0000000000784797
AUTHOR
Teresa Ferrer-blasco
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 …
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…
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…
Repeatability of in-vitro optical quality measurements of intraocular lenses with a deflectometry technique effect of the toricity
Aim To evaluate the repeatability of an optical device for measuring the Zernike coefficients of toric intraocular lenses (IOLs) and assess whether its toricity has any impact in its repeatability. Methods An experienced technician used the NIMO TR1504 to measure the Zernike coefficients 30 times for an aperture of 4.50 mm for all lenses included. The IOLs included were divided into two group: toric and non-toric ones. The cylindrical powers of the toric lenses included in the present study were 1.00, 1.50, 2.25, 3.00 and 3.75 D. Finally, the repeatability of the NIMO TR1504 was described in terms of within subject standard deviation (Sw) and repeatability limit. Results The Sw was smaller …
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…
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…
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…
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…
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 …
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…
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…
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 …
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…
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…
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…
Prevention of hyperopic surprise after LASIK in patients with refractive multifocal intraocular lenses.
Purpose. Three cases of patients who developed a similar hyperopic defect in refraction following laser in situ keratomileusis (LASIK) after multifocal intraocular lens (IOL) implantation are described. Methods. Ophthalmologic evaluation including refractive status, corrected and uncorrected visual acuity (both at far and near), and corneal topography in patients presenting similar hyperopic refractive surprise in one eye as a result of LASIK refinement of residual ametropia after refractive multifocal IOL implantation. Results. Laser in situ keratomileusis enhancement for residual ametropia of −1.00 to −1.50 D in patients with a prior implantation of refractive multifocal IOL resulted in a…
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 …
Ocular autofluorescence in diabetes mellitus. A review
Diabetes mellitus is a metabolic disease with a considerable impact on healthcare owing to its increased prevalence and high mortality rate. Structural, morphological, and physiological changes in each of the ocular components have been described in detail. Autofluorescence has been described as a good indicator of metabolic activity. The aim of the present review is to provide an overview of ocular endogenous fluorophores in the cornea, the crystalline lens, and the retinal pigment epithelium, the effects of diabetes mellitus and therefore the potential of autofluorescence assessment for screening and monitoring changes in diabetic patients.
Intrasubject repeatability of corneal power, thickness, and wavefront aberrations with a new version of a dual rotating Scheimpflug–Placido system
Purpose To determine the intrasubject repeatability of a recently introduced dual-camera rotating Scheimpflug–Placido imaging system (Galilei G4) in determining corneal thickness, power, and wavefront aberrations in young healthy subjects. Setting University of Valencia, Valencia, Spain. Design Prospective evaluation of diagnostic technology. Methods The study comprised right eyes of 25 subjects aged 20 to 40 years with a spherical equivalent ranging from −4.25 to +1.00 diopters. The central corneal thickness, thinnest point value and location, anterior and posterior surface curvatures, total corneal power, and corneal wavefront aberrations were measured for distance vision using the dual S…
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…
Contrast sensitivity and color perception with orange and yellow intraocular lenses
To evaluate contrast sensitivity function (CSF) and color vision after implantation of either orange or yellow-tinted intraocular lenses (IOLs).Fifty-six eyes of 28 cataract patients who had bilateral implantation of orange-tinted (PC440Y Orange, Ophtec), yellow-tinted (AcrySof Natural SN60AT, Alcon), or clear (AcrySof SA60AT, Alcon) IOLs were examined. Six months postoperatively, monocular CSF under photopic and mesopic (with and without glare) conditions were measured using the Functional Visual Analyzer. Color discrimination was determined with the Farnsworth-Munsell 100-Hue test.Patients implanted with orange-tinted, yellow-tinted, or clear IOLs displayed similar CSF values, with no sta…
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 …
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…
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…
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…
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 …
Preliminary in vivo positional analysis of a posterior chamber phakic intraocular lens by optical coherence tomography and its correlation with clinical outcomes
Purpose: To analyze by spectral-domain optical coherence tomography the anatomical relationship of a specific type of posterior chamber phakic intraocular lens (pIOL) implanted in cases of high to moderate myopia with the adjacent intraocular structures and to correlate it with clinical outcomes. Methods: Prospective observational case series including 18 eyes with high to moderate myopia (spherical equivalent between −5.88 and −15.75 D) of 9 patients (age range, 29–49 years) undergoing bilateral Phakic Refractive Lens (PRL, Zeiss) implantation. Postoperative visual acuity, refraction, contrast sensitivity (CS), and ocular higher order aberrations (HOA) were evaluated. Furthermore, the in v…
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…
Effects of LASIK on Corneal Endothelium Using the 15-kHz IntraLase Femtosecond Laser
PURPOSE: To assess the effects of LASIK with the 15-kHz IntraLase femtosecond laser on corneal endothelium. METHODS: In a prospective, single-center clinical trial, 138 patients (mean age: 32.0±7.1 years [range: 21 to 42 years]) underwent femtosecond LASIK for the correction of myopia −0.75 to −9.00 diopters (D) and cylinder up to 3.25 D. Patients were divided into two groups: contact lens group (n=76) and non-contact lens group (n=62). Pre- and 12-month postoperative specular microscopy of the central corneal endothelium was performed. The integrity of the central endothelium was assessed in terms of endothelial cell density and percentage of hexagonality. RESULTS: In the contact lens gro…
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.
Long-term comparison of corneal aberration changes after laser in situ keratomileusis: mechanical microkeratome versus femtosecond laser flap creation.
Purpose To compute and compare visual acuity, refractive outcomes, and anterior corneal aberration changes after myopic laser in situ keratomileusis (LASIK) with flap creation by a mechanical microkeratome and by a femtosecond laser. Setting Private practice refractive surgery center, Valencia, Spain. Design Comparative case series. Methods Patients were assigned to have LASIK flap creation with a mechanical microkeratome (Carriazo-Barraquer) or a femtosecond laser (IntraLase). The Visx S2 excimer laser was used for myopic ablation in all cases. Main outcome measures included uncorrected and corrected distance visual acuities and the defocus equivalent. Higher-order aberrations (HOAs) were …
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…
Iris-fixated toric phakic intraocular lens for myopic astigmatism
Purpose To evaluate the efficacy, predictability, safety, stability, and complications of the Artiflex toric iris-fixated phakic intraocular lens (pIOL) for myopic astigmatism. Setting Private practice surgery centers, Valencia and Terrassa, Spain. Design Cohort study. Methods At 12 months, refraction, uncorrected (UDVA) and corrected (CDVA) distance visual acuities, complications, pIOL misalignment, and endothelial cell count (ECC) were evaluated. Indices of success and misalignment were calculated using vector analysis. Results The study enrolled 42 eyes in 25 patients aged 21 to 39 years. The mean spherical equivalent decreased from −8.85 diopters (D) ± 2.71 (SD) to −0.37 ± 0.46 D, with …
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 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…
Effect of partial and full correction of corneal spherical aberration on visual acuity and contrast sensitivity
A 60-year-old white man had cataract surgery with an AcrySof IQ intraocular lens (IOL) implanted in the right eye and a Tecnis IOL implanted in the left eye. The ocular spherical aberration (SA) target for a 6.0 mm pupil was +0.10 microm for the right eye and 0 microm for the left eye. After surgery, the ocular SA in the right eye was significantly higher than that in the left eye (+0.112 microm +/- 0.002 [SD] versus +0.021 +/- 0.003 microm; P.001). No between-eye difference in the best corrected visual acuity and photopic contrast sensitivity was found. The contrast sensitivity was significantly better in the eye with the AcrySof IQ IOL at 12 and 18 cpd under mesopic conditions. The best c…
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 …
Intraocular Telescopic System Design: Optical and Visual Simulation in a Human Eye Model
Purpose. To design an intraocular telescopic system (ITS) for magnifying retinal image and to simulate its optical and visual performance after implantation in a human eye model. Methods. Design and simulation were carried out with a ray-tracing and optical design software. Two different ITS were designed, and their visual performance was simulated using the Liou-Brennan eye model. The difference between the ITS was their lenses’ placement in the eye model and their powers. Ray tracing in both centered and decentered situations was carried out for both ITS while visual Strehl ratio (VSOTF) was computed using custom-made MATLAB code. Results. The results show that between 0.4 and 0.8 mm of d…
Visual function after bilateral implantation of a new zonal refractive aspheric multifocal intraocular lens.
Purpose To evaluate visual function after bilateral implantation of a zonal refractive aspheric multifocal intraocular lens (IOL). Setting Private practice surgery center, Valencia, Spain. Design Cohort study. Methods Consecutive eyes with cataract had bilateral implantation of Lentis Mplus LS-312 multifocal IOLs. Distance, intermediate, and near visual acuities; contrast sensitivity; defocus curves; and a quality-of-vision questionnaire, including presence of halos or dysphotopsia, were evaluated 6 months postoperatively. A control group of age-matched monofocal pseudophakic patients was included to compare contrast sensitivity function. Results In the multifocal group, the mean binocular …
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…
Retinal Straylight Before and After Penetrating Keratoplasty in an Eye with a Post-Herpetic Corneal Scar
Objetivo: Estudio in vivo de la luz dispersa que alcanza la retina en un paciente antes y despues de someterse a una queratoplastia penetrante (o sus siglas en ingles, PKP). Metodos: En un paciente varon de 65 anos con una ulcera corneal herpetica se midio la proporcion de luz dispersa que alcanza la retina tanto antes como despues de una PKP, utilizando para ello un metodo psicometrico denominado "de comparacion por compensacion" («Compensation comparison method», C-Quant straylightmeter, Oculus GmbH, Alemania). Resultados: La cantidad de luz dispersa que alcanza la retina medida antes de la cirugia fue elevada en comparacion con los valores obtenidos en estudios previos en sujetos normale…
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...
Visual performance with simultaneous vision multifocal contact lenses.
Purpose: The aim was to assess visual performance after PureVision high addition multifocal contact lens (PM) fitting through contrast sensitivity measured under different illumination levels for both distance and near. Methods: In a cross-over study, 20 presbyopic patients were randomly assigned to PM or spectacles. Near contrast sensitivity was measured with the Vistech VCTS 6500 system. Distance contrast sensitivity and distance visual acuity (VA) were measured with the Functional Vision Analyser under photopic (85 cd/m2) and mesopic (3.0 cd/m2) conditions, the latter also under two levels of induced glare: 1.0 lux and 28 lux. Near VA was measured by logMAR charts under approximately 8…
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…
Proclear EP vs placebo: visual outcomes and symptoms of asthenopia in nonpresbyopes and early presbyopes
Purpose: Over the past 20 years, many studies have reported the success of multifocal contact lenses (MFCLs) compared to monovision (MV), with only partial success being reported for MFCLs. Chronologically it appears there has been a gradual improvement in the performance of MFCLs. This study investigated whether this change in success is reflected in clinical practice. Method: Lens fit data collected from 2005 to 2009 by the International Contact Lens Prescribing Survey Consortium was reviewed for patients over 45 years old. A similar survey conducted from 1988 to 1989 was also reviewed and compared. Twelve published (Pubmed.gov) reports of clinical trials involving MFCLs and MV were revie…
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…
Lack of effect of intraocular lens asphericity on visual performance with acrylic intraocular lenses.
Purpose. To determine whether implantation of acrylic intraocular lens (IOL) with aspheric design (Tecnis Z9003, AMO) results in improved visual acuity or contrast sensitivity compared with conventional spherical acrylic IOL (AR40e, AMO). Methods. In an intraindividual randomized prospective study of 60 patients with bilateral cataract, the Tecnis Z9003 IOL was compared with the AR40e IOL. Ocular aberrations for a 4.0-mm pupil and 6.0-mm pupil were measured with a Hartmann-Shack aberrometer. Quality of vision was measured using visual acuity and contrast sensitivity under mesopic and photopic conditions. Results. Eyes with the Tecnis Z9003 IOL had significantly less spherical aberration and…
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…
Artiflex Toric Phakic Intraocular Lens Implantation in Congenital Nystagmus
Case: A 44-year-old woman with congenital nystagmus and myopic astigmatism in both eyes who was submitted to phakic intraocular lens (pIOL) implantation. Methods: Full ophthalmologic examination including refractive status, corrected (CDVA) and uncorrected (UCVA) monocular and binocular visual acuities, ocular motility, slit-lamp evaluation, tonometry and fundoscopy before and after implantation of toric pIOLs (Artiflex; Ophtec BV, The Netherlands) in both eyes. Results: Preoperative logMAR CDVA were 0.699 and 0.420 in the right and left eye, respectively. Three months after surgery, logMAR UCVA were 0.398 and 0.182, reaching binocular logMAR UCVA of 0.132. There were no changes in nystagmu…
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…
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…
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…
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…
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…
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…
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. …
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…
Visual and optical performance with the ReZoom multifocal intraocular lens
Purpose This study evaluated visual acuity, contrast sensitivity, and wavefront aberrations after refractive multifocal intraocular lens (IOL) implantation. Methods A prospective study comprising 174 eyes of 87 patients who had bilateral implantation of a multifocal IOL was carried out. A control group of 100 eyes of 50 age-matched patients with a monofocal IOL was used for comparison. Uncorrected and corrected distance and near visual acuity, contrast sensitivity (CS), and wavefront analysis (Hartmann-Shack) was performed 6 months after surgery. Contrast sensitivity was tested for distance and near under mesopic (2 cd/m2) and photopic conditions (90 cd/m2). Results Distance photopic CS was…
Single versus double femtosecond laser pass for incomplete laser in situ keratomileusis flap in contralateral eyes: Visual and optical outcomes
Purpose To evaluate visual acuity, refractive outcomes, and anterior corneal higher-order aberrations (HOAs) after myopic laser in situ keratomileusis (LASIK) with uneventful single femtosecond laser pass versus double pass performed for intraoperative suction loss. Setting Private refractive surgery center, Valencia, Spain. Design Cohort study. Methods After the LASIK flap was created with a single pass of an Intralase femtosecond laser in 1 eye and a double pass in the fellow eye, the ablation was performed with a Visx S2 laser. At 12 months, the refraction, uncorrected (UDVA) and corrected (CDVA) distance visual acuities, and anterior corneal HOAs were measured with 4.0 mm and 6.0 mm pup…
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 …
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…
The posterior chamber phakic refractive lens (PRL): a review
Implantation of phakic intraocular lenses (pIOLs) is a reversible refractive procedure, preserving the patient’s accommodative function with minimal induction of higher order aberrations compared with corneal photoablative procedures. Despite this, as an intraocular procedure, it has potential risks such as cataracts, chronic uveitis, pupil ovalization, corneal endothelial cell loss, pigmentary dispersion syndrome, pupillary block glaucoma, astigmatism, or endophthalmitis. Currently, only two models of posterior chamber pIOLs are commercially available, the implantable collammer lens (STAAR Surgical Co.) and the phakic refractive lens (PRL; Zeiss Meditec). The number of published reports on…
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…
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 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…
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…
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 …
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…
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…
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…
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…
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…