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Salgado-Borges J, Borges A, Ferreira I, González-Méijome JM, Faria-Ribeiro M. Optical characterization and through-focus performance of two advanced monofocal intraocular lenses. Graefes Arch Clin Exp Ophthalmol 2024; 262:1539-1544. [PMID: 38038729 PMCID: PMC11031439 DOI: 10.1007/s00417-023-06322-8] [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: 05/26/2023] [Revised: 11/08/2023] [Accepted: 11/23/2023] [Indexed: 12/02/2023] Open
Abstract
PURPOSE To compare the refractive power profile, subjective depth-of-field and objective optical quality of two advanced monofocal intraocular lenses (IOLs) designed to improve intermediate vision. METHODS This prospective study evaluated forty-six eyes of twenty-three patients, aged 54-68 years, binocularly implanted with two monofocal enhanced intraocular lenses (IOLs), the Tecnis Eyhance and the Physiol Isopure. Subjective through-focus visual acuity curves were obtained by placing trial lenses in front of the eye while wearing its best spherical-cylindrical correction for distance. Objective optical quality was defined as the area under the modulation transfer function, calculated from the wavefront maps measured with a high-resolution aberrometer. The optical design of both lenses was compared based on their refractive power profiles measured with the lenses immersed in saline solution. RESULTS Both lenses have progressive aspherical geometries, in which the sagittal power decreases rapidly from the center to the edge of the optical zone. Mean monocular through-focus curves show a best corrected distance visual acuity of - 0.02 logMAR with both lenses. Through-focus visual acuity was marginally higher for the Eyhance, with a difference of 1 letter at the defocus position of - 0.5D and 3 letters between - 1.0D and - 2.0D. Objective assessment of optical quality revealed only a difference of about 2 points in MTF area at distance. CONCLUSION Both IOLs use a similar approach to improve intermediate vision. The Eyhance showed marginally better subjective performance than the Isopure at the target vergences between - 1.00D and - 2.00D, although these results did not reach statistical significance and were not replicated by the objective findings.
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Affiliation(s)
| | | | | | | | - Miguel Faria-Ribeiro
- Physics Center of Minho and Porto Universities, University of Minho, Campus de Gualtar, Ed. 6, Braga, Portugal.
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Esteban-Ibañez E, Montagud-Martínez D, Sawides L, Zaytouny A, de Castro A, Sisó-Fuertes I, Barcala X, Piñero DP, Furlan WD, Dorronsoro C, Gambra E. Simulation of daily soft multifocal contact lenses using SimVis Gekko: from in-vitro and computational characterization to clinical validation. Sci Rep 2024; 14:8592. [PMID: 38615153 PMCID: PMC11016090 DOI: 10.1038/s41598-024-59178-1] [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: 05/18/2023] [Accepted: 04/08/2024] [Indexed: 04/15/2024] Open
Abstract
Multifocal contact lenses (MCLs) are one of the solutions to correct presbyopia, but their adoption is not widespread. To address this situation, visual simulators can be used to refine the adaptation process. This study aims to obtain accurate simulations for a visual simulator (SimVis Gekko; 2EyesVision) of daily soft MCL designs from four manufacturers. In-vitro characterization of these MCLs-several powers and additions- was obtained using NIMO TR-1504. From the averaged relative power profiles across powers, phase maps were reconstructed and the Through-Focus Visual Strehl metric was calculated for each MCL design. The SimVis Gekko simulation corresponding to each MCL design was obtained computationally and bench-validated. Finally, the MCL simulations were clinically validated involving presbyopic patients. The clinical validation results show a good agreement between the SimVis Gekko simulations and the real MCLs for through-focus visual acuity (TF-VA) curves and VA at three real distances. All MCL designs showed a partial correlation higher than 0.90 and a Root Mean Square Error below 0.07 logMAR between the TF-VA of simulations and Real MCLs across subjects. The validity of the simulation approach using SimVis Gekko and in-vitro measurements was confirmed in this study, opening the possibility to accelerate the adaptation of MCLs.
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Affiliation(s)
- Eduardo Esteban-Ibañez
- 2EyesVision SL, Plaza de la Encina, 10, Nucleo 3, Planta 4ª, 28760, Tres Cantos, Madrid, Spain.
- Institute of Optics 'Daza de Valdés', Spanish National Research Council, IO-CSIC, Madrid, Spain.
| | - Diego Montagud-Martínez
- Centro de Tecnologías Físicas, Universitat Politècnica de València, Valencia, Spain
- Departamento de Óptica y Optometría y Ciencias de la Visión, Universitat de València, Valencia, Spain
| | - Lucie Sawides
- 2EyesVision SL, Plaza de la Encina, 10, Nucleo 3, Planta 4ª, 28760, Tres Cantos, Madrid, Spain
- Institute of Optics 'Daza de Valdés', Spanish National Research Council, IO-CSIC, Madrid, Spain
| | - Amal Zaytouny
- Institute of Optics 'Daza de Valdés', Spanish National Research Council, IO-CSIC, Madrid, Spain
| | - Alberto de Castro
- Institute of Optics 'Daza de Valdés', Spanish National Research Council, IO-CSIC, Madrid, Spain
| | - Irene Sisó-Fuertes
- 2EyesVision SL, Plaza de la Encina, 10, Nucleo 3, Planta 4ª, 28760, Tres Cantos, Madrid, Spain
| | - Xoana Barcala
- 2EyesVision SL, Plaza de la Encina, 10, Nucleo 3, Planta 4ª, 28760, Tres Cantos, Madrid, Spain
| | - David P Piñero
- Departamento de Óptica, Farmacología y Anatomía, Universidad de Alicante, Alicante, Spain
| | - Walter D Furlan
- Departamento de Óptica y Optometría y Ciencias de la Visión, Universitat de València, Valencia, Spain
| | - Carlos Dorronsoro
- 2EyesVision SL, Plaza de la Encina, 10, Nucleo 3, Planta 4ª, 28760, Tres Cantos, Madrid, Spain
- Institute of Optics 'Daza de Valdés', Spanish National Research Council, IO-CSIC, Madrid, Spain
| | - Enrique Gambra
- 2EyesVision SL, Plaza de la Encina, 10, Nucleo 3, Planta 4ª, 28760, Tres Cantos, Madrid, Spain
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Plainis S, Ktistakis E, Tsilimbaris MK. Presbyopia correction with multifocal contact lenses: Evaluation of silent reading performance using eye movements analysis. Cont Lens Anterior Eye 2023; 46:101853. [PMID: 37164776 DOI: 10.1016/j.clae.2023.101853] [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: 01/12/2023] [Revised: 04/27/2023] [Accepted: 05/01/2023] [Indexed: 05/12/2023]
Abstract
PURPOSE Many activities of daily living rely on reading, thus is not surprising that complaints from presbyopes originate in reading difficulties rather in visual acuity. Here, the effectiveness of presbyopia correction with multifocal contact lenses (CLs) is evaluated using an eye-fixation based method of silent reading performance. ΜETHODS: Visual performance of thirty presbyopic volunteers (age: 50 ± 5 yrs) was assessed monocularly and binocularly following 15 days of wear of monthly disposable CLs (AIR OPTIX™ plus HydraGlyde™, Alcon Laboratories) with: (a) single vision (SV) lenses - uncorrected for near (b) aspheric multifocal (MF) CLs. LogMAR acuity was measured with ETDRS charts. Reading performance was evaluated using standard IReST paragraphs displayed on a screen (0.4 logMAR print size at 40 cm distance). Eye movements were monitored with an infrared eyetracker (Eye-Link II, SR Research Ltd). Data analysis included computation of reading speed, fixation duration, fixations per word and percentage of regressions. RESULTS Average reading speed was 250 ± 68 and 235 ± 70 wpm, binocularly and monocularly, with SV CLs, improving statistically significantly to 280 ± 67 (p = 0.002) and 260 ± 59 wpm (p = 0.01), respectively, with MF CLs. Moreover, fixation duration, fixations per word and ex-Gaussian parameter of fixation duration, μ, showed a statistically significant improvement when reading with MF CLs, with fixation duration exhibiting the stronger correlation (r = 0.79, p < 0.001) with improvement in reading speed. The correlation between improvement in VA and reading speed was moderate (r = 0.46, p = 0.016), as was the correlation between VA and any eye fixation parameter. CONCLUSION Average silent reading speed in a presbyopic population was found improved with MF compared to SV CL correction and was faster with binocular compared to monocular viewing: this was mainly due to the faster average fixation duration and the lower number of fixations. Evaluating reading performance using eye fixation analysis could offer a reliable outcome of functional vision in presbyopia correction.
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Affiliation(s)
- Sotiris Plainis
- Laboratory of Optics and Vision (LOV), School of Medicine, University of Crete, Greece; Optometry & Vision Science Research Group, Aston University School of Life and Health Sciences, Birmingham, UK.
| | - Emmanouil Ktistakis
- Laboratory of Optics and Vision (LOV), School of Medicine, University of Crete, Greece
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Faria-Ribeiro M, González-Méijome JM, Ferreira MIP, Morais-Borges AF, Salgado-Borges J. Analysis of Wavefront Data Obtained With a Pyramidal Sensor in Pseudophakic Eyes Implanted With Diffractive Intraocular Lenses. J Refract Surg 2023; 39:438-444. [PMID: 37449506 DOI: 10.3928/1081597x-20230523-01] [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: 07/18/2023]
Abstract
PURPOSE To investigate the clinical validity of using wavefront measurements obtained with a recently available pyramidal aberrometer to assess the optical quality of eyes implanted with diffractive intraocular lenses (IOLs). METHODS Individual biometric data were used to create models of pseudophakic eyes implanted with two diffractive IOLs. Their synthetic wavefronts were calculated by ray-tracing with near infrared wavelength (0.85 μm). Comparisons of the through-focus visual acuity of 12 pseudophakic eyes were obtained with three different methods: clinical defocus curves; simulated defocus curves calculated from ray-tracing in the customized model eyes; and through-focus simulated defocus curves calculated from the wavefront data measured with a pyramidal aberrometer. RESULTS Image quality calculated from wavefront data obtained by ray-tracing with 0.85 μm wavelength, without scaling the phase to 0.55 μm, resulted in a significantly different through-focus curve compared to the reference values. Even so, after scaling of the wavefront data to 0.55 μm, the defocus curves calculated from the wavefronts measured with the pyramidal aberrometer did not match the shape and the depth of field of the clinical defocus curves or the theoretical expected values. CONCLUSIONS Correcting for the longitudinal chromatic aberration of the eye when measuring the wavefront of eyes implanted with diffractive IOLs under near infrared light only accounts for the best focus shift due to the longitudinal chromatic aberration, but not for the wavelength dependence of the diffractive element. The pyramidal sensor does not seem to properly sample the slopes of a wavefront measured from a pseudophakic eye implanted with a presbyopia-correcting diffractive IOL to a clinically acceptable level. [J Refract Surg. 2023;39(7):438-444.].
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García-Marqués JV, Macedo-De-Araújo RJ, McAlinden C, Faria-Ribeiro M, Cerviño A, González-Méijome JM. Short-term tear film stability, optical quality and visual performance in two dual-focus contact lenses for myopia control with different optical designs. Ophthalmic Physiol Opt 2022; 42:1062-1073. [PMID: 35801815 PMCID: PMC9540637 DOI: 10.1111/opo.13024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Revised: 06/20/2022] [Accepted: 06/20/2022] [Indexed: 12/14/2022]
Abstract
Purpose To assess and compare short‐term visual and optical quality and tear film stability between two dual‐focus (DF) prototype myopia control contact lenses (CLs) having different inner zone diameters. Methods Twenty‐eight myopic subjects were included in this randomised, double‐masked crossover study. Refraction, best‐corrected visual acuity (VA) and tear film stability were measured at baseline (i.e., when uncorrected). Subjects were then binocularly fitted with the DF CLs, with only the sensorial dominant eye being assessed. Lenses were of the same material and had inner zone diameters of either 2.1 mm (S design) or 4.0 mm (M design). Visual and physical short‐term lens comfort, over‐refraction, best‐corrected VA, stereopsis at 40 cm, best‐corrected photopic and mesopic contrast sensitivity (CS), size and shape of light disturbance (LD), wavefront aberrations, subjective quality of vision (QoV Questionnaire) and tear film stability were measured for each lens. Results Both CL designs decreased tear film stability compared with baseline (p < 0.05). VA and photopic CS were within normal values for the subjects' age with each CL. When comparing lenses, the M design promoted better photopic CS for the 18 cycles per degree spatial frequency (p < 0.001) and better LD (p < 0.02). However, higher‐order aberrations were improved with the S design (p = 0.02). No significant difference between the two CLs was found for QoV scores and tear film stability. Conclusions Both DF CLs provided acceptable visual performance under photopic conditions. The 4.0 mm inner zone gave better contrast sensitivity at high frequencies and lower light disturbance, while the 2.1 mm central diameter induced fewer higher‐order aberrations for a 5 mm pupil diameter. Both CLs produced the same subjective visual short‐term lens comfort.
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Affiliation(s)
- José Vicente García-Marqués
- Optometry Research Group, Department of Optics and Optometry and Vision Sciences, University of Valencia, Valencia, Spain
| | - Rute Juliana Macedo-De-Araújo
- Clinical and Experimental Optometry Research Laboratory (CEORLab) Center of Physics (Optometry), School of Sciences, University of Minho, Braga, Portugal
| | - Colm McAlinden
- Department of Ophthalmology, Royal Gwent Hospital, Newport, UK.,Wenzhou Medical University, Wenzhou, China.,Eye & ENT Hospital of Fudan University, Shanghai, China
| | - Miguel Faria-Ribeiro
- Clinical and Experimental Optometry Research Laboratory (CEORLab) Center of Physics (Optometry), School of Sciences, University of Minho, Braga, Portugal
| | - Alejandro Cerviño
- Optometry Research Group, Department of Optics and Optometry and Vision Sciences, University of Valencia, Valencia, Spain
| | - José Manuel González-Méijome
- Clinical and Experimental Optometry Research Laboratory (CEORLab) Center of Physics (Optometry), School of Sciences, University of Minho, Braga, Portugal
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Fernandes P, Ferreira C, Domingues J, Amorim-de-Sousa A, Faria-Ribeiro M, Queirós A, González-Meijome JM. Short-term delay in neural response with multifocal contact lens might start at the retinal level. Doc Ophthalmol 2022; 145:37-51. [PMID: 35364776 DOI: 10.1007/s10633-022-09870-2] [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: 03/04/2020] [Accepted: 03/08/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Multifocal simultaneous imaging challenges the visual system to process the multiple overlaps of focused and defocused images. Retinal image processing may be an important step in neuroadaptation to multifocal optical images. Our aims are, firstly to evaluate the short-term effect of different multifocal contact lenses (MF) on retinal activity in young healthy subjects (Experiment#1) and secondly, to evaluate any changes in retinal activity in presbyopic patients fitted with MF over a 15-day period (Experiment#2). METHODS In Experiment-#1, 10 emmetropic healthy young subjects were included to evaluate the short-term effect of different MFs designs. In Experiment #2, 4 presbyopic subjects were included to wear MF for 15 days. Following the ISCEV Standards, multifocal electroretinograms (mfERGs) were recorded to evaluate different retinal regions under different conditions: with single vision contact lens (SVCL) and with center-distance and center-near MF. RESULTS In Exp#1 the peak time of N1, P1 and N2 were found to be delayed with the MF (p ≤ 0.040). There was a significant reduction for N1 amplitude in all retinal regions (p < 0.001), while for P1 and N2 amplitudes this reduction was more significant in the peripheral regions (p < 0.005, ring 5 to 6). With center-near MF the mean response density (nV/deg2) showed a significant decrease in all wave components of the mfERGs response, particularly from Ring 3 to Ring 6 (p < 0.001, all Rings). In Exp#2, the mean mfERG response is similar between SVCL and center-distance MF, while center-near MF showed an increase in implicit time N1 and P1 on day 1 that tends to recover to baseline values after 15 days of MF wear. CONCLUSIONS significant changes in the mfERGs responses were found with the MF lens, being most noticeable with the center-near MF lens design. The present results suggest that the observed delay in cortical response described during the adaptation to multifocality may partially begin at the retina level.
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Affiliation(s)
- Paulo Fernandes
- Clinical & Experimental Optometry Research Lab (CEORLab), Physics Center of Minho and Porto Universities (CF-UM-UP), University of Minho, 4710-057 Gualtar, Braga, Portugal.
| | - Cesarina Ferreira
- Clinical & Experimental Optometry Research Lab (CEORLab), Physics Center of Minho and Porto Universities (CF-UM-UP), University of Minho, 4710-057 Gualtar, Braga, Portugal
| | - Joana Domingues
- Clinical & Experimental Optometry Research Lab (CEORLab), Physics Center of Minho and Porto Universities (CF-UM-UP), University of Minho, 4710-057 Gualtar, Braga, Portugal
| | - Ana Amorim-de-Sousa
- Clinical & Experimental Optometry Research Lab (CEORLab), Physics Center of Minho and Porto Universities (CF-UM-UP), University of Minho, 4710-057 Gualtar, Braga, Portugal
| | - Miguel Faria-Ribeiro
- Clinical & Experimental Optometry Research Lab (CEORLab), Physics Center of Minho and Porto Universities (CF-UM-UP), University of Minho, 4710-057 Gualtar, Braga, Portugal
| | - António Queirós
- Clinical & Experimental Optometry Research Lab (CEORLab), Physics Center of Minho and Porto Universities (CF-UM-UP), University of Minho, 4710-057 Gualtar, Braga, Portugal
| | - José M González-Meijome
- Clinical & Experimental Optometry Research Lab (CEORLab), Physics Center of Minho and Porto Universities (CF-UM-UP), University of Minho, 4710-057 Gualtar, Braga, Portugal
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Bifocal and Multifocal Contact Lenses for Presbyopia and Myopia Control. J Ophthalmol 2020; 2020:8067657. [PMID: 32318285 PMCID: PMC7152962 DOI: 10.1155/2020/8067657] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 02/10/2020] [Accepted: 02/24/2020] [Indexed: 02/07/2023] Open
Abstract
Bifocal and multifocal optical devices are intended to get images into focus from objects placed at different distances from the observer. Spectacles, contact lenses, and intraocular lenses can meet the requirements to provide such a solution. Contact lenses provide unique characteristics as a platform for implementing bifocality and multifocality. Compared to spectacles, they are closer to the eye, providing a wider field of view, less distortion, and their use is more consistent as they are not so easily removed along the day. In addition, contact lenses are also minimally invasive, can be easily exchangeable, and, therefore, suitable for conditions in which surgical procedures are not indicated. Contact lenses can remain centered with the eye despite eye movements, providing the possibility for simultaneous imaging from different object distances. The main current indications for bifocal and multifocal contact lenses include presbyopia correction in adult population and myopia control in children. Considering the large numbers of potential candidates for optical correction of presbyopia and the demographic trends in myopia, the potential impact of contact lenses for presbyopia and myopia applications is undoubtedly tremendous. However, the ocular characteristics and expectations vary significantly between young and older candidates and impose different challenges in fitting bifocal and multifocal contact lenses for the correction of presbyopia and myopia control. This review presents the recent developments in material platforms, optical designs, simulated visual performance, and the clinical performance assessment of bifocal and multifocal contact lenses for presbyopia correction and/or myopia progression control.
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