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Petelczyc K, Bolek J, Kakarenko K, Krix-Jachym K, Kołodziejczyk A, Rękas M. Use of the perceptual point-spread function to assess dysphotopsias. PLoS One 2024; 19:e0306331. [PMID: 39028737 PMCID: PMC11259305 DOI: 10.1371/journal.pone.0306331] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 06/14/2024] [Indexed: 07/21/2024] Open
Abstract
Nowadays many patients are choosing EDOF or multifocal lenses for replacement of natural lens in cataract surgery. This can result in issues such as presence of dysphotopsias, namely halo and glare. In this work, we propose a new perimetry method to describe dysphotopsias in far-field region in a presence of bright, point-like light source. We constructed a custom device and designed measurement procedure for quantitative measurement of dysphotopias in the center of visual field and used it to examine patients with mild cataracts or implanted IOLs. Our approach may help in establishing an objective method to study and compare dysphotopsias.
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Affiliation(s)
| | - Jan Bolek
- Faculty of Physics, Warsaw University of Technology, Warsaw, Poland
| | - Karol Kakarenko
- Faculty of Physics, Warsaw University of Technology, Warsaw, Poland
| | | | | | - Marek Rękas
- Ophthalmology Department, Military Institute of Medicine, Warsaw, Poland
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2
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Castro-Torres JJ, Casares-López M, Ortiz-Peregrina S, Martino F, Gómez-Robledo L, Jiménez JR. Effect of the chromaticity of stimuli on night vision disturbances. Sci Rep 2024; 14:10183. [PMID: 38702452 PMCID: PMC11068904 DOI: 10.1038/s41598-024-61069-4] [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: 10/17/2023] [Accepted: 04/30/2024] [Indexed: 05/06/2024] Open
Abstract
The perception of halos and other night vision disturbances is a common complaint in clinical practice. Such visual disturbances must be assessed in order to fully characterize each patient's visual performance, which is particularly relevant when carrying out a range of daily tasks. Visual problems are usually assessed using achromatic stimuli, yet the stimuli encountered in daily life have very different chromaticities. Hence, it is important to assess the effect of the chromaticity of visual stimuli on night vision disturbances. The aim of this work is to study the influence of the chromaticity of different visual stimuli on night vision disturbances by analyzing straylight and visual discrimination under low-light conditions. For that, we assessed the monocular and binocular visual discrimination of 27 subjects under low illumination using the Halo test. The subjects' visual discrimination was assessed after exposure to different visual stimuli: achromatic, red, green, and blue, both at the monitor's maximum luminance and maintaining the same luminance value for the different visual stimuli. Monocular straylight was also measured for an achromatic, red, green, and blue stimuli. The blue stimulus had the greatest effect on halos in both monocular and binocular conditions. Visual discrimination was similar for the red, green, and achromatic stimuli, but worsened at lower luminance. The greatest influence of straylight was observed for the blue stimulus. In addition, visual discrimination correlated with straylight measurements for achromatic stimuli, wherein greater straylight values correlated with an increased perception of halos and other visual disturbances.
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Affiliation(s)
- José J Castro-Torres
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071, Granada, Spain.
| | - Miriam Casares-López
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071, Granada, Spain
| | - Sonia Ortiz-Peregrina
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071, Granada, Spain
| | - Francesco Martino
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071, Granada, Spain
| | - Luis Gómez-Robledo
- Basic and Applied Colorimetry Lab, Department of Optics, University of Granada, 18071, Granada, Spain
| | - José R Jiménez
- Laboratory of Vision Sciences and Applications, Department of Optics, University of Granada, 18071, Granada, Spain
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3
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Zhao W, Zhao J, Zhang Z, Han T, Wang J, Zhou X. Evaluating early-stage disk halo changes after small incision lenticule extraction. Eur J Ophthalmol 2022; 33:11206721221138306. [PMID: 36377271 DOI: 10.1177/11206721221138306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
PURPOSE To investigate early changes in the disk halo under different light conditions after myopic small incision lenticule extraction (SMILE). METHODS This prospective study included 70 eyes of 70 myopic patients aged 18-33 years, with a spherical equivalent (SE) of -5.87 ± 1.86 D, who underwent SMILE. The subjective refraction, higher-order aberrations (HOAs), pupillometry, and halo were measured preoperatively and postoperatively to analyse disk halo variations and correlated factors. RESULTS At 5 cd/m2 and 1 cd/m2 luminance, the halo radius in the high myopia (HM) group reached a postoperative peak after 1 week (p = 0.000 and 0.019, respectively), and recovered to baseline after 3 months. In the low-to-moderate (LM) myopia group, the halo radius did not differ 1 week postoperatively compared to the preoperative level (p = 0.015), but significantly improved after 3 months (p = 0.000). The halo radius correlated with SE, uncorrected distance visual acuity (UDVA), ocular HOAs, coma, and the pupillary light reflex in the LM group at all time points, but there were no correlations in the HM group. CONCLUSIONS Halo symptoms occurred early after SMILE, but recovered within 3 months. The recovery process was slower in the HM group than in the LM group, and the halo radius correlated with SE, UDVA, ocular HOAs, coma, and the pupillary light reflex.
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Affiliation(s)
- Wuxiao Zhao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
- Present at Center for Optometry and Visual Science, Guangxi Academy of Medical Sciences, Nanning, China
| | - Jing Zhao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Zhe Zhang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Tian Han
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Jifang Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
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4
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Zhao W, Zhao J, Han T, Wang J, Zhang Z, Zhou X. A Comprehensive Investigation of Contrast Sensitivity and Disk Halo in High Myopia Treated With SMILE and EVO Implantable Collamer Lens Implantation. Transl Vis Sci Technol 2022; 11:23. [PMID: 35452094 PMCID: PMC9055559 DOI: 10.1167/tvst.11.4.23] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose To investigate the clinical outcomes in small incision lenticule extraction (SMILE) and EVO implantable Collamer lens (ICL)–treated high myopia. Methods Thirty-three SMILE-treated and 32 EVO ICL-treated patients were included and followed up for 6 months. Subjective refraction, contrast sensitivity, and disk halo size were measured preoperatively and postoperatively. Patient-reported outcomes (PROs) were obtained at the final visit. Results Significant differences in efficacy and safety indices were observed between the SMILE and EVO ICL groups at 6 months postoperatively (P < 0.05). In the SMILE group, the mesopic contrast sensitivity at 2.2 cycles per degree (cpd) and photopic contrast sensitivity at 0.5, 3.4, and 7.1 cpd were significantly improved. In the EVO ICL group, the mesopic contrast sensitivity at 7.1 cpd and photopic contrast sensitivity at 0.5, 7.1, and 14.6 cpd were significantly improved. The halo radii after SMILE were significantly increased at 1 week, showed a decreasing trend at 1 month, returned to baseline at 3 months, and progressed stably at 6 months. However, it was unchanged in the EVO ICL group. Regarding subjective experience, haloes were the most common disturbance with mild and little bothersomeness after EVO ICL in contrast to starbursts after SMILE. Conclusions EVO ICL implantation yielded better visual outcomes, improved contrast sensitivity particularly at high spatial frequencies, had a stabler disk halo size, and increased incidence of haloes, with less influence than that of SMILE. Translational Relevance The disk halo and PRO findings will be of benefit for consultations and evaluations in visual performance and disturbances.
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Affiliation(s)
- Wuxiao Zhao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Jing Zhao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Tian Han
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Jifang Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Zhe Zhang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China.,NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
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5
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Zhao W, Zhao J, Han T, Li M, Wang J, Zhou X. Evaluation of Disk Halo Size and Identification of Correlated Factors in Myopic Adults. Front Med (Lausanne) 2022; 9:743543. [PMID: 35155490 PMCID: PMC8831374 DOI: 10.3389/fmed.2022.743543] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2021] [Accepted: 01/05/2022] [Indexed: 11/15/2022] Open
Abstract
This study aimed to evaluate glare source-induced disk halo size and assess its correlation with higher-order aberrations (HOAs), pupillometry findings, and contrast sensitivity in myopic adults (aged 23.8 ± 4.4 years). In this cross-sectional study, 150 eyes of 150 patients were assessed. All patients underwent routine ophthalmic examinations, wavefront aberrometry, halo size measurement, dynamic pupillometry, and contrast sensitivity tests. Spearman's correlation analysis and independent sample t-tests were performed for data analysis. The mean halo radius was 82.5 ± 21.8 and 236.7 ± 52.2 arc min at 5 and 1 cd/m2 luminance levels, respectively. The values were inversely correlated with internal spherical aberration (SA) (r = −0.175, p = 0.032 and r = −0.241, p = 0.003, respectively), but not correlated with spherical equivalent (SE, both p > 0.05). Positive correlations were observed between halo radius and pupil size, contraction amplitude, and dilation speed during pupillary light reflex. Halo radii at 5 and 1 cd/m2 luminance levels were not significantly correlated with the area under the log contrast sensitivity function (r = −0.093, p = 0.258 and r = −0.149, p = 0.069, respectively). The mean halo radius was not clinically different between myopic and healthy eyes at 5 cd/m2 luminance level and did not differ significantly between the high and low-to-moderate myopia at 5 and 1 cd/m2 luminance levels (all p > 0.05). According to a stepwise linear regression model, the internal SA had a negative effect on the halo radius under low photpic condition; the average pupil diameter, internal SA and corneal HOAs played a large role in determining the halo radius under mesopic condition.
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Affiliation(s)
- Wuxiao Zhao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Jing Zhao
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Tian Han
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Meng Li
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Jifang Wang
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai, China
- NHC Key Laboratory of Myopia (Fudan University), Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
- *Correspondence: Xingtao Zhou
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6
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Bertaud S, Zenouda A, Lombardi M, Authié C, Brasnu E, Hamard P, Sahel JA, Baudouin C, Labbé A. Glare and Mobility Performance in Glaucoma: A Pilot Study. J Glaucoma 2021; 30:963-970. [PMID: 34506355 DOI: 10.1097/ijg.0000000000001936] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 08/14/2021] [Indexed: 11/26/2022]
Abstract
PRCIS Glare disability affects patients with moderate and severe glaucoma. Under glare conditions, mobility performances of glaucoma patients are reduced. PURPOSE The aim of this study was to evaluate glare disability and its impact on mobility and orientation in glaucoma patients. METHODS Twenty-two glaucoma patients and 12 age-matched control subjects were included. All patients underwent a clinical evaluation of visual function and halo size measurements to determine glare disability with a glare score (GS) of the best eye and worse eye. Mobility was evaluated by 4 mobility courses on an artificial street (StreetLab) under photopic conditions (P) and mesopic conditions with an additional light source in front of the patient to mimic dazzling conditions (M+G). Mobility time, mobility incidents, trajectory segmentation, distance traveled, preferred walking speed on trial (WS) and percentage of preferred walking speed (PPWS) were recorded, and the Nasa task load index (Nasa-TLX) was evaluated. RESULTS GS of the worse eye and GS of the best eye were significantly higher in glaucoma patients than in the control group (P=0.001 and 0.003). It was significantly different between moderate glaucoma patients and controls (P=0.001 and 0.010, respectively) and between severe glaucoma patients and controls (P=0.049 and 0.016). In locomotion tasks, comparing performance under M+G and P conditions, mobility performance was significantly different concerning mobility time (P=0.010), distance traveled (P=0.008), WS (P=0.007), PPWS (P=0.006), and Nasa-TLX (P=0.017) in the glaucoma group. Under M+G lighting conditions, mobility performance for glaucoma patients was significantly worse than controls with regard to WS (P=0.038), PPWS (P=0.0498), mobility time (P=0.046), and Nasa-TLX (P=0.006). CONCLUSION Glare disability was observed in patients with moderate and severe glaucoma and had an impact on their mobility performance.
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Affiliation(s)
| | | | - Marco Lombardi
- CHNO des Quinze-Vingts, IHU FOReSIGHT
- Streetlab, Institut de la Vision, Paris, France
| | | | - Emmanuelle Brasnu
- Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, IHU FOReSIGHT
| | - Pascale Hamard
- Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, IHU FOReSIGHT
| | - José-Alain Sahel
- CHNO des Quinze-Vingts, IHU FOReSIGHT
- Inserm, U968, UPMC Univ Paris 06, UMR_S968, Institut de la Vision, CNRS, UMR 7210, CHNO des Quinze-Vingts, INSERM-DHOS CIC 503
- Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, IHU FOReSIGHT
| | - Christophe Baudouin
- CHNO des Quinze-Vingts, IHU FOReSIGHT
- Inserm, U968, UPMC Univ Paris 06, UMR_S968, Institut de la Vision, CNRS, UMR 7210, CHNO des Quinze-Vingts, INSERM-DHOS CIC 503
- Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, IHU FOReSIGHT
- Department of Ophthalmology, Ambroise Paré Hospital, AP-HP, Paris Saclay University
| | - Antoine Labbé
- CHNO des Quinze-Vingts, IHU FOReSIGHT
- Inserm, U968, UPMC Univ Paris 06, UMR_S968, Institut de la Vision, CNRS, UMR 7210, CHNO des Quinze-Vingts, INSERM-DHOS CIC 503
- Department of Ophthalmology III, Quinze-Vingts National Ophthalmology Hospital, IHU FOReSIGHT
- Department of Ophthalmology, Ambroise Paré Hospital, AP-HP, Paris Saclay University
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7
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Tangmonkongvoragul C, Supalaset S, Tananuvat N, Ausayakhun S. Two-Step Transepithelial Photorefractive Keratectomy with WaveLight EX500 Platform for Adolescents and Adults with Low to Moderate Myopia: A 12-Month Comparative Evaluation. Clin Ophthalmol 2021; 15:4109-4119. [PMID: 34675478 PMCID: PMC8520963 DOI: 10.2147/opth.s336727] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 10/01/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose To compare the visual and refractive results obtained after two-step TransPRK using an EX500 excimer laser for low to moderate myopic correction in adolescents and adults. Patients and Methods Retrospectively, 91 eyes of 52 patients were categorized into four groups based on age and level of myopia. The demographics, data of efficacy, safety, predictability, stability, and post-operative complications were evaluated at 1, 3, 6, and 12 months post-operatively. Results At 1-month, adolescents with low myopia achieved the highest mean efficacy index (P =0.034). The efficacy indices continuously increased during the 1-year follow-up in all groups, except in adolescents with moderate myopia. The highest safety and efficacy indices were recorded in adolescents with low myopia at 1-year. Post-operative spherical equivalent within ±0.50 D at 1 year was 48.75% of all treated eyes; however, the final mean refractive spherical equivalent (MRSE) was under-corrected in all groups. By month 3, the percentage of eyes that had grade 0.5 haze was most prevalent in adolescents with moderate myopia (P <0.001). Conclusion two-step TransPRK using an EX500 proved to be an effective, predictable, stable and safe procedure for the correction of low to moderate myopia with or without astigmatism at 1 year. Adolescents with low myopia achieved the best-post-operative UDVA, efficacy and safety indices. Adolescents tolerated night visual problems and dry eye symptoms better than adults.
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Affiliation(s)
- Chulaluck Tangmonkongvoragul
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,CMU LASIK Center, Center of Medical Excellence, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Sumet Supalaset
- Department of Ophthalmology, Chulabhorn Hospital, HRH Princess Chulabhorn College of Medical Science, Chulabhorn Royal Academy, Bangkok, Thailand
| | - Napaporn Tananuvat
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,CMU LASIK Center, Center of Medical Excellence, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Somsanguan Ausayakhun
- Department of Ophthalmology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.,CMU LASIK Center, Center of Medical Excellence, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
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8
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Zhao W, Han T, Li M, Sekundo W, Aruma A, Zhou X. Nighttime Symptoms After Monocular SMILE: A Contralateral Eye Study. Ophthalmol Ther 2021; 10:1033-1044. [PMID: 34559401 PMCID: PMC8589907 DOI: 10.1007/s40123-021-00396-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 09/06/2021] [Indexed: 11/25/2022] Open
Abstract
Introduction To investigate nighttime symptoms in patients with myopic anisometropia after monocular small incision lenticule extraction (SMILE) surgery. Methods Thirty-six patients who had undergone monocular SMILE more than 6 months previously were recruited at the Eye & ENT Hospital of Fudan University. The average age at surgery was 25.4 ± 6.1 years. Preoperative spherical equivalent (SE) was −3.77 ± 1.56 D in SMILE-treated eyes and −0.08 ± 0.66 D in unoperated eyes. Main measurements included uncorrected and corrected distance visual acuity, manifest refraction, halo radius, contrast sensitivity, nighttime symptoms, and patient satisfaction. Results The mean follow-up time was 13.9 ± 3.4 months. The efficacy and safety indexes were 1.18 and 1.28, respectively. The halo radius was not significantly different between SMILE-treated and unoperated eyes under luminance conditions of 1, 5, and 100 cd/m2 (P = 0.055). No significant differences were observed in contrast sensitivity at all spatial frequencies between eyes under both uncorrected and corrected conditions (all P > 0.05). None of the patients reported moderate or severe symptoms at night. Mild symptoms (glare, halo, starburst) were reported and binocularly equal in 13 patients, whereas four patients reported better night vision in SMILE-treated eyes than unoperated eyes, and one of them experienced mild night vision disturbance. The overall satisfaction score was 9.39 ± 0.80. Conclusions The disk halo size and contrast sensitivity in SMILE-treated eyes were similar to those in unoperated eyes, and nighttime symptoms almost completely resolved after SMILE.
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Affiliation(s)
- Wuxiao Zhao
- Eye Institute and Department of Ophthalmology and Optometry, Eye & ENT Hospital of Fudan University, No.19 Baoqing Road, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Tian Han
- Eye Institute and Department of Ophthalmology and Optometry, Eye & ENT Hospital of Fudan University, No.19 Baoqing Road, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Meiyan Li
- Eye Institute and Department of Ophthalmology and Optometry, Eye & ENT Hospital of Fudan University, No.19 Baoqing Road, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Walter Sekundo
- Department of Ophthalmology, Phillips University of Marburg, Marburg, Germany
| | - Aruma Aruma
- Eye Institute and Department of Ophthalmology and Optometry, Eye & ENT Hospital of Fudan University, No.19 Baoqing Road, Shanghai, 200031, China
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China
| | - Xingtao Zhou
- Eye Institute and Department of Ophthalmology and Optometry, Eye & ENT Hospital of Fudan University, No.19 Baoqing Road, Shanghai, 200031, China.
- NHC Key Laboratory of Myopia (Fudan University), Shanghai, China.
- Shanghai Research Center of Ophthalmology and Optometry, Shanghai, China.
- Shanghai Engineering Research Center of Laser and Autostereoscopic 3D for Vision Care (20DZ2255000), Shanghai, China.
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9
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Fernández J, Rodríguez-Vallejo M, Martínez J, Burguera N, Piñero DP. What we have learnt from 30 years living with positive dysphotopsia after intraocular lens implantation?: a review. EXPERT REVIEW OF OPHTHALMOLOGY 2021. [DOI: 10.1080/17469899.2021.1917997] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
- Joaquín Fernández
- Department of Ophthalmology (Qvision, VITHAS Hospital, Almería, Spain
| | | | - Javier Martínez
- Department of Ophthalmology (Qvision, VITHAS Hospital, Almería, Spain
| | - Noemi Burguera
- Department of Ophthalmology (Qvision, VITHAS Hospital, Almería, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
- Department of Ophthalmology (Imqo-oftalmar), Vithas Medimar International Hospital, Alicante, Spain
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10
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Kohnen T, Suryakumar R. Measures of visual disturbance in patients receiving extended depth-of-focus or trifocal intraocular lenses. J Cataract Refract Surg 2021; 47:245-255. [PMID: 32818348 DOI: 10.1097/j.jcrs.0000000000000364] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 07/14/2020] [Indexed: 02/07/2023]
Abstract
The degree of visual disturbance associated with a particular model of intraocular lens (IOL) depends on several factors, including IOL optic, material, and mechanics. Characterization of visual disturbance profiles is paramount for informing clinical IOL selection. Although many studies evaluating presbyopia-correcting IOLs include subjective assessment of visual symptoms, the types of patient-reported outcome measures (PROMs) used to capture these outcomes are inconsistent across studies, complicating data contextualization. Furthermore, some tools produce more meaningful results than others. This review presents a discussion on the scientific literature published on the subjective and semiobjective (halo and glare simulator, light-distortion analyzer, vision monitor, and halometers) methods used to assess visual disturbances in patients implanted with trifocal or extended depth-of-focus IOLs, highlighting their advantages and limitations. It underscores the importance of between-study comparisons and the need for standardized PROMs in clinical IOL research to provide more accurate information for IOL selection.
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Affiliation(s)
- Thomas Kohnen
- From the Department of Ophthalmology (Kohnen), Goethe University Frankfurt, Frankfurt, Germany; and Alcon Vision LLC (Suryakumar), Fort Worth, Texas, USA
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Yao L, Xu Y, Han T, Qi L, Shi J, Zou Z, Zhou X. Relationships Between Haloes and Objective Visual Quality in Healthy Eyes. Transl Vis Sci Technol 2020; 9:13. [PMID: 32974085 PMCID: PMC7488622 DOI: 10.1167/tvst.9.10.13] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 07/15/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose To determine the normal values and relationships between haloes and objective optical quality in healthy eyes. Methods In this cross-sectional study, haloes, pupillary responses to light, and objective optical quality were measured with the optical quality analysis system (OQAS) and a vision monitor (MonCv3) in 138 right eyes of 138 healthy young men with mean spherical equivalent of 0.32 ± 0.47 D. Results The mean disc halo size was 77.17 ± 25.03 arcmin. The mean objective optical quality values were as follows: objective scatter index (OSI), 0.58 ± 0.33; Strehl ratio (SR), 0.21 ± 0.05; modulation transfer function cutoff, 36.27 ± 7.98 cpd; OQAS value (OV)100%, 1.21 ± 0.27; OV20%, 0.91 ± 0.23; and OV9%, 0.59 ± 0.16. Disc halo size correlated independently with OSI (P < 0.001) and minimum pupil size (P = 0.003) by forward stepwise regression analysis (disc halo size = 16.60 + 26.24 × OSI + 11.34 × minimum pupil size; R2 value = 17.7%; F = 14.52; P < 0.001). Conclusions Reference values for disc halo size and objective optical quality in healthy young subjects were established. Eyes with worse objective vision quality exhibited larger haloes. Translational Relevance The study provided the knowledge and the relationships of OQAS and halo measurements from a well-defined group of healthy young subjects. Both measurements are useful in clinical practice to help quantify the vision quality and complement each other.
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Affiliation(s)
- Lu Yao
- Department of Aviation Physical Examination, Air Force Medical Center, Beijing
| | - Ye Xu
- Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China.,NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai 200031, China
| | - Tian Han
- Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China.,NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai 200031, China
| | - Linsong Qi
- Department of Aviation Physical Examination, Air Force Medical Center, Beijing
| | | | - Zhikang Zou
- Department of Aviation Physical Examination, Air Force Medical Center, Beijing
| | - Xingtao Zhou
- Department of Ophthalmology, Eye & ENT Hospital, Fudan University, Shanghai 200031, China.,NHC Key Laboratory of Myopia (Fudan University); Key Laboratory of Myopia, Chinese Academy of Medical Sciences, Shanghai 200031, China.,Shanghai Research Center of Ophthalmology and Optometry, Shanghai 200031, China
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Adrian J, Hue D, Porte S, Le Brun J. Validation of the driver ecological glare test. JOURNAL OF SAFETY RESEARCH 2020; 72:139-143. [PMID: 32199556 DOI: 10.1016/j.jsr.2019.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/21/2019] [Revised: 07/08/2019] [Accepted: 12/11/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION The present study proposes to validate the Driver Ecological Glare Test (DEGT), a test developed to measure the benefit of a headlight glare Advanced Driver Assistance System (ADAS), by comparing it to a laboratory glare test. METHOD Twenty-four participants, aged from 55 to 70 years, were recruited to complete a visual examination, including monocular halo size measurement for both eyes using Vision Monitor device (MonCv3; Metrovision). An on-field evaluation took place at night at the UTAC CERAM test track to obtain disability glare measures using the DEGT. RESULTS A significant correlation was found between the two glare tests and Bland-Altman analysis reveals a good agreement with a bias of 73.7 arcmin between the halo size measurements obtained from the DEGT and Vision Monitor. The results of the present study demonstrate that the DEGT is a valid method to test halo size and is adapted to evaluate the benefits of an antiglare device for drivers in an ecological situation.
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Affiliation(s)
| | - David Hue
- Valeo Lighting Systems, Bobigny, France
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Evaluation of disk halo size after small incision lenticule extraction (SMILE). Graefes Arch Clin Exp Ophthalmol 2019; 257:2789-2793. [PMID: 31664518 DOI: 10.1007/s00417-019-04481-1] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 08/21/2019] [Accepted: 09/13/2019] [Indexed: 10/25/2022] Open
Abstract
PURPOSE To investigate changes in objective disk halo size produced by a glare source after small incision lenticule extraction (SMILE) for myopia correction. METHODS This prospective clinical study included 45 right eyes of 45 patients with a mean age of 25.40 ± 5.06 years and mean spherical equivalent (SE) of - 6.08 ± 1.90 diopters. Disk halo size was measured with a vision monitor before surgery and at postoperative 1 week and 3 months. Other information was collected, including age, SE, lenticule thickness, lenticule diameter, dark pupil, and pupillary response to light parameters (initial diameter; amplitude, latency, duration, and velocity of contraction; latency, duration, and velocity of dilation; and maximum, minimum, and average pupil size). RESULTS Compared to preoperative values, disk halo size increased significantly at postoperative 1 week (P = 0.026) and returned to baseline at postoperative 3 months (P = 0.349). Preoperative disk halo size significantly correlated with SE (r = - 0.346, P = 0.020), minimum pupil size (r = 0.365, P = 0.014), and average pupil size (r = 0.310, P = 0.038). Disk halo size at postoperative 1 week was significantly correlated with age (r = 0.324, P = 0.030) and minimum pupil size (r = 0.297, P = 0.047). Disk halo size at postoperative 3 months was significantly correlated with lenticule diameter (r = - 0.362, P = 0.015), initial diameter (r = 0.311, P = 0.037), maximum pupil size (r = 0.312, P = 0.037), minimum pupil size (r = 0.440, P = 0.002), and average pupil size (r = 0.373, P = 0.012). CONCLUSIONS After SMILE, disk halo size demonstrated a temporary increase and then returned to baseline.
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Evaluation of Disk Halo Size after Implantation of a Collamer Lens with a Central Hole (ICL V4c). J Ophthalmol 2019; 2019:7174913. [PMID: 31485347 PMCID: PMC6710753 DOI: 10.1155/2019/7174913] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Accepted: 07/11/2019] [Indexed: 11/25/2022] Open
Abstract
Purpose To investigate disk halo size changes produced by a glare source after surgical insertion of an implantable collamer lens with a central hole (ICL V4c) for myopia correction. Methods In this prospective study, disk halo size and pupillary light response with a vision monitor were measured preoperatively and at 1 week, 1 month, and 3 months postoperatively. Pupillary light response parameters included contraction amplitude, latency, duration, and velocity; dilation latency, duration, and velocity; and initial, maximum, minimum, and average pupil diameters. Results Forty-two right eyes of 42 patients were enrolled. Postoperative uncorrected distance visual acuity was better than or equal to 20/20 in all eyes. Compared to preoperative values, disk halo size showed no significant difference at 1 week postoperatively (P > 0.05) and then decreased significantly at 1 and 3 months postoperatively (both P < 0.001). Contraction amplitude and velocity, as well as dilation velocity, decreased significantly at all postoperative time points (all P < 0.001). Disk halo size at 3 months postoperatively was significantly correlated with initial (r = 0.446, P=0.003), maximum (r = 0.483, P=0.001), minimum (r = 0.425, P=0.005), and average pupil diameters (r = 0.474, P=0.002). Conclusions After ICL V4c implantation, disk halo size was reduced in the short term. Patients with smaller pupil sizes during pupillary response to light experienced smaller halos after ICL V4c implantation.
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From Presbyopia to Cataracts: A Critical Review on Dysfunctional Lens Syndrome. J Ophthalmol 2018; 2018:4318405. [PMID: 30050689 PMCID: PMC6040261 DOI: 10.1155/2018/4318405] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 06/05/2018] [Indexed: 01/19/2023] Open
Abstract
Dysfunctional lens syndrome (DLS) is a term coined to describe the natural aging changes in the crystalline lens. Different alterations in the refractive properties and transparency of the lens are produced during the development of presbyopia and cataract, such as changes in internal high order aberrations or an increase in ocular forward scattering, with a potentially significant impact on clinical measures, including visual acuity and contrast sensitivity. Objective technologies have emerged to solve the limits of current methods for the grading of the lens aging, which have been linked to the DLS term. However, there is still not a gold standard or evidence-based clinical guidelines around these new technologies despite multiple research studies have correlated their results with conventional methods such as visual acuity or the lens opacification system (LOCS), with more scientific background around the ocular scattering index (OSI) and Scheimpflug densitometry. In either case, DLS is not a new evidence-based concept that leads to new knowledge about crystalline lens aging but it is a nomenclature change of two existing terms, presbyopia and cataracts. Therefore, this term should be used with caution in the scientific peer-reviewed literature.
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Zhao F, Han T, Chen X, Chen Z, Zheng K, Wang X, Zhou X. Minimum pupil in pupillary response to light and myopia affect disk halo size: a cross-sectional study. BMJ Open 2018; 8:e019914. [PMID: 29643157 PMCID: PMC5898290 DOI: 10.1136/bmjopen-2017-019914] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVES To evaluate the relationship between pupillary response to light, myopia and disk halo size. DESIGN Cross-sectional study. SETTING Single refractive surgery centre. PARTICIPANTS In this study, 197 right eyes of 197 patients between 20 and 35 years of age were evaluated for disk halo size and pupillary response to light with a vision monitor. PRIMARY AND SECONDARY OUTCOME MEASURES Halo radius, age, spherical equivalent (SE), axial length (AL), initial diameter, amplitude of contraction, latency of contraction, duration of contraction, velocity of contraction, latency of dilation, duration of dilation, velocity of dilation, maximum pupil, minimum pupil, average pupil and dark pupil. RESULTS Significant associations were found between disk halo size and SE (r=-0.219, P=0.002), AL (r=0.152, P=0.033) and minimum pupil (r=0.149, P=0.037). There were no associations between disk halo size and initial diameter, amplitude of contraction, latency of contraction, duration of contraction, velocity of contraction, latency of dilation, duration of dilation, velocity of dilation, maximum pupil, average pupil, dark pupil and age (P>0.05). A significant difference in disk halo size was detected between the low-moderate and high myopia (SE< -6 D) groups (P=0.002) and between the small and large (minimum pupil≥4 mm) minimum pupil size groups (P=0.014). CONCLUSIONS Patients with a high SE and large minimum pupil size (minimum pupil ≥4 mm) suffered more disability glare than those with a low SE and small minimum pupil size.
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Affiliation(s)
- Feng Zhao
- Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai, China
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Tian Han
- Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai, China
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Xun Chen
- Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai, China
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Zhi Chen
- Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai, China
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Ke Zheng
- Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai, China
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Xiaoying Wang
- Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai, China
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
| | - Xingtao Zhou
- Key Laboratory of Myopia, Ministry of Health, Fudan University, Shanghai, China
- Department of Ophthalmology, Eye and ENT Hospital, Fudan University, Shanghai, China
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Through-Focus Vision Performance and Light Disturbances of 3 New Intraocular Lenses for Presbyopia Correction. J Ophthalmol 2018; 2018:6165493. [PMID: 29651343 PMCID: PMC5831879 DOI: 10.1155/2018/6165493] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Revised: 12/07/2017] [Accepted: 12/14/2017] [Indexed: 12/13/2022] Open
Abstract
Purpose To compare the through-focus visual performance in a clinical population of pseudophakic patients implanted with two new trifocal intraocular lenses (IOLs) and one extended depth of focus IOL. Methods Prospective, nonrandomized, examiner-masked case series. Twenty-three patients received the FineVision® and seven patients received the PanOptix™ trifocal IOLs. Fifteen patients received the Symfony extended depth of focus IOL. Mean age of patients was 63 ± 8 years. Through-focus visual acuity was measured from –3.00 to +1.00 D vergences. Contrast sensitivity was measured with and without a source of glare. Light disturbances were evaluated with the Light Distortion Analyzer. Results Though-focus evaluation showed that trifocal IOLs performed significantly better at near distance (33 and 40 cm), and extended depth of focus performed significantly better at intermediate distance (1.0 m). Contrast sensitivity function with glare and dysphotopsia was similar between the three IOLs and subjective response to questionnaire showed a significantly higher score (worse performance) for the extended depth of focus IOL compared to both trifocal IOLs in the bothersome subscale (p < 0.05). Conclusions Trifocal IOLs grant better performance at near distance while extended depth of focus IOL performs better at intermediate distance. Objective dysphotopsia measured with the Light Distortion Analyzer is not reduced in extended depth of focus IOL compared to trifocal IOLs.
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Abstract
PURPOSE To investigate the individual effects of forward light scatter (FLS) and refractive blur on low-contrast vision and the size of the disk halo produced in response to an external glare source. METHODS Monocular disk halo radius, high- and low-contrast distance visual acuity (HCVA, LCVA), and contrast sensitivity (CS) were determined in 25 eyes of 25 healthy subjects under normal, FLS, and blur conditions. FLS was induced using the filter Black ProMist 2 to simulate an early cataract. Blur was induced using a +1.00 diopter lens to simulate an uncorrected refractive error. RESULTS Similar significant mean increases in halo radius were observed for the FLS (0.32 ± 0.10 log arc min; P < .0001) and refractive blur (0.40 ± 0.18 log arc min; P < .0001). Under induced blur, 3 lines of HCVA (0.32 ± 0.15 logMAR; P < .0001) and 4 lines of LCVA (0.39 ± 0.16 logMAR; P < .0001) were lost. FLS had a minimal (but significant) effect on HCVA, but worsened mean LCVA by more than 1 line (0.13 ± 0.10 logMAR; P < .0001). Similar significant mean CS reductions of 0.17 ± 0.12 (P < .0001) and 0.14 ± 0.12 log units (P < .0001) were produced in response to FLS and refractive blur, respectively (approximately 1 triplet). CONCLUSIONS Forward light scatter and refractive blur contributed to an increased size of the disk halo produced by a glare source in similar proportion. Although defocus blur has a substantial effect on LCVA, a loss of more than 1 line of LCVA after best refractive correction would be indicative of FLS.
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Corneal Aberrations, Contrast Sensitivity, and Light Distortion in Orthokeratology Patients: 1-Year Results. J Ophthalmol 2016; 2016:8453462. [PMID: 27867660 PMCID: PMC5102743 DOI: 10.1155/2016/8453462] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Revised: 07/27/2016] [Accepted: 08/30/2016] [Indexed: 11/17/2022] Open
Abstract
Purpose. To evaluate the corneal higher-order aberrations (HOA), contrast sensitivity function (CSF), and light distortion (LD) in patients undergoing orthokeratology (OK). Methods. Twenty healthy subjects (mean age: 21.40 ± 8 years) with mean spherical equivalent refractive error M = −2.19 ± 0.97 D were evaluated at 1 day, 1 month, and 1 year after starting OK treatment. Monocular LD, photopic monocular CSF, and corneal HOA for 6 mm pupil size were measured. Results. LD showed an increase after the first night (p < 0.05) and recovery to baseline after 1 month, remaining stable after 1 year (p > 0.05). Spherical-like, coma-like, and secondary astigmatism HOA RMS increased significantly (p ≤ 0.022) from baseline to 1-month visit, remaining unchanged over the follow-up. Contrast sensitivity for medium frequencies (3.0, 4.24, and 6.00 cpd) was significantly correlated with LD parameters at baseline (r ≤ −0.529, p < 0.001). However, after 1 year of treatment, this correlation was only statistically significant for 12 cpd spatial frequency (r ≤ −0.565, p < 0.001). Spherical-like RMS for 6 mm pupil size correlated with irregularity of the LD (r = −0.420, p < 0.05) at the 1-year visit. Conclusion. LD experienced by OK patients recovers after one month of treatment and remains stable in the long term while optical aberrations remain significantly higher than baseline.
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Palomo-Álvarez C, Puell MC. Capacity of straylight and disk halo size to diagnose cataract. J Cataract Refract Surg 2016; 41:2069-74. [PMID: 26703281 DOI: 10.1016/j.jcrs.2015.10.047] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 03/20/2015] [Accepted: 03/22/2015] [Indexed: 11/19/2022]
Abstract
PURPOSE To examine the capacity of straylight and disk halo size to diagnose cataract. SETTING Faculty of Optics and Optometry, Universidad Complutense de Madrid, Spain. DESIGN Prospective study. METHODS Straylight, disk halo radius, and high-contrast corrected distance visual acuity (CDVA) measurements were compared between patients with age-related cataract and age-matched normal-sighted control subjects by calculating the area under the curve (AUC) receiver operating characteristic. RESULTS Measurements were made in 53 eyes of 53 patients with a mean age of 67.94 years ± 7.11 (SD) and 31 eyes of 31 controls with a mean age 66.06 ± 5.43 years. Significantly worse (P < .001) mean straylight (1.38 ± 0.24 log[s]), mean disk halo radius (2.40 ± 0.18 log minutes of arc [arcmin]), and mean CDVA (0.17 ± 0.11 logMAR) were recorded in the cataract group than in the control group (1.17 ± 0.11 log[s], 2.10 ± 0.16 log arcmin, and 0.08 ± 0.08 logMAR). Significant differences in AUCs were observed for disk halo radius (0.89 ± 0.04) versus straylight (0.77 ± 0.05) (P = .03) and disk halo radius versus CDVA (0.72 ± 0.05) (P = .001). The comparison of disk halo radius versus the discriminant function with input from CDVA and straylight (0.80 ± 0.05) was at the limit of significance only (0.091 ± 0.05, P = .051). CONCLUSION Although all 3 variables discriminated well between normal eyes and eyes with cataract, the disk halo radius showed the best diagnostic capacity. FINANCIAL DISCLOSURE Neither author has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- Catalina Palomo-Álvarez
- From the Applied Vision Research Group, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain.
| | - María C Puell
- From the Applied Vision Research Group, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
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Puell MC, Pérez-Carrasco MJ, Hurtado-Ceña FJ, Álvarez-Rementería L. Disk halo size measured in individuals with monofocal versus diffractive multifocal intraocular lenses. J Cataract Refract Surg 2016; 41:2417-23. [PMID: 26703491 DOI: 10.1016/j.jcrs.2015.04.030] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2014] [Revised: 04/23/2015] [Accepted: 04/23/2015] [Indexed: 10/22/2022]
Abstract
PURPOSE To compare disk halo size in response to a glare source in eyes with an aspheric apodized diffractive multifocal intraocular lens (IOL) or aspheric monofocal IOL. SETTING Rementeria Ophthalmological Clinic, Madrid, Spain. DESIGN Prospective randomized masked study. METHOD Halo radius was measured using a vision monitor (MonCv3) with low-luminance optotypes in eyes that had cataract surgery and bilateral implantion of an Acrysof Restor SN6AD1 multifocal IOL or Acrysof IQ monofocal IOL 6 to 9 months previously. The visual angle subtended by the disk halo radius was calculated in minutes of arc (arcmin). Patient complaints of halo disturbances were recorded. Monocular uncorrected distance visual acutity (UDVA) and corrected distance visual acuity (CDVA) were measured using high-contrast (96%) and low-contrast (10%) logMAR letter charts. RESULTS The study comprised 39 eyes of 39 subjects (aged 70 to 80 years); 21 eyes had a multifocal IOL and 18 eyes a monofocal IOL. The mean halo radius was 35 arcmin larger in the multifocal IOL group than the monofocal group (P < .05). Greater halo effects were reported in the multifocal IOL group (P < .05). The mean monocular high-contrast UDVA and low-contrast UDVA did not vary significantly between groups, whereas the mean monocular high-contrast CDVA and low-contrast CDVA were significantly worse at 0.12 logMAR and 0.13 logMAR in the multifocal than in the monofocal IOL group, respectively (P < .01). A significant positive correlation was detected by multiple linear regression between the halo radius and low-contrast UDVA in the multifocal IOL group (r = 0.72, P < .001). CONCLUSIONS The diffractive multifocal IOL gave rise to a larger disk halo size, which was correlated with a worse low-contrast UDVA. FINANCIAL DISCLOSURE None of the authors has a financial or proprietary interest in any material or method mentioned.
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Affiliation(s)
- M C Puell
- From the Applied Vision Research Group (Puell, Pérez-Carrasco), Faculty of Optics and Optometry, Complutense University of Madrid, and Clínica Rementería (Hurtado-Ceña, Álvarez-Rementería), Madrid, Spain.
| | - M J Pérez-Carrasco
- From the Applied Vision Research Group (Puell, Pérez-Carrasco), Faculty of Optics and Optometry, Complutense University of Madrid, and Clínica Rementería (Hurtado-Ceña, Álvarez-Rementería), Madrid, Spain
| | - F J Hurtado-Ceña
- From the Applied Vision Research Group (Puell, Pérez-Carrasco), Faculty of Optics and Optometry, Complutense University of Madrid, and Clínica Rementería (Hurtado-Ceña, Álvarez-Rementería), Madrid, Spain
| | - L Álvarez-Rementería
- From the Applied Vision Research Group (Puell, Pérez-Carrasco), Faculty of Optics and Optometry, Complutense University of Madrid, and Clínica Rementería (Hurtado-Ceña, Álvarez-Rementería), Madrid, Spain
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Whitman J, Dougherty PJ, Parkhurst GD, Olkowski J, Slade SG, Hovanesian J, Chu R, Dishler J, Tran DB, Lehmann R, Carter H, Steinert RF, Koch DD. Treatment of Presbyopia in Emmetropes Using a Shape-Changing Corneal Inlay: One-Year Clinical Outcomes. Ophthalmology 2016; 123:466-75. [PMID: 26804761 DOI: 10.1016/j.ophtha.2015.11.011] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 10/02/2015] [Accepted: 11/06/2015] [Indexed: 11/19/2022] Open
Abstract
PURPOSE To report 1-year safety and efficacy clinical outcomes of a shape-changing corneal inlay for the treatment of presbyopia. DESIGN Prospective, nonrandomized, multicenter United States Food and Drug Administration Investigational Device Exemption clinical trial (clinicaltrials.gov identifier, NCT01373580). PARTICIPANTS Nondominant eyes (N = 373) of emmetropic presbyopic subjects were implanted at 11 sites with the Raindrop Near Vision Inlay (ReVision Optics, Lake Forest, CA); 340 eyes underwent the 1-year follow-up visit. METHODS The corneal inlay was implanted under a corneal flap at the center of the light-constricted pupil created with a femtosecond laser. MAIN OUTCOME MEASURES For subjects completing the 1-year follow-up, monocular and binocular uncorrected and corrected visual acuity, refractive stability, contrast sensitivity (CS; photopic and mesopic), symptom and satisfaction questionnaire results, and adverse events. RESULTS At 1 year in the treated eye, on average, uncorrected near visual acuity (UNVA) improved by 5.1 lines, uncorrected intermediate visual acuity (UIVA) improved by 2.5 lines, and uncorrected distance visual acuity (UDVA) decreased by 1.2 lines. From 3 months through 1 year, 93% of subjects achieved UNVA of 20/25 or better, 97% achieve UIVA of 20/32 or better, and 95% achieved UDVA of 20/40 or better. Binocularly, the mean UDVA exceeded 20/20 from 3 months through 1 year. Contrast sensitivity loss occurred only at the highest spatial frequencies, with no loss binocularly. Absent or mild scores were reported in 96% of subjects for visual symptoms (glare, halos, double vision, and fluctuations in vision), in 99% for ocular symptoms (pain, light sensitivity, and discomfort), and in 95% for dryness. Adverse events were treatable and resolved. Eighteen inlays were replaced, usually soon after implantation because of decentration, but UNVA was little affected in this group thereafter. In the 11 cases requiring inlay explantations, 100% achieved a corrected distance visual acuity of 20/25 or better by 3 months after explant. CONCLUSIONS The Raindrop Near Vision Inlay provides significant improvement in near and intermediate visual performance, with no significant change in binocular distance vision or CS. Subject satisfaction is improved significantly with minimal ocular or visual symptoms.
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Affiliation(s)
| | | | | | | | | | | | - Ralph Chu
- Chu Vision Institute, Bloomington, Minnesota
| | - Jon Dishler
- Dishler Laser Institute, Greenwood Village, Colorado
| | - Dan B Tran
- Coastal Vision Laser Eye Center, Orange, California
| | | | | | - Roger F Steinert
- Gavin Herbert Eye Institute, University of California, Irvine, California
| | - Douglas D Koch
- Department of Ophthalmology, Baylor College of Medicine, Houston, Texas
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Ferreira-Neves H, Macedo-de-Araújo R, Rico-Del-Viejo L, da-Silva AC, Queirós A, González-Méijome JM. Validation of a method to measure light distortion surrounding a source of glare. JOURNAL OF BIOMEDICAL OPTICS 2015; 20:75002. [PMID: 26146877 DOI: 10.1117/1.jbo.20.7.075002] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2015] [Accepted: 05/04/2015] [Indexed: 06/04/2023]
Abstract
Our objective was to validate a new device dedicated to measure the light disturbances surrounding bright sources of light under different sources of potential variability. Twenty subjects were involved in the study. Light distortion was measured using an experimental prototype (light distortion analyzer, CEORLab, University of Minho, Portugal) comprising twenty-four LED arrays panel at 2 m. Sources of variability included: intrasession and intersession repeated measures, pupil size (3 versus 6 mm), defocus (+0.50 ) correction for the working distance, angular resolution (15 deg versus 30 deg), temporal stimuli presentation, and pupil size. Size, shape, location, and irregularity parameters have been obtained. At a low speed of presentation of the stimuli, changes in angular resolution did not have an effect on the results of the parameters measured. Results did not change with pupil size. Intensity of the central glare source significantly influenced the outcomes. Examination time was reduced by 30% when a 30 deg angular resolution was explored instead of 15 deg. Measurements were fast and repeatable under the same experimental conditions. Size and shape parameters showed the highest consistency, whereas location and irregularity parameters showed lower consistency. The system was sensitive to changes in the intensity of the central glare source but not to pupil changes in this sample of healthy subjects
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Puell MC, Pérez-Carrasco MJ, Palomo-Alvarez C, Antona B, Barrio A. Relationship between halo size and forward light scatter. Br J Ophthalmol 2014; 98:1389-92. [PMID: 24814964 DOI: 10.1136/bjophthalmol-2014-304872] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
PURPOSE To determine the relationship between the size of a halo induced by a glare source and forward scatter or visual acuity (VA) in healthy eyes. METHOD Measurements were made in the right eyes of 51 healthy individuals of mean age 29.3 ± 7.5 years. Halo radius was measured using the Vision Monitor and low luminance (1 cd/m(2)) optotypes presented at a distance of 2.5 m. The visual angle subtended by the radius of the halo was calculated in minutes of arc (arc min). Forward scatter or, straylight, was measured using the compensation comparison technique. Best-corrected distance VA was measured using high contrast (HC) (96%) and low contrast (LC) (10%) Bailey-Lovie logMAR letter charts under photopic (85 cd/m(2)) and mesopic (0.15 cd/m(2)) luminance conditions. RESULTS Mean halo radius was 202 ± 43 arc min (3.4 ± 0.7°) and mean retinal straylight was 0.95 ± 0.12 log units. Mean photopic distance HC-VA and LC-VA were -0.02 ± 0.06 and 0.12 ± 0.09 logMAR, respectively. Mean mesopic distance HC-VA and LC-VA were 0.35 ± 0.11 and 0.74 ± 0.11 logMAR, respectively. Forward stepwise regression analysis revealed that halo radius was significantly correlated with straylight (r=0.45) and mesopic LC-VA (r=0.48), but not with photopic HC-VA and/or LC-VA and mesopic HC-VA. CONCLUSIONS In healthy eyes, the larger the halo size induced by a given glare source, the greater the forward-scatter (straylight) and worse the mesopic LC-VA. Halo size seems to be independent of photopic HC-VA or LC-VA and mesopic HC-VA.
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Affiliation(s)
- María C Puell
- Applied Vision Research Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - María J Pérez-Carrasco
- Applied Vision Research Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Catalina Palomo-Alvarez
- Applied Vision Research Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Beatriz Antona
- Applied Vision Research Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Ana Barrio
- Applied Vision Research Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
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