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McBee D, Kozhaya K, Wang L, Weikert MP, Koch DD. Repeatability of a Combined Adaptive Optics Visual Simulator and Hartman-Shack Aberrometer in Pseudophakic Eyes With and Without Previous Corneal Refractive Surgery. J Refract Surg 2024; 40:e645-e653. [PMID: 39254243 DOI: 10.3928/1081597x-20240718-02] [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: 09/11/2024]
Abstract
PURPOSE To evaluate the intrasession repeatability of wavefront aberrations obtained by a combined adaptive optics visual simulator and Hartman-Shack aberrometer in pseudophakic eyes with and without previous corneal refractive surgery. METHODS Three consecutive measurements were performed in one eye of each individual. Total ocular aberrations were recorded up to the 5th Zernike order for a 4.5-mm pupil. Repeatability was assessed by calculating the within-subject standard deviation (Sw), the repeatability limit (R), and the intraclass correlation coefficient (ICC). Vector analysis was performed to assess astigmatism variability between scans. RESULTS The study enrolled 32 normal individuals and 24 individuals with a history of refractive surgery. In normal and eyes that had previous refractive surgery, respectively, the Sw values were 0.155 and 0.176 diopters (D) for sphere and 0.184 and 0.265 D for cylinder. The Sw values for all 3rd order terms ranged from 0.037 to 0.047 µm in normal eyes and 0.044 to 0.063 µm in eyes that had previous refractive surgery. The Sw for primary spherical aberration was 0.020 µm in normal eyes and 0.026 µm in eyes that had previous refractive surgery. ICC values for measurements of astigmatism yielded larger variability (ICC = 0.751 and 0.879). However, both groups demonstrated excellent repeatability (ICC > 0.9) for root mean square higher order aberrations (RMS-HOA) and total RMS values. CONCLUSIONS In pseudophakic eyes, the adaptive optics Hartmann-Shack device demonstrated acceptable repeatability for measurement of sphere and 3rd and 4th order HOAs with higher variability for astigmatism measurements, especially in eyes with a prior history of corneal refractive surgery. [J Refract Surg. 2024;40(9):e645-e653.].
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Rua Amaro D, Bertelmann E, von Sonnleithner C. Clinical outcomes and optical performance of a new segmental refractive extended depth-of-focus intraocular lens. BMC Ophthalmol 2024; 24:320. [PMID: 39090592 PMCID: PMC11293127 DOI: 10.1186/s12886-024-03586-4] [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: 01/10/2024] [Accepted: 07/22/2024] [Indexed: 08/04/2024] Open
Abstract
BACKGROUND The visual performance and the optical quality of a segmental refractive extended depth-of-focus (EDoF) intraocular lens (IOL) were evaluated in a prospective, single-arm, single-center study. METHODS A total of 20 patients (40 eyes) after bilateral implantation of the refractive segmental EDoF Acunex Vario AN6V were included. Assessment procedure: refraction outcome, monocular and binocular uncorrected (UCVA) and distance-corrected visual acuity (DCVA), defocus curve, contrast sensitivity (CS), higher-order aberrations (HOAs) and patient satisfaction were evaluated 1 and 3 months after surgery. RESULTS At 3-month follow-up, mean spherical equivalent was - 0.23 ± 0.32 D. Binocular uncorrected distance visual acuity (VA) at distance, intermediate and near was - 0.08 ± 0.06 logMAR at 4 m, -0.03 ± 0.06 logMAR at 66 cm and 0.16 ± 0.06 logMAR at 40 cm, respectively. The binocular defocus curve showed a VA better than 0.20 logMAR over a range from + 1.50 to - 2.45 D. Contrast sensitivity aligned with monofocal lenses, highlighting the lens's clinical value. Aberrometry showed minimal changes in corneal aberrations. NEI-RQL-42-Questionnaire showed a high patient satisfaction for daily activities and revealed reduced dependence on glasses, particularly for near and intermediate vision. The Acunex Vario AN6V demonstrated minimal dysphotopsias, making it a promising option for those seeking spectacle independence. CONCLUSION This segmental refractive EDoF IOL provides a high degree of spectacle independence for far and intermediate distances with functional near VA. Although inducing residual coma aberrations, it showed subjectively good results with little dysphotopsias. TRIAL REGISTRATION This study protocol was reviewed and approved by ethics committee of Charité University, Berlin, Germany, with approval number EA4/126/20.
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Affiliation(s)
- David Rua Amaro
- Department of Ophthalmology, Charité Medical University, Campus Virchow, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Eckart Bertelmann
- Department of Ophthalmology, Charité Medical University, Campus Virchow, Augustenburger Platz 1, 13353, Berlin, Germany
| | - Christoph von Sonnleithner
- Department of Ophthalmology, Charité Medical University, Campus Virchow, Augustenburger Platz 1, 13353, Berlin, Germany.
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Mechó-García M, Arcas-Carbonell M, Orduna-Hospital E, Sánchez-Cano A, González-Méijome JM. The Influence of Accommodative Demand on Ocular Aberrations: A Study of Zernike Coefficients Repeatability and Variability. Curr Eye Res 2024:1-10. [PMID: 39004896 DOI: 10.1080/02713683.2024.2378009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 07/03/2024] [Indexed: 07/16/2024]
Abstract
PURPOSE To evaluate the repeatability of the Zernike coefficients in healthy eyes when monocular accommodation was stimulated at different vergences demands. METHODS A total of 36 right eyes from healthy volunteers were prospectively and consecutively recruited for this study. Wavefront aberrometry was conducted to objectively characterize the ocular optical quality during accommodation, from the individual's far point to a 5 D accommodation demand in steps of 0.5 D. The repeatability of Zernike coefficients up to the fourth order was assessed by calculating the within-eye repeatability (Sw), the coefficient of repeatability (CR), the coefficient of variation (CV), and the intraclass correlation coefficient (ICC) as an indicator of measurement reliability. RESULTS Correlation among repeated measurements showed high reliability (ICC > 0.513) for all parameters measured except some fourth-order Zernike coefficients, C(4, -4) (ICC < 0.766), C(4, -2) (ICC < 0.875), C(4, 2) (ICC < 0.778) and C(4, 4) (ICC < 0.811). Greater repeatability and less variability were obtained for high-order Zernike coefficients (CR < 0.154), although an increase in CR in the coefficients analyzed was observed with increasing accommodative demand. No clear trend was evident in CV; however, it was observed that the low-order Zernike coefficients exhibit lower CV (CV < 1.93) compared to the high-order Zernike coefficients (CV > 0). CONCLUSIONS The reliability of Zernike coefficients up to the fourth order in healthy young individuals demonstrated a strong consistency in measuring terms up to the fourth order, with more variability observed for high-order terms. The Zernike coefficients up to the third order exhibited the highest level of repeatability.
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Affiliation(s)
- María Mechó-García
- Clinical & Experimental Optometry Research Lab, Physics Center of Minho, and Porto Universities (CF-UM-UP), School of Sciences, University of Minho, Braga, Portugal
| | - María Arcas-Carbonell
- Departamento de Física Aplicada, Universidad de Zaragoza, Zaragoza, España
- Aragon Health Research Institute (IIS Aragon), Zaragoza, Aragon, Spain
| | - Elvira Orduna-Hospital
- Departamento de Física Aplicada, Universidad de Zaragoza, Zaragoza, España
- Aragon Health Research Institute (IIS Aragon), Zaragoza, Aragon, Spain
| | - Ana Sánchez-Cano
- Departamento de Física Aplicada, Universidad de Zaragoza, Zaragoza, España
- Aragon Health Research Institute (IIS Aragon), Zaragoza, Aragon, Spain
| | - José Manuel González-Méijome
- Clinical & Experimental Optometry Research Lab, Physics Center of Minho, and Porto Universities (CF-UM-UP), School of Sciences, University of Minho, Braga, Portugal
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McCabe CM, Peterson R, Hull J, Bala C. Impact of Aspheric Monofocal Intraocular Lens Implantation on Uncorrected Intermediate Visual Acuity: a Combined Analysis. Clin Ophthalmol 2024; 18:1491-1501. [PMID: 38827774 PMCID: PMC11143991 DOI: 10.2147/opth.s458125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Accepted: 05/16/2024] [Indexed: 06/05/2024] Open
Abstract
Purpose To evaluate binocular intermediate visual acuity (IVA), depth of focus, and other visual outcomes achieved with a monofocal aspheric intraocular lens (IOL) using pooled data from 2 randomized, double-masked, controlled trials. Patients and Methods The studies conducted at 32 sites included patients aged ≥22 years with bilateral cataracts, preoperative corneal astigmatism 1.0 D, and lens power 18.0-25.0 D. Patients received bilateral AcrySof IQ IOLs (SN60WF). Primary endpoint data were collected at month 6. Binocular uncorrected and corrected distance visual acuity (UDVA and CDVA) at 4 m, binocular uncorrected and corrected IVA (UIVA and DCIVA) at 66 cm, manifest refraction spherical equivalent (MRSE), and binocular defocus curve at 4 m were assessed under photopic conditions. Validated questionnaires were used to assess spectacle use and quality of vision. Results Of 233 patients who received SN60WF, 228 had visual acuity data at 6 months. Under photopic conditions, 51% of the eyes had pupils >4 mm, 40% had pupils 3-4 mm, and 9% had pupils <3 mm. Mean ± SD UDVA and CDVA were -0.019 ± 0.110 and -0.088 ± 0.082 logMAR, respectively. Mean ± SD UIVA and DCIVA were 0.125 ± 0.145 and 0.196 ± 0.139 logMAR, respectively. UIVA and DCIVA of 20/32 or better were achieved by 83% (188/228) and 71% (162/228) of patients, respectively. Mean ± SD MRSE was -0.007 ± 0.404 D for the first eye and 0.036 ± 0.371 for the second eye. The defocus curve demonstrated binocular vision of 0.24 logMAR or better from +1.2 to -1.5 D. Spectacle independence for distance and intermediate vision was reported by 86% and 41% of the patients, respectively. Based on questionnaires, 61%, 79%, and 65% of the patients did not experience starbursts, halos, or glare. Conclusion A monofocal aspheric IOL (SN60WF) assessed in a large, pooled study provided excellent distance vision and clinically functional intermediate vision.
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Gargallo D, Martinez-Espert A, Perches S, Victoria Collados M, Remón Martín L, Ares J. Multi-toric optical element to compensate ocular astigmatism with increased tolerance under rotation. OPTICS LETTERS 2024; 49:2289-2292. [PMID: 38691701 DOI: 10.1364/ol.518973] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Accepted: 03/18/2024] [Indexed: 05/03/2024]
Abstract
A new, to the best of our knowledge, optical element designed to compensate regular astigmatism while exhibiting increased tolerance to rotational misalignment is introduced. The element incorporates an optical design based on concentric annular regions with slightly different cylindrical axis angular positions. To assess visual quality performance as a function of rotation, retinal image simulation and clinical assessments with an adaptive optics visual simulator were carried out. The results demonstrate the superior performance of the newly proposed element in the presence of rotational errors when compared to traditional solutions.
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Bang SP, Sabesan R, Yoon G. Effects of Neural Adaptation to Habitual Spherical Aberration on Depth of Focus. RESEARCH SQUARE 2024:rs.3.rs-3917931. [PMID: 38410431 PMCID: PMC10896392 DOI: 10.21203/rs.3.rs-3917931/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/28/2024]
Abstract
We investigated how long-term visual experience with habitual spherical aberration (SA) influences subjective depth of focus (DoF). Nine healthy cycloplegic eyes with habitual SAs of different signs and magnitudes were enrolled. An adaptive optics (AO) visual simulator was used to measure through-focus high-contrast visual acuity after correcting all monochromatic aberrations and imposing +0.5 μm and -0.5 μm SAs for a 6-mm pupil. The positive (n=6) and negative (n=3) SA groups ranged from 0.17 to 0.8 μm and from -1.2 to -0.12 μm for a 6-mm pupil, respectively. For the positive habitual SA group, the median DoF with positive AO-induced SA (2.18D) was larger than that with negative AO-induced SA (1.91D); for the negative habitual SA group, a smaller DoF was measured with positive AO-induced SA (1.81D) than that with negative AO-induced SA (2.09D). The difference in the DoF of individual participants between the induced positive and negative SA groups showed a quadratic relationship with the habitual SA. Subjective DoF tended to be larger when the induced SA in terms of the sign and magnitude was closer to the participant's habitual SA, suggesting the importance of considering the habitual SA when applying the extended DoF method using optical or surgical procedures.
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Soomro SR, Sager S, Paniagua-Diaz AM, Prieto PM, Artal P. Head-mounted adaptive optics visual simulator. BIOMEDICAL OPTICS EXPRESS 2024; 15:608-623. [PMID: 38404335 PMCID: PMC10890873 DOI: 10.1364/boe.506858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 12/22/2023] [Accepted: 12/26/2023] [Indexed: 02/27/2024]
Abstract
Adaptive optics visual simulation is a powerful tool for vision testing and evaluation. However, the existing instruments either have fixed tabletop configurations or, being wearable, only offer the correction of defocus. This paper proposes a novel head-mounted adaptive optics visual simulator that can measure and modify complex ocular aberrations in real-time. The prototype is composed of two optical modules, one for the objective assessment of aberrations and the second for wavefront modulation, all of which are integrated into a wearable headset. The device incorporates a microdisplay for stimulus generation, a liquid crystal on silicon (LCoS) spatial light modulator for wavefront manipulation, and a Hartmann-Shack wavefront sensor. Miniature optical components and optical path folding structures, together with in-house 3D printed mounts and housing, were adapted to realize the compact size. The system was calibrated by characterizing and compensating the internal aberrations of the visual relay. The performance of the prototype was analyzed by evaluating the measurement and compensation of low-order and higher-order aberrations induced through trial lenses and phase masks in an artificial eye. The defocus curves for a simulated bifocal diffractive lens were evaluated in real eyes. The results show high accuracy while measuring and compensating for the induced defocus, astigmatism, and higher-order aberrations, whereas the MTF analysis shows post-correction resolution of up to 37.5 cycles/degree (VA 1.25). Moreover, the subjective test results show the defocus curves closely matched to a commercial desktop visual simulator.
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Affiliation(s)
- Shoaib R. Soomro
- Voptica S.L., Campus de Espinardo (Edificio Pleiades), 30100 Murcia, Spain
- Electronic Engineering Department, Mehran University of Engineering and Technology, Pakistan
| | - Santiago Sager
- Voptica S.L., Campus de Espinardo (Edificio Pleiades), 30100 Murcia, Spain
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo (Edificio 34), 30100 Murcia, Spain
| | - Alba M. Paniagua-Diaz
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo (Edificio 34), 30100 Murcia, Spain
| | - Pedro M. Prieto
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo (Edificio 34), 30100 Murcia, Spain
| | - Pablo Artal
- Laboratorio de Óptica, Universidad de Murcia, Campus de Espinardo (Edificio 34), 30100 Murcia, Spain
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Kozhaya K, Kenny PI, Esfandiari S, Wang L, Weikert MP, Koch DD. Effect of spherical aberration on visual acuity and depth of focus in pseudophakic eyes. J Cataract Refract Surg 2024; 50:24-29. [PMID: 37702444 DOI: 10.1097/j.jcrs.0000000000001314] [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: 03/13/2023] [Accepted: 09/08/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE To assess the performance of 4 intraocular lenses (IOLs) in various spherical aberration (SA) conditions, using the VAO adaptive optics simulator. SETTING Cullen Eye Institute, Baylor College of Medicine, Houston, Texas. DESIGN Prospective case series. METHODS Distance-corrected visual acuities at distance (CDVA), intermediate (DCIVA), and near (DCNVA) were measured in 42 dilated pseudophakic eyes at baseline and with ocular SA ranging from -0.4 to +0.4 μm in increments of 0.2 μm (6.0-mm pupil). 4 IOL types were assessed: monofocal IOLs with zero-SA, enhanced-monofocal, extended depth-of-focus (EDOF), and continuous range-of-vision. RESULTS Compared with SA = 0 μm, significant changes (all P < .05) were: (1) zero-SA monofocal IOLs' DCNVA at high contrast improved by 0.13 logMAR with SA = -0.4 μm and worsened by 0.09 and 0.10 logMAR with SA = +0.2 and +0.4 μm, respectively. DCNVA at low contrast worsened by 0.09 logMAR with SA = +0.4 μm; and (2) with SA = -0.4 μm, the enhanced monofocal IOL lost 0.06 logMAR of CDVA at high contrast and gained 0.09 logMAR of DCNVA at low contrast. There were no significant changes from SA = 0 μm for EDOF and continuous range-of-vision IOLs. CONCLUSIONS Zero-SA and EDOF IOLs were the most and least sensitive to SA modulation, respectively. In perfect optical systems where all the optical elements are aligned, induction of targeted amounts of negative SA improved the depth of focus of some IOL types. No benefit was found with positive SA.
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Affiliation(s)
- Karim Kozhaya
- From the Department of Ophthalmology, Cullen Eye Institute, Baylor College of Medicine, Houston, Texas
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Shetty N, Shetty R, Ranade R, Narasimhan R, Artal P, Nuijts RMMA, Sinha Roy A. Using adaptive optics to optimize the spherical aberration of eyes implanted with EDOF and enhanced monofocal intraocular lenses. J Cataract Refract Surg 2024; 50:30-36. [PMID: 37732726 DOI: 10.1097/j.jcrs.0000000000001315] [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: 04/12/2023] [Accepted: 09/08/2023] [Indexed: 09/22/2023]
Abstract
PURPOSE To assess the effect of change in ocular spherical aberration (SA) with adaptive optics on visual acuity (VA) at different defocus after implantation of extended depth-of-focus (EDOF) and enhanced monofocal intraocular lenses (IOLs). SETTINGS Narayana Nethralaya Eye Hospital, Bangalore, India. DESIGN Prospective, longitudinal, observational. METHODS 80 eyes (40 patients) that had cataract surgery were included in the study. 40 eyes were implanted with Eyhance EDOF IOLs and the remaining with Vivity EDOF IOLs. Baseline ocular aberrations were measured with a visual adaptive optics aberrometer, then the optimal SA was determined by increasing it in steps of -0.01 μm up to -0.1 μm until the maximum improvement in near distance VA was observed for a given eye. Then the defocus curve for each eye was measured after modifying the ocular SA by magnitude equal to optimal SA. RESULTS Most of the eyes accepted a negative induced SA of -0.05 μm (Eyhance group: 67.6%; Vivity group, 45.2%). In the Eyhance group (dominant eyes), VA improved at -2 diopters (D) ( P < .02) only and degraded at 0 D, +0.5 D, and +1 D defocus ( P < .05). In the Vivity group, the VA remained unchanged at all defocus ( P > .05). In the Eyhance group (nondominant eyes), VA improved at -3.5 D defocus only and degraded at +1.5 D and +2 D defocus ( P < .05). In the Vivity group, VA improved at -2.5 D defocus ( P < .05) only. CONCLUSIONS A negative induced SA of -0.05 μm in implanted eyes was optimal for a slight improvement in distance-corrected near and intermediate VA without any significant decrease in baseline distance-corrected VA.
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Affiliation(s)
- Naren Shetty
- From the Department of Cataract Surgery, Narayana Nethralaya Eye Hospital, Bangalore, India (N. Shetty, Ranade); Department of Cornea and Refractive Surgery, Narayana Nethralaya Eye Hospital, Bangalore, India (R. Shetty, Ranade); Imaging, Biomechanics and Mathematical Modelling Solutions Lab, Narayana Nethralaya Foundation, Bangalore, India (Narasimhan, Roy); Laboratorio de Óptica, Instituto Universitario de Investigación en Óptica y Nanofísica, Universidad de Murcia, Spain (Artal); University Eye Clinic Maastricht, Maastricht University Medical Center (MUMC+), Maastricht, the Netherlands (Nuijts)
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Marín JM, Hervella L, Villegas E, Robles C, Alcón E, Yago I, Artal P. Visual Performance at All Distances and Patient Satisfaction With a New Aspheric Inverted Meniscus Intraocular Lens. J Refract Surg 2023; 39:582-588. [PMID: 37675912 DOI: 10.3928/1081597x-20230802-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
PURPOSE To evaluate visual performance, spectacle independence, and quality of vision of new intraocular lenses (IOLs) for presbyopia correction with an aspheric inverted meniscus optical design (ArtIOLs; Voptica SL) in patients undergoing bilateral cataract surgery. METHODS In this prospective study, 60 eyes from 30 patients implanted bilaterally with Art40 and Art70 IOLs were included. These new IOLs were designed with an inverted meniscus shape to improve the peripheral performance and with aspheric surfaces to induce different amounts of negative spherical aberration in each IOL model. Distance-corrected and uncorrected through-focus visual acuities and contrast sensitivity were measured 1 to 3 months after surgery. Twenty-eight patients answered Patient Reported Spectacle Independence (PRSIQ) and Quality of Vision (QoV) questionnaires. RESULTS Mean monocular (Art40 and Art70) and binocular (Art40/70) corrected distance visual acuities (CDVA) were zero logMAR (20/20). Binocular uncorrected distance visual acuity (UDVA) at far, intermediate (66 cm), and near (40 cm) distances was 0.00 ± 0.01, 0.01 ± 0.03, and 0.09 ± 0.09 logMAR, respectively. Spectacle independence was achieved by 24 (85.7%) patients for far and intermediate vision and 20 patients (71.4%) for near vision. The number of patients never reporting experiencing glare, halos, and starbursts was 28, 27, and 26 (100%, 96.4%, and 92.9%), respectively. CONCLUSIONS The binocular combination of two ArtIOLs models (Art40 and Art70) significantly extended the depth of focus up to at least 40 cm. This combination resulted in a full range of vision with a high level of spectacle independence and without the compromise of halos or dysphotopsias. [J Refract Surg. 2023;39(9):582-588.].
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Hirabayashi MT, Gharabagi AP, Hesemann NP, Johnson SM, Webel AD, Petroski GF, Davis GR. Spherical Aberration of Cataractous Eyes and Its Relationship With Age, Ocular Biometry, and Various IOL Platforms. J Refract Surg 2023; 39:89-94. [PMID: 36779463 DOI: 10.3928/1081597x-20221207-01] [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: 02/14/2023]
Abstract
PURPOSE To determine the median spherical aberration (SA) of the cataractous population, how it relates to biometry, and the theoretical effect of different intraocular lens (IOL) platforms. METHODS A retrospective chart review of patients undergoing cataract surgery evaluation with a high quality Pentacam (Oculus Optikgeräte GmbH) were included. Age, gender, Q-value, mean total SA, higher order aberration root mean square wavefront error, and equivalent keratometry were collected from the Holladay report and axial length and anterior chamber depth (ACD) from the IOLMaster 700 (Carl Zeiss Meditec AG). RESULTS Data from 1,725 eyes of 999 patients were collected. SA had a median of 0.37 µm (95% confidence interval: 0.36 to 0.38. Age (r = .136, P < .001), Q-factor (r = .743, P < .001), and higher order aberration root mean square wavefront error (r = .307, P < .001) were positively correlated with SA. Average equivalent keratometry (r = -.310, P < .001) was negatively correlated with SA. Axial length (r = -0.037, P = .120) and ACD (r = .004, P = .856) had no association with SA. Up to 1,499 (86.9%) theoretically had SA moved closer to zero with IOLs that had negative SA. Up to 102 (5.9%) had SA theoretically worsened. CONCLUSIONS SA is not normally distributed, suggesting that there may be no "average" SA that IOLs should aim to correct. Patients might benefit from tailoring IOL choice to individual SA. Without access to SA data, eyes with steeper average keratometry or younger patients may have less SA, which could influence IOL choice. [J Refract Surg. 2023;39(2):89-94.].
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Marcos S, Artal P, Atchison DA, Hampson K, Legras R, Lundström L, Yoon G. Adaptive optics visual simulators: a review of recent optical designs and applications [Invited]. BIOMEDICAL OPTICS EXPRESS 2022; 13:6508-6532. [PMID: 36589577 PMCID: PMC9774875 DOI: 10.1364/boe.473458] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 05/02/2023]
Abstract
In their pioneering work demonstrating measurement and full correction of the eye's optical aberrations, Liang, Williams and Miller, [JOSA A14, 2884 (1997)10.1364/JOSAA.14.002884] showed improvement in visual performance using adaptive optics (AO). Since then, AO visual simulators have been developed to explore the spatial limits to human vision and as platforms to test non-invasively optical corrections for presbyopia, myopia, or corneal irregularities. These applications have allowed new psychophysics bypassing the optics of the eye, ranging from studying the impact of the interactions of monochromatic and chromatic aberrations on vision to neural adaptation. Other applications address new paradigms of lens designs and corrections of ocular errors. The current paper describes a series of AO visual simulators developed in laboratories around the world, key applications, and current trends and challenges. As the field moves into its second quarter century, new available technologies and a solid reception by the clinical community promise a vigorous and expanding use of AO simulation in years to come.
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Affiliation(s)
- Susana Marcos
- Center for Visual Sciences; The Institute of Optics and Flaum Eye Institute, University of Rochester, New York 14642, USA
| | - Pablo Artal
- Laboratorio de Optica, Universidad de Murcia, Campus Universitario de Espinardo, 30100, Spain
| | - David A. Atchison
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane Q, 4059, Australia
| | - Karen Hampson
- Department of Optometry, University of Manchester, Manchester M13 9PL, UK
| | - Richard Legras
- LuMIn, CNRS, ENS Paris-Saclay, Université Paris-Saclay, CentraleSupelec, Université Paris-Saclay Orsay, 91400, France
| | - Linda Lundström
- KTH (Royal Institute of Technology), Stockholm, 10691, Sweden
| | - Geunyoung Yoon
- College of Optometry, University of Houston, Houston, 77004, USA
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Lago CM, de Castro A, Benedí-García C, Aissati S, Marcos S. Evaluating the effect of ocular aberrations on the simulated performance of a new refractive IOL design using adaptive optics. BIOMEDICAL OPTICS EXPRESS 2022; 13:6682-6694. [PMID: 36589555 PMCID: PMC9774854 DOI: 10.1364/boe.473573] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/30/2022] [Accepted: 11/01/2022] [Indexed: 05/02/2023]
Abstract
Adaptive optics (AO) visual simulators are excellent platforms for non-invasive simulation visual performance with new intraocular lens (IOL) designs, in combination with a subject own ocular aberrations and brain. We measured the through focus visual acuity in subjects through a new refractive IOL physically inserted in a cuvette and projected onto the eye's pupil, while aberrations were manipulated (corrected, or positive/negative spherical aberration added) using a deformable mirror (DM) in a custom-developed AO simulator. The IOL increased depth-of-focus (DOF) to 1.53 ± 0.21D, while maintaining high Visual Acuity (VA, -0.07 ± 0.05), averaged across subjects and conditions. Modifying the aberrations did not alter IOL performance on average.
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Affiliation(s)
- Carmen M. Lago
- Visual Optics and Biophotonics Laboratory, Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Calle Serrano 121, Madrid, 28006, Spain
- 2EyesVision S.L., Plaza de la Encina 10, Madrid, 28760, Spain
| | - Alberto de Castro
- Visual Optics and Biophotonics Laboratory, Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Calle Serrano 121, Madrid, 28006, Spain
| | - Clara Benedí-García
- Visual Optics and Biophotonics Laboratory, Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Calle Serrano 121, Madrid, 28006, Spain
| | - Sara Aissati
- Visual Optics and Biophotonics Laboratory, Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Calle Serrano 121, Madrid, 28006, Spain
- Center for Visual Sciences; The Institute of Optics and Flaum Eye Institute, University of Rochester,14642, New York, USA
| | - Susana Marcos
- Visual Optics and Biophotonics Laboratory, Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Calle Serrano 121, Madrid, 28006, Spain
- Center for Visual Sciences; The Institute of Optics and Flaum Eye Institute, University of Rochester,14642, New York, USA
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14
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Wei D, Wei L, Yanjun H, Zequan X, Lei J, Qiang W. Visual quality analysis using the Chinese Catquest-9SF scale following different spherical aberration IOL implantation. Front Public Health 2022; 10:1029002. [PMID: 36407986 PMCID: PMC9670146 DOI: 10.3389/fpubh.2022.1029002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/21/2022] [Indexed: 11/06/2022] Open
Abstract
Purpose Based on the Chinese version of the Catquest-9SF scale, the contrast sensitivity meter and wavefront aberrometer were used to evaluate the visual quality of cataract patients implanted with different spherical aberrations IOL. Design Retrospective Observational Study. Methods Patients who had the lens implantation in our department from January 2020 to December 2021 were enrolled. All patients underwent uncorrected visual acuity, best corrected visual acuity and slit lamp microscope, high-order aberrations and contrast sensitivity test. The KR-1W wavefront analyzer (Topcon Medical System, Tokyo, Japan) was used to measure wavefront aberrations post-operation. The Chinese Catquest-9SF scale was used to score the postoperative visual satisfaction of the patients. Results 145 patients were screened according to the exclusion criteria, including 51 patients in the zero aspherical IOL (SOFTEC HD) group, 42 patients in the negative aspherical IOL (ZCB00) group, and a total of 52 patients in the spherical IOL (HQ-201HEP) group. The score was the highest in the zero spherical aberration group, followed by the negative spherical aberration group with the lowest scores in the spherical IOL group. Higher-order aberrations are relatively low in eyes implanted with the zero spherical aberration group. Contrast sensitivity with spherical lenses under glare-free and glare conditions was lower than those with aspheric lenses, and at higher frequencies the zero-aberration aspheric lens performed the best. Conclusion The Chinese Catquest-9SF scale provides an indication of visual quality after aspheric IOL implantation.
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Affiliation(s)
- Du Wei
- Department of Ophthalmology, The Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China,Department of Ophthalmology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou First People's Hospital, Xuzhou Eye Disease Prevention and Treatment Institute, Xuzhou, China
| | - Lou Wei
- Department of Ophthalmology, The Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Hua Yanjun
- Department of Ophthalmology, The Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Xu Zequan
- Department of Ophthalmology, The Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China
| | - Jin Lei
- Department of Ophthalmology, The Affiliated Xuzhou Municipal Hospital of Xuzhou Medical University, Xuzhou First People's Hospital, Xuzhou Eye Disease Prevention and Treatment Institute, Xuzhou, China
| | - Wu Qiang
- Department of Ophthalmology, The Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China,*Correspondence: Wu Qiang
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15
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Assessment of a New Trifocal Diffractive Corneal Inlay for Presbyopia Correction Using an Adaptive Optics Visual Simulator. PHOTONICS 2022. [DOI: 10.3390/photonics9030135] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
In this work, we analyze a proposal of a new intracorneal diffractive lens for presbyopia correction that could allow good, distance, intermediate and near vision. By using an adaptive optics visual simulator, we study the influence of two factors in the inlay performance: the spherical aberration (SA) and the potential errors of in thickness, induced in the manufacturing process. We show that the inlay through-the-focus imaging performance can be customized with the SA value, favoring either distance–intermediate or intermediate–near vision. Moreover, we found that with thickness variations of 10%, the inlay still maintains its trifocal nature.
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Fernández J, Rodríguez-Vallejo M, Burguera N, Rocha-de-Lossada C, Piñero DP. Spherical aberration for expanding depth of focus. J Cataract Refract Surg 2021; 47:1587-1595. [PMID: 34128496 DOI: 10.1097/j.jcrs.0000000000000713] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/05/2021] [Indexed: 11/26/2022]
Abstract
The increase in the depth of focus (DoF) for the treatment of presbyopia or cataracts is a topic of great interest for anterior segment surgeons who have seen how new surgical possibilities to achieve DoF enlargement have emerged. Nowadays, several technologies to extend the DoF are available, from corneal laser refractive surgery procedures in presbyopia to intraocular lens (IOL) implantation in cataract or refractive lens exchange. Some of these procedures are based on aspheric profiles, either in the cornea or in the IOL, which modulate the spherical aberration (SA) and, therefore, extend the light energy on different focal planes. The aim of this narrative review was to give an overall picture about the reasons why there is not a general solution persistent along time of SA induction to extend DoF, especially considering that SA depends on pupil diameter and this decreases with age.
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Affiliation(s)
- Joaquín Fernández
- From the Department of Ophthalmology (Qvision), VITHAS Hospital, Almería, Spain (Fernández, Rodríguez-Vallejo, Burguera, Rocha-de-Lossada), the Department of Ophthalmology, Hospital Virgen de las Nieves, Av. de las Fuerzas Armadas, Granada, Spain (Rocha-de-Lossada), the Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain (Piñero), and the Department of Ophthalmology (IMQO-Oftalmar), Vithas Medimar International Hospital, Alicante, Spain (Piñero)
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17
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Benedi-Garcia C, Vinas M, Lago CM, Aissati S, de Castro A, Dorronsoro C, Marcos S. Optical and visual quality of real intraocular lenses physically projected on the patient's eye. BIOMEDICAL OPTICS EXPRESS 2021; 12:6360-6374. [PMID: 34745742 PMCID: PMC8548014 DOI: 10.1364/boe.432578] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 05/06/2023]
Abstract
Visual simulators aim at evaluating vision with ophthalmic corrections prior to prescription or implantation of intraocular lenses (IOLs) in the patient's eye. In the present study, we present the design, implementation, and validation of a new IOL-in-cuvette channel in an Adaptive Optics visual simulator, which provides an alternative channel for pre-operative simulation of vision with IOLs. The IOL is projected on the pupil's plane of the subject by using a Rassow system. A second lens, the Rassow lens, compensates for an IOL of 20 D while other powers can be corrected with a Badal system within a 5 D range. The new channel was evaluated by through-focus (TF) optical quality in an artificial eye on bench, and by TF visual acuity in patients, with various IOL designs (monofocal, diffractive trifocal, and refractive extended depth of focus).
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Affiliation(s)
- Clara Benedi-Garcia
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain
| | - Maria Vinas
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain
- Currently with Wellman Center for Photomedicine, Massachusetts General Hospital Harvard Medical School, Boston, MA, USA
| | - Carmen M Lago
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain
- 2EyesVision, Madrid, Spain
| | - Sara Aissati
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain
| | - Alberto de Castro
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain
| | - Carlos Dorronsoro
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain
- 2EyesVision, Madrid, Spain
| | - Susana Marcos
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain
- Center for Visual Sciences, The Institute of Optics, Flaum Eye Institute, University of Rochester, Rochester, NY 14642, USA
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Chandra KK, Malhotra C, Jain AK, Sachdeva K, Singh S. EFFECT OF DECENTRATION ON THE QUALITY OF VISION: A COMPARISON BETWEEN ASPHERIC BALANCE CURVE DESIGN AND POSTERIOR ASPHERIC DESIGN INTRAOCULAR LENSES. J Cataract Refract Surg 2021; 48:576-583. [PMID: 34486577 DOI: 10.1097/j.jcrs.0000000000000810] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 08/24/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE To study the effect of decentration on the quality of vision in two aspheric intraocular lenses (IOLs): aspheric balance curve(ABC) design Vivinex iSert XY1(Hoya Surgical Opticals, Inc.) and posterior aspheric design AcrySof IQ SN60WF (Alcon Laboratories, Inc.). SETTING Advanced Eye Centre, PGIMER, Chandigarh, India. DESIGN Randomised Prospective Trial using Random number table. METHODS Eighty-five eyes were randomized to Group 1 (Vivinex XY1) and Group 2 (Acrysof IQ) with 40 and 45 eyes respectively. The HOA profile, Strehl's ratio, decentration of IOL from the visual axis (DVA) and the geometric axis (DGA), angle Alpha and Kappa were recorded on the iTrace aberrometer and contrast sensitivity was measured using the Functional Acuity Contrast Test at 12 weeks post-surgery. RESULTS The mean values of the Strehl's ratio (p=0.48) and the HOA's (p=0.12) of both IOLs were comparable. The HOA's gradually increased with increasing DVA for both lenses at 3, 4 and 5mm pupil sizes. On comparing the HOA's with the DGA a statistically insignificant positive correlation was observed. The Strehl's ratio did not deteriorate with increasing angle alpha in the Vivinex XY1 group, however worsened in the Acrysof IQ group. The contrast sensitivity was comparable in both the IOLs except at 1.5cpd under photopic conditions where Acrysof IQ was better. CONCLUSIONS Decentration of the lens is best measured with respect to the visual axis. In eyes with a large alpha, the ABC design induced lesser HOA's and maintained a better Strehl's ratio.
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Marcos S, Martinez-Enriquez E, Vinas M, de Castro A, Dorronsoro C, Bang SP, Yoon G, Artal P. Simulating Outcomes of Cataract Surgery: Important Advances in Ophthalmology. Annu Rev Biomed Eng 2021; 23:277-306. [PMID: 33848431 DOI: 10.1146/annurev-bioeng-082420-035827] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
As the human eye ages, the crystalline lens stiffens (presbyopia) and opacifies (cataract), requiring its replacement with an artificial lens [intraocular lens (IOL)]. Cataract surgery is the most frequently performed surgical procedure in the world. The increase in IOL designs has not been paralleled in practice by a sophistication in IOL selection methods, which rely on limited anatomical measurements of the eye and the surgeon's interpretation of the patient's needs and expectations. We propose that the future of IOL selection will be guided by 3D quantitative imaging of the crystalline lens to map lens opacities, anticipate IOL position, and develop fully customized eye models for ray-tracing-based IOL selection. Conversely, visual simulators (in which IOL designs are programmed in active elements) allow patients to experience prospective vision before surgery and to make more informed decisions about which IOL to choose. Quantitative imaging and optical and visual simulations of postsurgery outcomes will allow optimal treatments to be selected for a patient undergoing modern cataract surgery.
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Affiliation(s)
- Susana Marcos
- Instituto de Óptica "Daza de Valdés," Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid 28006, Spain;
| | - Eduardo Martinez-Enriquez
- Instituto de Óptica "Daza de Valdés," Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid 28006, Spain;
| | - Maria Vinas
- Instituto de Óptica "Daza de Valdés," Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid 28006, Spain;
| | - Alberto de Castro
- Instituto de Óptica "Daza de Valdés," Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid 28006, Spain;
| | - Carlos Dorronsoro
- Instituto de Óptica "Daza de Valdés," Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid 28006, Spain; .,2EyesVision, Madrid 28760, Spain
| | - Seung Pil Bang
- Flaum Eye Institute, The Institute of Optics, Center for Visual Science, Department of Biomedical Engineering, University of Rochester, Rochester, New York 14632, USA
| | - Geunyoung Yoon
- Flaum Eye Institute, The Institute of Optics, Center for Visual Science, Department of Biomedical Engineering, University of Rochester, Rochester, New York 14632, USA
| | - Pablo Artal
- Laboratorio de Óptica, Universidad de Murcia, Murcia 30100, Spain
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20
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Furlan WD, Montagud-Martínez D, Ferrando V, García-Delpech S, Monsoriu JA. A new trifocal corneal inlay for presbyopia. Sci Rep 2021; 11:6620. [PMID: 33758219 PMCID: PMC7987980 DOI: 10.1038/s41598-021-86005-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 02/26/2021] [Indexed: 11/15/2022] Open
Abstract
Corneal inlays (CIs) are the most recent surgical procedure for the treatment of presbyopia in patients who want complete independence from the use of glasses or contact lenses. Although refractive surgery in presbyopic patients is mostly performed in combination with cataract surgery, when the implantation of an intraocular lens is not necessary, the option of CIs has the advantage of being minimally invasive. Current designs of CIs are, either: small aperture devices, or refractive devices, however, both methods do not have good performance simultaneously at intermediate and near distances in eyes that are unable to accommodate. In the present study, we propose the first design of a trifocal CI, allowing good vision, at the same time, at far, intermediate and near vision in presbyopic eyes. We first demonstrate the good performance of the new inlay in comparison with a commercially available CI by using optical design software. We next confirm experimentally the image forming capabilities of our proposal employing an adaptive optics based optical simulator. This new design also has a number of parameters that can be varied to make personalized trifocal CI, opening up a new avenue for the treatment of presbyopia.
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Affiliation(s)
- Walter D Furlan
- Departamento de Óptica y Optometría y Ciencias de la Visión, Universitat de València, 46100, Valencia, Spain.
| | - Diego Montagud-Martínez
- Departamento de Óptica y Optometría y Ciencias de la Visión, Universitat de València, 46100, Valencia, Spain
| | - Vicente Ferrando
- Centro de Tecnologías Físicas, Universitat Politècnica de València, 46022, Valencia, Spain
| | | | - Juan A Monsoriu
- Centro de Tecnologías Físicas, Universitat Politècnica de València, 46022, Valencia, Spain
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