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Yang Y, Ning R, Xu S, Xiahou J, Li J, Savini G, Schiano-Lomoriello D, Zhou X, Huang J. Evaluation of the Agreement Between a New Pyramid Wavefront Sensor Aberrometer and Scheiner-Smirnov Aberrometers. J Refract Surg 2024; 40:e218-e228. [PMID: 38593257 DOI: 10.3928/1081597x-20240311-02] [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: 04/11/2024]
Abstract
PURPOSE To assess agreement between a new aberrometer (Osiris-T; CSO) employing pyramid wavefront sensor technique and Scheiner-Smirnov aberrometer (OPD-Scan III; Nidek) on measuring ocular, corneal, and internal aberrations in healthy participants. METHODS The measurements were conducted three times consecutively by an experienced examiner. The total root mean square (RMS) aberrations, higher order aberration RMS, coma Z3±1, trefoil Z3±3, spherical aberration Z40, and astigmatism II Z4±2 up to 7th order were exported in both 4-and 6-mm pupil zones. The parameters between the two devices were statistically compared using the paired t-test, and the differences assessed with Bland-Altman plots and 95% limits of agreement. RESULTS This prospective study included 70 right eyes of 70 healthy participants with an average age of 25.94 ± 6.59 years (range: 18 to 47 years). The mean difference in the two devices ranged from 0.01 µm for astigmatism II Z4±2 to 0.63 µm for total RMS in 4 mm and from 0.01 to 1.41 µm in 6-mm pupil size. The Bland-Altman analysis of ocular, corneal, and internal aberrations indicated high agreement between the two devices and the maximum absolute values for 95% limits of agreement ranged from 0.03 to 1.06 µm for 4-mm pupil diameters and 0.12 to 1.13 µm for 6-mm pupil diameters. CONCLUSIONS The newly developed pyramid wavefront sensor technique aberrometer demonstrated a high agreement with a Scheiner-Smirnov aberrometer when measuring ocular, corneal, and internal aberrations in healthy participants. Thus, the two aberrometers may be considered interchangeable for clinical applications. [J Refract Surg. 2024;40(4):e218-e228.].
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Chay IW, Lin ST, Lim EWL, Heng WJ, Bin Ismail MA, Tan MCL, Zhao PSB, Nah GKM, Ang BCH. Higher order aberrations and visual function in a young Asian population of high myopes. Heliyon 2023; 9:e14901. [PMID: 37151700 PMCID: PMC10161382 DOI: 10.1016/j.heliyon.2023.e14901] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 03/11/2023] [Accepted: 03/21/2023] [Indexed: 05/09/2023] Open
Abstract
Purpose To examine the associations between higher order aberrations (HOAs), visual performance, demographics, and ocular characteristics in a young Asian population with high myopia. Methods This was a retrospective review of military pre-enlistees conducted between March 2014 to September 2018. Visual acuity and contrast sensitivity were tested under photopic, mesopic and simulated night conditions. Ocular, corneal and internal HOAs were measured with a Hartmann-Shack wavefront aberrometer (KR-1W, Topcon Co., Tokyo, Japan). Results 522 eyes of 263 consecutive subjects with severe high myopia (defined as spherical equivalent refraction [SER] ≤ -10.00D) in at least one eye, and high myopia (SER ≤ -6.00D) in the fellow eye, [mean (SD) SER -11.85 (2.03D)] were analysed. The mean (SD) age of subjects was 18.5 (1.6) years. Chinese eyes had significantly greater internal total HOA root-mean-square (RMS) compared to Malay eyes [mean difference (SD) 0.0246 (0.007) μm, p < 0.001). More negative SER was associated with greater ocular total HOA (p = 0.038), primary coma (p = 0.003) and tetrafoil (p = 0.025) RMS, as well as more positive ocular (p = 0.003) and internal primary spherical aberration (p = 0.009). Greater ocular total HOAs was associated with reduced visual acuity in simulated night conditions and low contrast, decreased contrast sensitivity under mesopic and simulated night conditions (all p < 0.05). Conclusions Greater HOAs were associated with Chinese ethnicity and more negative SER in a young Asian population with high myopia. Greater HOAs were associated with poorer visual performance in low luminance and reduced contrast conditions.
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Affiliation(s)
- Isaac W. Chay
- Vision Performance Centre, Military Medicine Institute, Singapore Armed Forces Medical Corps, Singapore
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
| | - Sheng Tong Lin
- DSO National Laboratories, Defence Medical and Environmental Research Institute, Singapore
| | - Edmund WL. Lim
- Vision Performance Centre, Military Medicine Institute, Singapore Armed Forces Medical Corps, Singapore
| | - Wee Jin Heng
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
| | | | | | - Paul SB. Zhao
- Department of Ophthalmology, National University Health System, Singapore
| | - Gerard KM. Nah
- Department of Ophthalmology, National University Health System, Singapore
- W Eye Clinic, Singapore
| | - Bryan CH. Ang
- Vision Performance Centre, Military Medicine Institute, Singapore Armed Forces Medical Corps, Singapore
- National Healthcare Group Eye Institute, Tan Tock Seng Hospital, Singapore
- Department of Ophthalmology, Woodlands Health Campus, Singapore
- Corresponding author. 11 Jln Tan Tock Seng, Singapore 308433.
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Liu Y, Li X, Zhang L, Yi X, Xing Y, Li K, Wang Y. Comparison of wavefront aberrations in the object and image spaces using wide-field individual eye models. BIOMEDICAL OPTICS EXPRESS 2022; 13:4939-4953. [PMID: 36187261 PMCID: PMC9484411 DOI: 10.1364/boe.464781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/06/2022] [Accepted: 08/08/2022] [Indexed: 06/16/2023]
Abstract
Wavefront aberrations in the image space are critical for visual perception, though the clinical available instruments usually give the wavefront aberrations in the object space. This study aims to compare the aberrations in the object and image spaces. With the measured wavefront aberrations over the horizontal and vertical ±15° visual fields, the in-going and out-going wide-field individual myopic eye models were constructed to obtain the wavefront aberrations in the object and image spaces of the same eye over ±45° horizontal and vertical visual fields. The average differences in the mean sphere and astigmatism were below 0.25 D between the object and image spaces over the horizontal and vertical ±45° visual fields under 3 mm and 6 mm pupil diameter. The wavefront aberrations in the object space are a proper representation of the aberrations in the image space at least for horizontal visual fields ranging from -35°to +35° and vertical visual fields ranging from -15°to +15°.
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Affiliation(s)
- Yongji Liu
- Tianjin Key Laboratory of Micro-scale Optical Information Science and Technology, Institute of Modern Optics, Nankai University, 38 Tongyan Road, Haihe Education Park, Tianjin, 300350, China
- Nankai University Eye Institute, Nankai University Affiliated Eye Hospital, Nankai University, 38 Tongyan Road, Haihe Education Park, Tianjin, 300350, China
| | - Xiaolan Li
- Tianjin Key Laboratory of Micro-scale Optical Information Science and Technology, Institute of Modern Optics, Nankai University, 38 Tongyan Road, Haihe Education Park, Tianjin, 300350, China
| | - Lin Zhang
- Nankai University Eye Institute, Nankai University Affiliated Eye Hospital, Nankai University, 38 Tongyan Road, Haihe Education Park, Tianjin, 300350, China
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, 4 Gansu Rd, Tianjin 300020, China
| | - Xianglong Yi
- Nankai University Eye Institute, Nankai University Affiliated Eye Hospital, Nankai University, 38 Tongyan Road, Haihe Education Park, Tianjin, 300350, China
| | - Yuwei Xing
- Tianjin Key Laboratory of Micro-scale Optical Information Science and Technology, Institute of Modern Optics, Nankai University, 38 Tongyan Road, Haihe Education Park, Tianjin, 300350, China
| | - Kunqi Li
- Tianjin Key Laboratory of Micro-scale Optical Information Science and Technology, Institute of Modern Optics, Nankai University, 38 Tongyan Road, Haihe Education Park, Tianjin, 300350, China
| | - Yan Wang
- Nankai University Eye Institute, Nankai University Affiliated Eye Hospital, Nankai University, 38 Tongyan Road, Haihe Education Park, Tianjin, 300350, China
- Tianjin Key Laboratory of Ophthalmology and Visual Science, Tianjin Eye Institute, Tianjin Eye Hospital, 4 Gansu Rd, Tianjin 300020, China
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Gui X, Zhang R, Li S, Zhao N, Zhang HR, Zhou YK, Huan CY, Zhao CY, Wang HY, Song HY, Shen W, Zhang JH. Comparative analysis of the clinical outcomes between wavefront-guided and conventional femtosecond LASIK in myopia and myopia astigmatism. Int J Ophthalmol 2021; 14:1581-1588. [PMID: 34667736 DOI: 10.18240/ijo.2021.10.16] [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: 04/25/2021] [Accepted: 08/20/2021] [Indexed: 11/23/2022] Open
Abstract
AIM To compare the clinical outcomes of wavefront guided femtosecond LASIK (WFG LASIK) and conventional femtosecond LASIK (NWFG LASIK) in eyes with myopia and myopia astigmatism. METHODS This was a retrospective, nonrandomized, comparative investigation enrolling 236 eyes of 122 patients (18-50y) with low & moderate and high myopia. The WFG group including 97 eyes (50 patients) undergone WFG LASIK and the NWFG group including 139 eyes (72 patients) undergone conventional LASIK. Mean efficacy index, high order aberrations (HOAs), pupil size and the quality of visual questionnaire were evaluated 6mo postoperatively. RESULTS There is no difference between WFG group (-0.054±0.049 in logMAR) and NWFG group (-0.040±0.056) in uncorrected distance visual acuity (UDVA) postoperatively. The myopia astigmatism is higher in WFG group than that in NWFG group (P<0.05). However, the mean efficacy index (MEI) in the WFG group (1.09±0.106) is better than that in the NWFG group (1.036±0.124; P<0.001). Increased HOAs were observed in NWFG group (0.30±0.196) than that in WFG group (0.146±0.188; P<0.001). The pupil size is larger in WFG group (5.15±0.76 mm) than that in NWFG group (4.32±0.52 mm). The patients are satisfied with the clinical surgery, yet WFG group showed better visual quality using the questionnaire survey. Meanwhile, high myopia would result in worse MEI, HOAs and visual quality than low & moderate myopia. CONCLUSION WFG and NWFG FS-LASIK are both effective and safe procedures to correct low & moderate and high myopia, but WFG FS-LASIK gives a better postoperative MEI, aberrometric control and predictable outcome. Meanwhile, WFG FS-LASIK is better than NWFG FS-LASIK in correction of myopia astigmatism. Low & moderate myopia allow better clinical outcomes than high myopia using any surgical method.
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Affiliation(s)
- Xiao Gui
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Rui Zhang
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Sha Li
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Na Zhao
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Hao-Rui Zhang
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Yu-Kun Zhou
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Chen-Yang Huan
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Chun-Yan Zhao
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Hong-Ying Wang
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Hong-Yuan Song
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China.,Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200080, China
| | - Wei Shen
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
| | - Jian-Hua Zhang
- Department of Ophthalmology, the First Affiliated Hospital of Naval Medical University, Shanghai 200433, China
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Comparison of the optical quality after SMILE and FS-LASIK for high myopia by OQAS and iTrace analyzer: a one-year retrospective study. BMC Ophthalmol 2021; 21:292. [PMID: 34340669 PMCID: PMC8330115 DOI: 10.1186/s12886-021-02048-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 07/09/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND To compare the correction effect and optical quality after small-incision lenticule extraction (SMILE) and femtosecond laser assisted laser in situ keratomileusis (FS-LASIK) for high myopia. METHODS 51 high myopia eyes after SMILE and 49 high myopia eyes after FS-LASIK were enrolled and divided into two groups retrospectively. The OQAS and iTrace analyzer were used for optical quality inspection. Between the two groups the spherical equivalent (SE), astigmatism, uncorrected distant visual acuity (UDVA), strehl ratio (SR), modulation transfer function cutoff frequency (MTF cutoff), objective scatter index (OSI) and wavefront aberrations were analyzed and compared before surgery and at 1, 6 and 12 months after surgery. RESULTS After the operation: (1) SE and astigmatism declined and UDVA increased significantly in both groups, and UDVA was better after SMILE than FS-LASIK. (2) SR and MTF cutoff reduced and OSI increased significantly after SMILE and FS-LASIK. SR and MTF cutoff were significantly higher after SMILE than FS-LASIK. OSI was significantly lower after SMILE than FS-LASIK. (3) The total wavefront aberration, total low-order wavefront aberration, defocus and astigmatism aberration as well as trefoil aberration reduced significantly in both groups. The total high-order wavefront aberration increased significantly after FS-LASIK. The spherical and coma aberration increased significantly in both groups. The total high-order wavefront aberration and coma aberration at 1 month were higher after FS-LASIK than SMILE. CONCLUSION The optical quality descended after SMILE and FS-LASIK. SMILE was superior to FS-LASIK at the correction effect and optical quality for high myopia. The combination of OQAS and iTrace analyzer is a valuable complementary measurement in evaluating the optical quality after the refractive surgery. TRIAL REGISTRATION This is a retrospective study. This research was approved by the ethics committee of Xiangya Hospital and the IRB approval number is 201612074.
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de Asís Bartol-Puyal F, Giménez G, Méndez-Martínez S, Altemir I, Larrosa JM, Polo V, Pablo L. Bias of near-infrared light in evaluation of patients implanted with multifocal intraocular lenses. Int Ophthalmol 2021; 41:3171-3181. [PMID: 34032978 DOI: 10.1007/s10792-021-01882-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Accepted: 05/12/2021] [Indexed: 10/21/2022]
Abstract
PURPOSE To compare visual quality between subjective tests and optical devices using near-infrared (NIR) light in patients implanted with monofocal, multifocal and enlarged depth-of-focus (EDoF) intraocular lenses (IOLs). METHODS Cross-sectional study enrolling patients aged between 55 and 75 (axial length between 22 and 25 mm) bilaterally implanted with Tecnis IOLs (Johnson & Johnson) four months previously: 40 patients (80 eyes) with monofocal ZCB00, 41 patients (82 eyes) with bifocal diffractive ZMB00 and 48 patients (96 eyes) with EDoF Symfony. They were examined using subjective and objective tests. The subjective tests comprised visual acuity (VA) with ETDRS charts, contrast sensitivity (CS) with Pelli-Robson and CSV-1000E tests, and clear vision range (CVR). The objective tests using NIR light were performed with the KR-1 W wavefront analyzer and the OQAS. RESULTS In the subjective tests, the monofocal group achieved the best outcomes in some of the VA and CS sections, while the bifocal group obtained the worst outcomes in some of the CS sections. In the objective tests, the bifocal group achieved the best results for VA and CS. Discrepancies between pseudoaccommodation range and CVR were found in the bifocal and EDoF groups. CONCLUSIONS Assessment of visual quality using NIR light implies greater bias for diffractive lenses than for EDoF lenses. This bias may be even greater with devices using longer light wavelengths or Hartmann-Shack technology. The difference in wavelength between NIR and visible light leads to dimming of near-vision focus and magnification of distance focus.
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Affiliation(s)
- Francisco de Asís Bartol-Puyal
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain. .,Miguel Servet Ophthalmology Research Group (GIMSO), Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain. .,University of Zaragoza, Zaragoza, Spain.
| | - Galadriel Giménez
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain.,University of Zaragoza, Zaragoza, Spain
| | - Silvia Méndez-Martínez
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain.,University of Zaragoza, Zaragoza, Spain
| | - Irene Altemir
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain.,University of Zaragoza, Zaragoza, Spain
| | - José Manuel Larrosa
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain.,University of Zaragoza, Zaragoza, Spain
| | - Vicente Polo
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain.,University of Zaragoza, Zaragoza, Spain
| | - Luis Pablo
- Ophthalmology Department, Miguel Servet University Hospital, Zaragoza, Spain.,Miguel Servet Ophthalmology Research Group (GIMSO), Institute for Health Research Aragón (IIS Aragón), Zaragoza, Spain.,University of Zaragoza, Zaragoza, Spain.,Biotech Vision SLP, University of Zaragoza, Zaragoza, Spain
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Asano H, Hiraoka T, Seki Y, Shibata T, Osada H, Saruta T, Hatsusaka N, Fujikake F, Tabata Y, Mhina C, Sanyiwa A, Oshika T, Sasaki H. Distribution of corneal spherical aberration in a Tanzanian population. PLoS One 2019; 14:e0222297. [PMID: 31513608 PMCID: PMC6742233 DOI: 10.1371/journal.pone.0222297] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Accepted: 08/26/2019] [Indexed: 11/18/2022] Open
Abstract
Purpose To investigate the distribution of corneal spherical aberration (SA) in Tanzanian people of African descent, and to examine the correlation between corneal SA and ocular parameters. Design Cross-sectional population-based study. Methods Residents aged 40 years and older in three villages in the Mkuranga district in Tanzania were enlisted as study participants. Corneal higher-order aberrations (HOAs) for the right eye were measured with a wavefront analyzer (KR-1W, Topcon) and calculated for the central 6.0-mm zone. Corneal curvature radius (CR), corneal astigmatism, and axial length (AL) were also measured and their correlation with corneal SA was assessed. Results The right eyes of 657 participants (336 male, 321 female) were analyzed. The mean age of the subjects was 57.2 ± 10.3 years (mean ± SD). The mean corneal SA (Zernike spherical aberration coefficient C40) was 0.188 ± 0.095 μm (-0.242 to 0.613). The SAs in about three-quarters of all subjects were between 0.10 and 0.30 μm. The root mean squares of total corneal HOAs and the third- and fourth-order aberrations were 0.629 ± 0.250 μm, 0.539 ± 0.236 μm, and 0.269 ± 0.110 μm, respectively. Corneal SA showed weak significant correlations with CR (Spearman’s rank correlation coefficient, r = -0.177, p < 0.001), corneal astigmatism (r = -0.142, p < 0.001), AL (r = -0.168, p < 0.001), and age (r = -0.085, p < 0.05). Conclusions This finding may be beneficial for selecting aspheric intraocular lens in this population.
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Affiliation(s)
- Hiroki Asano
- Department of Ophthalmology, Tsuchiura Kyodo Hospital Namegata District Medical Center, Ibaraki, Japan
- * E-mail:
| | - Takahiro Hiraoka
- Department of Ophthalmology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
| | - Yusuke Seki
- Department of Ophthalmology, Kanazawa Medical University, Ishikawa, Japan
| | - Teppei Shibata
- Department of Ophthalmology, Kanazawa Medical University, Ishikawa, Japan
| | - Hiromi Osada
- Department of Ophthalmology, Kanazawa Medical University, Ishikawa, Japan
- Department of Ophthalmology, Nagano Matsushiro General Hospital, Nagano, Japan
| | - Takanori Saruta
- Department of Ophthalmology, Tsuchiura Kyodo Hospital Namegata District Medical Center, Ibaraki, Japan
| | - Natsuko Hatsusaka
- Department of Ophthalmology, Kanazawa Medical University, Ishikawa, Japan
| | - Fukumi Fujikake
- Visual Science Course, Department of Rehabilitation, Faculty of Medical Science and Welfare, Tohoku Bunka Gakuen University, Miyagi, Japan
| | | | - Cellina Mhina
- Department of Ophthalmology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Anna Sanyiwa
- Department of Ophthalmology, Muhimbili University of Health and Allied Sciences, Dar es Salaam, Tanzania
| | - Tetsuro Oshika
- Department of Ophthalmology, Institute of Clinical Medicine, University of Tsukuba, Ibaraki, Japan
| | - Hiroshi Sasaki
- Department of Ophthalmology, Kanazawa Medical University, Ishikawa, Japan
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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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