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Kanclerz P, Bazylczyk N, Przewłócka K, Khoramnia R, Atchison DA, Tuuminen R. Risk Factors for Corneal Monochromatic Aberrations and Implications for Multifocal and Extended Depth-of-Focus Intraocular Lens Implantation. J Refract Surg 2024; 40:e420-e434. [PMID: 38848055 DOI: 10.3928/1081597x-20240416-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
PURPOSE To discuss factors influencing corneal aberrations that might influence the optical quality after intraocular lens (IOL) implantation. METHODS PubMed and Scopus were the main resources used to search the medical literature. An extensive search was performed to identify relevant articles concerning factors influencing the level of corneal aberrations as of August 27, 2023. The following keywords were used in various combinations: corneal, aberrations, defocus, astigmatism, spherical aberration, coma, trefoil, quadrafoil, intraocular lens, and IOL. RESULTS Conclusive evidence is lacking regarding the correlation between age and changes in corneal aberrations. Patients with astigmatism have greater corneal higher-order aberrations than those with minimal astigmatism, particularly concerning trefoil and coma. Increased levels of corneal higher-order aberrations are noted following contact lens wear, in patients with dry eye disease, and with pterygium. Increased higher-order aberrations have been reported following corneal refractive surgery and for 3 months following trabeculectomy; regarding intraocular lens surgery, the results remain controversial. CONCLUSIONS Several factors influence the level of corneal higher-order aberrations. Multifocal and extended depth-of-focus IOLs can share similarities in their optical properties, and the main difference arises in their design and performance with respect to spherical aberration. Preoperative evaluation is critical for proper IOL choice, particularly in corneas with risk of high levels of aberrations. [J Refract Surg. 2024;40(6):e420-e434.].
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Erdinest N, London N, Landau D, Barbara R, Barbara A, Naroo SA. Higher order aberrations in keratoconus. Int Ophthalmol 2024; 44:172. [PMID: 38594548 DOI: 10.1007/s10792-024-03118-5] [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: 03/30/2023] [Accepted: 03/24/2024] [Indexed: 04/11/2024]
Abstract
INTRODUCTION Keratoconus is a progressive disorder of the cornea that causes thinning (Sedaghat et al. in Sci Rep 11(1):11971, 2021), ectasia, and irregular astigmatism, resulting in poor visual acuity that cannot be corrected with standard sphero-cylindrical spectacle lenses. One feature distinguishing keratoconic corneas is ocular aberrations, manifesting up to five or six times the amount of higher-order aberrations than a normal, healthy eye. These aberrations can cause visual disturbances even at the very early stages of the disease. METHODS In the past, a diagnosis was derived from clinical symptoms, but technological advances have revealed multiple pre-clinical features, allowing for the differentiation between keratoconic and normal eyes at a much earlier stage. These include anterior and posterior corneal surface elevations, the corneal pachymetry profile, corneal epithelial patterns, wavefront aberration metrics, and corneal biomechanics (Sedaghat et al. in Sci Rep 11(1):11971, 2021).This review discusses the aberrations associated with keratoconus, how to measure them, and treatment methods to minimize their negative influence. CONCLUSIONS Early diagnosis can lead to early treatment and may allow for arresting progression, thereby improving the long-term prognosis. With the acceleration of refractive surgery, it is important to identify patients with keratoconus, as they are usually contraindicated for refractive surgery.
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Affiliation(s)
- Nir Erdinest
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | | | - David Landau
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Ramez Barbara
- Ophthalmology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Adel Barbara
- IVISION Cornea and Refractive Surgery Center, Haifa, Israel
| | - Shehzad A Naroo
- College of Health and Life Sciences, Aston University, Birmingham, UK
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Zhang J, Lin X, Wang X, Cheng Z, Li X, He J, Shi W, Gao H. Investigation of contrast visual acuity with rigid gas permeable contact lenses after penetrating Keratoplasty. BMC Ophthalmol 2023; 23:12. [PMID: 36624403 PMCID: PMC9830785 DOI: 10.1186/s12886-023-02769-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 01/04/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND To investigate the effects of rigid gas permeable contact lens (RGP-CL) wear on contrast visual acuity in patients after penetrating keratoplasty. METHODS Nineteen patients (19 eyes), aged 30.45 ± 5.83 years, who had received penetrating keratoplasty and were successfully fitted with RGP-CLs at our hospital from July 2017 to June 2018 were included. Contrast visual acuities at 100%, 25%, and 10% with spectacles and RGP-CLs were analyzed using the Chi-square test. The wavefront aberrations at the anterior surface of the cornea before and 1 month after RGP-CL wear were compared using the matched sample t-test. RESULTS The mean best spectacle-corrected visual acuities were 0.390 ± 0.135 logMAR, 0.706 ± 0.182 logMAR, and 0.952 ± 0.223 logMAR at the 100%, 25%, and 10% contrast levels, respectively, which were significantly lower than the RGP-CL-corrected visions at the three levels (0.255 ± 0.133 logMAR, 0.488 ± 0.168 logMAR, and 0.737 ± 0.159 logMAR; all P < 0.001). The vision losses with RGP-CLs were 0.231 ± 0.099 logMAR and 0.466 ± 0.094 logMAR at the 25% and 10% contrast levels, respectively. The Zernike spherical aberration Z04 was reduced from 3.734 ± 1.061 μm to 2.622 ± 0.725 μm after wearing the RGP-CLs (P ≤ 0.001). The astigmatism parameters of Z- 22 and Z22 were also reduced from 3.761 ± 2.309 μm and 3.316 ± 2.147 μm to 2.637 ± 1.722 μm and 2.016 ± 1.184 μm, respectively (P < 0.05). CONCLUSION For post-keratoplasty patients, RGP-CLs can help to improve visual performance, especially low contrast visual acuity. The improvement may be related to the reduction of corneal aberrations, mainly the spherical and astigmatism aberrations.
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Affiliation(s)
- Ju Zhang
- grid.410587.fShandong First Medical University & Shandong Academy of Medical Sciences, Shandong Jinan, China
| | - Xiao Lin
- grid.464402.00000 0000 9459 9325Medical School of Ophthalmology and optometry, Shandong University of Traditional Chinese medicine, Jinan, Shandong China
| | - Xinhai Wang
- grid.490473.dState Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Hospital, Shandong Eye Institute of Shandong First Medical University, 372 Jingsi Road, 250021 Jinan, Shandong China
| | - Zhiwei Cheng
- grid.490473.dState Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Hospital, Shandong Eye Institute of Shandong First Medical University, 372 Jingsi Road, 250021 Jinan, Shandong China
| | - Xiaoxiao Li
- grid.490473.dState Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Hospital, Shandong Eye Institute of Shandong First Medical University, 372 Jingsi Road, 250021 Jinan, Shandong China
| | - Jicang He
- grid.419984.90000 0000 8661 453XNew England College of Optometry, Boston, MA USA
| | - Weiyun Shi
- grid.490473.dState Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Hospital, Shandong Eye Institute of Shandong First Medical University, 372 Jingsi Road, 250021 Jinan, Shandong China
| | - Hua Gao
- grid.490473.dState Key Laboratory Cultivation Base, Shandong Provincial Key Laboratory of Ophthalmology, Shandong Eye Hospital, Shandong Eye Institute of Shandong First Medical University, 372 Jingsi Road, 250021 Jinan, Shandong China
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Marty AS, Jurkiewicz T, Mouchel R, Febvay C, Caillat T, Burillon C. Benefits of Scleral Lens in the Management of Irregular Corneas and Dry Eye Syndrome After Refractive Surgery. Eye Contact Lens 2022; 48:318-321. [PMID: 35877182 DOI: 10.1097/icl.0000000000000919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/20/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To evaluate the utility of the SPOT scleral lens (Oxygen Permeable Scleral Lens of Thonon; LAO, Thonon-les-Bains, France) in the management of the irregular cornea after refractive surgery. METHOD We included 19 patients (35 eyes) with irregular corneas after refractive surgery. Patients were fitted with scleral lenses after the failure of conventional contact lenses adaptation. The ophthalmologic examination included measurement of best-corrected visual acuity (BCVA), slitlamp examination, and evaluation of ocular aberrations (Objective Scattering Index [OSI] and higher-order aberration [HOA]). RESULT Scleral lens fitting increases significantly the BCVA from 0.33 (±0.25) to 0.08 (±0.13) LogMAR (P<0.001). There was also a significant decrease in Ocular Surface Disease Index from 66.2±22.8 to 42.4±18.9 (P<0.001). Ocular aberrations (OAs) are also significantly reduced by the scleral lenses, the mean OSI goes from 7.2 (±4.2) to 3.0 (±1.8) (P<0.001), OA from 2.58 (±1.34) to 1.98 μm (±2.31) (P=0.035), and HOA from 0.94 (±0.51) to 0.48 (±0.23) (P=0.0018). CONCLUSION Fitting with scleral lenses improves patients' optical and ocular surface problems. Scleral lens restores BCVA and the quality of life. Fitting with scleral lenses is an alternative to further surgery on these fragile eyes and is sometimes the only viable treatment option for the patient.
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Affiliation(s)
- Anne-Sophie Marty
- Clinique Ophtalmologique Thiers (A.-S.M.), Bordeaux, France; Centre Ophtalmologique Vendôme (T.J.), Lyon, France; Department of Neuro-Ophthalmology (T.J.), Hôpital Pierre-Wertheimer, Bron, France; Department of Ophthalmology (R.M., T.C., C.B.), Pavillon C, Hôpital Edouard-Herriot, Lyon, France; Cabinet d'Ophtalmologie De La Vallée (C.F.), Ornans, France; and Faculté de médecine Lyon Sud (C.B.), Charles-Mérieux, rue du Grand-Revoyet, Oullins, France
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Kumar M, Shetty R, Lalgudi VG, Khamar P, Vincent SJ, Atchison DA. The effect of scleral lenses on vision, refraction and aberrations in post-LASIK ectasia, keratoconus and pellucid marginal degeneration. Ophthalmic Physiol Opt 2021; 41:664-672. [PMID: 33769593 DOI: 10.1111/opo.12802] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2020] [Accepted: 01/21/2021] [Indexed: 12/28/2022]
Abstract
PURPOSE To quantify the effect of a single scleral lens design on visual acuity and ocular higher-order aberrations in eyes with post-LASIK ectasia, keratoconus and pellucid marginal degeneration (PMD) that could not achieve satisfactory vision with spectacles or soft contact lenses. METHODS Forty-six eyes of 28 participants fitted with diagnostic scleral lenses (KeraCare) were analysed, including 19, 15 and 12 eyes with post-LASIK ectasia, keratoconus and PMD, respectively. Corrected distance visual acuity (CDVA) and ocular aberrations were measured prior to lens wear and during lens wear after 60 min of settling. An i-Trace aberrometer was used to determine aberrations over a 4.5 mm diameter pupil. RESULTS Before lens wear, the median (95% confidence interval) values across all groups were: CDVA 0.30 (0.30, 0.40) logMAR, spherical equivalent refraction -2.75 (-5.25, -2.12) D, cylindrical refraction 3.75 (2.50, 5.00) D, higher-order-root-mean-square error (HO-RMS) 0.90 (0.64, 1.03) μm and vertical coma co-efficient C(3,-1) -0.32 (-0.42, -0.12) μm. RMS coma of 0.52 (0.40, 0.74) μm was higher for the keratoconus group than for the other groups (p < 0.05). During lens wear, values improved considerably across all groups: CDVA 0.0 (0.0, 0.00) logMAR, spherical equivalent refraction -0.50 (-0.75, +0.50) D, cylindrical refraction 0.50 (0.00, 0.50) D, HO-RMS 0.32 (0.26, 0.42) μm and C(3,-1) +0.12 (+0.02, +0.19) μm (all p < 0.001 compared to pre-lens wear). While reduced significantly, RMS coma remained higher in the keratoconus group at 0.35 (0.31, 0.52) μm than in the post-LASIK ectasia and PMD groups at 0.17 (0.12, 0.21) μm and 0.07 (0.02, 0.46) μm, respectively (p < 0.05). CONCLUSIONS The KeraCare scleral contact lens reduced ocular aberrations and improved visual acuity in patients with post-LASIK ectasia, keratoconus and PMD. The sign of vertical coma changed in keratoconus and PMD.
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Affiliation(s)
| | | | | | | | - Stephen J Vincent
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - David A Atchison
- Centre for Vision and Eye Research, School of Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
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Jacobs DS, Carrasquillo KG, Cottrell PD, Fernández-Velázquez FJ, Gil-Cazorla R, Jalbert I, Pucker AD, Riccobono K, Robertson DM, Szczotka-Flynn L, Speedwell L, Stapleton F. CLEAR - Medical use of contact lenses. Cont Lens Anterior Eye 2021; 44:289-329. [PMID: 33775381 DOI: 10.1016/j.clae.2021.02.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 02/01/2021] [Indexed: 12/11/2022]
Abstract
The medical use of contact lenses is a solution for many complex ocular conditions, including high refractive error, irregular astigmatism, primary and secondary corneal ectasia, disfiguring disease, and ocular surface disease. The development of highly oxygen permeable soft and rigid materials has extended the suitability of contact lenses for such applications. There is consistent evidence that bandage soft contact lenses, particularly silicone hydrogel lenses, improve epithelial healing and reduce pain in persistent epithelial defects, after trauma or surgery, and in corneal dystrophies. Drug delivery applications of contact lens hold promise for improving topical therapy. Modern scleral lens practice has achieved great success for both visual rehabilitation and therapeutic applications, including those requiring retention of a tear reservoir or protection from an adverse environment. This report offers a practical and relevant summary of the current evidence for the medical use of contact lenses for all eye care professionals including optometrists, ophthalmologists, opticians, and orthoptists. Topics covered include indications for use in both acute and chronic conditions, lens selection, patient selection, wear and care regimens, and recommended aftercare schedules. Prevention, presentation, and management of complications of medical use are reviewed.
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Affiliation(s)
- Deborah S Jacobs
- Massachusetts Eye & Ear, Cornea and Refractive Surgery Service, Harvard Medical School, Boston, MA, USA.
| | | | | | | | | | | | | | | | | | - Loretta Szczotka-Flynn
- Department of Ophthalmology & Visual Science, Case Western Reserve University, Cleveland, OH, USA
| | - Lynne Speedwell
- Great Ormond Street Hospital for Children NHS Trust, Moorfields Eye Hospital, London, UK
| | - Fiona Stapleton
- School of Optometry and Vision Science, UNSW Sydney, Australia
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Barnett M, Courey C, Fadel D, Lee K, Michaud L, Montani G, van der Worp E, Vincent SJ, Walker M, Bilkhu P, Morgan PB. CLEAR - Scleral lenses. Cont Lens Anterior Eye 2021; 44:270-288. [PMID: 33775380 DOI: 10.1016/j.clae.2021.02.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 02/01/2021] [Indexed: 12/25/2022]
Abstract
Scleral lenses were the first type of contact lens, developed in the late nineteenth century to restore vision and protect the ocular surface. With the advent of rigid corneal lenses in the middle of the twentieth century and soft lenses in the 1970's, the use of scleral lenses diminished; in recent times there has been a resurgence in their use driven by advances in manufacturing and ocular imaging technology. Scleral lenses are often the only viable form of contact lens wear across a range of clinical indications and can potentially delay the need for corneal surgery. This report provides a brief historical review of scleral lenses and a detailed account of contemporary scleral lens practice including common indications and recommended terminology. Recent research on ocular surface shape is presented, in addition to a comprehensive account of modern scleral lens fitting and on-eye evaluation. A range of optical and physiological challenges associated with scleral lenses are presented, including options for the clinical management of a range of ocular conditions. Future applications which take advantage of the stability of scleral lenses are also discussed. In summary, this report presents evidence-based recommendations to optimise patient outcomes in modern scleral lens practice.
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Affiliation(s)
- Melissa Barnett
- University of California, Davis Eye Center, Sacramento, CA, United States.
| | | | | | - Karen Lee
- University of Houston, College of Optometry, Houston, TX, United States
| | | | - Giancarlo Montani
- Università del Salento, Dipartimento di Matematica e Fisica CERCA, Lecce, Italy
| | - Eef van der Worp
- Eye-Contact-Lens Research & Education, Amsterdam, NL, Netherlands
| | - Stephen J Vincent
- Queensland University of Technology (QUT), Centre for Vision and Eye Research, School of Optometry and Vision Science, Contact Lens and Visual Optics Laboratory, Brisbane, Australia
| | - Maria Walker
- University of Houston, College of Optometry, Houston, TX, United States
| | - Paramdeep Bilkhu
- School of Optometry & Vision Science, Aston University, Birmingham, United Kingdom
| | - Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, University of Manchester, Manchester, United Kingdom
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Macedo-de-Araújo RJ, Faria-Ribeiro M, McAlinden C, van der Worp E, González-Méijome JM. Optical Quality and Visual Performance for One Year in a Sample of Scleral Lens Wearers. Optom Vis Sci 2020; 97:775-789. [DOI: 10.1097/opx.0000000000001570] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
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10
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Vincent SJ, Fadel D. Optical considerations for scleral contact lenses: A review. Cont Lens Anterior Eye 2019; 42:598-613. [DOI: 10.1016/j.clae.2019.04.012] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Revised: 04/24/2019] [Accepted: 04/25/2019] [Indexed: 01/07/2023]
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LogMAR and Stereoacuity in Keratoconus Corrected with Spectacles and Rigid Gas-permeable Contact Lenses. Optom Vis Sci 2019; 95:391-398. [PMID: 29554011 DOI: 10.1097/opx.0000000000001205] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
SIGNIFICANCE This study showed an improvement in three-dimensional depth perception of subjects with bilateral and unilateral keratoconus with rigid gas-permeable (RGP) contact lens wear, relative to spectacles. This novel information will aid clinicians to consider RGP contact lenses as a management modality in keratoconic patients complaining of depth-related difficulties with their spectacles. PURPOSE The aim of this study was to systematically compare changes in logMAR acuity and stereoacuity from best-corrected spherocylindrical spectacles to RGP contact lenses in bilateral and unilateral keratoconus vis-à-vis age-matched control subjects. METHODS Monocular and binocular logMAR acuity and random-dot stereoacuity were determined in subjects with bilateral (n = 30; 18 to 24 years) and unilateral (n = 10; 18 to 24 years) keratoconus and 20 control subjects using standard psychophysical protocols. RESULTS Median (25th to 75th interquartile range) monocular (right eye) and binocular logMAR acuity and stereoacuity improved significantly from spectacles to RGP contact lenses in the bilateral keratoconus cohort (P < .001). Only monocular logMAR acuity of affected eye and stereoacuity improved from spectacles to RGP contact lenses in the unilateral keratoconus cohort (P < .001). There was no significant change in the binocular logMAR acuity from spectacles to RGP contact lenses in the unilateral keratoconus cohort. The magnitude of improvement in binocular logMAR acuity and stereoacuity was also greater for the bilateral compared with the unilateral keratoconus cohort. All outcome measures of cases with RGP contact lenses remained poorer than control subjects (P < .001). CONCLUSIONS Binocular resolution and stereoacuity improve from spectacles to RGP contact lenses in bilateral keratoconus, whereas only stereoacuity improves from spectacles to RGP contact lenses in unilateral keratoconus. The magnitude of improvement in visual performance is greater for the binocular compared with the unilateral keratoconus cohort.
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Kumar M, Shetty R, Dutta D, Rao HL, Jayadev C, Atchison DA. Effects of a semi-scleral contact lens on refraction and higher order aberrations. Cont Lens Anterior Eye 2019; 42:670-674. [PMID: 31230973 DOI: 10.1016/j.clae.2019.06.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Revised: 05/23/2019] [Accepted: 06/11/2019] [Indexed: 10/26/2022]
Abstract
PURPOSE To investigate effects of Rose K2 XL semi-scleral contact lenses (Menicon Co.) on visual acuity and higher-order aberrations in eyes with irregular corneas. METHODS One hundred and twelve eyes of 84 patients fitted with Rose K2 XL lenses were analysed. Participants were in 4 clinical groups: keratoconus, intra-corneal ring segments, radial keratotomy, and penetrating keratoplasty. Corrected distance visual acuity and ocular aberrations were determined before lens wear and 60 min into lens wear. The i-Trace aberrometer was used to determine aberrations at 4.5 mm pupil size. RESULTS There were 55, 22, 19 and 16 eyes in keratoconus, intra-corneal ring segments, radial keratotomy and penetrating keratoplasty groups, respectively. Before lens wear, eyes had poor corrected distance vision acuity (mean and standard deviation +0.55 ± 0.33 logMAR), high negative spherical equivalent refraction (-6.4 ± 3.7 D), high cylindrical errors (4.5 ± 2.2 D), large higher-order root-mean-squared (HO-RMS) aberration (1.5 ± 1.3 μm) and large higher-order aberration components. Cylinder was particular high for the penetrating keratoplasty group (mean 5.9 ± 2.5 D), root-mean-squared third-order coma was lowest for the radial keratotomy group (0.7 ± 1.0 μm), and fourth-order spherical aberration was highly negative for the intra-corneal ring segment group (co-efficient -0.4 ± 0.7 μm). With lens wear, the values changed considerably. Corrected distance visual acuity improved by 0.51 ± 0.31 logMAR, cylinder decreased by 3.6 ± 2.1 D, HO-RMS aberration reduced by 1.1 ± 1.2 μm, and higher-order aberration components decreased considerably. Magnitudes of group changes reflected the magnitudes before lens wear. CONCLUSIONS Rose K2 XL semi-scleral contact lenses were effective in improving vision and reducing ocular aberrations for eyes with irregular corneas.
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Affiliation(s)
- Mukesh Kumar
- Cornea and Refractive Department, Narayana Nethralaya, Bangalore, India.
| | - Rohit Shetty
- Cornea and Refractive Department, Narayana Nethralaya, Bangalore, India
| | - Debarun Dutta
- School of Optometry and Vision Science, The University of New Wales, Sydney, New South Wales, Australia
| | - Harsha L Rao
- Cornea and Refractive Department, Narayana Nethralaya, Bangalore, India
| | - Chaitra Jayadev
- Cornea and Refractive Department, Narayana Nethralaya, Bangalore, India
| | - David A Atchison
- Institute of Health & Biomedical Innovation and School of Optometry & Vision Science, Queensland University of Technology, Kelvin Grove Q 4059 Australia
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Clinical Evaluation of Large Diameter Rigid-Gas Permeable Versus Soft Toric Contact Lenses for the Correction of Refractive Astigmatism. A MultiCenter Study. Eye Contact Lens 2018; 44:164-169. [PMID: 27898516 DOI: 10.1097/icl.0000000000000323] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE This study aims to address the clinical performance of a large diameter rigid gas permeable lens (LRGP) in a group of subjects with low-to-moderate (0.75-2.75 D) refractive astigmatism. An additional goal was to determine whether soft toric or LRGP contact lenses performed better objectively in the correction of astigmatism and to determine which modality is preferred by subjects. METHODS This was a multisite prospective cross-over clinical study. Ten asymptomatic contact lens wearers per site (four university clinics) were recruited and randomly assigned to group A or group B. Group A was assigned to start wearing Comfilcon A soft toric lens first, for two weeks, and then crossed over to LRGP lenses (Boston XO, 14.3 mm diameter miniscleral lens). Group B initially wore LRGP lenses and then crossed over to soft toric lenses. For each type of lens worn, low-contrast and high-contrast visual acuity (VA) were evaluated at distance. At the conclusion of the study, after two months, all subjects completed a questionnaire in which they were asked to indicate their preference for one type of lens (soft toric or LRGP) and to rate the quality of vision in day-to-day activities. RESULTS Thirty-six of 38 (94.7%) subjects completed the study with 75% preferring the vision of the LRGP lens as compared to the soft toric lenses worn in the study. 52.7% expressed a preference to continue with this modality despite only 38.8% reporting that these LRGP lenses are easy or very easy to handle. Wear time, subjective comfort, and subjective vision ratings exhibited no significant difference between the two groups. CONCLUSIONS In a population of asymptomatic contact lens wearers, LRGP lenses can be considered as a good alternative to soft toric lenses for the correction of refractive astigmatism.
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Abou Samra WA, Badawi AE, Kishk H, Abd El ghafar A, Elwan MM, Abouelkheir HY. Fitting Tips and Visual Rehabilitation of Irregular Cornea with a New Design of Corneoscleral Contact Lens: Objective and Subjective Evaluation. J Ophthalmol 2018; 2018:3923170. [PMID: 29484205 PMCID: PMC5816849 DOI: 10.1155/2018/3923170] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2017] [Revised: 12/07/2017] [Accepted: 12/17/2017] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES To study the fitting and the visual rehabilitation obtained with a corneoscleral contact lens, namely, Rose K2 XL in patients with irregular cornea. METHODS This prospective study included 36 eyes of 36 patients with irregular cornea fitted with Rose K2 XL. Refractive and visual outcomes and mesopic and aberrometric parameters of fitted eyes were assessed at 2 weeks, 3 months, and 6 months after the initial lens use. Objective and subjective parameters of patient satisfaction and lens comfort were noted. Causes of lens discontinuation and complications were also recorded. RESULTS Average logMAR VA improved significantly from 0.95 ± 0.09 without correction to 0.04 ± 0.05 six months after lens wear. Similarly, mesopic and aberrometric measures were significantly improved. Statistical analysis of the subjective patients' responses showed a significant acceptance of the lens by most of them. At the end of follow-up, the mean wearing time was 9.9 ± 2.9 hours per day. The most common cause of wearing discontinuation was persistent discomfort (16.7%) and high lens expenses(16.7%). Self-assessed questionnaire showed statistically significant improvement in nearly all measured subjective parameters. CONCLUSION Rose K2 XL lenses provide patients with irregular cornea with both quantitative and qualitative optimal visual function with high degree of patient comfort and satisfaction.
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Affiliation(s)
| | - Amani E. Badawi
- Mansoura Ophthalmology Center, Mansoura University, Mansoura, Egypt
| | - Hanem Kishk
- Mansoura Ophthalmology Center, Mansoura University, Mansoura, Egypt
| | | | - Mohamed M. Elwan
- Mansoura Ophthalmology Center, Mansoura University, Mansoura, Egypt
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Post-LASIK Visual Quality With a Corneoscleral Contact Lens to Treat Irregular Corneas. Eye Contact Lens 2017; 43:46-50. [DOI: 10.1097/icl.0000000000000231] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Aydin Kurna S, Altun A, Oflaz A, Karatay Arsan A. Evaluation of the impact of persistent subepithelial corneal infiltrations on the visual performance and corneal optical quality after epidemic keratoconjunctivitis. Acta Ophthalmol 2015; 93:377-82. [PMID: 25043311 DOI: 10.1111/aos.12496] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2014] [Accepted: 06/17/2014] [Indexed: 11/30/2022]
Abstract
PURPOSE Aim was to measure the effect of persistent subepithelial corneal infiltrates (SEIs) after epidemic keratoconjunctivitis (EKC) on visual performance and corneal optical quality. METHODS We examined 53 patients divided into two groups. Patients with previous EKC constituted the study group (Group 1, n: 27). Healthy age matched subjects constituted the control group (Group 2, n: 26). Study group was subdivided into eyes with SEI (Group 1A, 40 eyes) and healthy fellow eyes (Group 1B, 14 eyes). Patients were submitted to a complete examination including high- and low-contrast visual acuities (HCVA, LCVA), corneal topography and aberrometry. RESULTS The mean interval between epidemic conjunctivitis and examination was 7.25 ± 5.63 months. Mean number of corneal infiltrates was 17.30 ± 14.38. The mean HCVA and LCVA were significantly lower in the eyes with SEI than fellow eyes and control group (p = 0.001). LCVA value was also worse in the fellow eyes when compared to control (p = 0.048). Corneal topography values were significantly higher in the eyes with SEI from both fellow eyes and control group. During corneal aberrometry, the mean root mean square value of spheric aberration, irregular astigmatism and total aberration were significantly higher in SEI group when compared to fellow eyes and control group (p < 0.05). Total aberrations were higher than control subjects in the fellow eyes. Trefoil aberration was higher in SEI group only when compared to control subjects, while there was no significant difference in coma aberration values between the groups (p > 0.05). CONCLUSION Results of this study suggested that visual performance is compromised in patients with EKC by aberrations and changes in topographic variables.
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Affiliation(s)
- Sevda Aydin Kurna
- Fatih Sultan Mehmet Education and Research Hospital; Ophthalmology Clinics; Istanbul Turkey
| | - Ahmet Altun
- Fatih Sultan Mehmet Education and Research Hospital; Ophthalmology Clinics; Istanbul Turkey
| | - Aynur Oflaz
- Fatih Sultan Mehmet Education and Research Hospital; Ophthalmology Clinics; Istanbul Turkey
| | - Aysu Karatay Arsan
- Fatih Sultan Mehmet Education and Research Hospital; Ophthalmology Clinics; Istanbul Turkey
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Romero-Jiménez M, Flores-Rodríguez P. Utility of a semi-scleral contact lens design in the management of the irregular cornea. Cont Lens Anterior Eye 2013; 36:146-50. [DOI: 10.1016/j.clae.2012.12.006] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Revised: 11/18/2012] [Accepted: 12/05/2012] [Indexed: 10/27/2022]
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Wavefront analysis and Zernike polynomial decomposition for evaluation of corneal optical quality. J Cataract Refract Surg 2011; 38:343-56. [PMID: 22176886 DOI: 10.1016/j.jcrs.2011.11.016] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2011] [Revised: 09/09/2011] [Accepted: 10/07/2011] [Indexed: 11/20/2022]
Abstract
Wavefront-guided excimer laser refractive surgery and new customized intraocular lens and contact lens designs are major clinical applications of corneal wavefront analysis. Other therapeutic applications include corneal disorders, conventional excimer laser refractive surgery, incisional techniques and cataract surgery, corneal transplantation, intrastromal corneal ring segment implantation, and crosslinking therapy. Basic data regarding corneal wavefront aberrations, such as distribution in the population and changes with aging, are essential for understanding the nature of each aberration and correcting it. Corneal aberrometry also improved our comprehension of the optical effects of the aforementioned topics while helping us assess the success of the procedures. Zernike polynomials are representations of the higher- and lower-order aberrations of the cornea, allowing a mathematical approach to their determination. Polynomials are used to model individual components of the wavefront in familiar terms. This article reviews the current knowledge of the wavefront aberrations of the human cornea and analyzes studies in the fields of anterior segment surgery and/or therapy, diseases, and optical quality in the context of this knowledge.
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Gumus K, Gire A, Pflugfelder SC. The impact of the Boston ocular surface prosthesis on wavefront higher-order aberrations. Am J Ophthalmol 2011; 151:682-690.e2. [PMID: 21269603 DOI: 10.1016/j.ajo.2010.10.027] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2010] [Revised: 10/12/2010] [Accepted: 10/14/2010] [Indexed: 10/18/2022]
Abstract
PURPOSE To evaluate the effect of the Boston Ocular Surface Prosthesis (Boston Foundation for Sight) on higher-order wavefront aberrations in eyes with keratoconus, eyes that have undergone penetrating keratoplasty, eyes that have undergone refractive surgery, and eyes with ocular surface diseases. DESIGN Prospective, clinical study. METHODS The study evaluated 56 eyes of 39 patients with irregular astigmatism who were treated with the Boston Ocular Surface Prosthesis when conventional treatments failed. Patients were sorted into 4 clinical groups based on the underlying cause of irregular astigmatism, including keratoconus (group 1), post-penetrating keratoplasty (group 2), post-refractive surgery (group 3), and ocular surface diseases (group 4). Another 6 eyes of 5 patients who were treated with rigid gas permeable lenses also were evaluated. Best-corrected visual acuity; topographic refractive indices, including spherical, cylindrical, spherical equivalent values; and higher-order and total wavefront aberration errors were noted at baseline and after fitting the lens. RESULTS In all groups, higher-order wavefront aberration error was noted to decrease significantly in eyes wearing the Boston Ocular Surface Prosthesis (P<.001, P=.001, P=.002, and P=.001, respectively). By post hoc analysis, significant differences in the level of higher-order aberrations were observed only between groups 1 and 4 (P=.012) and groups 1 and 2 (P=.033). In the overall group, mean correction rate of higher-order aberration error with the Boston Ocular Surface Prosthesis was 72.3%. However, in eyes with rigid gas permeable lenses, 2 eyes demonstrated increased higher-order aberration error, whereas the mean correction rate in other 4 eyes was only 42.5%. CONCLUSIONS With its unique structure, the Boston Ocular Surface Prosthesis was found to be very effective in reducing higher-order wavefront aberrations in patients with irregular astigmatism resulting from a number of corneal and ocular surface conditions who had not responded satisfactorily to conventional methods of optical correction.
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Tan G, Chen X, Xie RZ, He H, Liu Q, Guo Y, Liao A, Zhong X. Reverse geometry rigid gas permeable contact lens wear reduces high-order aberrations and the associated symptoms in post-LASIK patients. Curr Eye Res 2010; 35:9-16. [PMID: 20021249 DOI: 10.3109/02713680903421186] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE This study evaluated the efficacy of custom-made reverse geometry rigid gas permeable (RGP) contact lenses in the control of symptoms related to increased wavefront aberrations after LASIK correction of myopia. MATERIALS AND METHODS Twenty-eight myopes treated with LASIK were assessed for post-LASIK symptoms (declined night vision, glare, halos and/or monocular diplopia) and corneal topography. A set of RGP contact lenses was selected as trial lenses based on the matching between the lens and the patient's corneal topography. If the fluorescein pattern between the trial lens and the corneal surface showed a central alignment, a mid-peripheral bearing and peripheral clearance and if the patient felt comfortable with the lens wear, a duplicated lens was ordered for the patient. Otherwise, a lens satisfied with corneal topography of the patient and clinical judgment was used. Visual acuity (VA) and wavefront aberrations were measured after the lens wear. RESULTS The custom-made lenses well matched the host cornea with no dislodgment in all subjects. The post-LASIK eyes showed an increase of 1 Snellen line in VA (from 0.90 +/- 0.33 to 1.11 +/- 0.24) and a significant improvement in all symptoms after the lens wear. The total higher-order aberration is significantly reduced after the lens wear with at least 70% reduction in either spherical aberration, coma, third or fourth aberration but only 33% reduction in the fifth aberration. CONCLUSIONS Reverse geometry RGP lenses with the design based on individual topographic data can improve visual performance of post-LASIK eyes by reducing higher order aberrations.
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Affiliation(s)
- Gang Tan
- Zhongshan Ophthalmic Center and State Key Laboratory of Ophthalmology, Sun Yat-sen University, Guangzhou, China
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Abstract
PURPOSE Assessment of the relative performance in measuring corneal shape and corneal aberrations for two specular reflection topographers: Keratron Placido Ring Topographer, VU Topographer, and two slit-lamp imaging instruments: Orbscan II and Topcon SL-45 Scheimpflug. METHODS Corneal height maps of the anterior corneal surface were obtained from a group of 34 subjects with all four instruments; posterior corneal surface height maps were only obtained with the two slit-lamp imaging instruments. Corneal surface shapes are calculated in terms of radius of curvature and asphericity fitting an aspheric model. Wave aberrations for the anterior corneal surface and the total cornea are determined up to and including sixth order Zernike convention by means of ray tracing. RESULTS Clinical relevant differences were observed for radius of curvature of the anterior corneal surface, where the slit-imaging instruments measure higher values (mean difference = 0.05 mm, p < 0.05) and anterior corneal astigmatism for which the Orbscan II measures higher values than the VU Topographer [mean difference = 0.174 microm (0.134 Equivalent Diopters), p < 0.01]. Small significant differences were observed for asphericity and spherical aberration of the anterior corneal surface; however, these are not clinically relevant. Clinically relevant differences were also observed for posterior radius (difference = 0.135 mm p < 0.001), total corneal astigmatism (difference = 0.207 microm (0.159 Equivalent Diopters), p = 0.001), and central corneal thickness (CCT) (difference = -18.6 microm, p < 0.001). The differences found for total corneal coma and trefoil were not clinical relevant. Furthermore, the precision of the specular reflection topographers is superior to that of the slit-lamp instruments by at least a factor of two. CONCLUSIONS For traditional spectacle and contact lens applications, the corneal topographers are interchangeable except for measuring anterior radius of curvature. However, for more modern techniques as customized corneal refractive surgery, the subtle differences (e.g., total corneal astigmatism and CCT) between the instruments are clinically relevant.
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Tahzib NG, MacRae SM, Yoon G, Berendschot TTJM, Eggink FAGJ, Hendrikse F, Nuijts RMMA. Higher-order aberrations after implantation of iris-fixated rigid or foldable phakic intraocular lenses. J Cataract Refract Surg 2008; 34:1913-20. [PMID: 19006738 DOI: 10.1016/j.jcrs.2008.07.014] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2008] [Accepted: 07/25/2008] [Indexed: 11/26/2022]
Abstract
PURPOSE To evaluate higher-order aberrations (HOAs) after implantation of Artiflex phakic intraocular lenses (pIOLs). SETTING Department of Ophthalmology, Academic Hospital Maastricht, Maastricht, The Netherlands. METHODS This retrospective comparative case series comprised 27 eyes (14 patients) that had Artiflex pIOL implantation and 22 eyes (13 patients) that had Artisan pIOL implantation. Refractive data, pupil size, IOL decentration, and HOA values were recorded and compared. Laboratory analysis was performed. Follow-up was 1 year. RESULTS In the Artiflex group, the mean spherical equivalent (SE) changed from -9.95 diopters (D) +/- 1.43 (SD) (range -6.75 to -12.13 D) to -0.30 +/- 0.53 D (range -1.94 to 0.56 D). Postoperatively, trefoil-y increased (increase factor 1.73) and spherical aberration decreased (increase factor 0.55). The mean pIOL decentration was 0.24 +/- 0.12 mm; 96.3% were decentered 0.5 mm or less. There was a significant correlation between pIOL decentration and postoperative spherical aberration and coma-y. In the Artisan group, the mean SE changed from -9.90 +/- 2.74 D (range -4.00 to -14.50 D) to -0.20 +/- 0.42 D (range -0.75 to 0.50 D). Postoperatively, trefoil-y and spherical aberration increased (increase factors 3.32 and 6.84, respectively). Laboratory analysis confirmed the negative and positive spherical aberration profile of the Artiflex pIOL and Artisan pIOL, respectively. CONCLUSIONS Artiflex pIOL implantation decreased spherical aberration, while Artisan pIOL implantation increased spherical aberration. Trefoil-y increased in both groups. These changes might be explained by incision size differences in relation to trefoil and differences in optic design in relation to spherical aberration.
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Affiliation(s)
- Nayyirih G Tahzib
- Department of Ophthalmology, Academic Hospital Maastricht, Maastricht, The Netherlands.
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Menicon Z Rigid Gas Permeable Lenses for Keratoconus and Irregular Corneas: A Retrospective Case Series. Eye Contact Lens 2008; 34:254-60. [DOI: 10.1097/icl.0b013e31817f6db0] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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