penetrating keratoplasty (PKP) eyes. SETTING: Instituto OftalmolFernOviedo, Spain. DESIGN: Cohort study. METHODS: Patients with previous PKP had ICRS implantation after femtosecond laser tunnel creation. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities and residual refractive errors were recorded before and 6 months after ICRS implantation. The power vector method was used to analyze refractive errors preoperatively and postoperatively. RESULTS: This study enrolled 32 eyes of 30 patients. The mean UDVA (Snell…

Visual simulation through an aspheric aberration-correcting intraocular lens in subjects with different corneal profiles using adaptive optics.

The aim of this study was to analyse the visual quality of the AcrySof IQ SN60WF® intraocular lens (IOL) when combined with different corneal profiles. Ten eyes of 10 participants with no prior history of refractive or cataract surgery were evaluated. An adaptive optics visual simulator was used to simulate the wavefront aberration pattern of an aspheric aberration-correcting IOL (AcrySof IQ SN60WF®). Normal corneas (group A), low and high myopic corneal ablations (groups B and C, respectively) and low and high hyperopic corneal ablations (groups D and E, respectively) were also simulated. Monocular distance visual acuities at 100, 50 and 10 per cent of contrast were measured. At 100, 50 an…

Stereoacuity with simultaneous vision multifocal contact lenses.

Our purpose was to evaluate near stereoacuity (SA) with Focus Progressives and PureVision Multifocal simultaneous vision contact lenses. In a cross-over study design, 20 presbyopic subjects were fitted with either the Focus Progressives or PureVision Multifocal lenses. After 1 month, SA was measured with the vectographic Titmus, Random dot stereotests, and the Howard-Dolman apparatus under photopic conditions (85 lux) at 40 cm. Binocular high-contrast visual acuity at distance and near was examined. Subjects were then refitted with the alternative correction and the procedure was repeated. Mean SA with the Focus Progressive was 21 +/- 7 sec arc, 54 +/- 17 sec arc, and 51 +/- 21 sec arc, wit…

Pilot Study on Visual Function and Fundus Autofluorescence Assessment in Diabetic Patients.

Purpose. Evaluate optimized fundus autofluorescence (FAF) imaging in early stages of diabetic retinopathy (DR) and relate findings with conventional colour fundus imaging and visual function in diabetic patients and control subjects.Materials and Methods. FAF and colour images were obtained using the CR-2 Plus digital nonmydriatic retinal camera in seven diabetic patients and thirteen control subjects. Visual-Functioning Questionnaire-25 (VFQ-25) and Diabetes Self-Management Questionnaire (DSMQ) were used to assess the quality of life and diabetes self-care. Contrast sensitivity function (CSF) was evaluated with the Vistech 6500 chart.Results. FAF and optimized-FAF imaging showed more retin…

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 …

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 …

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 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 …