Comparison of age-related changes between corneal and ocular aberration in young and mid-age myopic patients

Postoperative Visual Function of Extended Depth-of-Focus Intraocular Lenses Versus Monofocal Lenses

PURPOSE

To assess the effects of intraocular lens (IOL) decentration and tilt, as well as age, on postoperative visual function (corrected distance visual acuity [CDVA] and contrast sensitivity) by comparing an extended depth-of-focus IOL using higher order aspheric optics against a monofocal IOL from the same platform.

METHODS

This retrospective observational study targeted patients without other eye diseases who underwent surgery to implant the Tecnis Eyhance OptiBlue or the monofocal IOL Tecnis OptiBlue 1-Piece (J&J Vision) during cataract surgery from November 2021 to December 2022. The effects of age, axial length, IOL decentration, tilt, and corneal higher order aberrations (HOAs) on the postoperative 5 m CDVA and area under log contrast sensitivity function (AULCSF) under photopic and scotopic conditions were evaluated within 3 months of surgery.

RESULTS

No significant difference was found in postoperative CDVA between the Tecnis Eyhance OptiBlue group (n = 61 eyes) and the Tecnis OptiBlue 1-Piece group (n = 35 eyes), but AULCSF was significantly better in the Tecnis Eyhance OptiBlue group for photopic (1.58 ± 0.13 vs 1.46 ± 0.18; P = .002) and scotopic (1.71 ± 0.11 vs 1.59 ± 0.19; P = .002) eyes. Multivariate analysis showed a negative correlation between AULCSF and IOL decentration and age in the Tecnis Eyhance OptiBlue group (P < .01), with no significant correlation with tilt, axial length, and corneal HOAs.

CONCLUSIONS

The Tecnis Eyhance OptiBlue yielded significantly better contrast sensitivity under photopic and scotopic conditions than the Tecnis OptiBlue 1-Piece. However, it is important to consider the effects of IOL decentration and age when evaluating the contrast sensitivity of the Tecnis Eyhance OptiBlue. [J Refract Surg. 2024;40(7):e499-e505.].

The dynamic changes and influencing factors of visual symptoms after small incision lenticule extraction

BACKGROUND

To investigate the dynamic changes and influencing factors of visual symptoms after small incision lenticule extraction (SMILE).

METHODS

This was a prospective observational study. Visual symptoms including glare, haloes, starbursts, hazy vision, fluctuation, blurred vision, double vision and focusing difficulties were evaluated before and 1, 3, 6 months after SMILE using a questionnaire. Generalized linear mixed models were used to assess the effects of preoperative characteristics and objective visual quality parameters on postoperative visual symptoms.

RESULTS

73 patients/146 eyes were enrolled. Preoperatively, the most common symptoms were glare (55% of eyes), haloes (48%), starbursts (44%) and blurred vision (37%). At 1 month postoperatively, the incidence and extent scores of glare, haloes, hazy vision and fluctuation rose significantly. At 3 months, the incidence and extent scores of glare, haloes and hazy vision restored to baseline. And at 6 months, the extent scores of fluctuation returned to baseline. Other symptoms (e.g., starbursts) did not change before and 1, 3, 6 months after SMILE. Preoperative visual symptoms were associated with postoperative symptoms, as patients with a symptom preoperatively had higher postoperative scores for that symptom. Age was related to postoperative extent of double vision (coefficient = 0.12, P = 0.046). There were no significant associations between postoperative visual symptoms and preoperative SE, scotopic pupil size, angle kappa (with intraoperative adjustment), postoperative HOAs or scattering indexes.

CONCLUSIONS

The incidence and extent scores of hazy vision, glare, haloes and fluctuation increased at the first month after SMILE, and recovered to baseline at 3 or 6 months. Preoperative visual symptoms were associated with the postoperative symptoms and should be fully considered before SMILE.

Relationship between higher-order aberrations and myopia progression in schoolchildren: a retrospective study

AIM

To investigate the relationship between higher-order aberration (HOA) and myopic progression in school children.

METHODS

Between April 23, 2011 and August 29, 2011 in the children's myopia outpatient clinic of the West China Hospital of Sichuan University, 148 eyes of 74 schoolchildren were reviewed. HOAs for a 6-mm pupil were measured with an aberrometer. Myopic progression rate was defined according to the change in spherical equivalent refraction (SER) divided by the time span (years). Subjects with myopic progression rate of ≥0.50 diopters (D) were classified as the 'fast' group and the subjects with myopic progression rate of <0.50D were classified as the 'slow' group. A retrospective study was conducted to compare HOA between the two groups, using root mean square (RMS) values and Zernike coefficients.

RESULTS

The RMS values of HOA (t=2.316, P=0.02), HOA without Z4 (0) (t=2.224, P=0.03), third-order aberrations (t'=2.62, P=0.01), and coma (t'=2.49, P=0.01) were significantly higher in the fast group than those in the slow group. The individual Zernike coefficients of Z3 (-1) (t=-2.072, P=0.04) and Z5 (1) (Z =-2.627, P=0.01) displayed statistically significant differences between the two groups. Significant correlations were found between the RMS values of HOA (r=0.193, P=0.019), RMS values of HOA without Z4 (0) (r=0.23, P =0.005), RMS values of coma (r=0.235, P=0.004), RMS values of third-order aberrations (r=0.243, P =0.003), and the progression rate.

CONCLUSION

Our results provide evidence of a relationship between HOA and myopic progression. In a future prospective longitudinal study, we aim to verify whether HOA is a risk factor for myopic progression.

Population spherical aberration: associations with ametropia, age, corneal curvature, and image quality

PURPOSE

The aim of this analysis was to determine the total ocular wavefront aberration values of a large phakic population of physiologically normal, ametropic eyes, gathered under the same clinical protocol using the same diagnostic wavefront sensor.

MATERIALS AND METHODS

Studies were conducted at multiple sites in Asia, North America, Europe, and Australia. A Bausch + Lomb Zywave II Wavefront Aberrometer (Rochester, NY, USA) was used to measure the lower and higher order aberrations of each eye. Data analysis was conducted using linear regression analysis to determine the relationship between total spherical aberration, ametropia, age, corneal curvature, and image quality.

RESULTS

Linear regression analysis showed no correlation (r = 0.0207, P = 0.4874) between degree of ametropia and the amount of spherical aberration. There was also no correlation when the population was stratified into myopic and hyperopic refractive groups (r m = 0.0529, P m = 0.0804 and r h = 0.1572, P h = 0.2754). There was a statistically significant and weak positive correlation (r = 0.1962, P < 0.001) between age and the amount of spherical aberration measured in the eye; spherical aberration became more positive with increasing age. Also, there was a statistically significant and moderately positive correlation (r = 0.3611, P < 0.001) with steepness of corneal curvature; spherical aberration became more positive with increasing power of the anterior corneal surface. Assessment of image quality using optical design software (Zemax™, Bellevue, WA < USA) showed that there was an overall benefit in correcting the average spherical aberration of this population.

CONCLUSION

Analysis of this dataset provides insights into the inherent spherical aberration of a typical phakic, pre-presbyopic, population and provides the ability to determine what drives the spherical aberration of the eye, as well as what potential benefit a person could gain by compensating for that average spherical aberration.