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Wolffsohn JS, Berkow D, Chan KY, Chaurasiya SK, Fadel D, Haddad M, Imane T, Jones L, Sheppard AL, Vianya-Estopa M, Walsh K, Woods J, Zeri F, Morgan PB. BCLA CLEAR Presbyopia: Evaluation and diagnosis. Cont Lens Anterior Eye 2024; 47:102156. [PMID: 38641525 DOI: 10.1016/j.clae.2024.102156] [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: 04/21/2024]
Abstract
It is important to be able to measure the range of clear focus in clinical practice to advise on presbyopia correction techniques and to optimise the correction power. Both subjective and objective techniques are necessary: subjective techniques (such as patient reported outcome questionnaires and defocus curves) assess the impact of presbyopia on a patient and how the combination of residual objective accommodation and their natural DoF work for them; objective techniques (such as autorefraction, corneal topography and lens imaging) allow the clinician to understand how well a technique is working optically and whether it is the right choice or how adjustments can be made to optimise performance. Techniques to assess visual performance and adverse effects must be carefully conducted to gain a reliable end-point, considering the target size, contrast and illumination. Objective techniques are generally more reliable, can help to explain unexpected subjective results and imaging can be a powerful communication tool with patients. A clear diagnosis, excluding factors such as binocular vision issues or digital eye strain that can also cause similar symptoms, is critical for the patient to understand and adapt to presbyopia. Some corrective options are more permanent, such as implanted inlays / intraocular lenses or laser refractive surgery, so the optics can be trialled with contact lenses in advance (including differences between the eyes) to better communicate with the patient how the optics will work for them so they can make an informed choice.
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Affiliation(s)
- James S Wolffsohn
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom.
| | - David Berkow
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
| | - Ka Yin Chan
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong
| | - Suraj K Chaurasiya
- Department of Contact Lens and Anterior Segment, CL Gupta Eye Institute, Moradabad, India; Department of Optometry and Vision Science, CL Gupta Eye Institute, Moradabad, India
| | - Daddi Fadel
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Mera Haddad
- Faculty of Applied Medical Sciences, Department of Allied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Tarib Imane
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, United States
| | - Lyndon Jones
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong; Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Amy L Sheppard
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom
| | - Marta Vianya-Estopa
- Vision and Hearing Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
| | - Karen Walsh
- CooperVision Inc., San Ramon, CA, United States
| | - Jill Woods
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Fabrizio Zeri
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom; University of Milano-Bicocca, Department of Materials Science, Milan, Italy
| | - Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, University of Manchester, United Kingdom
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Ibrahim P, Assaf JF, Bejjani R, Torbey J, Yehia M, Bahir Al-Ulloom S, Awwad ST. Repeatability of pyramidal aberrometer measurements in keratoconus and normal eyes. J Cataract Refract Surg 2024; 50:739-745. [PMID: 38480607 DOI: 10.1097/j.jcrs.0000000000001443] [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: 07/03/2023] [Accepted: 03/08/2024] [Indexed: 06/25/2024]
Abstract
PURPOSE To evaluate the intrasubject repeatability of pyramidal aberrometer measurements in a sample of keratoconus and normal eyes. SETTING American University of Beirut Medical Center, Beirut, Lebanon. DESIGN Prospective comparative repeatability analysis. METHODS Study population: Keratoconus and normal eyes from adult patients. Observation procedures: Each eye was evaluated with 3 consecutive acquisitions using a pyramidal aberrometer. Main outcome measures: The repeatability of different ocular higher-order aberrations and lower-order aberrations (HOAs and LOAs, respectively), and Zernike coefficients down to the fifth order, was evaluated. Repeatability was assessed by within-subject SDs (Sw), repeatability limits ( r ), and intraclass correlation coefficients (ICCs), among other parameters. RESULTS 72 keratoconus patients (72 eyes) and 76 normal patients (76 eyes) were included. In normal and keratoconus eyes, the ICC of total LOAs and HOAs, as well as each of the Zernike coefficients, was >0.9. The Sw for keratoconus eyes with mean maximal keratometry (Kmax) <50 diopters (D) was 0.1345 for total LOAs, 0.0619 for total HOAs, 0.0292 for horizontal coma, 0.0561 for vertical coma, and 0.0221 for spherical aberration as compared with 0.2696, 0.1486, 0.0972, 0.1497, and 0.0757 for keratoconus eyes with Kmax ≥50 D. Similar trend of better repeatability for grade 1 keratoconus and HOAs <2 D as compared with grades 2 and 3 keratoconus and eyes with HOAs >2 D were also noted. CONCLUSIONS Ocular aberrometer measurements generated by high definition pyramidal aberrometers have high repeatability in both normal and mild keratoconus eyes and moderate repeatability, yet still clinically acceptable, in advanced keratoconus. This is of particular importance in ocular wavefront-guided treatments.
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Affiliation(s)
- Perla Ibrahim
- From the Department of Ophthalmology, American University of Beirut Medical Center, Beirut, Lebanon (Ibrahim, Torbey, Yehia, Al-Ulloom, Awwad); American University of Beirut, Faculty of Medicine, Beirut, Lebanon (Assaf, Bejjani)
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Ma S, Gao R, Sun J, Yang J, Wen K, Chen X, Zhao F, Xu X, Tian F. Comparison of two swept-source optical coherence tomography devices, a Scheimpflug camera system and a ray-tracing aberrometer in the measurement of corneal power in patients with cataract. Graefes Arch Clin Exp Ophthalmol 2024; 262:1567-1578. [PMID: 38150029 PMCID: PMC11031469 DOI: 10.1007/s00417-023-06348-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 12/03/2023] [Accepted: 12/14/2023] [Indexed: 12/28/2023] Open
Abstract
PURPOSE To assess the differences and similarities in the corneal curvature obtained by two swept-source optical coherence tomography (SS-OCT) devices, Scheimpflug imaging system and one ray tracing aberrometer in patients with cataracts. Moreover, this study aimed to compare the differences in posterior corneal (PK), total corneal (TK) and true net power (TNP) measurements among the IOLMaster 700, CASIA2, and Pentacam. METHODS A total of 200 eyes of 200 patients (116 female, 58%) were enrolled in this study, with a mean age of 65.9 ± 9.5 years. The flattest (Kf), steepest (Ks), and mean cornal powers (Km), J0, and J45 were obtained using two SS-OCT-based biometric devices, one rotating camera system and one ray-tracing aberrometer. The PK, TK and TNP values were also measured using these devices. To evaluate the differences and similarities between the devicves, the Friedman test, Pearson correlation coefficient (r), intraclass coefficient correlation (ICC) and Bland‒Altman plots with 95% limits of agreement (LoA) were used, and boxplots and stacked histograms were generated to describe the distributions of the data. RESULTS There were no significant differences between the IOLMaster 700 and Pentacam for any of the keratometry values. Additionally, there were no significant differences between the IOLMaster 700 and iTrace in evaluating J0 and J45. Bland‒Altman plots revealed relatively wide LoA widths, almost larger than 1 diopter for the keratometry values and almost larger than 0.5 diopter for J0 and J45 values among the four devices. In terms of PK and TK values, significant differences and low ICCs were found among the three devices. CONCLUSIONS Although strong correlations and good agreement were found among the IOLMaster700, CASIA2, Pentacam and iTrace for Kf, Ks, Km and J0, J45, it seems that the measurements should not be used interchangeably because of the wide LoA widths and the presence of significant differences among the devices. Similarly, due to significant differences and low ICCs, the PK, TK and TNP values obtained by IOLMaster 700, CASIA2, and Pentacam should not be used interchangeably.
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Affiliation(s)
- Shan Ma
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300380, China
- Weifang Eye Hospital, National Key Clinical Specialty, Zhengda Guangming Eye Group, Weifang, 261000, China
- Weifang Eye Institute, Weifang, 261000, China
| | - Rongyu Gao
- Weifang Eye Hospital, National Key Clinical Specialty, Zhengda Guangming Eye Group, Weifang, 261000, China
- Weifang Eye Institute, Weifang, 261000, China
| | - Jing Sun
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300380, China
| | - Jun Yang
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300380, China
| | - Kai Wen
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300380, China
| | - Xiteng Chen
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300380, China
| | - Fangyu Zhao
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300380, China
| | - Xinyan Xu
- Weifang Eye Hospital, National Key Clinical Specialty, Zhengda Guangming Eye Group, Weifang, 261000, China.
- Weifang Eye Institute, Weifang, 261000, China.
| | - Fang Tian
- Tianjin Key Laboratory of Retinal Functions and Diseases, Tianjin Branch of National Clinical Research Center for Ocular Disease, Eye Institute and School of Optometry, Tianjin Medical University Eye Hospital, Tianjin, 300380, China.
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Erdinest N, London N, Landau D, Barbara R, Barbara A, Naroo SA. Higher order aberrations in keratoconus. Int Ophthalmol 2024; 44:172. [PMID: 38594548 DOI: 10.1007/s10792-024-03118-5] [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: 03/30/2023] [Accepted: 03/24/2024] [Indexed: 04/11/2024]
Abstract
INTRODUCTION Keratoconus is a progressive disorder of the cornea that causes thinning (Sedaghat et al. in Sci Rep 11(1):11971, 2021), ectasia, and irregular astigmatism, resulting in poor visual acuity that cannot be corrected with standard sphero-cylindrical spectacle lenses. One feature distinguishing keratoconic corneas is ocular aberrations, manifesting up to five or six times the amount of higher-order aberrations than a normal, healthy eye. These aberrations can cause visual disturbances even at the very early stages of the disease. METHODS In the past, a diagnosis was derived from clinical symptoms, but technological advances have revealed multiple pre-clinical features, allowing for the differentiation between keratoconic and normal eyes at a much earlier stage. These include anterior and posterior corneal surface elevations, the corneal pachymetry profile, corneal epithelial patterns, wavefront aberration metrics, and corneal biomechanics (Sedaghat et al. in Sci Rep 11(1):11971, 2021).This review discusses the aberrations associated with keratoconus, how to measure them, and treatment methods to minimize their negative influence. CONCLUSIONS Early diagnosis can lead to early treatment and may allow for arresting progression, thereby improving the long-term prognosis. With the acceleration of refractive surgery, it is important to identify patients with keratoconus, as they are usually contraindicated for refractive surgery.
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Affiliation(s)
- Nir Erdinest
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | | | - David Landau
- Department of Ophthalmology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Ramez Barbara
- Ophthalmology Department, University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Adel Barbara
- IVISION Cornea and Refractive Surgery Center, Haifa, Israel
| | - Shehzad A Naroo
- College of Health and Life Sciences, Aston University, Birmingham, UK
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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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Yakar K, Kan E, Duran M. Comparison between wavefront-derived refraction and auto-refraction. Photodiagnosis Photodyn Ther 2023; 44:103712. [PMID: 37459941 DOI: 10.1016/j.pdpdt.2023.103712] [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: 05/13/2023] [Revised: 07/02/2023] [Accepted: 07/14/2023] [Indexed: 09/02/2023]
Abstract
BACKGROUND This study aimed to compare objective refractive errors and keratometry measurements obtained using the Nidek OPD-Scan II aberrometer/topographer and Topcon KR 8900 autorefractokeratometer. METHODS The right eye medical records of 176 patients aged 18-35 years who were admitted to our clinic as refractive surgery candidates were tested for refractive status and keratometry measurements with a Nidek OPD-Scan II aberrometer/topographer and a standard table-top autorefractokeratometer (Topcon KR 8900) before and after the induction of cycloplegia. Patients who had undergone any eye surgery and had hereditary, ectatic, or acquired corneal pathology were excluded. Refractive data were compared as spheres, cylinders, spherical equivalents, and power vectors before and after the induction of cycloplegia. Flat and steep keratometry (K1-K2) readings were recorded in diopters (D) and axis degrees, respectively, for each eye. RESULTS The spherical, cylindrical, spherical equivalence, J0-J45 vector values and K1-K2 readings (D, axis) between the two devices were statistically significant before and after the induction of cycloplegia (p<0.05). Bland-Altman analysis identified mean differences (95%CI of limits of agreement) of 0.77 (-0,57 to 2,11) in sphere, 0.74 (-0,54 to 2,01) in spherical equivalent, -0,07 (-0,41 to 0,26) in J0 vector, 0,06 (-0,31 to 0,43) in J45 vector, -0,16 (-0,66 to 0,33) in K1, -0,23 (-0,79 to 0,33) in K2 values before induction of cycloplegia. CONCLUSION The refractive and keratometry results of the Nidek OPD Scan II system and Topcon KR 8900 standard table-top autorefractokeratometer are not interchangeable in healthy adult population before and after induction of cycloplegia.
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Affiliation(s)
- Konuralp Yakar
- Department of Ophthalmology, Medicana International Hospital, Samsun, Turkey.
| | - Emrah Kan
- Department of Ophthalmology, Medicana International Hospital, Samsun, Turkey
| | - Mustafa Duran
- Department of Ophthalmology, Hitit University Erol Olçok Training and Research Hospital, Çorum, Turkey
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Skrzypecki J, Izdebska J, Ordon AJ, Przybek-Skrzypecka J, Szaflik JP. Spherical aberrations and their role in modern ophthalmology. Clin Exp Optom 2023; 106:703-710. [PMID: 36822601 DOI: 10.1080/08164622.2022.2160235] [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: 07/20/2022] [Revised: 10/31/2022] [Accepted: 11/03/2022] [Indexed: 02/25/2023] Open
Abstract
Spherical aberration is an imperfection of the optical system of the human eye. The role of spherical aberration of the human eye in the quality of vision and pseudoaccommodation is reviewed. Spherical aberration is an imperfection of the optical system of the human eye. In most cases, due to well-developed neuroadaptation, it is insignificant for the perception of the image. Nevertheless, its role in modern ophthalmology is far from straightforward. On the one hand, there are clinical scenarios in which an excess of spherical aberration degrades the retinal image and leads to a high dissatisfaction rate among patients.©Recently, there is a growing interest in the modulation of spherical aberration in the clinical setting. Modern intraocular lenses as well as laser refractive procedures are aimed at interfering with spherical aberrations of the optical system in order to increase range of pseudoaccommodation. Here, we review the role of spherical aberration of the human eye in the quality of vision and pseudoaccommodation.
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Affiliation(s)
- Janusz Skrzypecki
- Departament of Ophthalmology, Independent Public University Eye Hospital, Warsaw, Poland
- Department of Experimental Physiology and Pathophysiology, Medical University of Warsaw, Warsaw, Poland
| | - Justyna Izdebska
- Departament of Ophthalmology, Independent Public University Eye Hospital, Warsaw, Poland
- Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland
| | - Agata Joanna Ordon
- Departament of Ophthalmology, Independent Public University Eye Hospital, Warsaw, Poland
- Department of Binocular Vision Pathophysiology and Strabismus, Medical University of Lodz, Lodz, Poland
| | - Joana Przybek-Skrzypecka
- Departament of Ophthalmology, Independent Public University Eye Hospital, Warsaw, Poland
- Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland
| | - Jacek Pawel Szaflik
- Departament of Ophthalmology, Independent Public University Eye Hospital, Warsaw, Poland
- Department of Ophthalmology, Medical University of Warsaw, Warsaw, Poland
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Beniwal A, Bafna RK. A Case of Anterior Lenticonus Managed With Ray Tracing Aberrometry. Asia Pac J Ophthalmol (Phila) 2023; 12:343. [PMID: 36650073 DOI: 10.1097/apo.0000000000000536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Accepted: 04/06/2022] [Indexed: 01/19/2023] Open
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Koh S, Inoue R, Iwamoto Y, Mihashi T, Soma T, Maeda N, Nishida K. Comparison of Ocular Wavefront Aberration Measurements Obtained Using Two Hartmann-Shack Wavefront Aberrometers. Eye Contact Lens 2023; 49:98-103. [PMID: 36729105 DOI: 10.1097/icl.0000000000000965] [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: 05/20/2022] [Accepted: 11/03/2022] [Indexed: 02/03/2023]
Abstract
OBJECTIVES To assess agreement between measurements of ocular wavefront aberrations obtained using the Pentacam AXL Wave (Oculus Optikgeräte GmbH) (Aberrometer A) and KR-1W (Topcon Corp) (Aberrometer B), both of which are based on the Hartmann-Shack principle. METHODS In this prospective case-control study, ocular wavefront aberrations measurements were obtained using both aberrometers in patients with keratoconus (KC) and control participants. Ocular wavefront aberrations were measured through the natural pupil without dilation using both devices in a dark room. For both aberrometers, accommodation was inhibited by automatically adding fogging. The individual Zernike coefficients from the second to fourth order were compared between the two aberrometers for a 4-mm pupil diameter. RESULTS Twenty-six KC and 29 control eyes were assessed. Statistically significant correlations ( P <0.05) were observed for all Zernike coefficients, except for Z 4-2 in the control group. Bland-Altman analysis indicated good agreement between aberrometers and no statistically significant differences in the control group. However, in the KC group, patterns of proportional error were observed in vertical coma Z 3-1 (r=0.338, P =0.008), trefoil Z 4-4 (r=0.701, P =0.003), secondary astigmatism Z 4-2 (r=0.348, P =0.025), and spherical aberrations Z 40 (r=0.407, P =0.012). CONCLUSIONS The Zernike coefficient values measured by the two aberrometers were well correlated in the control and KC groups. However, in eyes with KC, Aberrometer B tended to present greater values in several Zernike coefficients than Aberrometer A, suggesting that wavefront measurements obtained using the two aberrometers are not interchangeable in patients with KC.
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Affiliation(s)
- Shizuka Koh
- Department of Innovative Visual Science (S.K., R.I.), Osaka University Graduate School of Medicine, Osaka, Japan; Department of Ophthalmology (S.K., Y.I., T.S., K.N.), Osaka University Graduate School of Medicine, Osaka, Japan; SEED CO. (R.I.), LTD., Tokyo, Japan; and Department of Orthoptics (T.M.), Faculty of Medical Technology, Teikyo University, Tokyo, Japan
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Mota DF, Haddad JS, Rocha KM, George Oral Waring IV, Tanos FW, Ambrosio R. The role of the tear film in dysfunctional lens syndrome: a prospective review. REVISTA BRASILEIRA DE OFTALMOLOGIA 2022. [DOI: 10.37039/1982.8551.20220063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Kundu G, Shetty R, Ranade R, Trivedi D, Lalgudi VG, Nuijts RMMA, Annavajjhala S, Khamar P. Repeatability and Agreement of a New Scheimpflug Device and a Hartmann-Shack Aberrometer With a Ray-Tracing Aberrometer in Normal, Keratoconus, and CXL Groups. J Refract Surg 2022; 38:201-208. [PMID: 35275005 DOI: 10.3928/1081597x-20220110-01] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
PURPOSE To assess repeatability and agreement of a Scheimpflug topographer and a Hartmann-Shack aberrometer with a ray-tracing aberrometer in normal, keratoconus, and corneal cross-linking (CXL) groups. METHODS In this cross-sectional, observational study, normal, keratoconus, and CXL groups with 125 eyes in each of the three groups were included. All eyes underwent three sets of measurements, at a single visit, using the Pentacam AXL Wave (Oculus Optikgeräte GmbH) and iTrace (Tracey Technologies). Keratometry, pachymetry, objective refraction, and total ocular aberrations including root mean square (RMS) lower order aberrations (LOAs), RMS higher order aberrations (HOAs), RMS coma, and spherical aberrations (SA) were analyzed. Objective assessment of haze after CXL was done using the Pentacam AXL Wave. Repeatability was assessed using within-subject standard deviation (Sw), test-retest variability, within-subject coefficient of variation (COV), and intraclass correlation coefficient (ICC). Bland-Altman analysis assessed 95% limits of agreement and correlation coefficient (r) determined the strength of the relationship between measurements. RESULTS The Pentacam AXL Wave had Sw for keratometry of 0.12 in the normal group and 0.15 in the keratoconus group and lower (poorer) Sw of 0.17 in the CXL group. For pachymetry, Sw was 9.18, 9.53, and 10.11 in the normal, keratoconus, and CXL groups, respectively. Total aberrations had ICCs ranging from 0.88 for RMS HOAs to 0.95 for SA in the normal group, 0.86 for RMS HOAs to 0.92 for SA in the keratoconus group, and 0.72 for RMS HOAs to 0.82 for SA (poorer) in the CXL group. In the normal group, mean differences between the two devices were nonsignificant for all parameters except SA (0.011 ± 0.038 μm, P < .01; limits of agreement = -0.09 to 0.07; r = 0.87). In the keratoconus group, mean differences were significant in all aberrations except RMS LOAs (-0.27 ± 0.85 μm, P = .10; limits of agreement = -3.3 to 3.8; r = 0.92). In the CXL group, all parameters varied significantly (P < .006). CONCLUSIONS The Pentacam AXL Wave showed comparable repeatability in the normal and keratoconus groups, but was poorer in the CXL group, more so with increasing corneal haze. Both devices can be used interchangeably in normal eyes, except for SA, but not in eyes with keratoconus or CXL for aberration measurements. [J Refract Surg. 2022;38(3):201-208.].
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Alio JL, D'Oria F, Toto F, Balgos J, Palazon A, Versaci F, Del Barrio JLA. Retinal image quality with multifocal, EDoF, and accommodative intraocular lenses as studied by pyramidal aberrometry. EYE AND VISION 2021; 8:37. [PMID: 34615549 PMCID: PMC8496005 DOI: 10.1186/s40662-021-00258-y] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 09/06/2021] [Indexed: 11/10/2022]
Abstract
Background To study and compare the clinical optical image quality following implantation with different premium IOLs by analysing the point spread function (PSF) Strehl ratio using a pyramidal wavefront sensor (PWS)-based aberrometer. Methods This study included 194 eyes implanted with: (a) 19 AcrySof SA60AT (control group); (b) 19 Miniwell; (c) 24 LENTIS Mplus LS-313 MF30; d) 33 LENTIS Mplus LS-313 MF15; (e) 17 AkkoLens Lumina; (f) 31 AT LISA Tri 839MP; (g) 20 Precizon Presbyopic; (h) 20 AcrySof IQ PanOptix; (i) 11 Tecnis Eyhance. Main outcome measures were PSF Strehl ratio, PSF Strehl ratio excluding second-order aberrations (PSFw2), total root mean square (RMS), low-order aberration (LOA) and high-order aberration (HOA) RMS measured by PWS aberrometer. Results AT LISA Tri had the highest PSFw2 Strehl ratio at both 3.0- and 4.0-mm pupil size (0.52 ± 0.14 and 0.31 ± 0.10; P < 0.05), followed by SA60AT (0.41 ± 0.11 and 0.28 ± 0.07) and PanOptix (0.4 ± 0.07 and 0.26 ± 0.04). AT LISA Tri was found to provide a significantly better retinal image quality than PanOptix at both 3.0 mm (P < 0.0001) and 4.0 mm (P = 0.004). Mplus MF15 was found to be significantly better than Mplus MF30 at both 3.0 mm (P < 0.0001) and 4.0 mm (P = 0.002). Total RMS, LOA RMS, HOA RMS, PSF Strehl ratio and PSFw2 varied significantly between the studied groups (P < 0.001). Conclusions Far distance clinical image quality parameters measured by PWS aberrometer differed significantly according to the technology of the implanted lens. AT LISA Tri, SA60AT and PanOptix showed the highest values of far distance retinal image quality, while the lowest PSFw2 Strehl ratios were displayed by Miniwell, Mplus MF30 and Precizon Presbyopic.
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Affiliation(s)
- Jorge L Alio
- Vissum Innovation, Alicante, Spain. .,Division of Ophthalmology, Universidad Miguel Hernández, Vissum Miranza, c/ Cabañal, 1, 03016, Alicante, Spain.
| | - Francesco D'Oria
- Vissum Innovation, Alicante, Spain.,Division of Ophthalmology, Universidad Miguel Hernández, Vissum Miranza, c/ Cabañal, 1, 03016, Alicante, Spain.,Section of Ophthalmology, Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari, Bari, Italy
| | | | | | - Antonio Palazon
- Department of Clinical Medicine, Miguel Hernández University, San Juan de Alicante, Spain
| | - Francesco Versaci
- R&D Department, Costruzione Strumenti Oftalmici (CSO), Florence, Italy
| | - Jorge L Alio Del Barrio
- Vissum Innovation, Alicante, Spain.,Division of Ophthalmology, Universidad Miguel Hernández, Vissum Miranza, c/ Cabañal, 1, 03016, Alicante, Spain
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Repeatability and Agreement of Wavefront aberrations of Pentacam AXL Wave- a new hybrid topographer and aberrometer with ITrace in healthy eyes. J Cataract Refract Surg 2021; 48:408-416. [PMID: 34393184 DOI: 10.1097/j.jcrs.0000000000000775] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Accepted: 08/06/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess repeatability and agreement of Pentacam AXL Wave, with iTrace aberrometer. SETTING Narayana Nethralaya, Bangalore, India. DESIGN Prospective ,cross-sectional study. METHODS One hundred eyes of 100 patients underwent three sets of measurements, at a single visit, using Pentacam AXL Wave (Oculus, Germany) and iTrace (Tracey Technologies, USA).Lower-order aberration (LOA), higher-order aberration (HOA), Coma and Spherical Aberrations (SA) were analyzed. Repeatability was assessed using within-subject standard deviation (Sw), test-retest variability (TRT), within-subject coefficient of variation (COV) and Intraclass Correlation Coefficient (ICC). The Bland-Altman analysis was used to assess 95% limits of agreement (LoA) and the correlation coefficient (r) to determine strength of relationship between measurements. RESULTS All measurements with Pentacam AXL Wave had repeatability with an ICC for total ocular aberrations ranging from 0.84 for HOAto 0.92 for LOA and corneal from 0.76 for HOA to 0.86 for LOA The Sw, TRT, COV of all aberrations were significantly lower (better) than those of iTrace (p < 0.001). The mean differences between 2 devices were insignificant for the comparison of all parameters, except for spherical aberration (0.011(0.002571 to 0.02008; P= 0.01). Both devices showed excellent corelations for ocular aberrations (tHOA (P=0.12,LoA= -0.52 to 0.025; r= 0.89); LOA (P=0.14, LoA = -2.71 to 2.61 ; r= 0.96) coma (P=0.27, LoA = -0.11 to 0.12; r= 0.89) and in SA (P=0.01, LoA = -0.09 to 0.07;r=0.97)). CONCLUSIONS The repeatability estimates for wavefront aberrations using Pentacam AXL Wave were significantly better than that using iTrace. Both devices showed excellent corelations for total ocular aberrations.
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Tomás J, Piñero DP, Alió JL. Intra‐observer repeatability of optical quality measures provided by a double‐pass system. Clin Exp Optom 2021; 95:60-5. [DOI: 10.1111/j.1444-0938.2011.00660.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Affiliation(s)
- Javier Tomás
- Vissum/Instituto Oftalmológico de Alicante, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Spain
| | - Jorge L Alió
- Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain. E‐mail:
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Haddad JS, Gouvea L, Ferreira JL, Ambrósio R, Waring GO, Rocha KM. Impact of a Chromatic Aberration-Correcting Intraocular Lens on Automated Refraction. J Refract Surg 2020; 36:334-339. [DOI: 10.3928/1081597x-20200403-01] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/02/2020] [Indexed: 11/20/2022]
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16
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Leisser C, Hirnschall N, Ullrich M, Findl O. Repeatability of wavefront measurements in pseudophakic eyes. SPEKTRUM DER AUGENHEILKUNDE 2019. [DOI: 10.1007/s00717-018-0419-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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17
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Plaza-Puche AB, Salerno LC, Versaci F, Romero D, Alio JL. Clinical evaluation of the repeatability of ocular aberrometry obtained with a new pyramid wavefront sensor. Eur J Ophthalmol 2018; 29:585-592. [PMID: 30516061 DOI: 10.1177/1120672118816060] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate the intrasubject repeatability of the ocular aberrometry obtained with a new ocular pyramidal aberrometer technology in a sample of normal eyes. METHODS A total of 53 healthy eyes of 53 subjects with ages ranging from 18 to 45 years were included in this study. In all cases, three consecutive acquisitions were obtained. Intrasubject repeatability of the measurements with a pyramidal aberrometer was calculated. Intrasubject repeatability for 4.0- and 6.0-mm pupils was evaluated within the subject standard deviation (Sw) and intraclass correlation coefficient. RESULTS Low values of the Sw and intraclass correlation coefficient outcomes close to 1 were observed for the sphere and cylinder at 3.0-mm pupil size. Most low Sw and intraclass correlation coefficient values close to 1 were observed for total, low-order aberrations and higher-order aberrations root mean square and for each Zernike coefficient analysis (intraclass correlation coefficient ⩾0.798) at 4.0-mm pupil size, with more limited outcomes for the aberrometric coefficient of Z(4, 4) with an intraclass correlation coefficient of 0.683. For a 6.0 mm pupil diameter, low Sw and intraclass correlation coefficient values close to 1 were observed for all aberrometric parameters or Zernike coefficients analyzed (intraclass correlation coefficient ⩾0.850). CONCLUSION The new pyramidal aberrometer Osiris provides repeatable and consistent measurements of ocular aberrometry measurements in normal eyes.
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Affiliation(s)
| | | | - Francesco Versaci
- R&D Department, Costruzione Strumenti Oftalmici (CSO), Florence, Italy
| | - Daniel Romero
- Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain
| | - Jorge L Alio
- Vissum, Alicante, Spain.,Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain
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Abstract
PURPOSE OF REVIEW Laser vision correction remains an active area of research, and there have been many recent advances in the field. The purpose of this review is to provide an update on the recent advances for one of the most common methods of laser vision correction, wavefront-guided laser in-situ keratomileusis (LASIK). RECENT FINDINGS Recent technological advancements in wavefront aberrometry are largely responsible for the improved visual outcomes that have been recently reported. In addition, improvements in femtosecond and excimer laser technology, used in flap creation and corneal ablation, have been shown to provide superior results when compared to microkeratomes and earlier lasers. Wavefront-guided LASIK appears to have advantages over some other keratorefractive modalities in terms of visual acuity, predictability, astigmatism correction, and subjective visual symptoms. Nonetheless, there may be some limitations in highly aberrated corneas, and also in biomechanical stability relative to other available platforms. SUMMARY Improvements in wavefront aberrometry, and also femtosecond and excimer lasers, have continued to improve our ability to correct refractive errors. Wavefront-guided LASIK remains a well tolerated and effective keratorefractive procedure, with a trend toward superiority. Nonetheless, further studies comparing this modality to others are needed to define the role each can serve.
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Fredriksson A, Behndig A. Eccentric small-zone ray tracing wavefront aberrometry for refraction in keratoconus. Acta Ophthalmol 2016; 94:679-684. [PMID: 27496244 DOI: 10.1111/aos.13183] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 06/03/2016] [Indexed: 11/30/2022]
Abstract
PURPOSE To compare objective refraction using small-zone eccentric laser ray tracing (LRT) wavefront aberrometry to standard autorefraction in keratoconus (KC), and whether the visual acuities achieved with these refractions differ from corresponding values in healthy eyes. METHODS Twenty-nine eyes of 29 patients with KC and 29 eyes of 29 healthy controls were included in this prospective unmasked case-control study. The uncorrected (UCVA) and spectacle-corrected (SCVA) Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuities based on refractions derived from LRT in central and four eccentric zones were compared to those achieved with standard autorefraction. The spherical equivalent (M) and two astigmatic power vectors (C0 and C45) were calculated for all refractions. Pentacam HR® was used to generate keratometry readings of the corresponding zones. RESULTS In KC, the refraction from the upper nasal zone rendered a higher SCVA than the standard autorefraction more often than in the controls (p < 0.001). There were no significant variation in M between the different LRT measurement points in the control group, but central data provided the best SCVA. The UCVA:s and SCVA:s were worse in KC, and the KC eyes showed inferior myopia and superior hyperopia. Multiple refractions rendered similar SCVA:s in KC. Pentacam HR® showed higher keratometry readings infero-temporally, but also lower readings supero-nasally, compared to controls. CONCLUSION In KC, eccentric LRT measurements gave better SCVA than standard autorefraction more often than in healthy eyes. Eccentric LRT may become a valuable tool in the demanding task of subjective refraction in KC.
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Affiliation(s)
- Anneli Fredriksson
- Department of Clinical Sciences/Ophthalmology; Umeå University Hospital; Umeå Sweden
| | - Anders Behndig
- Department of Clinical Sciences/Ophthalmology; Umeå University Hospital; Umeå Sweden
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Sáles CS, Manche EE. Comparison of ocular aberrations measured by a Fourier-based Hartmann-Shack and Zernike-based Tscherning aberrometer before and after laser in situ keratomileusis. J Cataract Refract Surg 2016; 41:1820-5. [PMID: 26603389 DOI: 10.1016/j.jcrs.2015.09.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2014] [Revised: 02/23/2015] [Accepted: 02/25/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To assess agreement between a Hartmann-Shack aberrometer (Wavescan) and a Tscherning aberrometer (Wavelight Allegro Analyzer) and their respective agreement with manifest refraction before and after laser in situ keratomileusis (LASIK). SETTING Stanford Eye Laser Center, California, USA. DESIGN Prospective comparative observational study. METHODS Multiple readings were obtained both aberrometers preoperatively and 12 months after wavefront-guided LASIK. Sphere, cylinder, spherical equivalent (SE), defocus Z(2,0), astigmatism Z(2,2), spherical aberration Z(4,0), coma Z(3,1), trefoil Z(3,3), and total higher-order aberrations (HOAs) were compared using intraclass correlation coefficients (ICCs) (perfect agreement = 1; disagreement = 0). RESULTS In the 100 study eyes, preoperative agreement was good to excellent between the aberrometers for the parameters of defocus, astigmatism, and spherical aberration (ICC: 0.8, 0.9, and 0.7, respectively) but was poor for coma, trefoil, and total HOAs (ICC: 0.6, -0.2, and 0.4, respectively). At 12 months, ICCs worsened for all parameters (ICC: defocus = 0.6; astigmatism = 0.2; spherical aberration = 0.6; coma = 0.4; trefoil = -0.3; total HOAs = 0.4). Preoperative agreement of sphere, cylinder, and SE was good to excellent between the manifest refraction and both aberrometers (ICC Hartmann-Shack: 0.98, 0.95, and 0.97, respectively; ICC Tscherning: 0.97, 0.92, and 0.98, respectively). However, agreement was poor to fair between the manifest refraction and both aberrometers at 12 months (ICC Hartmann-Shack: 0.4, 0.1, and 0.4, respectively; ICC Tscherning: 0.03, 0.02, and 0.2, respectively). CONCLUSIONS Although some HOAs measured with both aberrometers agreed preoperatively, such agreement might not persist after LASIK. Spherocylinder measurements with both aberrometers seemed to agree closely with the manifest refraction before LASIK, but not at 12 months. FINANCIAL DISCLOSURE Dr. Manche has equity in Calhoun Vision, Inc., Krypton Vision, Seros Medical, LLC, and Veralas and is a consultant to Best Doctors, Gerson Lehrman Group.
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Affiliation(s)
- Christopher S Sáles
- From the Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California, USA
| | - Edward E Manche
- From the Byers Eye Institute, Stanford University School of Medicine, Palo Alto, California, USA.
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Precision (Repeatability and Reproducibility) and Agreement of Corneal Power Measurements Obtained by Topcon KR-1W and iTrace. PLoS One 2016; 11:e0147086. [PMID: 26752059 PMCID: PMC4709181 DOI: 10.1371/journal.pone.0147086] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 12/26/2015] [Indexed: 11/19/2022] Open
Abstract
Purpose To evaluate the repeatability and reproducibility of corneal power measurements obtained by Topcon KR-1W and iTrace, and assess the agreement with measurements obtained by Allegro Topolyzer and IOLMaster. Methods The right eyes of 100 normal subjects were prospectively scanned 3 times using all the 4 devices. Another observer performed additional 3 consecutive scans using the Topcon KR-1W and iTrace in the same session. About one week later, the first observer repeated the measurements using the Topcon KR-1W and iTrace. The steep keratometry (Ks), flat keratometry (Kf), mean keratometry (Km), J0 and J45 were analyzed. Repeatability and reproducibility of measurements were evaluated by the within-subject standard deviation (Sw), coefficient of variation (CoV), test-retest repeatability (2.77Sw), and intraclass correlation coefficient (ICC). Agreements between devices were assessed using Bland-Altman analysis and 95% limits of agreement (LoA). Results Intraobserver repeatability and interobserver and intersession reproducibility of the Ks, Kf and Km showed a CoV of no more than 0.5%, a 2.77Sw of 0.70 D or less, and an ICC of no less than 0.99. However, J0 and J45 showed poor intraobserver repeatability and interobserver and intersession reproducibility (all ICCs not greater than 0.446). Statistically significant differences existed between Topcon KR-1W and IOLMaster, Topcon KR-1W and iTrace, Topcon KR-1W and Topolyzer, iTrace and Topolyzer, iTrace and IOLMaster for Ks, Kf and Km measurements (all P < 0.05). The mean differences between Topcon KR-1W, iTrace, and the other 2 devices were small. The 95% LoA were approximately 1.0 D to 1.5 D for all measurements. Conclusions The Ks, Kf and Km obtained by Topcon KR-1W and iTrace showed excellent intraobserver repeatability and interobserver and intersession reproducibility in normal eyes. The agreement between Topcon KR-1W and Topolyzer, Topcon KR-1W and IOLMaster, iTrace and Topolyzer, iTrace and IOLMaster, Topcon KR-1W and iTrace were not so good, they should not be interchangeable in clinical application. Given that the intraobserver repeatability and interobserver and intersession reproducibility of corneal astigmatism measurements obtained by Topcon KR-1W and iTrace were poor, it should be cautious that Topcon KR-1W and iTrace were applied for the preparation of toric lens implantation.
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Jesus DA, Iskander DR. Simplifying numerical ray tracing for two-dimensional non circularly symmetric models of the human eye. APPLIED OPTICS 2015; 54:10123-10127. [PMID: 26836669 DOI: 10.1364/ao.54.010123] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Ray tracing is a powerful technique to understand the light behavior through an intricate optical system such as that of a human eye. The prediction of visual acuity can be achieved through characteristics of an optical system such as the geometrical point spread function. In general, its precision depends on the number of discrete rays and the accurate surface representation of each eye's components. Recently, a method that simplifies calculation of the geometrical point spread function has been proposed for circularly symmetric systems [Appl. Opt.53, 4784 (2014)]. An extension of this method to 2D noncircularly symmetric systems is proposed. In this method, a two-dimensional ray tracing procedure for an arbitrary number of surfaces and arbitrary surface shapes has been developed where surfaces, rays, and refractive indices are all represented in functional forms being approximated by Chebyshev polynomials. The Liou and Brennan anatomically accurate eye model has been adapted and used for evaluating the method. Further, real measurements of the anterior corneal surface of normal, astigmatic, and keratoconic eyes were substituted for the first surface in the model. The results have shown that performing ray tracing, utilizing the two-dimensional Chebyshev function approximation, is possible for noncircularly symmetric models, and that such calculation can be performed with a newly created Chebfun toolbox.
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Aberraciones corneales anteriores y posteriores medidas mediante imágenes de Scheimpflug en el queratocono en niños. REVISTA MEXICANA DE OFTALMOLOGÍA 2015. [DOI: 10.1016/j.mexoft.2015.04.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Gabriel C, Klaproth OK, Titke C, Baumeister M, Bühren J, Kohnen T. Repeatability of topographic and aberrometric measurements at different accommodative states using a combined topographer and open-view aberrometer. J Cataract Refract Surg 2015; 41:806-11. [PMID: 25840305 DOI: 10.1016/j.jcrs.2014.07.037] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2014] [Revised: 06/30/2014] [Accepted: 07/10/2014] [Indexed: 10/23/2022]
Abstract
PURPOSE To evaluate the repeatability of corneal first-surface aberrations and aberrometric measurements of a combined aberrometer-topographer (iTrace Visual Function Analyzer) for 5 accommodative stimuli. SETTING Department of Ophthalmology, Goethe-University, Frankfurt, Germany. DESIGN Prospective case series. METHODS Eyes of young adults with low to moderate myopia or hyperopia were examined in 2 measurement series comprising 3 corneal topography measurements and wavefront measurements focusing on targets at 5 distances (0.4, 0.5, 0.6, 1.0, and 4.0 m). Repeatability was analyzed using the standard deviation (SD) within 6 measurements and the coefficient of repeatability (CoR) by Bland-Altman analysis of the means of the 2 measurement series. RESULTS Fifty eyes (50 subjects) were evaluated. The lowest calculated mean SD/CoR measurements using the aberrometer function at 5 target distances were 0.07 μm/0.14 μm for total ocular aberrations root mean square (RMS), 0.07 μm/0.16 μm for lower-order aberrations (LOAs) RMS, 0.03 μm/0.66 μm for higher-order aberrations (HOAs) RMS, 0.10 diopter (D)/0.22 D for sphere, 0.08 D/0.13 D for cylinder, and 0.09 D/0.21 D for the spherical equivalent (SE). Repeatability of the total RMS, LOAs RMS, sphere, and SE measurements improved with increasing target distance (P < .01 for aberrometric values; P < .03 for refractive values). Measurement reproducibility using the corneal topographer showed mean SDs/CoRs of 0.19 μm/0.41 μm for total RMS, 0.19 μm/0.39 μm for LOAs RMS, and 0.08 μm/0.23 μm for HOAs RMS. CONCLUSION The aberrometer showed satisfactory results for measurement repeatability at all target distances and declining repeatability with increasing accommodation effort. FINANCIAL DISCLOSURE No author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Claudia Gabriel
- From the Department of Ophthalmology, Goethe-University, Frankfurt, Germany
| | | | - Christine Titke
- From the Department of Ophthalmology, Goethe-University, Frankfurt, Germany
| | - Martin Baumeister
- From the Department of Ophthalmology, Goethe-University, Frankfurt, Germany
| | - Jens Bühren
- From the Department of Ophthalmology, Goethe-University, Frankfurt, Germany
| | - Thomas Kohnen
- From the Department of Ophthalmology, Goethe-University, Frankfurt, Germany.
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Abstract
PURPOSE To compare the optical quality measurements obtained from the double-pass system and ocular aberrations, subjective visual acuity, and contrast sensitivity score in pseudophakic eyes. METHODS Three months after cataract surgery, modulation transfer function (MTF) cutoff frequency, Strehl ratio, objective scatter index, and objective pseudoaccommodation obtained from the double-pass system were compared with total aberration, higher-order aberration, and spherical aberration obtained from ray-tracing aberrometer. In addition, parameters of the double-pass system were compared with subjective visual acuity and the contrast sensitivity score. RESULTS Forty eyes of 40 patients were included. The MTF cutoff frequency and Strehl ratio were negatively correlated with total aberration (r = -0.503, p = 0.003; r = -0.509, p = 0.003, respectively) and subjective visual acuity (r = -0.453, p = 0.007; r = -0.354, p = 0.040, respectively). The objective scatter index was positively correlated with total aberration (r = 0.451, p = 0.024) and subjective visual acuity (r = 0.516, p = 0.008). The MTF cutoff frequency showed a correlation with contrast sensitivity score under photopic and mesopic conditions. CONCLUSIONS Optical quality parameters obtained from the double-pass system were correlated with ocular aberrations, subjective visual acuity, and contrast sensitivity score in pseudophakic eyes.
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Lee K, Ahn JM, Kim EK, Kim TI. Comparison of optical quality parameters and ocular aberrations after wavefront-guided laser in-situ keratomileusis versus wavefront-guided laser epithelial keratomileusis for myopia. Graefes Arch Clin Exp Ophthalmol 2013; 251:2163-9. [PMID: 23652467 DOI: 10.1007/s00417-013-2356-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2012] [Revised: 03/05/2013] [Accepted: 04/18/2013] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND To compare optical quality, ocular scattering, and higher-order aberrations (HOAs) after laser in-situ keratomileusis (LASIK) versus laser epithelial keratomileusis (LASEK). METHODS A total of 47 eyes from 47 participants who had undergone LASIK (group I) or LASEK (group II) procedure at least 6 months prior were enrolled. Ocular aberrations and modulation transfer function (MTF) values measured using iTrace, a ray-tracing type aberrometer, were compared to MTF (modulation transfer function) cut-off values, Strehl ratio, and objective indices of scattering obtained using the Objective Quality Analysis System II (OQAS II). RESULTS There was no significant correlation between the postoperative optical quality parameters and the HOAs between both groups. In group I, the MTF cut-off value was significantly correlated with cylinder refraction (p = 0.037), and the objective scattering index (OSI) was positively correlated with spherical equivalent (p = 0.023). In group II, there was a statistically significant correlation between the OSI and achieved refractive correction (p = 0.001). Regression analysis showed that the OSI was the most significant predictor of MTF cut-off values after refractive surgery. Additionally, MTF values measured by OQAS were significantly lower than those measured by iTrace without correlation. CONCLUSION Optical quality after refractive surgery may be influenced by not only ocular aberrations but also by scattering. Even though the accuracies of the machines used in this study to measure optical quality have yet to be proven, this study showed limited correlation among the values measured using the two different machines after refractive surgery. Therefore, for more generalized evaluation of visual function after refractive surgery, more advanced optical devices still need to be developed.
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Affiliation(s)
- Kwanghyun Lee
- The Institute of Vision Research, Department of Ophthalmology, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul, 120-752, Republic of Korea
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Yoo EJ, Kang SY, Kim HM, Song JS. The Effects of Pharmacologic Pupil Dilatation on Ocular, Corneal, and Internal Aberrations. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2013. [DOI: 10.3341/jkos.2013.54.4.581] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Eun Joo Yoo
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Su Yeon Kang
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Hyo Myung Kim
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
| | - Jong Suk Song
- Department of Ophthalmology, Korea University College of Medicine, Seoul, Korea
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Ramón ML, Piñero DP, Blanes-Mompó FJ, Pérez-Cambrodí RJ. Clinical and quality of life data correlation with a single-optic accommodating intraocular lens. JOURNAL OF OPTOMETRY 2013; 6:25-35. [PMCID: PMC3880534 DOI: 10.1016/j.optom.2012.06.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2012] [Accepted: 05/27/2012] [Indexed: 06/03/2023]
Abstract
Purpose To examine a single-optic accommodating intraocular lens (IOL) visual performance by correlating IOL implanted eyes’ defocus curve with the intraocular aberrometric profile and the impact on the quality of life (QOL). Methods Prospective consecutive case series study including a total of 25 eyes of 14 patients with ages ranging between 52 and 79 years old. All cases underwent cataract surgery with implantation of the single-optic accommodating IOL Crystalens HD (Bausch & Lomb). Distance and near visual acuity outcomes, intraocular aberrations, the defocus curve and QOL (NEI VFQ-25) were evaluated 3 months after surgery. Results A significant improvement in distance visual acuity was found postoperatively (p = 0.02). Mean postoperative LogMAR uncorrected near visual acuity was 0.44 ± 0.23 (20/30). 60% of eyes had a postoperative addition between 0 and 1.5 diopters (D). The defocus curve showed an area of maximum visual acuity for the levels of defocus corresponding to distance and intermediate vision (−1 to +0.5 D). Postoperative intermediate visual acuity correlated significantly some QOL indices (r ≥ 0.51, p ≤ 0.03; difficulty in going down steps or seeing how people react to things that patient says) as well as with J0 component of manifest cylinder. Postoperative distance-corrected near visual acuity correlated significantly with age (r = 0.65, p < 0.01). Conclusions This accommodating IOL seems to be able to restore the distance visual function as well as to provide an improvement in intermediate and near vision with a significant impact on patient's QOL, although limited by age and astigmatism. Future studies with larger sample sizes should confirm all these trends.
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Affiliation(s)
- María L. Ramón
- Department of Ophthalmology, Oftalmar, Hospital Internacional Medimar, Alicante, Spain
- Foundation for the Visual Quality (FUNCAVIS, Fundación para la Calidad Visual), Alicante, Spain
| | - David P. Piñero
- Department of Ophthalmology, Oftalmar, Hospital Internacional Medimar, Alicante, Spain
- Foundation for the Visual Quality (FUNCAVIS, Fundación para la Calidad Visual), Alicante, Spain
- Departamento de Óptica, Farmacología y Anatomía, Universidad de Alicante, Spain
| | - Francisco J. Blanes-Mompó
- Department of Ophthalmology, Oftalmar, Hospital Internacional Medimar, Alicante, Spain
- Foundation for the Visual Quality (FUNCAVIS, Fundación para la Calidad Visual), Alicante, Spain
| | - Rafael J. Pérez-Cambrodí
- Department of Ophthalmology, Oftalmar, Hospital Internacional Medimar, Alicante, Spain
- Foundation for the Visual Quality (FUNCAVIS, Fundación para la Calidad Visual), Alicante, Spain
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Mello GR, Rocha KM, Santhiago MR, Smadja D, Krueger RR. Applications of wavefront technology. J Cataract Refract Surg 2012; 38:1671-83. [DOI: 10.1016/j.jcrs.2012.07.004] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2011] [Revised: 01/27/2012] [Accepted: 02/13/2012] [Indexed: 10/28/2022]
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Piñero DP, Juan JT, Alió JL. Intrasubject repeatability of internal aberrometry obtained with a new integrated aberrometer. J Refract Surg 2010; 27:509-17. [PMID: 21188958 DOI: 10.3928/1081597x-20101214-01] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2010] [Accepted: 11/10/2010] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the intrasubject repeatability of the internal aberrometry obtained with a new integrated aberrometer in a sample of normal eyes to assess its clinical usefulness. METHODS Twenty-six healthy eyes of 26 participants, aged 20 to 50 years, were included in the study. All eyes achieved corrected distance visual acuity of 1.0 (Snellen decimal notation) and did not undergo previous ocular surgeries. Three consecutive measurements of internal aberrations were obtained with the KR-1W system (Topcon Corp) by an experienced examiner. Intrasubject repeatability for 4- and 6-mm pupils was evaluated by the within-subject standard deviation (S(w)) and intraclass correlation coefficient (ICC). RESULTS Low values of S(w) and values of ICC close to 1 were found for the 4-mm pupil astigmatism and for several aberrometric coefficients: primary spherical aberration and higher order, third order, and trefoil root-mean-square (RMS). Significant correlations of the S(w) for the 4-mm pupil higher order aberrations RMS with the magnitude of different aberrometric coefficients were found (r≥0.611, P<.01). In addition, tetrafoil RMS for 4-mm pupils correlated significantly with the S(w) for some higher order errors (r≥0.675, P<.01). Significantly larger values of S(w) for 6-mm pupils were found for trefoil (P<.01) and secondary astigmatism RMS (P=.02). CONCLUSIONS The KR-1W provided repeatable measurements of internal astigmatism and some higher order aberrations, although consistency of such measurements appears to be limited by the level of aberration.
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Affiliation(s)
- David P Piñero
- Departamento de Optica, Universidad de Alicante, Alicante, Spain.
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Knapp S, Awwad ST, Ghali C, McCulley JP. Ocular aberrations measured by the Fourier-based WaveScan and Zernike-based LADARWave Hartmann-Shack aberrometers. J Refract Surg 2009; 25:201-9. [PMID: 19241771 DOI: 10.3928/1081597x-20090201-05] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate agreements in lower and higher order aberration measurements by two Hartmann-Shack wavefront-sensing devices. METHODS Using the VISX WaveScan and Alcon LADARWave aberrometers, ocular aberrations at a fixed optical zone of 6 mm were measured on 36 eyes of 18 patients. A tunable light intensity source was used to control pupil size, which was checked using infrared pupillometry. Repeatability of measurements was evaluated using the intra-class correlation coefficient with 3 consecutive measurements on each aberrometer. RESULTS Mean absolute defocus for WaveScan and LADARWave was 2.82 +/- 2.69 and 2.93 +/- 3.24 root-mean-square (RMS) microm, whereas astigmatism was 0.81 +/- 0.49 and 0.87 +/- 0.57 microm, respectively. Pearson correlation coefficients between the two aberrometers were 0.908 and 0.870 for defocus and astigmatism, respectively, whereas higher order aberration correlation was less tight (Pearson correlation coefficient=0.596 for coma, 0.746 for trefoil, 0.836 for spherical aberration, 0.637 for secondary astigmatism, and 0.963 for quadra-foil [P<.001 for all]). The LADARWave had a tendency to display more spherical aberration than the WaveScan, especially at high aberration values, with mean absolute difference in measurement of 0.12 +/- 0.08 microm, and only 44% of eyes having less than +/-0.10 RMS microm of difference. The mean total higher order aberration absolute difference was 0.14 +/- 0.14 microm, with only 50% of eyes within +/-0.1 RMS of agreement. Vector analysis revealed appreciable discrepancies in third- and fourth-order directional Zemike components, while showing similar values for fifth-order components. Intra-class correlation coefficient values for both aberrometers over different aberration orders showed excellent repeatability. CONCLUSIONS The WaveScan and LADARWave share similar lower order aberration measurements, but display significantly different higher order aberration values.
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Affiliation(s)
- Stefanie Knapp
- Department of Ophthalmology, UT Southwestern Medical Center, Dallas, Texas 75390-9057, USA
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Affiliation(s)
- Naoyuki Maeda
- Department of Ophthalmology, Osaka University Medical School, Osaka, Japan.
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Wavefront-Guided (Customized) Excimer Laser Refractive Surgery. Ophthalmology 2009. [DOI: 10.1016/b978-0-323-04332-8.00021-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Alió J, Galal A, Montalbán R, Piñero D. Corneal Wavefront-guided LASIK Retreatments for Correction of Highly Aberrated Corneas Following Refractive Surgery. J Refract Surg 2007; 23:760-73. [DOI: 10.3928/1081-597x-20071001-05] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Kim M, Lee YG, Seo KR, Kim EK, Lee HK. Comparison of higher-order aberrations between eyes with natural supervision and highly myopic eyes in Koreans. KOREAN JOURNAL OF OPHTHALMOLOGY 2007; 21:79-84. [PMID: 17592237 PMCID: PMC2629696 DOI: 10.3341/kjo.2007.21.2.79] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Purpose To describe the characteristics and investigate the differences of higher-order aberrations (HOAs) between the eyes with a natural, uncorrected visual acuity (UCVA) of 20/12 and eyes with highly myopic eyes in Korean adults. Methods Thirty-one eyes of 20 subjects with UCVA of 20/12 (Group 1) and 54 eyes of 36 myopic patients with greater than -6 diopters (Group 2) were analyzed for type and magnitude of HOAs across a 6.0 mm pupil. HOAs were measured by Wavescan (VISX, Santa Clara, CA, USA) in natural scotopic conditions and were presented as root-mean-square (RMS:µm) in Belle aberration maps. Results The mean spherical equivalent (SE) of manifest refraction was -0.15±0.25 D (range: +0.37 to -0.50 D) in Group 1 and -7.25±0.78 D (range: -6.00 to -9.25 D) in Group 2. The total root-mean-square (RMS) values of HOAs for Group 1 and Group 2 were 0.28±0.09 µm and 0.27±0.087 µm, respectively (P>0.05). The mean values of coma, trefoil, and spherical aberration were 0.14±0.091 µm, 0.14±0.089 µm, 0.091±0.059 µm in Group 1 and 0.16±0.077 µm, 0.14±0.073 µm, 0.082±0.059 µm in Group 2, respectively. Conclusions This study helped establish ocular aberration standards for those with natural supervision and those with highly myopic eyes among Koreans. Individuals with natural supervision had significant amounts of HOAs, and there was no significant difference in the amount of HOAs between the two groups. The index of higher-order aberrations may not be a perfect predictor of the amount of refractive error.
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Affiliation(s)
- Min Kim
- Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | | | - Kyung Ryul Seo
- Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Eung Kweon Kim
- Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
| | - Hyung Keun Lee
- Department of Ophthalmology, Yonsei University College of Medicine, Seoul, Korea
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Abstract
PURPOSE To provide a summary of the methods used by clinical wavefront analyzers and their historical, current, and future applications. METHODS Review of the literature and authors' experience with the various devices. RESULTS A wide range of clinical wavefront aberrometers, which use different principles, are available to clinicians and researchers. CONCLUSIONS Applications of wavefront analyzers in vision sciences range from assessment of refractive error, refractive surgery planning, evaluation of outcomes, optimization of contact lenses and IOL designs, evaluation of pathology relating to optical performance of the eye, and evaluation of accommodation alterations.
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Affiliation(s)
- Alejandro Cerviño
- School of Life and Health Sciences, Aston University, Birmingham, United Kingdom
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Awwad ST, El-Kateb M, McCulley JP. Comparative higher-order aberration measurement of the LADARWave and Visx WaveScan aberrometers at varying pupil sizes and after pharmacologic dilation and cycloplegia. J Cataract Refract Surg 2006; 32:203-14. [PMID: 16564994 DOI: 10.1016/j.jcrs.2005.08.058] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2004] [Indexed: 11/29/2022]
Abstract
PURPOSE To compare higher-order aberration (HOA) measurements of LADARWave and Visx WaveScan aberrometers, to test the validity of the peripheral wavefront data, and to evaluate the effect of pharmacologic dilation and mild cycloplegia. METHODS Thirty-three myopic eyes of 17 volunteers were enrolled and had the ocular HOAs measured and analyzed with varying pupil diameters (PD) controlled by a tunable light intensity source and after instillation of tropicamide 1% and phenylephrine 2.5%. RESULTS Higher-order aberrations increased with PD and optical zone (OZ), especially an OZ between 6.0 mm and 6.5 mm. Spherical aberration increased the most, followed by coma, then trefoil and secondary astigmatism. Measurement differences were observed between LADARWave and WaveScan at an OZ of 6.0 mm, although measurement correlations between the 2 machines were high. In the case of the WaveScan, when PD = OZ (6.0 mm), the spherical aberration and, to a less extent, the coma data differed from those obtained with larger PDs and the same OZ. In the case of the LADARWave, at an OZ of 6.0 mm, the HOAs measured in eyes with physiologic pupils were similar to those in pharmacologically dilated pupils when the physiologic pupil center was taken as the reference. CONCLUSIONS There were detectable measurement differences between LADARWave and Visx WaveScan. Ensuring that the PD is at least 0.5 mm larger than the desired OZ is very important. Dilation and mild cycloplegia did not clinically affect the wave measurement magnitude or pattern.
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Affiliation(s)
- Shady T Awwad
- Department of Ophthalmology, University of Texas Southwestern Medical Center, Dallas, Texas 75390-9057, USA
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Nissman SA, Tractenberg RE, Saba CM, Douglas JC, Lustbader JM. Accuracy, Repeatability, and Clinical Application of Spherocylindrical Automated Refraction Using Time-Based Wavefront Aberrometry Measurements. Ophthalmology 2006; 113:577.e1-2. [PMID: 16527354 DOI: 10.1016/j.ophtha.2005.12.021] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2005] [Revised: 12/05/2005] [Accepted: 12/08/2005] [Indexed: 11/28/2022] Open
Abstract
PURPOSE To evaluate the clinical utility of spherocylindrical automated refraction (AR) based on time-based wavefront technology compared with subjective manifest refraction (MR) for the purpose of prescribing eyeglasses. DESIGN Prospective observational case series. PARTICIPANTS A convenience sample of 105 eyes of 53 patients (ages 19 to 87) with corrected acuity no worse than 20/40(-2). METHODS Manifest refraction was performed on all subjects followed by three consecutive wavefront measurements at both a 4-mm and 6-mm optical zone using the 3D Wave OPD Scan ARK 10,000 aberrometer. MAIN OUTCOME MEASURES Repeatability of multiple consecutive ARs; difference in the sphere, cylinder, and axis of AR compared with MR; difference between the corrected visual acuity based on AR- and MR-derived acuity. RESULTS Repeatability analysis showed that the initial wavefront refraction was not significantly different from the mean of the three refractions. At the 4-mm zone, the absolute value (+/- standard deviation) of the difference between the initial AR compared with the MR was 0.34+/-0.28 diopters (D) for sphere, 0.22+/-0.21 D for cylinder, and 12.5+/-15.8 degrees for axis. At the 6-mm zone, these values were 0.32+/-0.29 D for sphere, 0.25+/-0.24 D for cylinder, and 11.8+/-14.6 degrees for axis. When 4-mm AR visual acuity was superior to MR acuity (19.0% of eyes) it was 0.28+/-0.24 Snellen lines better, and when inferior (53.3% of eyes) it was 0.47+/-0.37 lines worse. When 6-mm AR acuity was superior to MR acuity (16.2% of eyes) it was 0.32+/-0.22 Snellen lines better, and when inferior (60.0% of eyes) it was 0.48+/-0.48 lines worse. The absolute value of the difference in spherical equivalent of the first AR measurement at the 4-mm zone compared with the MR value was 0.33+/-0.23 D, and at the 6-mm zone it was 0.30+/-0.27 D. CONCLUSIONS The wavefront-derived AR values reflect the physical optical system, but not necessarily subjectively derived values, and the impact of this disagreement on patient satisfaction is unknown. Future studies evaluating this technology and its role in clinical ophthalmology are warranted.
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Affiliation(s)
- Steven A Nissman
- Department of Ophthalmology, Center for Sight, Georgetown University Hospital, Washington, DC 20007 , USA
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Affiliation(s)
- Shady T Awwad
- University of Texas Southwestern Medical Center at Dallas, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA
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Abstract
In the 5 years since the first wavefront-based LASIK treatment on normal eyes, the ophthalmology profession has had to confront a new language based on astronomy, optics and mathematics. Over this time wavefront technology has been used for diagnosis and treatment, and its application has made the profession define what is meant by good vision, and determine whether, with psychophysical and psychometric tests, it is possible understand how an individual perceives the world. The clinical application of wavefront technology has forced ophthalmologists and vision scientists with an engineering bias to talk to those with a biological bias, and to appreciate that if you try and change the corneal shape, its biological, anatomical and optical properties exist within a complex external eye environment. This perspective article demonstrates that wave-front analysis is a useful diagnostic tool, and that wavefront-based corneal refractive surgery is an improvement over conventional techniques. Its use by an ophthalmologist is a clinical decision specific to an individual patient.
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Affiliation(s)
- Michael A Lawless
- Northern Sydney Health, Department of Ophthalmology, University of Sydney, Sydney, New South Whales, Australia.
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Abstract
PURPOSE We evaluated the correlation of Alcon LADARWave wavefront measurements with clinical refraction and corneal topography. METHODS In a retrospective, non-comparative case series, 60 eyes (30 patients) of healthy individuals evaluated by preoperative examination for refractive surgery were enrolled (manifest sphere, -11.00 to +4.50 D; manifest cylinder, 0 to -4.75 D; 45 eyes were myopic, 12 eyes were hyperopic, and 3 had mixed astigmatism). Correlation of manifest refraction, cycloplegic refraction, and topographic data with wavefront refraction and higher order aberration was assessed. Match percentage given by the wavefront was analyzed. This number represents how much of the wavefront refraction is due to sphere and cylinder (high percentage match) or is influenced by higher order aberration (low percentage match), in which case aberrometer refraction will not be close to phoropter refraction. Pearson's correlation coefficient was assessed for two continuous variables, adjusting for repeated measurements. RESULTS The median match percentage was 91%. Mean values for all higher order aberration components in a 7.0-mm pupil were: coma = 0.35 +/- 0.29 microm, spherical aberrations = 0.36 +/- 0.31 microm, and other terms of higher order aberrations = 0.31 +/- 0.14 microm. Wavefront sphere, cylinder, and axis terms were highly correlated to manifest and cycloplegic measurements. The high match subgroup had a higher correlation coefficient than the low match subgroup for refraction. Topographic cylinder and axis were not strongly correlated to wavefront refraction, but manifest axis was significantly correlated to topographic axis. CONCLUSION In 60 normal eyes, the Alcon LADARWave wavefront measurement was highly correlated with refraction, but less well with corneal topography.
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Affiliation(s)
- Maria Regina Chalita
- Department of Refractive Surgery, Cole Eye Institute, Cleveland Clinic Foundation, 9500 Euclid Ave., Cleveland, OH 44195, USA
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Charman WN, Chateau N. The prospects for super-acuity: limits to visual performance after correction of monochromatic ocular aberration. Ophthalmic Physiol Opt 2003; 23:479-93. [PMID: 14622350 DOI: 10.1046/j.1475-1313.2003.00132.x] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
It has recently been suggested that correction of the monochromatic aberration of the eye could lead to substantial improvements in visual acuity and contrast sensitivity function. After consideration of the best-corrected visual acuity of normal eyes, the optical and neural limits to visual performance are reviewed. It is concluded that, even if current problems with the accuracy of the suggested techniques of aberration correction, through corneal excimer laser ablation or customised contact lenses, can be overcome, changes in monochromatic ocular aberration over time, the continuing presence of chromatic aberration, errors of focus associated with lags and leads in accommodation, and other factors, are likely to result in only minor improvements in the high-contrast acuity performance of most normal eyes being produced by attempted aberration control. Significant gains in contrast sensitivity might, however, be achievable, particularly under mesopic and scotopic conditions when the pupil is large, provided that correct focus can be maintained. In the immediate future, reduction of the high levels of aberration that are currently found in eyes that have undergone refractive surgery and in some abnormal eyes should bring useful benefits.
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Affiliation(s)
- W N Charman
- Department of Optometry and Neuroscience, UMIST, PO Box 88, Manchester M60 1QD, UK.
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Uçakhan OO. Predicted corneal visual acuity in keratoconus as determined by ray tracing. ACTA OPHTHALMOLOGICA SCANDINAVICA 2003; 81:264-70. [PMID: 12780406 DOI: 10.1034/j.1600-0420.2003.00061.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
PURPOSE To evaluate the optical quality of the central anterior corneal surface in normal eyes and in eyes with keratoconus, and to investigate the accuracy of the predicted corneal visual acuity (PCVA) index as determined by ray tracing analysis. METHODS Twenty keratoconus eyes with contact lens-corrected visual acuity (VA) of 20/20 or better (11 patients, group A) and 20 eyes of 15 normal subjects (group B) were evaluated. After a detailed eye examination including measurement of pupil diameter, keratometry, topography and pachymetry, each subject eye was evaluated using ray tracing analysis with the Technomed C-scan colour ellipsoid topometer, using basic software (Technomed GmbH, Baesweiler, Germany). The PCVA was determined for each patient, and the results were analysed comparatively using two-sample t-test, regression analysis and Pearson correlation analysis. RESULTS The average best spectacle-corrected VA was measured as 0.2 +/- 0.2 logMAR (20/32) in group A and -0.1 +/- 0.1 logMAR (20/16) in group B. The average PCVA measurements derived from ray tracing analysis for 3.0 mm, 3.5 mm and 4.0 mm pupil diameters were 0.06 +/- 0.12 logMAR, 0.14 +/- 0.13 logMAR and 0.21 +/- 0.17 logMAR, respectively, in group A, and -0.14 +/- 0.08 logMAR,-0.11 +/- 0.09 logMAR and -0.09 +/- 0.11 logMAR, respectively, in group B. There was good correlation between best corrected VA and PCVA in both groups for all pupil diameters measured (p < 0.007). CONCLUSION Predicted corneal visual acuity as determined by ray tracing analysis is useful for estimating best spectacle-corrected VA in normal corneas and the effect of irregular corneal astigmatism on VA in eyes with mild to moderate keratoconus. Further studies are required to evaluate the efficacy of ray tracing in evaluation of aberrations of the optical system of the eye.
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Affiliation(s)
- Omür O Uçakhan
- Department of Ophthalmology, Ankara University School of Medicine, Turkey.
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Wang L, Wang N, Koch DD. Evaluation of refractive error measurements of the Wavescan Wavefront system and the Tracey Wavefront aberrometer. J Cataract Refract Surg 2003; 29:970-9. [PMID: 12781285 DOI: 10.1016/s0886-3350(02)01967-3] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE To evaluate the accuracy and repeatability of the WaveScan WavePrint system and the Tracey wavefront aberrometer in measuring refractive errors in phakic eyes. SETTING Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA. METHODS Using subjective manifest refraction (MR) as the standard, the spherical equivalent (SE), sphere, and cylinder were compared to values measured by WaveScan and Tracey devices in virgin eyes and eyes that had had corneal refractive surgery. Astigmatism was evaluated using vector analysis. The accuracy of the WaveScan and Tracey devices was assessed by 95% limits of agreement (95% LA), and repeatability was analyzed by 2 standard deviations (SDs) and intraclass correlation coefficients (ICCs). RESULTS The mean differences in SE, sphere, and cylinder between MR and WaveScan were -0.26 diopter (D), -0.12 D, and -0.28 D, respectively, and between MR and Tracey, -0.21 D, -0.01 D, and -0.40 D, respectively. The 95% LA for SE, sphere, and cylinder were -1.09 to 0.57 D, -1.14 to 0.89 D, and -0.95 to 0.40 D, respectively, for WaveScan and -1.37 to 0.95 D, -1.27 to 1.26 D, and -1.16 to 0.35 D, respectively, for Tracey. Vector analysis revealed mean differences of -0.47 +0.07 x 9 degrees between MR and WaveScan and of -0.53 +0.27 x 12 between MR and Tracey. The 2 SDs for SE, sphere, and cylinder were 0.26 D, 0.29 D, and 0.16 D, respectively, for WaveScan and 0.31 D, 0.36 D, and 0.33 D, respectively, for Tracey. The ICCs for SE, sphere, and cylinder were 0.993, 0.992, and 0.902, respectively, for WaveScan and 0.994, 0.992, and 0.764, respectively, for Tracey. The Tracey device measured all eyes evaluated; the WaveScan could not measure 14% of normal eyes and 50% of post laser in situ keratomileusis eyes. CONCLUSIONS Using MR as the standard, refractive errors measured by the WaveScan and Tracey devices were reliable and reproducible. However, the Tracey device was more robust in its ability to obtain measurements in normal and postoperative eyes.
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Affiliation(s)
- Li Wang
- Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, 6565 Fannin, Houston, TX 77030, USA
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Abstract
Refractive surgery is still one of the most innovative and evolving fields in ophthalmology. With the advent of customized ablation, a change in paradigm has been established: the primary goal of refractive surgery is not only to eliminate spectacles but to improve or at least prevent deterioration of the optical performance of the eye. Wavefront-guided refractive surgery has, as a new goal, to correct or at least minimize all optical aberrations of the eye, and consequently to improve or preserve visual performance, especially under scotopic conditions.
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Affiliation(s)
- Theo Seiler
- Department of Ophthalmology, University of Zurich, Zurich, Switzerland
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Wang L, Misra M, Pallikaris IG, Koch DD. Comparison of a ray-tracing refractometer, autorefractor, and computerized videokeratography in measuring pseudophakic eyes. J Cataract Refract Surg 2002; 28:276-82. [PMID: 11821210 DOI: 10.1016/s0886-3350(01)01103-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To test the accuracy and reliability of the first-generation prototype of Tracey-1, a ray-tracing refractometer. SETTING Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA. METHODS The refractive spherical equivalent (SE) and astigmatism measured by Tracey-1, subjective manifest refraction (MR), and autorefraction (AR) (Nidek AR-3300) were compared in 58 pseudophakic eyes of 44 patients with a mean age of 69.95 years +/- 8.6 (SD). The astigmatic values obtained from Tracey-1 and computerized videokeratography were also compared. Astigmatism values were compared using power vector analysis. RESULTS The mean SEs measured by MR, Tracey, and AR were -0.76 diopter (D) +/- 0.96 (SD) (range 1.00 to -3.00 D), 0.37 +/- 0.64 D (range 1.68 to -1.49 D), and -0.44 +/- 1.13 D (range 1.63 to -3.50 D), respectively. The Pearson correlation coefficients between MR and Tracey values and between MR and AR values were high (r = 0.895 and r = 0.875, respectively; both P < .0001). However, the mean difference between the Tracey and MR values was 1.13 +/- 0.48 D (range 2.45 to -0.06 D) (P < .001). The mean cylindrical differences between MR and Tracey and between MR and AR were 0.03 +/- 0.51 D (range 1.22 to -1.07 D) (P = .709) and -0.30 +/- 0.62 D (range 0.50 to -2.25 D) (P = .003), respectively. Power vector analysis revealed difference vectors of -0.16 x 60 between Tracey and MR and -0.22 x 87 between AR and MR. CONCLUSIONS Spherical and cylindrical refractive data obtained with the Tracey system correlated well with those derived from MR; however, there was a mean spherical error of approximately 1.10 D. Further work is required to refine the accuracy and range of this device.
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Affiliation(s)
- Li Wang
- Cullen Eye Institute, Baylor College of Medicine, Houston, Texas, USA
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Pallikaris LG, Panagopoulou SI, Siganos CS, Molebny VV. Objective Measurement of Wavefront Aberrations With and Without Accommodation. J Refract Surg 2001; 17:S602-7. [PMID: 11583240 DOI: 10.3928/1081-597x-20010901-20] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE The measurement of the refractive error profile is more useful than corneal topography in understanding the complexities of refractive surgery. We report on experimental studies of the spatially resolved refractometer Tracey-1, developed in Ukraine by IBME in medical cooperation with VEIC, Greece. METHODS Ten eyes were subjected to dynamic measurement of accommodation, in order to test the effectiveness of Tracey refractometry. Measurements were performed in zones 0 to 6 mm. The refractive aberrations were calculated and accommodation was evaluated. RESULTS Evaluation of data shows that the instrument can effectively follow the dynamic change of refractive aberrations through the accommodation process. CONCLUSION Clinical tests of Tracey technology demonstrated the ability to investigate accommodation using this instrument.
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Affiliation(s)
- L G Pallikaris
- Vardinoyannion Eye Institute of Crete, University of Crete, Greece.
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Miranda D, Krueger RR. Highlights of the 1st International Congress of Wavefront Sensing and Aberration-free Refractive Correction. J Refract Surg 2001; 17:S566-72. [PMID: 11583232 DOI: 10.3928/1081-597x-20010901-12] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
As we review the many new and evolving techniques for treating patients with customized ablation, it is obvious that there is a rapid evolution of technology and thought. Newly refined diagnostic technology, such as wavefront sensing, and more sophisticated spot laser delivery systems with eye tracking gives the refractive surgical team greater flexibility in tackling challenging optical abnormalities. These highlights of the 2000 Congress now set the stage for further development, outlined in the following selected papers from the 2001 Congress.
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Affiliation(s)
- D Miranda
- Refractive Surgery Department, Cole Eye Institute, Cleveland Clinic Foundation, OH 44195, USA
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Abstract
Wavefront sensing is an emerging technology that can measure irregular astigmatism as a higher-order wavefront aberration. The application of wavefront sensing in ophthalmology might enable the non-invasive observation of living retinal cone cells; the measurement of detailed visual function of the central nervous system by eliminating higher-order aberrations during examinations by adaptive optics; the correction of irregular astigmatism; and the prevention of iatrogenic irregular astigmatism induced by conventional refractive surgical procedures. In addition, it will be theoretically possible to obtain supernormal vision by wavefront-guided refractive surgery.
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Affiliation(s)
- N Maeda
- Department of Ophthalmology, Osaka University Medical School, Osaka, Japan.
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