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Alfonso-Bartolozzi B, Fernández-Vega-Cueto L, Lisa C, Palacios A, Madrid-Costa D, Alfonso JF. Ten-year follow-up of posterior chamber phakic intraocular lens with central port design in patients with low and normal vault. J Cataract Refract Surg 2024; 50:441-447. [PMID: 38085219 DOI: 10.1097/j.jcrs.0000000000001379] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 12/05/2023] [Indexed: 04/24/2024]
Abstract
PURPOSE To assess the clinical outcomes and postoperative complications of the implantable collamer lens (ICL) with a central port throughout 10 years of follow-up in patients with low and normal vault. SETTING Fernández-Vega Ophthalmological Institute, Oviedo, Spain. DESIGN Retrospective and comparative case series. METHODS This study included eyes that underwent a V4c ICL implantation with 10 years of follow-up. The eyes were divided into 2 groups according to the vault at 1 year postoperatively: vault <250 μm and between 250 μm and 800 μm. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), intraocular pressure (IOP), endothelial cell density (ECD), vault, complications, and secondary surgeries were analyzed. RESULTS 37 and 90 eyes were enrolled in the low and normal-vault groups, respectively. No differences in UDVA, CDVA, and refraction were found between the groups over 10 years of follow-up. No cases developed ICL-induced anterior subcapsular opacity over the follow-up period. 2 (5.4%) and 8 (8.9%) eyes in the low and normal-vault groups, respectively, required ICL exchange. 1 (2.8%) and 2 (2.2%) eyes in the low and normal-vault groups, respectively, required excimer laser to correct residual refractive error. The IOP remained stable throughout the 10-year follow-up. The loss in ECD from that preoperatively to 10 years postoperatively was 3.8% and 4.5% in the low and normal-vault groups, respectively ( P = .4). No pigment dispersion glaucoma or other vision-threatening complications were reported. CONCLUSIONS This study shows good long-term outcomes of the V4c ICL, supporting that the central hole provides safety to the procedure and prevents the potential risk associated with low vault.
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Affiliation(s)
- Belén Alfonso-Bartolozzi
- From the Fernández-Vega Ophthalmological Institute, Oviedo, Spain (Alfonso-Bartolozzi, Fernández-Vega-Cueto, Lisa, Palacios, Alfonso); Clinical and Experimental Eye Reseach Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain (Madrid-Costa)
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Alfonso-Bartolozzi B, Fernández-Vega-Cueto L, Fernández-Vega L, Martínez-Alberquilla I, Madrid-Costa D, Alfonso JF. Triple Procedure: A Stepwise Combination of Deep Anterior Lamellar Keratoplasty and Cataract Surgery. Cornea 2024; 43:301-306. [PMID: 37603699 DOI: 10.1097/ico.0000000000003364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 07/05/2023] [Indexed: 08/23/2023]
Abstract
PURPOSE The aim of this study was to evaluate clinical outcomes of the combined surgery (triple procedure) of deep anterior lamellar keratoplasty (DALK), phacoemulsification, and intraocular lens (IOL) implantation using a new surgical strategy. METHODS The study included 43 eyes of 43 patients who underwent a triple procedure. Twenty-six eyes with good visibility through the cornea underwent phacoemulsification before the stromal dissection. Seventeen eyes with bad visibility underwent the DALK procedure first until achieving enough visibility to perform the lensectomy. IOL power calculation was performed for a postoperative estimated flat keratometry of 43.5 and aiming to avoid hyperopic postoperative refraction. The postoperative visual examination included uncorrected and corrected distance visual acuity (CDVA) measurements and manifest refraction. RESULTS The mean follow-up time after suture removal was 3.06 ± 2.14 years. Mean CDVA significantly changed from 0.86 ± 0.56 logMAR preoperatively to 0.37 ± 0.28 logMAR in the last visit ( P < 0.0001). The percentage of eyes with CDVA ≤0.3 logMAR changed from 6.9% preoperatively to 62.8%. No eyes lost lines of vision after surgery, and 80% experienced an improvement of 2 or more lines. The safety index was 2.2. The mean postoperative refractive sphere was +0.13 ± 2.04 D, and the postoperative refractive cylinder was -4.02 ± 2.24 D. Only 2 cases (4.65%) obtained postoperative hyperopic astigmatism. No intraoperative complications were found. CONCLUSIONS Combined surgery of DALK, phacoemulsification, and IOL implantation is an effective and safe procedure. Depending on the corneal transparency, different surgical strategies can be established to provide more efficacy and safety.
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Affiliation(s)
| | | | | | - Irene Martínez-Alberquilla
- Clinical and Experimental Eye Research Group (CEER), Optometry and Vision Department, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - David Madrid-Costa
- Clinical and Experimental Eye Research Group (CEER), Optometry and Vision Department, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - José F Alfonso
- Fernández-Vega Ophthalmological Institute, Oviedo, Spain; and
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Romano V, Madrid-Costa D, Alfonso JF, Alio J, Allan B, Angunawela R, Auffarth G, Carones F, Khoramnia R, Moore J, Nanavaty MA, Savini G, Pagano L, Romano MR, Virgili G, Fernández-Vega-Cueto L. Reply to comment on: Recommendation for presbyopia-correcting intraocular lenses: A Delphi consensus statement by the ESASO study group. Am J Ophthalmol 2024; 258:223. [PMID: 37549819 DOI: 10.1016/j.ajo.2023.07.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/09/2023]
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Vinciguerra R, Fernández-Vega-Cueto L, Roberts CJ, Poo-Lopez A, Eliasy A, Merayo-Lloves J, Elsheikh A, Madrid-Costa D, Lisa C, Alfonso JF. Effect of intrastromal corneal ring segments on in vivo corneal biomechanics in keratoconus: 1-year results. J Cataract Refract Surg 2023; 49:1258-1263. [PMID: 37982775 DOI: 10.1097/j.jcrs.0000000000001298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 08/24/2023] [Indexed: 11/21/2023]
Abstract
PURPOSE To evaluate the 1-year effects of the implantation of intrastromal corneal ring segments (ICRS) in keratoconus (KC) on the dynamic corneal response (DCR) parameters obtained with the Corvis. SETTING Fernández-Vega Ophthalmological Institute, Oviedo, Spain. DESIGN Prospective, single-center, clinical study. METHODS Included were patients who underwent ICRS implantation for KC over a period of 1 year. On the day of the surgery and at least 6 months after ICRS implantation, the following measurements were made: corrected distance and uncorrected distance visual acuity, corneal tomography indices with the Pentacam, biomechanically corrected intraocular pressure and the Corvis DCRs (integrated inverse concave radius, deformation amplitude ratio, stiffness parameter at first applanation, stress-strain index [SSI] and the highest concavity radius). RESULTS 30 eyes were included with a mean follow-up time of 15 months. Statistical analysis showed that ICRS implantation induced significant improvements in corneal biomechanics measurements between preoperative and long-term follow-up as demonstrated by a significant increase in SSI (P = .003). To confirm that this difference was actually induced due to a stiffening between early postoperative (previously published) and long-term an additional t-test was done between month 1 and late follow-up which confirmed a significant stiffening in the value of SSI (P = .01). CONCLUSIONS Patients implanted with ICRS alone for KC showed a significantly stiffer response due to increased structural support compared with preoperative values and 1 month postoperative.
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Affiliation(s)
- Riccardo Vinciguerra
- From the Humanitas San Pio X Hospital, Milan, Italy (Vinciguerra); Surgery Department, School of Medicine, University of Oviedo, Asturias, Spain (Vinciguerra, Fernández-Vega-Cueto, Poo-Lopez, Merayo-Lloves, Lisa, Alfonso); Fernández-Vega Ophthalmological Institute, Oviedo, Spain (Fernández-Vega-Cueto, Poo-Lopez, Merayo-Lloves, Madrid-Costa, Lisa, Alfonso); Department of Ophthalmology & Visual Science, Department of Biomedical Engineering, The Ohio State University, Columbus, Ohio (Roberts); School of Engineering, University of Liverpool, Liverpool, United Kingdom (Eliasy, Elsheikh); Beijing Advanced Innovation Centre for Biomedical Engineering, Beihang University, Beijing, China (Elsheikh); National Institute for Health Research (NIHR) Biomedical Research Centre for Ophthalmology, Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology, London, United Kingdom (Elsheikh)
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Alfonso JF, Fernández-Vega-Cueto L, Lisa C, Alfonso-Bartolozzi B, Palacios A, Madrid-Costa D. Clinical and Aberrometric Outcomes of a New Implantable Collamer Lens for Myopia and Presbyopia Correction in Phakic Patients. J Refract Surg 2023; 39:589-596. [PMID: 37675906 DOI: 10.3928/1081597x-20230726-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
PURPOSE To assess the clinical and aberrometric outcomes of a new Implantable Collamer Lens (EVO Viva ICL; STAAR Surgical) to correct moderate to high myopia and presbyopia. METHODS The study included 80 eyes of 40 patients who had bilateral EVO Viva ICL implantation. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, presbyopic add power, binocular through-focus visual acuity, total ocular spherical aberration (SA), coma aberration, and root mean square of ocular higher order aberrations (RMS HOAs) (i-Trace Aberrometer; Tracey Technologies) for a 4.5-mm pupil size were evaluated. RESULTS The mean binocular postoperative UDVA and CDVA were 0.09 ± 0.19 and 0.02 ± 0.03 logMAR, respectively. The postoperative spherical equivalent was -0.61 ± 0.54 diopters (D). The presbyopic add power reduced from +1.31 ± 0.74 D preoperatively to +0.44 ± 0.58 D after surgery (P < .0001). The mean visual acuity was 0.1 logMAR or better (20/25 or better) across the vergence range from +0.50 to -1.50 D, better than 0.2 logMAR (20/32 or better) up to the vergence of -2.00 D, and remained better than 0.3 logMAR (20/40 or better) up to the vergence of -2.50 D. The total ocular aberrations induced by EVO Viva ICL were -0.34 ± 0.09 µm of SA, 0.24 ± 0.18 µm of coma, and 0.26 ± 0.12 µm of RMS HOAs. CONCLUSIONS The outcomes support that the new ICL might be a good alternative for myopia and presbyopia correction in patients aged between 45 and 55 years. Further studies are needed to evaluate the threshold lens misalignment from which the patient´s visual quality would be affected. [J Refract Surg. 2023;39(9):589-596.].
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Romano V, Madrid-Costa D, Alfonso JF, Alio J, Allan B, Angunawela R, Auffarth G, Carones F, Khoramnia R, Moore J, Nanavaty MA, Savini G, Pagano L, Romano MR, Virgili G, Fernández-Vega-Cueto L. Recommendation for Presbyopia-Correcting Intraocular Lenses: A Delphi Consensus Statement by the ESASO Study Group. Am J Ophthalmol 2023; 253:169-180. [PMID: 37236521 DOI: 10.1016/j.ajo.2023.05.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 03/27/2023] [Accepted: 05/01/2023] [Indexed: 05/28/2023]
Abstract
PURPOSE To establish consensus among experts in lens and refractive surgery to guide general ophthalmologists on issues related to presbyopia-correcting intraocular lenses (IOLs). DESIGN A modified Delphi method to reach a consensus among experts. METHODS A steering committee formulated 105 relevant items grouped into four sections (preoperative considerations, IOL selection, intraoperative considerations, and postoperative considerations). The consensus was defined as ≥ 70% of experts agreeing with the evaluation of a statement. RESULTS Ten experts participated and completed all rounds of questionnaires (100% response rate). Of 68 items considered in the preoperative considerations, consensus was achieved in 48 (70.6%). There was a lack of consensus over IOL selection, the experts only agreed on the importance of the patient's habits for the optical IOL design selection. Of the 14 considerations related to intraoperative issues, the experts reached a consensus on 10 (71.4%). The postoperative considerations section reached the highest consensus in 10 items of 13 (76.9%). CONCLUSIONS Key recommendations for a diffractive multifocal IOL were a potential postoperative visual acuity > 0.5, a keratometry between 40-45 diopters, a pupil >2.8 mm under photopic conditions and <6.0 mm under scotopic conditions, a root mean square of higher order corneal aberrations <0.5 µm for 6-mm pupil size, while monofocal or non-diffractive IOLs should be considered for patients with coexisting eye disorders. A lack of agreement was found in the issues related to the IOL selection.
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Affiliation(s)
- Vito Romano
- From Eye Unit, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, University of Brescia, Brescia, Italy (V.R.).
| | - David Madrid-Costa
- Faculty of Optics and Optometry, Universidad Complutense de Madrid, Spain (D.M.-C.)
| | - Jose F Alfonso
- Fernández-Vega Ophthalmological Institute, Oviedo, Spain (J.F.A., L.F.-V.-C.)
| | - Jorge Alio
- Cornea, Cataract and Refractive Surgery Department, VISSUM, Calle Cabañal, Alicante, Spain (J.A.)
| | - Bruce Allan
- The Refractive Surgery Service, Moorfields Eye Hospital, London, United Kingdom (B.A.)
| | | | - Gerd Auffarth
- Department of Ophthalmology, David J Apple Center for Vision Research, University Hospital Heidelberg, Heidelberg, Germany (G.A.)
| | | | - Ramin Khoramnia
- International Vision Correction Research Centre (IVCRC), University Eye Clinic Heidelberg, Heidelberg, Germany (R.K.)
| | | | | | | | - Luca Pagano
- Royal Liverpool University Hospital, Liverpool, United Kingdom (L.P.)
| | - Mario R Romano
- Eye Unit, Department of Biomedical science, Humanitas University, Milan, Italy (M.R.R.)
| | - Gianni Virgili
- Eye clinic, AOU Careggi Teaching Hospital, University of Florence, Florence, Italy (G.V.); Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
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Alfonso-Bartolozzi B, Fernández-Vega-Cueto L, Poo-López A, Lisa C, Madrid-Costa D, Alfonso JF. Intrastromal Corneal Ring Segments Implantation After Deep Anterior Lamellar Keratoplasty for Astigmatism Correction: Mid-term and Long-term Follow-up. Cornea 2023; 42:962-969. [PMID: 36036677 DOI: 10.1097/ico.0000000000003110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/11/2022] [Indexed: 11/27/2022]
Abstract
PURPOSE The aim of this study was to assess the long-term outcomes of implanting intrastromal corneal ring segments (ICRSs) using a femtosecond laser for correcting astigmatism in patients who had previous deep anterior lamellar keratoplasty (DALK) throughout a 5-year follow-up period. METHODS This retrospective study included 40 eyes of 40 patients with previous DALK and astigmatism ≥3.00 D who underwent Ferrara-type ICRS implantation. The manifest refraction, uncorrected (UDVA) and corrected (CDVA) distance visual acuity (logMAR), and corneal topography were recorded preoperatively and at 6, 12, 36, and 60 months postoperatively. RESULTS The mean UDVA (logMAR scale) improved from 1.39 ± 0.55 preoperatively to 0.71 ± 0.37 at 6 months postoperatively ( P < 0.0001). The mean CDVA (logMAR) significantly improved from 0.36 ± 0.17 to 0.22 ± 0.12 at 6 months after surgery ( P < 0.0001). Both UDVA and CDVA remained unchanged throughout the follow-up ( P = 0.09). Postoperatively, no eyes lost lines of CDVA compared to preoperatively, and around 80% of the eyes gained lines of CDVA. The safety index remained stable at a value of 1.4 throughout the follow-up. The refractive cylinder decreased from -6.86 ± 2.62 D preoperatively to -2.33 ± 1.09D at 6 months postoperatively ( P < 0.0001), and subsequently, it was stable over the postoperative period ( P = 0.2). The maximum and minimum keratometry measurements significantly decreased after surgery and remained stable over the postoperative follow-up period ( P > 0.07). CONCLUSIONS This study shows the long-term viability of Ferrara-type ICRS implantation using a femtosecond laser as a surgical alternative for astigmatism correction in post-DALK eyes.
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Affiliation(s)
- Belén Alfonso-Bartolozzi
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Oviedo, Spain; and
| | - Luis Fernández-Vega-Cueto
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Oviedo, Spain; and
| | - Aranzazu Poo-López
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Oviedo, Spain; and
| | - Carlos Lisa
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Oviedo, Spain; and
| | - David Madrid-Costa
- Clinical and Experimental Eye Research Group (CEER), Faculty of Optics and Optometry, Universidad Complutense de Madrid, Spain
| | - José F Alfonso
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Oviedo, Spain; and
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Fernández-Vega-Cueto L, Vega F, Guerra-Velasco R, Millán MS, Madrid-Costa D, Alfonso JF. Reply: Efficacy of Enhanced Monofocal Intraocular Lens in Eyes With High Hyperopia. J Refract Surg 2023; 39:214-215. [PMID: 36892235 DOI: 10.3928/1081597x-20230126-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
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Fernández-Vega-Cueto L, Lisa C, Vasanthananthan K, Madrid-Costa D, Alfonso JF, Melles GRJ. Spontaneous corneal clearance after graft detachment in DMEK. Arch Soc Esp Oftalmol (Engl Ed) 2023; 98:170-174. [PMID: 36738920 DOI: 10.1016/j.oftale.2022.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2022] [Accepted: 11/04/2022] [Indexed: 02/05/2023]
Abstract
Descemet Membrane detachment is a potential complication after Descemet Membrane Endothelial Keratoplasty (DMEK). Here, we present a unique case of a DMEK surgery in a complicated eye that suffered a nearly complete DMEK graft detachment and later a graft opacification with a pseudo-anterior chamber. In Mid-November 2020, a planned DMEK was performed in a 64-year-old male patient due to corneal decompensation. Four months after DMEK, a fibrotic DMEK graft was seen across the anterior chamber with a pseudo-anterior chamber; however, the recipient cornea showed complete clearance with an endothelial cell count of about 1204 cells/mm2 and a best-corrected visual acuity of 20/25. Three months later, we observed a significant opacification of the detached graft, and the best-corrected distance visual acuity decreased to 20/63. We proceeded with the graft removal without performing a second DMEK. Ten months after graft removal, the cornea remained clear with an endothelial cell count of about 510 cells/mm2, and the best-corrected visual acuity was 20/25.
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Affiliation(s)
| | - C Lisa
- Instituto Oftalmológico Fernández-Vega, Oviedo, Asturias, Spain
| | - K Vasanthananthan
- Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands
| | - D Madrid-Costa
- Instituto Oftalmológico Fernández-Vega, Oviedo, Asturias, Spain
| | - J F Alfonso
- Instituto Oftalmológico Fernández-Vega, Oviedo, Asturias, Spain
| | - G R J Melles
- Netherlands Institute for Innovative Ocular Surgery, Rotterdam, The Netherlands
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Madrid-Costa D, Fernández-Vega-Cueto L, Azor-Morón JA, Vega F, Millán MS, Alfonso JF. Beam-Shaping Extended Depth of Focus Intraocular Lens: Optical Assessment With Corneas of Increasing Spherical Aberration. J Refract Surg 2023; 39:95-102. [PMID: 36779468 DOI: 10.3928/1081597x-20221215-02] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/14/2023]
Abstract
PURPOSE To assess the optical quality and halo formation of a beam-shaping extended depth-of-focus (EDOF) intraocular lens (IOL) (AcrySof IQ Vivity; Alcon Laboratories, Inc) with corneas of long-range spherical aberration (SA) such as those resulting from myopic laser ablations. METHODS The optical quality of the EDOF IOL and a reference monofocal IOL was evaluated with three corneas (A, B, and C, with SA =+0.135, +0.290, +0.540 µm, respectively, for a 5.15-mm pupil at the IOL plane). The through-focus modulation transfer function area (MTFa) curves were obtained between -5.00 and +2.00 diopters (D) defocus range. The halo was also assessed with the three corneas. RESULTS Through-focus MTFa curves for a 4.5-mm IOL pupil showed a slight decrease in the maximum MTFa value provided by the EDOF IOL compared to the monofocal IOL in the three corneal situations (A: 45.9 vs 38.6 units; B: 41.1 vs 33.1 units, and C: 26.9 vs 23.8 units). For the 3.0-mm pupil, the EDOF IOL also had lower maximum MTFa than the monofocal IOL; however, the depth-of-focus increased to -2.20 D. With corneas A and B, the halo induced was of low energy with both IOLs. With cornea C, the EDOF IOL created a much larger and intense halo. CONCLUSIONS The EDOF IOL provided a good distance optical performance and an extended range of focus of approximately 2.00 D, with a halo of low intensity when evaluated with a corneal SA similar to the one induced by a low to moderate myopic ablation. With a high myopic ablation, the halo induced would be of considerable size and energy. [J Refact Surg. 2023;39(2):95-102.].
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Ibares-Frías L, Fernández-Vega-Cueto L, Alfonso-Bartolozzi B, Poo-López A, Madrid-Costa D, Alfonso JF. Long-Term Follow-Up of a 150° Arc-Length Intrastromal Corneal Ring Segment Implantation in Post-LASIK Ectasia. Curr Eye Res 2022; 48:365-370. [PMID: 36524598 DOI: 10.1080/02713683.2022.2159983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
PURPOSE To evaluate the outcomes of implanting a 150° arc-length intrastromal corneal ring segment (ICRS) using a femtosecond laser in patients with post-LASIK ectasia throughout a 5-year follow-up period. METHODS This study enrolled 45 eyes of 45 patients diagnosed with post-LASIK ectasia who underwent a 150° arc-length Ferrara-type ICRS implantation. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities, residual refractive errors, and root mean square (RMS) for coma-like aberration were evaluated preoperatively and at 6-, 12-, 36, and 60 months postoperatively. RESULTS Mean UDVA (logMAR) ameliorated from 0.53 ± 0.33 preoperatively to 0.26 ± 0.24 at 6 months postoperatively (p < 0.0001). Mean CDVA improved from 0.12 ± 0.13 to 0.04 ± 0.06 (p < 0.0001). Mean UDVA and CDVA remained stable throughout the 5-year follow-up (p > 0.1). No eyes lost lines of CDVA at any follow-up visit compared to preoperatively, and most eyes gained lines. The eyes with a refractive cylinder ≤ 2.00 D varied from 26.7% preoperatively to more than 75% at all postoperative follow-up visits. The maximum keratometry was significantly flattened (p < 0.0001), and the RMS for corneal coma-like aberration was halved (p < 0.0001). 93.3% of the eyes did not show signs of disease progression or regression of the visual or refractive outcomes at any follow-up visits. CONCLUSION These results suggest that implanting a single 150° arc-length Ferrara-type ICRS is a safe, effective and stable procedure for visual restoration in post-LASIK ectasia. In very few cases, visual and/or refractive instability was experienced throughout the follow-up.
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Affiliation(s)
- Lucía Ibares-Frías
- Fernández-Vega Ophthalmological Institute, Oviedo, Spain
- Department of Ophthalmology, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | | | | | | | - David Madrid-Costa
- Clinical and Experimental Eye Research (CEER). Optometry and Vision Department, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
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Crooke A, Martínez-Alberquilla I, Madrid-Costa D, Ruiz-Alcocer J. Presbyopia: An outstanding and global opportunity for early detection of pre-frailty and frailty states. Front Med (Lausanne) 2022; 9:968262. [PMID: 36267611 PMCID: PMC9576860 DOI: 10.3389/fmed.2022.968262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/20/2022] [Indexed: 11/25/2022] Open
Affiliation(s)
- Almudena Crooke
- Department of Biochemistry and Molecular Biology, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain,Clinical and Experimental Eye Research Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain,*Correspondence: Almudena Crooke
| | - Irene Martínez-Alberquilla
- Clinical and Experimental Eye Research Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain,Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - David Madrid-Costa
- Clinical and Experimental Eye Research Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain,Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Javier Ruiz-Alcocer
- Clinical and Experimental Eye Research Group, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain,Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
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Alfonso-Bartolozzi B, Lisa C, Fernández-Vega-Cueto L, Baamonde B, Madrid-Costa D, Alfonso JF. Three-year follow-up of posterior chamber phakic intraocular lens with a central port design after deep anterior lamellar keratoplasty. Eye and Vis 2022; 9:34. [PMID: 36068603 PMCID: PMC9450313 DOI: 10.1186/s40662-022-00306-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Accepted: 08/17/2022] [Indexed: 11/10/2022]
Abstract
Abstract
Background
To evaluate clinical outcomes of the Visian implantable collamer lens (ICL) with a central port to correct myopia and astigmatism after deep anterior lamellar keratoplasty (DALK) for keratoconus throughout 3 years of follow-up.
Methods
This study included 20 eyes of 20 patients that underwent V4c ICL (13 eyes with a spherical ICL and 7 eyes with a toric ICL) implantation after DALK. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure (IOP), endothelial cell density (ECD), and vault were analyzed.
Results
The mean UDVA improved from the preoperative 1.18 ± 0.33 logMAR to 0.25 ± 0.14 logMAR at 6 months after surgery (P < 0.0001) and remained unchanged throughout the whole follow-up (P = 0.4). All eyes gained lines of CDVA compared to preoperative values. At the last follow-up visit, all eyes achieved CDVA of 0.2 logMAR or better and 13 eyes (65%) 0.1 logMAR or better. At 6 months post-surgery, all eyes (100%) had a spherical equivalent within ± 1.50 D, and 19 (95%) within ± 1.00 D. The mean manifest spherical equivalent was stable over the postoperative follow-up (P = 0.25). No significant increase in IOP occurred in any case throughout the 3 years of follow-up. The loss in ECD from the preoperative baseline at the last follow-up visit was 2.27%.
Conclusions
The clinical outcomes suggest that the V4c ICL implantation for correction of myopia and regular astigmatism in post-DALK eyes was satisfactory in terms of effectiveness, safety, and stability during 3 years of follow-up.
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Fernández-Vega-Cueto L, Vega F, Guerra-Velasco R, Millán MS, Madrid-Costa D, Alfonso JF. Optical and Clinical Outcomes of an Enhanced Monofocal Intraocular Lens for High Hyperopia. J Refract Surg 2022; 38:572-579. [PMID: 36098391 DOI: 10.3928/1081597x-20220802-01] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the optical and clinical performance of an enhanced monofocal intraocular lens (IOL) (TECNIS Eyhance ICB00; Johnson & Johnson Vision) in patients with high hyperopia and a short axial length. METHODS Power mapping, wavefront analysis, and the through-focus modulation transfer function area (TF-MTFa) were measured in vitro for three IOL powers (10.00, 20.00, and 30.00 diopters [D]). The clinical study included 22 patients with an axial length of less than 22.5 mm. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity and binocular defocus curve were evaluated 6 months postoperatively. RESULTS For the three IOL powers, the power mapping revealed an increase in positive power from the periphery to the center of the lens, providing an extra positive correction of 1.00 D for a 2-mm pupil size. The TF-MTFa curves showed only a peak of maximum MTFa at the distance focus. As the pupil size became smaller, there was a focus extension effect, providing an extended depth of focus of up to -1.50 D for a 2-mm pupil size. No significant dependency of the IOL base power on the power profile, wavefront, or optical quality was found. The clinical outcomes showed that all patients achieved a binocular CDVA of 0.1 logMAR or better. The mean visual acuity was better than 0.1 logMAR between +0.50 and -1.50 D of defocus. At a vergence of -2.00 D, the visual acuity was 0.11 ± 0.13 logMAR. CONCLUSIONS The monofocal enhanced IOL provided good distance optical and visual quality and optimal visual acuity up to an intermediate-near vision distance of 50 to 40 cm in patients with high hyperopia and a short axial length. [J Refract Surg. 2022;38(9):572-579.].
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Alfonso-Bartolozzi B, Lisa C, Fernández-Vega-Cueto L, Madrid-Costa D, Alfonso JF. Femto-LASIK after Deep Anterior Lamellar Keratoplasty to Correct Residual Astigmatism: A Long-Term Case Series Study. Medicina (Kaunas) 2022; 58:medicina58081036. [PMID: 36013505 PMCID: PMC9412627 DOI: 10.3390/medicina58081036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 07/21/2022] [Accepted: 07/28/2022] [Indexed: 11/30/2022]
Abstract
Purpose: To evaluate the long-term outcomes of femtosecond laser-assisted in situ keratomileusis (Femto-LASIK) to correct residual astigmatism after deep anterior lamellar keratoplasty (DALK). Methods: This retrospective case series study included 10 eyes that underwent Femto-LASIK after a DALK. The refractive error, uncorrected (UDVA) and corrected (CDVA) distance visual acuities, thinnest corneal thickness (TCT), and central corneal thickness (CCT) were registered. The postoperative follow-up ranged between 36 and 60 months. Results: All surgeries were uneventful, with no intra- or postoperative complications. The mean UDVA (Snellen scale) rose from 0.13 ± 0.05 to 0.47 ± 0.15 six months after Femto-LASIK (p < 0.001). All cases experienced a significant improvement in UDVA. None of the eyes lost lines of CDVA, and seven eyes (70%) improved the CDVA compared to preoperative values. The refractive cylinder changed from a preoperative value of −3.88 ± 1.00 D to −0.93 ± 0.39 six months after Femto-LASIK (p < 0.0001). In eight eyes (80%), the UDVA and refractive outcomes remained stable at postoperative follow-up visits. In contrast, one eye experienced a refractive regression over the follow-up. TCT and CCT were stable at the different postoperative follow-up visits. Conclusions: Our findings suggest that Femto-LASIK might safely and effectively corrects residual astigmatism after DALK. Despite these encouraging results, further long-term studies, including a larger number of cases, are required to confirm the safety of the procedure. The refractive stability in eyes with prior RK might be lower than for other DALK indications.
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Affiliation(s)
| | - Carlos Lisa
- Fernández-Vega Ophthalmological Institute, 33012 Oviedo, Spain; (B.A.-B.); (C.L.); (L.F.-V.-C.)
| | | | - David Madrid-Costa
- Clinical and Experimental Eye Research Group (CEER), Faculty of Optics and Optometry, Universidad Complutense de Madrid, 28037 Madrid, Spain;
| | - José F. Alfonso
- Fernández-Vega Ophthalmological Institute, 33012 Oviedo, Spain; (B.A.-B.); (C.L.); (L.F.-V.-C.)
- Correspondence:
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Vinciguerra R, Fernández-Vega-Cueto L, Poo-Lopez A, Eliasy A, Merayo-Lloves J, Elsheikh A, Madrid-Costa D, Lisa C, Alfonso JF. The Effect of Intracorneal Ring Segments Implantation for Keratoconus on In Vivo Corneal Biomechanics Assessed With the Corvis ST. J Refract Surg 2022; 38:264-269. [PMID: 35412924 DOI: 10.3928/1081597x-20220202-01] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the effect of the implantation of intracorneal ring segments (ICRS) in keratoconus on the dynamic corneal response (DCR) parameters obtained with the Corvis ST (Oculus Optikgeräte GmbH). METHODS This prospective clinical study included patients who underwent ICRS implantation for keratoconus over a period of 1 year. On the day of the surgery and at least 1 month after ICRS implantation, the following measurements were made: corrected and uncorrected distance visual acuity, corneal tomography indices with the Pentacam (Oculus Optikgeräte GmbH), biomechanically corrected intraocular pressure (bIOP), Corvis ST DCR parameters, integrated inverse concave radius (1/R), deformation amplitude ratio (DA ratio), stiffness parameter at first applanation (SP-A1), stress-strain index (SSI), and highest concavity radius (HRC). RESULTS Fifty-one eyes of 40 patients were included with a median follow-up time of 3 months (interquartile ratio [IQR]: 2 to 6 months). Statistical analysis showed that ICRS implantation did not affect corneal biomechanical measurements evaluated with the Corvis ST, which was demonstrated by non-significant changes in the SP-A1 (P = .637), 1/R (P = .647), HRC (P = .177), DA ratio (P = .735), and SSI (P = .501). Additionally, the results showed that bIOP measurements were not significantly affected by ICRS implantation (P = .113). CONCLUSIONS ICRS implantation does not affect corneal biomechanical measurements in early follow-up. [J Refract Surg. 2022;38(4):264-269.].
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Fernández-Vega-Cueto L, Madrid-Costa D, Alfonso-Bartolozzi B, Vega F, Millán MS, Alfonso JF. Optical and Clinical Outcomes of an Extended Range of Vision Intraocular Lens. J Refract Surg 2022; 38:168-176. [PMID: 35275001 DOI: 10.3928/1081597x-20220104-01] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess the in vitro optical quality and halo formation of the AcrySof IQ Vivity intraocular lens (IOL) (Alcon Laboratories, Inc) and to evaluate the clinical outcomes in patients who had bilateral implantation of this IOL. METHODS The optical quality was evaluated with the PMTF optical bench (Lambda-X). Through-focus modulation transfer function area (MTFa) curves between -5.00 and +2.00 diopters (D) were obtained for 3- and 4.5-mm pupil apertures. The halo was assessed in vitro with a test bench. The clinical study included 30 patients. Uncorrected (UDVA) and corrected (CDVA) distance visual acuity and binocular defocus curve were evaluated 6 months postoperatively. RESULTS The through-focus MTFa curve for the 4.5-mm pupil size showed only one peak at distance focus (38.4 units). For the 3-mm pupil size, the through-focus MTFa showed a lower peak of MTFa (28.9 units), located at -0.70 D, and an extended depth of focus up to -2.20 D. The halo formed was larger and more intense compared to a standard monofocal IOL. The clinical outcomes at 6 months revealed satisfactory visual acuity outcomes. All patients achieved a binocular CDVA of 0.1 logMAR or better. The mean visual acuity was better than 0.2 logMAR between +1.00 and -2.00 D of defocus. At a vergence of -2.50 D, the visual acuity was 0.31 ± 0.09 logMAR. CONCLUSIONS The AcrySof IQ Vivity IOL provided good distance optical and visual quality and an extended range of focus of approximately 2.00 D, obtaining an optimal or functional visual acuity up to 50 to 40 cm. The halo formed was low intensity overall, but higher intensity than a monofocal IOL. [J Refract Surg. 2022;38(3):168-176.].
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Alfonso-Bartolozzi B, Lisa C, Fernández-Vega-Cueto L, Madrid-Costa D, Alfonso JF. A New Pre-descemetic Corneal Ring (Neoring) in Deep Anterior Lamellar Keratoplasty for Moderate-Advanced Keratoconus: A Pilot 2-Year Long-Term Follow-Up Study. Front Med (Lausanne) 2021; 8:771365. [PMID: 34805231 PMCID: PMC8599962 DOI: 10.3389/fmed.2021.771365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 10/04/2021] [Indexed: 11/30/2022] Open
Abstract
Purpose: To assess the outcomes of implanting a new polymethylmethacrylate (PMMA) ring (Neoring; AJL Ophthalmic) in pre-descemet deep anterior lamellar keratoplasty (PD-DALK) procedure for moderate-advanced keratoconus. Methods: This prospective study included 10 eyes of 10 patients with moderate-advanced keratoconus who underwent PD-DALK with Neoring implantation. Neoring was implanted in a pre-descemetic pocket. The post-operative examination included refraction, corrected distance visual acuity (CDVA), corneal tomography, and endothelial cell density (ECD). The root mean squares (RMSs) for coma-like aberrations and spherical aberration were evaluated for a pupil size of 4.5 mm. The junctional graft (Tg) and host (Th) thicknesses were measured. The post-operative follow-up was 24 months. Results: Post-operative CDVA was 0.82 ± 0.14 (decimal scale), 100% of the eyes achieved a CDVA of 0.7 (decimal scale). The refractive cylinder was −2.86 ± 1.65 2-years after surgery. No eyes had a post-operative refractive cylinder ≥5.00 D and in five eyes (50%), it was ≤2.50 D. At the last visit, the mean keratometry was 45.64 ± 1.96 D, the RMS for coma-like aberrations was 0.30 ± 0.15 μm and spherical aberration was 0.22 ± 0.09. The mean ECD remains without changes over the follow-up (P = 0.07). At the last visit, Tg and Th were 679.9 ± 39.0 and 634.8 ± 41.2 μm, respectively. The thickness of the complex (host-Neoring) was 740.6 ± 35.6 μm. In all cases, this thickness was thicker than Tg. Conclusion: The results of this study suggest that PD-DALK along Neoring implantation is a viable, effective, and safe option to optimize the post-operative results for moderate-severe keratoconus.
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Affiliation(s)
| | - Carlos Lisa
- Fernández-Vega Ophthalmological Institute, Universidad de Oviedo, Oviedo, Spain
| | | | - David Madrid-Costa
- Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - José F Alfonso
- Fernández-Vega Ophthalmological Institute, Universidad de Oviedo, Oviedo, Spain
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Fernández-Vega-Cueto L, Alfonso-Bartolozzi B, Lisa C, Madrid-Costa D, Alfonso JF. Seven-year follow-up of posterior chamber phakic intraocular lens with central port design. Eye Vis (Lond) 2021; 8:23. [PMID: 34112241 PMCID: PMC8194243 DOI: 10.1186/s40662-021-00247-1] [Citation(s) in RCA: 28] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/22/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND To assess the clinical outcomes of the Visian Implantable Collamer Lens (ICL) with a central port throughout 7 years of follow-up. METHODS Eighty-four eyes of 52 patients were evaluated over a follow-up period of 7 years after V4c ICL implantation. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, intraocular pressure (IOP), endothelial cell density (ECD) and vault were analysed. RESULTS The mean postoperative UDVA (logMAR) was 0.04 ± 0.11, 0.13 ± 0.19 and 0.17 ± 0.23 at 1-, 5- and 7-years, respectively (P < 0.0001). The mean CDVA (logMAR) remains unchanged throughout a 7-year follow-up period (0.02 ± 0.08 and 0.02 ± 0.08, at 5- and 7-years, respectively, P = 0.2). At all follow-up visits, more than 95% of the eyes achieved a CDVA of 20/25 or better and more than 85% a CDVA of 20/20. At the end of the follow-up (7 years), no eye lost more lines of CDVA, 56 eyes (66.7%) and 28 eyes (33.3%) gained lines of CDVA. At 7-years, the spherical equivalent was - 0.62 ± 0.62 D. No significant increase in IOP (> 20 mmHg or an increase higher than 5 mmHg) occurred in any case throughout the 7-year of follow-up. The loss in ECD from the preoperative baseline at the last follow-up visit was 2.6%. No intraoperative or postoperative complications or adverse events occurred during the follow-up period. CONCLUSIONS The outcomes of this study show the long-term viability of the V4c ICL implantation as a surgical option for the correction of myopia.
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Affiliation(s)
| | | | - Carlos Lisa
- Fernández-Vega Ophthalmological Institute, Avda. Dres. Fernández-Vega 114, 33012, Oviedo, Spain
| | - David Madrid-Costa
- Optometry and Vision Department, Faculty of Optics and Optometry, University Complutense de Madrid, Madrid, Spain
| | - José F Alfonso
- Fernández-Vega Ophthalmological Institute, Avda. Dres. Fernández-Vega 114, 33012, Oviedo, Spain.
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Alfonso JF, Torquetti L, Fernández-Vega-Cueto L, Allan B, Poo-López A, Alfonso-Bartolozzi B, de la Cruz J, Monteiro T, Madrid-Costa D. Visual and Tomographic Outcomes of a 300° Arc-length ICRS Implantation in Moderate to Advanced Central Keratoconus. J Refract Surg 2021; 37:249-255. [PMID: 34038659 DOI: 10.3928/1081597x-20210115-01] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
PURPOSE To assess the outcomes of implanting a new 300° arc-length intrastromal corneal ring segment (ICRS) in moderate to advanced central hyperprolate keratoconus. METHODS Forty-two eyes with moderate to advanced central hyperprolate keratoconus were evaluated before and after implanting an inferior 300° ICRS (AJL Ophthalmic). The clinical measurements taken included manifest refraction, uncorrected (UDVA) and corrected (CDVA) distance visual acuity (logMAR scale), and corneal tomographic analysis (Sirius; Costruzioni Strumenti Oftalmici). Changes in the anterior and posterior corneal surfaces and the root mean square (RMS) for coma-like aberrations for a pupil size of 4.5 mm were evaluated. All examinations were performed before surgery and 6 months after surgery. RESULTS The mean UDVA improved from 1.12 ± 0.48 logMAR preoperatively to 0.73 ± 0.37 logMAR postoperatively (P < .0001). The mean CDVA changed from 0.33 ± 0.20 to 0.20 ± 0.11 logMAR (P < .0001). Postoperatively, the CDVA improved by two or more lines in 45.2% of the eyes and increased by one line in 19.04%, and none of the patients lost lines of CDVA. All of the anterior and posterior corneal tomographic parameters analyzed were significantly improved after surgery, except posterior flat keratometry, which remained unchanged. In 80.95% of the eyes, the postoperative mean keratometry was 50.00 diopters or less. The 6-month RMS for coma-like aberrations also declined significantly from 1.57 ± 0.68 to 1.06 ± 0.42 µm after surgery (P < .0001). CONCLUSIONS These results suggest that implanting a 300° arc-length ICRS is a safe and effective procedure for treating patients with moderate to advanced central hyperprolate keratoconus and clear cornea. [J Refract Surg. 2021;37(4):249-255.].
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Ruiz-Alcocer J, Martínez-Alberquilla I, Lorente-Velázquez A, Alfonso JF, Madrid-Costa D. Effect of defocus combined with rotation on the optical performance of trifocal toric IOLs. Eur J Ophthalmol 2021; 32:249-254. [PMID: 33706567 DOI: 10.1177/11206721211002121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To objectively analyze the optical quality of the FineVision Toric intraocular lens (IOL) with two cylinder powers when different combinations of rotations and residual refractive errors are induced. METHODS This study assessed the FineVision Toric IOL with two different cylinder powers: 1.5 and 3.0 diopters (D). Three different rotation positions were considered: centered, 5° and 10° rotated. An optical bench (PMTF) was used for optical analysis. The optical quality of the IOLs was calculated by the modulation transfer function (MTF) at five different focal points (0.0, 0.25, 0.50, 0.75, and 1.00 D). RESULTS The MTF averaged value of the reference situation was 38.58 and 37.74 for 1.5 and 3.0 D of cylinder, respectively. For the 1.5 D cylinder, the combination of 5° of rotation with a defocus of 0.25, 0.50, 0.75, and 1.0 D induced a decrease on the MTF of 12.39, 19.94, 23.43, 24.23 units, respectively. When induced rotation was 10°, the MTF decrease was 17.26, 23.40, 24.33, 24.48 units, respectively. For the 3.0 D cylinder, the combination of 5° with 0.25, 0.50, 0.75, and 1.0 D of defocus, induced a decrease on the MTF of 12.51, 18.97, 22.36, 22.48 units, respectively. When induced rotation was 10°, the MTF decrease was: 18.42, 21.57, 23.08, and 23.61 units, respectively. CONCLUSION For both FineVision Toric IOLs there is a certain optical tolerance to rotations up to 5° or residual refractive errors up to 0.25 D. Situations over these limits and their combination would affect the visual quality of patients implanted with these trifocal toric IOLs.
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Affiliation(s)
| | | | | | - José F Alfonso
- Fernández-Vega Ophthalmological Institute, Oviedo, Spain
| | - David Madrid-Costa
- Faculty of Optics and Optometry, Complutense University of Madrid, Spain
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Crooke A, Martínez-Alberquilla I, García-Montero M, Rico-Del-Viejo L, Ruiz-Alcocer J, Madrid-Costa D. Impact of contact lens wear on NLRP3 gene expression: Implications for ocular frailty in middle-aged adults. Exp Eye Res 2020; 202:108356. [PMID: 33197452 DOI: 10.1016/j.exer.2020.108356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Revised: 10/15/2020] [Accepted: 11/09/2020] [Indexed: 11/30/2022]
Abstract
The inflammatory process plays a crucial role in frailty syndrome, which can appear in middle age and is associated with a poor health outcome. Consequently, gerontologists recommend screening inflammatory biomarkers in middle-aged adults to detect frailty and, therefore, prevent chronic diseases and mortality. External factors could be a risk factor for frailty because they can generate and extend the inflammatory process. For these reasons, we analysed the effect of long-term contact lens wear on mRNA level of genes linked to inflammation (IL-6, NLRP3, NK1R, CD73, MUC16 and TRPV1 genes) in conjunctival cells of middle-aged individuals, by quantitative PCR. Middle-aged contact lens wearers presented a significant increase of NLRP3 and MUC16 mRNA level as well as a decrease of CD73 mRNA level, in comparison with non-contact lens wearers. Additionally, we checked for a potential correlation between these transcript levels and clinical changes of the participants' ocular surface. Unlike molecular analysis, clinical examination fails to detect inflammation in contact lens wearers. These data suggest that long-term contact lens wear could trigger an inflammatory response in middle age orchestrated by NLRP3 inflammasome and modulated by CD73 and MUC16 proteins. Further studies are needed to confirm our gene expression findings at the protein level as well as to investigate the potential role of long-term CL wear in the onset of ocular frailty.
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Affiliation(s)
- Almudena Crooke
- Department of Biochemistry and Molecular Biology, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain.
| | - Irene Martínez-Alberquilla
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - María García-Montero
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Laura Rico-Del-Viejo
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Javier Ruiz-Alcocer
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - David Madrid-Costa
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
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Fernández-Vega-Cueto L, Lisa C, Alfonso-Bartolozzi B, Madrid-Costa D, Alfonso JF. Intrastromal corneal ring segment implantation in paracentral keratoconus with perpendicular topographic astigmatism and comatic axis. Eur J Ophthalmol 2020; 31:1540-1545. [PMID: 32830575 DOI: 10.1177/1120672120952346] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE To evaluate the outcomes of implanting intrastromal corneal ring segment (ICRS) using two different strategies in a specific paracentral keratoconus phenotype. METHODS Eighty-nine eyes with paracentral keratoconus with perpendicular topographic astigmatism and comatic axes were evaluated before and after implanting a 150° arc-length ICRS. Patients were divided into two groups according to the axis where the ICRS was implanted: Group I: comatic axis and Group II: flat topographic axis. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refractive errors, and root mean square (RMS) for coma-like aberration were recorded. The postoperative follow-up was 1 year. RESULTS Mean UDVA (logMAR) changed from 0.49 ± 0.37 preoperatively to 0.30 ± 0.32 6 months afterwards (p < 0.001) in the group I and from 0.53 ± 0.34 to 0.37 ± 0.35 (p < 0.001), in the group II. Mean CDVA in group I changed from 0.11 ± 0.18 preoperatively to 0.06 ± 0.14 6 months after surgery (p < 0.001). In group II the improvement did not reach statistical significance (from 0.09 ± 0.10 to 0.07 ± 0.09; p = 0.06). No eyes lost lines of CDVA in group I. Eight eyes (15.7%) lost lines of CDVA in group II. The spherical equivalent decreased after surgery in both groups (p < 0.001). The RMS for corneal coma-like aberration only decreased in the group I (p < 0.001). CONCLUSION Both strategies provided safe and effective visual and refractive outcomes in the specific keratoconus phenotype analyzed. The orthopedic strategy provided better visual outcomes than the refractive one.
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Affiliation(s)
| | - Carlos Lisa
- Fernández-Vega Ophthalmological Institute, Oviedo, Spain
| | | | - David Madrid-Costa
- Optometry and Vision Department, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - José F Alfonso
- Fernández-Vega Ophthalmological Institute, Oviedo, Spain
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Ruiz-Alcocer J, Lorente-Velázquez A, Hernández-Verdejo JL, De Gracia P, Madrid-Costa D. Optical Performance of a Trifocal IOL and a Novel Extended Depth of Focus IOL Combined With Different Corneal Profiles. J Refract Surg 2020; 36:435-441. [DOI: 10.3928/1081597x-20200519-02] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Accepted: 05/19/2020] [Indexed: 11/20/2022]
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Ruiz-Alcocer J, Lorente-Velázquez A, de Gracia P, Madrid-Costa D. Optical tolerance to rotation of trifocal toric intraocular lenses as a function of the cylinder power. Eur J Ophthalmol 2020; 31:1007-1013. [PMID: 32460622 DOI: 10.1177/1120672120926845] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The aim was to assess the impact of 5- and 10-degree rotations in the optical quality of a trifocal toric intraocular lens with different amounts of cylinder. METHODS Two Physiol Toric intraocular lenses with 1.5 and 3.0 D of cylinder were analysed in three different positions: centred, 5 and 10 degrees rotated. The optical quality of the intraocular lenses was evaluated with the PMTF optical bench through specific perpendicular targets. The analysis was performed by the through-focus modulation transfer function curves and the modulation transfer function corresponding to distance vision (0 D of vergence). RESULTS For a centred situation, the through-focus modulation transfer function curves of both intraocular lenses showed the classical three peaks corresponding to the powers of the two principal meridians of the intraocular lenses. When 5 and 10 degrees of rotation were induced, the three peaks were attenuated in both cases. The case with the intraocular lens with 3.0 D of cylinder and 10 degrees of rotation showed the worst optical quality and a significant loss of trifocality. The modulation transfer function values obtained for distance vision also showed the worst optical quality for the intraocular lens with 3.0 D of cylinder and 10 degrees of rotation. CONCLUSION Rotations over 5 degrees decreased the optical quality of trifocal toric intraocular lenses, being this reduction moderate from 5 to 10 degrees for low levels of cylinder (≤1.5 D). For mid-high levels of cylinder (≥3.0 D), rotations over 5 degrees cause a significant loss of optical quality at all object distances.
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Affiliation(s)
- Javier Ruiz-Alcocer
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Amalia Lorente-Velázquez
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
| | - Pablo de Gracia
- Chicago College of Optometry, Midwestern University, Downers Grove, IL, USA
| | - David Madrid-Costa
- Department of Optometry and Vision, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
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Rico-del-Viejo L, Benítez-del-Castillo JM, Gómez-Sanz FJ, García-Montero M, Llorens-Quintana C, Madrid-Costa D. The influence of meibomian gland loss on ocular surface clinical parameters. Cont Lens Anterior Eye 2019; 42:562-568. [DOI: 10.1016/j.clae.2019.04.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 03/31/2019] [Accepted: 04/03/2019] [Indexed: 10/27/2022]
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Monteiro T, Alfonso JF, Franqueira N, Faria-Correira F, Ambrósio R, Madrid-Costa D. Comparison of clinical outcomes between manual and femtosecond laser techniques for intrastromal corneal ring segment implantation. Eur J Ophthalmol 2019; 30:1246-1255. [DOI: 10.1177/1120672119872367] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Purpose: The purpose was to compare the visual, refractive and aberrometric results of intrastromal corneal ring segments implantation with manual dissection and femtosecond laser–assisted surgery. Methods: This is a multicentre study, which included consecutive patients with paracentral keratoconus, in which the difference between the axes of the topographic flattest and the coma aberration was <60°, who had Ferrara-type intrastromal corneal ring segment implantation using manual dissection or femtosecond laser technique. LogMAR uncorrected (uncorrected distance visual acuity) and corrected (corrected distance visual acuity) distance visual acuity, refractive errors and the root mean square for corneal coma-like aberration were recorded before and at 6 months after surgery. Results: The study included 84 and 110 eyes in the manual group and in the femtosecond group, respectively. After surgery, there was a statistically significant improvement in uncorrected distance visual acuity and corrected distance visual acuity for both groups ( p < 0.0001), and there were no statistically significant differences between groups ( p > 0.3). For both groups, there was a reduction in spherical equivalent after intrastromal corneal ring segment implantation ( p < 0.0001). There were no statistically significant differences between groups in the magnitude of spherical equivalent reduction ( p = 0.34) The magnitude of the root mean square coma-like reduction was 0.93 ± 0.76 and 0.83 ± 0.80 μm in the manual and femtosecond group, respectively ( p = 0.2). While in the femtosecond laser group no complications were reported, in the manual group, the intraoperative or postoperative complications rate was 13.09%. Conclusion: Although both surgical techniques provide comparable visual, refractive and aberrometric outcomes, it should be noted that the femtosecond laser is a safer surgical procedure, with no complications reported.
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Affiliation(s)
- Tiago Monteiro
- Hospital de Braga, Braga, Portugal
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | | | - Nuno Franqueira
- Hospital de Braga, Braga, Portugal
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | - Fernando Faria-Correira
- Hospital de Braga, Braga, Portugal
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | - Renato Ambrósio
- Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Rio de Janeiro, Brazil
- Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
| | - David Madrid-Costa
- Department of Optometry and Vision, Universidad Complutense de Madrid, Madrid, Spain
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Llorens-Quintana C, Rico-Del-Viejo L, Syga P, Madrid-Costa D, Iskander DR. A Novel Automated Approach for Infrared-Based Assessment of Meibomian Gland Morphology. Transl Vis Sci Technol 2019; 8:17. [PMID: 31392084 PMCID: PMC6681863 DOI: 10.1167/tvst.8.4.17] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2018] [Accepted: 06/14/2019] [Indexed: 02/06/2023] Open
Abstract
Purpose We present and validate a new methodology for analyzing, in an automated and objective fashion, infrared images of the meibomian glands (MG). Methods The developed algorithm consists of three main steps: selection of the region of interest, detection of MG, and analysis of MG morphometric parameters and dropout area (DOA). Additionally, a new approach to quantify the irregularity of MG is introduced. We recruited 149 adults from a general population. Infrared meibography, using Keratograph 5M, was performed. Images were assessed and graded subjectively (Meiboscore) by two experienced clinicians and objectively with the proposed automated method. Results The correlation of subjective DOA assessment between the two clinicians was poor and the average percentage of DOA estimated objectively for each Meiboscore group did not lie within their limits. The objective assessment showed lower variability of meibography grading than that obtained subjectively. Additionally, a new grading scale of MG DOA that reduces intraclass variation is proposed. Reported values of MG length and width were inversely proportional to the DOA. Gland irregularity was objectively quantified. Conclusions The proposed automatic and objective method provides accurate estimates of the DOA as well as additional morphologic parameters that could add valuable information in MG dysfunction understanding and diagnosis. Translational Relevance This approach highlights the shortcomings of currently used subjective methods, and provides the clinicians with an objective, quantitative and less variable alternative for assessing MG in a noninvasive and automated fashion. It provides a viable alternative to more time-consuming subjective methods.
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Affiliation(s)
- Clara Llorens-Quintana
- Wroclaw University of Science and Technology, Faculty of Fundamental Problems of Technology, Department of Biomedical Engineering, Wroclaw, Poland
| | - Laura Rico-Del-Viejo
- Complutense University of Madrid, Faculty of Optics and Optometry, Department of Optometry and Vision, Madrid, Spain
| | - Piotr Syga
- Wroclaw University of Science and Technology, Faculty of Fundamental Problems of Technology, Department of Computer Science, Wroclaw, Poland
| | - David Madrid-Costa
- Complutense University of Madrid, Faculty of Optics and Optometry, Department of Optometry and Vision, Madrid, Spain
| | - D Robert Iskander
- Wroclaw University of Science and Technology, Faculty of Fundamental Problems of Technology, Department of Biomedical Engineering, Wroclaw, Poland
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Monteiro T, Alfonso JF, Freitas R, Franqueira N, Faria-Correira F, Ambrósio R, Madrid-Costa D. Comparison of Complication Rates between Manual and Femtosecond Laser-Assisted Techniques for Intrastromal Corneal Ring Segments Implantation in Keratoconus. Curr Eye Res 2019; 44:1291-1298. [PMID: 31226888 DOI: 10.1080/02713683.2019.1635165] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Purpose: To compare the incidence of complications between manual and femtosecond-laser assisted surgery for intrastromal corneal ring segments (ICRS) implantation.Material and methods: This study included keratoconus patients who had ICRS implantation using manual dissection and using the femtosecond laser with a minimum follow-up of 12 months. Uncorrected (UDVA) corrected (CDVA) distance visual acuity (CDVA), refraction, corneal topography and aberrometry, pachymetry map and slit-lamp microscopy were assessed before and after surgery.Results: The study included 265 eyes in the manual group and 111 in the femtosecond laser group. In the manual group, there were complications in 48 eyes (18.11%); while in the femtosecond laser 4 eyes had a complication (3.6%). In the manual group, the most frequent complications were ICRS exchange/adjustment for visual and refractive enhancement (25 eyes; 9.43%) and late ICRS spontaneous extrusion (15 eyes; 5.66%). In the manual group, 81.25% of complications were observed during the first 3 years of surgeon's experience. Eyes who suffered a complication had preoperatively higher mean refractive (p = .002) and topographic cylinder (p = .003) and lower UDVA (p = .005) and CDVA (p = .002). After a second surgical procedure for complication management visual, refractive and topographic outcomes significantly improved.Conclusion: Manual mechanical ICRS surgery shows a higher rate of intra- and postoperative mechanical and refractive complications when compared to femtosecond laser assisted technique. The incidence is specially higher during the surgeon's first years of implementation of the technique.
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Affiliation(s)
- Tiago Monteiro
- Ophthalmology Department, Hospital de Braga, Braga, Portugal.,Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | - José F Alfonso
- Instituto Universitario Fernández-Vega, Fundación de Investigación Oftalmológica, Universidad de Oviedo, Oviedo, Spain
| | - Rui Freitas
- Ophthalmology Department, Hospital de Braga, Braga, Portugal.,Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | - Nuno Franqueira
- Ophthalmology Department, Hospital de Braga, Braga, Portugal.,Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | - Fernando Faria-Correira
- Ophthalmology Department, Hospital de Braga, Braga, Portugal.,Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | - Renato Ambrósio
- Rio de Janeiro Corneal Tomography and Biomechanics Study Group, Rio de Janeiro, Brazil.,Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil
| | - David Madrid-Costa
- Optometry and Vision Department, Faculty of Optics and Optometry, Universidad Complutense de Madrid, Madrid, Spain
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Lorente-Velázquez A, García-Montero M, Gómez-Sanz FJ, Rico Del Viejo L, Hernández-Verdejo JL, Madrid-Costa D. Comparison of the impact of nesofilcon A hydrogel contact lens on the ocular surface and the comfort of presbyopic and non-presbyopic wearers. Int J Ophthalmol 2019; 12:640-646. [PMID: 31024820 DOI: 10.18240/ijo.2019.04.19] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2018] [Accepted: 12/13/2018] [Indexed: 11/23/2022] Open
Abstract
AIM To assess and compare the impact of a daily disposable contact lens (CL) with high water content on the ocular surface and comfort of the presbyopic and non-presbyopic population after one day of use. METHODS Totally 20 presbyopes and 30 non-presbyopes non-contact wearers were fitted with nesofilcon A CLs. CL thickness was measured to assess material stability during daily wear, and ocular surface parameters were also assessed. Optical quality was analyzed for all cases. In addition, CL comfort was rated. RESULTS No significant differences were found in CL thickness, tear film osmolarity, average tear break-up time, bulbar redness, central corneal thickness, corneal volume, root-mean-square of higher-order aberrations (RMS of HOAs) and vertical and horizontal coma, either as a function of the group or time of use. A significant decrease in tear meniscus height and first break-up of the tear film was found in the presbyopic group (P=0.038; P=0.007 respectively). A decrease in spherical aberration coefficient was found after CL insertion (P=0.031 monofocal CL; P=0.023 low addition multifocal CL; P=0.016 high addition multifocal CL). Multifocal CL were thicker than monofocal CL (P=0.045). Comparison between groups showed more discomfort in presbyopes than non-presbyopes (P=0.003). CONCLUSION This study evidence that the behavior of the daily disposable CL with high water content seems to be stable during the day of use. Ocular parameters measured during wear show that CL behavior is the same for presbyopes and non-presbyopes, being more uncomfortable for presbyopes.
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Affiliation(s)
- Amalia Lorente-Velázquez
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid 28037, Spain
| | - María García-Montero
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid 28037, Spain
| | - Francisco Javier Gómez-Sanz
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid 28037, Spain
| | - Laura Rico Del Viejo
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid 28037, Spain
| | - José Luis Hernández-Verdejo
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid 28037, Spain
| | - David Madrid-Costa
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, Madrid 28037, Spain
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Fernández-Vega-Cueto L, Lisa C, Poo-López A, Alfonso JF, Madrid-Costa D. Three-year follow-up of intrastromal corneal ring segment implantation in central keratoconus with regular astigmatism: ‘Bow-tie’ shape. Eur J Ophthalmol 2019; 30:643-649. [DOI: 10.1177/1120672119835397] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose: To assess the outcomes of implanting Ferrara-type intrastromal corneal ring segments in central ‘bow-tie’-shaped keratoconus over 3 years of follow-up. Methods: A total of 20 eyes with central ‘bow-tie’-shaped keratoconus were evaluated before and after implanting Ferrara-type intrastromal corneal ring segments (AJL Ophthalmic, Spain). LogMAR uncorrected distance visual acuity and best corrected distance visual acuity and residual refractive errors analysed using vector analysis were recorded preoperatively, at 6 months, 1 year, and 3 years postoperatively. Results: The mean uncorrected distance visual acuity (LogMAR scale) rose from a preoperative 0.75 ± 0.28 to a 6-month postoperative 0.38 ± 0.28 (p < 0.0001). The corrected distance visual acuity, in turn, improved from 0.07 ± 0.06 to 0.05 ± 0.06 (p = 0.0008). Both the uncorrected distance visual acuity and corrected distance visual acuity were stable over the postoperative period in both groups (p > 0.05). None of the eyes lost uncorrected distance visual acuity and corrected distance visual acuity lines over the postoperative follow-up period. The spherical equivalent and the refractive cylinder declined steeply after intrastromal corneal ring segments implantation (p < 0.0001). Both the spherical equivalent and refractive cylinder were stable over the postoperative period. None of the eyes had an increase in maximum or minimum keratometry greater than 0.75D over the postoperative period. Conclusion: The planning for intrastromal corneal ring segments insertion proposed in this study reduces the spherical equivalent and refractive cylinder in this type of keratoconus, while improving post-surgery uncorrected distance visual acuity and corrected distance visual acuity. These results remain stable over 3 years of follow-up. Therefore, this procedure could be considered as an effective therapeutic alternative in patients affected by this type of keratoconus.
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Affiliation(s)
| | - Carlos Lisa
- Fernández-Vega Ophthalmological Institute, Oviedo, Spain
| | | | - José F Alfonso
- Fernández-Vega Ophthalmological Institute, Oviedo, Spain
| | - David Madrid-Costa
- Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
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Monteiro T, Alfonso JF, Franqueira N, Faria-Correia F, Ambrósio R, Madrid-Costa D. Predictability of Tunnel Depth for Intrastromal Corneal Ring Segments Implantation Between Manual and Femtosecond Laser Techniques. J Refract Surg 2018. [DOI: 10.3928/1081597x-20180108-01] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Fernández-Vega L, Madrid-Costa D, Alfonso JF, Poo-López A, Montés-Micó R. Bilateral Implantation of the Acri.LISA Bifocal Intraocular Lens in Myopic Eyes. Eur J Ophthalmol 2018; 20:83-9. [DOI: 10.1177/112067211002000111] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Purpose To asses visual quality after bilateral implantation of the Acri.LISA 366D intraocular lens (IOL) (Carl Zeiss Meditec) in patients with high and low–moderate myopia. Methods A total of 304 eyes of 152 patients had bilateral implantation of the Acri.LISA 366D IOL. The patients were divided into 2 groups: low–moderate myopia (IOL power from 15 to 20.5 D) and high myopia (IOL power from 0 to 14.5 D). Monocular and binocular best-corrected distance visual acuity (BCVA) and best distance-corrected near visual acuity (BCNVA), binocular best distance-corrected intermediate visual acuity (BCIVA), and distance contrast sensitivity (OS) under photopic (85 cd/m2) and mesopic (5 cd/m2) conditions were determined. Results At the 6-month postoperative visit, there were no statistically significant differences in monocular and binocular BCVA (p=0.13 and p=0.22, respectively). Monocular and binocular BCNVA was comparable between the groups (p=0.26 and p=0.09, respectively). The mean binocular BCIVA changed significantly as a function of the distance of the test (p<0.01) in both groups, and there were no statistically significant differences between groups at any distance. Monocular and binocular CS under photopic and mesopic conditions was similar between both groups (p>0.01). Conclusions Bilateral implantation of the Acri.LISA 366D in high myopic eyes provides a satisfactory full range of vision comparable to that obtained in low–moderate myopic eyes.
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Affiliation(s)
- Luis Fernández-Vega
- Fernández-Vega Ophthalmological Institute
- Surgery Department, School of Medicine, University of Oviedo
| | - David Madrid-Costa
- Fernández-Vega Ophthalmological Institute
- Optics and Optometry Department, Universidad Europea de Madrid
| | - José F. Alfonso
- Fernández-Vega Ophthalmological Institute
- Surgery Department, School of Medicine, University of Oviedo
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Ruiz-Alcocer J, Monsálvez-Romín D, García-Lázaro S, Albarrán-Diego C, Hernández-Verdejo JL, Madrid-Costa D. Impact of contact lens material and design on the ocular surface. Clin Exp Optom 2017; 101:188-192. [PMID: 29023989 DOI: 10.1111/cxo.12622] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Revised: 05/29/2017] [Accepted: 05/29/2017] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND To evaluate the impact on the ocular surface of a daily disposable hydrogel contact lens with high water content compared with two silicone hydrogel daily disposable lenses of lower water content. METHODS The hydrogel lens assessed was made from nesofilcon A and the silicone hydrogel lenses were made of delefilcon A and stenfilcon A. Contact lens thickness was measured to assess material stability during daily wear, and ocular surface parameters such as tear film osmolarity, tear meniscus area and central corneal thickness were also assessed. Optical quality was analysed for all cases by means of wavefront aberrometry. RESULTS The nesofilcon A was shown to be the thinnest lens (p < 0.001), while no differences in lens thickness were found between the two silicone hydrogel lenses (p = 0.495). No significant differences were found in tear film osmolarity, tear meniscus area, central corneal thickness or corneal aberrations, either as a function of the lens measured or time of use (p > 0.05). CONCLUSION In spite of having the thinnest lens and the highest water content, the hydrogel does not significantly impact on tear film and corneal swelling after one day of use in first-time wearers.
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Affiliation(s)
| | | | | | - César Albarrán-Diego
- Research Group (GIO), Optics Department, University of Valencia, Valencia, Spain
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Menduni F, Davies LN, Madrid-Costa D, Fratini A, Wolffsohn JS. Characterisation of the porcine eyeball as an in-vitro model for dry eye. Cont Lens Anterior Eye 2017; 41:13-17. [PMID: 28986008 DOI: 10.1016/j.clae.2017.09.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2017] [Revised: 08/28/2017] [Accepted: 09/08/2017] [Indexed: 10/18/2022]
Abstract
PURPOSE To characterise the anatomical parameters of the porcine eye for potentially using it as a laboratory model of dry eye. METHODS Anterior chamber depth and angle, corneal curvature, shortest and longest diameter, endothelial cell density, and pachymetry were measured in sixty freshly enucleated porcine eyeballs. RESULTS Corneal steepest meridian was 7.85±0.32mm, corneal flattest meridian was 8.28±0.32mm, shortest corneal diameter was 12.69±0.58mm, longest corneal diameter was 14.88±0.66mm and central corneal ultrasonic pachymetry was 1009±1μm. Anterior chamber angle was 28.83±4.16°, anterior chamber depth was 1.77±0.27mm, and central corneal thickness measured using OCT was 1248±144μm. Corneal endothelial cell density was 3250±172 cells/mm2. CONCLUSIONS Combining different clinical techniques produced a pool of reproducible data on the porcine eye anatomy, which can be used by researchers to assess the viability of using the porcine eye as an in-vitro/ex-vivo model for dry eye. Due to the similar morphology with the human eye, porcine eyeballs may represent a useful and cost effective model to individually study important key factors in the development of dry eye, such as environmental and mechanical stresses.
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Affiliation(s)
- Francesco Menduni
- School of Life and Health Science, Aston University, Birmingham, UK; Optics and Optometry Department, Complutense University of Madrid, Madrid, Spain.
| | - Leon N Davies
- School of Life and Health Science, Aston University, Birmingham, UK
| | - D Madrid-Costa
- Optics and Optometry Department, Complutense University of Madrid, Madrid, Spain
| | - Antonio Fratini
- School of Life and Health Science, Aston University, Birmingham, UK
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Papadatou E, Del Águila-Carrasco AJ, Esteve-Taboada JJ, Madrid-Costa D, Cerviño-Expósito A. Objective assessment of the effect of pupil size upon the power distribution of multifocal contact lenses. Int J Ophthalmol 2017; 10:103-108. [PMID: 28149785 DOI: 10.18240/ijo.2017.01.17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Accepted: 09/18/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To analytically assess the effect of pupil size upon the refractive power distributions of different designs of multifocal contact lenses. METHODS Two multifocal contact lenses of center-near design and one multifocal contact lens of center-distance design were used in this study. Their power profiles were measured using the NIMO TR1504 device (LAMBDA-X, Belgium). Based on their power profiles, the power distribution was assessed as a function of pupil size. For the high addition lenses, the resulting refractive power as a function of viewing distance (far, intermediate, and near) and pupil size was also analyzed. RESULTS The power distribution of the lenses was affected by pupil size differently. One of the lenses showed a significant spread in refractive power distribution, from about -3 D to 0 D. Generally, the power distribution of the lenses expanded as the pupil diameter became greater. The surface of the lens dedicated for each distance varied substantially with the design of the lens. CONCLUSION In an experimental basis, our results show how the lenses power distribution is affected by the pupil size and underlined the necessity of careful evaluation of the patient's visual needs and the optical properties of a multifocal contact lens for achieving the optimal visual outcome.
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Affiliation(s)
- Eleni Papadatou
- Optometry Research Group, University of Valencia, Valencia 46100, Spain
| | | | | | - David Madrid-Costa
- Optics II Department, Optics and Optometry Faculty, Complutense University of Madrid, Madrid 28037, Spain
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Zoulinakis G, Esteve-Taboada JJ, Ferrer-Blasco T, Madrid-Costa D, Montés-Micó R. Accommodation in human eye models: a comparison between the optical designs of Navarro, Arizona and Liou-Brennan. Int J Ophthalmol 2017; 10:43-50. [PMID: 28149775 DOI: 10.18240/ijo.2017.01.07] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2016] [Accepted: 06/20/2016] [Indexed: 11/23/2022] Open
Abstract
AIM To simulate and compare accommodation in accommodative and non-accommodative human eye models. METHODS Ray tracing and optical design program was used. Three eye models were designed and studied: the Navarro, the Arizona and the Liou-Brennan. In order to make the Navarro and Liou-Brennan models to accommodate, specific geometric parameters of the models were altered with values that were chosen from the literature. For the Arizona model, its' mathematical functions for accommodation were used for the same accommodative demands. The simulation included four distances of accommodation for each model: at infinity, 3, 1 and 0.5 m.The results were diffraction images of a "letter F" for graphical comparison, spot diagrams on the retinal field and Modulation Transfer Function (MTF) graphs. RESULTS Zernike coefficients for the aberrations, Airy disk diameter, root mean square (RMS) error diameter and total axial length of the model were provided from the program. These were compared between them in all distances. The Navarro model had the smallest axial length change as a simple model. The Arizona did not change its axial length because it is designed to be accommodative. The Liou-Brennan model had different results concerning the aberrations because of the decentration of the pupil. The MTF graphs showed small differences between the models because of the differences in their designs. CONCLUSION All the three models are able to simulate accommodation with the expected results. There is no model that can be assumed as the best choice. Accommodation can be simulated in non-accommodativemodels and in customized ones.
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Affiliation(s)
- Georgios Zoulinakis
- Department of Optics and Optometry and Vision Sciences, Physics Faculty, University of Valencia, Burjassot, Valencia 46100, Spain; Interuniversity laboratory for research in Vision and Optometry, Mixed group University of Valencia, University of Murcia, Spain
| | - Jose Juan Esteve-Taboada
- Department of Optics and Optometry and Vision Sciences, Physics Faculty, University of Valencia, Burjassot, Valencia 46100, Spain; Interuniversity laboratory for research in Vision and Optometry, Mixed group University of Valencia, University of Murcia, Spain
| | - Teresa Ferrer-Blasco
- Department of Optics and Optometry and Vision Sciences, Physics Faculty, University of Valencia, Burjassot, Valencia 46100, Spain; Interuniversity laboratory for research in Vision and Optometry, Mixed group University of Valencia, University of Murcia, Spain
| | - David Madrid-Costa
- Department of Optics and Optometry and Vision Sciences, Physics Faculty, University of Valencia, Burjassot, Valencia 46100, Spain; Interuniversity laboratory for research in Vision and Optometry, Mixed group University of Valencia, University of Murcia, Spain
| | - Robert Montés-Micó
- Department of Optics and Optometry and Vision Sciences, Physics Faculty, University of Valencia, Burjassot, Valencia 46100, Spain; Interuniversity laboratory for research in Vision and Optometry, Mixed group University of Valencia, University of Murcia, Spain
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Pérez-Prados R, Piñero DP, Pérez-Cambrodí RJ, Madrid-Costa D. Soft multifocal simultaneous image contact lenses: a review. Clin Exp Optom 2016; 100:107-127. [PMID: 27800638 DOI: 10.1111/cxo.12488] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Revised: 04/27/2016] [Accepted: 06/12/2016] [Indexed: 11/30/2022] Open
Abstract
Soft multifocal simultaneous image contact lenses have boomed in recent years due to the growing number of presbyopic patients demanding visual solutions, allowing them to maintain their current standard of living. The concept of 'simultaneous image' is based on blur interpretation and/or blur tolerance of superimposed multiple images on the retina formed by various powers of a contact lens. This is the basis for a specific type of multifocal contact lens developed for the compensation of presbyopia. Manufacturers have released a great variety of soft simultaneous image lens designs to meet different patient needs but their fitting is still unsatisfactory in some cases. Some presbyopes discontinue wearing contact lenses due to some limitations in visual quality and comfort that can be overcome with an appropriate contact lens selection based on a comprehensive pre-fitting evaluation. This paper aims to review the different types of soft multifocal contact lenses that are currently available for presbyopic correction and to define the steps and factors crucial for their fitting, such as pupil, aberrations, accommodation and centring. A discussion about useful tools to achieve a customised fitting leading to a successful outcome, such as the defocus curve, power profile and questionnaires, is performed.
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Affiliation(s)
- Roque Pérez-Prados
- Centro Óptico Benalúa, Alicante, Spain.,Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain
| | - David P Piñero
- Department of Optics, Pharmacology and Anatomy, University of Alicante, Alicante, Spain.,Department of Ophthalmology (Oftalmar), Medimar International Hospital, Alicante, Spain.,Foundation for the Visual Quality (FUNCAVIS, Fundación para la Calidad Visual), Alicante, Spain
| | - Rafael J Pérez-Cambrodí
- Department of Ophthalmology (Oftalmar), Medimar International Hospital, Alicante, Spain.,Foundation for the Visual Quality (FUNCAVIS, Fundación para la Calidad Visual), Alicante, Spain
| | - David Madrid-Costa
- Faculty of Optics and Optometry, Complutense University of Madrid, Madrid, Spain
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Papadatou E, Del Águila-Carrasco AJ, Esteve-Taboada JJ, Madrid-Costa D, Montés-Micó R. Assessing the in vitro optical quality of presbyopic solutions based on the axial modulation transfer function. J Cataract Refract Surg 2016; 42:780-7. [DOI: 10.1016/j.jcrs.2015.11.049] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 11/22/2015] [Accepted: 11/28/2015] [Indexed: 11/25/2022]
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García-Lázaro S, Ferrer-Blasco T, Madrid-Costa D, Albarrán-Diego C, Montés-Micó R. Visual Performance of Four Simultaneous-Image Multifocal Contact Lenses Under Dim and Glare Conditions. Eye Contact Lens 2015; 41:19-24. [DOI: 10.1097/icl.0000000000000060] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Madrid-Costa D, Ruiz-Alcocer J, Ferrer-Blasco T, García-Lázaro S, Montés-Micó R. In vitro optical performance of a new aberration-free intraocular lens. Eye (Lond) 2014; 28:614-20. [PMID: 24556881 DOI: 10.1038/eye.2014.25] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2013] [Accepted: 01/15/2014] [Indexed: 10/25/2022] Open
Abstract
PURPOSE To assess the optical performance of the new EnVista intraocular lens (IOL). MATERIALS AND METHODS Four aspheric IOLs were evaluated; the new EnVista is one amoung them. This IOL, similarly to the Z-Flex HB and the Bi-Flex 1.8 667AB ones, has a neutral aspheric design, whereas the fourth IOL under test (AcrySof IQ IOL SN60WF) presents a negative spherical aberration (SA). The IOL's aberration patterns were measured in vitro, by setting them up on an optical bench. From these aberration-pattern data, the modulation transfer function (MTF), the average modulation values, and the points spread function (PSF) were calculated. Furthermore, in order to assess the potential optical quality that these IOLs would yield once they are implanted, an average corneal-aberration pattern was juxtaposed to the in-vitro profiles and the same parameters were calculated again. RESULTS For the IOL-only scenario (ie, without including the corneal factor), it was the EnVista IOL, which is aberration-free that showed the higher MTF, PSF values. This was followed by the other two aberration-free IOL models. However, when the effect of an average corneal pattern was also taken into consideration, the AcrySof IQ IOL SN60WF always outperformed the other neutral-asphericity IOLs. CONCLUSIONS The in-vitro optical performance of the EnVista IOL was good, but it decreases substantially in a whole-eye scenario, when the wavefront profile of an average cornea is added. Other designs with different degrees of SA should be considered for this IOL in order to surpass these results.
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Affiliation(s)
- D Madrid-Costa
- Optometry Research Group, Optics Department, University of Valencia, Valencia, Spain
| | - J Ruiz-Alcocer
- Optometry Research Group, Optics Department, University of Valencia, Valencia, Spain
| | - T Ferrer-Blasco
- Optometry Research Group, Optics Department, University of Valencia, Valencia, Spain
| | - S García-Lázaro
- Optometry Research Group, Optics Department, University of Valencia, Valencia, Spain
| | - R Montés-Micó
- Optometry Research Group, Optics Department, University of Valencia, Valencia, Spain
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Pérez-Vives C, Ferrer-Blasco T, Madrid-Costa D, García-Lázaro S, Montés-Micó R. Visual quality comparison of conventional and Hole-Visian implantable collamer lens at different degrees of decentering. Br J Ophthalmol 2013; 98:59-64. [PMID: 24246374 DOI: 10.1136/bjophthalmol-2013-303787] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE To compare the visual quality of implantable collamer lens (ICL) with and without central hole (Hole ICL and conventional ICL) at different degrees of decentering. METHODS An adaptive optics visual simulator (crx1, Imagine Eyes, Orsay, France) was used to simulate the -3, -6 and -12 dioptres (D) conventional and Hole ICLs in three conditions: centred and decentred 0.3 and 0.6 mm. Visual acuity (VA) at high-contrast, medium-contrast and low-contrast and contrast sensitivity (CS) were measured in 15 observers for 3 and 4.5 mm pupils. RESULTS No statistically significant differences in VA and CS were found between conventional and Hole ICLs for any ICL powers and pupil sizes evaluated (p>0.05). Regarding the effect of the ICL decentration on visual performance, we did not find statistically significant differences in VA and CS between centred, 0.3 and 0.6 mm decentred (p>0.05). Moreover, the ICL decentration affected the same manner on the conventional and Hole ICLs. CONCLUSIONS The outcomes showed that conventional and Hole ICLs provided good and comparable visual performance for all powers and pupil sizes evaluated. Besides, ICL decentering affects the same manner both ICL models evaluated. The ICL decentering did not have any effect on the visual performance.
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Affiliation(s)
- Cari Pérez-Vives
- GIO, Optics Department, Faculty of Physics, University of Valencia, , Valencia, Spain
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Madrid-Costa D, Ruiz-Alcocer J, Ferrer-Blasco T, García-Lázaro S, Montés-Micó R. Optical Quality Differences Between Three Multifocal Intraocular Lenses: Bifocal Low Add, Bifocal Moderate Add, and Trifocal. J Refract Surg 2013; 29:749-54. [DOI: 10.3928/1081597x-20131021-04] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2013] [Accepted: 07/30/2013] [Indexed: 01/19/2023]
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Montés-Micó R, Madrid-Costa D, Domínguez-Vicent A, Belda-Salmerón L, Ferrer-Blasco T. In vitro power profiles of multifocal simultaneous vision contact lenses. Cont Lens Anterior Eye 2013; 37:162-7. [PMID: 24156956 DOI: 10.1016/j.clae.2013.09.014] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 09/18/2013] [Accepted: 09/28/2013] [Indexed: 11/16/2022]
Abstract
PURPOSE To evaluate the power profile of multifocal contact lenses (CLs) using a new technology based on quantitative deflectometry. METHODS The Nimo TR1504 was used to analyze the power distribution of multifocal CLs. The CLs under study were: Air Optix Aqua Multifocal Low, Medium and High Addition and Focus Progressives. Three lenses of each model were considered. RESULTS All multifocal CLs showed a power profile characterized by a change toward more positive power values when aperture sizes become smaller. The near refractive addition of the lenses under study was +2.61 D, +1.44 D, +1.30 D and +0.30 D for the Focus Progressives, the Air Optix Aqua Multifocal High, Medium Add and Low Add, respectively. The refractive power of the Focus Progressives did not reach the value of the nominal distance power until a radial distance of 0.9 mm from the center of the lens. For the Air Optix Aqua Multifocal Low Add the distance nominal power was reached at a radial distance of 1.5mm from the center of the lens, whereas this occurred at a distance of 1.8mm for the Air Optix Aqua Multifocal Medium and High Add. CONCLUSION The relation between the pupil diameter of the patients and the power profile of these CLs has a crucial implication on the final distance correction and near addition that these lenses provide to patients. Practitioners should know the power profile of these CLs and measure the pupil diameter of each patient in different situations in order to carry out a customized fitting.
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Affiliation(s)
- Robert Montés-Micó
- Optometry Research Group, Optics Department, Faculty of Physics, University of Valencia, c/ Dr. Moliner, 50, 46100 Burjassot, Valencia, Spain.
| | - David Madrid-Costa
- Optometry Research Group, Optics Department, Faculty of Physics, University of Valencia, c/ Dr. Moliner, 50, 46100 Burjassot, Valencia, Spain
| | - Alberto Domínguez-Vicent
- Optometry Research Group, Optics Department, Faculty of Physics, University of Valencia, c/ Dr. Moliner, 50, 46100 Burjassot, Valencia, Spain
| | - Lurdes Belda-Salmerón
- Optometry Research Group, Optics Department, Faculty of Physics, University of Valencia, c/ Dr. Moliner, 50, 46100 Burjassot, Valencia, Spain
| | - Teresa Ferrer-Blasco
- Optometry Research Group, Optics Department, Faculty of Physics, University of Valencia, c/ Dr. Moliner, 50, 46100 Burjassot, Valencia, Spain
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Pérez-Vives C, Domínguez-Vicent A, Ferrer-Blasco T, Madrid-Costa D, Montés-Micó R. Optical quality of hyperopic and myopic phakic intraocular lenses. Indian J Ophthalmol 2013; 62:437-41. [PMID: 24145572 PMCID: PMC4064218 DOI: 10.4103/0301-4738.119423] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIMS To assess and compare the optical quality of the myopic and hyperopic implantable collamer lens (ICL) from its wavefront aberrations for different powers and pupil diameters. SETTINGS AND DESIGN Prospective study. MATERIAL AND METHODS The wavefront aberrations of two myopic (-3 and -6 diopters (D)) and two hyperopic V4b ICLs (+3 and +6D) were measured in vitro. To assess and compare the optical quality of different powers of ICLs, we analyzed the root mean square (RMS) of total higher order aberrations (HOAs), trefoil, coma, tetrafoil, secondary astigmatism, and spherical aberration at 3- and 4.5-mm pupil. In addition, the point spread functions (PSFs) of each ICL evaluated were calculated from the wavefront aberrations at 3- and 4.5-mm pupil. STATISTICAL ANALYSIS A Student's t-test for unpaired data was used for comparison between myopic and hyperopic ICLs. RESULTS Myopic ICLs showed negative spherical aberration, in contrast hyperopic ICLs showed positive spherical aberration, which increases when the ICL power increases, due to the innate optical properties of the lens. All ICLs evaluated had negligible amounts of other aberrations. We did not find statistical significant differences in any Zernike coefficient RMS values analyzed between myopic and hyperopic ICLs at 3- and 4.5-mm pupil (P > 0.05). CONCLUSIONS Myopic and hyperopic ICLs provide good and comparable optical quality for low to moderate refractive error. The ICLs evaluated showed values of wavefront aberrations clinically negligible to affect the visual quality after implantation.
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Affiliation(s)
- Cari Pérez-Vives
- Department of Optics, Faculty of Physics, University of Valencia, Valencia, Spain
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Ruiz-Alcocer J, Madrid-Costa D, García-Lázaro S, Ferrer-Blasco T, Montés-Micó R. Optical performance of two new trifocal intraocular lenses: through-focus modulation transfer function and influence of pupil size. Clin Exp Ophthalmol 2013; 42:271-6. [DOI: 10.1111/ceo.12181] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Accepted: 07/26/2013] [Indexed: 01/19/2023]
Affiliation(s)
- Javier Ruiz-Alcocer
- Optometry Research Group; Optics Department; University of Valencia; Burjassot Spain
| | - David Madrid-Costa
- Optometry Research Group; Optics Department; University of Valencia; Burjassot Spain
| | | | - Teresa Ferrer-Blasco
- Optometry Research Group; Optics Department; University of Valencia; Burjassot Spain
| | - Robert Montés-Micó
- Optometry Research Group; Optics Department; University of Valencia; Burjassot Spain
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Belda-Salmerón L, Madrid-Costa D, Ferrer-Blasco T, García-Lázaro S, Montés-Micó R. In vitro power profiles of daily disposable contact lenses. Cont Lens Anterior Eye 2013; 36:247-52. [DOI: 10.1016/j.clae.2013.03.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2012] [Revised: 03/26/2013] [Accepted: 03/28/2013] [Indexed: 10/26/2022]
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Alfonso JF, Lisa C, Cueto LFV, Belda-Salmerón L, Madrid-Costa D, Montés-Micó R. Clinical outcomes after implantation of a posterior chamber collagen copolymer phakic intraocular lens with a central hole for myopic correction. J Cataract Refract Surg 2013; 39:915-21. [DOI: 10.1016/j.jcrs.2013.01.036] [Citation(s) in RCA: 63] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2012] [Revised: 01/04/2013] [Accepted: 01/05/2013] [Indexed: 02/02/2023]
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Alfonso JF, Fernández-Vega Cueto L, Baamonde B, Merayo-Lloves J, Madrid-Costa D, Montés-Micó R. Inferior Intrastromal Corneal Ring Segments in Paracentral Keratoconus With No Coincident Topographic and Coma Axis. J Refract Surg 2013; 29:266-72. [DOI: 10.3928/1081597x-20130318-06] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2012] [Accepted: 01/24/2013] [Indexed: 11/20/2022]
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Pérez-Vives C, Domínguez-Vicent A, Madrid-Costa D, Ferrer-Blasco T, Montés-Micó R. Myopic astigmatism correction: comparison of a Toric Implantable Collamer Lens and a bioptics technique by an adaptive optics visual simulator. Ophthalmic Physiol Opt 2013; 33:114-22. [PMID: 23297759 DOI: 10.1111/opo.12019] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2012] [Accepted: 11/20/2012] [Indexed: 11/30/2022]
Abstract
PURPOSE To compare the optical and visual quality of a simulated Toric Implantable Collamer Lens (TICL) and a bioptics technique to treat high myopic astigmatism. METHODS An adaptive optics visual simulator was used to simulate the vision after TICL implantation and a bioptics procedure from the wavefront aberration pattern for moderate and high-myopic astigmatism. Visual acuity (VA) at different contrasts and contrast sensitivity (CS) at 10, 20 and 25 cycles degree(-1) were measured for 3 and 5-mm pupils. Modulation Transfer Function (MTF) and Point Spread Function (PSF) were calculated for a 5-mm pupil. RESULTS At a 3-mm pupil we only found statistically significant differences in VA between the two simulated surgeries at low-contrast for moderate- and high-myopic astigmatism (p < 0.05). Statistically significant differences were found in CS at 3-mm pupil between both procedures at the highest spatial frequency for moderate-myopic astigmatism and at all frequencies for high-myopic astigmatism (p < 0.05). At a 5-mm pupil we found statistically significant differences in VA and CS between both simulated surgeries at all contrasts and frequencies evaluated for both groups (p < 0.05). In all cases VA and CS were better with the TICL than with the bioptics technique. MTFs for the bioptics technique were worse than those computed for the TICL. The TICL showed less spread out of the PSF than the bioptics procedure. CONCLUSIONS Simulated TICL and bioptics procedures provided good optical and visual quality, although TICL implantation provided slightly better outcomes than the bioptics procedure, especially when the pupil diameter was increased.
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Affiliation(s)
- Cari Pérez-Vives
- GIO, Optics Department, Faculty of Physics, Universidad de Valencia, Valencia, Spain.
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