1
|
Hu J, Zhang WP, Cao DM, Lei Q. Research progress on prediction of postoperative intraocular lens position. Indian J Ophthalmol 2024; 72:S176-S182. [PMID: 38271414 DOI: 10.4103/ijo.ijo_1839_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 11/09/2023] [Indexed: 01/27/2024] Open
Abstract
With the progress in refractive cataract surgery, more intraocular lens (IOL) power formulas have been introduced with the aim of reducing the postoperative refractive error. The postoperative IOL position is critical to IOL power calculations. Therefore, the improvements in postoperative IOL position prediction will enable better selection of IOL power and postoperative refraction. In the past, the postoperative IOL position was mainly predicted by preoperative anterior segment parameters such as preoperative axial length (AL), anterior chamber depth (ACD), and corneal curvature. In recent years, some novel methods including the intraoperative ACD, crystalline lens geometry, and artificial intelligence (AI) of prediction of postoperative IOL position have been reported. This article attempts to give a review about the research progress on prediction of the postoperative IOL position.
Collapse
Affiliation(s)
- Jun Hu
- Department of Glaucoma and Cataract, Aier Eye Hospital of Wuhan University, Wuhan, Hubei Province, China
| | | | | | | |
Collapse
|
2
|
de la Hoz A, Martinez-Enriquez E, Marcos S. Estimation of Crystalline Lens Material Properties From Patient Accommodation Data and Finite Element Models. Invest Ophthalmol Vis Sci 2023; 64:31. [PMID: 37639248 PMCID: PMC10461688 DOI: 10.1167/iovs.64.11.31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 08/03/2023] [Indexed: 08/29/2023] Open
Abstract
Purpose The mechanical properties of the crystalline lens are related to its optical function of accommodation, and their changes with age are one of the potential causes for presbyopia. We estimated the mechanical parameters of the crystalline lens using quantitative optical coherence tomography (OCT) imaging and wavefront sensing data from accommodating participants and computer modeling. Methods Full-lens shape data (from quantitative swept-source OCT and eigenlens representation) and optical power data (from Hartmann-Shack wavefront sensor) were obtained from 11 participants (22-30 years old) for relaxed accommodation at infinity and -4.5 D accommodative demand. Finite element models of lens, capsular bag, zonulae, and ciliary body were constructed using measured lens geometry and literature data, assuming a 60-mN radial force. An inverse modeling scheme was used to determine the shear moduli of the nucleus and cortex of the lens, such that the simulated deformed (maximally stretched) lens matched the participant's lens at -4.5 D. Results The shear moduli of the nucleus and cortex were 1.62 ± 1.32 and 8.18 ± 5.63 kPa, on average, respectively. The shear modulus of the nucleus was lower than that of the cortex for all participants evaluated. The average of the two moduli per participant was statistically significantly correlated with age (R2 = 0.76, P = 0.0049). Conclusions In vivo imaging and mechanical modeling of the crystalline lens allow estimations of the crystalline lens' mechanical properties. Differences between nuclear and cortical moduli and their dependency with age appear to be critical in accommodative function and likely in its impairment in presbyopia.
Collapse
Affiliation(s)
- Andres de la Hoz
- Instituto de Óptica “Daza de Valdés,” Consejo Superior de Investigaciones Científicas (IO, CSIC), Madrid, Spain
| | - Eduardo Martinez-Enriquez
- Instituto de Óptica “Daza de Valdés,” Consejo Superior de Investigaciones Científicas (IO, CSIC), Madrid, Spain
| | - Susana Marcos
- Center for Visual Science, The Institute of Optics, Flaum Eye Institute, University of Rochester, New York, United States
| |
Collapse
|
3
|
Martínez-Enríquez E, Maceo Heilman B, de Castro A, Mohamed A, Ruggeri M, Zvietcovich F, Manns F, Marcos S. Estimation of the full shape of the crystalline lens from OCT: validation using stretched donor lenses. BIOMEDICAL OPTICS EXPRESS 2023; 14:4261-4276. [PMID: 37799671 PMCID: PMC10549758 DOI: 10.1364/boe.493795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 06/17/2023] [Accepted: 06/19/2023] [Indexed: 10/07/2023]
Abstract
Quantifying human crystalline lens geometry as a function of age and accommodation is important for improved cataract and presbyopia treatments. In previous works we presented eigenlenses as a basis of 3-D functions to represent the full shape of the crystalline lens ex vivo. Also, we presented the application of eigenlenses to estimate the full shape of the lens in vivo from 3-D optical coherence tomography (OCT) images, where only the central part of the lens -visible through the pupil- is available. The current work presents a validation of the use of eigenlenses to estimate in vivo the full shape of dis-accommodated lenses. We used 14 ex vivo crystalline lenses from donor eyes (11-54 y/o) mounted in a lens stretcher, and measured the geometry and the power of the lenses using a combined OCT and ray tracing aberrometry system. Ex vivo, the full extent of the lens is accessible from OCT because the incident light is not blocked by the iris. We measured in non-stretched (fully accommodated) and stretched (mimicking in vivo dis-accommodated lenses) conditions. Then, we simulated computationally in vivo conditions on the obtained ex vivo lenses geometry (assuming that just the portion of the lens within a given pupil is available), and estimated the full shape using eigenlenses. The mean absolute error (MAE) between estimated and measured lens' diameters and volumes were MAE = 0.26 ± 0.18 mm and MAE = 7.0 ± 4.5 mm3, respectively. Furthermore, we concluded that the estimation error between measured and estimated lenses did not depend on the accommodative state (change in power due to stretching), and thus eigenlenses are also useful for the full shape estimation of in vivo dis-accommodated lenses.
Collapse
Affiliation(s)
| | - Bianca Maceo Heilman
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
| | - Alberto de Castro
- Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Madrid, Madrid, Spain
| | - Ashik Mohamed
- Ophthalmic Biophysics, LV Prasad Eye Institute, Hyderabad, Telangana, India
- Brien Holden Vision Institute, Sydney, NSW, Australia
| | - Marco Ruggeri
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, FL, USA
| | - Fernando Zvietcovich
- Department of Engineering, Pontificia Universidad Católica del Peru, Lima 15088, Peru
| | - Fabrice Manns
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
| | - Susana Marcos
- Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Madrid, Madrid, Spain
- Center for Visual Science. The Institute of Optics. Flaum Eye Institute, University of Rochester, Rochester, NY, USA
| |
Collapse
|
4
|
Henderson BA, Aramberri J, Vann R, Abulafia A, Ainslie-Garcia M, Berdahl J, Ferko N, Gundersen KG, Goto S, Gupta P, Multack S, Persaud E, Raoof D, Savini G, Shammas HJ, Wang L, Wang WZ. The Current Burden and Future Solutions for Preoperative Cataract-Refractive Evaluation Diagnostic Devices: A Modified Delphi Study. Clin Ophthalmol 2023; 17:2109-2124. [PMID: 37521152 PMCID: PMC10378607 DOI: 10.2147/opth.s412847] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 07/11/2023] [Indexed: 08/01/2023] Open
Abstract
Purpose To obtain consensus on the key areas of burden associated with existing devices and to understand the requirements for a comprehensive next-generation diagnostic device to be able to solve current challenges and provide more accurate prediction of intraocular lens (IOL) power and presbyopia correction IOL success. Patients and Methods Thirteen expert refractive cataract surgeons including three steering committee (SC) members constituted the voting panel. Three rounds of voting included a Round 1 structured electronic questionnaire, Round 2 virtual face-to-face meeting, and Round 3 electronic questionnaire to obtain consensus on topics related to current limitations and future solutions for preoperative cataract-refractive diagnostic devices. Results Forty statements reached consensus including current limitations (n = 17) and potential solutions (n = 23) associated with preoperative diagnostic devices. Consistent with existing evidence, the panel reported unmet needs in measurement accuracy and validation, IOL power prediction, workflow, training, and surgical planning. A device that facilitates more accurate corneal measurement, effective IOL power prediction formulas for atypical eyes, simplified staff training, and improved decision-making process for surgeons regarding IOL selection is expected to help alleviate current burdens. Conclusion Using a modified Delphi process, consensus was achieved on key unmet needs of existing preoperative diagnostic devices and requirements for a comprehensive next-generation device to provide better objective and subjective outcomes for surgeons, technicians, and patients.
Collapse
Affiliation(s)
- Bonnie An Henderson
- Department of Ophthalmology, Tufts University School of Medicine, Boston, MA, USA
| | | | - Robin Vann
- Department of Ophthalmology, Duke University School of Medicine, Durham, NC, USA
| | - Adi Abulafia
- Department of Ophthalmology, Shaare Zedek Medical Center, Hadassah Faculty of Medicine, the Hebrew University, Jerusalem, Israel
| | | | | | | | | | - So Goto
- Herbert Wertheim School Optometry and Vision Science, University of California, Berkeley, CA, USA
- Department of Ophthalmology, National Hospital Organization, Tokyo Medical Center, Meguro-ku, Tokyo, Japan
| | - Preeya Gupta
- Triangle Eye Consultants, Raleigh, NC, USA
- Department of Ophthalmology, Tulane University, New Orleans, LA, USA
| | - Samuel Multack
- Laser and Cataract Institute, Frankfort, IL, USA
- Advocate South Suburban Hospital, Hazel Crest, IL, USA
- Advocate Trinity Hospital, Chicago, IL, USA
| | | | - Duna Raoof
- NVISION Eye Center, Newport Beach, CA, USA
| | | | - H John Shammas
- Department of Ophthalmology, University of Southern California, Los Angeles, CA, USA
| | - Li Wang
- Cullen Eye Institute, Department of Ophthalmology, Baylor College of Medicine, Houston, TX, USA
| | | |
Collapse
|
5
|
Pérez-Merino P, Aramberri J, Quintero AV, Rozema JJ. Ray tracing optimization: a new method for intraocular lens power calculation in regular and irregular corneas. Sci Rep 2023; 13:4555. [PMID: 36941337 PMCID: PMC10027892 DOI: 10.1038/s41598-023-31525-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/14/2023] [Indexed: 03/23/2023] Open
Abstract
To develop a novel algorithm based on ray tracing, simulated visual performance and through-focus optimization for an accurate intraocular lens (IOL) power calculation. Custom-developed algorithms for ray tracing optimization (RTO) were used to combine the natural corneal higher-order aberrations (HOAs) with multiple sphero-cylindrical corrections in 210 higher order statistical eye models for developing keratoconus. The magnitude of defocus and astigmatism producing the maximum Visual Strehl was considered as the optimal sphero-cylindrical target for IOL power calculation. Corneal astigmatism and the RMS HOAs ranged from - 0.64 ± 0.35D and 0.10 ± 0.04 μm (0-months) to - 3.15 ± 1.38D and 0.82 ± 0.47 μm (120-months). Defocus and astigmatism target was close to neutral for eyes with low amount of HOAs (0 and 12-months), where 91.66% of eyes agreed within ± 0.50D in IOL power calculation (RTO vs. SRK/T). However, corneas with higher amounts of HOAs presented greater visual improvement with an optimized target. In these eyes (24- to 120-months), only 18.05% of eyes agreed within ± 0.50D (RTO vs. SRK/T). The power difference exceeded 3D in 42.2% while the cylinder required adjustments larger than 3D in 18.4% of the cases. Certain amounts of lower and HOAs may interact favourably to improve visual performance, shifting therefore the refractive target for IOL power calculation.
Collapse
Affiliation(s)
- Pablo Pérez-Merino
- Centre for Microsystems Technology, Ghent University and Imec, Technologiepark 126, 9052, Ghent, Belgium.
| | - Jaime Aramberri
- Miranza Begitek, San Sebastian, Spain
- Miranza Okular, Vitoria, Spain
| | - Andrés Vásquez Quintero
- Centre for Microsystems Technology, Ghent University and Imec, Technologiepark 126, 9052, Ghent, Belgium
| | - Jos J Rozema
- Visual Optics Lab Antwerp (VOLANTIS), Faculty of Medicine and Health Sciences, University of Antwerp, Building T4, Universiteitsplein 1, 2610, Wilrijk, Belgium
- Department of Ophthalmology, Antwerp University Hospital, Wilrijkstraat 10, 2650, Edegem, Belgium
| |
Collapse
|
6
|
Gouvea L, Haddad JS, Kapeles M, Waring GO, Jammal AA, Chamon W, Rocha KM. Spectral-Domain OCT Lens Meridian Position as a Metric to Estimate Postoperative Anatomical Lens Position. J Refract Surg 2023; 39:165-170. [PMID: 36892236 DOI: 10.3928/1081597x-20230103-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
PURPOSE To evaluate the prediction of postoperative anatomical lens position (ALP) using intraoperative spectral-domain optical coherence tomography (SD-OCT) lens anatomy metrics in patients who underwent femtosecond laser-assisted cataract surgery. METHODS Intraoperative SD-OCT (Catalys; Johnson & Johnson Vision) and postoperative optical biometry (IOLMaster 700; Carl Zeiss Meditec AG) were used to assess anterior segment landmarks, including lens thickness, lens volume, anterior chamber depth, lens meridian position (LMP), and measured ALP. LMP was defined as the distance from the corneal epithelium to the lens equator, and ALP was defined as the distance from the corneal epithelium to the IOL surface. Eyes were divided into groups according to axial length (> 22.5 mm, 22.5 to 24.5 mm, and > 24.5 mm) and IOL type (Tecnis ZCB00 [Johnson & Johnson Vision]; AcrySof SN-60WF [Alcon Laboratories, Inc], or enVista MX60E [Bausch & Lomb]) to further analyze the correlation between LMP and ALP. Theoretical effective lens position was back-calculated using a specific formula. Primary outcome was correlation between postoperative measured ALP and LMP. RESULTS A total of 97 eyes were included in this study. Linear regression analysis displayed a statistically significant correlation between intraoperative LMP and postoperative ALP (R2 = 0.522; P < .01). No statistically significant correlation was observed between LMP and lens thickness (R2 = 0.039; P = .06) or between ALP and lens thickness (R2 = 0.02; P = .992). The greatest predictor for ALP was LMP (β = 0.766, P < .001; R2 = 0.523). CONCLUSIONS Intraoperative SD-OCT-measured LMP correlated better than anterior chamber depth and axial length to postoperative ALP. Further studies are necessary to analyze the impact of preoperative or intraoperative LMP measurements on postoperative refractive outcomes. [J Refract Surg. 2023;39(3):165-170.].
Collapse
|
7
|
Martínez-Enríquez E, Curatolo A, de Castro A, Birkenfeld JS, González AM, Mohamed A, Ruggeri M, Manns F, Fernando Z, Marcos S. Estimation of the full shape of the crystalline lens in-vivo from OCT images using eigenlenses. BIOMEDICAL OPTICS EXPRESS 2023; 14:608-626. [PMID: 36874490 PMCID: PMC9979676 DOI: 10.1364/boe.477557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/29/2022] [Accepted: 11/29/2022] [Indexed: 06/18/2023]
Abstract
Quantifying the full 3-D shape of the human crystalline lens is important for improving intraocular lens power or sizing calculations in treatments of cataract and presbyopia. In a previous work we described a novel method for the representation of the full shape of the ex vivo crystalline lens called eigenlenses, which proved more compact and accurate than compared state-of-the art methods of crystalline lens shape quantification. Here we demonstrate the use of eigenlenses to estimate the full shape of the crystalline lens in vivo from optical coherence tomography images, where only the information visible through the pupil is available. We compare the performance of eigenlenses with previous methods of full crystalline lens shape estimation, and demonstrate an improvement in repeatability, robustness and use of computational resources. We found that eigenlenses can be used to describe efficiently the crystalline lens full shape changes with accommodation and refractive error.
Collapse
Affiliation(s)
| | - Andrea Curatolo
- Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Madrid, Madrid, Spain
- Institute of Physical Chemistry, Polish Academy of Sciences (IChF-PAN), Warsaw, Poland
- International Centre for Translational Eye Research (ICTER), Warsaw, Poland
| | - Alberto de Castro
- Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Madrid, Madrid, Spain
| | - Judith S. Birkenfeld
- Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Madrid, Madrid, Spain
| | - Ana M. González
- Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Madrid, Madrid, Spain
| | - Ashik Mohamed
- Ophthalmic Biophysics, LV Prasad Eye Institute, Hyderabad, Telangana, India
- Brien Holden Vision Institute, Sydney, NSW, Australia
| | - Marco Ruggeri
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
| | - Fabrice Manns
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami School of Medicine, Miami, FL, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
| | - Zvietcovich Fernando
- Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Madrid, Madrid, Spain
| | - Susana Marcos
- Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Madrid, Madrid, Spain
- Center for Visual Science. The Institute of Optics. Flaum Eye Institute, University of Rochester, Rochester, NY, USA
| |
Collapse
|
8
|
Zhang J, Shao J, Zheng L, Zhao X, Chen S. Implantable collamer lens sizing based on measurement of the sulcus-to-sulcus distance in ultrasound biomicroscopy video clips and ZZ ICL formula. BMC Ophthalmol 2022; 22:363. [PMID: 36071422 PMCID: PMC9454160 DOI: 10.1186/s12886-022-02583-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 08/29/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To evaluate a new method of implantable collamer lens (ICL) sizing based on ultrasound biomicroscopy (UBM) video clips. METHODS This observational study included consecutive patients with myopia and myopic astigmatism scheduled for V4c toric ICL (TICL) implantation (STAAR) at Hangzhou MSK Eye Hospital (October 2020 to November 2020). Sulcus-to-sulcus (STS) distance, lens thickness (LT), and clinical refraction were measured preoperatively. The ZZ ICL formula (provides the predicted vault height and refraction based on TICL size, intraocular meridian, power, and eye parameters, including STS distance and LT) was used to select TICL size and predict vault height and residual refraction, which was also compared with the STAAR software recommended. Vault and residual refraction were measured at 3 months postoperatively. RESULTS The analysis included 168 eyes in 84 patients. Postoperative vault size was comparable to that predicted by the ZZ ICL formula (528 ± 193 vs. 545 ± 156 μm, P = 0.227). Vault prediction error (PE) by the ZZ ICL formula was within 100, 300, and 500 μm in 40.48%, 88.10%, and 100% of eyes, respectively. Spherical equivalent (SE) and absolute cylindrical refractive error were 0.36 ± 0.48 and 0.40 ± 0.31 D at 3 months postoperatively. The SE PE, absolute cylindrical PE, and percentages of eyes with an absolute cylindrical PE within ± 0.50 D and ± 1.00 D were lower for the ZZ ICL formula than for the STAAR software (P < 0.01). CONCLUSIONS Combining measurements obtained in UBM video clips with the ZZ ICL formula provides an effective method of sizing TICLs and predicting vault height and residual refractive error.
Collapse
Affiliation(s)
- Jun Zhang
- Department of Ophthalmology, Hangzhou MSK Eye Hospital & MSK Eye Hospital of Hangzhou Medical College, Hangzhou, China.
| | - Jie Shao
- Department of Ophthalmology, Hangzhou MSK Eye Hospital & MSK Eye Hospital of Hangzhou Medical College, Hangzhou, China
| | - Li Zheng
- Department of Ophthalmology, Hangzhou MSK Eye Hospital & MSK Eye Hospital of Hangzhou Medical College, Hangzhou, China
| | - Xia Zhao
- Department of Ophthalmology, Hangzhou MSK Eye Hospital & MSK Eye Hospital of Hangzhou Medical College, Hangzhou, China
| | - Shu Chen
- Department of Ophthalmology, Hangzhou MSK Eye Hospital & MSK Eye Hospital of Hangzhou Medical College, Hangzhou, China
| |
Collapse
|
9
|
Achiron A, Elhaddad O, Leadbetter D, Levinger E, Voytsekhivskyy O, Smith K, Avadhanam V, Darcy K, Tole D. Intraocular lens power calculation in patients with irregular astigmatism. Graefes Arch Clin Exp Ophthalmol 2022; 260:3889-3895. [PMID: 35776172 DOI: 10.1007/s00417-022-05729-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Revised: 05/07/2022] [Accepted: 06/07/2022] [Indexed: 11/25/2022] Open
Abstract
PURPOSE Accurate intraocular lens (IOL) calculation in subjects with irregular astigmatism is challenging. This study evaluated the accuracy of using Scheimpflug-derived central 2-mm equivalent keratometry reading (EKR) values for IOL calculation in irregular astigmatism. METHODS This retrospective study included subjects (31 eyes of 30 patients) who underwent cataract surgery and IOL calculation using the 2-mm central EKR methods. We compared prediction error (PE) and absolute PE (APE) outcomes using SRK/T and Barrett Universal II formulas for keratometry data obtained from the IOLMaster 500 and Pentacam (anterior corneal sim k) devices. RESULTS Cataract surgery and IOL calculation using the 2-mm central EKR methods resulted in improved visual acuity (uncorrected: from 1.13 ± 0.38 to 0.65 ± 0.46 logMar, p < 0.01; best-corrected: from 0.45 ± 0.24 to 0.26 ± 0.20 logMar, p < 0.01) after surgery. The percentage of subjects with best-corrected visual acuity of 6/6 was 22%, < 6/9 was 58%, and < 6/12 was 71%. For both the SRK/T and the Barrett formulas, the PE was similar to those obtained by IOLMaster (> 0.14) but lower than those obtained by the anterior corneal sim k (p < 0.02). IOLMaster provided keratometry reading in only 23/31 (74.1%) of cases. CONCLUSIONS The use of Scheimpflug central 2-mm EKR for IOL calculation in irregular astigmatism was beneficial in terms of visual acuity improvement. It had comparable refractive prediction performance to the IOLMaster 500 and better than the anterior corneal sim K. The 2-mm EKR method can be used when IOLMaster cannot provide a reliable reading in abnormal corneas.
Collapse
Affiliation(s)
- Asaf Achiron
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin St, Bristol, BS1 2LX, UK.
- Sourasky Tel-Aviv Medical Center and the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel.
| | - Omar Elhaddad
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin St, Bristol, BS1 2LX, UK
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Duncan Leadbetter
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin St, Bristol, BS1 2LX, UK
| | - Eliya Levinger
- Sourasky Tel-Aviv Medical Center and the Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | | | - Katy Smith
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin St, Bristol, BS1 2LX, UK
| | - Venkata Avadhanam
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin St, Bristol, BS1 2LX, UK
| | - Kieren Darcy
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin St, Bristol, BS1 2LX, UK
| | - Derek Tole
- Bristol Eye Hospital, University Hospitals Bristol NHS Foundation Trust, Lower Maudlin St, Bristol, BS1 2LX, UK
| |
Collapse
|
10
|
Alexopoulos P, Madu C, Wollstein G, Schuman JS. The Development and Clinical Application of Innovative Optical Ophthalmic Imaging Techniques. Front Med (Lausanne) 2022; 9:891369. [PMID: 35847772 PMCID: PMC9279625 DOI: 10.3389/fmed.2022.891369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Accepted: 05/23/2022] [Indexed: 11/22/2022] Open
Abstract
The field of ophthalmic imaging has grown substantially over the last years. Massive improvements in image processing and computer hardware have allowed the emergence of multiple imaging techniques of the eye that can transform patient care. The purpose of this review is to describe the most recent advances in eye imaging and explain how new technologies and imaging methods can be utilized in a clinical setting. The introduction of optical coherence tomography (OCT) was a revolution in eye imaging and has since become the standard of care for a plethora of conditions. Its most recent iterations, OCT angiography, and visible light OCT, as well as imaging modalities, such as fluorescent lifetime imaging ophthalmoscopy, would allow a more thorough evaluation of patients and provide additional information on disease processes. Toward that goal, the application of adaptive optics (AO) and full-field scanning to a variety of eye imaging techniques has further allowed the histologic study of single cells in the retina and anterior segment. Toward the goal of remote eye care and more accessible eye imaging, methods such as handheld OCT devices and imaging through smartphones, have emerged. Finally, incorporating artificial intelligence (AI) in eye images has the potential to become a new milestone for eye imaging while also contributing in social aspects of eye care.
Collapse
Affiliation(s)
- Palaiologos Alexopoulos
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Chisom Madu
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, United States
| | - Gadi Wollstein
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, United States
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY, United States
- Center for Neural Science, College of Arts & Science, New York University, New York, NY, United States
| | - Joel S. Schuman
- Department of Ophthalmology, NYU Langone Health, NYU Grossman School of Medicine, New York, NY, United States
- Department of Biomedical Engineering, NYU Tandon School of Engineering, Brooklyn, NY, United States
- Center for Neural Science, College of Arts & Science, New York University, New York, NY, United States
- Department of Electrical and Computer Engineering, NYU Tandon School of Engineering, Brooklyn, NY, United States
| |
Collapse
|
11
|
High speed, long range, deep penetration swept source OCT for structural and angiographic imaging of the anterior eye. Sci Rep 2022; 12:992. [PMID: 35046423 PMCID: PMC8770693 DOI: 10.1038/s41598-022-04784-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/13/2021] [Indexed: 11/24/2022] Open
Abstract
This study reports the development of prototype swept-source optical coherence tomography (SS-OCT) technology for imaging the anterior eye. Advances in vertical-cavity surface-emitting laser (VCSEL) light sources, signal processing, optics and mechanical designs, enable a unique combination of high speed, long range, and deep penetration that addresses the challenges of anterior eye imaging. We demonstrate SS-OCT with a 325 kHz A-scan rate, 12.2 µm axial resolution (in air), and 15.5 mm depth range (in air) at 1310 nm wavelength. The ultrahigh 325 kHz A-scan rate not only facilitates biometry measurements by minimizing acquisition time and thus reducing motion, but also enables volumetric OCT for comprehensive structural analysis and OCT angiography (OCTA) for visualizing vasculature. The 15.5 mm (~ 11.6 mm in tissue) depth range spans all optical surfaces from the anterior cornea to the posterior lens capsule. The 1310 nm wavelength range enables structural OCT and OCTA deep in the sclera and through the iris. Achieving high speed and long range requires linearizing the VCSEL wavenumber sweep to efficiently utilize analog-to-digital conversion bandwidth. Dual channel recording of the OCT and calibration interferometer fringe signals, as well as sweep to sweep wavenumber compensation, is used to achieve invariant 12.2 µm (~ 9.1 µm in tissue) axial resolution and optimum point spread function throughout the depth range. Dynamic focusing using a tunable liquid lens extends the effective depth of field while preserving the lateral resolution. Improved optical and mechanical design, including parallax “split view” iris cameras and stable, ergonomic patient interface, facilitates accurate instrument positioning, reduces patient motion, and leads to improved imaging data yield and measurement accuracy. We present structural and angiographic OCT images of the anterior eye, demonstrating the unique imaging capabilities using representative scanning protocols which may be relevant to future research and clinical applications.
Collapse
|
12
|
Li Z, Qu W, Huang J, Meng Z, Li X, Zou R, Zhao Y. Effect of age and cycloplegia on the morphology of the human crystalline lens: swept-source OCT study. J Cataract Refract Surg 2022; 48:8-15. [PMID: 34016824 PMCID: PMC8700289 DOI: 10.1097/j.jcrs.0000000000000693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 04/27/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate the effect of age and cycloplegia on the morphology of the crystalline lens using a swept-source optical coherence tomography (SS-OCT) system. SETTING Hospital. DESIGN Prospective cross-sectional study. METHODS The parameters including anterior chamber depth (ACD), the radii of curvature of the anterior and posterior surface of the crystalline lens (ALR and PLR), lens thickness (LT), lens equatorial diameter (LED), and lens vault (LV) were quantified by the SS-OCT before and after cycloplegia. The paired t test was used to compare the parameters before and after cycloplegia. A multivariate linear regression model was built to analyze the association between the parameters/cycloplegia-induced changes and age, while adjusting for the effect of axial length, refractive status, and sex. RESULTS 76 individuals (age range, 18 to 86 years) were recruited. The ALR and ACD were negatively correlated with age (P ≤ .002), and the LT, LV, and LED were positively correlated with age (P ≤ .004). In participants younger than 60 years, the ALR and ACD significantly increased, whereas the LV and LT significantly decreased after cycloplegia (all P < .001). With aging, cycloplegia-induced differences of ALR (P = .001) and ACD (P = .014) significantly decreased, and of LT (P < .001), LT (P < .001), and LV (P = .001) significantly increased. CONCLUSIONS The crystalline lens morphology measured by the SS-OCT revealed steepening anterior surface and increasing equatorial diameter with age. Cycloplegia caused a significant change of anterior surface morphology in participants younger than 60 years, and this effect diminished with age.
Collapse
|
13
|
Marcos S. Improving pseudophakic optical quality beyond aspheric intraocular lenses: the next frontier. J Cataract Refract Surg 2021; 47:1111-1114. [PMID: 34468446 DOI: 10.1097/j.jcrs.0000000000000762] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
|
14
|
Shon K, Sung KR, Yoon JY. Implications of the Relationship Between Refractive Error and Biometry in the Pathogenesis of Primary Angle Closure. Invest Ophthalmol Vis Sci 2021; 62:38. [PMID: 34463718 PMCID: PMC8411854 DOI: 10.1167/iovs.62.10.38] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to investigate the relationship between refractive error and ocular biometry and its implication in the pathogenesis of primary angle closure (PAC). Methods We have retrospectively recruited 119 PAC eyes and 388 non-PAC eyes with an axial length (AL) of ≤25.0 mm and a spherical equivalent (SE) of ≥−6.0 diopters (D). Stepwise multiple regression was performed for keratometry value (K), AL, anterior chamber depth (ACD), and SE. Results PAC eyes were more likely to be in women and have a higher IOP and shorter AL than non-PAC eyes. In a multiple regression analysis, SE was not associated with PAC. The associations between AL and SE or AL and ACD were not different in PAC eyes compared with non-PAC eyes. However, the cornea was flatter in PAC eyes (β = −0.448, P < 0.001), and a flatter cornea was associated with more hyperopic refraction (β = −0.454, P < 0.001) and shallower ACD (β = 0.073, P < 0.001) in PAC eyes. ACD was not associated with SE in non-PAC eyes, but shallower ACD was associated with greater myopic refraction in PAC eyes (β = 1.117, P = 0.006). Conclusions PAC eyes seem to have flatter cornea compared with non-PAC eyes. A shallower ACD seems to be associated with greater myopic refraction in PAC eyes, but not in non-PAC eyes.
Collapse
Affiliation(s)
- Kilhwan Shon
- Department of Ophthalmology, Gangneung Asan Hospital, Gangneung, Korea
| | - Kyung Rim Sung
- Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea
| | - Joo Young Yoon
- Department of Ophthalmology, College of Medicine, University of Ulsan, Asan Medical Center, Seoul, Korea
| |
Collapse
|
15
|
Gatinel D, Debellemanière G, Saad A, Dubois M, Rampat R. Determining the Theoretical Effective Lens Position of Thick Intraocular Lenses for Machine Learning-Based IOL Power Calculation and Simulation. Transl Vis Sci Technol 2021; 10:27. [PMID: 34004006 PMCID: PMC8088222 DOI: 10.1167/tvst.10.4.27] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Purpose To describe a formula to back-calculate the theoretical position of the principal object plane of an intraocular lens (IOL), as well as the theoretical anatomic position in a thick lens eye model. A study was conducted to ascertain the impact of variations in design and IOL power, on the refractive outcomes of cataract surgery. Methods A schematic eye model was designed and manipulated to reflect changes in the anterior and posterior radii of an IOL, while keeping the central thickness and paraxial powers static. Modifications of the shape factor (X) of the IOL affects the thick lens estimated effective lens position (ELP). Corresponding postoperative spherical equivalent (SE) were computed for different IOL powers (-5 diopters [D], 5 D, 15 D, 25 D, and 35 D) with X ranging from -1 to +1 by 0.1. Results The impact of the thick lens estimated effective lens position shift on postoperative refraction was highly dependent on the optical power of the IOL and its thickness. Design modifications could theoretically induce postoperative refraction variations between approximately 0.50 and 3.0 D, for implant powers ranging from 15 D to 35 D. Conclusions This work could be of interest for researchers involved in the design of IOL power calculation formulas. The importance of IOL geometry in refractive outcomes, especially for short eyes, should challenge the fact that these data are not usually published by IOL manufacturers. Translational Relevance The back-calculation of the estimated effective lens position is central to intraocular lens calculation formulas, especially for artificial intelligence-based optical formulas, where the algorithm can be trained to predict this value.
Collapse
Affiliation(s)
- Damien Gatinel
- Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France
| | | | - Alain Saad
- Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France
| | - Mathieu Dubois
- Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France
| | - Radhika Rampat
- Department of Ophthalmology, Rothschild Foundation Hospital, Paris, France
| |
Collapse
|
16
|
Zhang J, Shao J, Zheng L, Shen Y, Zhao X. Comparative clinical accuracy analysis of the newly developed ZZ IOL and four existing IOL formulas for post-corneal refractive surgery eyes. BMC Ophthalmol 2021; 21:231. [PMID: 34034681 PMCID: PMC8146991 DOI: 10.1186/s12886-021-01991-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 05/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Intraocular lens (IOL) calculation using traditional formulas for post-corneal refractive surgery eyes can yield inaccurate results. This study aimed to compare the clinical accuracy of the newly developed Zhang & Zheng (ZZ) formula with previously reported IOL formulas. STUDY DESIGN Retrospective study. METHODS Post-corneal refractive surgery eyes were assessed for IOL power using the ZZ, Haigis-L, Shammas, Barrett True-K (no history), and ray tracing (C.S.O Sirius) IOL formulas, and their accuracy was compared. No pre-refractive surgery information was used in the calculations. RESULTS This study included 38 eyes in 26 patients. ZZ IOL yielded a lower arithmetic IOL prediction error (PE) compared with ray tracing (P = 0.04), whereas the other formulas had values like that of ZZ IOL (P > 0.05). The arithmetic IOL PE for the ZZ IOL formula was not significantly different from zero (P = 0.96). ZZ IOL yielded a lower absolute IOL PE compared with Shammas (P < 0.01), Haigis-L (P = 0.02), Barrett true K (P = 0.03), and ray tracing (P < 0.01). The variance of the mean arithmetic IOL PE for ZZ IOL was significantly smaller than those of Shammas (P < 0.01), Haigis-L (P = 0.03), Barrett True K (P = 0.02), and ray tracing (P < 0.01). The percentages of eyes within ± 0.5 D of the target refraction with the ZZ IOL, Shammas, Haigis-L, Barrett True-K, and ray-tracing formulas were 86.8 %, 45.5 %, 66.7 %, 73.7 %, and 50.0 %, respectively (P < 0.05 for Shammas and ray tracing vs. ZZ IOL). CONCLUSIONS The ZZ IOL formula might offer superior outcomes for IOL power calculation for post-corneal refractive surgery eyes without prior refractive data.
Collapse
Affiliation(s)
- Jun Zhang
- Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
| | - Jie Shao
- Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
| | - Li Zheng
- Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
| | - Ye Shen
- Ophthalmology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
| | - Xia Zhao
- Ophthalmology, Hangzhou MSK Eye Hospital, Hangzhou, China
| |
Collapse
|
17
|
El-Khayat AR, Tesha P. Optimizing the intraocular lens formula constant according to intraocular lens diameter. Int J Ophthalmol 2021; 14:700-703. [PMID: 34012884 DOI: 10.18240/ijo.2021.05.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 01/05/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To determine whether the different diameters of a specific intraocular lens (IOL) have significantly different optimized SRK/T A constants and whether these new A constants can improve refractive outcomes. METHODS Data were collected prospectively from Jan. 2011 to Dec. 2012 on all patients undergoing routine cataract surgery at a district general hospital in the UK. Patients were divided into three groups according to the size of the Akreos AO MI60 IOL used. A constants for the SRK/T formula were optimized according to the size of the IOL. These optimized A constants were then used to select future refractive outcomes. RESULTS A total of 2398 cataract operations were performed during the study period of which 1131 met the inclusion criteria. The three optimized A constants for the different sized IOLs were 118.98, 119.13, 119.32. The difference between them was highly significant (P≤0.0001). Two optimized A constants for three sizes of IOL led to an improvement in refractive outcomes (from 93.4% to 94.6% of refractive outcomes within 1.00 D of predicted spherical equivalent). The optimized A constant for the largest IOL was based on a small number of cases and was not used. CONCLUSION Optimizing the A constant for the three distinct sizes of the Bausch & Lomb Akreos MI60 lens lead to three significantly different A constants. In our practice, using two different optimized A constants for three different sized IOLs give the least refractive error, however, using three optimized A constants may give better results with a larger dataset.
Collapse
Affiliation(s)
- Abdul R El-Khayat
- Department of Ophthalmology, Leicester Royal Infirmary, Leicester, LE1 5WW, UK
| | - Paul Tesha
- Department of Ophthalmology, Lincoln County Hospital, Lincoln, LN2 5QY, UK
| |
Collapse
|
18
|
Waring GO, Chang DH, Rocha KM, Gouvea L, Penatti R. Correlation of Intraoperative Optical Coherence Tomography of Crystalline Lens Diameter, Thickness, and Volume with Biometry and Age. Am J Ophthalmol 2021; 225:147-156. [PMID: 33385370 DOI: 10.1016/j.ajo.2020.12.021] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2020] [Revised: 09/30/2020] [Accepted: 12/17/2020] [Indexed: 12/12/2022]
Abstract
PURPOSE To characterize crystalline lens dimensions derived from in vivo spectral-domain optical coherence tomography (SD-OCT) and identify associations among these parameters, ocular biometry, and age. METHODS In this retrospective study, lens thickness (LT), lens diameter (LD), and lens volume (LV) were measured intraoperatively using SD-OCT in 293 eyes undergoing lens surgery. Correlations among LT, LD, LV, age, axial length (AL), and anterior chamber depth (ACD) were analyzed. Multiple regression analysis was performed to determine whether a combination of biometric data could predict LD and LV. RESULTS Wide variations were observed in LT (3.6-5.7 mm), LD (7.5-11.9 mm), and LV (119.9-312.4 mm3) of aging eyes. Correlations among the 3 lens dimensions were statistically significant (LV-LT: r = 0.785; P < .001; LV-LD: r = 0.696; P < .001; and LT-LD: r = 0.121; P = .039). With age, the correlation coefficients of LT, LD, and LV were 0.526, 0.326, and 0.573, respectively (P < .001). Although there was significant correlation of AL with LT (r = -0.137; P = .002) and LD (r = 0.268; P < .001), it was not significant with LV (r = 0.084; P = .15). Subgroup analysis revealed that 19.8% of long eyes had LD >1 standard deviation (SD) above and that 5.2% had LD <1 SD below the mean LD. CONCLUSIONS Dimensions of the aging lens vary considerably and are most accurately characterized by direct measurement of LT, LD, and LV, rather than making assumptions based on AL. These findings challenge historically proposed relationships between LD and AL and represent a normative dataset of contemporary geometric features of the aging lens, possibly aiding in surgical decision making and future developments in lens surgery.
Collapse
Affiliation(s)
| | - Daniel H Chang
- Empire Eye and Laser Center, Bakersfield, California, USA
| | - Karolinne Maia Rocha
- Storm Eye Institute, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Larissa Gouvea
- Department of Ophthalmology and Vision Sciences, University of Toronto, Toronto, Ontario, Canada
| | | |
Collapse
|
19
|
Marcos S, Martinez-Enriquez E, Vinas M, de Castro A, Dorronsoro C, Bang SP, Yoon G, Artal P. Simulating Outcomes of Cataract Surgery: Important Advances in Ophthalmology. Annu Rev Biomed Eng 2021; 23:277-306. [PMID: 33848431 DOI: 10.1146/annurev-bioeng-082420-035827] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
As the human eye ages, the crystalline lens stiffens (presbyopia) and opacifies (cataract), requiring its replacement with an artificial lens [intraocular lens (IOL)]. Cataract surgery is the most frequently performed surgical procedure in the world. The increase in IOL designs has not been paralleled in practice by a sophistication in IOL selection methods, which rely on limited anatomical measurements of the eye and the surgeon's interpretation of the patient's needs and expectations. We propose that the future of IOL selection will be guided by 3D quantitative imaging of the crystalline lens to map lens opacities, anticipate IOL position, and develop fully customized eye models for ray-tracing-based IOL selection. Conversely, visual simulators (in which IOL designs are programmed in active elements) allow patients to experience prospective vision before surgery and to make more informed decisions about which IOL to choose. Quantitative imaging and optical and visual simulations of postsurgery outcomes will allow optimal treatments to be selected for a patient undergoing modern cataract surgery.
Collapse
Affiliation(s)
- Susana Marcos
- Instituto de Óptica "Daza de Valdés," Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid 28006, Spain;
| | - Eduardo Martinez-Enriquez
- Instituto de Óptica "Daza de Valdés," Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid 28006, Spain;
| | - Maria Vinas
- Instituto de Óptica "Daza de Valdés," Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid 28006, Spain;
| | - Alberto de Castro
- Instituto de Óptica "Daza de Valdés," Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid 28006, Spain;
| | - Carlos Dorronsoro
- Instituto de Óptica "Daza de Valdés," Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid 28006, Spain; .,2EyesVision, Madrid 28760, Spain
| | - Seung Pil Bang
- Flaum Eye Institute, The Institute of Optics, Center for Visual Science, Department of Biomedical Engineering, University of Rochester, Rochester, New York 14632, USA
| | - Geunyoung Yoon
- Flaum Eye Institute, The Institute of Optics, Center for Visual Science, Department of Biomedical Engineering, University of Rochester, Rochester, New York 14632, USA
| | - Pablo Artal
- Laboratorio de Óptica, Universidad de Murcia, Murcia 30100, Spain
| |
Collapse
|
20
|
Li T, Stein J, Nallasamy N. AI-powered effective lens position prediction improves the accuracy of existing lens formulas. Br J Ophthalmol 2021; 106:1222-1226. [PMID: 33836989 PMCID: PMC9411905 DOI: 10.1136/bjophthalmol-2020-318321] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Revised: 02/21/2021] [Accepted: 03/12/2021] [Indexed: 11/03/2022]
Abstract
AIMS To assess whether incorporating a machine learning (ML) method for accurate prediction of postoperative anterior chamber depth (ACD) improves the refraction prediction performance of existing intraocular lens (IOL) calculation formulas. METHODS A dataset of 4806 patients with cataract was gathered at the Kellogg Eye Center, University of Michigan, and split into a training set (80% of patients, 5761 eyes) and a testing set (20% of patients, 961 eyes). A previously developed ML-based method was used to predict the postoperative ACD based on preoperative biometry. This ML-based postoperative ACD was integrated into new effective lens position (ELP) predictions using regression models to rescale the ML output for each of four existing formulas (Haigis, Hoffer Q, Holladay and SRK/T). The performance of the formulas with ML-modified ELP was compared using a testing dataset. Performance was measured by the mean absolute error (MAE) in refraction prediction. RESULTS When the ELP was replaced with a linear combination of the original ELP and the ML-predicted ELP, the MAEs±SD (in Diopters) in the testing set were: 0.356±0.329 for Haigis, 0.352±0.319 for Hoffer Q, 0.371±0.336 for Holladay, and 0.361±0.331 for SRK/T which were significantly lower (p<0.05) than those of the original formulas: 0.373±0.328 for Haigis, 0.408±0.337 for Hoffer Q, 0.384±0.341 for Holladay and 0.394±0.351 for SRK/T. CONCLUSION Using a more accurately predicted postoperative ACD significantly improves the prediction accuracy of four existing IOL power formulas.
Collapse
Affiliation(s)
- Tingyang Li
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan, USA
| | - Joshua Stein
- Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA.,Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan, USA.,Center for Eye Policy and Innovation, University of Michigan, Ann Arbor, Michigan, USA
| | - Nambi Nallasamy
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, Michigan, USA .,Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
21
|
Chen Y, Manzanera S, Mompeán J, Ruminski D, Grulkowski I, Artal P. Increased crystalline lens coverage in optical coherence tomography with oblique scanning and volume stitching. BIOMEDICAL OPTICS EXPRESS 2021; 12:1529-1542. [PMID: 33796370 PMCID: PMC7984769 DOI: 10.1364/boe.418051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 02/13/2021] [Accepted: 02/16/2021] [Indexed: 05/30/2023]
Abstract
A three-dimensional optical coherence tomography (OCT) crystalline lens imaging method based on oblique scanning and image stitching is presented. The method was designed to increase OCT imaging volume of crystalline lens in vivo. A long-range swept-source (SS)-OCT imaging system, which can measure the entire anterior segment of eye in a single acquisition, is used to acquire one central volume and 4 extra volumes with different angles between optical axis of OCT instrument and the pupillary axis. The volumes are then stitched automatically by developed software. To show its effectiveness and verify its validity, we scanned the subjects before and after pupil dilation drops and compared the experimental results. By determining the number of voxels representing the signal from the crystalline lens in 3-D OCT images, our method can provide around 17% additional volumetric lens coverage compared with a regular imaging procedure. The proposed approach could be used clinically in early diagnosis of cortical cataract. Wider field of view offered by this method may facilitate more accurate lens biometry in its peripheral zones, which potentially contributes to understanding of lens shape modifications of the accommodating eye.
Collapse
Affiliation(s)
- Yiwei Chen
- Laboratorio de Óptica, Instituto Universitario de Investigación en Óptica y Nanofísica, Universidad de Murcia, Campus de Espinardo, E-30100 Murcia, Spain
| | - Silvestre Manzanera
- Laboratorio de Óptica, Instituto Universitario de Investigación en Óptica y Nanofísica, Universidad de Murcia, Campus de Espinardo, E-30100 Murcia, Spain
| | - Juan Mompeán
- Laboratorio de Óptica, Instituto Universitario de Investigación en Óptica y Nanofísica, Universidad de Murcia, Campus de Espinardo, E-30100 Murcia, Spain
| | - Daniel Ruminski
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, ul. Grudziądzka 5, 87-100 Toruń, Poland
| | - Ireneusz Grulkowski
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, ul. Grudziądzka 5, 87-100 Toruń, Poland
| | - Pablo Artal
- Laboratorio de Óptica, Instituto Universitario de Investigación en Óptica y Nanofísica, Universidad de Murcia, Campus de Espinardo, E-30100 Murcia, Spain
| |
Collapse
|
22
|
Rodríguez-Aramendía A, Díaz-Doutón F, Fernández-Trullàs J, Falgueras P, González L, Pujol J, Grulkowski I, Güell JL. Whole anterior segment and retinal swept source OCT for comprehensive ocular screening. BIOMEDICAL OPTICS EXPRESS 2021; 12:1263-1278. [PMID: 33796352 PMCID: PMC7984787 DOI: 10.1364/boe.414592] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Revised: 12/30/2020] [Accepted: 01/04/2021] [Indexed: 05/20/2023]
Abstract
Whole eye visualization and morphometry are of high relevance in clinical practice. However, most standard ophthalmic OCT instruments are dedicated either to retinal or to anterior segment imaging. We demonstrate a swept source optical coherence tomography system (SS-OCT) that images both the whole anterior segment and the retina alternately using a single source and detector. A pilot population was imaged with the proof of concept prototype. We demonstrate the clinical potential of whole eye OCT screening for the description and early detection of relevant clinical features in the anterior segment and retina of several patients.
Collapse
Affiliation(s)
- Ana Rodríguez-Aramendía
- Instituto de Microcirugía Ocular (IMO), Josep María Lladó 3, Barcelona 08035, Spain
- Center for Sensors, Instruments and Systems Development (CD6), Universitat Politècnica de Catalunya (UPC), Rambla Sant Nebridi 10, Terrassa 08222, Barcelona, Spain
| | - Fernando Díaz-Doutón
- Center for Sensors, Instruments and Systems Development (CD6), Universitat Politècnica de Catalunya (UPC), Rambla Sant Nebridi 10, Terrassa 08222, Barcelona, Spain
| | - José Fernández-Trullàs
- Center for Sensors, Instruments and Systems Development (CD6), Universitat Politècnica de Catalunya (UPC), Rambla Sant Nebridi 10, Terrassa 08222, Barcelona, Spain
| | - Pol Falgueras
- Center for Sensors, Instruments and Systems Development (CD6), Universitat Politècnica de Catalunya (UPC), Rambla Sant Nebridi 10, Terrassa 08222, Barcelona, Spain
| | - Laura González
- Instituto de Microcirugía Ocular (IMO), Josep María Lladó 3, Barcelona 08035, Spain
| | - Jaume Pujol
- Center for Sensors, Instruments and Systems Development (CD6), Universitat Politècnica de Catalunya (UPC), Rambla Sant Nebridi 10, Terrassa 08222, Barcelona, Spain
| | - Ireneusz Grulkowski
- Institute of Physics, Faculty of Physics, Astronomy and Informatics, Nicolaus Copernicus University, ul. Grudziądzka 5, 87-100 Toruń, Poland
| | - José Luis Güell
- Instituto de Microcirugía Ocular (IMO), Josep María Lladó 3, Barcelona 08035, Spain
| |
Collapse
|
23
|
Mohamed A, Nandyala S, Martinez-Enriquez E, Heilman BM, Augusteyn RC, de Castro A, Ruggeri M, Parel JMA, Marcos S, Manns F. Isolated human crystalline lens three-dimensional shape: A comparison between Indian and European populations. Exp Eye Res 2021; 205:108481. [PMID: 33545121 DOI: 10.1016/j.exer.2021.108481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 01/07/2021] [Accepted: 01/26/2021] [Indexed: 11/25/2022]
Abstract
There have been many studies on lens properties in specific populations (e.g. in China, Europe, Singapore, etc.) some of which suggest there may be differences between populations. Differences could be caused by ethnic or environmental influences or experimental procedures. The purpose of this study is to evaluate if any differences exist between Indian and European populations in the central geometric and full shape properties of human lenses. Two custom-developed spectral domain optical coherence tomography systems were used to acquire the crystalline lens geometry: one in India (69 lenses from 59 donors) and the other in Spain (24 lenses from 19 donors). The steps for obtaining accurate 3-D models from optical coherence tomography raw images comprised of image segmentation, fan and optical distortion correction, tilt removal and registration. The outcome variables were lens equatorial diameter, lens thickness, anterior and posterior lens thicknesses and their ratio, central radius of curvature of the anterior and posterior lens surfaces, lens volume and lens surface area. A mixed effects model by maximum likelihood estimation was used to evaluate the effect of age, population and their interaction (age*population) on lens parameters. After adjusting for age, there were no population differences observed in anterior and posterior radii of curvature, equatorial diameter, lens thickness, anterior and posterior lens thicknesses and their ratio, volume and surface area (all p ≥ 0.08). There was also no effect of the interaction term on anterior and posterior radii of curvature, equatorial diameter, lens thickness, anterior and posterior lens thicknesses and their ratio, volume and surface area (all p ≥ 0.06). All central geometric and full shape parameters appeared to be comparable between the European and Indian populations. This is the first study to compare geometric and full shape lens parameters between different populations in vitro.
Collapse
Affiliation(s)
- Ashik Mohamed
- Ophthalmic Biophysics, L V Prasad Eye Institute, Hyderabad, India; Brien Holden Vision Institute Limited, Sydney, Australia.
| | - Sushma Nandyala
- Ophthalmic Biophysics, L V Prasad Eye Institute, Hyderabad, India
| | - Eduardo Martinez-Enriquez
- Visual Optics and Biophotonics Lab, Institute of Optics, Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid, Spain
| | - Bianca Maceo Heilman
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
| | - Robert C Augusteyn
- Brien Holden Vision Institute Limited, Sydney, Australia; Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Alberto de Castro
- Visual Optics and Biophotonics Lab, Institute of Optics, Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid, Spain
| | - Marco Ruggeri
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
| | - Jean-Marie A Parel
- Brien Holden Vision Institute Limited, Sydney, Australia; Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA; Anne Bates Leach Eye Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Susana Marcos
- Visual Optics and Biophotonics Lab, Institute of Optics, Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid, Spain
| | - Fabrice Manns
- Ophthalmic Biophysics Center, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA; Department of Biomedical Engineering, University of Miami College of Engineering, Coral Gables, FL, USA
| |
Collapse
|
24
|
Intraocular lens power calculation for plus and minus lenses in high myopia using partial coherence interferometry. Int Ophthalmol 2021; 41:1585-1592. [PMID: 33521894 PMCID: PMC8087604 DOI: 10.1007/s10792-020-01684-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Accepted: 12/19/2020] [Indexed: 11/17/2022]
Abstract
Purpose We assessed the accuracy of lens power calculation in highly myopic patients implanting plus and minus intraocular lenses (IOL). Methods We included 58 consecutive, myopic eyes with an axial length (AL) > 26.0 mm, undergoing phacoemulsification and IOL implantation following biometry using the IOLMaster 500. For lens power calculation, the Haigis formula was used in all cases. For comparison, refraction was back-calculated using the Barrett Universal II (Barrett), Holladay I, Hill-RBF (RBF) and SRK/T formulae. Results The mean axial length was 30.17 ± 2.67 mm. Barrett (80%), Haigis (87%) and RBF (82%) showed comparable numbers of IOLs within 1 diopter (D) of target refraction. Visual acuity (BSCVA) improved (p < 0.001) from 0.60 ± 0.35 to 0.29 ± 0.29 logMAR (> 28-days postsurgery). The median absolute error (MedAE) of Barrett 0.49 D, Haigis 0.38, RBF 0.44 and SRK/T 0.44 did not differ. The MedAE of Haigis was significantly smaller than Holladay (0.75 D; p = 0.01). All median postoperative refractive errors (MedRE) differed significantly with the exception of Haigis to SRK/T (p = 0.6): Barrett − 0.33 D, Haigis 0.25, Holladay 0.63, RBF 0.04 and SRK/T 0.13. Barrett, Haigis, Holladay and RBF showed a tendency for higher MedAEs in their minus compared to plus IOLs, which only reached significance for SRK/T (p = 0.001). Barrett (p < 0.001) and RBF (p = 0.04) showed myopic, SRK/T (p = 002) a hyperopic shift in their minus IOLs. Conclusions In highly myopic patients, the accuracies of Barrett, Haigis and RBF were comparable with a tendency for higher MedAEs in minus IOLs. Barrett and RBF showed myopic, SRK/T a hyperopic shift in their minus IOLs.
Collapse
|
25
|
Refractive Outcomes of Cataract Surgery With or Without Endocyclophotocoagulation. J Glaucoma 2020; 30:e180-e183. [PMID: 33394850 DOI: 10.1097/ijg.0000000000001777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 12/08/2020] [Indexed: 11/27/2022]
Abstract
PRECIS Surgeons that perform cataract surgery combined with endocyclophotocoagulation (ECP) should rely on their preferred intraocular lens (IOL) calculation formula. There is no need to perform any correction to the IOL power, as this procedure does not modify the refractive outcome. PURPOSE The purpose of this study was to compare postoperative refractive outcomes in patients with glaucoma who underwent phacoemulsification and IOL implantation with or without ECP and the change in intraocular pressure (IOP) and number of antiglaucoma medications between groups. METHODS A cross-sectional study in which the medical records of the patients with any type of glaucoma, who underwent phacoemulsification with IOL implantation in the capsular bag in addition to ECP or as a standalone procedure from June 2016 to August 2019 were analyzed. Clinical data collected included axial length, steep, flat, and mean keratometry values, target spherical equivalent (SE) estimated by the SRK/T formula, manifest refraction SE at the 1-month follow-up, IOP, and number of antiglaucoma medications before and 12 months after surgery. Primary and secondary outcome measures were the mean predictive error (MPE), the postoperative SE, and the change in IOP after surgery in both groups, respectively. Significance was assessed using the Student t test for all variables between groups according to data distribution. P-values <0.05 were considered to be statistically significant. RESULTS A total of 196 eyes of 196 patients were included, 98 in the combined phacoemulsification-ECP group, and 98 in the non-ECP group. The observed MPE was -0.043±0.44, and 0.06±0.38 D MPE, respectively (P=0.079). Overall, 74.34% in the phacoemulsification-ECP group and 78.4% in the non-ECP group had a postoperative SE of ±0.50. The ECP group had lower IOP and a greater decrease in antiglaucoma medications at 12 months of follow-up. CONCLUSIONS SRK/T formula performed well in both groups, with no statistically significant difference in the MPE and the percentage of eyes achieving postoperative SE of ±0.50. We consider it is unnecessary to perform any kind of correction to the IOL power calculation when performing ECP.
Collapse
|
26
|
Li T, Stein JD, Nallasamy N. AI-Powered Effective Lens Position Prediction Improves the Accuracy of Existing Lens Formulas. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2020:2020.10.29.20222539. [PMID: 33173915 PMCID: PMC7654911 DOI: 10.1101/2020.10.29.20222539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
AIMS To assess whether incorporating a machine learning (ML) method for accurate prediction of postoperative anterior chamber depth (ACD) improves the refraction prediction performance of existing intraocular lens (IOL) calculation formulas. METHODS A dataset of 4806 cataract patients were gathered at the Kellogg Eye Center, University of Michigan, and split into a training set (80% of patients, 5761 eyes) and a testing set (20% of patients, 961 eyes). A previously developed ML-based method was used to predict the postoperative ACD based on preoperative biometry. This ML-based postoperative ACD was integrated into new effective lens position (ELP) predictions using regression models to rescale the ML output for each of four existing formulas (Haigis, Hoffer Q, Holladay, and SRK/T). The performance of the formulas with ML-modified ELP was compared using a testing dataset. Performance was measured by the mean absolute error (MAE) in refraction prediction. RESULTS When the ELP was replaced with a linear combination of the original ELP and the ML-predicted ELP, the MAEs ± SD (in Diopters) in the testing set were: 0.356 ± 0.329 for Haigis, 0.352 ± 0.319 for Hoffer Q, 0.371 ± 0.336 for Holladay, and 0.361 ± 0.331 for SRK/T which were significantly lower than those of the original formulas: 0.373 ± 0.328 for Haigis, 0.408 ± 0.337 for Hoffer Q, 0.384 ± 0.341 for Holladay, and 0.394 ± 0.351 for SRK/T. CONCLUSION Using a more accurately predicted postoperative ACD significantly improves the prediction accuracy of four existing IOL power formulas.
Collapse
Affiliation(s)
- Tingyang Li
- Department of Computational Medicine and Bioinformatics, University of Michigan
| | - Joshua D Stein
- Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan
- Center for Eye Policy and Innovation, University of Michigan, Ann Arbor, MI
- Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, MI
| | - Nambi Nallasamy
- Department of Computational Medicine and Bioinformatics, University of Michigan
- Kellogg Eye Center, Department of Ophthalmology and Visual Sciences, University of Michigan
| |
Collapse
|
27
|
Martinez-Enriquez E, de Castro A, Marcos S. Eigenlenses: a new model for full crystalline lens shape representation and its applications. BIOMEDICAL OPTICS EXPRESS 2020; 11:5633-5649. [PMID: 33149976 PMCID: PMC7587276 DOI: 10.1364/boe.397695] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 07/24/2020] [Accepted: 07/24/2020] [Indexed: 06/11/2023]
Abstract
The crystalline lens is an important optical element in the eye, responsible for focusing, and which experiences significant changes throughout life. The shape of the lens is usually studied only in the optical area (central 4 to 6 mm). However, for a great number of applications, a description of the full shape of the crystalline lens is required. We propose a new method for the representation of the full shape of the crystalline lens, constructed from 3-dimensional optical coherence tomography images of 133 isolated crystalline lenses (0-71 y/o), which we have called eigenlenses. The method is shown to be compact and accurate to describe not only the full shape of the crystalline lens, but also the optical zone in comparison with other methods. We also demonstrate its application to the extrapolation of the full shape of the crystalline lens from in-vivo optical images of the anterior segment of the eye, where only the central part of the lens visible through the pupil is available, and in the generation (synthesis) of realistic full lenses of a given age. The method has critical applications, among others, in improving and evaluating myopia and presbyopia treatments.
Collapse
|
28
|
Martinez-Enriquez E, de Castro A, Mohamed A, Sravani NG, Ruggeri M, Manns F, Marcos S. Age-Related Changes to the Three-Dimensional Full Shape of the Isolated Human Crystalline Lens. Invest Ophthalmol Vis Sci 2020; 61:11. [PMID: 32293664 PMCID: PMC7401430 DOI: 10.1167/iovs.61.4.11] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose Studying the full shape crystalline lens geometry is important to understand the changes undergone by the crystalline lens leading to presbyopia, cataract, or failure of emmetropization, and to aid in the design and selection of intraocular lenses and new strategies for correction. We used custom-developed three-dimensional (3-D) quantitative optical coherence tomography (OCT) to study age-related changes in the full shape of the isolated human crystalline lens. Methods A total of 103 ex vivo human isolated lenses from 87 subjects (age range, 0–56 years) were imaged using a 3-D spectral-domain OCT system. Lens models, constructed after segmentation of the surfaces and distortion correction, were used to automatically quantify central geometric parameters (lens thickness, radii of curvatures, and asphericities of anterior and posterior surfaces) and full shape parameters (lens volume, surface area, diameter, and equatorial plane position). Age-dependencies of these parameters were studied. Results Most of the measured parameters showed a biphasic behavior, statistically significantly increasing (radii of curvature, lens volume, surface area, diameter) or decreasing (asphericities, lens thickness) very fast in the first two decades of life, followed by a slow but significant increase after age 20 years (for all the parameters except for the posterior surface asphericity and the equatorial plane position, that remained constant). Conclusions Three-dimensional quantitative OCT allowed us to study the age-dependency of geometric parameters of the full isolated human crystalline lens. We found that most of the lens geometric parameters showed a biphasic behavior, changing rapidly before age 20 years and with a slower linear growth thereafter.
Collapse
|
29
|
Personalized Optical Designs and Manipulating Optics: Applications on the Anterior Segment of the Eye. J Ophthalmol 2020; 2020:9586062. [PMID: 32318287 PMCID: PMC7152974 DOI: 10.1155/2020/9586062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 12/30/2019] [Indexed: 11/17/2022] Open
|
30
|
Development of a new intraocular lens power calculation method based on lens position estimated with optical coherence tomography. Sci Rep 2020; 10:6501. [PMID: 32300162 PMCID: PMC7162886 DOI: 10.1038/s41598-020-63546-y] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2019] [Accepted: 04/01/2020] [Indexed: 12/02/2022] Open
Abstract
A new method is developed and validated for intraocular lens (IOL) power calculation based on paraxial ray tracing of the postoperative IOL positions, which are obtained with the use of anterior segment optical coherence tomography. Of the 474 eyes studied, 137 and 337 were grouped into training and validation sets, respectively. The positions of the implanted IOLs of the training datasets were characterized with multiple linear regression analyses one month after the operations. A new regression formula was developed to predict the postoperative anterior chamber depth with the use of the stepwise analysis results. In the validation dataset, postoperative refractive values were calculated according to the paraxial ray tracing of the cornea and lens based on the assumption of finite structural thicknesses with separate surface curvatures. The predicted refraction error was calculated as the difference of the expected postoperative refraction from the spherical-equivalent objective refraction values. The percentage error (within ±0.50 diopters) of the new formula was 84.3%. This was not significantly correlated to the axial length or keratometry. The developed formula yielded excellent postoperative refraction predictions and could be applicable to eyes with abnormal proportions, such as steep or flat corneal curvatures and short and long axial lengths.
Collapse
|
31
|
Muralidharan G, Martínez-Enríquez E, Birkenfeld J, Velasco-Ocana M, Pérez-Merino P, Marcos S. Morphological changes of human crystalline lens in myopia. BIOMEDICAL OPTICS EXPRESS 2019; 10:6084-6095. [PMID: 31853387 PMCID: PMC6913406 DOI: 10.1364/boe.10.006084] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 10/01/2019] [Accepted: 10/02/2019] [Indexed: 05/09/2023]
Abstract
Ocular biometric parameters, including full shape crystalline lens, were assessed in myopes and emmetropes using 3-D optical coherence tomography. The anterior chamber depth, the radius of the curvature of the anterior cornea, anterior lens, and posterior lens, lens thickness, lens equatorial diameter, surface area, equatorial position, volume, and power, were evaluated as functions of refractive errors and axial lengths while controlling for age effects. The crystalline lens appears to change with myopia consistent with lens thinning, equatorial, and capsular stretching while keeping constant volume. Axial elongation appears counteracted by a crystalline lens power reduction, while corneal power remains unaffected.
Collapse
|
32
|
Relationship between Crystalline Lens Thickness and Shape and the Identification of Anterior Ocular Segment Parameters for Predicting the Intraocular Lens Position after Cataract Surgery. BIOMED RESEARCH INTERNATIONAL 2019; 2019:3458548. [PMID: 31360711 PMCID: PMC6644274 DOI: 10.1155/2019/3458548] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 06/17/2019] [Accepted: 06/18/2019] [Indexed: 11/17/2022]
Abstract
Purpose This study was performed to investigate the relationships among crystalline lens shape, actual intraocular lens (IOL) position, and crystalline lens thickness (LT), as measured by anterior segment optical coherence tomography (AS-OCT), and to determine anterior ocular segment parameters that predict postoperative IOL position. Methods Seventy-nine eyes of 79 patients who underwent uneventful cataract surgery were enrolled. For crystalline lens preoperative anterior segment data, the LT, and anterior, equatorial, and posterior surface depths (ASD, ESD, and PSD, respectively) of crystalline lenses were quantitatively determined. For postoperative anterior segment data, the actual IOL position was quantified. Moreover, the following correlations were analyzed: LT with the ASD, ESD, PSD, and IOL position; IOL position with the ASD, ESD, and PSD; and refractive prediction error with the difference between the predicted postoperative anterior chamber depth (ACD) of the SRK/T formula and the IOL position, ASD, ESD, and PSD (each depth minus the predicted postoperative ACD of the SRK/T formula). Results The LT was significantly correlated with the ASD (r = -0.65) and PSD (r = 0.41), whereas it was not correlated with the ESD or IOL position. The IOL position was significantly correlated with the ASD (r = 0.67), ESD (r = 0.72), and PSD (r = 0.74). The refractive prediction error was significantly correlated with the difference between the predicted postoperative ACD of the SRK/T formula and the IOL position (r = 0.65), ASD (r = 0.46), ESD (r = 0.54), and PSD (r = 0.58). Conclusions The ESD and PSD obtained using AS-OCT were highly correlated with the IOL position and significantly correlated with the refractive prediction error. These findings suggest that the ESD and PSD may enhance the accuracy of actual IOL position prediction.
Collapse
|
33
|
Abstract
PURPOSE OF REVIEW To provide a consolidated update regarding preoperative evaluation for cataract surgery. RECENT FINDINGS Visual acuity alone is a poor gauge of cataract disability. Modalities such as wave front aberrometry, lens densitometry, and light-scatter assessments can quantify optical aspects of cataract and may prove clinically useful in surgical evaluation. Advances in biometry are driving improvements in refractive outcomes, which in turn have increased patient expectations. Future advances in biometry technology may include three-dimensional imaging of the cornea and lens. Screening for ocular comorbidities has become increasingly important, particularly to guide lens selection. Risk stratification systems can help guide surgical decisions and may decrease intraoperative complication rate. A comprehensive medical history and physical is currently mandated for all Medicare patients undergoing cataract surgery but may be of limited utility for low-risk patients. SUMMARY Rising patient expectations and a growing number of surgical choices have expanded the cataract preoperative evaluation. A systematic and comprehensive examination which includes identifying any ocular comorbidity is essential for surgical planning and counseling on visual prognosis. New technologies will continue to inform, but not replace, sound clinical judgment.
Collapse
|