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Schnider C, Yuen L, Rampat R, Zhu D, Dhallu S, Trinh T, Gurnani B, Abdelmaksoud A, Bhogal-Bhamra G, Wolffsohn JS, Naroo SA. BCLA CLEAR presbyopia: Management with intraocular lenses. Cont Lens Anterior Eye 2024; 47:102253. [PMID: 39068141 DOI: 10.1016/j.clae.2024.102253] [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] [Indexed: 07/30/2024]
Abstract
Cataract surgery including intraocular lens (IOL) insertion, has been refined extensively since the first such procedure by Sir Harold Ridley in 1949. The intentional creation of monovision with IOLs using monofocal IOL designs has been reported since 1984. The first reported implantation of multifocal IOLs was published in 1987. Since then, various refractive and or diffractive multifocal IOLs have been commercialised. Most are concentric, but segmented IOLs are also available. The most popular are trifocal designs (overlaying two diffractive patterns to achieve additional focal planes at intermediate and near distances) and extended depth of focus designs which leave the patient largely spectacle independent with the reduced risk of bothersome contrast reduction and glare. As well as mini-monovision, surgical strategies to minimise the impact of presbyopia with IOLs includes mixing and matching lenses between the eyes and using IOLs whose power can be adjusted post-implantation. Various IOL designs to mimic the accommodative process have been tried including hinge optics, dual optics, lateral shifts lenses with cubic-type surfaces, lens refilling and curvature changing approaches, but issues in maintaining the active mechanism with post-surgical fibrosis, without causing ocular inflammation, remain a challenge. With careful patient selection, satisfaction rates with IOLs to manage presbyopia are high and anatomical or physiological complications rates are no higher than with monofocal IOLs.
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Affiliation(s)
| | - Leonard Yuen
- ONE Medical Doctors Group & Day Surgical Centre, Quarry Bay, Hong Kong
| | | | - Dagny Zhu
- NVISION Eye Centers Rowland Heights, CA, USA
| | - Sandeep Dhallu
- Department of Clinical, Pharmaceutical and Biological Science, University of Hertfordshire, Hatfield, UK
| | - Tanya Trinh
- Mosman Eye Clinic, Sydney, New South Wales, Australia; Sydney Hospital and Sydney Eye Hospital, New South Wales, Australia
| | - Bharat Gurnani
- Gomabai Netralaya and Research Centre, Neemuch, Madhya Pradesh, India
| | | | | | - James S Wolffsohn
- College of Health & Life Sciences, Aston University, Birmingham, United Kingdom
| | - Shehzad A Naroo
- College of Health & Life Sciences, Aston University, Birmingham, United Kingdom.
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2
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Tandogan T, Urbonavicius A, Langenegger M, Goldblum D, Tappeiner C. Real-World Clinical Results with the Hoya Vivinex Impress Intraocular Lens with Enhanced Depth of Focus. Klin Monbl Augenheilkd 2024; 241:374-377. [PMID: 38653291 DOI: 10.1055/a-2220-0620] [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: 04/25/2024]
Abstract
BACKGROUND In cataract surgery, intraocular lenses (IOLs) with enhanced depth of focus are an option to correct presbyopia. The purpose of this quality assurance analysis was to evaluate visual acuity and patient satisfaction after implantation of the Hoya Vivinex Impress IOL. METHODS The Hoya Vivinex Impress IOL was implanted in patients undergoing cataract surgery at the Pallas Klinik, Olten, Switzerland. Five weeks postoperatively, a clinical examination and a survey on patient satisfaction were conducted. RESULTS A total of 17 eyes (9 patients; mean age 64 years) underwent cataract surgery with implantation of a Hoya Vivinex Impress IOL. Five weeks postoperatively, mean uncorrected distance visual acuity (UDVA) was 0.2 logMAR, uncorrected intermediate visual acuity (UIVA) was 0.0 logMAR, and uncorrected near visual acuity (UNVA) was 0.2 logMAR. The mean distance-corrected visual acuity results were 0.0 logMAR, 0.1 logMAR, and 0.3 logMAR, respectively. Reading the newspaper without glasses was possible for 33.4% of patients. Visual disturbances such as halos and glares were not reported. CONCLUSION Cataract surgery with Hoya Vivinex Impress IOL implantation revealed good distance and intermediate vision and, in some patients, functional near vision as well as a high patient satisfaction.
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Affiliation(s)
- Tamer Tandogan
- Department of Ophthalmology, Pallas Kliniken, Olten, Switzerland
- Department of Ophthalmology, David J. Apple Center for Vision Research, University Hospital Heidelberg, Heidelberg, Germany
| | | | | | - David Goldblum
- Department of Ophthalmology, Pallas Kliniken, Olten, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
| | - Christoph Tappeiner
- Department of Ophthalmology, Pallas Kliniken, Olten, Switzerland
- Department of Ophthalmology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- Medical Faculty, University of Bern, Bern, Switzerland
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3
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De la Paz M, Tsai LM. Outcomes and predictive factors in multifocal and extended depth of focus intraocular lens implantation. Curr Opin Ophthalmol 2024; 35:28-33. [PMID: 37910172 DOI: 10.1097/icu.0000000000001013] [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: 11/03/2023]
Abstract
PURPOSE OF REVIEW Options for addressing presbyopia with intraocular lens (IOL) implantation have become more varied and sophisticated. We reviewed recent literature on multifocal and extended depth of focus (EDOF) IOLs in order to provide insight on their respective advantages, with emphasis on the visual outcomes of each design. RECENT FINDINGS Increased patient age, spectral domain optical coherence tomography (SD-OCT) abnormalities, abnormal optical axis measurements, and better preoperative visual acuity have been implicated as predictors of worse postoperative vision or visual quality in multifocal IOLs. Despite differences in objective outcomes, patient-reported outcomes such as satisfaction are consistently similar between multifocal and EDOF IOLs. EDOFs may have slightly lower rates of spectacle independence than trifocals, but there is more support for their use in the setting of with other ocular conditions. SUMMARY Multifocal and EDOF IOLs are both viable options for patients who wish to preserve near vision. Given their similar objective performance in many aspects, enabling patients to make informed decisions based on their expectations and visual requirements is critical to postoperative satisfaction. Evidence for advanced technology IOL implantation in pediatric patients remains inconclusive.
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Affiliation(s)
- Matthew De la Paz
- Department of Ophthalmology, Washington University School of Medicine, St. Louis, Missouri, USA
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4
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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.
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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
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5
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Torres-Sepúlveda W, Mira-Agudelo A, Barrera-Ramírez JF, Kolodziejczyk A. Objective method for visual performance prediction. JOURNAL OF THE OPTICAL SOCIETY OF AMERICA. A, OPTICS, IMAGE SCIENCE, AND VISION 2023; 40:C138-C149. [PMID: 37132983 DOI: 10.1364/josaa.478022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
We propose, implement, and validate a new objective method for predicting the trends of visual acuity through-focus curves provided by specific optical elements. The proposed method utilized imaging of sinusoidal gratings provided by the optical elements and the definition of acuity. A custom-made monocular visual simulator equipped with active optics was used to implement the objective method and to validate it via subjective measurements. Visual acuity measurements were obtained monocularly from a set of six subjects with paralyzed accommodation for a naked eye and then that eye compensated by four multifocal optical elements. The objective methodology successfully predicts the trends of the visual acuity through-focus curve for all considered cases. The Pearson correlation coefficient was 0.878 for all tested optical elements, which agrees with results obtained by similar works. The proposed method constitutes an easy and direct alternative technique for the objective testing of optical elements for ophthalmic and optometric applications, which can be implemented before invasive, demanding, or costly procedures on real subjects.
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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.
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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
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7
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Hecht I, Kanclerz P, Tuuminen R. Secondary outcomes of lens and cataract surgery: More than just “best-corrected visual acuity”. Prog Retin Eye Res 2022:101150. [DOI: 10.1016/j.preteyeres.2022.101150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 11/07/2022] [Accepted: 11/20/2022] [Indexed: 12/12/2022]
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8
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Croft MA, Peterson J, Smith C, Kiland J, Nork TM, Mcdonald JP, Katz A, Hetzel S, Lütjen-Drecoll E, Kaufman PL. Accommodative movements of the choroid in the optic nerve head region of human eyes, and their relationship to the lens. Exp Eye Res 2022; 222:109124. [PMID: 35688214 PMCID: PMC9783760 DOI: 10.1016/j.exer.2022.109124] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 04/30/2022] [Accepted: 05/18/2022] [Indexed: 12/27/2022]
Abstract
The ciliary muscle (CM) powers the accommodative response, and during accommodation the CM pulls the choroid forward in the region of the ora serrata. Our goal was to elucidate the accommodative movements of the choroid in the optic nerve region in humans and to determine whether these movements are related to changes in the lens dimensions that occur with aging, in the unaccommodated and accommodated state. Both eyes of 12 human subjects (aged 18-51 yrs) were studied. Homatropine (1 drop/5%) was used to relax the ciliary muscle (unaccommodated or "resting" eye) and pilocarpine was used to induce the maximum accommodative response (2 drops/4%) (accommodated eye). Images of the fundus and choroid were collected in the region of the optic nerve (ON) via Spectralis OCT (infrared and EDI mode), and choroidal thickness was determined. Ultrasound biomicroscopy (UBM; 50 MHz, 35 MHz) images were collected in the region of the lens/capsule and ciliary body. OCT and UBM images were collected in the resting and accommodated state. The unaccommodated choroidal thickness declined significantly with age (p = 0.0073, r = 0.73) over the entire age range of the subjects studied (18-51 years old). The choroidal thickness was significantly negatively correlated with lens thickness in the accommodated (p = 0.01) and the unaccommodated states (p = 0.005); the thicker the lens the thinner the choroid. Choroid movements around the optic nerve during accommodation were statistically significant; during accommodation the choroid both thinned and moved centrifugally (outward/away from the optic nerve head). The accommodative choroid movements did not decline significantly with age and were not correlated with accommodative amplitude. Measurement of the choroidal thickness is possible with the Spectralis OCT instrument using EDI mode and can be used to determine the accommodative changes in choroidal thickness. The choroidal thickness decreased with age and during accommodation. It may be that age-related choroidal thinning is due to changes in the geometry of the accommodative apparatus to which it is attached (i.e., ciliary muscle/lens complex) such that when the lens is thicker, the choroid is thinner. Accommodative decrease in choroidal thickness and stretch of the retina/choroid may indicate stress/strain forces in the region of the optic nerve during accommodation and may have implications for glaucoma.
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Affiliation(s)
- Mary Ann Croft
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, 53792, USA.
| | - John Peterson
- Diagnostic Imaging Services Lead, UCSF Health, Wayne and Gladys Valley Center for Vision, 490 Illinois St., San Francisco, CA, 94158, USA
| | - Christopher Smith
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, 53792, USA
| | - Julie Kiland
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, 53792, USA
| | - T Michael Nork
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, 53792, USA
| | - Jared P Mcdonald
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, 53792, USA
| | - Alexander Katz
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, 53792, USA
| | - Scott Hetzel
- Department of Biostatistics and Medical Informatics, University of Wisconsin-Madison, Madison, USA
| | | | - Paul L Kaufman
- Department of Ophthalmology and Visual Sciences, University of Wisconsin-Madison, Madison, WI, 53792, USA; Wisconsin National Primate Research Center, USA
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9
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Imelda E, Idroes R, Khairan K, Lubis RR, Abas AH, Nursalim AJ, Rafi M, Tallei TE. Natural Antioxidant Activities of Plants in Preventing Cataractogenesis. Antioxidants (Basel) 2022; 11:antiox11071285. [PMID: 35883773 PMCID: PMC9311900 DOI: 10.3390/antiox11071285] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Revised: 06/23/2022] [Accepted: 06/24/2022] [Indexed: 01/07/2023] Open
Abstract
A cataract is a condition that causes 17 million people to experience blindness and is the most significant cause of vision loss, around 47.9%. The formation of cataracts is linked to both the production of reactive oxygen species (ROS) and the reduction of endogenous antioxidants. ROS are highly reactive molecules produced by oxygen. Examples of ROS include peroxides, super-oxides, and hydroxyl radicals. ROS are produced in cellular responses to xenobiotics and bacterial invasion and during mitochondrial oxidative metabolism. Excessive ROS can trigger oxidative stress that initiates the progression of eye lens opacities. ROS and other free radicals are highly reactive molecules because their outer orbitals have one or more unpaired electrons and can be neutralized by electron-donating compounds, such as antioxidants. Examples of natural antioxidant compounds are vitamin C, vitamin E, and beta-carotene. Numerous studies have demonstrated that plants contain numerous antioxidant compounds that can be used as cataract preventatives or inhibitors. Natural antioxidant extracts for cataract therapy may be investigated further in light of these findings, which show that consuming a sufficient amount of antioxidant-rich plants is an excellent approach to cataract prevention. Several other natural compounds also prevent cataracts by inhibiting aldose reductase and preventing apoptosis of the eye lens.
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Affiliation(s)
- Eva Imelda
- Graduate School of Mathematics and Applied Sciences, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia;
- Department of Ophthalmology, General Hospital Dr. Zainoel Abidin, Banda Aceh 23126, Indonesia
- Department of Ophthalmology, School of Medicine, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
| | - Rinaldi Idroes
- Department of Chemistry, Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia
- Department of Pharmacy, Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia;
- Correspondence:
| | - Khairan Khairan
- Department of Pharmacy, Faculty of Mathematics and Natural Sciences, Universitas Syiah Kuala, Banda Aceh 23111, Indonesia;
| | - Rodiah Rahmawaty Lubis
- Department of Ophthalmology, Faculty of Medicine, Universitas Sumatera Utara, Medan 20222, Indonesia;
| | - Abdul Hawil Abas
- Department of Biology, Faculty of Mathematics and Natural Sciences, Sam Ratulangi University, Manado 95115, Indonesia; (A.H.A.); (T.E.T.)
| | - Ade John Nursalim
- Department of Ophthalmology, General Hospital Prof. Dr. R. D. Kandou, Manado 955234, Indonesia;
| | - Mohamad Rafi
- Department of Chemistry, Faculty of Mathematics and Natural Sciences, IPB University, Bogor 16680, Indonesia;
| | - Trina Ekawati Tallei
- Department of Biology, Faculty of Mathematics and Natural Sciences, Sam Ratulangi University, Manado 95115, Indonesia; (A.H.A.); (T.E.T.)
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Luo C, Wang H, Chen X, Xu J, Yin H, Yao K. Recent Advances of Intraocular Lens Materials and Surface Modification in Cataract Surgery. Front Bioeng Biotechnol 2022; 10:913383. [PMID: 35757812 PMCID: PMC9213654 DOI: 10.3389/fbioe.2022.913383] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/23/2022] [Indexed: 11/13/2022] Open
Abstract
Advances in cataract surgery have increased the demand for intraocular lens (IOL) materials. At present, the progress of IOL materials mainly contains further improving biocompatibility, providing better visual quality and adjustable ability, reducing surgical incision, as well as dealing with complications such as posterior capsular opacification (PCO) and ophthalmitis. The purpose of this review is to describe the research progress of relevant IOL materials classified according to different clinical purposes. The innovation of IOL materials is often based on the common IOL materials on the market, such as silicon and acrylate. Special properties and functions are obtained by adding extra polymers or surface modification. Most of these studies have not yet been commercialized, which requires a large number of clinical trials. But they provide valuable thoughts for the optimization of the IOL function.
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Affiliation(s)
| | | | | | | | | | - Ke Yao
- Eye Center of the Second Affiliated Hospital, Medical College of Zhejiang University, Hangzhou, China
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11
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Xie X, Sultan W, Corradetti G, Lee JY, Song A, Pardeshi A, Yu F, Chopra V, Sadda SR, Xu BY, Huang AS. Assessing accommodative presbyopic biometric changes of the entire anterior segment using single swept-source OCT image acquisitions. Eye (Lond) 2022; 36:119-128. [PMID: 33633350 PMCID: PMC8727625 DOI: 10.1038/s41433-020-01363-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/30/2020] [Accepted: 12/02/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND/OBJECTIVES To evaluate biometric changes throughout the anterior chamber during accommodation and presbyopia using single image acquisition swept-source anterior-segment optical coherence tomography (AS-OCT). SUBJECT/METHODS Anterior-segment images were obtained using a new swept-source AS-OCT device (ANTERION, Heidelberg Engineering) from healthy volunteers (n = 71) across two centers in this prospective observational case series. In one image acquisition, cornea through posterior lens, including the ciliary muscle on both sides of the right eye, was imaged. Subjects undertook no accommodative effort and -1, -3, and -5 D of target vergence. Two-way repeated measures ANOVA modeling was performed for ciliary muscle measurements, lens parameters, aqueous depth (AD), and pupil diameter (PD). The first ANOVA factor was accommodative stimuli, and the second factor included age and refractive status. RESULTS Maximum ciliary muscle thickness increased with accommodative stimuli (p < 0.001), while the distance from the scleral spur to the maximal point on the ciliary muscle and posterior ciliary muscle thickness (CMT2) decreased (p < 0.001-0.002). Older individuals showed no accommodative changes for ciliary muscle parameters, lens thickness, lens vault, PD, and AD (p = 0.07-0.32). Younger- and middle-aged eyes showed statistically significant accommodative structural alterations for these endpoints (p < 0.001-0.002), but with different patterns, including early loss of CMT2 contraction in middle-aged eyes. Within the middle-aged group, myopic eyes maintained better capacity for accommodative structural change. CONCLUSIONS Swept-source AS-OCT demonstrated multiple simultaneous anterior-segment biometric alterations in single acquisition images, including early loss of posterior ciliary muscle function and better maintained capacity for anterior-segment structural change in myopia.
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Affiliation(s)
- Xiaobin Xie
- grid.410318.f0000 0004 0632 3409Eye Hospital of China Academy of Chinese Medical Sciences, Beijing, China ,grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA
| | - William Sultan
- grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA
| | - Giulia Corradetti
- grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA
| | - Jong Yeon Lee
- grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA ,grid.256155.00000 0004 0647 2973Department of Ophthalmology, College of Medicine, Gil Medical Center, Gachon University, Incheon, South Korea
| | - Abe Song
- grid.42505.360000 0001 2156 6853Roski Eye Institute, Department of Ophthalmology, University of Southern California, Los Angeles, CA USA
| | - Anmol Pardeshi
- grid.42505.360000 0001 2156 6853Roski Eye Institute, Department of Ophthalmology, University of Southern California, Los Angeles, CA USA
| | - Fei Yu
- grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA
| | - Vikas Chopra
- grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA
| | - Srinivas R. Sadda
- grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA
| | - Benjamin Y. Xu
- grid.42505.360000 0001 2156 6853Roski Eye Institute, Department of Ophthalmology, University of Southern California, Los Angeles, CA USA
| | - Alex S. Huang
- grid.19006.3e0000 0000 9632 6718Doheny Eye Institute and Stein Eye Institute, Department of Ophthalmology, David Geffen School of Medicine, University of California, Los Angeles, CA USA
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12
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Nagase D, Akura J, Omatsu Y, Inoue Y. Intraoperative Measurement of Crystalline Lens Diameter in Living Humans. Yonago Acta Med 2022; 65:53-62. [DOI: 10.33160/yam.2022.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Accepted: 12/27/2021] [Indexed: 11/05/2022]
Affiliation(s)
- Daisuke Nagase
- Division of Ophthalmology and Visual Science, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Junsuke Akura
- Kushimoto Arita Hospital, Higashimuro 649-3514, Japan
| | - Yutaka Omatsu
- Division of Ophthalmology and Visual Science, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Yoshitsugu Inoue
- Division of Ophthalmology and Visual Science, Department of Medicine of Sensory and Motor Organs, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
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13
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Citation network analysis of the various types of multifocal intraocular lenses. ARCHIVOS DE LA SOCIEDAD ESPAÑOLA DE OFTALMOLOGÍA 2021; 96:527-544. [PMID: 34620483 DOI: 10.1016/j.oftale.2020.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Accepted: 11/21/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND OBJECTIVE The implantation of multifocal intraocular lens (IOL) has increased in recent years, allowing patients to achieve good quality vision at all distances, independence from use of glasses, and consequently, an increase in quality of life. The main purpose of this study was to analyse the links between publications and authors via citation networks, as well to as identify the different research areas and determine the most cited publications. MATERIAL AND METHODS The publication search was performed through the Web of Science database, using the terms «Multifocal intraocular lens», «Bifocal intraocular lens», «Trifocal intraocular lens», «Diffractive intraocular lens», «Refractive intraocular lens», «Accommodative intraocular lens» and «Extended depth of focus intraocular lens», for a time interval from 1989 to August 2020. The software used to analyse the publications was the Citation Network Explorer. RESULTS A total of 1293 publications were found, with 11,730 citations generated in the network, and 2019 had the highest number of publications of any year. The most cited publication was «European multicenter study of the AcrySof ReSTOR apodized diffractive intraocular lens» by Kohnen et al., published in 2006. Four groups about different research areas in this field were found using the Clustering functionality: visual quality, IOL designs, ocular aberrations, or defocus curves. CONCLUSIONS The citation network offers an objective and comprehensive analysis of the main articles on the different designs and classes of multifocal IOL.
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14
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Hidalgo-Alvarez V, Dhowre HS, Kingston OA, Sheridan CM, Levis HJ. Biofabrication of Artificial Stem Cell Niches in the Anterior Ocular Segment. Bioengineering (Basel) 2021; 8:135. [PMID: 34677208 PMCID: PMC8533470 DOI: 10.3390/bioengineering8100135] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Revised: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 11/16/2022] Open
Abstract
The anterior segment of the eye is a complex set of structures that collectively act to maintain the integrity of the globe and direct light towards the posteriorly located retina. The eye is exposed to numerous physical and environmental insults such as infection, UV radiation, physical or chemical injuries. Loss of transparency to the cornea or lens (cataract) and dysfunctional regulation of intra ocular pressure (glaucoma) are leading causes of worldwide blindness. Whilst traditional therapeutic approaches can improve vision, their effect often fails to control the multiple pathological events that lead to long-term vision loss. Regenerative medicine approaches in the eye have already had success with ocular stem cell therapy and ex vivo production of cornea and conjunctival tissue for transplant recovering patients' vision. However, advancements are required to increase the efficacy of these as well as develop other ocular cell therapies. One of the most important challenges that determines the success of regenerative approaches is the preservation of the stem cell properties during expansion culture in vitro. To achieve this, the environment must provide the physical, chemical and biological factors that ensure the maintenance of their undifferentiated state, as well as their proliferative capacity. This is likely to be accomplished by replicating the natural stem cell niche in vitro. Due to the complex nature of the cell microenvironment, the creation of such artificial niches requires the use of bioengineering techniques which can replicate the physico-chemical properties and the dynamic cell-extracellular matrix interactions that maintain the stem cell phenotype. This review discusses the progress made in the replication of stem cell niches from the anterior ocular segment by using bioengineering approaches and their therapeutic implications.
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Affiliation(s)
- Veronica Hidalgo-Alvarez
- Institute of Biological Chemistry, Biophysics and Bioengineering, School of Engineering and Physical Sciences, Heriot-Watt University, Edinburgh EH14 4AS, UK
| | - Hala S. Dhowre
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK; (H.S.D.); (O.A.K.)
| | - Olivia A. Kingston
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK; (H.S.D.); (O.A.K.)
| | - Carl M. Sheridan
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK; (H.S.D.); (O.A.K.)
| | - Hannah J. Levis
- Department of Eye and Vision Science, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool L7 8TX, UK; (H.S.D.); (O.A.K.)
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15
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Chang DH, Waring GO, Hom M, Barnett M. Presbyopia Treatments by Mechanism of Action: A New Classification System Based on a Review of the Literature. Clin Ophthalmol 2021; 15:3733-3745. [PMID: 34522079 PMCID: PMC8432361 DOI: 10.2147/opth.s318065] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 07/08/2021] [Indexed: 01/07/2023] Open
Abstract
Presbyopia, a loss of accommodative ability associated with aging, is a significant cause of vision impairment globally. At the clinical level, it is a frustrating and difficult issue that negatively impacts patients’ quality of life. Less appreciated is the fact that loss of accommodative ability and its current treatments methods may present safety concerns, for example, increasing the risk of falls. Therefore, a more complete understanding of treatment options with respect to how they relate to the natural ability of the eye is needed to improve decision making and to aid clinicians in individualizing treatment options. This article reviews the options for expanding functional through focus—a term coined to describe the ability of the eye to see at all distances with minimal latency—by how they vary the refractive power over time, across the visual field, between eyes, or across a range of distances. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: https://youtu.be/HZw7qvIu6pw
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Affiliation(s)
| | | | | | - Melissa Barnett
- University of California, Davis Eye Center, Sacramento, CA, USA
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16
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Factors Affecting Posterior Capsule Opacification in the Development of Intraocular Lens Materials. Pharmaceutics 2021; 13:pharmaceutics13060860. [PMID: 34200928 PMCID: PMC8230425 DOI: 10.3390/pharmaceutics13060860] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 06/03/2021] [Accepted: 06/07/2021] [Indexed: 01/01/2023] Open
Abstract
Posterior capsule opacification (PCO) is the most common complication arising from the corrective surgery used to treat cataract patients. PCO arises when lens epithelial cells (LEC) residing in the capsular bag post-surgery undergo hyper-proliferation and transdifferentiation into myofibroblasts, migrating from the posterior capsule over the visual axis of the newly implanted intraocular lens (IOL). The developmental pathways underlying PCO are yet to be fully understood and the current literature is contradictory regarding the impact of the recognised risk factors of PCO. The aim of this review is firstly to collate the known biochemical pathways that lead to PCO development, providing an up-to-date chronological overview from surgery to established PCO formation. Secondly, the risk factors of PCO are evaluated, focussing on the impact of IOLs’ properties. Finally, the latest experimental model designs used in PCO research are discussed to demonstrate the ongoing development of clinical PCO models, the efficacy of newly developed IOL technology, and potential therapeutic interventions. This review will contribute to current PCO literature by presenting an updated overview of the known developmental pathways of PCO, an evaluation of the impact of the risk factors underlying its development, and the latest experimental models used to investigate PCO. Furthermore, the review should provide developmental routes for research into the investigation of potential therapeutic interventions and improvements in IOL design in the aid of preventing PCO for new and existing patients.
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Katz JA, Karpecki PM, Dorca A, Chiva-Razavi S, Floyd H, Barnes E, Wuttke M, Donnenfeld E. Presbyopia - A Review of Current Treatment Options and Emerging Therapies. Clin Ophthalmol 2021; 15:2167-2178. [PMID: 34079215 PMCID: PMC8163965 DOI: 10.2147/opth.s259011] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 05/11/2021] [Indexed: 01/07/2023] Open
Abstract
Presbyopia is a common age-related vision disorder characterized by a progressive inability to focus on near objects. If uncorrected or under-corrected, presbyopia can significantly impact patients' quality of life. Presbyopia represents an area of considerable unmet need due to its rising prevalence worldwide as the population ages, the high proportion of under-treated individuals in some parts of the world, and the limitations of currently available corrective methods. Progressive or bifocal spectacles are associated with peripheral blur, a restricted visual field and impaired depth perception, which have been linked to an increased risk of falls in the elderly. Contact lens options can be difficult to maintain due to the development of age-related dry eye symptoms and reduced manual dexterity. Other corrective methods involve surgical interventions that modify the optics of the cornea, replace the crystalline lens, or attempt to restore active accommodation. While patients undergoing surgery report satisfactory outcomes post-operatively, many of them eventually require reading glasses. Non-invasive therapies with novel mechanisms of action are currently being investigated; these include miotic agents and UNR844, a lipoic acid choline ester. In this narrative review, available evidence on presbyopia prevalence, quality of life impact and risk factors are described, with a focus on observational studies in non-clinical settings. The diagnosis pathway and patient journey in presbyopia are outlined, and various treatment options are analyzed. The data reviewed herein reveals significant gaps in the provision of vision correction for this common condition, with a paucity of effective, non-invasive treatment options broadly accessible to presbyopic individuals.
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Affiliation(s)
- James A Katz
- The Midwest Center for Sight, Des Plaines, IL, USA
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18
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A numerical investigation of changes in lens shape during accommodation. Sci Rep 2021; 11:9639. [PMID: 33953252 PMCID: PMC8100116 DOI: 10.1038/s41598-021-89145-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/22/2021] [Indexed: 12/25/2022] Open
Abstract
The purpose of this study was to investigate how the mechanical properties and geometry of the lens influence the changes in lens shape during accommodation. To do so, ex vivo stretching tests of the isolated lens were simulated via finite element analysis. In these tests, the lens is stretched from the accommodated state to the non-accommodated state. Several key characteristics of the lens were studied: the stiffness gradient of the lens material, the distribution of the capsule thickness, the mechanical properties of the capsule and the material comprising the lens, nucleus and cortex, and the influence of two different age-related lens geometries (17 and 29 y/o subjects). To determine the effects on the changes in lens shape during accommodation, changes in the anterior and posterior radius, the lens and nucleus thicknesses and the equatorial lens diameter were analysed. The results suggest that multiple factors exert statistically significant influences on how the lens changes its shape, but two factors predominate over the rest: the stiffness ratio between the nucleus and cortex and the stiffness of the capsule, specifically the posterior surface.
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19
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Brussee T, Alagahgi B, Nispen RMA, Rens GHMB. Measurement properties of reading tests in subjects with maculopathy. Acta Ophthalmol 2021; 99:275-287. [PMID: 32833321 DOI: 10.1111/aos.14574] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 07/02/2020] [Indexed: 11/28/2022]
Abstract
PURPOSE A reliable reading test provides a standardized measure of the visual component of reading performance. This study evaluated reproducibility, agreement and feasibility of five Dutch language continuous text reading tests used in clinical practice and research in visually impaired participants. METHODS In 42 participants with macular pathologies (mean age 77 years), the Colenbrander Reading Card (Colenbrander), International Reading Speed Texts (IReST), Laboratory of Experimental Ophthalmology (LEO) charts, 'de Nederlanders' (NED) and the Radner Reading Charts (Radner) were evaluated. The coefficient of repeatability was calculated for different reading parameters, and agreement between the reading tests was determined. RESULTS Between the reading tests, the differences found in repeatability for reading performance were mainly within the limit of one line (0.1 logMAR). Exceptions were the inter-session repeatability for critical print size: Colenbrander (0.35 logMAR), LEO (0.34), Radner (0.23). The highest agreement was found between the LEO and Radner; Reading acuity bias 0.03 logMAR (SD 0.10), CPS 0.03 (0.12). CONCLUSION This study shows that reading performance results obtained with reading tests are not always reliable and reading parameters could not always be properly assessed in participants with maculopathies. Therefore, choices regarding which reading test to use especially for research purposes should be based on both the feasibility and reliability of the reading test. The NED (a historical test) was the least feasible, and it is recommend that this test is no longer used. To allow standardized and comparable analysis of reading performance a highly standardized reading test, like the Radner is recommended.
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Affiliation(s)
- Tamara Brussee
- Ophthalmology Amsterdam Public Health Research Institute Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam The Netherlands
- Ophthalmology Elkerliek Hospital Helmond The Netherlands
| | - Basel Alagahgi
- Ophthalmology Amsterdam Public Health Research Institute Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Ruth M. A. Nispen
- Ophthalmology Amsterdam Public Health Research Institute Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam The Netherlands
| | - Ger H. M. B. Rens
- Ophthalmology Amsterdam Public Health Research Institute Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam The Netherlands
- Ophthalmology Elkerliek Hospital Helmond The Netherlands
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20
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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.
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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
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21
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Martinez-Perez C, Alvarez-Peregrina C, Villa-Collar C, Arance-Gil A, Sánchez-Tena MA. Citation network analysis of the various types of multifocal intraocular lenses. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2021; 96:S0365-6691(20)30492-5. [PMID: 33495051 DOI: 10.1016/j.oftal.2020.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 11/16/2020] [Accepted: 11/21/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND AND OBJECTIVE The implantation of multifocal intraocular lens (IOL) has increased in recent years, allowing patients to achieve good quality vision at all distances, independence from use of glasses, and consequently, an increase in quality of life. The main purpose of this study was to analyse the links between publications and authors via citation networks, as well to as identify the different research areas and determine the most cited publications. MATERIAL AND METHODS The publication search was performed through the Web of Science database, using the terms «Multifocal intraocular lens», «Bifocal intraocular lens», «Trifocal intraocular lens», «Diffractive intraocular lens», «Refractive intraocular lens», «Accommodative intraocular lens» and «Extended depth of focus intraocular lens», for a time interval from 1989 to August 2020. The software used to analyse the publications was the Citation Network Explorer. RESULTS A total of 1293 publications were found, with 11730 citations generated in the network, and 2019 had the highest number of publications of any year. The most cited publication was «European multicenter study of the AcrySof ReSTOR apodized diffractive intraocular lens» by Kohnen et al., published in 2006. Four groups about different research areas in this field were found using the Clustering functionality: visual quality, IOL designs, ocular aberrations, or defocus curves. CONCLUSIONS The citation network offers an objective and comprehensive analysis of the main articles on the different designs and classes of multifocal IOL.
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Affiliation(s)
- C Martinez-Perez
- Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, España.
| | - C Alvarez-Peregrina
- Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, España
| | - C Villa-Collar
- Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, España
| | - A Arance-Gil
- Hospital Universitario HM Montepríncipe, Madrid, España
| | - M A Sánchez-Tena
- Facultad de Ciencias Biomédicas y de la Salud, Universidad Europea de Madrid, Madrid, España
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22
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Moshirfar M, Thomson AC, Thomson RJ, Martheswaran T, McCabe SE. Use of presbyopia-correcting intraocular lenses in patients with prior corneal refractive surgery. Curr Opin Ophthalmol 2021; 32:45-53. [PMID: 33122489 DOI: 10.1097/icu.0000000000000722] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
PURPOSE OF REVIEW Corneal refractive surgery has achieved spectacle-free vision for millions of patients, but this aging population is now developing cataracts. Many of these patients may wish to avoid reliance on glasses after cataract surgery. Presbyopia-correcting intraocular lenses (IOLs) offer a solution, but corneal changes after refractive surgery may compound higher order aberrations and dysphotopic symptoms associated with these IOLs. This review aims to discuss potential factors that could aid in determining suitable postkeratorefractive candidates for presbyopia-correcting IOLs. RECENT FINDINGS Studies investigating which preoperative measures influence outcomes are lacking. The few studies that have examined presbyopia-correcting IOLs in postkeratorefractive patients report that satisfactory outcomes are possible. However, recommendations for preoperative thresholds appear limited to expert opinion and studies involving virgin corneas. SUMMARY As the number of presbyopia-correcting IOLs and postkeratorefractive patients grows, continued investigation into relevant preoperative factors and appropriate IOLs is required to make evidence-based decisions. The current literature shows that with rigorous counseling and appropriate patient selection, presbyopia-correcting IOLs can provide postkeratorefractive patients with satisfactory results and spectacle independence. In addition, the development of postoperative modifiable IOLs may prove to be the preferred option.
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Affiliation(s)
- Majid Moshirfar
- Hoopes Vision Research Center, Hoopes Vision, Draper
- Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah School of Medicine, Salt Lake City
- Utah Lions Eye Bank, Murray, Utah
| | - Andrew C Thomson
- McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
| | - Robert J Thomson
- McGovern Medical School at The University of Texas Health Science Center at Houston, Houston, Texas
| | - Tanisha Martheswaran
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, Massachusetts, USA
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23
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Dick HB, Gerste RD. Future Intraocular Lens Technologies. Ophthalmology 2020; 128:e206-e213. [PMID: 33373617 DOI: 10.1016/j.ophtha.2020.12.025] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 12/16/2020] [Accepted: 12/22/2020] [Indexed: 11/18/2022] Open
Abstract
The future of intraocular lens (IOL) technology has already begun with a number of recent innovations. The postoperative change of refractive power will lead to a customized fine-tuning that provides patients with the individual vision they expect and with as much spectacle independence as possible. The latest-generation (2.0) Light-Adjustable Lens (RxSight) was recently introduced into clinical practice, with the first results being very encouraging. Other methods of altering the power of an already implanted IOL are under development. The same can be said about the correction of presbyopia, the so-called last frontier in refractive surgery. Extended depth-of-focus IOLs have been introduced, as has the technology of the pinhole IOL. The latter has therapeutic potential beyond the refractive aspect and has already proven helpful in cases of iris defects and irregular corneas. Several technologies are currently being tested to achieve-finally-an accommodative IOL. One such concept uses the (remaining) strength of the ciliary muscle, whereas another is triggered by the pupil reaction when shifting focus from far to near. Not an IOL itself, but rather a high-tech innovation that so far has mostly been implanted during cataract surgery, is a microelectronic sensor that measures habitual intraocular pressure (IOP) at any given time and promises to revolutionize the management of glaucoma patients. The last generation of this device (Eyemate; Implandata Opthalmics Products GmbH) is implanted during small-incision cataract surgery; the latest development is an even smaller sensor that will be inserted suprachoroidally before, in the near future, such a device will be part of a capsular ring. These IOP sensors are a prime example that IOL technology will continue to be a driving force in ophthalmology, with a positive impact far beyond cataract surgery.
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24
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Bilbao-Calabuig R, Gónzalez-López F, Llovet-Rausell A, Ortega-Usobiaga J, Tejerina Fernández V, Llovet-Osuna F. Lens-based surgical correction of presbyopia. Where are we in 2020? ACTA ACUST UNITED AC 2020; 96:74-88. [PMID: 32868085 DOI: 10.1016/j.oftal.2020.07.012] [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: 04/28/2020] [Revised: 07/19/2020] [Accepted: 07/20/2020] [Indexed: 01/06/2023]
Abstract
INTRODUCTION Presbyopia is the progressive and irreversible loss of accommodation due to aging. It is one of the main causes of loss of quality of life in people from 45 years of age, due to the, often novel, dependence on spectacles. The eagerness to correct it by ophthalmologists impulsed by the desire of millions of people who suffer from it, has become one of the main drivers for the development of intraocular lens (IOL) technology over the last twenty years. MATERIAL AND METHODS This review briefly presents the different alternatives that have allowed us to improve the crystalline lens surgical approach of presbyopia; from monofocal lenses and monovision technique, accommodative, refractive, and diffractive multifocal lenses, and finally the most recent extended depth of focus/field lenses known as EDOFs. RESULTS Each IOL has its advantages, limitations and disadvantages. Furthermore, there is no single lens that suits the needs of all patients. CONCLUSIONS It is necessary to know the variety of lenses available, and to have an in-depth understanding of their optical properties, as well as the impact that these will have later on their clinical performance and on the visual quality of the patients. This should help us to select the best alternative for each of them.
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Affiliation(s)
- R Bilbao-Calabuig
- Unidad de Cirugía Refractiva y Cataratas, Clínica Baviera-Aier Hospital Eye Group, Madrid, España.
| | - F Gónzalez-López
- Unidad de Cirugía Refractiva y Cataratas, Clínica Baviera-Aier Hospital Eye Group, Madrid, España
| | - A Llovet-Rausell
- Unidad de Cirugía Refractiva y Cataratas, Clínica Baviera-Aier Hospital Eye Group, Valencia, España; Servicio Oftalmología, Hospital Universitario La Fe, Valencia, España
| | - J Ortega-Usobiaga
- Unidad de Cirugía Refractiva y Cataratas, Clínica Baviera-Aier Hospital Eye Group, Bilbao, España
| | - V Tejerina Fernández
- Unidad de Cirugía Refractiva y Cataratas, Clínica Baviera-Aier Hospital Eye Group, Madrid, España
| | - F Llovet-Osuna
- Unidad de Cirugía Refractiva y Cataratas, Clínica Baviera-Aier Hospital Eye Group, Madrid, España; Unidad de Cirugía Refractiva y Cataratas, Clínica Baviera-Aier Hospital Eye Group, Valencia, España
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25
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Ang M, Gatinel D, Reinstein DZ, Mertens E, Alió Del Barrio JL, Alió JL. Refractive surgery beyond 2020. Eye (Lond) 2020; 35:362-382. [PMID: 32709958 DOI: 10.1038/s41433-020-1096-5] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Revised: 05/19/2020] [Accepted: 07/08/2020] [Indexed: 02/07/2023] Open
Abstract
Refractive surgery refers to any procedure that corrects or minimizes refractive errors. Today, refractive surgery has evolved beyond the traditional laser refractive surgery, embodied by the popular laser in situ keratomileusis or 'LASIK'. New keratorefractive techniques such as small incision lenticule extraction (SMILE) avoids corneal flap creation and uses a single laser device, while advances in surface ablation techniques have seen a resurgence in its popularity. Presbyopic treatment options have also expanded to include new ablation profiles, intracorneal implants, and phakic intraocular implants. With the improved safety and efficacy of refractive lens exchange, a wider variety of intraocular lens implants with advanced optics provide more options for refractive correction in carefully selected patients. In this review, we also discuss possible developments in refractive surgery beyond 2020, such as preoperative evaluation of refractive patients using machine learning and artificial intelligence, potential use of stromal lenticules harvested from SMILE for presbyopic treatments, and various advances in intraocular lens implants that may provide a closer to 'physiological correction' of refractive errors.
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Affiliation(s)
- Marcus Ang
- Singapore Eye Research Institute, Singapore National Eye Centre, Singapore, Singapore. .,Department of Ophthalmology and Visual Science, Duke-NUS Graduate Medical School, Singapore, Singapore.
| | | | - Dan Z Reinstein
- London Vision Clinic, London, UK.,Department of Ophthalmology, Columbia University Medical Center, New York, NY, USA.,Sorbonne Université, Paris, France.,Biomedical Science Research Institute, Ulster University, Belfast, UK
| | - Erik Mertens
- Medipolis-Antwerp Private Clinic, Antwerp, Belgium
| | - Jorge L Alió Del Barrio
- Division of Ophthalmology, School of Medicine, Universidad Miguel Hernández, Alicante, Spain.,Cornea, Cataract and Refractive Surgery Unit, Vissum (Miranza Group), Alicante, Spain
| | - Jorge L Alió
- Division of Ophthalmology, School of Medicine, Universidad Miguel Hernández, Alicante, Spain.,Cornea, Cataract and Refractive Surgery Unit, Vissum (Miranza Group), Alicante, Spain
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Schmid R, Luedtke H. A Novel Concept of Correcting Presbyopia: First Clinical Results with a Phakic Diffractive Intraocular Lens. Clin Ophthalmol 2020; 14:2011-2019. [PMID: 32764867 PMCID: PMC7373407 DOI: 10.2147/opth.s255613] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 06/04/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose To evaluate the effect of a novel technique to correct presbyopia. A phakic IOL (presbyopic IPCL; implantable phakic contact lens) with a diffractive optic is implanted and its impact on visual acuity, refraction, patient satisfaction in patients striving for spectacle-independence is evaluated. Design Retrospective noncomparative open-label clinical trial. Methods Sixteen eyes of 8 patients (average age 47 years) had a presbyopic IPCL implanted in the posterior chamber. The visual acuity on different distances, refractive status, corneal topography, endothelial cell density, anterior chamber depth, white-to-white, mesopic pupil size and intraocular pressure (IOP) were measured before implantation of this novel phakic IOL with diffractive optic and four weeks after surgery. Results At follow-up four weeks after surgery, 9 of the 16 eyes were emmetropic and uncorrected distance visual acuity was at least 0.8. Near vision was excellent in all patients without the need to wear reading glasses. There was neither a significant change in IOP nor a significant surgical impact on endothelial cells. Patient satisfaction was high. There was no major complaint of halos or glare. Conclusion The presbyopic IPCL can provide the presbyopic patient with good visual acuity and spectacle-independence for far and near distance. We found this novel technique to have a good safety profile during the surgical procedure and our short follow-up period. Further long-term follow-up is mandatory.
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Affiliation(s)
- Ruediger Schmid
- Accuratis. Private Practice for Refractive Surgery, Ulm, Germany
| | - Holger Luedtke
- Accuratis. Private Practice for Refractive Surgery, Ulm, Germany
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27
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Shafer BM, Greenwood M. Presbyopia Correction at the Time of Cataract Surgery. CURRENT OPHTHALMOLOGY REPORTS 2020. [DOI: 10.1007/s40135-020-00236-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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28
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Gadzhanova S, Gillam M, Roughead E. Risk of falls and injuries requiring hospitalisation after first-eye cataract surgery in elderly Australians. Acta Ophthalmol 2020; 98:e495-e498. [PMID: 31654472 DOI: 10.1111/aos.14286] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 10/03/2019] [Indexed: 12/24/2022]
Abstract
PURPOSE To investigate the impact of the type of the intraocular lenses (IOLs) in first-eye cataract surgery in elderly people on the risk of hospitalisation due to falls and injuries. METHODS A retrospective cohort study was conducted using the Australian Government Department Veterans' Affairs claims data. All people aged 65 years and above who had first cataract surgery between January 2007 and July 2017 were identified. Two cohorts were established depending on the type of IOL-monofocal and multifocal. The risk of injuries and falls requiring hospitalisation in the first 3 months post the surgery was assessed using Cox proportional hazard models with age at entry as primary time scale and adjusting for gender, comorbidities and prior history of falls. RESULTS There were 45 728 people across the two cohorts with the majority receiving monofocal lenses (97%), followed by multifocal lenses (3%) at the time of first cataract surgery. The risk of injury and falls was lower (but not significant) in the multifocal cohort compared to monofocal cohort (adjusted hazard ratio (aHR) 0.56, 95% CI 0.26-1.17). The risk was also lower (but not significant) when stratifying by age group at the time of the surgery. CONCLUSIONS Regardless of age, multifocal lenses did not appear to be associated with the higher risk of serious injuries and falls after first-eye cataract surgery compared to monofocal lenses.
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Affiliation(s)
- Svetla Gadzhanova
- Quality Use of Medicines and Pharmacy Research Centre University of South Australia Adelaide SA Australia
| | - Marianne Gillam
- Quality Use of Medicines and Pharmacy Research Centre University of South Australia Adelaide SA Australia
| | - Elizabeth Roughead
- Quality Use of Medicines and Pharmacy Research Centre University of South Australia Adelaide SA Australia
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29
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Torres-Sepúlveda W, Mira-Agudelo A, Barrera-Ramírez JF, Petelczyc K, Kolodziejczyk A. Optimization of the Light Sword Lens for Presbyopia Correction. Transl Vis Sci Technol 2020; 9:6. [PMID: 32704426 PMCID: PMC7347505 DOI: 10.1167/tvst.9.3.6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Purpose We propose and evaluate the modifications of a light sword lens (LSL) to obtain better performance for distance vision while maintaining good operation for near and intermediate vision. Methods The modifications consisted of assigning angular or circular windows for distance vision while rescaling the LSL profile in the remaining area of the element. The objective performance of the redesigned LSLs was verified numerically by the Strehl ratio and experimentally using correlation coefficients and Michelson contrast. Subjective assessments were provided by monocular visual acuity (VA) and contrast sensitivity (CS) through-focus curves for six patients with paralyzed accommodation. The tested object vergence range was [-4.0, 0.0] diopters (D). All experiments were conducted in a custom-made monocular visual simulator. Results Computational simulations and objective experiments confirmed the better performance of the modified LSL for the imaging of distant objects. The proposed angular and radial modulations resulted in flat VA and CS through-focus curves, indicating more uniform quality of vision with clearly improved distance vision. The VA provided by the modified LSL profiles showed a maximal improvement of 1.5 lines of acuity with respect to the VA provided by the conventional LSL at distance vision. Conclusions Optimized LSLs provide better imaging of distant objects while maintaining a large depth of focus. This results in comparable and acceptable quality for distance, intermediate, and near vision. Therefore, the modified LSLs appear to be promising presbyopia correctors. Translational Relevance The new design of LSL reveals an improved performance for all ranges of vision and becomes a promissory element for a real presbyopia correction in clinical applications.
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Affiliation(s)
- Walter Torres-Sepúlveda
- Grupo de Óptica y Fotónica, Instituto de Física, Facultad de Ciencias Exactas y Naturales, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - Alejandro Mira-Agudelo
- Grupo de Óptica y Fotónica, Instituto de Física, Facultad de Ciencias Exactas y Naturales, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - John Fredy Barrera-Ramírez
- Grupo de Óptica y Fotónica, Instituto de Física, Facultad de Ciencias Exactas y Naturales, Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín, Colombia
| | - Krzysztof Petelczyc
- Faculty of Physics, Warsaw University of Technology, Koszykowa 75, 00-662, Warszawa, Poland
| | - Andrzej Kolodziejczyk
- Faculty of Physics, Warsaw University of Technology, Koszykowa 75, 00-662, Warszawa, Poland
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30
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Petelczyc K, Kolodziejczyk A, Błocki N, Byszewska A, Jaroszewicz Z, Kakarenko K, Kołacz K, Miler M, Mira-Agudelo A, Torres-Sepúlveda W, Rękas M. Model of the light sword intraocular lens: in-vitro comparative studies. BIOMEDICAL OPTICS EXPRESS 2020; 11:40-54. [PMID: 32010498 PMCID: PMC6968750 DOI: 10.1364/boe.11.000040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2019] [Revised: 11/15/2019] [Accepted: 11/17/2019] [Indexed: 06/10/2023]
Abstract
This work presents the first models of light sword intraocular lenses (LS IOLs) with angularly modulated optical power. We performed an experimental, comparative study with multifocal and extended depth of focus intraocular lenses, which are available on the market. The measurements conducted in an original optical bench were utilised for an analysis of point spread functions, elongated foci, modulation transfer functions and the areas defined by them. The LS IOL models perform homogeneous imaging in the whole range of designed defocus. The proposed concept of extended depth of focus seems to be promising for the development of presbyopia-correcting intraocular lenses capable of regaining fully functional vision.
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Affiliation(s)
- Krzysztof Petelczyc
- Faculty of Physics, Warsaw University of
Technology, ul. Koszykowa 75, 00-662 Warsaw, Poland
| | - Andrzej Kolodziejczyk
- Faculty of Physics, Warsaw University of
Technology, ul. Koszykowa 75, 00-662 Warsaw, Poland
| | - Narcyz Błocki
- Łukasiewicz Research Network
– Maksymilian Pluta Institute of Applied Optics, ul.
Kamionkowska 18, 03-805 Warsaw, Poland
| | - Anna Byszewska
- Faculty of Physics, Warsaw University of
Technology, ul. Koszykowa 75, 00-662 Warsaw, Poland
- Ophthalmology Department, Military
Institute of Medicine, ul. Szaserów 128, 04-141 Warsaw,
Poland
| | - Zbigniew Jaroszewicz
- Łukasiewicz Research Network
– Maksymilian Pluta Institute of Applied Optics, ul.
Kamionkowska 18, 03-805 Warsaw, Poland
- National Institute of Telecommunications,
ul. Szachowa 1, 04-894 Warsaw, Poland
| | - Karol Kakarenko
- Faculty of Physics, Warsaw University of
Technology, ul. Koszykowa 75, 00-662 Warsaw, Poland
| | - Katarzyna Kołacz
- Łukasiewicz Research Network
– Maksymilian Pluta Institute of Applied Optics, ul.
Kamionkowska 18, 03-805 Warsaw, Poland
| | - Michał Miler
- Faculty of Physics, Warsaw University of
Technology, ul. Koszykowa 75, 00-662 Warsaw, Poland
- Łukasiewicz Research Network
– Maksymilian Pluta Institute of Applied Optics, ul.
Kamionkowska 18, 03-805 Warsaw, Poland
| | - Alejandro Mira-Agudelo
- Grupo de Óptica y Fotónica,
Instituto de Física, Facultad de Ciencias Exactas y Naturales,
Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín,
Colombia
| | - Walter Torres-Sepúlveda
- Grupo de Óptica y Fotónica,
Instituto de Física, Facultad de Ciencias Exactas y Naturales,
Universidad de Antioquia UdeA, Calle 70 No. 52-21, Medellín,
Colombia
| | - Marek Rękas
- Ophthalmology Department, Military
Institute of Medicine, ul. Szaserów 128, 04-141 Warsaw,
Poland
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31
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Wang LY, Li BC, Sheng B, Xu BL, Huang YS, Ni ZJ, Zhang DW. Optimized multielement accommodative intraocular lens with a four-freeform-surface Alvarez lens and a separate aspheric lens. APPLIED OPTICS 2019; 58:7609-7614. [PMID: 31674416 DOI: 10.1364/ao.58.007609] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 08/27/2019] [Indexed: 06/10/2023]
Abstract
This paper proposes an accommodative intraocular lens (IOL), which consists of a two-element Alvarez lens and an aspheric lens for changing focal power and refractive power, respectively. The four-freeform-surface Alvarez lens is optimized for a multiple field of view; further, the aspheric lens also corrects the aberrations induced by the corneal asphericity of the human eye over the whole range of accommodation. A simulation using optical design software demonstrates its excellent performance in that the values of the modulation transfer function at 100 cycles/mm all reach ∼0.4 with a ±5° field of view for 3 and 5 mm pupils.
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32
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Wang K, Pierscionek BK. Biomechanics of the human lens and accommodative system: Functional relevance to physiological states. Prog Retin Eye Res 2019; 71:114-131. [DOI: 10.1016/j.preteyeres.2018.11.004] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Revised: 09/24/2018] [Accepted: 11/07/2018] [Indexed: 12/28/2022]
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33
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Galstian T, Asatryan K, Presniakov V, Zohrabyan A. Electrically variable liquid crystal lenses for ophthalmic distance accommodation. OPTICS EXPRESS 2019; 27:18803-18817. [PMID: 31252817 DOI: 10.1364/oe.27.018803] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 05/09/2019] [Indexed: 06/09/2023]
Abstract
We present the example of a specific design of an electrically tunable liquid crystal lens (TLCL) with floating electrode to analyze experimentally the potential of using TLCLs in intraocular implants. An optimized voltage-frequency driving technique is demonstrated to achieve high optical powers (up to 4 diopters) with very low aberrations (below 0.1μm) for an optical aperture of 3mm. In addition, the continuous character of distance accommodation and the absence of granularity across the aperture of the lens (pixel-free) make this component an excellent choice for various ophthalmic applications.
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Gerhart J, Werner L, Mamalis N, Infanti J, Withers C, Abdalla F, Gerhart C, Bravo-Nuevo A, Gerhart O, Getts L, Rhodes K, Bowers J, Getts R, George-Weinstein M. Depletion of Myo/Nog Cells in the Lens Mitigates Posterior Capsule Opacification in Rabbits. ACTA ACUST UNITED AC 2019; 60:1813-1823. [DOI: 10.1167/iovs.19-26713] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
- Jacquelyn Gerhart
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, United States
| | - Liliana Werner
- John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, United States
| | - Nick Mamalis
- John A. Moran Eye Center, University of Utah, Salt Lake City, Utah, United States
| | - Joseph Infanti
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, United States
| | - Colleen Withers
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, United States
| | - Fathma Abdalla
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, United States
| | - Colby Gerhart
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, United States
| | - Arturo Bravo-Nuevo
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, United States
| | - Olivia Gerhart
- Philadelphia College of Osteopathic Medicine, Philadelphia, Pennsylvania, United States
| | - Lori Getts
- Genisphere, LLC, Hatfield, Pennsylvania, United States
| | - Kelly Rhodes
- Genisphere, LLC, Hatfield, Pennsylvania, United States
| | | | - Robert Getts
- Genisphere, LLC, Hatfield, Pennsylvania, United States
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35
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Wang K, Hoshino M, Uesugi K, Yagi N, Pierscionek BK. Contributions of shape and stiffness to accommodative loss in the ageing human lens: a finite element model assessment. JOURNAL OF THE OPTICAL SOCIETY OF AMERICA. A, OPTICS, IMAGE SCIENCE, AND VISION 2019; 36:B116-B122. [PMID: 31044989 DOI: 10.1364/josaa.36.00b116] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Accepted: 03/06/2019] [Indexed: 06/09/2023]
Abstract
Ageing changes to the various components of the accommodative system of the eye lens contribute to the loss of focusing power. The relative contributions of each ageing component, however, are not well defined. This study investigates the contribution of geometric parameters and material properties on accommodation, simulated using models based on human lenses aged 16, 35, and 48 years. Each model was tested using two different sets of material properties and a range of zonular fiber angles and was compared to results from in vivo measurements. The geometries and material parameters of older and younger lens models were interchanged to investigate the role of shape and material on accommodative capacity. Results indicate that geometry has the greater role in accommodation.
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36
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Zeng L, Fang F. Advances and challenges of intraocular lens design [Invited]. APPLIED OPTICS 2018; 57:7363-7376. [PMID: 30182957 DOI: 10.1364/ao.57.007363] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Accepted: 06/29/2018] [Indexed: 06/08/2023]
Abstract
Phacoemulsification technique with intraocular lens implantation has been a common treatment for cataract patients. With rising demand among the public, new technologies for lens design have emerged to minimize intraocular aberrations, improving visual quality to the largest extent. This paper systematically reviews the development of materials applied in lens manufacturing, the different categories of intraocular lenses, and respective design principles. The advantages and potential drawbacks of intraocular lenses are illustrated in the paper, and prospective research to improve the design are presented in the end.
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37
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Zvorničanin J, Zvorničanin E. Premium intraocular lenses: The past, present and future. J Curr Ophthalmol 2018; 30:287-296. [PMID: 30555960 PMCID: PMC6276729 DOI: 10.1016/j.joco.2018.04.003] [Citation(s) in RCA: 61] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2017] [Revised: 04/09/2018] [Accepted: 04/25/2018] [Indexed: 12/13/2022] Open
Abstract
Purpose To present potential benefits as well as limitations of premium intraocular lens (IOL) use, and provide insight in future of premium cataract surgery. Methods Bibliographic research was performed in PubMed/Medline database, and the most recently updated papers were evaluated. Keywords used were: premium intraocular lens, multifocal intraocular lens, toric intraocular lens, toric multifocal intraocular lens, accommodative intraocular lens, and the respective brand names. Results Multifocal IOLs provide uncorrected distance visual acuity (UDVA) of 0.03 logMAR in 82.3%–95.7% of patients and overall spectacle independence in 81%–85% of patients. Toric IOLs provide UDVA of 0.3 logMAR in 70%–95% of patients, residual astigmatism of 1 D or less is noted in 67%–88% of patients, and spectacle independence is reported in 60%–85% of patients. Toric multifocal IOLs provide UDVA of 0.3 logMAR in 92%–97% of patients, and spectacle independence is reported in 79%–90% of patients. Accommodative IOLs represent intensively developing field in ophthalmology, and the results are still variable depending on the IOL model. Conclusions Premium IOL technology and advanced surgical techniques have significantly improved postoperative visual outcomes. Future developments will potentiate development of new premium IOL designs that will provide spectacle independence and excellent visual outcomes after cataract surgery.
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Affiliation(s)
- Jasmin Zvorničanin
- Department of Ophthalmology, University Clinical Center Tuzla, Bosnia and Herzegovina
| | - Edita Zvorničanin
- Department of Ophthalmology, University Clinical Center Tuzla, Bosnia and Herzegovina
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