1
|
Mena-Guevara KJ, de Fez D, Molina-Martín A, Piñero DP. Binocular vision measurements with a new online digital platform: comparison with conventional clinical measures. Clin Exp Optom 2024; 107:716-722. [PMID: 37944504 DOI: 10.1080/08164622.2023.2277880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Revised: 10/22/2023] [Accepted: 10/27/2023] [Indexed: 11/12/2023] Open
Abstract
CLINICAL RELEVANCE New digital systems are being developed for evaluating different aspects of the visual function, such as binocularity, and it is important to know their real performance in clinical practice in order to use them appropriately. BACKGROUND The aim was to compare binocular vision measures obtained with an online digital platform with conventional measures using prisms and printed tests. METHODS Prospective study enrolling 49 healthy patients (mean age: 35.5 ± 13.6 years). A complete visual examination was performed including measurement of near phoria (cover test), negative fusional vergence (NFV) and positive fusional vergence (PFV) ranges (prism bar), and stereopsis (24 patients Randot Stereo Test and 25 patients TNO Random Dot Test 19th edition). These same parameters were also measured with the Bynocs system (Kanohi Eye Pvt Ltd). Bland - Altman plots were used to analyse the agreement between methods. RESULTS Digital measurement of near phoria was significantly lower than that obtained with the cover test, with a median difference (MD) of 4.71 (-0.07-20.07) prism dioptres (pd) (p < 0.001). No significant differences were found between Bynocs and prism bar methods in NFV break (MD 2.00, range -21-26 pd, p = 0.584) and recovery points (MD 0.00, range -16-24 pd, p = .571). Near PFV were significantly lower with Bynocs (break: MD -9.00, range -38-12 pd; recovery: MD -14.00, range -43-20 pd; p < 0.001). Bynocs stereoacuity threshold was significantly lower than that obtained with TNO (p = 0.004), but significantly higher compared to Randot (p < 0.001). Large and clinically relevant confidence intervals for the comparison between digital and conventional measures were detected in Passing-Bablok analysis. CONCLUSIONS Digital measures of near phoria, NFV, PFV, and stereopsis with the Bynocs platform cannot be used interchangeably with conventional measures. The normal ranges of normality for this new tool are defined.
Collapse
Affiliation(s)
- Kevin J Mena-Guevara
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - Dolores de Fez
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - Ainhoa Molina-Martín
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| |
Collapse
|
2
|
Orbegozo J, Pérez A, Basterra I, Noguera H, González L, Lauzirika G, Piñero DP. Clinical outcomes of a toric continuous range of vision presbyopia-correcting intraocular lens. J Cataract Refract Surg 2024; 50:724-732. [PMID: 38530027 DOI: 10.1097/j.jcrs.0000000000001428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Accepted: 02/12/2024] [Indexed: 03/27/2024]
Abstract
PURPOSE To evaluate the clinical outcomes of the toric version of a presbyopia-correcting intraocular lens (IOL) based on the combination of a diffractive-based extended depth-of-focus (EDOF) pattern and a diffractive multifocal platform. SETTING Miranza COI Bilbao, Bilbao, Spain. DESIGN Prospective case series. METHODS 35 patients (51 to 84 years) with corneal astigmatism ranging from 0.75 to 2.19 diopters (D) undergoing bilateral cataract surgery with implantation of the Synergy Toric II IOL were evaluated during a 3-month follow-up. Visual acuity, refraction, defocus curve, and patient-reported outcomes with the Catquest-9SF questionnaire were analyzed. A vectorial analysis was used to analyze the accuracy of astigmatic correction. RESULTS Mean 3-month monocular postoperative uncorrected distance, intermediate (80 cm) and near (40 cm) visual acuities were 0.06 ± 0.11 logMAR, 0.13 ± 0.12 logMAR, and 0.13 ± 0.09 logMAR, respectively. Mean monocular distance-corrected intermediate (80 cm) and near visual acuity (40 cm) were 0.11 ± 0.12 logMAR and 0.10 ± 0.10 logMAR, respectively. Mean binocular defocus curve showed visual acuities of 0.10 logMAR or better for defocus levels from +0.50 to -2.50 D. Residual cylinder was within ±0.50 D in 97.0% of eyes. The surgically induced astigmatism prediction error ranged between -0.49 D and 0.50 D, with a mean value of 0.04 ± 0.16 D. Mean absolute IOL rotation was 3.79 ± 2.94 degrees. Significant improvements were found in all Rasch-calibrated scores obtained with Catquest-9SF ( P < .001). CONCLUSIONS The implantation of the toric presbyopia-correcting IOL evaluated provides an efficacious astigmatic correction while providing a fully restoration of the visual function across different distances.
Collapse
Affiliation(s)
- Javier Orbegozo
- From the Centro Oftalmológico Integral Bilbao Berri SL, Miranza COI Bilbao, Bilbao, Spain (Orbegozo, Pérez, Basterra, Noguera); R&D Department of Miranza Group, Barcelona, Spain (González, Lauzirika); Instituto de Microcirugía Ocular (IMO) Barcelona, Miranza Group, Barcelona, Spain (González); Miranza Begitek, Donostia-San Sebastián, Spain (Lauzirika); Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain (Piñero)
| | | | | | | | | | | | | |
Collapse
|
3
|
Pérez-Sanz L, Charbel C, Poyales F, Garzón N. Optical and aberrometric evaluation of a new enhanced monofocal intraocular lens with isofocal optic design. Ophthalmic Physiol Opt 2024; 44:584-592. [PMID: 38349231 DOI: 10.1111/opo.13287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 01/29/2024] [Accepted: 01/30/2024] [Indexed: 04/08/2024]
Abstract
PURPOSE To evaluate the optical and aberrometric outcomes of an enhanced monofocal intraocular lens (ISOPure) compared with those of a standard monofocal lens (MicroPure) having the same platform and material. METHODS A prospective, comparative and randomised clinical study. A total of 28 eyes of 28 patients were randomly assigned to either group. Monocular visual acuity (VA) was measured at distance and intermediate under photopic and mesopic conditions. Aberrometry was analysed for 3.0-, 4.0-, 4.5- and 5.0 mm pupils. The contrast sensitivity defocus curve was measured for 3.0- and 4.5-mm pupils, while the modulation transfer function (MTF) and Strehl ratio (SR) were assessed with a double-pass system. All measurements were performed monocularly 3 months after surgery. RESULTS No significant differences were found for distance VA. Under photopic conditions, intermediate VA was better with the ISOPure lens, while no significant differences were found between the lenses under mesopic conditions. Internal and total aberrations were higher for the ISOPure lens. No significant differences were found for corneal aberrations. Additionally, both the contrast sensitivity defocus curve and optical quality showed similar behaviour for each lens, with the MTF cut-off frequency exceeding 30 c/deg in both cases. CONCLUSION The isofocal ISOPure lens enhanced intermediate VA without affecting distance VA under photopic conditions. Moreover, there were no significant differences in visual quality between the ISOPure and MicroPure lenses, despite the former exhibiting higher internal and total aberrations than the monofocal model.
Collapse
Affiliation(s)
- Lidia Pérez-Sanz
- Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
- Miranza IOA, Madrid, Spain
| | - Carla Charbel
- Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
| | | | - Nuria Garzón
- Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
| |
Collapse
|
4
|
Fernández J, Burguera N, Maldonado-Carmona C, Ginel J, Sáez-Martín Á, Rodríguez-Vallejo M. Simulations of Multifocal Vision in Patients With Previous Monofocal Intraocular Lens Implantation. J Refract Surg 2023; 39:831-839. [PMID: 38063826 DOI: 10.3928/1081597x-20231101-02] [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: 12/18/2023]
Abstract
PURPOSE To evaluate the effectiveness and patient acceptance of multifocal vision simulation in patients with previous monofocal intraocular lens (IOL) implantation, and to explore their willingness-to-pay (WTP) and willingness-to-accept (WTA) based on the perceived advantages and disadvantages of multifocal vision. METHODS Seventeen patients with previous monofocal IOL implantation participated in this cross-sectional study. The SimVis Gekko device (2EyesVision SL) was used to simulate monofocal (Evaluation B) and multifocal (Evaluation C) visual experiences, compared to their existing vision (Evaluation A). Visual acuity at three distances and defocus curves were measured. Patients responded to inquiries about visual quality in each evaluation, bothersomeness of photic phenomena, probability to select the visual experience, and the monetary value they associated with enhanced WTP or diminished WTA visual quality. RESULTS The simulations underestimated the visual acuity reported for the IOL in existing literature by one or two lines, depending on the testing distance. This underestimation was more pronounced in defocus curves. However, 70.6% of patients were likely or very likely to opt for multifocal vision, indicating they perceived the benefits of multifocality. The WTP for multifocal vision was twice that of monofocal vision, and the WTP/WTA ratio exceeded 1, suggesting the perceived vision benefits outweighed potential drawbacks. CONCLUSIONS Despite underestimating the expected postoperative visual performance, the multifocal simulation enabled patients to perceive the benefits of multifocal vision to some extent. This system could be beneficial in avoiding potential postoperative complaints, but the possible rise in false-positive results should be considered and evaluated in future research. [J Refract Surg. 2023;39(12):831-839.].
Collapse
|
5
|
Fernández J, Srinivasan S, Burguera N, Martínez J, Rodríguez-Vallejo M. One-year follow-up of a multifocal intraocular lens with optimized elevated phase shift. J Cataract Refract Surg 2023; 49:1018-1024. [PMID: 37464551 DOI: 10.1097/j.jcrs.0000000000001266] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 07/13/2023] [Indexed: 07/20/2023]
Abstract
PURPOSE To evaluate the standard outcomes of a multifocal intraocular lens (mIOL) with optimized elevated phase shift (EPS). SETTING Qvision, Ophthalmology Department, VITHAS Almería, Spain. DESIGN Retrospective observational. METHODS 41 patients, consecutively operated on cataracts or refractive lens exchange with the implantation of the Liberty 640PM (EPS 2.0) and followed during 12 months, were included in the analysis. Retrieved variables were visual acuities at far, intermediate, and near distances; defocus curves (VADC); and prediction error of 4 formulas optimized for IOLMaster 500 and Pentacam AXL Wave. Patient-reported outcomes were also obtained for assessing spectacle independence, satisfaction, bothersome to dysphotopsia, difficulties in daily life tasks, and decision to be operated with the same mIOL. RESULTS The median monocular efficacy with best distance correction was 0, 0.1, and 0.1 logMAR at far, intermediate, and near distances, respectively, with patients achieving binocularly a median of 0 logMAR at the 3 distances. VADC showed a depth of field of 3 diopters (D) above 0.2 logMAR with a median increase of 0.07 logMAR from -1.5 to -2.5 D. Complete spectacle independence was achieved at far distance, whereas 97.6% and 85.4% was achieved at intermediate and near distances, respectively. 7.3% of patients were bothered by dysphotopsia, and 92.6% of patients were likely to be operated again. CONCLUSIONS EPS 2.0 restored patients' vision in the full range of the depth of field with a nearly monotone decrease of visual performance from far to near, achieving high rates of spectacle independence at all distances and with low positive dysphotopsia rates ( ClinicalTrials.gov Identifier: NCT05735990).
Collapse
Affiliation(s)
- Joaquín Fernández
- From the Qvision, Department of Ophthalmology, VITHAS Almería Hospital, Almería, Spain (Fernández, Burguera, Martínez, Rodríguez-Vallejo); Department of Ophthalmology, University Hospital Ayr, Ayr, Scotland (Srinivasan)
| | | | | | | | | |
Collapse
|
6
|
Fernández J, Burguera N, Rocha-de-Lossada C, Rachwani-Anil R, Rodríguez-Vallejo M. Objective cataract grading methods and expected contrast sensitivity reestablishment with multifocal intraocular lenses. Int Ophthalmol 2023; 43:2825-2832. [PMID: 36871115 DOI: 10.1007/s10792-023-02680-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 02/25/2023] [Indexed: 03/06/2023]
Abstract
PURPOSE To determine the cut-off points for age and metrics provided by cataract grading objective systems for which a reestablishment in contrast sensitivity (CS) is expected after multifocal intraocular lens (MIOL) implantation. METHODS One hundred seven subjects were included in this retrospective analysis carried out during the screening for presbyopia and cataract surgery. Monocular distance corrected contrast sensitivity defocus curve (CSDC) and visual acuity were measured, and crystalline lens sclerosis was graded with three objective metrics: Ocular Scatter Index (OSI), Dysfunctional Lens Index (DLI) and Pentacam Nucleus Staging (PNS). A CS value of 0.8 logCS at far distance, following published literature on this matter, was selected to compute the cut-off that maximized the detection of eyes exceeding this value at the preoperative screening, either for age or objective metrics. RESULTS The CDCS showed a stronger correlation than CDVA with objective grading methods, whereas all objective metrics were significantly correlated between them (p < 0.05). The cut-offs for age, OSI, DLI and PNS were ≤ 62, ≤ 1.25, ≥ 7.67 and ≤ 1, respectively. The OSI provided the highest area under the receiver operating characteristic curve (0.85) followed by the age (0.84), DLI (0.74) and PNS (0.63). CONCLUSIONS Surgeons conducting clear lens exchange should communicate the possible distance CS loss after surgery with MIOL implantation according to the previous described cut-offs points. Age in combination with any cataract grading objective system is recommended to detect possible inconsistencies.
Collapse
Affiliation(s)
- Joaquín Fernández
- Qvision, Department of Ophthalmology, VITHAS Almería Hospital, 04120, Almería, Spain
| | - Noemí Burguera
- Qvision, Department of Ophthalmology, VITHAS Almería Hospital, 04120, Almería, Spain
| | - Carlos Rocha-de-Lossada
- Qvision, Department of Ophthalmology, VITHAS Almería Hospital, 04120, Almería, Spain
- Hospital Regional Universitario de Málaga, Plaza del Hospital Civil, S/N., 29009, Málaga, Spain
- Departamento de Cirugía, Universidad de Sevilla, Área de Oftalmología, Doctor Fedriani, S/N, 41009, Sevilla, Spain
| | - Rahul Rachwani-Anil
- Hospital Norte de Málaga, Avenida Poeta Muñoz Rojas, s/n, Málaga, 29200, Antequera, Spain
| | | |
Collapse
|
7
|
Fernández J, Alonso-Aliste F, Burguera N, Hernández-Lucena J, Amián-Cordero J, Rodríguez-Vallejo M. Effectiveness of SMILE Combined with Micro-Monovision in Presbyopic Patients: A Pilot Study. Life (Basel) 2023; 13:life13030838. [PMID: 36983993 PMCID: PMC10051050 DOI: 10.3390/life13030838] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 03/14/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
Binocular summation along all defocus range after a micro-monovision procedure has scarcely been studied. The aim of this pilot study was to evaluate the efficacy of SMILE combined with different levels of micro-monovision in presbyopic patients and to assess the binocular summation effect on contrast sensitivity defocus curves (CSDC) at the 6-month follow-up. Efficacy was assessed on the basis of visual acuity (VA) and stereopsis at far, intermediate, and near distances. Patient-reported outcomes (PROs) and binocular CSDC were also evaluated. Six patients completed the study with a programmed median anisometropia of 0.81 Diopter. The median binocular uncorrected VA was better than 0 logMAR at the three evaluated distances, and stereopsis was not impaired in any patient, achieving a median of ≤119 arcsec at any distance. CSDC increased binocularly after surgery, significantly in the range of -2 to -3 D (p < 0.05). No clinically relevant changes were observed in PROs compared with the preoperative period, and all patients achieved spectacle independence at intermediate/near distance and were likely or very likely to undergo the same surgery. In conclusion, micro-monovision with SMILE could be an effective procedure, with results that might be comparable to other laser correction techniques specifically designed for presbyopia correction.
Collapse
Affiliation(s)
- Joaquín Fernández
- Qvision, Ophthalmology Department, VITHAS Almería, 04120 Almería, Spain
| | | | - Noemí Burguera
- Qvision, Ophthalmology Department, VITHAS Almería, 04120 Almería, Spain
| | | | | | | |
Collapse
|
8
|
Guo D, Meng J, Zhang K, He W, Ma S, Lu ZL, Lu Y, Zhu X. Tolerance to lens tilt and decentration of two multifocal intraocular lenses: using the quick contrast sensitivity function method. EYE AND VISION (LONDON, ENGLAND) 2022; 9:45. [PMID: 36451233 PMCID: PMC9713962 DOI: 10.1186/s40662-022-00317-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Accepted: 11/05/2022] [Indexed: 12/05/2022]
Abstract
BACKGROUND Quick contrast sensitivity function (qCSF) method is an advanced quick method for contrast sensitivity function (CSF) evaluation. This study evaluated the contrast sensitivity (CS) of eyes undergoing cataract surgery with multifocal intraocular lens (IOL) implantation and its tolerance to IOL tilt and IOL decentration using the qCSF method. METHODS Patients undergoing uneventful phacoemulsification and a trifocal IOL (Zeiss AT LISA tri 839MP, Carl Zeiss, Germany) or an extended depth-of-focus (EDOF) IOL (Tecnis Symfony ZXR00, Johnson & Johnsons, USA) implantation were included. Monocular contrast sensitivity was measured using the qCSF method at one month post-surgery. IOL tilt and decentration were measured using an optical aberrometer (OPD-Scan III, NIDEK, Japan). RESULTS Seventy-two patients/eyes with the 839MP IOL and 64 patients/eyes with the ZXR00 IOL were included. Area under the log CSF (AULCSF) and CS acuity did not differ significantly between the two groups. The ZXR00 IOL group showed better CS at 1 cpd (1.137 ± 0.164 vs. 1.030 ± 0.183 logCS) and 1.5 cpd (1.163 ± 0.163 vs. 1.071 ± 0.161 logCS), while the 839MP IOL group had better CS at 6 cpd (0.855 ± 0.187 vs. 0.735 ± 0.363 logCS). In the 839MP IOL group, all CSF metrics were negatively correlated with IOL tilt (all P < 0.05), while in the ZXR00 IOL group, the CS at 3 cpd had no significant correlation with IOL tilt (P > 0.05). Among myopic eyes, fewer CSF metrics were negatively correlated with IOL tilt in the ZXR00 IOL group than in the 839MP IOL group. No significant correlation was found between CSF metrics and IOL decentration. CONCLUSIONS The ZXR00 and the 839MP IOL groups presented comparable CSF. CS was negatively correlated with IOL tilt, instead of decentration in multifocal IOLs, particularly among myopic eyes. The ZXR00 IOL had better tolerance to IOL tilt in myopic eyes.
Collapse
Affiliation(s)
- Dongling Guo
- grid.8547.e0000 0001 0125 2443Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,grid.506261.60000 0001 0706 7839Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China ,grid.8547.e0000 0001 0125 2443State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Jiaqi Meng
- grid.8547.e0000 0001 0125 2443Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,grid.506261.60000 0001 0706 7839Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China ,grid.8547.e0000 0001 0125 2443State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Keke Zhang
- grid.8547.e0000 0001 0125 2443Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,grid.506261.60000 0001 0706 7839Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China ,grid.8547.e0000 0001 0125 2443State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Wenwen He
- grid.8547.e0000 0001 0125 2443Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,grid.506261.60000 0001 0706 7839Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China ,grid.8547.e0000 0001 0125 2443State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Shiyu Ma
- grid.8547.e0000 0001 0125 2443Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,grid.506261.60000 0001 0706 7839Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China ,grid.8547.e0000 0001 0125 2443State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Zhong-lin Lu
- grid.449457.f0000 0004 5376 0118Division of Arts and Sciences, NYU Shanghai, Shanghai, China ,grid.137628.90000 0004 1936 8753Center for Neural Science and Department of Psychology, New York University, New York, USA ,grid.449457.f0000 0004 5376 0118NYU-ECNU Institute of Brain and Cognitive Science at NYU Shanghai, Shanghai, China
| | - Yi Lu
- grid.8547.e0000 0001 0125 2443Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,grid.506261.60000 0001 0706 7839Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China ,grid.8547.e0000 0001 0125 2443State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| | - Xiangjia Zhu
- grid.8547.e0000 0001 0125 2443Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, 200031 China ,grid.8547.e0000 0001 0125 2443NHC Key Laboratory of Myopia, Fudan University, Shanghai, China ,grid.506261.60000 0001 0706 7839Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China ,Shanghai Key Laboratory of Visual Impairment and Restoration, Shanghai, China ,grid.8547.e0000 0001 0125 2443State Key Laboratory of Medical Neurobiology, Fudan University, Shanghai, China
| |
Collapse
|
9
|
Standard for collecting and reporting outcomes of IOL–based refractive surgery: update for enhanced monofocal, EDOF, and multifocal IOLs. J Cataract Refract Surg 2022; 48:1235-1241. [DOI: 10.1097/j.jcrs.0000000000001013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
|
10
|
Abdulhussein D, Abdul Hussein M, Szymanka M, Farag S. A systematic review of the current availability of mobile applications in eyecare practices. Eur J Ophthalmol 2022; 33:11206721221131397. [PMID: 36199266 PMCID: PMC9999269 DOI: 10.1177/11206721221131397] [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: 10/25/2021] [Accepted: 09/09/2022] [Indexed: 11/16/2022]
Abstract
BACKGROUND There is an increasing shift towards non-communicable eye diseases (NCEDs) because of a demographic transition. Incorporation of telemedicine into everyday clinical practice is becoming increasingly popular. We sought to carry out a systematic review to look at which applications on portable devices are available for use in eyecare practices for patients with NCEDs, specifically refractive error, diabetic retinopathy, age-related macular degeneration (AMD) and glaucoma. METHODS Pubmed, EMBASE, Medline, PsychInfo databases were systematically searched using keywords and MeSH terms. Eligible articles included peer-reviewed, original full text articles evaluating apps for use on portable devices aimed at patients with NCEDs. RESULTS The initial search yielded 100 studies. Nine studies met the inclusion criteria, and an additional eight studies were identified through reference screening. Of the included studies, 29.4%% (n = 5) evaluated applications aimed for use to identify refractive errors, 35.3% (n = 6) aimed at patients with glaucoma, 23.5% (n = 4) for use by patients with AMD, 11.7% (n = 2) for the non-specific monitoring of visual acuity/fields. 76.5% (n = 13) of the studies showed that the application evaluated was an effective and reliable tool compared to clinical standards. CONCLUSIONS Portable device applications in patients with NCED have been shown to be effective. The use of these apps for patients is limited to either diagnostic or monitoring use. There is scope for apps which encompass other aspects of patient care that have been used in other specialties that may be applied to ophthalmic patients, including those with an educational aim which have a role in increasing compliance.
Collapse
Affiliation(s)
- D Abdulhussein
- The Imperial College Ophthalmic Research Group, Imperial College London, London, UK
| | | | - M Szymanka
- Faculty of Medicine, Imperial College London, London, UK
| | - S Farag
- Faculty of Medicine, Imperial College London, London, UK
| |
Collapse
|
11
|
Nováček LV, Němcová M, Sičová K, Tyx K, Rozsíval P, Němčanský J, Studený P. Simultaneous Presbyopia and Astigmatism Correction with a Novel Trifocal Toric Intraocular Lens-A One-Year Follow-Up. J Clin Med 2022; 11:4194. [PMID: 35887960 PMCID: PMC9322991 DOI: 10.3390/jcm11144194] [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: 06/09/2022] [Revised: 07/06/2022] [Accepted: 07/17/2022] [Indexed: 02/01/2023] Open
Abstract
The current investigation evaluates the efficiency of the trifocal toric Liberty 677MTY intraocular lens (IOL) in correcting preoperative corneal astigmatism in cataract patients demanding spectacle independence. The retrospective evaluation included 28 eyes of 15 patients with preoperative corneal astigmatism of at least 1.0 Dioptre (D). All patients were followed up for one year postoperatively. Residual refractive errors and visual acuities at multiple distances were measured. Binocular visual acuity and contrast sensitivity defocus curves were plotted. Visual functions and patient satisfaction were assessed. The efficiency of astigmatism correction was determined using the vector analysis method. The mean spherical equivalent refraction (SEQ) improved from 2.72 ± 1.62 D to 0.10 ± 0.48 D. The cylindric refraction decreased from 1.18 ± 0.45 D to 0.16 ± 0.31 D. Vector analysis proved efficient astigmatism correction with a centroid of 0.10 ± 0.34 D at 161°. Ninety-two percent of eyes resulted within 0.5 D from the target refraction. Visual acuities were 0.1 logMAR or better from +1.0 to -3.5 D defocus values. Visual tasks could be performed without major difficulties. Our patients were highly satisfied. Refractive and visual outcomes with the investigated presbyopia-correcting toric IOL are predictable and the lens provides excellent trifocal vision.
Collapse
Affiliation(s)
- Ladislav Viktor Nováček
- Department of Ophthalmology, School of Medicine Hradec Králové, Charles University Prague, 500 03 Hradec Králové, Czech Republic;
- Department of Ophthalmology, Institute of Aviation Medicine Prague, 160 00 Prague, Czech Republic; (M.N.); (K.S.); (K.T.)
- Department of Ophthalmology, Military University Hospital Prague, 1st Faculty of Medicine, Charles University Prague, 121 08 Prague, Czech Republic
- Department of Opthalmology, University Hospital Královské Vinohrady, 3rd Faculty of Medicine, Charles University Prague, 100 00 Prague, Czech Republic;
| | - Marie Němcová
- Department of Ophthalmology, Institute of Aviation Medicine Prague, 160 00 Prague, Czech Republic; (M.N.); (K.S.); (K.T.)
| | - Kristýna Sičová
- Department of Ophthalmology, Institute of Aviation Medicine Prague, 160 00 Prague, Czech Republic; (M.N.); (K.S.); (K.T.)
| | - Kateřina Tyx
- Department of Ophthalmology, Institute of Aviation Medicine Prague, 160 00 Prague, Czech Republic; (M.N.); (K.S.); (K.T.)
| | - Pavel Rozsíval
- Department of Ophthalmology, School of Medicine Hradec Králové, Charles University Prague, 500 03 Hradec Králové, Czech Republic;
- Department of Ophthalmology, Institute of Aviation Medicine Prague, 160 00 Prague, Czech Republic; (M.N.); (K.S.); (K.T.)
| | - Jan Němčanský
- Department of Ophthalmology, University Hospital Ostrava, 708 00 Ostrava, Czech Republic;
| | - Pavel Studený
- Department of Opthalmology, University Hospital Královské Vinohrady, 3rd Faculty of Medicine, Charles University Prague, 100 00 Prague, Czech Republic;
| |
Collapse
|
12
|
Suo L, Ke X, Zhang D, Qin X, Chen X, Hong Y, Dai W, Wu D, Zhang C, Zhang D. Use of Mobile Apps for Visual Acuity Assessment: Systematic Review and Meta-analysis. JMIR Mhealth Uhealth 2022; 10:e26275. [PMID: 35156935 PMCID: PMC8887635 DOI: 10.2196/26275] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 06/20/2021] [Accepted: 10/01/2021] [Indexed: 11/18/2022] Open
Abstract
Background Vision impairments (VIs) and blindness are major global public health issues. A visual acuity (VA) test is one of the most crucial standard psychophysical tests of visual function and has been widely used in a broad range of health care domains, especially in many clinical settings. In recent years, there has been increasing research on mobile app–based VA assessment designed to allow people to test their VA at any time and any location. Objective The goal of the review was to assess the accuracy and reliability of using mobile VA measurement apps. Methods We searched PubMed, Embase, Cochrane Library, and Google Scholar for relevant articles on mobile apps for VA assessment published between January 1, 2008, and July 1, 2020. Two researchers independently inspected and selected relevant studies. Eventually, we included 22 studies that assessed tablet or smartphone apps for VA measurement. We then analyzed sensitivity, specificity, and accuracy in the 6 papers we found through a meta-analysis. Results Most of the 22 selected studies can be considered of high quality based on the Quality Assessment of Diagnostic Accuracy Studies–2. In a meta-analysis of 6 studies involving 24,284 participants, we categorized the studies based on the age groups of the study participants (ie, aged 3-5 years, aged 6-22 years, and aged 55 years and older), examiner (ie, professional and nonprofessional examiners), and the type of mobile devices (ie, smartphone, iPad). In the group aged 3 to 5 years, the pooled sensitivity for VA app tests versus clinical VA tests was 0.87 (95% CI 0.79-0.93; P=.39), and the pooled specificity was 0.78 (95% CI 0.70-0.85; P=.37). In the group aged 6 to 22 years, the pooled sensitivity for VA app tests versus clinical VA tests was 0.86 (95% CI 0.84-0.87; P<.001), and the pooled specificity for VA app tests versus clinical VA tests was 0.91 (95% CI 0.90-0.91; P=.27). In the group aged 55 years and older, the pooled sensitivity for VA app tests versus clinical VA tests was 0.85 (95% CI 0.55-0.98), and the pooled specificity for VA app tests versus clinical VA tests was 0.98 (95% CI 0.95-0.99). We found that the nonprofessional examiner group (AUC 0.93) had higher accuracy than the professional examiner group (AUC 0.87). In the iPad-based group, the pooled sensitivity for VA app tests versus clinical VA tests was 0.86, and the pooled specificity was 0.79. In the smartphone-based group, the pooled sensitivity for VA app tests versus clinical VA tests was 0.86 (P<.001), and the pooled specificity for VA app tests versus clinical VA tests was 0.91 (P<.001). Conclusions In this study, we conducted a comprehensive review of the research on existing mobile apps for VA tests to investigate their diagnostic value and limitations. Evidence gained from this study suggests that mobile app–based VA tests can be useful for on-demand VI detection.
Collapse
Affiliation(s)
- Lingge Suo
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Xianghan Ke
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Di Zhang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Xuejiao Qin
- Department of Ophthalmology, Qilu Hospital of Shandong University, Jinan, China
| | - Xuhao Chen
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Ying Hong
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Wanwei Dai
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Defu Wu
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Chun Zhang
- Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Dongsong Zhang
- Department of Business Information Systems and Operations Management, University of North Carolina at Charlotte, Charlotte, NC, United States
| |
Collapse
|
13
|
Cervantes-Coste G, Tapia A, Corredor-Ortega C, Osorio M, Valdez R, Massaro M, Velasco-Barona C, Gonzalez-Salinas R. The Influence of Angle Alpha, Angle Kappa, and Optical Aberrations on Visual Outcomes after the Implantation of a High-Addition Trifocal IOL. J Clin Med 2022; 11:896. [PMID: 35160346 PMCID: PMC8836565 DOI: 10.3390/jcm11030896] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Revised: 01/26/2022] [Accepted: 02/04/2022] [Indexed: 12/28/2022] Open
Abstract
The aim of our investigation was to examine the possible correlations between optical aberrations, angle kappa, angle alpha, and visual outcomes following cataract surgery. In total, 56 eyes of 28 patients were implanted with the Liberty 677MY trifocal intraocular lens (IOL). Pre- and postoperative higher-order aberrations, coma, astigmatism, angle alpha, and angle kappa were registered, along with uncorrected and corrected visual acuities at multiple distances. Visual acuity and contrast sensitivity defocus curves were plotted, and the areas under the curve were calculated 1 and 3 months postoperatively. Excellent visual outcomes were found at all distances. Patients reported low levels of dysphotopsia, and 96.4% of patients achieved complete spectacle independence. While angle kappa significantly decreased during cataract surgery (p = 0.0007), angle alpha remained unchanged (p = 0.5158). Angle alpha correlated with postoperative HOAs and had a negative impact on near vision (p = 0.0543). Preoperative corneal HOA and coma had a strong adverse effect on future intermediate and near vision. Residual astigmatism significantly affected postoperative intermediate vision (p = 0.0091). Our results suggest that angle kappa is not an optimal predictive factor for future visual outcomes, while angle alpha and the preoperative screening of optical aberrations might help patient selection prior to multifocal IOL implantation.
Collapse
Affiliation(s)
- Guadalupe Cervantes-Coste
- Anterior Segment Surgery Department, Asociación para Evitar la Ceguera en México I.A.P., Mexico City 04030, Mexico; (A.T.); (C.C.-O.); (M.O.); (R.V.); (M.M.); (C.V.-B.); (R.G.-S.)
| | | | | | | | | | | | | | | |
Collapse
|
14
|
Mena-Guevara KJ, Piñero DP, de Fez D. Validation of Digital Applications for Evaluation of Visual Parameters: A Narrative Review. Vision (Basel) 2021; 5:vision5040058. [PMID: 34842847 PMCID: PMC8628957 DOI: 10.3390/vision5040058] [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: 07/17/2021] [Revised: 11/11/2021] [Accepted: 11/22/2021] [Indexed: 11/16/2022] Open
Abstract
The current review aimed to collect and critically analyze the scientific peer-reviewed literature that is available about the use of digital applications for evaluation of visual parameters in electronic devices (tablets and smartphones), confirming if there are studies calibrating and validating each of these applications. Three bibliographic search engines (using the search equation described in the paper) and the Mendeley reference manager search engine were used to complete the analysis. Only articles written in English and that are evaluating the use of tests in healthy patients to measure or characterize any visual function aspects using tablets or smartphones were included. Articles using electronic visual tests to assess the results of surgical procedures or are conducted in pathological conditions were excluded. A total of 19 articles meeting these inclusion and exclusion criteria were finally analyzed. One critical point of all these studies is that there was no mention of the characterization (spatial and/or colorimetrical) of screens and the stimuli used in most of them. Only two studies described some level of calibration of the digital device before the beginning of the study. Most revised articles described non-controlled comparatives studies (73.7%), reporting some level of scientific evidence on the validation of tools, although more consistent studies are needed.
Collapse
Affiliation(s)
- Kevin J. Mena-Guevara
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, San Vicente del Raspeig, 03690 Alicante, Spain; (K.J.M.-G.); (D.d.F.)
- Department of Pathology, University Miguel Hernández, Sant Joan d’Alacant, 03550 Alicante, Spain
| | - David P. Piñero
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, San Vicente del Raspeig, 03690 Alicante, Spain; (K.J.M.-G.); (D.d.F.)
- Department of Ophthalmology, Vithas Medimar International Hospital, 03016 Alicante, Spain
- Correspondence: ; Tel.: +34-965903500
| | - Dolores de Fez
- Group of Optics and Visual Perception, Department of Optics, Pharmacology and Anatomy, University of Alicante, San Vicente del Raspeig, 03690 Alicante, Spain; (K.J.M.-G.); (D.d.F.)
| |
Collapse
|
15
|
Fernández J, García-Montesinos J, Martínez J, Piñero DP, Rodríguez-Vallejo M. Posterior capsular opacification evaluation through contrast sensitivity defocus curves with two multifocal intraocular lenses of similar material. Graefes Arch Clin Exp Ophthalmol 2021; 259:2995-3002. [PMID: 34110451 DOI: 10.1007/s00417-021-05262-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 05/18/2021] [Accepted: 05/28/2021] [Indexed: 11/24/2022] Open
Abstract
PURPOSE To assess the degree of posterior capsular opacification (PCO) and its influence on contrast sensitivity defocus curve (CSDC) after implantation of two trifocal intraocular lenses (IOLs), Alsafit (AT) and Liberty (L), during a 12-month follow-up. A secondary aim was to evaluate the Nd:YAG capsulotomy rate in a long time. METHODS Data from 63 subjects, 34 implanted with AT and 29 with L, were retrospectively analyzed for this pilot study. In those eyes without capsulotomy during the first year (n = 58), CSDC at 3 and 12 months after surgery and PCO grading were measured, with additional answering of a visual function questionnaire (VF-14) and a question of general satisfaction. The period after surgery up to capsulotomy or last on-demand visit without Nd:YAG was recorded for survival analysis beyond the 12-month follow-up. RESULTS Total area under CSDC (TAUC) between 3 and 12 months decreased from 2.96 to 1.71 for AT (p < 0.05) and from 2.73 to 2.21 (p > 0.05) for L. Of eyes, 51.6, 19.3, and 29% with AT were graded as level 0, 1, and 2 of PCO, while 85.1, 11.1, and 3.7% of eyes with L were graded as level 0, 1, and 2 (p < 0.05). PCO grading was correlated with a decrease of TAUC (ρ = - 0.27, p = 0.04). Median time to require capsulotomy was 22 months with AT and 30 months with L (p < 0.05). CONCLUSIONS PCO decreases CSDC in patients with trifocal lenses. Despite using the same hydrophilic material, PCO grading and Nd:YAG capsulotomy rate was higher for AT than for L.
Collapse
Affiliation(s)
- Joaquín Fernández
- Department of Ophthalmology (Qvision), VITHAS Hospital, 04120, Almería, Spain
| | - Javier García-Montesinos
- Department of Ophthalmology (Qvision), VITHAS Hospital, 04120, Almería, Spain
- Department of Ophthalmology, Carlos Haya University Regional Hospital, 29010, Málaga, Spain
| | - Javier Martínez
- Department of Ophthalmology (Qvision), VITHAS Hospital, 04120, Almería, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- Department of Ophthalmology (OFTALMAR), Vithas Medimar International Hospital, Alicante, Spain
| | | |
Collapse
|
16
|
Fernández J, Rodríguez-Vallejo M, Martínez J, Burguera N, Piñero DP. Long-Term Efficacy, Visual Performance and Patient Reported Outcomes with a Trifocal Intraocular Lens: A Six-Year Follow-up. J Clin Med 2021; 10:jcm10092009. [PMID: 34067168 PMCID: PMC8125847 DOI: 10.3390/jcm10092009] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Revised: 04/30/2021] [Accepted: 05/01/2021] [Indexed: 11/23/2022] Open
Abstract
(1) Background: To evaluate the efficacy at 6 years postoperative after the implantation of a trifocal intraocular lens (IOL) AT Lisa Tri 839MP. The secondary objective was to evaluate the contrast sensitivity defocus curve (CSDC), light distortion analysis (LDA), and patient reported outcomes (PROs). (2) Methods: Sixty-two subjects participated in phone call interviews to collect data regarding a visual function questionnaire (VF-14), a patient reported spectacle independence questionnaire (PRSIQ), and questions related to satisfaction and decision to be implanted with the same IOL. Thirty-seven of these subjects were consecutively invited to a study visit for measurement of their visual acuity (VA), CSDC, and LDA. (3) Results: The mean monocular distance corrected VA was −0.05, 0.08, and 0.05 logMAR at far and distances of 67 cm and 40 cm, respectively. These VAs were significantly superior to those reported in previous literature (p < 0.05). The total area under the CSDC was 2.29 logCS/m−1 and the light distortion index 18.82%. The mean VF-14 score was 94.73, with 19.4% of subjects requiring spectacles occasionally for near distances, and 88.9% considering the decision of being operated again; (4) Conclusions: Long-term AT LISA Tri 839MP IOL efficacy results were equal or better than those reported 12 months postoperatively in previous studies. The spectacle independence and satisfaction rates were comparable to those reported in short-term studies.
Collapse
Affiliation(s)
- Joaquín Fernández
- Qvision, Department of Ophthalmology of VITHAS Almería Hospital, 04120 Almería, Spain; (J.F.); (J.M.); (N.B.)
| | - Manuel Rodríguez-Vallejo
- Qvision, Department of Ophthalmology of VITHAS Almería Hospital, 04120 Almería, Spain; (J.F.); (J.M.); (N.B.)
- Correspondence: ; Tel.: +34-9-5021-7171
| | - Javier Martínez
- Qvision, Department of Ophthalmology of VITHAS Almería Hospital, 04120 Almería, Spain; (J.F.); (J.M.); (N.B.)
| | - Noemi Burguera
- Qvision, Department of Ophthalmology of VITHAS Almería Hospital, 04120 Almería, Spain; (J.F.); (J.M.); (N.B.)
| | - David P. Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, 03009 Alicante, Spain;
- Department of Ophthalmology (IMQO-Oftalmar), Vithas Medimar International Hospital, 03016 Alicante, Spain
| |
Collapse
|
17
|
Fernández J, Rodríguez-Vallejo M, Martínez J, Burguera N, Piñero DP. Agreement between subjective and predicted high and low contrast visual acuities with a double-pass system. Graefes Arch Clin Exp Ophthalmol 2020; 259:1651-1657. [PMID: 33128671 DOI: 10.1007/s00417-020-04987-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 09/23/2020] [Accepted: 10/20/2020] [Indexed: 10/23/2022] Open
Abstract
PURPOSE To evaluate the agreement between subjective high and low contrast visual acuity (VA) and predicted values from double-pass system measurements in healthy candidates to laser refractive surgery. METHODS Ninety-two eyes measured during the preoperative screening to laser refractive surgery were included in this retrospective analysis. High contrast subjective visual acuity (HCVA) and low contrasts at 20% (LCVA20) and 9% (LCVA9) were compared with the predicted VA obtained with a commercial double-pass system (OQAS) at the same levels of contrast, 100% (OV100), 20% (OV20), and 9% (OV9). The agreement was evaluated with Bland-Altman analysis computing the limits of agreement (LoAs) and the correlations with the spearman rho. RESULTS An underestimation of VA was obtained with the double-pass system for the highest contrast. Differences between predictive and subjective measurements were statistically significant for 100% contrast (- 0.08 logMAR, p < 0.0005), but not for 20% (- 0.03 logMAR, p = 0.07) and 9% (- 0.02 logMAR, p = 0.9) of contrasts. The LoAs increased with the decrease of contrast from 0.29 with 100% to 0.39 logMAR with 9% of contrast. A weak correlation was obtained between subjective and predicted VA (rho ≤ 0.33) that was only significant for 100% (p = 0.001) and 20% (p = 0.004) contrasts. CONCLUSION Mean differences between methods were reasonably small so mean results obtained for predicted VA in OQAS studies can be considered as reliable, at least in healthy subjects and for low contrast. However, limits of agreement were considerably poor which means that OQAS cannot replace individual subjective measurements of VA in clinical practice.
Collapse
Affiliation(s)
- Joaquín Fernández
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, 04120, Almería, Spain
| | | | - Javier Martínez
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, 04120, Almería, Spain
| | - Noemi Burguera
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, 04120, Almería, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain.,Department of Ophthalmology (IMQO-Oftalmar), Vithas Medimar International Hospital, Alicante, Spain
| |
Collapse
|
18
|
Fernández J, Rodríguez-Vallejo M, Martínez J, Burguera N, Piñero DP. Pupil dependence assessment with multifocal intraocular lenses through visual acuity and contrast sensitivity defocus curves. Eur J Ophthalmol 2020; 31:2989-2996. [PMID: 32615809 DOI: 10.1177/1120672120940202] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE To identify the most sensitive visual performance metric for evaluating the pupil-dependency of a multifocal intraocular lens (MIOL) and to determine the pupil measurement method most correlated with such metric. METHODS Twenty-seven right eyes implanted with a MIOL were included in the analysis. Three pupil size measurements were obtained preoperatively and at 1 month after surgery with the Keratograph 5M system: photopic (PP), mesopic (MP), and the average from both (AP). Pupil was also measured with a rule (RP) under the same light conditions of postoperative visual performance measurements that included, corrected visual acuities (VA) at three distances (far, 67 cm and 40 cm), visual acuity (VADC) and contrast sensitivity defocus curves for optotype sizes of 0.3 logMAR (CSDC3) and 0.7 logMAR (CSDC7). Differences in visual performance were also analyzed for eyes with RP > 3 mm (Group A) and RP ⩽ 3 mm (Group B). RESULTS PP diameter decreased after surgery by 16% (p = 0.001), whereas MP (p = 0.013) and AP (p = 0.008) decreased by 10%. The best agreement with RP was obtained for AP. Group B showed a trend to better performance than Group A for all the included metrics (p > 0.05). From the three types of defocus curves, CSDC3 obtained generally highest statistical power for testing differences between groups. The strongest statistically significant correlations between pupil size and CSDC3 were obtained for RP and AP. CONCLUSION The CSDC3 was the most sensitive metric to detect MIOL pupil-dependency. PR and AP were more correlated with CSDC3 than PP and MP.
Collapse
Affiliation(s)
- Joaquín Fernández
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, Almería, Spain
| | | | - Javier Martínez
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, Almería, Spain
| | - Noemi Burguera
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, Almería, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain.,Department of Ophthalmology (IMQO-Oftalmar), Vithas Medimar International Hospital, Alicante, Spain
| |
Collapse
|
19
|
Rocha-de-Lossada C, Sánchez-González JM, Borroni D, Peraza-Nieves J. Standardisation in the methodology and interpretation of the defocus curves and contrast sensitivity in the evaluation of intraocular lenses. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2020; 95:313-314. [PMID: 32345480 DOI: 10.1016/j.oftal.2020.03.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2020] [Revised: 03/19/2020] [Accepted: 03/24/2020] [Indexed: 05/22/2023]
Affiliation(s)
| | - J M Sánchez-González
- Tecnolaser Clinic Vision, Sevilla, España; Departamento de Física de la Materia Condensada, Área óptica, Universidad de Sevilla, Sevilla, España
| | - D Borroni
- Department of Corneal and External Eye Diseases, St. Paul's Eye Unit, Royal Liverpool University Hospital, Liverpool, UK; Department of Doctoral Studies, Riga Stradins University, Riga, Latvia
| | | |
Collapse
|
20
|
Fernández J, Rodríguez-Vallejo M, Martínez J, Burguera N, Piñero DP. Prediction of Visual Acuity and Contrast Sensitivity From Optical Simulations With Multifocal Intraocular Lenses. J Refract Surg 2020; 35:789-795. [PMID: 31830295 DOI: 10.3928/1081597x-20191024-01] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 10/23/2019] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate whether the prediction of visual performance based on the modulation transfer function area (MTFa) calculated with optical simulations is better correlated with visual acuity or contrast sensitivity obtained from defocus curves in patients implanted with a trifocal intraocular lens. METHODS Biometric eye data from 43 patients were used to create a mean eye model. A trifocal intraocular lens with a power obtained from the mean of the eyes implanted was incorporated into the model and the MTFa was calculated at the 11 defocus planes corresponding the 11 defocus locations measured in clinical practice. Simulations were conducted for pupil diameters of 2.5, 3, 3.5, and 4 mm. The MTFa correlation with visual acuity and contrast sensitivity was evaluated with the mean obtained after stratification of the clinical sample in four groups according to the previous pupil diameters. RESULTS A linear model predicted the visual acuity and contrast sensitivity from MTFa with similar accuracy to nonlinear models, with R2 approximately 0.50 for visual acuity and approximately 0.42 for contrast sensitivity. A change of -0.01 logMAR and -0.02 logC was produced per unit of MTFa for visual acuity and contrast sensitivity, respectively. The mean difference between the visual acuity and contrast sensitivity obtained from the model and that measured in clinical practice was close to zero, but the bias varied depending on the defocus lens used, with higher deviation at -0.50 and -3.00 diopters of defocus. CONCLUSIONS The MTFa obtained from optical simulations can be used to predict the mean visual acuity and contrast sensitivity consistently, with contrast sensitivity being more sensitive but with higher bias. [J Refract Surg. 2019;35(12):789-795.].
Collapse
|
21
|
Fernández J, Rodríguez-Vallejo M, Martínez J, Tauste A, Piñero DP. Patient selection to optimize near vision performance with a low-addition trifocal lens. JOURNAL OF OPTOMETRY 2020; 13:50-58. [PMID: 31680039 PMCID: PMC6951843 DOI: 10.1016/j.optom.2019.06.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 05/31/2019] [Accepted: 06/26/2019] [Indexed: 06/10/2023]
Abstract
PURPOSE To assess the impact of ocular biometric variables on the visual performance achieved with a low addition trifocal intraocular lens (MIOL). METHODS Retrospective observational study including 34 eyes. Preoperative measured variables included mean corneal power (Km), corneal regular astigmatism (RA), anterior chamber depth (ACD), axial length (AXL), total irregular astigmatism (IA), spherical aberration (SA) and distance from pupil center to vertex normal (µ). Same variables were retrieved from the three month visit follow-up in addition to the actual lens position (ALP), the calculated effective addition (EA), the IOL centration from vertex normal (d), and the visual acuity defocus curve. The area under the defocus curve was computed along the total curve (TAUC) and ranges for far (FAUC), intermediate (IAUC) and near vision (NAUC). The sample was split in two groups of 17 eyes with TAUCs above and below the mean, and the differences among groups for different ocular parameters were assessed. RESULTS The group of eyes above TAUC of 2.03 logMAR*m-1 showed significantly lower Km and greater AXL and SA. Km was negatively correlated with TAUC and NAUC. NAUC was negatively correlated with IA and positively with d. A multiple lineal regression model including Km, d, and IA predicted NAUC (r-square = 34%). No significant differences between IA and SA were found between preoperative and postoperative values but µ significantly decreased after surgery. CONCLUSIONS The mean corneal power, irregular astigmatism, and centration from vertex normal should be considered for optimizing the near visual performance with this MIOL.
Collapse
Affiliation(s)
- Joaquín Fernández
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, 04120, Almería, Spain
| | | | - Javier Martínez
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, 04120, Almería, Spain
| | - Ana Tauste
- Department of Ophthalmology (Qvision), Vithas Virgen del Mar Hospital, 04120, Almería, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain; Department of Ophthalmology (IMQO-Oftalmar), Vithas Medimar International Hospital, Alicante, Spain
| |
Collapse
|