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Guo Y, Zhang M, Tong Y, Ma X, Wang S, Li Y, Du Y, Zhou Y. Impact of pupil and defocus ring intersection area on retinal defocus. Ophthalmic Physiol Opt 2024; 44:472-480. [PMID: 38234008 DOI: 10.1111/opo.13276] [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: 08/09/2023] [Revised: 12/28/2023] [Accepted: 12/29/2023] [Indexed: 01/19/2024]
Abstract
PURPOSE With the rising prevalence of myopia, especially among the young, orthokeratology (Ortho-K) stands out as a promising approach, not only to reduce myopia but also to control the progression of axial length (AL). This study examined how the intersection area between the pupil and defocus ring influenced retinal defocus and axial growth after Ortho-K. METHODS A case-control study was conducted with 100 participants (100 eyes). Both AL and the refraction difference value (RDV), that is, the peripheral refractive error measured with respect to the central value after wearing Ortho-K lenses, were determined. Subjects were categorised into two groups based on the size of the intersection area after 3 months of lens wear: Group A (<4.58 mm2 ) and Group B (≥4.58 mm2 ). RESULTS Group B demonstrated significantly lower changes in AL and RDV at 30-40° and 40-53° compared with Group A after 3 months of lens wear (all p < 0.05). After 6 months of lens wear, Group B showed significantly lower changes in AL and RDV in the 40-53° region compared with Group A (all p < 0.05). Correlation analysis revealed that as the intersection area increased, the changes in AL and RDV at 0-53°, 30-40° and 40-53° eccentricity decreased after both 3 and 6 months of lens wear (all p < 0.01). CONCLUSIONS A larger intersection area between the pupil and defocus ring within a certain time period can cause a greater amount of myopic defocus at 30-53° from the fovea. The results suggest that a larger intersection area might lead to more effective control of axial growth.
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Affiliation(s)
- Yujuan Guo
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
- Ophthalmology Beijing Ming Vision, Beijing, China
- Ineye Hospital of Chengdu University of Traditional Medicine, Chengdu, China
| | - Mingxu Zhang
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
| | - Yuting Tong
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
| | - Xiaoqi Ma
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
| | - Siyao Wang
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
| | - Yu Li
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
- Ineye Hospital of Chengdu University of Traditional Medicine, Chengdu, China
| | - Yuqin Du
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
- Ophthalmology Beijing Ming Vision, Beijing, China
| | - Yuehua Zhou
- Eye School of Chengdu University of Traditional Medicine, Chengdu, China
- Ophthalmology Beijing Ming Vision, Beijing, China
- Ineye Hospital of Chengdu University of Traditional Medicine, Chengdu, China
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Jiang F, Huang X, Xia H, Wang B, Lu F, Zhang B, Jiang J. The Spatial Distribution of Relative Corneal Refractive Power Shift and Axial Growth in Myopic Children: Orthokeratology Versus Multifocal Contact Lens. Front Neurosci 2021; 15:686932. [PMID: 34177459 PMCID: PMC8219929 DOI: 10.3389/fnins.2021.686932] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2021] [Accepted: 05/17/2021] [Indexed: 01/29/2023] Open
Abstract
Purpose To determine if the spatial distribution of the relative corneal refractive power shift (RCRPS) explains the retardation of axial length (AL) elongation after treatment by either orthokeratology (OK) or multifocal soft contact lenses (MFCLs). Methods Children (8–14 years) were enrolled in the OK (n = 35) or MFCL (n = 36) groups. RCRPS maps were derived by computing the difference between baseline and 12-month corneal topography maps and then subtracting the apex values. Values at the same radius were averaged to obtain the RCRPS profile, from which four parameters were extracted: (1) Half_x and (2) Half_y, i.e., the x- and y-coordinates where each profile first reached the half peak; (3) Sum4 and (4) Sum7, i.e., the summation of powers within a corneal area of 4- and 7-mm diameters. Correlations between AL elongation and these parameters were analyzed by multiple linear regression. Results AL elongation in the OK group was significantly smaller than that in the MFCL group (p = 0.040). Half_x and Half_y were also smaller in the OK group than the MFCL group (p < 0.001 each). Half_x was correlated with AL elongation in the OK group (p = 0.005), but not in the MFCL group (p = 0.600). In an analysis that combined eyes of both groups, Half_x was correlated with AL elongation (β = 0.161, p < 0.001). Conclusions The OK-induced AL elongation and associated RCRPS Half_x were smaller than for the MFCL. Contact lenses that induce RCRPS closer to the corneal center may exert better myopia control.
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Affiliation(s)
- Fan Jiang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Xiaopeng Huang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Houxue Xia
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Bingqi Wang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Fan Lu
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Bin Zhang
- College of Optometry, Nova Southeastern University, Fort Lauderdale, FL, United States
| | - Jun Jiang
- School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China.,Eye Hospital, Wenzhou Medical University, Wenzhou, China
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Abstract
PURPOSE A previous study reported that pharmacologically-dilated pupils changed the corneal shape. Researchers used mydriatic agents with significant cycloplegic effect. The current study investigates the effect of mydriasis on corneal shape using phenylephrine alone, where phenylephrine has minimal effect on the accommodative system and whether corneal topography can be done after pupil dilation. METHODS Forty-four young healthy subjects with one eye randomly selected for mydriasis were used in this study. Twenty-two received one drop of 2.5% phenylephrine (group 1); the other 22 subjects had one drop of 0.4% benoxinate instilled prior to the application of 2.5% phenylephrine (group 2). They were matched for age and refractive error. Anterior chamber depth, pupil size and corneal parameters were compared before and after mydriasis. The corneal parameters included best-fit sphere (BFS), surface asymmetry index (SAI), surface regularity index (SRI) and the axial and tangential powers in the form of flattest and steepest powers, and in the form of M, J(0), and J(45) vector presentation. RESULTS Group 1 and group 2 subjects had similar pre-mydriatic baseline ocular parameters. The mean (+/- SD) pupil dilation was 1.24 +/- 0.59 mm for group 1 and 1.80 +/- 0.95 mm for group 2. The dilation was significantly larger in group 2 (unpaired t-tests: t = 2.36, p = 0.02). There were no significant changes in corneal parameters from mydriasis in either group. CONCLUSIONS Previous investigations used mydriatic agents, which affected not only the pupil size but also accommodation. The current study found that mydriasis from phenylephrine, with minimal effect on accommodation, did not result in significant corneal alteration, and corneal topography can be measured after pupil dilation with phenylephrine.
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Affiliation(s)
- Ronnie Y C Huang
- School of Optometry, The Hong Kong Polytechnic University, Hong Kong SAR, China
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Brown SM, Bradley JC. Comparison of 2 monocular pupillometers and an autorefractor for measurement of the dark-adapted pupil diameter. J Cataract Refract Surg 2011; 37:660-4. [DOI: 10.1016/j.jcrs.2010.10.059] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2010] [Revised: 09/22/2010] [Accepted: 10/26/2010] [Indexed: 11/25/2022]
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Bradley JC, Bentley KC, Mughal AI, Bodhireddy H, Brown SM. Dark-Adapted Pupil Diameter as a Function of Age Measured with the NeurOptics Pupillometer. J Refract Surg 2011; 27:202-7. [DOI: 10.3928/1081597x-20100511-01] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2009] [Accepted: 04/21/2010] [Indexed: 11/20/2022]
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Effect of preoperative pupil size on quality of vision after wavefront-guided LASIK. Ophthalmology 2010; 118:736-41. [PMID: 21093922 DOI: 10.1016/j.ophtha.2010.07.030] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2010] [Revised: 07/29/2010] [Accepted: 07/29/2010] [Indexed: 11/22/2022] Open
Abstract
PURPOSE To evaluate the effect of preoperative pupil size on quality of vision after wavefront-guided LASIK. DESIGN Prospective study. PARTICIPANTS One hundred two eyes. INTERVENTION LASIK for mild to moderate myopia or astigmatism (preoperative manifest spherical equivalent, -3.99±1.42 diopters). MAIN OUTCOME MEASURES Questionnaires evaluating specific visual symptoms before and after surgery. Each eye was evaluated before surgery, and 1 week and 1, 3, 6, and 12 months postoperatively. Pupils were stratified according to size: small (≤5.5 mm), medium (5.6-6.4 mm), or large (≥6.5 mm). Mesopic pupil size and preoperative and postoperative variables were evaluated using an analysis of variance. A regression model was also performed to determine the correlation between mean spherical equivalent and cylinder and visual symptoms. RESULTS In the early postoperative period, there was no difference between the 3 groups with regard to any of the symptoms. At the final 12-month postoperative visit, patients with medium pupils experienced less glare at night than small pupils (P = 0.02), medium pupils had less halos than small or large pupils (P = 0.001 and P = 0.02, respectively), and medium pupils experienced greater satisfaction in visual improvement than small pupils (P = 0.014). CONCLUSIONS Twelve months after wavefront-guided LASIK surgery, large pupil size does not positively correlate with any postoperative visual symptoms.
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Clinical performance of a handheld digital infrared monocular pupillometer for measurement of the dark-adapted pupil diameter. J Cataract Refract Surg 2010; 36:277-81. [DOI: 10.1016/j.jcrs.2009.09.025] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2009] [Revised: 08/26/2009] [Accepted: 09/08/2009] [Indexed: 11/22/2022]
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Alfonso JF, Ferrer-Blasco T, González-Méijome JM, García-Manjarres M, Peixoto-de-Matos SC, Montés-Micó R. Pupil size, white-to-white corneal diameter, and anterior chamber depth in patients with myopia. J Refract Surg 2009; 26:891-8. [PMID: 20027985 DOI: 10.3928/1081597x-20091209-07] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2009] [Accepted: 11/03/2009] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate anatomical parameters in a population of patients with myopia. METHODS Nine hundred sixty-four myopic eyes (-3.00 to -20.00 diopters [D] spherical equivalent refraction) were evaluated to measure mesopic and photopic pupil size with an infrared pupillometer; anterior chamber depth and white-to-white corneal diameter were obtained with Orbscan II (Bausch & Lomb). Correlation analysis was performed to evaluate the relationships among anatomical parameters of the anterior segment of the eye. RESULTS Average change in pupil size between mesopic and photopic conditions shows a uniform gap of 1.5 mm in patients aged 18 to 62 years with a slight insignificant trend to decrease with age. Photopic and mesopic pupil size were highly correlated (r=0.694, P<.001) and the difference between both measures was positively correlated with mesopic pupil size (r=0.207, P<.001) and inversely correlated with photopic pupil size (r=0.561, P<.001). Anterior chamber depth and white-to-white corneal diameter were positively correlated (r=0.389, P<.001). White-to-white corneal diameter and anterior chamber depth were not correlated with age (r=-0.096, P<.001) or anterior chamber depth (r=-0.183, P<.001-0.183) as a function of age. CONCLUSIONS Average difference between photopic and mesopic pupil size remained constant across the range of ages included in this cohort. A positive correlation was noted between anterior segment dimensions, and anterior chamber depth decreased with age.
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Affiliation(s)
- José F Alfonso
- Fernandez-Vega Ophthalmological Institute, Oviedo, Spain.
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Lemarinel B, Racine L, Rohart C, Hoang-Xuan T, Gatinel D. [Long-term changes in pupil size after implantation of an Artisan phakic intraocular lens for correction of high myopia]. J Fr Ophtalmol 2007; 30:11-6. [PMID: 17287666 DOI: 10.1016/s0181-5512(07)89544-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
PURPOSE To evaluate the long-term changes in pupil size after implantation of an Artisan phakic intraocular lens for correction of high myopia. PATIENTS AND METHODS Fourteen myopic eyes of seven patients were included in the study. Pupil size was measured under photopic conditions, under scotopic conditions after 10 min of dark adaptation, and after topical medical mydriasis. The pupil size was measured using the eye image of the OPD scan (Nidek). RESULTS The mean follow-up was 46 months after surgery. The mean photopic pupil diameter was 2.94+/-0.33 mm (range, 2.54-3.6 mm). The diameter of the scotopic pupil remained less than 6.0 mm in all patients (4.68+/-0.59 mm, with maximal pupil diameter of 5.67 mm). The mean pupil diameter after pharmacological dilation was also reduced (5.39+/-1.08 mm; range, 4.19-7.59 mm), with pupil dilation more than 7 mm in only one patient. CONCLUSION The iris-fixated intraocular lens mechanically limited pupil dilation in our patients. The long-term reduction in pupil size after Artisan phakic intraocular lens implantation may contribute to the maintenance of the quality of vision in scotopic conditions.
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Affiliation(s)
- B Lemarinel
- Service d'Ophtalmologie, Fondation ophtalmologique Adolphe de Rothschild, Paris, France
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Allouch C, Touzeau O, Kopito R, Borderie V, Laroche L. Intérêt de l’auto-réfractomètre et de l’orbscan pour la mesure du diamètre pupillaire. J Fr Ophtalmol 2006; 29:373-9. [PMID: 16885803 DOI: 10.1016/s0181-5512(06)77695-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE We compared pupil size measurements obtained with the Orbscan and autorefractometer to the Colvard Infrared pupillometer in order to determine their respective clinical advantages. MATERIAL AND METHODS We prospectively measured the pupil diameter in 94 eyes of 47 normal patients using the Colvard device, the Nikon NKR 8000 autorefractometer, and the Orbscan device. For each device, two successive measurements were taken to determine its reproducibility. We also studied the relationship with the contralateral eye (i.e., difference and correlation). The measurements obtained with the different devices in different light intensities were compared and studied using regression analysis. RESULTS Pupil diameter measured using the Orbscan had the highest reproducibility (mean difference between the two successive measurements: 3.8% or 0.15mm) and showed the smallest difference between the two eyes (5.0% or 0.19mm) and the strongest correlation with the contralateral eye (r=0.93; p<0.001). Scotopic Colvard measurements and autorefractometer measurements with low light settings were not significantly different (5.86mm versus 5.86mm; p=0.48). Autorefractometer measurements with low light settings showed the strongest correlation with the scotopic Colvard measurements (r=0.84; p<0.001). The Orbscan measurements were less correlated with the scotopic or photopic Colvard measurements (r=0.73; p<0.001 and r=0.51; p=0.003, respectively). For the Colvard pupillometer, the correlation between photopic measurements and scotopic measurements was also poor (r=0.51; p<0.001). CONCLUSION Pupil size measurements with the autorefractometer may be advantageous before refractive surgery. Measuring pupil size in photopic conditions, as with the Orbscan, cannot screen people with large pupils in mesopic conditions.
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Affiliation(s)
- C Allouch
- Centre Hospitalier National d'Ophtalmologie des Quinze-Vingts, 28, rue de Charenton, 75012 Paris.
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Tahzib NG, Bootsma SJ, Eggink FAGJ, Nabar VA, Nuijts RMMA. Functional outcomes and patient satisfaction after laser in situ keratomileusis for correction of myopia. J Cataract Refract Surg 2005; 31:1943-51. [PMID: 16338565 DOI: 10.1016/j.jcrs.2005.08.022] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2005] [Accepted: 07/27/2005] [Indexed: 11/16/2022]
Abstract
PURPOSE To determine subjective patient satisfaction and self-perceived quality of vision after laser in situ keratomileusis (LASIK) to correct myopia and myopic astigmatism. SETTING Department of Ophthalmology, Academic Hospital Maastricht, Maastricht, The Netherlands. METHODS A validated questionnaire consisting of 66 items was self-administered by 142 consecutive patients. Seven scales covering a specific aspect of quality of vision were formulated. Aspects included global satisfaction, quality of uncorrected and corrected vision, quality of night vision, glare, daytime driving, and night driving. Main outcome measures were responses to individual questions and scale scores, and correlations with clinical parameters including refractive outcome, uncorrected visual acuity, best corrected visual acuity, ablation depth, and scotopic pupil-optical zone disparity were obtained. RESULTS The mean score for the overall satisfaction was 4.1 +/- 0.71 (SD) (scale 0 to 5.0). A total of 92.2% of patients were satisfied or very satisfied with their surgery, 93.6% considered their main goal of surgery achieved, and 92.3% would choose to have LASIK surgery again. Satisfaction with uncorrected vision was 3.03 +/- 0.71. The mean score for glare was 3.0 +/- 0.9. At night, glare from lights was believed to be more important than before surgery by 47.2%. Glare from oncoming car headlights after surgery was reported by 58.4% and was believed to be more bothersome for night driving than before surgery by 52.8%. Night driving was rated more difficult than before surgery by 39.4%, whereas 59.3% had less difficulty driving at night. There was a significant correlation between the uncorrected vision score and the postoperative spherical equivalent (r = 0.245) and postoperative astigmatism (r = 0.265). There was no correlation between the glare or night vision scores and the degree of correction, the amount of ablation depth, or the disparity between the scotopic pupil and the optical zone. CONCLUSIONS Self-perceived uncorrected vision after LASIK surgery for the correction of myopia and myopic astigmatism appears to be very good and is related to the postoperative residual error. Although the majority of patients postoperatively experienced glare, particularly with driving at night, this was not related to the pupil-optical zone disparity or degree of correction.
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Affiliation(s)
- Nayyirih G Tahzib
- Department of Ophthalmology, Academic Hospital Maastricht, Maastricht, The Netherlands.
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Laser literature watch. Photomed Laser Surg 2004; 22:261-76. [PMID: 15315736 DOI: 10.1089/1549541041438588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Montós-Micó R, Albarrán-Diego C, Muñoz ODG, Alió JL. USE OF ILLUMINANCE AND LUMINANCE UNITS/Response. J Refract Surg 2004; 20:490; author reply 490. [PMID: 15523963 DOI: 10.3928/1081-597x-20040901-14] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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