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Liao X, Li JY, Tan QQ, Tian J, Lin J, Lan CJ. Comparison of visual quality after implantation of A1-UV and SN60WF aspheric intraocular lens. Int J Ophthalmol 2020; 13:1727-1732. [PMID: 33215002 DOI: 10.18240/ijo.2020.11.07] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 08/27/2020] [Indexed: 12/22/2022] Open
Abstract
AIM To compare the visual performance of pseudophakic eyes implanted with A1-UV and SN60WF aspheric intraocular lens (IOL), and to investigate the correlations between visual quality parameters and pupil size. METHODS This prospective comparative study included 105 eyes of 90 patients with age-related cataract who underwent uneventful phacoemulsification. The subjects were divided into two groups according to the implanted IOL type. Three months postoperatively, visual acuity and contrast sensitivity were measured, wave-front aberrations were assessed using a KR-1W aberrometer (Topcon), and objective optical quality parameters were performed using an optical quality analysis system-OQAS II (Visiometrics). Independent sample t-test and Spearman correlation analysis were used for data analysis. RESULTS There were no significant differences found in visual acuity, contrast sensitivity and visual quality parameters between the two groups (P>0.05). The measured intraocular spherical aberration (SA) in A1-UV IOL eyes of -0.19±0.05 µm was close to the designed SA value of -0.20 µm. The modulation transfer function cutoff, Strehl ratio and OQAS values were negatively correlated with pupil size in both groups (P<0.01). CONCLUSION The subjective and objective visual quality in pseudophakic eyes with A1-UV and SN60WF IOLs are comparable. For aspheric IOL eyes, visual quality decreases with increasing pupil size.
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Affiliation(s)
- Xuan Liao
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China.,Department of Ophthalmology and Optometry, North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Ji-Yun Li
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China.,Department of Ophthalmology and Optometry, North Sichuan Medical College, Nanchong 637000, Sichuan Province, China.,Department of Ophthalmology, the First People's Hospital of Neijiang, Neijiang 641000, Sichuan Province, China
| | - Qing-Qing Tan
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China.,Department of Ophthalmology and Optometry, North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Jing Tian
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China.,Department of Ophthalmology and Optometry, North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Jia Lin
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China.,Department of Ophthalmology and Optometry, North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
| | - Chang-Jun Lan
- Department of Ophthalmology, Affiliated Hospital of North Sichuan Medical College, Nanchong 637000, Sichuan Province, China.,Department of Ophthalmology and Optometry, North Sichuan Medical College, Nanchong 637000, Sichuan Province, China
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Fernández J, Rodríguez-Vallejo M, Martínez J, Burguera N, Piñero DP. Agreement between subjective and predicted high and low contrast visual acuities with a double-pass system. Graefes Arch Clin Exp Ophthalmol 2020; 259:1651-1657. [PMID: 33128671 DOI: 10.1007/s00417-020-04987-z] [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: 07/07/2020] [Revised: 09/23/2020] [Accepted: 10/20/2020] [Indexed: 10/23/2022] Open
Abstract
PURPOSE To evaluate the agreement between subjective high and low contrast visual acuity (VA) and predicted values from double-pass system measurements in healthy candidates to laser refractive surgery. METHODS Ninety-two eyes measured during the preoperative screening to laser refractive surgery were included in this retrospective analysis. High contrast subjective visual acuity (HCVA) and low contrasts at 20% (LCVA20) and 9% (LCVA9) were compared with the predicted VA obtained with a commercial double-pass system (OQAS) at the same levels of contrast, 100% (OV100), 20% (OV20), and 9% (OV9). The agreement was evaluated with Bland-Altman analysis computing the limits of agreement (LoAs) and the correlations with the spearman rho. RESULTS An underestimation of VA was obtained with the double-pass system for the highest contrast. Differences between predictive and subjective measurements were statistically significant for 100% contrast (- 0.08 logMAR, p < 0.0005), but not for 20% (- 0.03 logMAR, p = 0.07) and 9% (- 0.02 logMAR, p = 0.9) of contrasts. The LoAs increased with the decrease of contrast from 0.29 with 100% to 0.39 logMAR with 9% of contrast. A weak correlation was obtained between subjective and predicted VA (rho ≤ 0.33) that was only significant for 100% (p = 0.001) and 20% (p = 0.004) contrasts. CONCLUSION Mean differences between methods were reasonably small so mean results obtained for predicted VA in OQAS studies can be considered as reliable, at least in healthy subjects and for low contrast. However, limits of agreement were considerably poor which means that OQAS cannot replace individual subjective measurements of VA in clinical practice.
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Affiliation(s)
- Joaquín Fernández
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, 04120, Almería, Spain
| | | | - Javier Martínez
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, 04120, Almería, Spain
| | - Noemi Burguera
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, 04120, Almería, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain.,Department of Ophthalmology (IMQO-Oftalmar), Vithas Medimar International Hospital, Alicante, Spain
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Abstract
SIGNIFICANCE This study suggests that despite having comparable best-corrected visual acuity and normal fundus appearance, objective measurements of optical quality showed that patients with diabetes but without overt retinopathy may have impaired visual function. Screening using the Optical Quality Analysis System might help identify those patients. PURPOSE Visual impairments are common in diabetes, but the status of the problem is unclear before the development of diabetic retinopathy. The aim of this pilot study was to investigate the optical quality and intraocular scattering in the diabetic eye without diabetic retinopathy. METHODS Twenty-seven patients with diabetes without diabetic retinopathy were enrolled. Twenty-seven age- and sex-matched healthy volunteers served as a control group. Optical quality parameters included modulation transfer function cutoff frequency, Strehl (two-dimensional) ratio, and Optical Quality Analysis System values at 100, 20, and 9 contrast levels. The objective scatter index was assessed using the Optical Quality Analysis System. Correlations were analyzed between the modulation transfer function cutoff, Strehl ratio, objective scatter index, and Optical Quality Analysis System value, and the age of the patient and the duration of diabetes mellitus. RESULTS The diabetic group exhibited lower modulation transfer function cutoff, Strehl ratio, and Optical Quality Analysis System values at 100, 20, and 9% contrast levels and higher objective scatter index than did the controls (all, P < .01). There were no associations between the optical quality parameters and age or the duration of diabetes mellitus in the diabetic participants (all, P > .05). Moderate associations were found between all parameters obtained from the Optical Quality Analysis System and age in the control group (all, P < .01). CONCLUSIONS This pilot study suggests that optical quality was reduced, and intraocular scattering increased in the diabetic eye without diabetic retinopathy compared with controls.
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Objective optical quality in eyes with customized selection of aspheric intraocular lens implantation. BMC Ophthalmol 2019; 19:152. [PMID: 31319806 PMCID: PMC6639902 DOI: 10.1186/s12886-019-1162-6] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 07/09/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND To compare the postoperative optical quality in eyes with customized selection and random selection of aspheric intraocular lens (IOL) implantation. METHODS A prospective, nonrandomized study was implemented in adult cataract patients who underwent unilateral phacoemulsification with aspheric IOL implantation. Patients were allocated into two treatment groups: a customized group and a control group. In the customized group, the aspheric IOL selection was based on the corneal spherical aberration to enable the postoperative target ocular spherical aberration closest to zero; in the control group, the aspheric IOLs were chosen using a random strategy. Primary outcome measurements included the following objective optical quality assessments: higher-order aberrations obtained by a Hartmann-shack aberrometer at 4 mm and 6 mm pupil diameters; objective scatter index (OSI), modulation transfer function (MTF) cut-off, Strehl ratio (SR) and a simulated contrast visual acuity-optical quality analysis system value (OV) obtained by a double-pass system with a 4-mm aperture. Subjective visual acuity was measured as secondary outcome. All the patients were followed up for 3 months. RESULTS Eighty-four patients in the customized group and 78 patients in the control group were evaluated. There was no significant difference in postoperative visual acuity between the two groups (P > 0.05). Significantly less ocular higher-order aberrations were shown in the customized group (P < 0.05). No significant difference was shown in OSI, MTF cut-off, SR and OV between the two groups (P > 0.05). CONCLUSIONS Although customized selection of aspheric IOL implantation showed less postoperative ocular aberrations, it performed similarly to random selection of aspheric IOL implantation in terms of postoperative visual acuity, simulated contrast visual acuity, intraocular scatter, modulation transfer function and Strehl ratio. TRIAL REGISTRATION Retrospectively registered on 07/06/2019. Registration number: ChiCTR1900024356 .
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Cho JH, Bae SH, Kim HK, Shin YJ. Optical Quality Assessment in Patients with Macular Diseases Using Optical Quality Analysis System. J Clin Med 2019; 8:jcm8060892. [PMID: 31234385 PMCID: PMC6617055 DOI: 10.3390/jcm8060892] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 06/13/2019] [Accepted: 06/17/2019] [Indexed: 11/16/2022] Open
Abstract
Macular diseases cause vision loss, as the macula is the functional center for vision. In this study we assessed optical quality in eyes with macular diseases and evaluated the effectiveness of the Optical Quality Analysis System (OQAS) to detect macular diseases. We analyzed 88 eyes of 88 patients with macular diseases (51 men and 37 women; mean age: 65.24 ± 12.96 years) and 43 eyes of 43 control subjects (11 men and 32 women; mean age: 54.70 ± 15.03 years). The macular diseases included age-related macular disease (n = 62), diabetic macular edema (n = 19), and retinal vein occlusion (n = 7). We measured the objective scattering index (OSI), modulation transfer function (MTF), Strehl ratio, and predicted visual acuities (PVAs) at 100, 20, and 10% contrast levels in both groups using OQAS. We measured the retinal thickness in the macular disease group on optical coherence tomography. The macular disease and control groups significantly differed in OSI, MTF, Strehl ratio, and PVAs at 20 and 10% contrast levels (p < 0.05). In the macular disease group, retinal thickness correlated with OSI (r = 0.370, p < 0.001) and MTF (r = -0.264, p = 0.014). In conclusion, optical quality was worse in the patients with macular diseases compared to the control subjects, and retinal thickness affected optical quality. Therefore, the distortion of macular shape may contribute to vision disturbance in patients with macular diseases.
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Affiliation(s)
- Joon Hee Cho
- Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Korea.
- Hyemin Eye Hospital, Seoul 05829, Korea.
| | - So Hyun Bae
- Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Korea.
| | - Ha Kyoung Kim
- Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Korea.
| | - Young Joo Shin
- Department of Ophthalmology, Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul 07441, Korea.
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Lu C, Yu S, Song H, Zhao Y, Xie S, Tang X, Yuan X. Posterior capsular opacification comparison between morphology and objective visual function. BMC Ophthalmol 2019; 19:40. [PMID: 30717688 PMCID: PMC6360676 DOI: 10.1186/s12886-019-1051-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2018] [Accepted: 01/29/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND To compare the influence of posterior capsule opacification (PCO) morphology and severity on intraocular stray light and visual function with different levels of contrast. METHODS Forty-five patients diagnosed with PCO were included in this prospective consecutive case series. The Optical Quality Analysis System II (OQAS II) was adopted to assess the objective visual function including objective scatter index (OSI) and optical quality analysis system values (OVs) with 100, 20, and 9% contrast. RTVue-100 OCT was used to evaluate the PCO morphology and severity. Comparisons among visual function, morphology, and severity between pear type and fibrosis PCO were performed. The correlations among the PCO morphology, severity, OSI, and OVs were also determined. RESULTS There was a significant correlation between increased OSI and decreased visual acuity in PCO patients before laser capsulotomy. The changes of OSI were also correlated with the PCO area for the 3 mm IOL optic region (r = 0.43, p = 0.02). The OSI was significantly higher in pear type PCO when compared with fibrosis PCO (Z = - 4.06, p ≤ 0.001). In addition, the increased OSI in pear type PCO was significantly correlated with the 100% OVs and the 20% OVs but not with the 9% OVs. In fibrosis PCO, OSI was only correlated with the 100% OVs and the 20% OVs pre-YAG. CONCLUSIONS OSI and OVs could objectively indicate the visual function impairment in PCO patients. Effects of PCO on light scattering and on objective visual function might be explained by the variations of morphology and severity.
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Affiliation(s)
- Chengzhe Lu
- Tianjin Eye Hospital, No.4 Gansu Road, Heping District, Tianjin, 300020, China
| | - Shasha Yu
- Tianjin Eye Hospital, No.4 Gansu Road, Heping District, Tianjin, 300020, China
| | - Hui Song
- Tianjin Eye Hospital, No.4 Gansu Road, Heping District, Tianjin, 300020, China
| | - Yun Zhao
- Tianjin Eye Hospital, No.4 Gansu Road, Heping District, Tianjin, 300020, China
| | - Shiyong Xie
- Tianjin Eye Hospital, No.4 Gansu Road, Heping District, Tianjin, 300020, China
| | - Xin Tang
- Tianjin Eye Hospital, No.4 Gansu Road, Heping District, Tianjin, 300020, China.,Tianjin Eye Institute, Tianjin, China.,Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin, China.,Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, China
| | - Xiaoyong Yuan
- Tianjin Eye Hospital, No.4 Gansu Road, Heping District, Tianjin, 300020, China. .,Tianjin Eye Institute, Tianjin, China. .,Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin, China. .,Clinical College of Ophthalmology, Tianjin Medical University, Tianjin, 300020, China.
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From Presbyopia to Cataracts: A Critical Review on Dysfunctional Lens Syndrome. J Ophthalmol 2018; 2018:4318405. [PMID: 30050689 PMCID: PMC6040261 DOI: 10.1155/2018/4318405] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 06/05/2018] [Indexed: 01/19/2023] Open
Abstract
Dysfunctional lens syndrome (DLS) is a term coined to describe the natural aging changes in the crystalline lens. Different alterations in the refractive properties and transparency of the lens are produced during the development of presbyopia and cataract, such as changes in internal high order aberrations or an increase in ocular forward scattering, with a potentially significant impact on clinical measures, including visual acuity and contrast sensitivity. Objective technologies have emerged to solve the limits of current methods for the grading of the lens aging, which have been linked to the DLS term. However, there is still not a gold standard or evidence-based clinical guidelines around these new technologies despite multiple research studies have correlated their results with conventional methods such as visual acuity or the lens opacification system (LOCS), with more scientific background around the ocular scattering index (OSI) and Scheimpflug densitometry. In either case, DLS is not a new evidence-based concept that leads to new knowledge about crystalline lens aging but it is a nomenclature change of two existing terms, presbyopia and cataracts. Therefore, this term should be used with caution in the scientific peer-reviewed literature.
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