Sample records for aberration-free refractive surgery

  1. Comparison of Aberrations After Standard and Customized Refractive Surgery

    NASA Astrophysics Data System (ADS)

    Fang, L.; He, X.; Wang, Y.

    2013-09-01

    To detect possible differences in residual wavefront aberrations between standard and customized laser refractive surgery based onmathematical modeling, the residual optical aberrations after conventional and customized laser refractive surgery were compared accordingto the ablation profile with transition zone. The results indicated that ablation profile has a significant impact on the residual aberrations.The amount of residual aberrations for conventional correction is higher than that for customized correction. Additionally, the residualaberrations for high myopia eyes are markedly larger than those for moderate myopia eyes. For a 5 mm pupil, the main residual aberrationterm is coma and yet it is spherical aberration for a 7 mm pupil. When the pupil diameter is the same as optical zone or greater, themagnitudes of residual aberrations is obviously larger than that for a smaller pupil. In addition, the magnitudes of the residual fifth orsixth order aberrations are relatively large, especially secondary coma in a 6 mm pupil and secondary spherical aberration in a 7 mm pupil.Therefore, the customized ablation profile may be superior to the conventional correction even though the transition zone and treatmentdecentration are taken into account. However, the customized ablation profile will still induce significant amount of residual aberrations.

  2. Surgical and healing changes to ocular aberrations following refractive surgery

    NASA Astrophysics Data System (ADS)

    Straub, Jochen; Schwiegerling, Jim

    2003-07-01

    Purpose: To measure ocular aberrations before and at several time periods after LASIK surgery to determine the change to the aberration structure of the eye. Methods: A Shack-Hartmann wavefront sensor was used to measure 88 LASIK patients pre-operatively and at 1 week and 12 months following surgery. Reconstructed wavefront errors are compared to look at induced differences. Manifest refraction was measured at 1 week, 1 month, 3 months, 6 months and 12 months following surgery. Sphere, cylinder, spherical aberration, and pupil diameter are analyzed. Results: A dramatic elevation in spherical aberration is seen following surgery. This elevation appears almost immediately and remains for the duration of the study. A temporary increase in pupil size is seen following surgery. Conclusions: LASIK surgery dramatically reduces defocus and astigmatism in the eye, but simultaneously increases spherical aberration levels. This increase occurs at the time of surgery and is not an effect of the healing response.

  3. Wavefront-guided correction of ocular aberrations: Are phase plate and refractive surgery solutions equal?

    NASA Astrophysics Data System (ADS)

    Marchese, Linda E.; Munger, Rejean; Priest, David

    2005-08-01

    Wavefront-guided laser eye surgery has been recently introduced and holds the promise of correcting not only defocus and astigmatism in patients but also higher-order aberrations. Research is just beginning on the implementation of wavefront-guided methods in optical solutions, such as phase-plate-based spectacles, as alternatives to surgery. We investigate the theoretical differences between the implementation of wavefront-guided surgical and phase plate corrections. The residual aberrations of 43 model eyes are calculated after simulated refractive surgery and also after a phase plate is placed in front of the untreated eye. In each case, the current wavefront-guided paradigm that applies a direct map of the ocular aberrations to the correction zone is used. The simulation results demonstrate that an ablation map that is a Zernike fit of a direct transform of the ocular wavefront phase error is not as efficient in correcting refractive errors of sphere, cylinder, spherical aberration, and coma as when the same Zernike coefficients are applied to a phase plate, with statistically significant improvements from 2% to 6%.

  4. Study on the transverse chromatic aberration of the individual eye model after LASIK refractive surgery

    NASA Astrophysics Data System (ADS)

    Zhang, Mei; Wang, Zhao-Qi; Wang, Yan; Zuo, Tong

    2010-10-01

    The aim of this research is to study the properties of the transverse chromatic aberration (TCA) after the LASIK refractive surgery based on the individual eye model involving the angle between visual axis and optical axis. According to the measurements of the corneal surfaces, the optical axis lengths and the wavefront aberrations, the individual eye models before and after LASIK refractive surgery are constructed for 15 eyes by using ZEMAX optic design software, while the angle between the visual axis and optical axis is calculated from the data of the anterior corneal surface. The constructed eye models are then used to investigate the variation of the TCA after the surgery. The statistical distributions of the magnitude of the foveal TCA for 15 eyes over the visible spectrum are provided. Finally, we investigate the influence of the TCA on the visual quality and compare the results with previous research. The TCA is an indispensable criterion to evaluate the performance of the refractive surgery. This research is very meaningful for the studies of not only foveal vision but also the peripheral vision.

  5. Comparison of Ocular Monochromatic Higher-order Aberrations in Normal Refractive Surgery Candidates of Arab and South Asian Origin

    PubMed Central

    Prakash, Gaurav; Srivastava, Dhruv; Choudhuri, Sounak; Bacero, Ruthchel

    2016-01-01

    Purpose: To compare the ocular monochromatic higher-order aberration. (HOA) profile in normal refractive surgery candidates of Arab and South Asian origin. Methods: This cross-sectional, observational, comparative study was performed in the cornea department of a specialty hospital. Normal refractive surgery candidates with no ocular morbidity except refractive error were recruited. Refractive surgery candidates underwent a preoperative evaluation, including wavefront aberrometry with the iDesign aberrometer (AMO, Inc., Santa Ana, California, United States). The HOA from right eyes were analyzed for HOA signed, absolute, and polar Zernike coefficients. Results: Two hundred Arab participants (group 1) and 200 participants of South-Asian origin (group 2) comprised the study sample. The age and refractive status were comparable between groups. The mean of the HOA root mean square (RMS) was 0.36 ± 17 μ and 0.38 ± 18 μ for Arab and South-Asian eyes, respectively (P < 0.05, rank sum test [RST]). Of the 22 higher order signed Zernike modes, only Z3−3, Z3−1,31, Z4−4, Z4−2, Z40, Z44, and Z5−5 were significantly different from zero (one sample t-test, P < 0.002, with a Bonferroni correction of 0.05/22). All the signed and absolute Zernike terms were comparable between groups (RST, P > 0.002 [0.05/22]). The polar coefficients for coma, trefoil, spherical aberration, and tetrafoil were comparable between groups (P > 0.05, RST). Combined RMS values of third, fourth, fifth, and sixth order also were comparable between groups (P > 0.05, RST). Conclusions: Preoperative whole eye HOA were similar for refractive surgery candidates of Arab and South-Asian origin. The values were comparable to historical data for Caucasian eyes and were lower than Asian (Chinese) eyes. These findings may aid in refining refractive nomograms for wavefront ablations. PMID:26957850

  6. Comparison of Ocular Monochromatic Higher-order Aberrations in Normal Refractive Surgery Candidates of Arab and South Asian Origin.

    PubMed

    Prakash, Gaurav; Srivastava, Dhruv; Choudhuri, Sounak; Bacero, Ruthchel

    2016-01-01

    To compare the ocular monochromatic higher-order aberration. (HOA) profile in normal refractive surgery candidates of Arab and South Asian origin. This cross-sectional, observational, comparative study was performed in the cornea department of a specialty hospital. Normal refractive surgery candidates with no ocular morbidity except refractive error were recruited. Refractive surgery candidates underwent a preoperative evaluation, including wavefront aberrometry with the iDesign aberrometer (AMO, Inc., Santa Ana, California, United States). The HOA from right eyes were analyzed for HOA signed, absolute, and polar Zernike coefficients. Two hundred Arab participants (group 1) and 200 participants of South-Asian origin (group 2) comprised the study sample. The age and refractive status were comparable between groups. The mean of the HOA root mean square (RMS) was 0.36 ± 17 μ and 0.38 ± 18 μ for Arab and South-Asian eyes, respectively (P < 0.05, rank sum test [RST]). Of the 22 higher order signed Zernike modes, only Z3 (-3), Z3 (-1),3 (1), Z4 (-4), Z4 (-2), Z4 (0), Z4 (4), and Z5 (-5) were significantly different from zero (one sample t-test, P < 0.002, with a Bonferroni correction of 0.05/22). All the signed and absolute Zernike terms were comparable between groups (RST, P > 0.002 [0.05/22]). The polar coefficients for coma, trefoil, spherical aberration, and tetrafoil were comparable between groups (P > 0.05, RST). Combined RMS values of third, fourth, fifth, and sixth order also were comparable between groups (P > 0.05, RST). Preoperative whole eye HOA were similar for refractive surgery candidates of Arab and South-Asian origin. The values were comparable to historical data for Caucasian eyes and were lower than Asian (Chinese) eyes. These findings may aid in refining refractive nomograms for wavefront ablations.

  7. Assessment of refractive astigmatism and simulated therapeutic refractive surgery strategies in coma-like-aberrations-dominant corneal optics.

    PubMed

    Zhou, Wen; Stojanovic, Aleksandar; Utheim, Tor Paaske

    2016-01-01

    The aim of the study is to raise the awareness of the influence of coma-like higher-order aberrations (HOAs) on power and orientation of refractive astigmatism (RA) and to explore how to account for that influence in the planning of topography-guided refractive surgery in eyes with coma-like-aberrations-dominant corneal optics. Eleven eyes with coma-like-aberrations-dominant corneal optics and with low lenticular astigmatism (LA) were selected for astigmatism analysis and for treatment simulations with topography-guided custom ablation. Vector analysis was used to evaluate the contribution of coma-like corneal HOAs to RA. Two different strategies were used for simulated treatments aiming to regularize irregular corneal optics: With both strategies correction of anterior corneal surface irregularities (corneal HOAs) were intended. Correction of total corneal astigmatism (TCA) and RA was intended as well with strategies 1 and 2, respectively. Axis of discrepant astigmatism (RA minus TCA minus LA) correlated strongly with axis of coma. Vertical coma influenced RA by canceling the effect of the with-the-rule astigmatism and increasing the effect of the against-the-rule astigmatism. After simulated correction of anterior corneal HOAs along with TCA and RA (strategies 1 and 2), only a small amount of anterior corneal astigmatism (ACA) and no TCA remained after strategy 1, while considerable amount of ACA and TCA remained after strategy 2. Coma-like corneal aberrations seem to contribute a considerable astigmatic component to RA in eyes with coma-like-aberrations dominant corneal optics. If topography-guided ablation is programmed to correct the corneal HOAs and RA, the astigmatic component caused by the coma-like corneal HOAs will be treated twice and will result in induced astigmatism. Disregarding RA and treating TCA along with the corneal HOAs is recommended instead.

  8. Refractive and Aberration Outcomes after Customized Photorefractive Keratectomy in Comparison with Customized Femtosecond Laser

    PubMed Central

    Sajjadi, Valleh; Ghoreishi, Mohammad; Jafarzadehpour, Ebrahim

    2015-01-01

    To compare the refractive and visual outcomes and higher order aberrations in patients with low to moderate myopia who underwent customized photorefractive keratectomy (PRK) or femtosecond laser in situ keratomileusis (Femto-LASIK) this research performed. This study includes data of 120 consecutive eyes of 60 patients with myopia between -3.00 D and -7.00 D with or without astigmatism in two surgery groups: PRK and Femto-LASIK. Refractive, visual, and aberration outcomes of the two methods of surgery were compared after 6 months of follow-up. After six months of follow-up, sphere and cylinder were found significantly decreased and there was no statistically significant difference between the two groups. The mean of uncorrected distance visual acuity in LogMar format for the PRK and Femto-LASIK groups was -0.03±0.07 and -0.01±0.08, respectively, which was not significantly different between the two groups. Higher orders and spherical aberrations increased in both groups significantly, while total aberrations decreased in both groups. After surgery, no differences were observed between the two groups in the amount of aberrations. In conclusion, Both PRK and Femto-LASIK are effective and safe in correcting myopia. In this study PRK induced more spherical and higher order aberrations than Femto-LASIK. PMID:27800501

  9. Refractive eye surgery in treating functional amblyopia in children.

    PubMed

    Levenger, Samuel; Nemet, Pinhas; Hirsh, Ami; Kremer, Israel; Nemet, Arie

    2006-01-01

    While excimer laser refractive surgery is recommended and highly successful for correcting refractive errors in adults, its use in children has not been extensively exercised or studied. We report our experience treating children with amblyopia due to high anisometropia, high astigmatism, high myopia and with associated developmental delay. Review of patient records of our refractive clinic. A retrospective review was made of all 11 children with stable refractive errors who were unsuccessfully treated non-surgically and then underwent corneal refractive surgery and in one case, lenticular surgery. Seven had high myopic anisometropia, 2 had high astigmatism, and two had high myopia--one with Down's Syndrome and one with agenesis of the corpus callosum. The surgical refractive treatment eliminated or reduced the anisometropia, reduced the astigmatic error, improved vision and improved the daily function of the children with developmental delay. There were no complications or untoward results. Refractive surgery is safe and effective in treating children with high myopic anisometropia, high astigmatism, high myopia and developmental delay due to the resulting poor vision. Surgery can improve visual acuity in amblyopia not responding to routine treatment by correcting the refractive error and refractive aberrations.

  10. Retrospective Analysis of the Post-Operative Changes in Higher-Order Aberrations: A Comparison of the WaveLight EX500 to the VISX S4 Laser in Refractive Surgery.

    PubMed

    Reed, Donovan S; Apsey, Douglas; Steigleman, Walter; Townley, James; Caldwell, Matthew

    2017-11-01

    In an attempt to maximize treatment outcomes, refractive surgery techniques are being directed toward customized ablations to correct not only lower-order aberrations but also higher-order aberrations specific to the individual eye. Measurement of the entirety of ocular aberrations is the most definitive means to establish the true effect of refractive surgery on image quality and visual performance. Whether or not there is a statistically significant difference in induced higher-order corneal aberrations between the VISX Star S4 (Abbott Medical Optics, Santa Ana, California) and the WaveLight EX500 (Alcon, Fort Worth, Texas) lasers was examined. A retrospective analysis was performed to investigate the difference in root-mean-square (RMS) value of the higher-order corneal aberrations postoperatively between two currently available laser platforms, the VISX Star S4 and the WaveLight EX500 lasers. The RMS is a compilation of higher-order corneal aberrations. Data from 240 total eyes of active duty military or Department of Defense beneficiaries who completed photorefractive keratectomy (PRK) or laser in situ keratomileusis (LASIK) refractive surgery at the Wilford Hall Ambulatory Surgical Center Joint Warfighter Refractive Surgery Center were examined. Using SPSS statistics software (IBM Corp., Armonk, New York), the mean changes in RMS values between the two lasers and refractive surgery procedures were determined. A Student t test was performed to compare the RMS of the higher-order aberrations of the subjects' corneas from the lasers being studied. A regression analysis was performed to adjust for preoperative spherical equivalent. The study and a waiver of informed consent have been approved by the Clinical Research Division of the 59th Medical Wing Institutional Review Board (Protocol Number: 20150093H). The mean change in RMS value for PRK using the VISX laser was 0.00122, with a standard deviation of 0.02583. The mean change in RMS value for PRK using the

  11. Clinical Outcomes of an Optimized Prolate Ablation Procedure for Correcting Residual Refractive Errors Following Laser Surgery.

    PubMed

    Chung, Byunghoon; Lee, Hun; Choi, Bong Joon; Seo, Kyung Ryul; Kim, Eung Kwon; Kim, Dae Yune; Kim, Tae-Im

    2017-02-01

    The purpose of this study was to investigate the clinical efficacy of an optimized prolate ablation procedure for correcting residual refractive errors following laser surgery. We analyzed 24 eyes of 15 patients who underwent an optimized prolate ablation procedure for the correction of residual refractive errors following laser in situ keratomileusis, laser-assisted subepithelial keratectomy, or photorefractive keratectomy surgeries. Preoperative ophthalmic examinations were performed, and uncorrected distance visual acuity, corrected distance visual acuity, manifest refraction values (sphere, cylinder, and spherical equivalent), point spread function, modulation transfer function, corneal asphericity (Q value), ocular aberrations, and corneal haze measurements were obtained postoperatively at 1, 3, and 6 months. Uncorrected distance visual acuity improved and refractive errors decreased significantly at 1, 3, and 6 months postoperatively. Total coma aberration increased at 3 and 6 months postoperatively, while changes in all other aberrations were not statistically significant. Similarly, no significant changes in point spread function were detected, but modulation transfer function increased significantly at the postoperative time points measured. The optimized prolate ablation procedure was effective in terms of improving visual acuity and objective visual performance for the correction of persistent refractive errors following laser surgery.

  12. Evaluation of thermal load during laser corneal refractive surgery using infrared thermography

    NASA Astrophysics Data System (ADS)

    Brunsmann, U.; Sauer, U.; Arba-Mosquera, S.; Magnago, T.; Triefenbach, N.

    2010-09-01

    Infrared thermography is used for evaluation of the mean temperature as a measure of thermal load during corneal refractive surgery. An experimental method to determine emissivity and to calibrate the thermografic system is presented. In a case study on the porcine eye two dimensional temperature distributions with lateral resolution of 170 μm and line scans with temporal resolution of 13 μs are discussed with respect to the meaning of mean temperature. Using the newest generation of surgery equipment it is shown, that the mean temperature rise can be kept below 5 °C during myopic laser in situ keratomileusis (LASIK) treatments corresponding to an aberration-free correction of -2.75 diopter.

  13. The BHVI-EyeMapper: peripheral refraction and aberration profiles.

    PubMed

    Fedtke, Cathleen; Ehrmann, Klaus; Falk, Darrin; Bakaraju, Ravi C; Holden, Brien A

    2014-10-01

    The aim of this article was to present the optical design of a new instrument (BHVI-EyeMapper, EM), which is dedicated to rapid peripheral wavefront measurements across the visual field for distance and near, and to compare the peripheral refraction and higher-order aberration profiles obtained in myopic eyes with and without accommodation. Central and peripheral refractive errors (M, J180, and J45) and higher-order aberrations (C[3, 1], C[3, 3], and C[4, 0]) were measured in 26 myopic participants (mean [±SD] age, 20.9 [±2.0] years; mean [±SD] spherical equivalent, -3.00 [±0.90] diopters [D]) corrected for distance. Measurements were performed along the horizontal visual field with (-2.00 to -5.00 D) and without (+1.00 D fogging) accommodation. Changes as a function of accommodation were compared using tilt and curvature coefficients of peripheral refraction and aberration profiles. As accommodation increased, the relative peripheral refraction profiles of M and J180 became significantly (p < 0.05) more negative and the profile of M became significantly (p < 0.05) more asymmetric. No significant differences were found for the J45 profiles (p > 0.05). The peripheral aberration profiles of C[3, 1], C[3, 3], and C[4, 0] became significantly (p < 0.05) less asymmetric as accommodation increased, but no differences were found in the curvature. The current study showed that significant changes in peripheral refraction and higher-order aberration profiles occurred during accommodation in myopic eyes. With its extended measurement capabilities, that is, permitting rapid peripheral refraction and higher-order aberration measurements up to visual field angles of ±50 degrees for distance and near (up to -5.00 D), the EM is a new advanced instrument that may provide additional insights in the ongoing quest to understand and monitor myopia development.

  14. The SCHWIND AMARIS Total-Tech Laser as An All-Rounder in Refractive Surgery

    PubMed Central

    Arbelaez, Maria Clara; Mosquera, Samuel Arba

    2009-01-01

    Purpose: To describe and argument an overview of the main features and unique technical points of AMARIS Total-Tech Laser, coupled with patient outcomes supporting the decision to perform LASIK treatments with maximised outcomes. Settings: Dr. M.C. Arbelaez, Muscat Eye Laser Center, Muscat, Sultanate of Oman. Methods: The findings collected during 18-month experience using SCHWIND AMARIS Total-Tech Laser have been reviewed to provide arguments for supporting the decision to perform LASIK treatments with maximised outcomes. For updated clinical outcomes, the last 100 myopic astigmatism treatments, the last 100 hyperopic astigmatism treatments, the last 30 ocular-wavefront-guided treatments, and the last 30 corneal-wavefront-guided treatments, all with 6-month follow-up, were included. For all those, LDV femtosecond system was used to prepare the flaps, and AMARIS flying spot system was used to perform ablations. Clinical outcomes were evaluated in terms of predictability, refractive outcome, safety, wavefront aberration, and contrast sensitivity. Results: 6-month postoperatively, mean defocus was −0.14±0.31D and astigmatism 0.25±0.37D. 70± eyes were within ±0.25D of emmetropia. 43± eyes gained lines of best spectacle-corrected visual acuity. For Aberration-Free treatments, none of the aberration metrics changed from pre- to postoperative values in a clinically relevant amount. For ocular-wavefront-guided treatments, the surgery did not change coma or spherical aberration, and reduced trefoil (p<0.005). For corneal-wavefront-guided treatments, the trefoil, coma, and spherical aberrations, as well as the total root-mean-square values of higher order aberration, were significantly reduced (p<.05) when the pre-existing aberrations were greater than the repeatability and the biological noise. Conclusions: Although this review does not allow for evidence-based conclusions, following our strategy, LASIK results were excellent. LASIK surgery with AMARIS system yield

  15. Indications for and outcomes of tertiary referrals in refractive surgery.

    PubMed

    Patryn, Eliza K; Vrijman, Violette; Nieuwendaal, Carla P; van der Meulen, Ivanka J E; Mourits, Maarten P; Lapid-Gortzak, Ruth

    2014-01-01

    To review the spectrum of disease, symptomatology, and management offered to patients referred for a second opinion after refractive surgery. A prospective cohort study was done on all patients referred from October 1, 2006, to September 30, 2011, to a tertiary eye clinic after refractive surgery of any kind (ie, corneal laser surgery, conductive keratoplasty, radial keratotomy, phakic implants, refractive lens exchanges, or any combination thereof). Data analysis was performed on all demographic and clinical aspects of this cohort, including the initial complaint, type of referral, number of complaints, procedure previously performed, diagnosis at our center, type of advice given, and rate and type of surgical intervention. One hundred thirty-one eyes (69 patients) were included. Corneal refractive surgery was performed in 82% (108 eyes), and 11% (14 eyes) were seen after phakic intraocular lens (PIOL) implantation and 7% (9 eyes) after refractive lens exchange. The most common diagnoses were tear film dysfunction (30 eyes, 23%), residual refractive error (25 eyes, 19%), and cataract (20 eyes, 15%). Most patients (42 patients, 61%) were treated conservatively. In 27 patients (39%), 36 eyes (28%) were managed surgically. Severe visual loss was seen in 1 eye. No major problems were found in most second opinions after refractive surgery referral. Dry eyes, small residual refractive error, or higher-order aberrations were the most common complaints. Surgical intervention was needed in 36 eyes (28%), almost half of which were cataract extractions. Severe visual loss was seen in 1 eye with a PIOL. There was no incidence of severe visual loss in keratorefractive and refractive lens exchange procedures. Copyright 2014, SLACK Incorporated.

  16. The BHVI-EyeMapper: Peripheral Refraction and Aberration Profiles

    PubMed Central

    Fedtke, Cathleen; Ehrmann, Klaus; Falk, Darrin; Bakaraju, Ravi C.; Holden, Brien A.

    2014-01-01

    ABSTRACT Purpose The aim of this article was to present the optical design of a new instrument (BHVI-EyeMapper, EM), which is dedicated to rapid peripheral wavefront measurements across the visual field for distance and near, and to compare the peripheral refraction and higher-order aberration profiles obtained in myopic eyes with and without accommodation. Methods Central and peripheral refractive errors (M, J180, and J45) and higher-order aberrations (C[3, 1], C[3, 3], and C[4, 0]) were measured in 26 myopic participants (mean [±SD] age, 20.9 [±2.0] years; mean [±SD] spherical equivalent, −3.00 [±0.90] diopters [D]) corrected for distance. Measurements were performed along the horizontal visual field with (−2.00 to −5.00 D) and without (+1.00 D fogging) accommodation. Changes as a function of accommodation were compared using tilt and curvature coefficients of peripheral refraction and aberration profiles. Results As accommodation increased, the relative peripheral refraction profiles of M and J180 became significantly (p < 0.05) more negative and the profile of M became significantly (p < 0.05) more asymmetric. No significant differences were found for the J45 profiles (p > 0.05). The peripheral aberration profiles of C[3, 1], C[3, 3], and C[4, 0] became significantly (p < 0.05) less asymmetric as accommodation increased, but no differences were found in the curvature. Conclusions The current study showed that significant changes in peripheral refraction and higher-order aberration profiles occurred during accommodation in myopic eyes. With its extended measurement capabilities, that is, permitting rapid peripheral refraction and higher-order aberration measurements up to visual field angles of ±50 degrees for distance and near (up to −5.00 D), the EM is a new advanced instrument that may provide additional insights in the ongoing quest to understand and monitor myopia development. PMID:25105690

  17. Aberration-free intraocular lenses - What does this really mean?

    PubMed

    Langenbucher, Achim; Schröder, Simon; Cayless, Alan; Eppig, Timo

    2017-09-01

    So-called aberration-free intraocular lenses (IOLs) are well established in modern cataract surgery. Usually, they are designed to perfectly refract a collimated light beam onto the focal point. We show how much aberration can be expected with such an IOL in a convergent light beam such as that found anterior to the human cornea. Additionally, the aberration in a collimated beam is estimated for an IOL that has no aberrations in the convergent beam. The convergent beam is modelled as the pencil of rays corresponding to the spherical wavefront resulting from a typical corneal power of 43m -1 . The IOLs are modelled as infinitely thin phase plates with 20m -1 optical power placed 5mm behind the cornea. Their aberrations are reported in terms of optical path length difference and longitudinal spherical aberration (LSA) of the marginal rays, as well as nominal spherical aberration (SA) calculated based on a Zernike representation of the wavefront-error at the corneal plane within a 6mm aperture. The IOL designed to have no aberrations in a collimated light beam has an optical path length difference of -1.8μm, and LSA of 0.15m -1 in the convergent beam of a typical eye. The corresponding nominal SA is 0.065μm. The IOL designed to have no aberrations in a convergent light beam has an optical path length difference of 1.8μm, and LSA of -0.15m -1 in the collimated beam. An IOL designed to have no aberrations in a collimated light beam will increase the SA of a patient's eye after implantation. Copyright © 2017. Published by Elsevier GmbH.

  18. Refractive Changes Induced by Spherical Aberration in Laser Correction Procedures: An Adaptive Optics Study.

    PubMed

    Amigó, Alfredo; Martinez-Sorribes, Paula; Recuerda, Margarita

    2017-07-01

    To study the effect on vision of induced negative and positive spherical aberration within the range of laser vision correction procedures. In 10 eyes (mean age: 35.8 years) under cyclopegic conditions, spherical aberration values from -0.75 to +0.75 µm in 0.25-µm steps were induced by an adaptive optics system. Astigmatism and spherical refraction were corrected, whereas the other natural aberrations remained untouched. Visual acuity, depth of focus defined as the interval of vision for which the target was still perceived acceptable, contrast sensitivity, and change in spherical refraction associated with the variation in pupil diameter from 6 to 2.5 mm were measured. A refractive change of 1.60 D/µm of induced spherical aberration was obtained. Emmetropic eyes became myopic when positive spherical aberration was induced and hyperopic when negative spherical aberration was induced (R 2 = 81%). There were weak correlations between spherical aberration and visual acuity or depth of focus (R 2 = 2% and 3%, respectively). Contrast sensitivity worsened with the increment of spherical aberration (R 2 = 59%). When pupil size decreased, emmetropic eyes became hyperopic when preexisting spherical aberration was positive and myopic when spherical aberration was negative, with an average refractive change of 0.60 D/µm of spherical aberration (R 2 = 54%). An inverse linear correlation exists between the refractive state of the eye and spherical aberration induced within the range of laser vision correction. Small values of spherical aberration do not worsen visual acuity or depth of focus, but positive spherical aberration may induce night myopia. In addition, the changes in spherical refraction when the pupil constricts may worsen near vision when positive spherical aberration is induced or improve it when spherical aberration is negative. [J Refract Surg. 2017;33(7):470-474.]. Copyright 2017, SLACK Incorporated.

  19. Influence of spherical aberration, stimulus spatial frequency, and pupil apodisation on subjective refractions

    PubMed Central

    Bradley, Arthur; Xu, Renfeng; Thibos, Larry; Marin, Gildas; Hernandez, Martha

    2014-01-01

    Purpose To test competing hypotheses (Stiles Crawford pupil apodising or superior imaging of high spatial frequencies by the central pupil) for the pupil size independence of subjective refractions in the presence of primary spherical aberration. Methods Subjective refractions were obtained with a variety of test stimuli (high contrast letters, urban cityscape, high and low spatial frequency gratings) while modulating pupil diameter, levels of primary spherical aberration and pupil apodisation. Subjective refractions were also obtained with low-pass and high-pass stimuli and using “darker” and “sharper” subjective criteria. Results Subjective refractions for stimuli containing high spatial frequencies focus a near paraxial region of the pupil and are affected only slightly by level of Seidel spherical aberration, degree of pupil apodisation and pupil diameter, and generally focused a radius of about 1 to 1.5 mm from the pupil centre. Low spatial frequency refractions focus a marginal region of the pupil, and are significantly affected by level of spherical aberration, amount of pupil apodisation, and pupil size. Clinical refractions that employ the “darker” or “sharper” subjective criteria bias the patient to use lower or higher spatial frequencies respectively. Conclusions In the presence of significant levels of spherical aberration, the pupil size independence of subjective refractions occurs with or without Stiles Crawford apodisation for refractions that optimise high spatial frequency content in the image. If low spatial frequencies are optimised by a subjective refraction, spherical refractive error varies with spherical aberration, pupil size, and level of apodisation. As light levels drop from photopic to scotopic, therefore, we expect a shift from pupil size independent to pupil size dependent subjective refractions. Emphasising a “sharper” criterion during subjective refractions will improve image quality for high spatial frequencies

  20. Interferometric analysis of the ablation profile in refractive surgery

    NASA Astrophysics Data System (ADS)

    Rodríguez-Rodríguez, M. I.; López-Olazagasti, E.; Rosales, M. A.; Ramírez-Zavaleta, G.; Cantú, R.; Tepichín, E.

    2008-08-01

    In ophthalmology, the laser excimer corneal surface ablation used to correct the refractive eye defects, such as myopia, astigmatism and hyperopia and, more recently, presbyopia is known as refractive surgery. Typically, the characterization of the corresponding technique, as well as the laser accuracy, is performed by analyzing standard ablation profiles made on PMMA (polymethylmethacrylate) plates. A drawback of this technique is that those plates do not necessarily represent the dimensions of the cornea during the ablation. On the other hand, due to the time varying process of the eye aberrations, the direct eye refractometric measurements can produce some errors. We report in this work the interferometric analysis of the ablation profile obtained with refractive surgery, applied directly on a contact lens. In this case, the resultant ablation profile might be closer to the real profile as well as time invariant. We use, as a reference, a similar contact lens without ablation. The preliminary results of the characterization of the corresponding ablation profile are also presented.

  1. Ocular wavefront aberration and refractive error in pre-school children

    NASA Astrophysics Data System (ADS)

    Thapa, Damber; Fleck, Andre; Lakshminarayanan, Vasudevan; Bobier, William R.

    2011-11-01

    Hartmann-Shack images taken from an archived collection of SureSight refractive measurements of pre-school children in Oxford County, Ontario, Canada were retrieved and re-analyzed. Higher-order aberrations were calculated over the age range of 3 to 6 years. These higher-order aberrations were compared with respect to magnitudes of ametropia. Subjects were classified as emmetropic (range -0.5 to + 0.5D), low hyperopic (+ 0.5 to +2D) and high hyperopic (+2D or more) based upon the resulting spherical equivalent. Higher-order aberrations were found to increase with higher levels of hyperopia (p < 0.01). The strongest effect was for children showing more than +2.00D of hyperopia. The correlation coefficients were small in all of the higher-order aberrations; however, they were significant (p < 0.01). These analyses indicate a weak association between refractive error and higher-order aberrations in pre-school children.

  2. Sources of the monochromatic aberrations induced in human eyes after laser refractive surgery

    NASA Astrophysics Data System (ADS)

    Porter, Jason

    Laser in-situ keratomileusis (LASIK) procedures correct the eye's defocus and astigmatism but also introduce higher order monochromatic aberrations. Little is known about the origins of these induced aberrations. The advent of wavefront sensor technology has made it possible to measure accurately and quickly the aberrations of normal and postoperative LASIK eyes. The goal of this thesis was to exploit this technology to better understand some of the potential mechanisms by which aberrations could be introduced during LASIK. A first step towards investigating these sources was to characterize the aberration changes in post-LASIK eyes. Higher order rms wavefront error increased after conventional and customized LASIK surgery. On average, spherical aberration approximately doubled, and significant changes in vertical and horizontal coma were observed. We examined two sources of postoperative aberrations: the creation of a microkeratome flap and the subsequent laser ablation. Higher order rms increased slightly and there was a wide variation in the response of individual Zernike modes after cutting a flap. The majority of induced spherical aberration was due to the laser ablation and not the flap-cut. Aberrations are also induced by static and dynamic decentrations of the patient's pupil. We found that ablations were typically decentered in the superotemporal direction due to shifts in pupil center location between aberration measurement (dilated) and surgical (undilated) conditions in customized LASIK eyes. There was a weak correlation between the horizontal coma theoretically induced by this offset and that measured postoperatively. Finally, dynamic eye movements during the procedure induce higher order aberrations. We found that the most problematic decentrations during LASIK are relatively slow drifts in eye position. An eye-tracking system with a 2-Hz closed-loop bandwidth could compensate for most eye movements during LASIK. One solution for reducing the

  3. Overview of refractive surgery.

    PubMed

    Bower, K S; Weichel, E D; Kim, T J

    2001-10-01

    Patients with myopia, hyperopia and astigmatism can now reduce or eliminate their dependence on contact lenses and eyeglasses through refractive surgery that includes radial keratotomy (RK), photorefractive keratectomy (PRK), laser-assisted in situ keratomileusis (LASIK), laser thermal keratoplasty (LTK) and intrastromal corneal rings (ICR). Since the approval of the excimer laser in 1995, the popularity of RK has declined because of the superior outcomes from PRK and LASIK. In patients with low-to-moderate myopia, PRK produces stable and predictable results with an excellent safety profile. LASIK is also efficacious, predictable and safe, with the additional advantages of rapid vision recovery and minimal pain. LASIK has rapidly become the most widely performed refractive surgery, with high patient and surgeon satisfaction. Noncontact Holium: YAG LTK provides satisfactory correction in patients with low hyperopia. ICR offers patients with low myopia the potential advantage of removal if the vision outcome is unsatisfactory. Despite the current widespread advertising and media attention about laser refractive surgery, not all patients are good candidates for this surgery. Family physicians should be familiar with the different refractive surgeries and their potential complications.

  4. Achieving target refraction after cataract surgery.

    PubMed

    Simon, Shira S; Chee, Yewlin E; Haddadin, Ramez I; Veldman, Peter B; Borboli-Gerogiannis, Sheila; Brauner, Stacey C; Chang, Kenneth K; Chen, Sherleen H; Gardiner, Matthew F; Greenstein, Scott H; Kloek, Carolyn E; Chen, Teresa C

    2014-02-01

    To evaluate the difference between target and actual refraction after phacoemulsification and intraocular lens implantation at an academic teaching institution's Comprehensive Ophthalmology Service. Retrospective study. We examined 1275 eye surgeries for this study. All consecutive cataract surgeries were included if they were performed by an attending or resident surgeon from January through December 2010. Postoperative refractions were compared with preoperative target refractions. Patients were excluded if they did not have a preoperative target refraction documented or if they did not have a recorded postoperative manifest refraction within 90 days. The main outcome measure was percentage of cases achieving a postoperative spherical equivalent ± 1.0 diopter (D) of target spherical equivalent. We performed 1368 cataract surgeries from January through December of 2010. Of these, 1275 (93%) had sufficient information for analysis. Of the included cases, 94% (1196 of 1275) achieved ± 1.0 D of target refraction by 90 days after cataract surgery. This paper establishes a new benchmark for a teaching hospital, where 94% of patients achieved within 1.0 D of target refraction after cataract surgery. The refractive outcomes after cataract surgery at this academic teaching institution were higher than average international benchmarks. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

  5. Questionnaires for Measuring Refractive Surgery Outcomes.

    PubMed

    Kandel, Himal; Khadka, Jyoti; Lundström, Mats; Goggin, Michael; Pesudovs, Konrad

    2017-06-01

    To identify the questionnaires used to assess refractive surgery outcomes, assess the available questionnaires in regard to their psychometric properties, validity, and reliability, and evaluate the performance of the available questionnaires in measuring refractive surgery outcomes. An extensive literature search was done on PubMed, MEDLINE, Scopus, CINAHL, Cochrane, and Web of Science databases to identify articles that described or used at least one questionnaire to assess refractive surgery outcomes. The information on content quality, validity, reliability, responsiveness, and psychometric properties was extracted and analyzed based on an extensive set of quality criteria. Eighty-one articles describing 27 questionnaires (12 refractive error-specific, including 4 refractive surgery-specific, 7 vision-but-non-refractive, and 8 generic) were included in the review. Most articles (56, 69.1%) described refractive error-specific questionnaires. The Quality of Life Impact of Refractive Correction (QIRC), the Quality of Vision (QoV), and the Near Activity Visual Questionnaire (NAVQ) were originally constructed using Rasch analysis; others were developed using the Classical Test Theory. The National Eye Institute Refractive Quality of Life questionnaire was the most frequently used questionnaire, but it does not provide a valid measurement. The QoV, QIRC, and NAVQ are the three best existing questionnaires to assess visual symptoms, quality of life, and activity limitations, respectively. This review identified three superior quality questionnaires for measuring different aspects of quality of life in refractive surgery. Clinicians and researchers should choose a questionnaire based on the concept being measured with superior psychometric properties. [J Refract Surg. 2017;33(6):416-424.]. Copyright 2017, SLACK Incorporated.

  6. Aberration Theory and Design Techniques for Refracting Prism Systems.

    NASA Astrophysics Data System (ADS)

    Al-Bizri, N.

    Available from UMI in association with The British Library. The general case of image formation by optical systems consisting of combinations of ordinary lens components and refracting prisms is studied in detail. Formulae for the sagittal and tangential magnifications, the pupil scale ratios, the image tilt, the positions of (newly defined) principal planes and the equivalent focal lengths have been derived. Formulae for the axial astigmatism, axial transverse chromatic aberration and the focal shift measure of the aberration due to the tilt of the image plane have also been obtained. All of these formulae are equally valid for any optical system which has a single plane of symmetry. The calculation of the wavefront aberration coefficients and of the variance of the aberration for such systems has been treated using the pre-inverted matrix method. In addition formulae for the numerical evaluation of the optical transfer function, the point spread function, the line spread function and the edge response function, have been obtained and programmed. First-order formulae, and a refinement technique, for the design of cemented refracting doublet prisms have been obtained, which ensure that the desired prismatic deviation of the axis is obtained, and that the axial astigmatism and the axial transverse chromatic aberration have stipulated target values. All of the above formulae have been carefully tested by numerical examples, and the design technique has been used to design endoscope objectives which provide small deviations (<10^circ ) of the optical axis.

  7. Unbiased Estimation of Refractive State of Aberrated Eyes

    PubMed Central

    Martin, Jesson; Vasudevan, Balamurali; Himebaugh, Nikole; Bradley, Arthur; Thibos, Larry

    2011-01-01

    To identify unbiased methods for estimating the target vergence required to maximize visual acuity based on wavefront aberration measurements. Experiments were designed to minimize the impact of confounding factors that have hampered previous research. Objective wavefront refractions and subjective acuity refractions were obtained for the same monochromatic wavelength. Accommodation and pupil fluctuations were eliminated by cycloplegia. Unbiased subjective refractions that maximize visual acuity for high contrast letters were performed with a computer controlled forced choice staircase procedure, using 0.125 diopter steps of defocus. All experiments were performed for two pupil diameters (3mm and 6mm). As reported in the literature, subjective refractive error does not change appreciably when the pupil dilates. For 3 mm pupils most metrics yielded objective refractions that were about 0.1D more hyperopic than subjective acuity refractions. When pupil diameter increased to 6 mm, this bias changed in the myopic direction and the variability between metrics also increased. These inaccuracies were small compared to the precision of the measurements, which implies that most metrics provided unbiased estimates of refractive state for medium and large pupils. A variety of image quality metrics may be used to determine ocular refractive state for monochromatic (635nm) light, thereby achieving accurate results without the need for empirical correction factors. PMID:21777601

  8. Comparison of real and computer-simulated outcomes of LASIK refractive surgery

    NASA Astrophysics Data System (ADS)

    Cano, Daniel; Barbero, Sergio; Marcos, Susana

    2004-06-01

    Computer simulations of alternative LASIK ablation patterns were performed for corneal elevation maps of 13 real myopic corneas (range of myopia, -2.0 to -11.5 D). The computationally simulated ablation patterns were designed with biconic surfaces (standard Munnerlyn pattern, parabolic pattern, and biconic pattern) or with aberrometry measurements (customized pattern). Simulated results were compared with real postoperative outcomes. Standard LASIK refractive surgery for myopia increased corneal asphericity and spherical aberration. Computations with the theoretical Munnerlyn ablation pattern did not increase the corneal asphericity and spherical aberration. The theoretical parabolic pattern induced a slight increase of asphericity and spherical aberration, explaining only 40% of the clinically found increase. The theoretical biconic pattern controlled corneal spherical aberration. Computations showed that the theoretical customized pattern can correct high-order asymmetric aberrations. Simulations of changes in efficiency due to reflection and nonnormal incidence of the laser light showed a further increase in corneal asphericity. Consideration of these effects with a parabolic pattern accounts for 70% of the clinical increase in asphericity.

  9. Measuring effects of refractive surgery on corneas using Taylor series polynomials

    NASA Astrophysics Data System (ADS)

    Corbin, Jacob A.; Klein, Stanley A.; van de Pol, Corina

    1999-06-01

    Corneal topographers have made it possible to accurately map corneal shape. We applied this technology to model the post- refractive surgery cornea using Taylor series polynomials. Topography data was taken from 58 patient eyes with photorefractive keratectomy (PRK) or astigmatic photorefractive keratectomy (PARK). We looked at the changes the cornea underwent surgically, as well as the healing process. We compared the post-ablation cornea to the pre-ablation cornea and to the intended correction using novel topography maps. From the refractive map, we quantified the spherical aberration as areas of defocus on the cornea. From the pre-op exam to the first post-op exam, we measured 0.19+/-0.10 mm radius decrease in PRK and a 0.13+/-0.08 mm radius decrease in PARK in the areas where rays come to within two diopeters of defocus. As this change occurs within the optical zone, this corresponds to an increase in spherical aberration for both the PRK and the PARK patient. As the patient healed, we found additional decrease in radius of the zones of best vision in PRK patients, whereas we found no significant decrease in PARK patients. This corresponds to increased spherical aberration in the PRK patient.

  10. Intelligent Planning for Laser Refractive Surgeries

    NASA Astrophysics Data System (ADS)

    Wang, Wei; Yue, Yong; Elsheikh, Ahmed; Bao, Fangjun

    2018-02-01

    Refractive error is one of leading ophthalmic diseases for both genders all over the world. Laser refractive correction surgery, e.g., laser in-situ keratomileusis (LASIK), has been commonly used worldwide. The prediction of surgical parameters, e.g., corneal ablation depth, depends on the doctor’s experience, theoretical formula and surgery reference manual in the preoperative diagnosis. The error of prediction may present a potential surgical risk and complication. Being aware of the surgery parameters is important because these can be used to estimate a patient’s post-operative visual quality and help the surgeon plan a suitable treatment. Therefore, in this paper we discuss data mining techniques that can be utilized for the prediction of laser refractive correction surgery parameters. It can provide the surgeon with a reference for possible surgical parameters and outcomes of the patient before the laser refractive correction surgery.

  11. Refractive corneal surgery - discharge

    MedlinePlus

    Nearsightedness surgery - discharge; Refractive surgery - discharge; LASIK - discharge; PRK - discharge ... November 27, 2017. Garg S, McColgin AZ, Steinert RF. LASIK. In: Tasman W, Jaeger EA, eds. Duane's Ophthalmology . ...

  12. Refractive surgery in Israel Defense Forces recruits.

    PubMed

    Horowitz, Josepha; Mezer, Eedy; Shochat, Tzippora; Mandel, Yossi; Buckman, Gila; Sasson, Adi; Geyer, Orna

    2008-02-01

    To determine the prevalence of refractive surgery history in recruits for military service in the Israel Defense Forces (IDF) between 1998 to 2005 and to evaluate the effect of surgery on the recruits' fitness to serve in combat units. Surgeon General's HQ, Medical Corps, Israel Defense Forces. The computerized medical records of all ametropic Israeli army inductees were reviewed. They included spectacle-wearing, contact lens-wearing, and post refractive-surgery individuals who were examined in the recruitment office before their compulsory military service. The extracted data from the personal files consisted of the assignment to combat units of those who had refractive surgery and those who wore corrective eyewear and the first and last military position of all ametropic recruits who were assigned to combat units. Five hundred ninety-seven inductees (513 men, 84 women) had refractive surgery before their military service during the study period. The prevalence of recruits who had refractive surgery increased from 0.8/1000 ametropes in 1998 to 4.9/1000 ametropes in 2005. Significantly more recruits who had surgery (73.5%) than recruits who wore corrective eyewear were assigned to combat units (P<.001). The dropout rate from combat units of the former was significantly lower than that of the latter (13.1% versus 29.2%) (P<.001). More corrective eyewear users had refractive surgery before their IDF military service, and relatively more of them applied for combat duty. The high percentage of recruits who had refractive surgery who serve uninterruptedly in combat units indicates that the procedure has no deleterious effect on the recruits' fitness.

  13. Influence of the flap on outcomes in corneal refractive surgery with femtosecond laser: SMILE vs. FLEx.

    PubMed

    Alió, J L; El Bahrawy, M; Angelov, A; Ortiz, D; Yébana, P

    2017-05-01

    To investigate the influence of creating a flap on the postoperative optical quality of the cornea in terms of predicted corneal curvature and Seidel aberrations after 2 modalities of femtosecond assisted corneal lenticule extraction laser for the correction of myopia and myopic astigmatism: The flapless procedure small incision lenticular extraction (SMILE) and the flap-based femtosecond lenticular extraction (FLEx). The study is a prospective consecutive non-randomised comparative interventional case series including 64 eyes with myopic or myopic astigmatism refractive errors. Patients were divided into 2 groups matched for age, sex and myopia. One group underwent SMILE treatment and the other underwent FLEx treatment. Seidel aberrations root-mean-square values were obtained with a 10mm aperture using the ATLAS 9000 topographer before surgery and 3 months after surgery. The relationship between the post-surgical corneal radius and the predicted sculpted radius were analysed in each group. The mean percentage change in the curvature radius was -2.03% in the FLEx group and -1.77% in the SMILE group (P=.655). The higher correlation for the SMILE group demonstrates a better predictability after the surgery. As regards corneal aberrations, the FLEx treatment showed a greater increase of higher order aberrations than SMILE treatment (P=.04). The mean refractive change in corneal curvature, which is indirectly related to the biomechanical response of the corneal surface after the lenticule cut and extraction, was similar after both treatments. However, the flap based FLEx procedure showed a greater degradation of the corneal optical quality in terms of induction of higher order aberrations. Copyright © 2016 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Alternative Refractive Surgery Procedures

    MedlinePlus

    ... alternative refractive surgery procedures to LASIK . Wavefront-Guided LASIK Before surgery, the excimer laser is programmed with ... precise "sculpting" of each unique cornea. In conventional LASIK , this programming is based on the patient's vision ...

  15. Impact of Primary Spherical Aberration, Spatial Frequency and Stiles Crawford Apodization on Wavefront determined Refractive Error: A Computational Study

    PubMed Central

    Xu, Renfeng; Bradley, Arthur; Thibos, Larry N.

    2013-01-01

    Purpose We tested the hypothesis that pupil apodization is the basis for central pupil bias of spherical refractions in eyes with spherical aberration. Methods We employed Fourier computational optics in which we vary spherical aberration levels, pupil size, and pupil apodization (Stiles Crawford Effect) within the pupil function, from which point spread functions and optical transfer functions were computed. Through-focus analysis determined the refractive correction that optimized retinal image quality. Results For a large pupil (7 mm), as spherical aberration levels increase, refractions that optimize the visual Strehl ratio mirror refractions that maximize high spatial frequency modulation in the image and both focus a near paraxial region of the pupil. These refractions are not affected by Stiles Crawford Effect apodization. Refractions that optimize low spatial frequency modulation come close to minimizing wavefront RMS, and vary with level of spherical aberration and Stiles Crawford Effect. In the presence of significant levels of spherical aberration (e.g. C40 = 0.4 µm, 7mm pupil), low spatial frequency refractions can induce −0.7D myopic shift compared to high SF refraction, and refractions that maximize image contrast of a 3 cycle per degree square-wave grating can cause −0.75D myopic drift relative to refractions that maximize image sharpness. Discussion Because of small depth of focus associated with high spatial frequency stimuli, the large change in dioptric power across the pupil caused by spherical aberration limits the effective aperture contributing to the image of high spatial frequencies. Thus, when imaging high spatial frequencies, spherical aberration effectively induces an annular aperture defining that portion of the pupil contributing to a well-focused image. As spherical focus is manipulated during the refraction procedure, the dimensions of the annular aperture change. Image quality is maximized when the inner radius of the induced

  16. Macroeconomic landscape of refractive surgery in the United States.

    PubMed

    Corcoran, Kevin J

    2015-07-01

    This review examines the economic history of refractive surgery and the decline of laser-assisted in-situ keratomileusis (LASIK) in the USA, and the emergence of refractive cataract surgery as an area of growth. Since it peaked in 2007 at 1.4 million procedures per year, LASIK has declined 50% in the USA, whereas refractive cataract surgery, including presbyopia-correcting intraocular lenses (IOLs), astigmatism-correcting IOLs, and femtosecond laser-assisted cataract surgery, has grown to 350 000 procedures per year, beginning in 2003. Patients are price-sensitive and responsive to publicity (good or bad) about refractive surgery and refractive cataract surgery. LASIK's decline has been partially offset by the emergence of refractive cataract surgery. About 11% of all cataract surgery in the USA involves presbyopia-correcting IOLs, astigmatism-correcting IOLs, or a femtosecond laser. From the surgeon's perspective, there are high barriers to entry into the marketplace for refractive surgery and refractive cataract surgery due to the high capital cost of excimer and femtosecond lasers, the high skill level required to deliver spectacular results to demanding patients who pay out of pocket, and the necessity to perform a high volume of surgeries to satisfy both of these requirements. Probably, less than 7% of US cataract surgeons can readily meet all of these requirements.

  17. Correlation among auto-refractor, wavefront aberration, and subjective manual refraction

    NASA Astrophysics Data System (ADS)

    Li, Qi; Ren, Qiushi

    2005-01-01

    Three optometry methods which include auto-refractor, wavefront aberrometer and subjective manual refraction were studied and compared in measuring low order aberrations of 60 people"s 117 normal eyes. Paired t-test and linear regression were used to study these three methods" relationship when measuring myopia with astigmatism. In order to make the analysis more clear, we divided the 117 normal eyes into different groups according to their subjective manual refraction and redid the statistical analysis. Correlations among three methods show significant in sphere, cylinder and axis in all groups, with sphere"s correlation coefficients largest(R>0.98, P<0.01) and cylinder"s smallest (0.900.01). Auto-refractor had significant change from the other two methods when measuring cylinder (P<0.01). The results after grouping differed a little from the analysis among total people. Although three methods showed significant change from each other in certain parameters, the amplitude of these differences were not large, which indicated that the coherence of auto-refractor, wavefront aberrometer and subjective refraction is good. However, we suggested that wavefront aberration measurement could be a good starting point of optometry, subjective refraction is still necessary for refinement.

  18. Aberration-free aspherical lens shape for shortening the focal distance of an already convergent beam

    PubMed Central

    Sutter, John P.; Alianelli, Lucia

    2017-01-01

    The shapes of single lens surfaces capable of focusing divergent and collimated beams without aberration have already been calculated. However, nanofocusing compound refractive lenses (CRLs) require many consecutive lens surfaces. Here a theoretical example of an X-ray nanofocusing CRL with 48 consecutive surfaces is studied. The surfaces on the downstream end of this CRL accept X-rays that are already converging toward a focus, and refract them toward a new focal point that is closer to the surface. This case, so far missing from the literature, is treated here. The ideal surface for aberration-free focusing of a convergent incident beam is found by analytical computation and by ray tracing to be one sheet of a Cartesian oval. An ‘X-ray approximation’ of the Cartesian oval is worked out for the case of small change in index of refraction across the lens surface. The paraxial approximation of this surface is described. These results will assist the development of large-aperture CRLs for nanofocusing. PMID:29091055

  19. Nanofocusing with aberration-corrected rotationally parabolic refractive X-ray lenses

    DOE PAGES

    Seiboth, Frank; Wittwer, Felix; Scholz, Maria; ...

    2018-01-01

    Wavefront errors of rotationally parabolic refractive X-ray lenses made of beryllium (Be CRLs) have been recovered for various lens sets and X-ray beam configurations. Due to manufacturing via an embossing process, aberrations of individual lenses within the investigated ensemble are very similar. By deriving a mean single-lens deformation for the ensemble, aberrations of any arbitrary lens stack can be predicted from the ensemble with σ¯ = 0.034λ. Using these findings the expected focusing performance of current Be CRLs are modeled for relevant X-ray energies and bandwidths and it is shown that a correction of aberrations can be realised without priormore » lens characterization but simply based on the derived lens deformation. As a result, the performance of aberration-corrected Be CRLs is discussed and the applicability of aberration-correction demonstrated over wide X-ray energy ranges.« less

  20. Refractive Surgery: Malpractice Litigation Outcomes.

    PubMed

    Custer, Benjamin L; Ballard, Steven R; Carroll, Robert B; Barnes, Scott D; Justin, Grant A

    2017-10-01

    To review data on malpractice claims related to refractive surgery to identify common allegations and injuries and financial outcomes. The WestlawNext database was reviewed for all malpractice lawsuits/settlements related to refractive eye surgery. Data evaluated included patient demographics, type of operation performed, plaintiff allegation, nature of injury, and litigation outcomes. A total of 167 cases met the inclusion criteria, of which 108 cases (64.7%) were found to be favorable and 59 cases (35.3%) unfavorable to the defendant. A total of 141 cases were tried by a jury with 108 cases (76.4%) favorable and 33 cases (23.6%) unfavorable to the defendant. Laser in situ keratomileusis was performed in 127 cases (76%). The most common allegations were negligence in treatment or surgery in 127 cases (76%) and lack of informed consent in 83 cases (49.7%). For all cases, the need for future surgery (P = 0.0001) and surgery resulting in keratoconus (P = 0.05) were more likely to favor the plaintiff. In jury verdict decisions, cases in which failure to diagnose a preoperative condition was alleged favored the defendant (P = 0.03), whereas machine malfunction (P = 0.05) favored the plaintiff. After adjustment for inflation, the overall mean award was $1,287,872. Jury verdicts and settlements led to mean awards of $1,604,801 and $826,883, respectively. Malpractice litigation in refractive surgery tends to favor the defendant. However, large awards and settlements were given in cases that were favorable to the plaintiff. The need for future surgery and surgery leading to keratoconus increased the chance of an unfavorable outcome.

  1. Laser Refractive Surgery

    NASA Astrophysics Data System (ADS)

    Wynne, James

    Refractive surgery has its roots in corneal transplant surgery, first performed in 1905, where the damaged or diseased cornea of a living individual is replaced by donated corneal tissue taken from a recently deceased individual. Since the cornea has no blood supply, there is no danger of organ rejection. Recognizing the exceptional healing power of corneal tissue, ophthalmologists began to explore methods of reshaping the cornea to improve the visual acuity of patients suffering from myopia, hyperopia, and astigmatism. In 1964, a procedure known as keratomileusis was introduced. In 1974, radial keratotomy (RK) was introduced. In 1981, excimer laser surgery was discovered by the speaker and his IBM Research colleagues. In 1983, the excimer laser was used to create clean, precise incisions in the cornea of enucleated calf eyes, derived from slaughter, launching the era of laser refractive surgery, with more precise and safer techniques to correct myopia, hyperopia, and stigmatism. This talk will describe the widely practiced surgical procedures known as photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK), which have improved the visual acuity of more than 35 million people. Most patients undergoing PRK or LASIK end up with uncorrected vision better than 20/20. In 2007, development commenced on a new procedure known as small incision lenticule extraction (SMILE), employing a femtosecond laser and no excimer laser. SMILE is promoted as minimally invasive and combining the advantages of PRK and LASIK. However, long term stability of visual acuity following SMILE surgery is yet to be determined.

  2. Do Peripheral Refraction and Aberration Profiles Vary with the Type of Myopia? - An Illustration Using a Ray-Tracing Approach

    PubMed Central

    Bakaraju, Ravi C.; Ehrmann, Klaus; Papas, Eric B.; Ho, Arthur

    2010-01-01

    Purpose Myopia is considered to be the most common refractive error occurring in children and young adults, around the world. Motivated to elucidate how the process of emmetropization is disrupted, potentially causing myopia and its progression, researchers have shown great interest in peripheral refraction. This study assessed the effect of the myopia type, either refractive or axial, on peripheral refraction and aberration profiles. Methods Using customized schematic eye models for myopia in a ray tracing algorithm, peripheral aberrations, including the refractive error, were calculated as a function of myopia type. Results In all the selected models, hyperopic shifts in the mean spherical equivalent (MSE) component were found whose magnitude seemed to be largely dependent on the field angle. The MSE profiles showed larger hyperopic shifts for the axial type of myopic models than the refractive ones and were evident in -4 and -6 D prescriptions. Additionally, greater levels of astigmatic component (J180) were also seen in axial-length-dependent models, while refractive models showed higher levels of spherical aberration and coma. Conclusion This study has indicated that myopic eyes with primarily an axial component may have a greater risk of progression than their refractive counterparts albeit with the same degree of refractive error. This prediction emerges from the presented theoretical ray tracing model and, therefore, requires clinical confirmation.

  3. Visual function of police officers who have undergone refractive surgery.

    PubMed

    Hovis, Jeffery K; Ramaswamy, Shankaran

    2006-11-01

    The visual acuity and contrast sensitivity of police recruits and officers was evaluated in both normal and dim illumination conditions to determine whether officers who have had refractive surgery have compromised night vision. The control group consisted of 76 officers and recruits who have not had refractive surgery and the refractive surgery group consisted of 22 officers and recruits who had refractive surgery. Visual acuity and contrast sensitivity were measured under both room illumination and dim illumination. The room illumination test series included high contrast acuity, low contrast acuity and Pelli-Robson contrast sensitivity. The dim illumination test series included high contrast acuity, low contrast acuity, Pelli-Robson contrast sensitivity, license plate number acuity (with and without glare) and the Mesotest. The general findings were that the refractive surgery group had lower acuity scores on low contrast targets in both room and dim light levels along with a reduction in the Mesotest scores with a glare source compared to the control group. Although refractive surgery police recruits and officers had reduced performance on some vision tests, these reductions were small and it is unlikely that their performance on vision related tasks would be compromised, on average. The major concern is the small number of refractive surgery candidates whose results were well outside the range of the non-surgical candidates. Their vision may be unacceptable for policing. Copyright (c) 2006 Wiley-Liss, Inc.

  4. Contribution of the gradient refractive index and shape to the crystalline lens spherical aberration and astigmatism.

    PubMed

    Birkenfeld, Judith; de Castro, Alberto; Ortiz, Sergio; Pascual, Daniel; Marcos, Susana

    2013-06-28

    The optical properties of the crystalline lens are determined by its shape and refractive index distribution. However, to date, those properties have not been measured together in the same lens, and therefore their relative contributions to optical aberrations are not fully understood. The shape, the optical path difference, and the focal length of ten porcine lenses (age around 6 months) were measured in vitro using Optical Coherence Tomography and laser ray tracing. The 3D Gradient Refractive Index distribution (GRIN) was reconstructed by means of an optimization method based on genetic algorithms. The optimization method searched for the parameters of a 4-variable GRIN model that best fits the distorted posterior surface of the lens in 18 different meridians. Spherical aberration and astigmatism of the lenses were estimated using computational ray tracing, with the reconstructed GRIN lens and an equivalent homogeneous refractive index. For all lenses the posterior radius of curvature was systematically steeper than the anterior one, and the conic constant of both the anterior and posterior positive surfaces was positive. In average, the measured focal length increased with increasing pupil diameter, consistent with a crystalline lens negative spherical aberration. The refractive index of nucleus and surface was reconstructed to an average value of 1.427 and 1.364, respectively, for 633 nm. The results of the GRIN reconstruction showed a wide distribution of the index in all lens samples. The GRIN shifted spherical aberration towards negative values when compared to a homogeneous index. A negative spherical aberration with GRIN was found in 8 of the 10 lenses. The presence of GRIN also produced a decrease in the total amount of lens astigmatism in most lenses, while the axis of astigmatism was only little influenced by the presence of GRIN. To our knowledge, this study is the first systematic experimental study of the relative contribution of geometry and GRIN to

  5. [Problems and challenges in the development of corneal refractive surgery].

    PubMed

    Wang, Y; Li, J

    2018-01-11

    Corneal refractive surgery, as one of the common visual correction methods, has been increasingly accepted in China. There are a large number of people in China who undergo the corneal refractive surgery due to the high incidence of myopia in the country. It is essential that the safest and most effective surgery should be used to correct refractive errors in the cases involved with relatively normal eyes and corneas. In recent years, corneal refractive surgery has been rapidly developing with new technologies and techniques emerging all the time, such as SMILE (small incision lenticule extraction) surgery, which has been extensively applied in China since five years ago when it was approved by FDA. However, little known are these new technologies and techniques, and the clinical and basic researches need further investigations by various approaches including histopathology and molecular biology, combined with mathematics, computer science, physics, chemistry and corneal biomechanics. To achieve minimal tissue damage and optimal clinical outcomes on visual quality by corneal refractive surgery requires the multidisciplinary partnerships of medical practitioners and researchers. (Chin J Ophthalmol, 2018, 54: 3-6) .

  6. Influence of shape and gradient refractive index in the accommodative changes of spherical aberration in nonhuman primate crystalline lenses.

    PubMed

    de Castro, Alberto; Birkenfeld, Judith; Maceo, Bianca; Manns, Fabrice; Arrieta, Esdras; Parel, Jean-Marie; Marcos, Susana

    2013-09-11

    To estimate changes in surface shape and gradient refractive index (GRIN) profile in primate lenses as a function of accommodation. To quantify the contribution of surface shape and GRIN to spherical aberration changes with accommodation. Crystalline lenses from 15 cynomolgus monkeys were studied in vitro under different levels of accommodation produced by a stretching system. Lens shape was obtained from optical coherence tomography (OCT) cross-sectional images. The GRIN was reconstructed with a search algorithm using the optical path measured from OCT images and the measured back focal length. The spherical aberration of the lens was estimated as a function of accommodation using the reconstructed GRIN and a homogeneous refractive index. The lens anterior and posterior radii of curvature decreased with increasing lens power. Both surfaces exhibited negative asphericities in the unaccommodated state. The anterior surface conic constant shifted toward less negative values with accommodation, while the value of the posterior remained constant. GRIN parameters remained constant with accommodation. The lens spherical aberration with GRIN distribution was negative and higher in magnitude than that with a homogeneous equivalent refractive index (by 29% and 53% in the unaccommodated and fully accommodated states, respectively). Spherical aberration with the equivalent refractive index shifted with accommodation toward negative values (-0.070 μm/diopter [D]), but the reconstructed GRIN shifted it farther (-0.124 μm/D). When compared with the lens with the homogeneous equivalent refractive index, the reconstructed GRIN lens has more negative spherical aberration and a larger shift toward more negative values with accommodation.

  7. Influence of Shape and Gradient Refractive Index in the Accommodative Changes of Spherical Aberration in Nonhuman Primate Crystalline Lenses

    PubMed Central

    de Castro, Alberto; Birkenfeld, Judith; Maceo, Bianca; Manns, Fabrice; Arrieta, Esdras; Parel, Jean-Marie; Marcos, Susana

    2013-01-01

    Purpose. To estimate changes in surface shape and gradient refractive index (GRIN) profile in primate lenses as a function of accommodation. To quantify the contribution of surface shape and GRIN to spherical aberration changes with accommodation. Methods. Crystalline lenses from 15 cynomolgus monkeys were studied in vitro under different levels of accommodation produced by a stretching system. Lens shape was obtained from optical coherence tomography (OCT) cross-sectional images. The GRIN was reconstructed with a search algorithm using the optical path measured from OCT images and the measured back focal length. The spherical aberration of the lens was estimated as a function of accommodation using the reconstructed GRIN and a homogeneous refractive index. Results. The lens anterior and posterior radii of curvature decreased with increasing lens power. Both surfaces exhibited negative asphericities in the unaccommodated state. The anterior surface conic constant shifted toward less negative values with accommodation, while the value of the posterior remained constant. GRIN parameters remained constant with accommodation. The lens spherical aberration with GRIN distribution was negative and higher in magnitude than that with a homogeneous equivalent refractive index (by 29% and 53% in the unaccommodated and fully accommodated states, respectively). Spherical aberration with the equivalent refractive index shifted with accommodation toward negative values (−0.070 μm/diopter [D]), but the reconstructed GRIN shifted it farther (−0.124 μm/D). Conclusions. When compared with the lens with the homogeneous equivalent refractive index, the reconstructed GRIN lens has more negative spherical aberration and a larger shift toward more negative values with accommodation. PMID:23927893

  8. Ocular wavefront aberrations in the common marmoset Callithrix jacchus: effects of age and refractive error

    PubMed Central

    Coletta, Nancy J.; Marcos, Susana; Troilo, David

    2012-01-01

    The common marmoset, Callithrix jacchus, is a primate model for emmetropization studies. The refractive development of the marmoset eye depends on visual experience, so knowledge of the optical quality of the eye is valuable. We report on the wavefront aberrations of the marmoset eye, measured with a clinical Hartmann-Shack aberrometer (COAS, AMO Wavefront Sciences). Aberrations were measured on both eyes of 23 marmosets whose ages ranged from 18 to 452 days. Twenty-one of the subjects were members of studies of emmetropization and accommodation, and two were untreated normal subjects. Eleven of the 21 experimental subjects had worn monocular diffusers or occluders and ten had worn binocular spectacle lenses of equal power. Monocular deprivation or lens rearing began at about 45 days of age and ended at about 108 days of age. All refractions and aberration measures were performed while the eyes were cyclopleged; most aberration measures were made while subjects were awake, but some control measurements were performed under anesthesia. Wavefront error was expressed as a seventh-order Zernike polynomial expansion, using the Optical Society of America’s naming convention. Aberrations in young marmosets decreased up to about 100 days of age, after which the higher-order RMS aberration leveled off to about 0.10 micron over a 3 mm diameter pupil. Higher-order aberrations were 1.8 times greater when the subjects were under general anesthesia than when they were awake. Young marmoset eyes were characterized by negative spherical aberration. Visually deprived eyes of the monocular deprivation animals had greater wavefront aberrations than their fellow untreated eyes, particularly for asymmetric aberrations in the odd-numbered Zernike orders. Both lens-treated and deprived eyes showed similar significant increases in Z3-3 trefoil aberration, suggesting the increase in trefoil may be related to factors that do not involve visual feedback. PMID:20800078

  9. Automated refraction is stable 1 week after uncomplicated cataract surgery.

    PubMed

    Ostri, Christoffer; Holfort, Stig K; Fich, Marianne S; Riise, Per

    2018-03-01

    To compare automated refraction 1 week and 1 month after uncomplicated cataract surgery. In this prospective cohort study, we recruited patients in a 2-month period and included consecutive patients scheduled for bilateral small-incision phacoemulsification cataract surgery. The exclusion criteria were (i) corneal and/or retinal pathology that could lead to automated refraction miscalculation and (ii) surgery complications. Automated refraction was measured 1 week and 1 month after surgery. Ninety-five patients met the in- and exclusion criteria and completed follow-up. The mean refractive shift in spherical equivalent was -0.02 dioptre (D) between 1 week and 1 month after surgery and not statistical significant (p = 0.78, paired t-test). The magnitude of refractive shift in either myopic or hyperopic direction was neither correlated to age, preoperative corneal astigmatism, axial length nor phacoemulsification energy used during surgery (p > 0.05 for all variables, regression analysis). The refractive target was missed with 1.0 D or more in 11 (12%) patients. In this subgroup, the mean refractive shift in spherical equivalent was 0.49 D between 1 week and 1 month after surgery with a trend towards statistical significance (p = 0.07, paired t-test). There was no difference in age, preoperative corneal astigmatism, axial length or phacoemulsification energy used during surgery compared to the remainder of the patients (p > 0.05 for all variables, unpaired t-test). Automated refraction is stabile 1 week after uncomplicated cataract surgery, but there is a trend towards instability, if the refractive target is missed with 1.0 D or more. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  10. Corneal higher-order aberrations and higher-order Strehl ratio after aberration-free ablation profile to treat compound myopic astigmatism.

    PubMed

    Brenner, Luis F

    2015-12-01

    To evaluate the changes in corneal higher-order aberrations (HOAs) and their impact on corneal higher-order Strehl ratio after aberration-free ablation profile. Verter Institute, H. Olhos, São Paulo, Brazil. Prospective interventional study. Eyes that had aberration-free myopic ablation were divided into 3 groups, based on the spherical equivalent (SE). The corneal HOAs and higher-order Strehl ratios were calculated before surgery and 3 months after surgery. The postoperative uncorrected-distance visual acuity, corrected-distance visual acuity, and SE did not present statistical differences among groups (88 eyes, P > .05). For a 6 mm pupil, the corneal HOA showed a mean increase of 0.17 μm (range 0.39 to 0.56 μm) (P < .001) and the corneal higher-order Strehl ratio presented a reduction of 0.03 (from 0.25 to 0.22) (P = .001). The following consistent linear predictive model was obtained: corneal HOA induction = 1.474 - 0.032 × SE - 0.225 × OZ, where OZ is the optical zone (R(2) = 0.49, adjusted R(2) = 0.48, P < .001). The corneal HOAs and the higher-order Strehl ratios deteriorated after moderate and high myopic ablations. The worsening in corneal aberrations and optical quality were related to the magnitude of the intended correction and did not affect high-contrast visual performance. The OZ was the only modifiable parameter capable to restrain the optical quality loss. The author has no financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  11. Comparison of monochromatic aberrations in young adults with different visual acuity and refractive errors.

    PubMed

    Yazar, Seyhan; Hewitt, Alex W; Forward, Hannah; McKnight, Charlotte M; Tan, Alex; Mountain, Jenny A; Mackey, David A

    2014-03-01

    To compare the monochromatic aberrations in a large cohort of 20-year-old Australians with differing levels of visual acuity and explore the relationship between these aberrations and refractive error. Lions Eye Institute, Perth, Western Australia, Australia. Cross-sectional analysis of a population-based cohort. Monochromatic aberrations were measured using a Zywave II wavefront aberrometer with natural pupils in a dark room. The logMAR corrected distance visual acuity (CDVA) was measured monocularly under normal illumination. Cycloplegic autorefraction was also performed. The study enrolled 2039 eyes of 1040 participants. Data from 1007 right eyes were analyzed. The median CDVA and spherical equivalent were -0.06 logMAR (interquartile range [IQR], -0.10 to 0.00) and +0.25 diopters (D) (IQR, -0.38 to 0.63), respectively. The median 6.0 mm higher-order aberration (HOA) was 0.58 μm (IQR, 0.44 to 0.79). Coma-like aberrations and 3rd-, 4th-, and 5th-order HOAs were significantly different between subjects with a CDVA of -0.10 logMAR or better and those with a CDVA worse than -0.10 logMAR. Fourth-order aberrations Z(4,-4) (P=.024) and Z(4,-2) (P=.029) and 2nd-order aberration Z(2,0) (P<.001) differed significantly between myopic eyes, emmetropic eyes, and hyperopic eyes. Subjects with higher myopia had slightly higher total HOAs. The HOAs in this population were marginally higher than previously reported values. The findings confirm there is a difference in monochromatic aberrations between different vision and refractive groups. Results in this study will benefit decision-making processes in the clinical setting. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  12. Corneal polarimetry after LASIK refractive surgery

    NASA Astrophysics Data System (ADS)

    Bueno, Juan M.; Berrio, Esther; Artal, Pablo

    2006-01-01

    Imaging polarimetry provides spatially resolved information on the polarization properties of a system. In the case of the living human eye, polarization could be related to the corneal biomechanical properties, which vary from the normal state as a result of surgery or pathologies. We have used an aberro-polariscope, which we recently developed, to determine and to compare the spatially resolved maps of polarization parameters across the pupil between normal healthy and post-LASIK eyes. The depolarization distribution is not uniform across the pupil, with post-surgery eyes presenting larger levels of depolarization. While retardation increases along the radius in normal eyes, this pattern becomes irregular after LASIK refractive surgery. The maps of slow axis also differ in normal and post-surgery eyes, with a larger disorder in post-LASIK eyes. Since these changes in polarization indicate subtle structural modifications of the cornea, this approach can be useful in a clinical environment to follow the biomechanical and optical changes of the cornea after refractive surgery or for the early diagnosis of different corneal pathologies.

  13. Reproducibility of manifest refraction between surgeons and optometrists in a clinical refractive surgery practice.

    PubMed

    Reinstein, Dan Z; Yap, Timothy E; Carp, Glenn I; Archer, Timothy J; Gobbe, Marine

    2014-03-01

    To measure and compare the interobserver reproducibility of manifest refraction according to a standardized protocol for normal preoperative patients in a refractive surgery practice. Private clinic, London, United Kingdom. Retrospective case series. This retrospective study comprised patients attending 2 preoperative refractions before laser vision correction. The first manifest refraction was performed by 1 of 7 optometrists and the second manifest refraction by 1 of 2 surgeons, all trained using a standard manifest refraction protocol. Spherocylindrical data were converted into power vectors for analysis. The dioptric power differences between observers were calculated and analyzed. One thousand nine hundred twenty-two consecutive eyes were stratified into a myopia group and a hyperopia group and then further stratified by each surgeon-optometrist combination. The mean surgeon-optometrist dioptric power difference was 0.21 diopter (D) (range 0.15 to 0.32 D). The mean difference in spherical equivalent refraction was 0.03 D, with 95% of all refractions within ±0.44 D for all optometrist-surgeon combinations. The severity of myopic or hyperopic ametropia did not affect the interobserver reproducibility of the manifest refraction. There was close agreement in refraction between surgeons and optometrists using a standard manifest refraction protocol of less than 0.25 D. This degree of interobserver repeatability is similar to that in intraobserver repeatability studies published to date and may represent the value of training and the use of a standard manifest refraction protocol between refraction observers in a refractive surgery practice involving co-management between surgeons and optometrists. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  14. A Limitation of Hartmann-Shack System in Measuring Wavefront Aberrations for Patients Received Laser Refractive Surgery

    PubMed Central

    Wu, Ying; He, Ji C.; Zhou, Xing T.; Chu, Ren Y.

    2015-01-01

    Purpose To explore the relationship between ablation parameters of myopic laser surgery and measurement area of wavefront aberration (WA) with Hartmann-Shack wavefront sensor. Methods 58 subjects undergone myopic laser surgeries and 74 uncorrected myopic subjects were enrolled in this experiment. The laser ablation parameters were obtained from surgical records, which included spherical error (Rx), depth, and optical zone (OZ) of ablation. The measured area of WA was tested by the WASCA, and the real pupil size was tested by Pentacam. The corneal eccentricity (E value) and curvature was also measured with the Pentacam. All the measurements were performed under mydriatic condition. Results For uncorrected myopic eyes, the measured area of WA was similar with the real pupil size. But for the corrected eyes, the measured area of WA was smaller than the real pupil size with a mean difference of 0.66 ± 0.54 mm for moderate myopia (t = 6.45, p < 0.0001) and 1.76 ± 0.55 mm for high myopia (t = 18.92, p < 0.0001), but not for mild myopia. The Rx (t = -3.20, p = 0.0017), OZ (t = 64.4, p < 0.0001) and postoperative corneal E value (t = 2.52, p = 0.017) were the independent factors of measured area of WA. Measured area of WA = -0.81*Rx + 1.13*OZ + 0.49*postoperative corneal E value (r2 = 0.997). Conclusions The WASCA has a limitation in measuring wavefront aberration over the whole pupil area when it’s used for patients received myopic laser surgery. The measured area is smaller than the real pupil size and depends linearly on ablation depth, optical zone and corneal eccentricity. PMID:25692489

  15. New Refractive Surgery Procedures and Their Implications for Aviation Safety

    DTIC Science & Technology

    2006-04-01

    airmen with laser refractive surgery, i.e., photorefractive keratectomy ( PRK ) and laser in situ keratomileusis ( LASIK ). A reference guide on refractive...surgery was published in September of 1998 (DOT/FAA/AM-98/25); however, at that time long-term clinical data on PRK and LASIK were not available...fractive surgery procedures (Photorefractive Keratectomy [ PRK ], Laser1 in situ Keratomileusis [ LASIK ]) and to assist Aviation Medical Examiners in

  16. Trends in refractive surgery at an academic center: 2007-2009.

    PubMed

    Kuo, Irene C

    2011-05-14

    The United States officially entered a recession in December 2007, and it officially exited the recession in December 2009, according to the National Bureau of Economic Research. Since the economy may affect not only the volume of excimer laser refractive surgery, but also the clinical characteristics of patients undergoing surgery, our goal was to compare the characteristics of patients completing excimer laser refractive surgery and the types of procedures performed in the summer quarter in 2007 and the same quarter in 2009 at an academic center. A secondary goal was to determine whether the volume of astigmatism- or presbyopia-correcting intraocular lenses (IOLs) has concurrently changed because like laser refractive surgery, these "premium" IOLs involve out-of-pocket costs for patients. Retrospective case series. Medical records were reviewed for all patients completing surgery at the Wilmer Laser Vision Center in the summer quarter of 2007 and the summer quarter of 2009. Outcome measures were the proportions of treated refractive errors, the proportion of photorefractive keratectomy (PRK) vs. laser-assisted in-situ keratomileusis (LASIK), and the mean age of patients in each quarter. Chi-square test was used to compare the proportions of treated refractive errors and the proportions of procedures; two-tailed t-test to compare the mean age of patients; and two-tailed z-test to compare proportions of grouped refractive errors in 2007 vs. 2009; alpha = 0.05 for all tests. Refractive errors were grouped by the spherical equivalent of the manifest refraction and were considered "low myopia" for 6 diopters (D) of myopia or less, "high myopia" for more than 6 D, and "hyperopia" for any hyperopia. Billing data were reviewed to obtain the volume of premium IOLs. Volume of laser refractive procedures decreased by at least 30%. The distribution of proportions of treated refractive errors did not change (p = 0.10). The proportion of high myopes, however, decreased (p = 0

  17. Trends in refractive surgery at an academic center: 2007-2009

    PubMed Central

    2011-01-01

    Background The United States officially entered a recession in December 2007, and it officially exited the recession in December 2009, according to the National Bureau of Economic Research. Since the economy may affect not only the volume of excimer laser refractive surgery, but also the clinical characteristics of patients undergoing surgery, our goal was to compare the characteristics of patients completing excimer laser refractive surgery and the types of procedures performed in the summer quarter in 2007 and the same quarter in 2009 at an academic center. A secondary goal was to determine whether the volume of astigmatism- or presbyopia-correcting intraocular lenses (IOLs) has concurrently changed because like laser refractive surgery, these "premium" IOLs involve out-of-pocket costs for patients. Methods Retrospective case series. Medical records were reviewed for all patients completing surgery at the Wilmer Laser Vision Center in the summer quarter of 2007 and the summer quarter of 2009. Outcome measures were the proportions of treated refractive errors, the proportion of photorefractive keratectomy (PRK) vs. laser-assisted in-situ keratomileusis (LASIK), and the mean age of patients in each quarter. Chi-square test was used to compare the proportions of treated refractive errors and the proportions of procedures; two-tailed t-test to compare the mean age of patients; and two-tailed z-test to compare proportions of grouped refractive errors in 2007 vs. 2009; alpha = 0.05 for all tests. Refractive errors were grouped by the spherical equivalent of the manifest refraction and were considered "low myopia" for 6 diopters (D) of myopia or less, "high myopia" for more than 6 D, and "hyperopia" for any hyperopia. Billing data were reviewed to obtain the volume of premium IOLs. Results Volume of laser refractive procedures decreased by at least 30%. The distribution of proportions of treated refractive errors did not change (p = 0.10). The proportion of high myopes

  18. Corneal refractive surgery: Is intracorneal the way to go and what are the needs for technology?

    NASA Astrophysics Data System (ADS)

    Hjortdal, Jesper; Ivarsen, Anders

    2014-02-01

    Corneal refractive surgery aims to reduce or eliminate refractive errors of the eye by changing the refractive power of the cornea. For the last 20 years controlled excimer laser ablation of corneal tissue, either directly from the corneal stromal surface or from the corneal interior after creation of a superficial corneal flap has become widely used to correct myopia, hyperopia, and astigmatism. Recently, an intrastromal refractive procedure whereby a tissue lenticule is cut free in the corneal stroma by a femtosecond laser and removed through a small peripheral incision has been introduced. This procedure avoids creation of a corneal flap and the potential associated risks while avoiding the slow visual recovery of surface ablation procedures. Precise intrastromal femtosecond laser cutting of the fine lenticule requires very controlled laser energy delivery in order to avoid lenticule irregularities, which would compromise the refractive result and visual acuity. This newly introduced all-femtosecond based flap-free intracorneal refractive procedure has been documented to be a predictable, efficient, and safe procedure for correction of myopia and astigmatism. Technological developments related to further improved cutting quality, hyperopic and individualized treatments are desirable.

  19. Managing residual refractive error after cataract surgery.

    PubMed

    Sáles, Christopher S; Manche, Edward E

    2015-06-01

    We present a review of keratorefractive and intraocular approaches to managing residual astigmatic and spherical refractive error after cataract surgery, including laser in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), arcuate keratotomy, intraocular lens (IOL) exchange, piggyback IOLs, and light-adjustable IOLs. Currently available literature suggests that laser vision correction, whether LASIK or PRK, yields more effective and predictable outcomes than intraocular surgery. Piggyback IOLs with a rounded-edge profile implanted in the sulcus may be superior to IOL exchange, but both options present potential risks that likely outweigh the refractive benefits except in cases with large residual spherical errors. The light-adjustable IOL may provide an ideal treatment to pseudophakic ametropia by obviating the need for secondary invasive procedures after cataract surgery, but it is not widely available nor has it been sufficiently studied. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  20. Optical aberrations induced by subclinical decentrations of the ablation pattern

    NASA Astrophysics Data System (ADS)

    Mrochen, Michael; Kaemmerer, Maik; Riedel, Peter; Mierdel, Peter; Krinke, Hans-Eberhard; Seiler, Theo

    2000-06-01

    Purpose: The aim of this work was to study the effect of currently used ablation profiles along with eccentric ablations on the increase of higher order aberrations observed after PRK. Material and Methods: The optical aberrations of 10 eyes were tested before and after PRK. Refractive surgery was performed using a ArF-excimer laser system. In all cases, the ablation zone was 6 mm or larger. The spherical equivalent of the correction was ranging from -2.5 D to -6.0 D. The measured wavefront error was compared to numerical simulations done with the reduced eye model and currently used ablation profiles as well as compared with experimental results obtained from ablation on PMMA balls. Results: The aberration measurements result in a considerable change of the spherical- and coma-like wavefront errors. This result was in good correlation with the numerical simulations and the experimental results. Furthermore, it has been derived that the major contribution on the induced higher order aberrations are a result of the small decentration (less than 1.0 mm) of the ablation zone. Conclusions: Higher order spherical- and coma-like aberrations after PRK are mainly determined by the decentration of the ablation zone during laser refractive surgery. However, future laser systems should use efficient eye-tracking systems and aspherical ablation profiles to overcome this problem.

  1. Postoperative refraction in the second eye having cataract surgery.

    PubMed

    Leffler, Christopher T; Wilkes, Martin; Reeves, Juliana; Mahmood, Muneera A

    2011-01-01

    Introduction. Previous cataract surgery studies assumed that first-eye predicted and observed postoperative refractions are equally important for predicting second-eye postoperative refraction. Methods. In a retrospective analysis of 173 patients having bilateral sequential phacoemulsification, multivariable linear regression was used to predict the second-eye postoperative refraction based on refractions predicted by the SRK-T formula for both eyes, the first-eye postoperative refraction, and the difference in IOL selected between eyes. Results. The first-eye observed postoperative refraction was an independent predictor of the second eye postoperative refraction (P < 0.001) and was weighted more heavily than the first-eye predicted refraction. Compared with the SRK-T formula, this model reduced the root-mean-squared (RMS) error of the predicted refraction by 11.3%. Conclusions. The first-eye postoperative refraction is an independent predictor of the second-eye postoperative refraction. The first-eye predicted refraction is less important. These findings may be due to interocular symmetry.

  2. Postoperative Refraction in the Second Eye Having Cataract Surgery

    PubMed Central

    Leffler, Christopher T.; Wilkes, Martin; Reeves, Juliana; Mahmood, Muneera A.

    2011-01-01

    Introduction. Previous cataract surgery studies assumed that first-eye predicted and observed postoperative refractions are equally important for predicting second-eye postoperative refraction. Methods. In a retrospective analysis of 173 patients having bilateral sequential phacoemulsification, multivariable linear regression was used to predict the second-eye postoperative refraction based on refractions predicted by the SRK-T formula for both eyes, the first-eye postoperative refraction, and the difference in IOL selected between eyes. Results. The first-eye observed postoperative refraction was an independent predictor of the second eye postoperative refraction (P < 0.001) and was weighted more heavily than the first-eye predicted refraction. Compared with the SRK-T formula, this model reduced the root-mean-squared (RMS) error of the predicted refraction by 11.3%. Conclusions. The first-eye postoperative refraction is an independent predictor of the second-eye postoperative refraction. The first-eye predicted refraction is less important. These findings may be due to interocular symmetry. PMID:24533181

  3. Influence of stromal refractive index and hydration on corneal laser refractive surgery.

    PubMed

    de Ortueta, Diego; von Rüden, Dennis; Magnago, Thomas; Arba Mosquera, Samuel

    2014-06-01

    To evaluate the influence of the stromal refractive index and hydration on postoperative outcomes in eyes that had corneal laser refractive surgery using the Amaris laser system. Augenzentrum Recklinghausen, Recklinghausen, Germany. Comparative case series. At the 6-month follow-up, right eyes were retrospectively analyzed. The effect of the stromal refractive index and hydration on refractive outcomes was assessed using univariate linear and multilinear correlations. Sixty eyes were analyzed. Univariate linear analyses showed that the stromal refractive index and hydration were correlated with the thickness of the preoperative exposed stroma and was statistically different for laser in situ keratomileusis and laser-assisted subepithelial keratectomy treatments. Univariate multilinear analyses showed that the spherical equivalent (SE) was correlated with the attempted SE and stromal refractive index (or hydration). Analyses suggest overcorrections for higher stromal refractive index values and for lower hydration values. The stromal refractive index and hydration affected postoperative outcomes in a subtle, yet significant manner. An adjustment toward greater attempted correction in highly hydrated corneas and less intended correction in low hydrated corneas might help optimize refractive outcomes. Mr. Magnago and Dr. Arba-Mosquera are employees of and Dr. Diego de Ortueta is a consultant to Schwind eye-tech-solutions GmbH & Co. KG. Mr. Rüden has no financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  4. Correcting spherical aberrations induced by an unknown medium through determination of its refractive index and thickness.

    PubMed

    Iwaniuk, Daniel; Rastogi, Pramod; Hack, Erwin

    2011-09-26

    In imaging and focusing applications, spherical aberration induces axial broadening of the point spread function (PSF). A transparent medium between lens and object of interest induces spherical aberration. We propose a method that first obtains both the physical thickness and the refractive index of the aberration inducing medium in situ by measuring the induced focal shifts for paraxial and large angle rays. Then, the fourth order angle dependence of the optical path difference inside the medium is used to correct the spherical aberration using a phase-only spatial light modulator. The obtained measurement accuracy of 3% is sufficient for a complete compensation as demonstrated in a model microscope with NA 0.3 with glass plate induced axial broadening of the PSF by a factor of 5. © 2011 Optical Society of America

  5. High order aberration and straylight evaluation after cataract surgery with implantation of an aspheric, aberration correcting monofocal intraocular lens

    PubMed Central

    Kretz, Florian T A; Tandogan, Tamer; Khoramnia, Ramin; Auffarth, Gerd U

    2015-01-01

    AIM To evaluate the quality of vision in respect to high order aberrations and straylight perception after implantation of an aspheric, aberration correcting, monofocal intraocular lens (IOL). METHODS Twenty-one patients (34 eyes) aged 50 to 83y underwent cataract surgery with implantation of an aspheric, aberration correcting IOL (Tecnis ZCB00, Abbott Medical Optics). Three months after surgery they were examined for uncorrected (UDVA) and corrected distance visual acuity (CDVA), contrast sensitivity (CS) under photopic and mesopic conditions with and without glare source, ocular high order aberrations (HOA, Zywave II) and retinal straylight (C-Quant). RESULTS Postoperatively, patients achieved a postoperative CDVA of 0.0 logMAR or better in 97.1% of eyes. Mean values of high order abberations were +0.02±0.27 (primary coma components) and -0.04±0.16 (spherical aberration term). Straylight values of the C-Quant were 1.35±0.44 log which is within normal range of age matched phakic patients. The CS measurements under mesopic and photopic conditions in combination with and without glare did not show any statistical significance in the patient group observed (P≥0.28). CONCLUSION The implantation of an aspherical aberration correcting monofocal IOL after cataract surgery resulted in very low residual higher order aberration (HOA) and normal straylight. PMID:26309872

  6. Comparison of corneal power, astigmatism, and wavefront aberration measurements obtained by a point-source color light-emitting diode-based topographer, a Placido-disk topographer, and a combined Placido and dual Scheimpflug device.

    PubMed

    Ventura, Bruna V; Wang, Li; Ali, Shazia F; Koch, Douglas D; Weikert, Mitchell P

    2015-08-01

    To evaluate and compare the performance of a point-source color light-emitting diode (LED)-based topographer (color-LED) in measuring anterior corneal power and aberrations with that of a Placido-disk topographer and a combined Placido and dual Scheimpflug device. Cullen Eye Institute, Baylor College of Medicine, Houston, Texas USA. Retrospective observational case series. Normal eyes and post-refractive-surgery eyes were consecutively measured using color-LED, Placido, and dual-Scheimpflug devices. The main outcome measures were anterior corneal power, astigmatism, and higher-order aberrations (HOAs) (6.0 mm pupil), which were compared using the t test. There were no statistically significant differences in corneal power measurements in normal and post-refractive surgery eyes and in astigmatism magnitude in post-refractive surgery eyes between the color-LED device and Placido or dual Scheimpflug devices (all P > .05). In normal eyes, there were no statistically significant differences in 3rd-order coma and 4th-order spherical aberration between the color-LED and Placido devices and in HOA root mean square, 3rd-order coma, 3rd-order trefoil, 4th-order spherical aberration, and 4th-order secondary astigmatism between the color-LED and dual Scheimpflug devices (all P > .05). In post-refractive surgery eyes, the color-LED device agreed with the Placido and dual-Scheimpflug devices regarding 3rd-order coma and 4th-order spherical aberration (all P > .05). In normal and post-refractive surgery eyes, all 3 devices were comparable with respect to corneal power. The agreement in corneal aberrations varied. Drs. Wang, Koch, and Weikert are consultants to Ziemer Ophthalmic Systems AG. Dr. Koch is a consultant to Abbott Medical Optics, Inc., Alcon Surgical, Inc., and i-Optics Corp. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  7. Indication of advanced orthokeratology as an additional treatment after refractive surgeries

    NASA Astrophysics Data System (ADS)

    Mitsui, Iwane; Yamada, Yoshida

    2005-04-01

    Ortho-K was indicated for twenty-three eyes of thirteen patients after refractive surgeries such as RK(1) ,PRK(2), and LASIK(3). The average of their Uncorrective Visual Acuity (UCVA) after surgeries was 20/30 or worse, and mean spherical equivalent (SE) was -2.42D. They were followed at least two years wearing of Advanced Ortho-K lenses during night. The following studies were examined on their auto-refraction, auto-keratometry, uncorrected and corrected visual acuity, intra-ocular pressure, corneal endothelium, corneal thickness, corneal curvature, and corneal shape for more than two years. 95% of the patients improved in UCVA up to 20/20 or better, 86% of them improved up to 20/15 or better, and 76% of them improved up to 20/10. The mean SEs improved to -1.20+/-1.02D during six months, - 1.03+/-0.83D during one year, and -0.73+/-0.64D during two years. Astigmatism also slightly decreased. Ophthalmologic examinations showed no abnormalities including flap formation, intra-ocular pressure, and endothelium. Among the refractive surgeries as well as RK and PRK, LASIK has been most popularly spread all over the world. However, patient's quality of vision is not always satisfied during and/or after refractive surgeries, because of several complications such as instability of flap formation, unexpected keratoectasia, diffuse lamellar keratitis, epithelial ingrowth, irregularity of corneal surface which caused myopia regression. In such cases, additional surgical procedures should not be indicated easily. However, Ortho-K is safe and effective enough to correct refractive errors still remained or re-appeared after refractive surgeries. It enables to restore the corneal irregularity to the ideal shape.

  8. Eye laterality: a comprehensive analysis in refractive surgery candidates.

    PubMed

    Linke, Stephan J; Druchkiv, Vasyl; Steinberg, Johannes; Richard, Gisbert; Katz, Toam

    2013-08-01

    To explore eye laterality (higher refractive error in one eye) and its association with refractive state, spherical/astigmatic anisometropia, age and sex in refractive surgery candidates. Medical records of 12 493 consecutive refractive surgery candidates were filtered. Refractive error (subjective and cycloplegic) was measured in each subject and correlated with eye laterality. Only subjects with corrected distance visual acuity (CDVA) of >20/22 in each eye were enrolled to exclude amblyopia. Associations between eye laterality and refractive state were analysed by means of t-test, chi-squared test, Spearman's correlation and multivariate logistic regression analysis, respectively. There was no statistically significant difference in spherical equivalent between right (-3.47 ± 2.76 D) and left eyes (-3.47 ± 2.76 D, p = 0.510; Pearson's r = 0.948, p < 0.001). Subgroup analysis revealed (I) right eye laterality for anisometropia >2.5 D in myopic (-5.64 ± 2.5 D versus -4.92 ± 2.6 D; p = 0.001) and in hyperopic (4.44 ± 1.69 D versus 3.04 ± 1.79 D; p = 0.025) subjects, (II) a tendency for left eye cylindrical laterality in myopic subjects, and (III) myopic male subjects had a higher prevalence of left eye laterality. (IV) Age did not show any significant impact on laterality. Over the full refractive spectrum, this study confirmed previously described strong interocular refractive correlation but revealed a statistically significant higher rate of right eye laterality for anisometropia >2.5 D. In general, our results support the use of data from one eye only in studies of ocular refraction. © 2013 The Authors. Acta Ophthalmologica © 2013 Acta Ophthalmologica Scandinavica Foundation.

  9. The New Zealand cataract and refractive surgery survey 1997/1998.

    PubMed

    Elder, M; Tarr, K; Leaming, D

    2000-04-01

    This study documents the current practice for cataract and refractive surgery in New Zealand. A postal questionnaire was distributed in late 1997 to all consultant members of the Ophthalmological Society of New Zealand that were resident in the country at that time. Most questions were identical to the 1997 survey of the American Society of Cataract and Refraction Surgeons (ASCRS) to enable a comparison. There were 98 returns from 101 surveys distributed. Of the returns, 72 performed cataract surgery, 23 performed PRK and 11 performed LASIK. ASCRS members did more refractive surgery than did New Zealanders: 28 versus 1% of 1-5 RK per month, 7 versus 1% of 1-2 clear lens extractions per month and 85 versus 51% had access to an excimer laser. For cataract surgery, ASCRS members used more topical anaesthesia (30 vs 5.5%), used no sutures more often (73 vs 51%), used more preoperative antibiotics (76 vs 26%) and used fewer injections of antibiotic/steroids (38 vs 61%). Otherwise the two groups were broadly similar.

  10. Reasons For Not Performing Keratorefractive Surgery in Patients Seeking Refractive Surgery in a Hospital-Based Cohort in “Yemen”

    PubMed Central

    Bamashmus, Mahfouth A.; Saleh, Mahmoud F.; Awadalla, Mohamed A.

    2010-01-01

    Background: To determine and analyze the reasons why keratorefractive surgery, laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) were not performed in patients who presented for refractive surgery consultation. Materials and Methods: A retrospective observational study was performed between January 2006 and December 2007 in the Yemen Magrabi Hospital. The case records of 2,091 consecutive new patients who presented for refractive surgery were reviewed. Information from the pre-operative ophthalmic examination, such as refractive error, corneal topography and visual acuity, were analyzed. The reasons for not performing LASIK and PRK in the cases that were rejected were recorded and analyzed. Results: In this cohort, 1,660 (79.4%) patients were advised to have LASIK or PRK from the 2,091 patients examined. LASIK and PRK were not advised in 431 (21%) patients. The most common reasons for not performing the surgery were high myopia >-11.00 Diopters (19%), keratoconus (18%), suboptimal central corneal thickness (15%), cataract (12%) and keratoconus suspect (forme fruste keratoconus) (10%). Conclusion: Patients who requested keratorefractive surgery have a variety of problems and warrant comprehensive attention to selection criteria on the part of the surgeon. Corneal topographies and pachymetry of refractive surgery candidates need to be read cautiously. High-refractive error, keratoconus and insufficient corneal thickness were found to be the leading reasons for not performing keratorefractive surgery in this study. PMID:21180437

  11. Wavefront coherence area for predicting visual acuity of post-PRK and post-PARK refractive surgery patients

    NASA Astrophysics Data System (ADS)

    Garcia, Daniel D.; van de Pol, Corina; Barsky, Brian A.; Klein, Stanley A.

    1999-06-01

    Many current corneal topography instruments (called videokeratographs) provide an `acuity index' based on corneal smoothness to analyze expected visual acuity. However, post-refractive surgery patients often exhibit better acuity than is predicted by such indices. One reason for this is that visual acuity may not necessarily be determined by overall corneal smoothness but rather by having some part of the cornea able to focus light coherently onto the fovea. We present a new method of representing visual acuity by measuring the wavefront aberration, using principles from both ray and wave optics. For each point P on the cornea, we measure the size of the associated coherence area whose optical path length (OPL), from a reference plane to P's focus, is within a certain tolerance of the OPL for P. We measured the topographies and vision of 62 eyes of patients who had undergone the corneal refractive surgery procedures of photorefractive keratectomy (PRK) and photorefractive astigmatic keratectomy (PARK). In addition to high contrast visual acuity, our vision tests included low contrast and low luminance to test the contribution of the PRK transition zone. We found our metric for visual acuity to be better than all other metrics at predicting the acuity of low contrast and low luminance. However, high contrast visual acuity was poorly predicted by all of the indices we studied, including our own. The indices provided by current videokeratographs sometimes fail for corneas whose shape differs from simple ellipsoidal models. This is the case with post-PRK and post-PARK refractive surgery patients. Our alternative representation that displays the coherence area of the wavefront has considerable advantages, and promises to be a better predictor of low contrast and low luminance visual acuity than current shape measures.

  12. Agreement Between Autorefraction and Subjective Refraction in Keraring-Implanted Keratoconic Eyes.

    PubMed

    Al-Tuwairqi, Waleed S; Ogbuehi, Kelechi C; Razzouk, Haya; Alanazi, Mana A; Osuagwu, Uchechukwu L

    2017-03-01

    To assess the agreement between subjective refraction and autorefraction and to explore the relationship between the magnitude of higher order aberration, and visual acuity and refraction, before and after keraring implantation. This prospective, randomized, interventional study enrolled 27 subjects (mean age 28.1±6.5 years) with keratoconus. Noncycloplegic refraction was performed subjectively by one clinician and with an autorefractor by another clinician, before and 6 months after surgery. The limit of agreement (LoA) between methods was assessed, and the relationships between the corrected distance visual acuity, logMAR on the one hand and refraction measurements and higher-order aberrations on the other, were examined. The agreement in mean spherical equivalent refraction (MSER) between methods was good postoperatively but poor preoperatively. The autorefractor gave a more myopic refraction than subjective refraction preoperatively (-3.28±3.06 D; LoA -9.27 to +2.71 D, P<0.0001) and postoperatively (-0.63±1.64 D; LoA -3.85 to +2.58 D, P=0.055), and returned higher negative cylinders preoperatively (-1.10±1.17 D; LoA -3.40 to +1.19 D, P<0.0001) and postoperatively (-1.08±1.27 D; LoA -3.60 to +1.41 D, P<0.0001) in keratoconic eyes. The difference in MSER between methods was significantly related to the refractive error at both visits (P<0.05) and to the magnitude of higher-order aberrations in keratoconic eyes preoperatively (P<0.05). The logMAR visual acuity achieved subjectively worsened as the magnitude of higher-order aberrations increased preoperatively (P<0.001). The autorefractor returns values that are significantly more myopic in MSER and higher negative cylinders than subjective refraction, preoperatively, but the MSER was similar between devices postoperatively. The autorefactor seems a valid starting point for subjective refraction in keratoconic eyes treated with keraring, but the cylinder should be corrected by about +1 D. The instruments agree

  13. Topical cyclosporine a treatment in corneal refractive surgery and patients with dry eye.

    PubMed

    Torricelli, Andre A M; Santhiago, Marcony R; Wilson, Steven E

    2014-08-01

    To evaluate preoperative and postoperative dry eye and the effect of cyclosporine A treatment in patients screened for corneal refractive surgery and treated with photorefractive keratectomy (PRK) or LASIK. A consecutive case series of 1,056 patients screened for corneal refractive surgery from 2007 to 2012 was retrospectively analyzed. The level of preoperative and postoperative dry eye and the responsiveness to topical cyclosporine A treatment were assessed. One eye of each patient was randomly selected. A total of 642 eyes progressed to surgery: 524 (81.6%) and 118 (18.4%) underwent LASIK and PRK, respectively. Of 81 (7.7%) diagnosed as having dry eye, 55 were deemed potential candidates and optimized for refractive surgery. Thirty-seven patients with moderate dry eye were treated with topical cyclosporine A prior to surgery (mean duration: 3.2 ± 2.1 months; range: 1 to 12 months). After cyclosporine A treatment, 28 (75.7%) eyes underwent LASIK, 4 (10.8%) eyes underwent PRK, and 5 (13.5%) eyes were not operated on due to failed treatment of dry eye. Postoperative refractive surgery-induced neurotrophic epitheliopathy (LINE in LASIK) was noted in 132 (27.3%) and 12 (11.1%) eyes that underwent LASIK and PRK, respectively. Topical cyclosporine A was prescribed in 79 LASIK-induced and 3 PRK-induced dry eyes. After 12 months or more of cyclosporine A treatment, 5 (6.1%) eyes continued to have dry eye symptoms or signs. Topical cyclosporine A treatment is effective therapy for optimizing patients for refractive surgery and treatment of new onset or worsened dry eye after surgery. Copyright 2014, SLACK Incorporated.

  14. Seven-year changes in corneal power and aberrations after PRK or LASIK.

    PubMed

    Ivarsen, Anders; Hjortdal, Jesper

    2012-09-06

    To examine long-term changes in corneal power and aberrations in myopic patients randomized to photorefractive keratectomy (PRK) or laser in situ keratomileusis (LASIK). Forty-five patients with myopia from -6 to -8 diopters (spherical equivalent refraction) were randomized to PRK (n = 20) or LASIK (n = 25). Patients were examined preoperatively and for up to 7 years after surgery. Measurements included refraction, topography (TMS-1), and ultrasound pachymetry. By 3 years, 16 PRK and 15 LASIK patients were examined and by 7 years, 9 PRK and 7 LASIK subjects were available. Only patients who had not been reoperated and attended the two late controls were included in data analyses. Optical analysis of topographic data was used to calculate corneal power and wavefront aberrations. PRK and LASIK caused a similar reduction in corneal power. During the first year after PRK, corneal power increased, but remained stable from 1 to 7 years. In contrast, corneal power continued to increase from 1 to 7 years after LASIK. Both PRK and LASIK caused an increase in coma-like and spherical aberrations that remained constant for 7 years. No significant changes in other higher-order aberrations were observed. The cornea may not be stable even 7 years after LASIK, as indicated by the continuing increase in corneal power. In contrast, PRK appears stable from 1 year post surgery. Coma-like and spherical aberrations are permanently increased after PRK and LASIK. (ClinicalTrials.gov number, NCT00404105.).

  15. [Complications after refractive surgery abroad].

    PubMed

    Terzi, E; Kern, T; Kohnen, T

    2008-05-01

    In this article a retrospective analysis of patients presenting at a German university following refractive surgery abroad is presented. A total of 20 cases of patients who had undergone treatment between 1998 and 2006 in China (1 case), Greece (1 case), Iran (1 case), Russia (2 cases), Switzerland (1 case), Slovakia (1 case), Spain (2 cases), South Africa (3 cases), Turkey (6 cases) and the USA (2 cases) were analyzed retrospectively. The following complications were observed: epithelial ingrowth into the interface with or without melting of the flap (6 cases), corneal ectasia (2 cases), dislocation of a phakic posterior chamber intraocular lens and prolapse into the anterior chamber with endothelial cell loss (1 case), secondary increase of intraocular pressure following implantation of a phakic intraocular lens (1 case), flap-related complications following laser-in-situ keratomileusis (LASIK) (2 cases), keratitis (1 case), dislocation of the complete flap (1 case), diffuse lamellar keratitis (DLK) grade IV (1 case), hyperopia as a consequence of radial keratotomy (1 case), and under correction/over correction and poor optical quality following laser epithelial keratomileusis (LASEK) and LASIK for high myopia (5 cases) with possible early corneal ectasia. There are four important problems arising from refractive surgery abroad, often referred to as "LASIK tourism": wrong indications, insufficient management of complications, lack of postoperative care and the health economic aspect.

  16. A Multicenter Retrospective Survey of Refractive Surgery in 78,248 Eyes.

    PubMed

    Kamiya, Kazutaka; Igarashi, Akihito; Hayashi, Ken; Negishi, Kazuno; Sato, Masaki; Bissen-Miyajima, Hiroko

    2017-09-01

    To retrospectively evaluate the current practice, trends, and outcomes of refractive surgery in Japan. This multicenter survey comprised 78,248 eyes of 39,727 consecutive patients who underwent refractive surgery at 45 major institutions in Japan. The corresponding ophthalmologists responded to a selfadministered questionnaire. The authors especially evaluated the safety, efficacy, predictability, stability, and adverse events of LASIK and phakic intraocular lens (IOL) implantation 3 months postoperatively. The most common refractive surgery was LASIK (90.9%), followed by corneal inlay (5.0%), posterior chamber phakic IOL implantation (1.3%), laser-assisted subepithelial keratomileusis (1.0%), refractive lens exchange (0.9%), photorefractive keratectomy (0.3%), and refractive lenticule extraction (0.2%). For subgroup analysis, 69,987 eyes (99.5%) and 67,512 eyes (95.9%) achieved corrected and uncorrected distance visual acuity of 20/20 or better, respectively, after LASIK, and 935 eyes (98.8%) and 890 eyes (94.1%), respectively, after phakic IOL implantation. There were 69,176 eyes (98.3%) and 908 eyes (96.0%) within ±1.00 diopter (D) of the attempted correction after LASIK and phakic IOL implantation, respectively. There were 1,926 eyes (2.7%) and 1 eye (0.1%) with changes in refraction of 1.00 D or less from 1 week to 3 months after LASIK and phakic IOL implantation, respectively. No vision-threatening complications occurred in any case. According to this survey, LASIK remains the most prevalent surgical technique in Japan. Both LASIK and phakic IOL implantation offered good safety and efficacy outcomes, yielding predictable and stable results. [J Refract Surg. 2017;33(9):598-602.]. Copyright 2017, SLACK Incorporated.

  17. Ray tracing matrix approach for refractive index mismatch aberrations in confocal microscopy.

    PubMed

    Nastyshyn, S Yu; Bolesta, I M; Lychkovskyy, E; Vankevych, P I; Yakovlev, M Yu; Pansu, B; Nastishin, Yu A

    2017-03-20

    The 2×2 ray tracing matrix (RTM) method is employed for the description of optical aberrations caused by the refractive index mismatch (RIM) in fluorescent confocal polarization microscopy. We predict and experimentally confirm that due to the RIM a liquid crystal layer with highly non-uniform director distribution appears to be imaged as a layer with non-uniform thickness, which shows up in the roughness of the rear surface. For the off-axial focusing of the probing beam in a droplet dispersed in an immiscible liquid, we have developed an extended method still keeping the 2×2 dimensionality of the RTM.

  18. A Novel Laser Refractive Surgical Treatment for Presbyopia: Optics-Based Customization for Improved Clinical Outcome.

    PubMed

    Pajic, Bojan; Pajic-Eggspuehler, Brigitte; Mueller, Joerg; Cvejic, Zeljka; Studer, Harald

    2017-06-13

    Laser Assisted in Situ Keratomileusis (LASIK) is a proven treatment method for corneal refractive surgery. Surgically induced higher order optical aberrations were a major reason why the method was only rarely used to treat presbyopia, an age-related near-vision loss. In this study, a novel customization algorithm for designing multifocal ablation patterns, thereby minimizing induced optical aberrations, was used to treat 36 presbyopic subjects. Results showed that most candidates went from poor visual acuity to uncorrected 20/20 vision or better for near (78%), intermediate (92%), and for distance (86%) vision, six months after surgery. All subjects were at 20/25 or better for distance and intermediate vision, and a majority (94%) were also better for near vision. Even though further studies are necessary, our results suggest that the employed methodology is a safe, reliable, and predictable refractive surgical treatment for presbyopia.

  19. [Advocating standardization and customization of corneal refractive surgery in Chinese domestic situation].

    PubMed

    Zhang, F J; Song, Y Z

    2016-07-01

    With the improvement and application of excimer laser and femtosecond laser equipment in clinical ophthalmology, the diversified strategies for corneal refractive surgery candidates have been provided. Based on the trend of " all-laser treatment", it is very necessary to take the domestic situation into consideration when a standard and customized choice is made according to the indications of each specific surgical type. The characteristics and limitations of various surgeries are elucidated and commented here in order to provide some reasonable treatment options for refractive surgery. (Chin J Ophthalmol, 2016, 52: 481-485).

  20. The use of WaveLight® Contoura to create a uniform cornea: the LYRA Protocol. Part 1: the effect of higher-order corneal aberrations on refractive astigmatism.

    PubMed

    Motwani, Manoj

    2017-01-01

    To demonstrate how higher-order corneal aberrations can cancel out, modify, or induce lower-order corneal astigmatism. Six representative eyes are presented that show different scenarios in which higher-order aberrations interacting with corneal astigmatism can affect the manifest refraction. WaveLight ® Contoura ablation maps showing the higher-order aberrations are shown, as are results of correction with full measured correction using the LYRA (Layer Yolked Reduction of Astigmatism) Protocol. Higher-order corneal aberrations such as trefoil, quadrafoil, and coma can create ovalization of the central cornea, which can interact with the ovalization caused by lower-order astigmatism to either induce, cancel out, or modify the manifest refraction. Contoura processing successfully determines the linkage of these interactions resulting in full astigmatism removal. Purely lenticular astigmatism appears to be rare, but a case is also demonstrated. The author theorizes that all aberrations require cerebral compensatory processing and can be removed, supported by the facts that full removal of aberrations and its linkage with lower-order astigmatism with the LYRA Protocol has not resulted in worse or unacceptable vision for any patients. Higher-order aberrations interacting with lower-order astigmatism is the main reason for the differences between manifest refraction and Contoura measured astigmatism, and the linkage between these interactions can be successfully treated using Contoura and the LYRA Protocol. Lenticular astigmatism is relatively rare.

  1. Intraocular lens calculation adjustment after laser refractive surgery using Scheimpflug imaging.

    PubMed

    Schuster, Alexander K; Schanzlin, David J; Thomas, Karin E; Heichel, Christopher W; Purcell, Tracy L; Barker, Patrick D

    2016-02-01

    To test a new method of intraocular lens (IOL) calculation after corneal refractive surgery using Scheimpflug imaging (Pentacam HR) and partial coherence interferometry (PCI) (IOLMaster) that does not require historical data; that is, the Schuster/Schanzlin-Thomas-Purcell (SToP) IOL calculator. Shiley Eye Center, San Diego, California, and Walter Reed National Military Medical Center, Bethesda, Maryland, USA. Retrospective data analysis and validation study. Data were retrospectively collected from patient charts including data from Scheimpflug imaging and refractive history. Target refraction was calculated using PCI and the Holladay 1 and SRK/T formulas. Regression analysis was performed to explain the deviation of the target refraction, taking into account the following influencing factors: ratio of posterior-to-anterior corneal radius, axial length (AL), and anterior corneal radius. The regression analysis study included 61 eyes (39 patients) that had laser in situ keratomileusis (57 eyes) or photorefractive keratectomy (4 eyes) and subsequent cataract. Two factors were found that explained the deviation of the target refraction using the Holladay 1 formula; that is, the ratio of the corneal radii and the AL and the ratio of corneal radii for the SRK/T formula. A new IOL adjustment calculator was derived and validated at a second center using 14 eyes (10 patients). The error in IOL calculation for normal eyes after laser refractive treatment was related to the ratio of posterior-to-anterior corneal radius. A formula requiring Scheimpflug data and suggested IOL power only yielded an improved postoperative result for patients with previous corneal laser refractive surgery having cataract surgery. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. All rights reserved.

  2. Prevalence of laser vision correction in ophthalmologists who perform refractive surgery.

    PubMed

    Kezirian, Guy M; Parkhurst, Gregory D; Brinton, Jason P; Norden, Richard A

    2015-09-01

    To determine the prevalence of laser corneal refractive surgery (laser vision correction [LVC]) among ophthalmologists who perform these procedures and to assess the willingness of these ophthalmologists to recommend LVC to immediate family members. Online survey with results analyzed at Surgivision Consultants, Inc., Scottsdale, Arizona, USA. Prospective randomized questionnaire study. The 22-question Global Survey on Refractive Surgery in Refractive Surgeons was sent by e-mail to 250 ophthalmologists randomly selected from a database of 2441 ophthalmologists known to have performed LVC at some point in the past decade. Responses were solicited by e-mail, with subsequent telephone reminders to nonresponders. Responses were received from 248 (99.2%) of 250 queried individuals, of which 232 (92.8%) met the protocol criteria of currently working as refractive surgeons. Of the 232 subjects, 161 (69.4%) reported that they had refractive errors potentially amenable to treatment with LVC, not including presbyopia. Of the 161 ophthalmologists with treatable refractive errors, 54 (33.5%) reported they were not candidates for LVC for a variety of reasons and 107 (66.5%) reported they were candidates for LVC. Of the LVC candidates, 62.6% reported that they had an LVC procedure in their own eyes. Of the overall 232 subjects, more than 90% recommend LVC for adult members of their immediate family. Ophthalmologists who perform LVC were significantly more likely than the general population to have LVC in their own eyes. The prevalence of refractive errors was significantly higher among ophthalmologists performing refractive surgery than in the general population. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  3. The use of WaveLight® Contoura to create a uniform cornea: the LYRA Protocol. Part 1: the effect of higher-order corneal aberrations on refractive astigmatism

    PubMed Central

    Motwani, Manoj

    2017-01-01

    Purpose To demonstrate how higher-order corneal aberrations can cancel out, modify, or induce lower-order corneal astigmatism. Patients and methods Six representative eyes are presented that show different scenarios in which higher-order aberrations interacting with corneal astigmatism can affect the manifest refraction. WaveLight® Contoura ablation maps showing the higher-order aberrations are shown, as are results of correction with full measured correction using the LYRA (Layer Yolked Reduction of Astigmatism) Protocol. Results Higher-order corneal aberrations such as trefoil, quadrafoil, and coma can create ovalization of the central cornea, which can interact with the ovalization caused by lower-order astigmatism to either induce, cancel out, or modify the manifest refraction. Contoura processing successfully determines the linkage of these interactions resulting in full astigmatism removal. Purely lenticular astigmatism appears to be rare, but a case is also demonstrated. The author theorizes that all aberrations require cerebral compensatory processing and can be removed, supported by the facts that full removal of aberrations and its linkage with lower-order astigmatism with the LYRA Protocol has not resulted in worse or unacceptable vision for any patients. Conclusion Higher-order aberrations interacting with lower-order astigmatism is the main reason for the differences between manifest refraction and Contoura measured astigmatism, and the linkage between these interactions can be successfully treated using Contoura and the LYRA Protocol. Lenticular astigmatism is relatively rare. PMID:28553069

  4. A Novel Laser Refractive Surgical Treatment for Presbyopia: Optics-Based Customization for Improved Clinical Outcome

    PubMed Central

    Pajic, Bojan; Pajic-Eggspuehler, Brigitte; Mueller, Joerg; Cvejic, Zeljka; Studer, Harald

    2017-01-01

    Laser Assisted in Situ Keratomileusis (LASIK) is a proven treatment method for corneal refractive surgery. Surgically induced higher order optical aberrations were a major reason why the method was only rarely used to treat presbyopia, an age-related near-vision loss. In this study, a novel customization algorithm for designing multifocal ablation patterns, thereby minimizing induced optical aberrations, was used to treat 36 presbyopic subjects. Results showed that most candidates went from poor visual acuity to uncorrected 20/20 vision or better for near (78%), intermediate (92%), and for distance (86%) vision, six months after surgery. All subjects were at 20/25 or better for distance and intermediate vision, and a majority (94%) were also better for near vision. Even though further studies are necessary, our results suggest that the employed methodology is a safe, reliable, and predictable refractive surgical treatment for presbyopia. PMID:28608800

  5. Peripheral refraction and higher-order aberrations with cycloplegia and fogging lenses using the BHVI-EyeMapper

    PubMed Central

    Bakaraju, Ravi Chandra; Fedtke, Cathleen; Ehrmann, Klaus; Falk, Darrin; Thomas, Varghese; Holden, Brien Anthony

    2015-01-01

    Purpose To determine if a fogging lens ameliorates accommodative effects driven by the closed-view design of the BHVI-EyeMapper (EM) instrument. We compared cycloplegic refraction and higher-order aberration measurements of the EM with those obtained with a fogging lens. Methods Twenty-six, young, participants (15F, 25 ± 5 years, range: 18–35 years, SE: +0.25 D and −3.50 D) with good ocular health were recruited. Five independent measurements of on- and off-axis refraction and higher-order aberrations were recorded across the horizontal visual field, under two conditions: non-cycloplegic measurements with +1.00 D fogging lens and cycloplegia, always in the same sequence. The contralateral eye was occluded during the measurements. Two drops of 1% Tropicamide delivered within 5 min facilitated cycloplegic measurements. All participants were refracted 30 min after installation of the second drop. Results Mean spherical equivalent measures of the non-cycloplegic condition were significantly more myopic than their cycloplegic counterparts (p < 0.05); approximately by 0.50 D centrally, increasing to 1.00 D towards the periphery. The horizontal astigmatic component, J180, demonstrated small but statistically significant differences between the test conditions. Differences were predominant for eccentricities greater than 30°, in both nasal and temporal meridians. The oblique astigmatic component, J45, was not significantly different between the test conditions. The primary spherical aberration coefficient C(4, 0) was significantly less positive for the non-cycloplegic state than its cycloplegic counterpart. This result held true across the entire horizontal visual field. The horizontal coma and trefoil coefficients C(3, 1) and C(3, 3) were not significantly different between the two conditions. Conclusions The use of +1.00 D fogging lens without cycloplegia did not provide complete relaxation of accommodation. The discrepancies between cycloplegic and non

  6. Peripheral refraction and higher-order aberrations with cycloplegia and fogging lenses using the BHVI-EyeMapper.

    PubMed

    Bakaraju, Ravi Chandra; Fedtke, Cathleen; Ehrmann, Klaus; Falk, Darrin; Thomas, Varghese; Holden, Brien Anthony

    2016-01-01

    To determine if a fogging lens ameliorates accommodative effects driven by the closed-view design of the BHVI-EyeMapper (EM) instrument. We compared cycloplegic refraction and higher-order aberration measurements of the EM with those obtained with a fogging lens. Twenty-six, young, participants (15F, 25±5 years, range: 18-35 years, SE: +0.25 D and -3.50 D) with good ocular health were recruited. Five independent measurements of on- and off-axis refraction and higher-order aberrations were recorded across the horizontal visual field, under two conditions: non-cycloplegic measurements with +1.00 D fogging lens and cycloplegia, always in the same sequence. The contralateral eye was occluded during the measurements. Two drops of 1% Tropicamide delivered within 5 min facilitated cycloplegic measurements. All participants were refracted 30 min after installation of the second drop. Mean spherical equivalent measures of the non-cycloplegic condition were significantly more myopic than their cycloplegic counterparts (p<0.05); approximately by 0.50 D centrally, increasing to 1.00 D towards the periphery. The horizontal astigmatic component, J180, demonstrated small but statistically significant differences between the test conditions. Differences were predominant for eccentricities greater than 30°, in both nasal and temporal meridians. The oblique astigmatic component, J45, was not significantly different between the test conditions. The primary spherical aberration coefficient C(4, 0) was significantly less positive for the non-cycloplegic state than its cycloplegic counterpart. This result held true across the entire horizontal visual field. The horizontal coma and trefoil coefficients C(3, 1) and C(3, 3) were not significantly different between the two conditions. The use of +1.00 D fogging lens without cycloplegia did not provide complete relaxation of accommodation. The discrepancies between cycloplegic and non-cycloplegic EM measurements were found to be more

  7. Simplified mathematics for customized refractive surgery.

    PubMed

    Preussner, Paul Rolf; Wahl, Jochen

    2003-03-01

    To describe a simple mathematical approach to customized corneal refractive surgery or customized intraocular lens (IOL) design that allows "hypervision" and to investigate the accuracy limits. University eye hospital, Mainz, Germany. Corneal shape and at least 1 IOL surface are approximated by the well-known Cartesian conic section curves (ellipsoid, paraboloid, or hyperboloid). They are characterized by only 2 parameters, the vertex radius and the numerical eccentricity. Residual refraction errors for this approximation are calculated by numerical ray tracing. These errors can be displayed as a 2-dimensional refraction map across the pupil or by blurring the image of a Landolt ring superimposed on the retinal receptor grid, giving an overall impression of the visual outcome. If the eye is made emmetropic for paraxial rays and if the numerical eccentricities of the cornea and lens are appropriately fitted to each other, the residual refractive errors are small enough to allow hypervision. Visual acuity of at least 2.0 (20/10) appears to be possible, particularly for mesopic pupil diameters. However, customized optics may have limited application due to their sensitivity to misalignment errors such as decentrations or rotations. The mathematical approach described by Descartes 350 years ago is adequate to calculate hypervision optics for the human eye. The availability of suitable mathematical tools should, however, not be viewed with too much optimism as long as the accuracy of the implementation in surgical procedures is limited.

  8. One-year refractive results, contrast sensitivity, high-order aberrations and complications after myopic small-incision lenticule extraction (ReLEx SMILE).

    PubMed

    Sekundo, Walter; Gertnere, Jana; Bertelmann, Thomas; Solomatin, Igor

    2014-05-01

    To report one year results of the first cohort of routine refractive lenticule extraction through a small incision (ReLEx SMILE) for correction of myopia and myopic astigmatism. Fifty-four eyes of 27 patients with spherical equivalent of -4.68 ± 1.29D who underwent routine ReLEx SMILE by a single surgeon were prospectively followed-up for 1 year. We used the VisuMax femtosecond laser system (Carl Zeiss Meditec AG, Germany) with a 500 kHz repetition rate. Folow-up intervals were at 1 day, 1 week, 1, 3, 6, and 12 months after surgery. We obtained following parameters: uncorrected (UDVA) and distance-corrected visual acuity (CDVA), contrast sensitivity, and wave front measurements. We also recorded all complications. Because of suction loss in one eye, 12-month results were obtained in 53 eyes as follows. After 1 year, 88% of eyes with plano target had an UDVA of 20/20 or better. Twelve percent of eyes lost 1 line of CDVA, while 31% gained 1 line and 3% gained 2 lines. The mean SE after 1 year was -0.19 ± 0.19. The mean refraction change between month 1 and 12 was 0.08 D. Neither mesopic nor photopic contrast sensitivity showed any significant changes. The high-order aberrations (HOA) increased from 0.17 to 0.27 μm (Malacara notation). No visually threatening complications were observed. In this first cohort, ReLEx SMILE produced satisfactory refractive outcomes with moderate induction of HOA and unaffected contrast sensitivity after 1 year.

  9. Risk assessment for ectasia after corneal refractive surgery.

    PubMed

    Randleman, J Bradley; Woodward, Maria; Lynn, Michael J; Stulting, R Doyle

    2008-01-01

    To analyze the epidemiologic features of ectasia after excimer laser corneal refractive surgery, to identify risk factors for its development, and to devise a screening strategy to minimize its occurrence. Retrospective comparative and case-control study. All cases of ectasia after excimer laser corneal refractive surgery published in the English language with adequate information available through December 2005, unpublished cases seeking treatment at the authors' institution from 1998 through 2005, and a contemporaneous control group who underwent uneventful LASIK and experienced a normal postoperative course. Evaluation of preoperative characteristics, including patient age, gender, spherical equivalent refraction, pachymetry, and topographic patterns; perioperative characteristics, including type of surgery performed, flap thickness, ablation depth, and residual stromal bed (RSB) thickness; and postoperative characteristics including time to onset of ectasia. Development of postoperative corneal ectasia. There were 171 ectasia cases, including 158 published cases and 13 unpublished cases evaluated at the authors' institution. Ectasia occurred after LASIK in 164 cases (95.9%) and after photorefractive keratectomy (PRK) in 7 cases (4.1%). Compared with controls, more ectasia cases had abnormal preoperative topographies (35.7% vs. 0%; P<1.0x10(-15)), were significantly younger (34.4 vs. 40.0 years; P<1.0x10(-7)), were more myopic (-8.53 vs. -5.09 diopters; P<1.0x10(-7)), had thinner corneas before surgery (521.0 vs. 546.5 microm; P<1.0x10(-7)), and had less RSB thickness (256.3 vs. 317.3 microm; P<1.0x10(-10)). Based on subgroup logistic regression analysis, abnormal topography was the most significant factor that discriminated cases from controls, followed by RSB thickness, age, and preoperative corneal thickness, in that order. A risk factor stratification scale was created, taking all recognized risk factors into account in a weighted fashion. This model had a

  10. SMILE and Wavefront-Guided LASIK Out-Compete Other Refractive Surgeries in Ameliorating the Induction of High-Order Aberrations in Anterior Corneal Surface

    PubMed Central

    2016-01-01

    Purpose. To compare the change of anterior corneal higher-order aberrations (HOAs) after laser in situ keratomileusis (LASIK), wavefront-guided LASIK with iris registration (WF-LASIK), femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK), and small incision lenticule extraction (SMILE). Methods. In a prospective study, 82 eyes underwent LASIK, 119 eyes underwent WF-LASIK, 88 eyes underwent FS-LASIK, and 170 eyes underwent SMILE surgery. HOAs were measured with Pentacam device preoperatively and 6 months after surgery. The aberrations were described as Zernike polynomials, and analysis focused on total HOAs, spherical aberration (SA), horizontal coma, and vertical coma over 6 mm diameter central corneal zone. Results. Six months postoperatively, all procedures result in increase of anterior corneal total HOAs and SA. There were no significant differences in the induced HOAs between LASIK and FS-LASIK, while SMILE induced fewer total HOAs and SA compared with LASIK and FS-LASIK. Similarly, WF-LASIK also induced less total HOAs than LASIK and FS-LASIK, but only fewer SA than FS-LASIK (P < 0.05). No significant difference could be detected in the induced total HOAs and SA between SMILE and WF-LASIK, whereas SMILE induced more horizontal coma and vertical coma compared with WF-LASIK (P < 0.05). Conclusion. FS-LASIK and LASIK induced comparable anterior corneal HOAs. Compared to LASIK and FS-LASIK, both SMILE and WF-LASIK showed advantages in inducing less total HOAs. In addition, SMILE also possesses better ability to reduce the induction of SA in comparison with LASIK and FS-LASIK. However, SMILE induced more horizontal coma and vertical coma compared with WF-LASIK, indicating that the centration of SMILE procedure is probably less precise than WF-LASIK. PMID:27818792

  11. Wave aberrations in rhesus monkeys with vision-induced ametropias

    PubMed Central

    Ramamirtham, Ramkumar; Kee, Chea-su; Hung, Li-Fang; Qiao-Grider, Ying; Huang, Juan; Roorda, Austin; Smith, Earl L.

    2007-01-01

    The purpose of this study was to investigate the relationship between refractive errors and high-order aberrations in infant rhesus monkeys. Specifically, we compared the monochromatic wave aberrations measured with a Shack-Hartman wavefront sensor between normal monkeys and monkeys with vision-induced refractive errors. Shortly after birth, both normal monkeys and treated monkeys reared with optically induced defocus or form deprivation showed a decrease in the magnitude of high-order aberrations with age. However, the decrease in aberrations was typically smaller in the treated animals. Thus, at the end of the lens-rearing period, higher than normal amounts of aberrations were observed in treated eyes, both hyperopic and myopic eyes and treated eyes that developed astigmatism, but not spherical ametropias. The total RMS wavefront error increased with the degree of spherical refractive error, but was not correlated with the degree of astigmatism. Both myopic and hyperopic treated eyes showed elevated amounts of coma and trefoil and the degree of trefoil increased with the degree of spherical ametropia. Myopic eyes also exhibited a much higher prevalence of positive spherical aberration than normal or treated hyperopic eyes. Following the onset of unrestricted vision, the amount of high-order aberrations decreased in the treated monkeys that also recovered from the experimentally induced refractive errors. Our results demonstrate that high-order aberrations are influenced by visual experience in young primates and that the increase in high-order aberrations in our treated monkeys appears to be an optical byproduct of the vision-induced alterations in ocular growth that underlie changes in refractive error. The results from our study suggest that the higher amounts of wave aberrations observed in ametropic humans are likely to be a consequence, rather than a cause, of abnormal refractive development. PMID:17825347

  12. Theoretical investigation of aberrations upon ametropic human eyes

    NASA Astrophysics Data System (ADS)

    Tan, Bo; Chen, Ying-Ling; Lewis, J. W. L.; Baker, Kevin

    2003-11-01

    The human eye aberrations are important for visual acuity and ophthalmic diagnostics and surgical procedures. Reported monochromatic aberration data of the normal 20/20 human eyes are scarce. There exist even fewer reports of the relation between ametropic conditions and aberrations. We theoretically investigate the monochromatic and chromatic aberrations of human eyes for refractive errors of -10 to +10 diopters. Schematic human eye models are employed using optical design software for axial, index, and refractive types of ametropia.

  13. Is an objective refraction optimised using the visual Strehl ratio better than a subjective refraction?

    PubMed

    Hastings, Gareth D; Marsack, Jason D; Nguyen, Lan Chi; Cheng, Han; Applegate, Raymond A

    2017-05-01

    To prospectively examine whether using the visual image quality metric, visual Strehl (VSX), to optimise objective refraction from wavefront error measurements can provide equivalent or better visual performance than subjective refraction and which refraction is preferred in free viewing. Subjective refractions and wavefront aberrations were measured on 40 visually-normal eyes of 20 subjects, through natural and dilated pupils. For each eye a sphere, cylinder, and axis prescription was also objectively determined that optimised visual image quality (VSX) for the measured wavefront error. High contrast (HC) and low contrast (LC) logMAR visual acuity (VA) and short-term monocular distance vision preference were recorded and compared between the VSX-objective and subjective prescriptions both undilated and dilated. For 36 myopic eyes, clinically equivalent (and not statistically different) HC VA was provided with both the objective and subjective refractions (undilated mean ± S.D. was -0.06 ± 0.04 with both refractions; dilated was -0.05 ± 0.04 with the objective, and -0.05 ± 0.05 with the subjective refraction). LC logMAR VA provided by the objective refraction was also clinically equivalent and not statistically different to that provided by the subjective refraction through both natural and dilated pupils for myopic eyes. In free viewing the objective prescription was preferred over the subjective by 72% of myopic eyes when not dilated. For four habitually undercorrected high hyperopic eyes, the VSX-objective refraction was more positive in spherical power and VA poorer than with the subjective refraction. A method of simultaneously optimising sphere, cylinder, and axis from wavefront error measurements, using the visual image quality metric VSX, is described. In myopic subjects, visual performance, as measured by HC and LC VA, with this VSX-objective refraction was found equivalent to that provided by subjective refraction, and was typically preferred

  14. Is an objective refraction optimised using the visual Strehl ratio better than a subjective refraction?

    PubMed Central

    Hastings, Gareth D.; Marsack, Jason D.; Nguyen, Lan Chi; Cheng, Han; Applegate, Raymond A.

    2017-01-01

    Purpose To prospectively examine whether using the visual image quality metric, visual Strehl (VSX), to optimise objective refraction from wavefront error measurements can provide equivalent or better visual performance than subjective refraction and which refraction is preferred in free viewing. Methods Subjective refractions and wavefront aberrations were measured on 40 visually-normal eyes of 20 subjects, through natural and dilated pupils. For each eye a sphere, cylinder, and axis prescription was also objectively determined that optimised visual image quality (VSX) for the measured wavefront error. High contrast (HC) and low contrast (LC) logMAR visual acuity (VA) and short-term monocular distance vision preference were recorded and compared between the VSX-objective and subjective prescriptions both undilated and dilated. Results For 36 myopic eyes, clinically equivalent (and not statistically different) HC VA was provided with both the objective and subjective refractions (undilated mean ±SD was −0.06 ±0.04 with both refractions; dilated was −0.05 ±0.04 with the objective, and −0.05 ±0.05 with the subjective refraction). LC logMAR VA provided by the objective refraction was also clinically equivalent and not statistically different to that provided by the subjective refraction through both natural and dilated pupils for myopic eyes. In free viewing the objective prescription was preferred over the subjective by 72% of myopic eyes when not dilated. For four habitually undercorrected high hyperopic eyes, the VSX-objective refraction was more positive in spherical power and VA poorer than with the subjective refraction. Conclusions A method of simultaneously optimising sphere, cylinder, and axis from wavefront error measurements, using the visual image quality metric VSX, is described. In myopic subjects, visual performance, as measured by HC and LC VA, with this VSX-objective refraction was found equivalent to that provided by subjective refraction

  15. Optical Coherence Tomography Accurately Measures Corneal Power Change From Laser Refractive Surgery

    PubMed Central

    McNabb, Ryan P.; Farsiu, Sina; Stinnett, Sandra S.; Izatt, Joseph A.; Kuo, Anthony N.

    2014-01-01

    Purpose To determine the ability of motion corrected optical coherence tomography (OCT) to measure the corneal refractive power change due to laser in situ keratomileusis (LASIK). Design Evaluation of a diagnostic test or technology in a cohort. Subjects 70 eyes from 37 subjects undergoing LASIK were measured preoperatively. 39 eyes from 22 subjects were measured postoperatively and completed the study. Methods Consecutive patients undergoing LASIK at the Duke Eye Center who consented to participate were imaged with Placido-ring topography, Scheimpflug photography and OCT on the day of their surgery. Patients were then reimaged with the same imaging systems at the post-operative month 3 visit. Change in pre- to post-operative corneal refractive power as measured by each of the imaging modalities was compared to the pre- to post-operative change in manifest refraction using t-test with generalized estimating equations. Main Outcome Measures Corneal refractive power change due to LASIK as measured by Placido-ring topography, Scheimpflug Photography, and OCT compared to the manifest refraction change vertexed to the corneal plane. The change in manifest refraction should correspond to the change in the corneal refractive power from LASIK and was considered the reference measurement. Results In 22 returning post-LASIK individuals (39 eyes), we found no significant difference between the clinically measured pre to post LASIK change in manifest refraction and both Scheimpflug photography (p = 0.714) and OCT (p = 0.216). In contrast, keratometry values from Placido-ring topography were found to be significantly different from the measured refractive change (p < 0.001). Additionally, of the three imaging modalities, OCT recorded the smallest mean absolute difference from the reference measurement with the least amount of variability. Conclusion Motion corrected OCT more accurately measures the change in corneal refractive power due to laser refractive surgery than

  16. Changes in Keratometric Values and Corneal High Order Aberrations After Hydrogel Inlay Implantation.

    PubMed

    Whang, Woong-Joo; Yoo, Young-Sik; Joo, Choun-Ki; Yoon, Geunyoung

    2017-01-01

    We sought to analyze surgically induced refractive change (SIRC) and change in high-order aberration after Raindrop corneal inlay insertion (ReVision Optics, Lake Forest, CA), and assess the extent to which Raindrop corneal inlay insertion could correct presbyopia. Interventional case series. Seventeen patients were included if they had a corneal thickness ≥500 μm and a stable manifest spherical equivalent refraction between 0.50 and +1.00 diopters (D). The Raindrop corneal inlay was implanted on the stromal bed of a femtosecond laser-assisted generated flap of nondominant eyes. Manifest refraction, corneal powers, and corneal high-order aberrations were measured preoperatively and at 3 and 12 months postoperatively. The SIRC by manifest refraction was 0.99 ± 0.26 D. The changes derived from simulated keratometry (K), true net power, and equivalent K reading (EKR) at 1.0-4.0 mm were greater than the SIRC (all P < .01) while the change in EKR at 6.0 mm was less than the SIRC (P < .01). The changes in EKR 5.0 mm, automated K, and EKR 4.5 mm did not differ significantly from the SIRC (P = .81, .29, and .09, respectively), and the difference was the least for EKR 5.0 mm. In analysis of high-order aberrations, only spherical aberration showed statistically significant difference between preoperative and postoperative on both anterior cornea and total cornea (all P < .01). Raindrop corneal inlay corrects presbyopia via increasing negative spherical aberration. The equivalent K reading at 5.0 mm accurately reflected the SIRC, and would be applicable for intraocular power prediction before cataract surgery. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Contact lens overrefraction variability in corneal power estimation after refractive surgery.

    PubMed

    Joslin, Charlotte E; Koster, James; Tu, Elmer Y

    2005-12-01

    To evaluate the accuracy and precision of the contact lens overrefraction (CLO) method in determining corneal refractive power in post-refractive-surgery eyes. Refractive Surgery Service and Contact Lens Service, University of Illinois, Chicago, Illinois, USA. Fourteen eyes of 7 subjects who had a single myopic laser in situ keratomileusis procedure within 12 months with refractive stability were included in this prospective case series. The CLO method was compared with the historical method of predicting the corneal power using 4 different lens fitting strategies and 3 refractive pupil scan sizes (3 mm, 5 mm, and total pupil). Rigid lenses included 3 9.0 mm overall diameter lenses fit flat, steep, and an average of the 2, and a 15.0 mm diameter lens steep fit. Cycloplegic CLO was performed using the autorefractor function of the Nidek OPD-Scan ARK-10000. Results with each strategy were compared with the corneal power estimated with the historical method. The bias (mean of the difference), 95% limits of agreement, and difference versus mean plots for each strategy are presented. In each subject, the CLO-estimated corneal power varied based on lens fit. On average, the bias between CLO and historical methods ranged from -0.38 to +2.42 diopters (D) and was significantly different from 0 in all but 3 strategies. Substantial variability in precision existed between fitting strategies, with the range of the 95% limits of agreement approximating 0.50 D in 2 strategies and 2.59 D in the worst-case scenario. The least precise fitting strategy was use of flat-fitting 9.0 mm diameter lenses. The accuracy and precision of the CLO method of estimating corneal power in post-refractive-surgery eyes was highly variable on the basis of how rigid lense were fit. One of the most commonly used fitting strategies in clinical practice--flat-fitting a 9.0 diameter lens-resulted in the poorest accuracy and precision. Results also suggest use of large-diameter lenses may improve outcomes.

  18. Comparison of newer IOL power calculation methods for post-corneal refractive surgery eyes

    PubMed Central

    Wang, Li; Tang, Maolong; Huang, David; Weikert, Mitchell P.; Koch, Douglas D.

    2015-01-01

    Objective To compare the newer formulae, the optical coherence tomography based intraocular lens (IOL) power formula (OCT formula) and the Barrett True-K formula (True-K), to the methods on the ASCRS calculator in eyes with previous myopic LASIK/PRK. Design Prospective case series. Participants One-hundred and four eyes of 80 patients who had previous myopic LASIK/PRK and subsequent cataract surgery and IOL implantation. Methods Using the actual refraction following cataract surgery as target refraction, predicted IOL power for each method was calculated. The IOL prediction error (PE) was obtained by subtracting the predicted IOL power from the power of IOL implanted. Main outcome measures Arithmetic IOL PEs, variances of mean arithmetic IOL PE, median refractive PE and percent of eyes within 0.5 D and 1.0 D of refractive PE. Results OCT produced smaller variance of IOL PE than did Wang-Koch-Maloney, and Shammas (P<0.05). With the OCT, True-K No History, Wang-Koch-Maloney, Shammas, Haigis-L, and Average of these 5 formulas, respectively, the median refractive PEs were 0.35 D, 0.42 D, 0.51 D, 0.48 D, 0.39 D, and 0.35 D, and the % of eyes within 0.5 D of refractive PE were 68.3%, 58.7%, 50.0%, 52.9%, 55.8%, and 67.3%, and within 1.0 D of RPE, 92.3%, 90.4%, 86.9%, 88.5%, 90.4%, and 94.2%, respectively. The OCT formula had smaller refractive PE compared to Wang-Koch-Maloney and Shammas, and the Average approach produced significantly smaller refractive PE than did all methods except OCT (all P<0.05). Conclusions The OCT and True-K No History are promising formulas. The ASCRS IOL calculator has been updated to include the OCT and Barrett True K formulas. Trial registration Intraocular Lens Power Calculation After Laser Refractive Surgery Based on Optical Coherence Tomography (OCT IOL); Identifier: NCT00532051; www.ClinicalTrials.gov PMID:26459996

  19. Effect of monochromatic aberrations on photorefractive patterns

    NASA Astrophysics Data System (ADS)

    Campbell, Melanie C. W.; Bobier, W. R.; Roorda, A.

    1995-08-01

    Photorefractive methods have become popular in the measurement of refractive and accommodative states of infants and children owing to their photographic nature and rapid speed of measurement. As in the case of any method that measures the refractive state of the human eye, monochromatic aberrations will reduce the accuracy of the measurement. Monochromatic aberrations cannot be as easily predicted or controlled as chromatic aberrations during the measurement, and accordingly they will introduce measurement errors. This study defines this error or uncertainty by extending the existing paraxial optical analyses of coaxial and eccentric photorefraction. This new optical analysis predicts that, for the amounts of spherical aberration (SA) reported for the human eye, there will be a significant degree of measurement uncertainty introduced for all photorefractive methods. The dioptric amount of this uncertainty may exceed the maximum amount of SA present in the eye. The calculated effects on photorefractive measurement of a real eye with a mixture of spherical aberration and coma are shown to be significant. The ability, developed here, to predict photorefractive patterns corresponding to different amounts and types of monochromatic aberration may in the future lead to an extension of photorefractive methods to the dual measurement of refractive states and aberrations of individual eyes. aberration, retinal image quality,

  20. Refractive lenticule extraction small incision lenticule extraction: A new refractive surgery paradigm

    PubMed Central

    Ganesh, Sri; Brar, Sheetal; Arra, Raghavender Reddy

    2018-01-01

    Small incision lenticule extraction (SMILE), a variant of refractive lenticule extraction technology is becoming increasingly popular, as a flapless and minimally invasive form of laser vision correction (LVC) for the treatment of myopia and myopic astigmatism. This review aims at summarizing the principles, surgical technique, and clinical outcomes in terms of visual and refractive results, safety, efficacy, postoperative dry eye, aberrations, and biomechanics of SMILE and its comparison with other conventional techniques of LVC, such as laser in situ keratomileusis (LASIK) and photorefractive keratectomy (PRK). Recent advancements in the laser frequency and energy delivery patterns, instrumentation, and surgical techniques have shown significant improvement in the visual recovery and outcomes after SMILE, compared to the initial results published by Sekundo and Shah et al. Most of the recently published literature on long-term outcomes of SMILE shows excellent stability of the procedure, especially for higher myopia. In terms of the postoperative dry eye, SMILE shows a clear advantage over LASIK as numerous studies have shown significant differences about the Schirmer's, Tear film break up time, corneal sensitivity, and corneal nerve regeneration to be better following SMILE compared to LASIK. There is some evidence that since the Bowman's membrane (BM) and the anterior lamellae remain intact after SMILE, this may be a potential advantage for corneal biomechanics over LASIK and PRK where the BM is either severed or ablated, respectively, however, the data on biomechanics are inconclusive at present. Overall, this procedure has proved to be promising, delivering equivalent, or better visual and refractive results to LASIK and providing clear advantage in terms of being a flapless, minimally invasive procedure with minimal pain and postoperative discomfort thus offering high patient satisfaction. PMID:29283117

  1. Mesopic pupil size in a refractive surgery population (13,959 eyes).

    PubMed

    Linke, Stephan J; Baviera, Julio; Munzer, Gur; Fricke, Otto H; Richard, Gisbert; Katz, Toam

    2012-08-01

    To evaluate factors that may affect mesopic pupil size in refractive surgery candidates. Medical records of 13,959 eyes of 13,959 refractive surgery candidates were reviewed, and one eye per subject was selected randomly for statistical analysis. Detailed ophthalmological examination data were obtained from medical records. Preoperative measurements included uncorrected distance visual acuity, corrected distance visual acuity, manifest and cycloplegic refraction, topography, slit lamp examination, and funduscopy. Mesopic pupil size measurements were performed with Colvard pupillometer. Relationship between mesopic pupil size and age, gender, refractive state, average keratometry, and pachymetry (thinnest point) were analyzed by means of ANOVA (+ANCOVA) and multivariate regression analyses. Overall mesopic pupil size was 6.45 ± 0.82 mm, and mean age was 36.07 years. Mesopic pupil size was 5.96 ± 0.8 mm in hyperopic astigmatism, 6.36 ± 0.83 mm in high astigmatism, and 6.51 ± 0.8 mm in myopic astigmatism. The difference in mesopic pupil size between all refractive subgroups was statistically significant (p < 0.001). Age revealed the strongest correlation (r = -0.405, p < 0.001) with mesopic pupil size. Spherical equivalent showed a moderate correlation (r = -0.136), whereas keratometry (r = -0.064) and pachymetry (r = -0.057) had a weak correlation with mesopic pupil size. No statistically significant difference in mesopic pupil size was noted regarding gender and ocular side. The sum of all analyzed factors (age, refractive state, keratometry, and pachymetry) can only predict the expected pupil size in <20% (R = 0.179, p < 0.001). Our analysis confirmed that age and refractive state are determinative factors on mesopic pupil size. Average keratometry and minimal pachymetry exhibited a statistically significant, but clinically insignificant, impact on mesopic pupil size.

  2. Comparison of the visual and intraocular optical performance of a refractive multifocal IOL with rotational asymmetry and an apodized diffractive multifocal IOL.

    PubMed

    Alió, Jorge L; Plaza-Puche, Ana B; Javaloy, Jaime; Ayala, María José

    2012-02-01

    To compare the visual outcomes and intraocular optical quality observed postoperatively in patients implanted with a rotationally asymmetric multifocal intraocular lens (IOL) and an apodized diffractive multifocal IOL. Seventy-four consecutive eyes of 40 cataract patients (age range: 36 to 79 years) were divided into two groups: zonal refractive group, 39 eyes implanted with a rotationally asymmetric multifocal IOL (Lentis Mplus LS-312 IOL, Oculentis GmbH); and diffractive group, 35 eyes implanted with an apodized diffractive multifocal IOL (ReSTOR SN6AD3, Alcon Laboratories Inc). Distance and near visual acuity outcomes, contrast sensitivity, intraocular optical quality, and defocus curves were evaluated during 3-month follow-up. Calculation of the intraocular aberrations was performed by subtracting corneal aberrations from total ocular aberrations. Uncorrected near visual acuity and distance-corrected near visual acuity were better in the diffractive group than in the zonal refractive group (P=.01), whereas intermediate visual acuity (defocus +1.00 and +1.50 diopters) was better in the zonal refractive group. Photopic contrast sensitivity was significantly better in the zonal refractive group (P=.04). Wavefront aberrations (total, higher order, tilt, primary coma) were significantly higher in the zonal refractive group than in the diffractive group (P=.02). Both multifocal IOLs are able to successfully restore visual function after cataract surgery. The zonal refractive multifocal IOL provides better results in contrast sensitivity and intermediate vision, whereas the diffractive multifocal IOL provides better near vision at a closer distance. Copyright 2012, SLACK Incorporated.

  3. Refractive surgery in aircrew members who fly for scheduled and nonscheduled civilian airlines : final report.

    DOT National Transportation Integrated Search

    2000-05-01

    Introduction. Civil airmen with refractive surgery are present in all classes of aeromedical certificate holders. Refractive surgical procedures have been associated with numerous side effects, including glare, reduced contrast sensitivity, and fluct...

  4. Corrective Techniques and Future Directions for Treatment of Residual Refractive Error Following Cataract Surgery.

    PubMed

    Moshirfar, Majid; McCaughey, Michael V; Santiago-Caban, Luis

    2014-12-01

    Postoperative residual refractive error following cataract surgery is not an uncommon occurrence for a large proportion of modern-day patients. Residual refractive errors can be broadly classified into 3 main categories: myopic, hyperopic, and astigmatic. The degree to which a residual refractive error adversely affects a patient is dependent on the magnitude of the error, as well as the specific type of intraocular lens the patient possesses. There are a variety of strategies for resolving residual refractive errors that must be individualized for each specific patient scenario. In this review, the authors discuss contemporary methods for rectification of residual refractive error, along with their respective indications/contraindications, and efficacies.

  5. Corrective Techniques and Future Directions for Treatment of Residual Refractive Error Following Cataract Surgery

    PubMed Central

    Moshirfar, Majid; McCaughey, Michael V; Santiago-Caban, Luis

    2015-01-01

    Postoperative residual refractive error following cataract surgery is not an uncommon occurrence for a large proportion of modern-day patients. Residual refractive errors can be broadly classified into 3 main categories: myopic, hyperopic, and astigmatic. The degree to which a residual refractive error adversely affects a patient is dependent on the magnitude of the error, as well as the specific type of intraocular lens the patient possesses. There are a variety of strategies for resolving residual refractive errors that must be individualized for each specific patient scenario. In this review, the authors discuss contemporary methods for rectification of residual refractive error, along with their respective indications/contraindications, and efficacies. PMID:25663845

  6. Change in corneal aberrations after cataract surgery with 2 types of aspherical intraocular lenses.

    PubMed

    Marcos, Susana; Rosales, Patricia; Llorente, Lourdes; Jiménez-Alfaro, Ignacio

    2007-02-01

    To study the effect of cataract surgery through 3.2 mm superior incisions on corneal aberrations with 2 types of monofocal intraocular lenses (IOLs) with an aspherical design. Instituto de Optica, Consejo Superior de Investigaciones Científicas, and Fundación Jiménez Díaz, Madrid, Spain. Corneal topography of 43 eyes was obtained before and after small corneal incision cataract surgery. Twenty-two eyes had implantation of a Tecnis Z9000 silicone IOL (Advanced Medical Optics) and 21 had implantation of an AcrySof IQ SN60WF acrylic IOL (Alcon Research Labs) using the recommended injector for each IOL type. The intended incision size (3.2 mm) was similar in the 2 groups. Corneal aberrations were estimated using custom-developed algorithms (based on ray tracing) for 10.0 mm and 5.0 mm pupils. Comparisons between preoperative and postoperative measurements and across the groups were made for individual Zernike terms and root-mean-square (RMS) wavefront error. The RMS (excluding tilt and defocus) did not change in the AcrySof IQ group and increased significantly in the Tecnis group with the 10.0 mm and 5.0 mm pupil diameters. Spherical aberration and coma-like terms did not change significantly; however, vertical astigmatism, vertical trefoil, and vertical tetrafoil changed significantly with surgery with the 10.0 mm and 5.0 mm pupil diameters (P<.0005). The induced wave aberration pattern for 3rd- and higher-order aberrations consistently showed a superior lobe, resulting from a combination of positive vertical trefoil (Z(3)(-3)) and negative tetrafoil (Z(4)(4)). The mean vertical astigmatism increased by 2.47 microm +/- 1.49 (SD) and 1.74 +/- 1.44 microm, vertical trefoil increased by 1.81 +/- 1.19 microm and 1.20 +/- 1.34 microm, and tetrafoil increased by -1.10 +/- 0.78 microm and -0.89 +/- 0.68 microm in the Tecnis group and AcrySof IQ group, respectively. There were no significant differences between the corneal aberrations in the 2 postoperative groups

  7. Wavefront Derived Refraction and Full Eye Biometry in Pseudophakic Eyes.

    PubMed

    Mao, Xinjie; Banta, James T; Ke, Bilian; Jiang, Hong; He, Jichang; Liu, Che; Wang, Jianhua

    2016-01-01

    To assess wavefront derived refraction and full eye biometry including ciliary muscle dimension and full eye axial geometry in pseudophakic eyes using spectral domain OCT equipped with a Shack-Hartmann wavefront sensor. Twenty-eight adult subjects (32 pseudophakic eyes) having recently undergone cataract surgery were enrolled in this study. A custom system combining two optical coherence tomography systems with a Shack-Hartmann wavefront sensor was constructed to image and monitor changes in whole eye biometry, the ciliary muscle and ocular aberration in the pseudophakic eye. A Badal optical channel and a visual target aligning with the wavefront sensor were incorporated into the system for measuring the wavefront-derived refraction. The imaging acquisition was performed twice. The coefficients of repeatability (CoR) and intraclass correlation coefficient (ICC) were calculated. Images were acquired and processed successfully in all patients. No significant difference was detected between repeated measurements of ciliary muscle dimension, full-eye biometry or defocus aberration. The CoR of full-eye biometry ranged from 0.36% to 3.04% and the ICC ranged from 0.981 to 0.999. The CoR for ciliary muscle dimensions ranged from 12.2% to 41.6% and the ICC ranged from 0.767 to 0.919. The defocus aberrations of the two measurements were 0.443 ± 0.534 D and 0.447 ± 0.586 D and the ICC was 0.951. The combined system is capable of measuring full eye biometry and refraction with good repeatability. The system is suitable for future investigation of pseudoaccommodation in the pseudophakic eye.

  8. Posterior corneal astigmatism in refractive lens exchange surgery.

    PubMed

    Rydström, Elin; Westin, Oscar; Koskela, Timo; Behndig, Anders

    2016-05-01

    To assess the anterior, posterior and total corneal spherical and astigmatic powers in patients undergoing refractive lens exchange (RLE) surgery. In 402 consecutive patients planned for RLE at Koskelas Eye Clinic, Luleå, Sweden, right eye data from pre- and postoperative subjective refraction, preoperative IOLMaster(®) biometry and Pentacam HR(®) measurements were collected. Postoperative Pentacam HR(®) data were collected for 54 of the patients. The spherical and astigmatic powers of the anterior and posterior corneal surfaces and for the total cornea were assessed and compared, and surgically, induced astigmatism was calculated using vector analysis. The spherical power of the anterior corneal surface was 48.18 ± 1.69D with an astigmatic power of 0.83 ± 0.54D. The corresponding values for the posterior surface were -6.05 ± 2,52D and 0.26 ± 0.15D, respectively. The total corneal spherical power calculated with ray tracing was 42.47 ± 2.89D with a 0.72 ± 0.48D astigmatic power, and the corresponding figures obtained by estimating the posterior corneal surface were 43.25 ± 1.51D (p < 0.001) with a 0.75 ± 0.49D astigmatic power (p = 0.003). In eyes with anterior astigmatism with-the-rule, the total corneal astigmatism is overestimated if the posterior corneal surface is estimated; in eyes, with against-the-rule astigmatism it is underestimated. Had the posterior corneal surface been measured in this material, 14.7% of the patients would have received a spheric instead of a toric IOL, or vice versa. Estimating the posterior corneal surface in RLE patients leads to systematic measurement errors that can be reduced by measuring the posterior surface. Such an approach can potentially increase the refractive outcome accuracy in RLE surgery. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

  9. Influence of posterior corneal astigmatism on postoperative refractive astigmatism in pseudophakic eyes after cataract surgery.

    PubMed

    Sano, Maki; Hiraoka, Takahiro; Ueno, Yuta; Itagaki, Hideo; Ogami, Tomohiro; Oshika, Tetsuro

    2016-12-01

    To examine the influence of posterior corneal astigmatism on postoperative refractive astigmatism in pseudophakic eyes after cataract surgery. The study enrolled 64 pseudophakic eyes of 50 patients (71.8 ± 9.9 years old, mean ± standard deviation) who had undergone phacoemulsification with non-toric IOL implantation. Refractive astigmatism was measured using an auto ref-keratometer with a 0.01- diopter (D) scale. Two types of corneal astigmatism were calculated using anterior segment optical coherence tomography; keratometric and total corneal astigmatism. Keratometric astigmatism was obtained based on anterior corneal curvature alone and total corneal astigmatism was calculated using both anterior and posterior corneal curvatures. The difference between refractive and corneal astigmatism was computed as the vector difference using 1) refractive and keratometric astigmatism and 2) refractive and total corneal astigmatism. The mean refractive, keratometric, and total corneal astigmatism was 0.92 ± 0.48 D, 0.87 ± 0.44 D, and 0.94 ± 0.46 D, respectively. The difference between refractive and keratometric astigmatism (0.70 ± 0.40 D, mean vector of 0.30 D axis 164°) was significantly larger than the difference between refractive and total corneal astigmatism (0.63 ± 0.38 D, mean vector of 0.12 D axis 137°) (P = .019). The difference between refractive and total corneal astigmatism, calculated using both anterior and posterior corneal curvatures, was significantly smaller than the difference between refractive and keratometric astigmatism using anterior corneal astigmatism alone, implying that the latter overestimates the true postoperative refractive astigmatism and can cause cylindrical inaccuracy after cataract surgery.

  10. The aviation accident experience of civilian airmen with refractive surgery : final report.

    DOT National Transportation Integrated Search

    2002-06-01

    Introduction: Civil airmen with refractive surgery may obtain any class of Federal Aviation Administration (FAA) medical certificate provided they meet the applicable vision standards, and an eye specialist verifies that healing is complete, visual a...

  11. Development of a subjective refraction simulator

    NASA Astrophysics Data System (ADS)

    Perches, S.; Ares, J.; Collados, M. V.

    2013-11-01

    We have developed simulation software by Matlab (MathworksInc.) with a graphical interface designed for non-expert users. This simulator allows you to complete the process of subjective refraction starting from the aberrometry of the patients and analyse the influence of different factors during the exam. In addition to explain the graphical interface and its working, we show two examples about a complete process of subjective refraction with the influence of high order aberrations and without them showing the retinal image obtained in each step of the refraction process. When the Jackson Cross-Cylinder technique is made with this software, it becomes clear the difficulty of chosen between two images when high order aberrations are present. Therefore, the variability of response during the refraction can be a problem when the examiner has to reach an adequate optical prescription.

  12. Monochromatic ocular wave aberrations in young monkeys

    PubMed Central

    Ramamirtham, Ramkumar; Kee, Chea-su; Hung, Li-Fang; Qiao-Grider, Ying; Roorda, Austin; Smith, Earl L.

    2006-01-01

    High-order monochromatic aberrations could potentially influence vision-dependent refractive development in a variety of ways. As a first step in understanding the effects of wave aberration on refractive development, we characterized the maturational changes that take place in the high-order aberrations of infant rhesus monkey eyes. Specifically, we compared the monochromatic wave aberrations of infant and adolescent animals and measured the longitudinal changes in the high-order aberrations of infant monkeys during the early period when emmetropization takes place. Our main findings were that (1) adolescent monkey eyes have excellent optical quality, exhibiting total RMS errors that were slightly better than those for adult human eyes that have the same numerical aperture and (2) shortly after birth, infant rhesus monkeys exhibited relatively larger magnitudes of high-order aberrations predominately spherical aberration, coma, and trefoil, which decreased rapidly to assume adolescent values by about 200 days of age. The results demonstrate that rhesus monkey eyes are a good model for studying the contribution of individual ocular components to the eye’s overall aberration structure, the mechanisms responsible for the improvements in optical quality that occur during early ocular development, and the effects of high-order aberrations on ocular growth and emmetropization. PMID:16750549

  13. Wavefront Derived Refraction and Full Eye Biometry in Pseudophakic Eyes

    PubMed Central

    Mao, Xinjie; Banta, James T.; Ke, Bilian; Jiang, Hong; He, Jichang; Liu, Che; Wang, Jianhua

    2016-01-01

    Purpose To assess wavefront derived refraction and full eye biometry including ciliary muscle dimension and full eye axial geometry in pseudophakic eyes using spectral domain OCT equipped with a Shack-Hartmann wavefront sensor. Methods Twenty-eight adult subjects (32 pseudophakic eyes) having recently undergone cataract surgery were enrolled in this study. A custom system combining two optical coherence tomography systems with a Shack-Hartmann wavefront sensor was constructed to image and monitor changes in whole eye biometry, the ciliary muscle and ocular aberration in the pseudophakic eye. A Badal optical channel and a visual target aligning with the wavefront sensor were incorporated into the system for measuring the wavefront-derived refraction. The imaging acquisition was performed twice. The coefficients of repeatability (CoR) and intraclass correlation coefficient (ICC) were calculated. Results Images were acquired and processed successfully in all patients. No significant difference was detected between repeated measurements of ciliary muscle dimension, full-eye biometry or defocus aberration. The CoR of full-eye biometry ranged from 0.36% to 3.04% and the ICC ranged from 0.981 to 0.999. The CoR for ciliary muscle dimensions ranged from 12.2% to 41.6% and the ICC ranged from 0.767 to 0.919. The defocus aberrations of the two measurements were 0.443 ± 0.534 D and 0.447 ± 0.586 D and the ICC was 0.951. Conclusions The combined system is capable of measuring full eye biometry and refraction with good repeatability. The system is suitable for future investigation of pseudoaccommodation in the pseudophakic eye. PMID:27010674

  14. Visual and refractive outcomes following myopic laser-assisted subepithelial keratectomy with a flying-spot excimer laser.

    PubMed

    McAlinden, Colm; Skiadaresi, Eirini; Moore, Jonathan E

    2011-05-01

    To investigate the visual and refractive outcomes following laser-assisted subepithelial keratectomy (LASEK) surgery with a flying-spot excimer laser. Private practice, Ireland. Case series. In this prospective study, the mean manifest spherical equivalent (SE), sphere, and cylinder were measured preoperatively. All eyes had LASEK surgery with an aberration-free algorithm with the Schwind Amaris excimer laser. Outcomes measured at 1 month, 6 months, and 1 year were uncorrected distance visual acuity (UDVA), manifest refraction, corrected distance visual acuity, contrast sensitivity, aberrometry, and complications. Accuracy, efficacy, and safety were evaluated at 1 year. Preoperatively, the mean SE, sphere, and cylinder in the 80 eyes (48 patients) were -3.58 diopters (D) ± 2.00 (SD), -3.23 ± 1.93 D, and -0.85 ± 0.65 D, respectively. One year postoperatively, the mean SE was -0.00 ± 0.22 D; 57 eyes (71%) were within -0.13 to +0.13 D of the SE, and 71 eyes (98%) were within ±0.50 D. The mean UDVA was -0.06 ± 0.07 logMAR, with an efficacy index of 1.04. The postoperative SE was stable between 1 month, 3 months, and 1 year. One eye (1%) had a change in SE by more than 0.50 D at 6 months and 1 year. There were no statistically significant differences in any aberrations at 1 year. The contrast sensitivity improved from 1.66 ± 0.17 log units preoperatively to 1.72 ± 0.15 log units at 1 month postoperatively (P=.0003), which was unchanged at 6 months and 1 year. This study demonstrated the effectiveness of LASEK for the treatment of myopia with this flying-spot excimer laser. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  15. Femtosecond laser-assisted cataract surgeries reported to the European Registry of Quality Outcomes for Cataract and Refractive Surgery: Baseline characteristics, surgical procedure, and outcomes.

    PubMed

    Lundström, Mats; Dickman, Mor; Henry, Ype; Manning, Sonia; Rosen, Paul; Tassignon, Marie-José; Young, David; Stenevi, Ulf

    2017-12-01

    To describe a large cohort of femtosecond laser-assisted cataract surgeries in terms of baseline characteristics and the related outcomes. Eighteen cataract surgery clinics in 9 European countries and Australia. Prospective multicenter case series. Data on consecutive eyes having femtosecond laser-assisted cataract surgery in the participating clinics were entered in the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO). A trained registry manager in each clinic was responsible for valid reporting to the EUREQUO. Demographics, preoperative corrected distance visual acuity (CDVA), risk factors, type of surgery, type of intraocular lens, visual outcomes, refractive outcomes, and complications were reported. Complete data were available for 3379 cases. The mean age was 64.4 years ± 10.9 (SD) and 57.8% (95% confidence interval [CI], 56.1-59.5) of the patients were women. A surgical complication was reported in 2.9% of all cases (95% CI, 2.4-3.5). The mean postoperative CDVA was 0.04 ± 0.15. logarithm of the minimum angle of resolution. A biometry prediction error (spherical equivalent) was within ±0.5 diopter in 71.8% (95% CI, 70.3-73.3) of all surgeries. Postoperative complications were reported in 3.3% (95% CI, 2.7-4.0). Patients with good preoperative CDVA had the best visual and refractive outcomes; patients with poor preoperative visual acuity had poorer outcomes. The visual and refractive outcomes of femtosecond laser-assisted cataract surgery were favorable compared with manual phacoemulsification. The outcomes were highly influenced by the preoperative visual acuity, but all preoperative CDVA groups had acceptable outcomes. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  16. Comparison of wavefront aberrations under cycloplegic, scotopic and photopic conditions using WaveScan.

    PubMed

    Fan, Rong; He, Tao; Qiu, Yan; Di, Yu-Lan; Xu, Su-yun; Li, Yao-yu

    2012-01-01

    To evaluate the differences of wavefront aberrations under cycloplegic, scotopic and photopic conditions. A total of 174 eyes of 105 patients were measured using the wavefront sensor (WaveScan® 3.62) under different pupil conditions: cycloplegic 8.58 ± 0.54 mm (6.4 mm - 9.5 mm), scotopic 7.53 ± 0.69 mm (5.7 mm - 9.1 mm) and photopic 6.08 ± 1.14 mm (4.1 mm - 8.8 mm). The pupil diameter, standard Zernike coefficients, root mean square of higher-order aberrations and dominant aberrations were compared between cycloplegic and scotopic conditions, and between scotopic and photopic conditions. The pupil diameter was 7.53 ± 0.69 mm under the scotopic condition, which reached the requirement of about 6.5 mm optical zone design in the wavefront-guided surgery and prevented measurement error due to the pupil centroid shift caused by mydriatics. Pharmacological pupil dilation induced increase of standard Zernike coefficients Z(3)(-3), Z(4)(0) and Z(5)(-5). The higher-order aberrations, third-order aberration, fourth-order aberration, fifth-order aberration, sixth-order aberration, and spherical aberration increased statistically significantly, compared to the scotopic condition (P<0.010). When the scotopic condition shifted to the photopic condition, the standard Zernike coefficients Z(4)(0), Z(4)(2), Z(6)(-4), Z(6)(-2), Z(6)(2) decreased and all the higher-order aberrations decreased statistically significantly (P<0.010), demonstrating that accommodative miosis can significantly improve vision under the photopic condition. Under the three conditions, the vertical coma aberration appears the most frequently within the dominant aberrations without significant effect by pupil size variance, and the proportion of spherical aberrations decreased with the decrease of the pupil size. The wavefront aberrations are significantly different under cycloplegic, scotopic and photopic conditions. Using the wavefront sensor (VISX WaveScan) to measure scotopic wavefront aberrations is

  17. Can manipulation of orthokeratology lens parameters modify peripheral refraction?

    PubMed

    Kang, Pauline; Gifford, Paul; Swarbrick, Helen

    2013-11-01

    To investigate changes in peripheral refraction, corneal topography, and aberrations induced by changes in orthokeratology (OK) lens parameters in myopes. Subjects were fitted with standard OK lenses that were worn overnight for 2 weeks. Peripheral refraction, corneal topography, and corneal surface aberrations were measured at baseline and after 14 nights of OK lens wear. Subsequent to a 2-week washout period, subjects were refitted with another set of lenses where one eye was randomly assigned to wear an OK lens with a smaller optic zone diameter (OZD) and the other eye with a steeper peripheral tangent. Measurements were taken again at a second baseline and after 14 days of overnight wear of the second OK lens set. Standard OK lenses with a 6-mm OZD and 1/4 peripheral tangent caused significant changes in both peripheral refraction and corneal topography. Significant hyperopic shift occurred in the central visual field (VF) while a myopic shift was found at 35 degrees in the nasal VF. OK induced significant reductions in corneal power at all positions along the horizontal corneal chord except at 2.4 mm nasal where there was no significant change and at 2.8 mm nasal where there was an increase in corneal refractive power. A positive shift in spherical aberration was induced for all investigated lens designs except for the 1/2 tangent design when calculated over a 4-mm pupil. Reducing OZD and steepening the peripheral tangent did not cause significant changes in peripheral refraction or corneal topography profiles across the horizontal meridian. OK lenses caused significant changes in peripheral refraction, corneal topography, and corneal surface aberrations. Modifying OZD and peripheral tangent made no significant difference to the peripheral refraction or corneal topography profile. Attempting to customize refraction and topography changes through manipulation of OK lens parameters appears to be a difficult task.

  18. Intraocular lens power estimation by accurate ray tracing for eyes underwent previous refractive surgeries

    NASA Astrophysics Data System (ADS)

    Yang, Que; Wang, Shanshan; Wang, Kai; Zhang, Chunyu; Zhang, Lu; Meng, Qingyu; Zhu, Qiudong

    2015-08-01

    For normal eyes without history of any ocular surgery, traditional equations for calculating intraocular lens (IOL) power, such as SRK-T, Holladay, Higis, SRK-II, et al., all were relativley accurate. However, for eyes underwent refractive surgeries, such as LASIK, or eyes diagnosed as keratoconus, these equations may cause significant postoperative refractive error, which may cause poor satisfaction after cataract surgery. Although some methods have been carried out to solve this problem, such as Hagis-L equation[1], or using preoperative data (data before LASIK) to estimate K value[2], no precise equations were available for these eyes. Here, we introduced a novel intraocular lens power estimation method by accurate ray tracing with optical design software ZEMAX. Instead of using traditional regression formula, we adopted the exact measured corneal elevation distribution, central corneal thickness, anterior chamber depth, axial length, and estimated effective lens plane as the input parameters. The calculation of intraocular lens power for a patient with keratoconus and another LASIK postoperative patient met very well with their visual capacity after cataract surgery.

  19. Predicting Refractive Surgery Outcome: Machine Learning Approach With Big Data.

    PubMed

    Achiron, Asaf; Gur, Zvi; Aviv, Uri; Hilely, Assaf; Mimouni, Michael; Karmona, Lily; Rokach, Lior; Kaiserman, Igor

    2017-09-01

    To develop a decision forest for prediction of laser refractive surgery outcome. Data from consecutive cases of patients who underwent LASIK or photorefractive surgeries during a 12-year period in a single center were assembled into a single dataset. Training of machine-learning classifiers and testing were performed with a statistical classifier algorithm. The decision forest was created by feature vectors extracted from 17,592 cases and 38 clinical parameters for each patient. A 10-fold cross-validation procedure was applied to estimate the predictive value of the decision forest when applied to new patients. Analysis included patients younger than 40 years who were not treated for monovision. Efficacy of 0.7 or greater and 0.8 or greater was achieved in 16,198 (92.0%) and 14,945 (84.9%) eyes, respectively. Efficacy of less than 0.4 and less than 0.5 was achieved in 322 (1.8%) and 506 (2.9%) eyes, respectively. Patients in the low efficacy group (< 0.4) had statistically significant differences compared with the high efficacy group (≥ 0.8), yet were clinically similar (mean differences between groups of 0.7 years, of 0.43 mm in pupil size, of 0.11 D in cylinder, of 0.22 logMAR in preoperative CDVA, of 0.11 mm in optical zone size, of 1.03 D in actual sphere treatment, and of 0.64 D in actual cylinder treatment). The preoperative subjective CDVA had the highest gain (most important to the model). Correlations analysis revealed significantly decreased efficacy with increased age (r = -0.67, P < .001), central corneal thickness (r = -0.40, P < .001), mean keratometry (r = -0.33, P < .001), and preoperative CDVA (r = -0.47, P < .001). Efficacy increased with pupil size (r = 0.20, P < .001). This model could support clinical decision making and may lead to better individual risk assessment. Expanding the role of machine learning in analyzing big data from refractive surgeries may be of interest. [J Refract Surg. 2017;33(9):592-597.]. Copyright 2017, SLACK

  20. Mechanisms of Optical Regression Following Corneal Laser Refractive Surgery: Epithelial and Stromal Responses

    PubMed Central

    MOSHIRFAR, Majid; DESAUTELS, Jordan D.; WALKER, Brian D.; MURRI, Michael S.; BIRDSONG, Orry C.; HOOPES, Phillip C. Sr

    2018-01-01

    Laser vision correction is a safe and effective method of reducing spectacle dependence. Photorefractive Keratectomy (PRK), Laser In Situ Keratomileusis (LASIK), and Small-Incision Lenticule Extraction (SMILE) can accurately correct myopia, hyperopia, and astigmatism. Although these procedures are nearing optimization in terms of their ability to produce a desired refractive target, the long term cellular responses of the cornea to these procedures can cause patients to regress from the their ideal postoperative refraction. In many cases, refractive regression requires follow up enhancement surgeries, presenting additional risks to patients. Although some risk factors underlying refractive regression have been identified, the exact mechanisms have not been elucidated. It is clear that cellular proliferation events are important mediators of optical regression. This review focused specifically on cellular changes to the corneal epithelium and stroma, which may influence postoperative visual regression following LASIK, PRK, and SMILE procedures. PMID:29644238

  1. Free-space optical polarization demultiplexing and multiplexing by means of conical refraction.

    PubMed

    Turpin, Alex; Loiko, Yurii; Kalkandjiev, Todor K; Mompart, Jordi

    2012-10-15

    Polarization demultiplexing and multiplexing by means of conical refraction is proposed to increase the channel capacity for free-space optical communication applications. The proposed technique is based on the forward-backward optical transform occurring when a light beam propagates consecutively along the optic axes of two identical biaxial crystals with opposite orientations of their conical refraction characteristic vectors. We present an experimental proof of usefulness of the conical refraction demultiplexing and multiplexing technique by increasing in one order of magnitude the channel capacity at optical frequencies in a propagation distance of 4 m.

  2. Relative peripheral refraction across 4 meridians after orthokeratology and LASIK surgery.

    PubMed

    Queirós, António; Amorim-de-Sousa, Ana; Lopes-Ferreira, Daniela; Villa-Collar, César; Gutiérrez, Ángel Ramón; González-Méijome, José Manuel

    2018-01-01

    To characterize the axial and off-axis refraction across four meridians of the retina in myopic eyes before and after Orthokeratology (OK) and LASIK surgery. Sixty right eyes with a spherical equivalent (M) between - 0.75 to - 5.25 D (cylinder <- 1.00 D) underwent LASIK (n = 26) or OK (n = 34) to treat myopia. Axial and off-axis refraction were measured with an open-field autorefractometer before and after stabilized treatments. Off-axis measurements were obtained for the horizontal (35° nasal and temporal retina) and vertical (15° superior and inferior retina) meridians, and for two oblique directions (45-225° and 135-315°) up to 20° of eccentricity. The refractive profile was addressed as relative peripheral refractive error (RPRE). OK and LASIK post-treatment results showed an increase of myopic relative refraction at several eccentric locations. At the four meridians evaluated, the M component of the pre-treatment RPRE values was not statistically different ( p > 0.05) from the post-treatment RPRE within 30° and 20° of the central visual field after LASIK and OK, respectively. These results demonstrated that the treatment zone warrants an optimal central field of vision. The present study gives an overview of RPRE after refractive corneal reshaping treatments (OK and LASIK) across vertical, horizontal and two oblique meridians together. This allows a 3D representation of RPRE at the retina and shows that the myopic shift induced by both treatments is more relevant in horizontal directions.

  3. [The application of vector analysis for evaluation of astigmatism correction in the corneal refractive surgery].

    PubMed

    Zhang, Jiamei; Wang, Yan

    2016-01-01

    Since sixty percent of ametropes obtain astigmatism, which has influence on the visual quality, correcting the astigmatism is always the focus of concerns during visual correction procedures especially for the corneal refractive surgery. The postoperative spherical equivalent or residual cylindrical dioptors was used as quantitative index to evaluate the correction of astigmatism previously; however, such results neglect the effect of astigmatic axis shift on the treatment. Taking astigmatism as a vector parameter could describe the magnitude and direction of astigmatism accurately, thus it was increasingly applied in the evaluation of astigmatism correction. This paper reviews the present vector analysis methods, evaluation indexes and its application for the correction of astigmatism in the corneal refractive surgery.

  4. Camera processing with chromatic aberration.

    PubMed

    Korneliussen, Jan Tore; Hirakawa, Keigo

    2014-10-01

    Since the refractive index of materials commonly used for lens depends on the wavelengths of light, practical camera optics fail to converge light to a single point on an image plane. Known as chromatic aberration, this phenomenon distorts image details by introducing magnification error, defocus blur, and color fringes. Though achromatic and apochromatic lens designs reduce chromatic aberration to a degree, they are complex and expensive and they do not offer a perfect correction. In this paper, we propose a new postcapture processing scheme designed to overcome these problems computationally. Specifically, the proposed solution is comprised of chromatic aberration-tolerant demosaicking algorithm and post-demosaicking chromatic aberration correction. Experiments with simulated and real sensor data verify that the chromatic aberration is effectively corrected.

  5. Evaluation of internal refraction with the optical path difference scan.

    PubMed

    Muftuoglu, Orkun; Erdem, Uzeyir

    2008-01-01

    To evaluate internal refraction and its relation to other optical properties of the eye across a large range of refractive errors, which can provide useful information for the assessment and design of intraocular lenses and corneal ablation patterns. Cohort study. Three hundred ninety-four eyes of 197 healthy subjects with a mean age of 27+/-7 years (range, 18-42). All eyes underwent optical path difference scans to evaluate corneal topography, whole and internal ocular refraction (determined by the subtraction of corneal refraction from whole ocular refraction), and total and higher-order aberrations (HOAs) were assessed. After the conversion of any spherocylindrical refractive errors to vectorial data (sphere equivalent, blurring strength; cylinder, J(0) [power of Jackson cross cylinder at 90 degrees and 180 degrees] and J45 [power of Jackson cross cylinder at 45 degrees and 135 degrees]), the distribution of internal refraction among refraction groups (high myopes, low to moderate myopes, hyperopes, mixed astigmats, and emmetropes) and relationships between internal refraction, corneal refraction, and wavefront aberrations were analyzed. The compensation relation and its rate between corneal and internal astigmatism was assessed by the compensation factor (CF). Whole ocular power and astigmatism, corneal power and astigmatism, internal power and astigmatism, CF for astigmatic data, location of the highest internal refraction zone, and wavefront aberrations. The highest refraction zone was mostly (90%) located in the center in myopes, whereas it was located at the nasal side (71%) in hyperopes. There was a significant correlation between whole ocular and internal powers (P<0.01), but no correlation was observed between corneal and internal powers (P>0.05). Internal astigmatism was mostly against the rule. The mean CF J(0) was 0.63+/-3.78 and CF J(45) was 0.57+/-2.47. The magnitude of the internal astigmatism under the 3-mm zone was correlated with the magnitude

  6. Aberration-free ultrathin flat lenses and axicons at telecom wavelengths based on plasmonic metasurfaces.

    PubMed

    Aieta, Francesco; Genevet, Patrice; Kats, Mikhail A; Yu, Nanfang; Blanchard, Romain; Gaburro, Zeno; Capasso, Federico

    2012-09-12

    The concept of optical phase discontinuities is applied to the design and demonstration of aberration-free planar lenses and axicons, comprising a phased array of ultrathin subwavelength-spaced optical antennas. The lenses and axicons consist of V-shaped nanoantennas that introduce a radial distribution of phase discontinuities, thereby generating respectively spherical wavefronts and nondiffracting Bessel beams at telecom wavelengths. Simulations are also presented to show that our aberration-free designs are applicable to high-numerical aperture lenses such as flat microscope objectives.

  7. The business of refractive laser assisted cataract surgery (ReLACS).

    PubMed

    Berdahl, John P; Jensen, Matthew P

    2014-01-01

    Refractive Laser Assisted Cataract Surgery (ReLACS) combines the femtosecond laser with other noncovered tests and services in an attempt to reduce spectacle dependence in combination with cataract surgery. Significant interest is present among ophthalmologists who are considering adopting this technology, however significant capital outlays and continuing expenses can make the decision to adopt ReLACS foreboding. We review the financial considerations of ReLACS and review the trends seen in early adopters of this technology. Recent findings have shown that ReLACS is a growing segment of cataract surgery. Most practices who have implemented the technology have broken even and have a positive outlook on the financial return of implementing the ReLACS program. The average break-even analysis point for practices is around 230 cases a year. ReLACS is growing and appears to be a financial viable approach for many practices.

  8. Using an International Medical Advisory Board to guide clinical governance in a corporate refractive surgery model.

    PubMed

    Vukich, John A

    2009-07-01

    To describe the role played by the International Medical Advisory Board (IMAB) in clinical and corporate governance at Optical Express, a corporate provider of refractive surgery. A review of goals, objectives, and actions of the IMAB. The IMAB has contributed to study design, data analysis, and selection of instruments and procedures. Through interactions with Optical Express corporate and clinical staff, the IMAB has supported management's effort to craft a corporate culture focused on continuous improvement in the safety and visual outcomes of refractive surgery. The IMAB has fashioned significant changes in corporate policies and procedures and has had an impact on corporate culture at Optical Express.

  9. Correlations between Preoperative Angle Parameters and Postoperative Unpredicted Refractive Errors after Cataract Surgery in Open Angle Glaucoma (AOD 500).

    PubMed

    Lee, Wonseok; Bae, Hyoung Won; Lee, Si Hyung; Kim, Chan Yun; Seong, Gong Je

    2017-03-01

    To assess the accuracy of intraocular lens (IOL) power prediction for cataract surgery with open angle glaucoma (OAG) and to identify preoperative angle parameters correlated with postoperative unpredicted refractive errors. This study comprised 45 eyes from 45 OAG subjects and 63 eyes from 63 non-glaucomatous cataract subjects (controls). We investigated differences in preoperative predicted refractive errors and postoperative refractive errors for each group. Preoperative predicted refractive errors were obtained by biometry (IOL-master) and compared to postoperative refractive errors measured by auto-refractometer 2 months postoperatively. Anterior angle parameters were determined using swept source optical coherence tomography. We investigated correlations between preoperative angle parameters [angle open distance (AOD); trabecular iris surface area (TISA); angle recess area (ARA); trabecular iris angle (TIA)] and postoperative unpredicted refractive errors. In patients with OAG, significant differences were noted between preoperative predicted and postoperative real refractive errors, with more myopia than predicted. No significant differences were recorded in controls. Angle parameters (AOD, ARA, TISA, and TIA) at the superior and inferior quadrant were significantly correlated with differences between predicted and postoperative refractive errors in OAG patients (-0.321 to -0.408, p<0.05). Superior quadrant AOD 500 was significantly correlated with postoperative refractive differences in multivariate linear regression analysis (β=-2.925, R²=0.404). Clinically unpredicted refractive errors after cataract surgery were more common in OAG than in controls. Certain preoperative angle parameters, especially AOD 500 at the superior quadrant, were significantly correlated with these unpredicted errors.

  10. Paraboloid-aspheric lenses free of spherical aberration

    NASA Astrophysics Data System (ADS)

    Lozano-Rincón, Ninfa del C.; Valencia-Estrada, Juan Camilo

    2017-07-01

    A method to design singlet paraboloid-aspheric lenses free of all orders of spherical aberration with maximum aperture is described. This work includes all parametric formulas to describe paraboloid-aspheric or aspheric-paraboloid lenses for any finite conjugated planes. It also includes the Schwarzchilds approximations (which can be used to calculate one rigorous propagation of light waves in physic optics) to design convex paraboloid-aspheric lenses for imaging an object at infinity, with explicit formulas to calculate thicknesses easily. The results were verified with software through ray tracing.

  11. Femtosecond all-solid-state laser for refractive surgery

    NASA Astrophysics Data System (ADS)

    Zickler, Leander; Han, Meng; Giese, G.'nter; Loesel, Frieder H.; Bille, Josef F.

    2003-06-01

    Refractive surgery in the pursuit of perfect vision (e.g. 20/10) requires firstly an exact measurement of abberations induced by the eye and then a sophisticated surgical approach. A recent extension of wavefront measurement techniques and adaptive optics to ophthalmology has quantitatively characterized the quality of the human eye. The next milestone towards perfect vision is developing a more efficient and precise laser scalpel and evaluating minimal-invasive laser surgery strategies. Femtosecond all-solid-state MOPA lasers based on passive modelocking and chirped pulse amplification are excellent candidates for eye surgery due to their stability, ultra-high intensity and compact tabletop size. Furthermore, taking into account the peak emission in the near IR and diffraction limited focusing abilities, surgical laser systems performing precise intrastromal incisions for corneal flap resection and intrastromal corneal reshaping promise significant improvement over today's Photorefractive Keratectomy (PRK) and Laser Assisted In Situ Keratomileusis (LASIK) techniques which utilize UV excimer lasers. Through dispersion control and optimized regenerative amplification, a compact femtosecond all-solid-state laser with pulsed energy well above LIOB threshold and kHz repetition rate is constructed. After applying a pulse sequence to the eye, the modified corneal morphology is investigated by high resolution microscopy (Multi Photon/SHG Confocal Microscope).

  12. Determining thickness and refractive index from free-standing ultra-thin polymer films with spectroscopic ellipsometry

    DOE PAGES

    Hilfiker, James N.; Stadermann, Michael; Sun, Jianing; ...

    2016-08-27

    It is a well-known challenge to determine refractive index (n) from ultra-thin films where the thickness is less than about 10 nm. In this paper, we discovered an interesting exception to this issue while characterizing spectroscopic ellipsometry (SE) data from isotropic, free-standing polymer films. Ellipsometry analysis shows that both thickness and refractive index can be independently determined for free-standing films as thin as 5 nm. Simulations further confirm an orthogonal separation between thickness and index effects on the experimental SE data. Effects of angle of incidence and wavelength on the data and sensitivity are discussed. Finally, while others have demonstratedmore » methods to determine refractive index from ultra-thin films, our analysis provides the first results to demonstrate high-sensitivity to the refractive index from ultra-thin layers.« less

  13. [Refractive precision and objective quality of vision after toric lens implantation in cataract surgery].

    PubMed

    Debois, A; Nochez, Y; Bezo, C; Bellicaud, D; Pisella, P-J

    2012-10-01

    To study efficacy and predictability of toric IOL implantation for correction of preoperative corneal astigmatism by analysing spherocylindrical refractive precision and objective quality of vision. Prospective study of 13 eyes undergoing micro-incisional cataract surgery through a 1.8mm corneal incision with toric IOL implantation (Lentis L313T(®), Oculentis) to treat over one D of preoperative corneal astigmatism. Preoperative evaluation included keratometry, subjective refraction, and total and corneal aberrometry (KR-1(®), Topcon). Six months postoperatively, measurements included slit lamp photography, documenting IOL rotation, tilt or decentration, uncorrected visual acuity, best-corrected visual acuity and objective quality of vision measurement (OQAS(®) Visiometrics, Spain). Postoperatively, mean uncorrected distance visual acuity was 8.33/10 ± 1.91 (0.09 ± 0.11 LogMar). Mean postoperative refractive sphere was 0.13 ± 0.73 diopters. Mean refractive astigmatism was -0.66 ± 0.56 diopters with corneal astigmatism of 2.17 ± 0.68 diopters. Mean IOL rotation was 4.4° ± 3.6° (range 0° to 10°). Mean rotation of this IOL at 6 months was less than 5°, demonstrating stability of the optic within the capsular bag. Objective quality of vision measurements were consistent with subjective uncorrected visual acuity. Implantation of the L313T(®) IOL is safe and effective for correction of corneal astigmatism in 1.8mm micro-incisional cataract surgery. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  14. Correlations between Preoperative Angle Parameters and Postoperative Unpredicted Refractive Errors after Cataract Surgery in Open Angle Glaucoma (AOD 500)

    PubMed Central

    Lee, Wonseok; Bae, Hyoung Won; Lee, Si Hyung; Kim, Chan Yun

    2017-01-01

    Purpose To assess the accuracy of intraocular lens (IOL) power prediction for cataract surgery with open angle glaucoma (OAG) and to identify preoperative angle parameters correlated with postoperative unpredicted refractive errors. Materials and Methods This study comprised 45 eyes from 45 OAG subjects and 63 eyes from 63 non-glaucomatous cataract subjects (controls). We investigated differences in preoperative predicted refractive errors and postoperative refractive errors for each group. Preoperative predicted refractive errors were obtained by biometry (IOL-master) and compared to postoperative refractive errors measured by auto-refractometer 2 months postoperatively. Anterior angle parameters were determined using swept source optical coherence tomography. We investigated correlations between preoperative angle parameters [angle open distance (AOD); trabecular iris surface area (TISA); angle recess area (ARA); trabecular iris angle (TIA)] and postoperative unpredicted refractive errors. Results In patients with OAG, significant differences were noted between preoperative predicted and postoperative real refractive errors, with more myopia than predicted. No significant differences were recorded in controls. Angle parameters (AOD, ARA, TISA, and TIA) at the superior and inferior quadrant were significantly correlated with differences between predicted and postoperative refractive errors in OAG patients (-0.321 to -0.408, p<0.05). Superior quadrant AOD 500 was significantly correlated with postoperative refractive differences in multivariate linear regression analysis (β=-2.925, R2=0.404). Conclusion Clinically unpredicted refractive errors after cataract surgery were more common in OAG than in controls. Certain preoperative angle parameters, especially AOD 500 at the superior quadrant, were significantly correlated with these unpredicted errors. PMID:28120576

  15. Prevalence and associations of anisometropia with spherical ametropia, cylindrical power, age, and sex in refractive surgery candidates.

    PubMed

    Linke, Stephan J; Richard, Gisbert; Katz, Toam

    2011-09-29

    To analyze the prevalence and associations of anisometropia with spherical ametropia, astigmatism, age, and sex in a refractive surgery population. Medical records of 27,070 eyes of 13,535 refractive surgery candidates were reviewed. Anisometropia, defined as the absolute difference in mean spherical equivalent powers between right and left eyes, was analyzed for subjective (A(subj)) and cycloplegic refraction (A(cycl)). Correlations between anisometropia (>1 diopter) and spherical ametropia, cylindrical power, age, and sex, were analyzed using χ² and nonparametric Kruskal-Wallis or Mann-Whitney tests and binomial logistic regression analyses. Power vector analysis was applied for further analysis of cylindrical power. Prevalence of A(subj) was 18.5% and of A(cycl) was 19.3%. In hyperopes, logistic regression analysis revealed that only spherical refractive error (odds ratio [OR], 0.72) and age (OR, 0.97) were independently associated with anisometropia. A(subj) decreased with increasing spherical ametropia and advancing age. Cylindrical power and sex did not significantly affect A(subj). In myopes all explanatory variables (spherical power OR, 0.93; cylindrical power OR, 0.75; age OR, 1.02; sex OR, 0.8) were independently associated with anisometropia. Cylindrical power was most strongly associated with anisometropia. Advancing age and increasing spherical/cylindrical power correlated positively with increasing anisometropia in myopic subjects. Female sex was more closely associated with anisometropia. This large-scale retrospective analysis confirmed an independent association between anisometropia and both spherical ametropia and age in refractive surgery candidates. Notably, an inverse relationship between these parameters in hyperopes was observed. Cylindrical power and female sex were independently associated with anisometropia in myopes.

  16. Spherical aberration correction in a scanning transmission electron microscope using a sculpted thin film.

    PubMed

    Shiloh, Roy; Remez, Roei; Lu, Peng-Han; Jin, Lei; Lereah, Yossi; Tavabi, Amir H; Dunin-Borkowski, Rafal E; Arie, Ady

    2018-06-01

    Nearly eighty years ago, Scherzer showed that rotationally symmetric, charge-free, static electron lenses are limited by an unavoidable, positive spherical aberration. Following a long struggle, a major breakthrough in the spatial resolution of electron microscopes was reached two decades ago by abandoning the first of these conditions, with the successful development of multipole aberration correctors. Here, we use a refractive silicon nitride thin film to tackle the second of Scherzer's constraints and demonstrate an alternative method for correcting spherical aberration in a scanning transmission electron microscope. We reveal features in Si and Cu samples that cannot be resolved in an uncorrected microscope. Our thin film corrector can be implemented as an immediate low cost upgrade to existing electron microscopes without re-engineering of the electron column or complicated operation protocols and can be extended to the correction of additional aberrations. Copyright © 2018 The Authors. Published by Elsevier B.V. All rights reserved.

  17. Bioinspired adaptive gradient refractive index distribution lens

    NASA Astrophysics Data System (ADS)

    Yin, Kezhen; Lai, Chuan-Yar; Wang, Jia; Ji, Shanzuo; Aldridge, James; Feng, Jingxing; Olah, Andrew; Baer, Eric; Ponting, Michael

    2018-02-01

    Inspired by the soft, deformable human eye lens, a synthetic polymer gradient refractive index distribution (GRIN) lens with an adaptive geometry and focal power has been demonstrated via multilayer coextrusion and thermoforming of nanolayered elastomeric polymer films. A set of 30 polymer nanolayered films comprised of two thermoplastic polyurethanes having a refractive index difference of 0.05 were coextruded via forced-assembly technique. The set of 30 nanolayered polymer films exhibited transmission near 90% with each film varying in refractive index by 0.0017. An adaptive GRIN lens was fabricated from a laminated stack of the variable refractive index films with a 0.05 spherical GRIN. This lens was subsequently deformed by mechanical ring compression of the lens. Variation in the optical properties of the deformable GRIN lens was determined, including 20% variation in focal length and reduced spherical aberration. These properties were measured and compared to simulated results by placido-cone topography and ANSYS methods. The demonstration of a solid-state, dynamic focal length, GRIN lens with improved aberration correction was discussed relative to the potential future use in implantable devices.

  18. Nasal and conjunctival screening prior to refractive surgery: an observational and cross-sectional study

    PubMed Central

    Kitazawa, Koji; Sotozono, Chie; Sakamoto, Masako; Sasaki, Miho; Hieda, Osamu; Yamasaki, Toshihide; Kinoshita, Shigeru

    2016-01-01

    Objectives To investigate bacterial flora of clinically healthy conjunctiva and nasal cavity among patients prior to refractive surgery, as well as the characteristics of patients with methicillin-resistant Staphylococcus aureus (MRSA) colonisation. Design Observational and cross-sectional study. Setting A single-centre study in Japan. Participants 120 consecutive patients pre-refractive surgery. Primary and secondary outcome measures methods Samples were obtained from the right conjunctival sac and the nasal cavity of 120 consecutive patients prior to refractive surgery and were then measured for the levels of the minimum inhibitory concentration (MIC) of antibiotics. Patients were interviewed regarding their occupation, family living situation and any personal history of atopic dermatitis, asthma, smoking or contact lens wear. Results Propionibacterium acnes (P. acnes) (32.5%) and Staphylococcus epidermidis (4.2%) were detected from the conjunctival sac. S. epidermidis was the most commonly isolated (68.3%) in the nasal cavity. Of the 30 patients (25.0%) with colonisation by S. aureus, 2 patients, both of whom were healthcare workers with atopic dermatitis, were found to be positive for MRSA in the nasal cavity. A history of contact lens wear, asthma or smoking, as well as patient gender and age, was not associated with MRSA colonisation. Conclusions There were only 2 patients who were colonised with MRSA, both of whom were healthcare workers with atopic dermatitis. P. acnes was predominantly found in the conjunctival sac. Further study is needed to investigate the involvement between nasal and conjunctival flora, and risk factors for infectious complications. PMID:27160843

  19. The Refractive Error of Professional Baseball Players.

    PubMed

    Laby, Daniel M; Kirschen, David G

    2017-05-01

    High levels of visual acuity are required to hit a baseball effectively. Research has shown that any decrease in vision is likely caused by low-order optical aberrations. This study is designed to validate the SVOne autorefractor, and describe the amount and type, of low-order optical aberrations present in a large cohort of professional baseball players. A retrospective chart review on the 608 Major League Baseball players evaluated during the 2016 Spring Training Season was performed. Results for a subset of players who had both manifest refraction as well as autorefraction were calculated. Subsequently, after determining the accuracy of the autorefraction system in this population, refractive results for the entire population were determined. There was a borderline statistically significant difference in mean spherical refractive error (M) between the manifest refraction and the SVOne auto refraction (-0.273D in the manifest refraction method vs. -0.503D in the SVOne method, P = .06) in the subset of athletes who underwent both tests. Additionally, there was no difference in the J0 or J45 cylindrical component vectors for each method. For the entire eligible population, the SVOne autorefraction system found a mean spherical refractive error (M) of -0.228D, a J0 value of -0.013D, and a J45 value of -0.040D. These data suggest that the SVOne autorefraction system is generally able to measure the refractive error in the baseball population. The system was slightly biased, often reporting more myopia in myopic subjects. Thus, careful evaluation of the refractive status of these athletes coupled with careful subjective refractive correction for those with less than average vision for baseball is strongly suggested.

  20. Sources of medical error in refractive surgery.

    PubMed

    Moshirfar, Majid; Simpson, Rachel G; Dave, Sonal B; Christiansen, Steven M; Edmonds, Jason N; Culbertson, William W; Pascucci, Stephen E; Sher, Neal A; Cano, David B; Trattler, William B

    2013-05-01

    To evaluate the causes of laser programming errors in refractive surgery and outcomes in these cases. In this multicenter, retrospective chart review, 22 eyes of 18 patients who had incorrect data entered into the refractive laser computer system at the time of treatment were evaluated. Cases were analyzed to uncover the etiology of these errors, patient follow-up treatments, and final outcomes. The results were used to identify potential methods to avoid similar errors in the future. Every patient experienced compromised uncorrected visual acuity requiring additional intervention, and 7 of 22 eyes (32%) lost corrected distance visual acuity (CDVA) of at least one line. Sixteen patients were suitable candidates for additional surgical correction to address these residual visual symptoms and six were not. Thirteen of 22 eyes (59%) received surgical follow-up treatment; nine eyes were treated with contact lenses. After follow-up treatment, six patients (27%) still had a loss of one line or more of CDVA. Three significant sources of error were identified: errors of cylinder conversion, data entry, and patient identification error. Twenty-seven percent of eyes with laser programming errors ultimately lost one or more lines of CDVA. Patients who underwent surgical revision had better outcomes than those who did not. Many of the mistakes identified were likely avoidable had preventive measures been taken, such as strict adherence to patient verification protocol or rigorous rechecking of treatment parameters. Copyright 2013, SLACK Incorporated.

  1. Photographic simulation of off-axis blurring due to chromatic aberration in spectacle lenses.

    PubMed

    Doroslovački, Pavle; Guyton, David L

    2015-02-01

    Spectacle lens materials of high refractive index (nd) tend to have high chromatic dispersion (low Abbé number [V]), which may contribute to visual blurring with oblique viewing. A patient who noted off-axis blurring with new high-refractive-index spectacle lenses prompted us to do a photographic simulation of the off-axis aberrations in 3 readily available spectacle lens materials, CR-39 (nd = 1.50), polyurethane (nd = 1.60), and polycarbonate (nd = 1.59). Both chromatic and monochromatic aberrations were found to cause off-axis image degradation. Chromatic aberration was more prominent in the higher-index materials (especially polycarbonate), whereas the lower-index CR-39 had more astigmatism of oblique incidence. It is important to consider off-axis aberrations when a patient complains of otherwise unexplained blurred vision with a new pair of spectacle lenses, especially given the increasing promotion of high-refractive-index materials with high chromatic dispersion. Copyright © 2015 American Association for Pediatric Ophthalmology and Strabismus. Published by Elsevier Inc. All rights reserved.

  2. Optical aberrations measurement with a low cost optometric instrument

    NASA Astrophysics Data System (ADS)

    Furlan, Walter D.; Muñoz-Escrivá, L.; Pons, A.; Martínez-Corral, M.

    2002-08-01

    A simple experimental method for measuring optical aberrations of a single lens is proposed. The technique is based on the use of an optometric instrument employed for the assessment of the refractive state of the eye: the retinoscope. Experimental results for spherical aberration and astigmatism are obtained.

  3. Peripheral Refraction Validity of the Shin-Nippon SRW5000 Autorefractor.

    PubMed

    Osuagwu, Uchechukwu Levi; Suheimat, Marwan; Wolffsohn, James S; Atchison, David A

    2016-10-01

    To investigate the operation of the Shin-Nippon/Grand Seiko autorefractor and whether higher-order aberrations affect its peripheral refraction measurements. Information on instrument design, together with parameters and equations used to obtain refraction, was obtained from a patent. A model eye simulating the operating principles was tested with an optical design program. Effects of induced defocus and astigmatism on the retinal image were used to calibrate the model eye to match the patent equations. Coma and trefoil were added to assess their effects on the image. Peripheral refraction of a physical model eye was measured along four visual field meridians with the Shin-Nippon/Grand Seiko autorefractor SRW-5000 and a Hartmann-Shack aberrometer, and simulated autorefractor peripheral refraction was derived using the Zernike coefficients from the aberrometer. In simulation, the autorefractor's square image was changed in size by defocus, into rectangles or parallelograms by astigmatism, and into irregular shapes by coma and trefoil. In the presence of 1.0 D oblique astigmatism, errors in refraction were proportional to the higher-order aberrations, with up to 0.8 D sphere and 1.5 D cylinder for ±0.6 μm of coma or trefoil coefficients with a 5-mm-diameter pupil. For the physical model eye, refraction with the aberrometer was similar in all visual field meridians, but refraction with the autorefractor changed more quickly along one oblique meridian and less quickly along the other oblique meridian than along the horizontal and vertical meridians. Simulations predicted that higher-order aberrations would affect refraction in oblique meridians, and this was supported by the experimental measurements with the physical model eye. The autorefractor's peripheral refraction measurements are valid for horizontal and vertical field meridians, but not for oblique field meridians. Similar instruments must be validated before being adopted outside their design scope.

  4. Simulation of the Effect of Different Presbyopia-Correcting Intraocular Lenses With Eyes With Previous Laser Refractive Surgery.

    PubMed

    Camps, Vicente J; Miret, Juan J; García, Celia; Tolosa, Angel; Piñero, David P

    2018-04-01

    To simulate the optical performance of three presbyopia-correcting intraocular lenses (IOLs) implanted in eyes with previous laser refractive surgery. A simulation of the through-focus modulation transfer function (MTF) was performed for three presbyopia-correcting IOLs (Mplus, Oculentis GmbH, Berlin, Germany; Symfony, Johnson & Johnson Vision, Santa Ana, CA; and Mini Well, SIFI S.p.A., Lavinaio, Italy) in one eye with previous myopic LASIK and another with hyperopic LASIK. Real topographic data and the wavefront aberration profile of each IOL obtained with a Hartmann-Shack sensor were used. In the eye with myopic LASIK, all IOLs lost optical quality at near and intermediate distances for 4- and 4.7-mm pupil size. For 3-mm pupil size, the Mini Well IOL showed the best intermediate and near MTF and maintained the far focus independently of the pupil. In the eye with hyperopic LASIK, the Mini Well IOL showed an intermediate, distance, and -4.00-diopter (D) foci for all pupils. The Symfony IOL showed a depth of focus at far and intermediate distance for 3-mm and a focus at -2.50 D in the rest. The Mplus showed a focus of -4.50 and -3.00 D for the 3- and 4-mm pupil, respectively. The Mini Well and Symfony IOLs seem to work better than the Mplus IOL in eyes with previous myopic LASIK. With previous hyperopic LASIK, the Mini Well IOL seems to be able to provide acceptable near, intermediate, and far foci for all pupil sizes. These findings should be confirmed in future clinical studies. [J Refract Surg. 2018;34(4):222-227.]. Copyright 2018, SLACK Incorporated.

  5. What Is Refractive Surgery?

    MedlinePlus

    Subspecialties Cataract/Anterior Segment Comprehensive Ophthalmology Cornea/External Disease Glaucoma Neuro-Ophthalmology/Orbit Pediatric Ophthalmology/Strabismus Ocular Pathology/Oncology Oculoplastics/Orbit Refractive Management/Intervention Retina/Vitreous Uveitis ...

  6. Complications of cataract and refractive surgery: a clinicopathological documentation.

    PubMed Central

    Apple, D J; Werner, L

    2001-01-01

    PURPOSE: To present selected complications of keratorefractive and phakic intraocular lens (IOL) surgery and a series of IOLs that required explantation because of various postimplantation opacification of the IOL optic. METHODS: Two specimens obtained after keratorefractive surgery, 2 phakic IOLs, and a total of 23 explanted IOLs from cases in which postimplantation opacification of the IOL optic had occurred were studied. These included 6 Bausch and Lomb (B&L) Hydroview H60 M designs, 9 Medical Developmental Research (MDR) SC60B-OUV designs, and 24 IOLs with rigid PMMA optics that had been implanted in the 1980s and early 1990s. Of the latter, 8 required late explantation because of decreased visual acuity. Analyses performed included gross and light microscopic evaluation, histochemical staining, electron microscopy, and energy-dispersive spectroscopy. RESULTS: We provide examples of 3 postrefractive surgery complications: (1) fungal keratitis after LASIK, (2) post-LASIK corneal decompensation, and (3) cataract formation after implantation of phakic posterior chamber IOLs. Regarding the IOL optic opacities, classifications of 3 types are described: (1) a surface calcification of the B&L Hydroview IOL; (2) diffusion of calcium into the substance of the optic of the hydrophilic "acrylic" SC60B-OUV MDR foldable IOL design, sometimes leading to total opacification of the IOL optic and also its haptics; (3) a distinct pattern of intraoptical opacification with rigid PMMA designs that we term a snowflake degeneration. This term is based on the clinical and pathologic appearance of the individual lesions. Each snowflake lesion represents a focal breakdown of PMMA material as opposed to deposition of exogenous material. CONCLUSIONS: Analysis of complications of refractive surgery represents a new field of ocular pathology. The clinicopathological reports presented here provide an overview of selected complications after refractive surgery. We also help define 3 newly

  7. Refractive surgery for accommodative esotropia: 5-year follow-up.

    PubMed

    Magli, Adriano; Forte, Raimondo; Gallo, Flavio; Carelli, Roberta

    2014-02-01

    To assess the long-term effectiveness and safety of refractive surgery with LASIK or photorefractive keratectomy (PRK) for treating accommodative esotropia in adults. All patients with accommodative esotropia treated with LASIK or PRK until December 2007 and with a minimum follow-up of 5 years were retrospectively included. LASIK was performed on 44 eyes of 22 patients (12 women, 10 men; mean age: 22.7 ± 2.9 years). Mean postoperative follow-up was 62.1 ± 3.2 months. PRK was performed on 16 eyes of 8 patients (4 women, 4 men; mean age: 23.7 ± 1.7 years). Mean postoperative follow-up was 61.3 ± 2.8 months. At the 5-year follow-up, the mean cycloplegic refraction was more hyperopic in the PRK group (0.3 ± 0.8 vs 0.06 ± 0.3 diopters, P = .01). Correction of esotropia to esophoria or orthotropia was present in 21 patients (95.4%) treated with LASIK and in all patients treated with PRK. Both LASIK and PRK were effective in the long-term reduction of accommodative esotropia. Copyright 2014, SLACK Incorporated.

  8. Linear self-focusing of continuous UV laser beam in photo-thermo-refractive glasses.

    PubMed

    Sidorov, Alexander I; Gorbyak, Veronika V; Nikonorov, Nikolay V

    2018-03-19

    The experimental and theoretical study of continuous UV laser beam propagation through thick silver-containing photo-thermo-refractive glass is presented. It is shown for the first time that self-action of UV Gaussian beam in glass results in its self-focusing. The observed linear effect is non-reversible and is caused by the transformation of subnanosized charged silver molecular clusters to neutral state under UV laser radiation. Such transformation is accompanied by the increase of molecular clusters polarizability and the refractive index increase in irradiated area. As a result, an extended positive lens is formed in glass bulk. In a theoretical study of linear self-focusing effect, the "aberration-free" approximation was used, taking into account spatial distribution of induced absorption.

  9. A highly-sensitive label-free biosensor based on two dimensional photonic crystals with negative refraction

    NASA Astrophysics Data System (ADS)

    Malmir, Narges; Fasihi, Kiazand

    2017-11-01

    In this work, we present a novel high-sensitive optical label-free biosensor based on a two-dimensional photonic crystal (2D PC). The suggested structure is composed of a negative refraction structure in a hexagonal lattice PC, along with a positive refraction structure which is arranged in a square lattice PC. The frequency shift of the transmission peak is measured respect to the changes of refractive indices of the studied materials (the blood plasma, water, dry air and normal air). The studied materials are filled into a W1 line-defect waveguide which is located in the PC structure with positive refraction (the microfluidic nanochannel). Our numerical simulations, which are based on finite-difference time-domain (FDTD) method, show that in the proposed structure, a sensitivity about 1100 nm/RIU and a transmission efficiency more than 75% can be achieved. With this design, to the best of our knowledge, the obtained sensitivity and the transmission efficiency are one of the highest values in the reported PC label-free biosensors.

  10. Investigation of retinal damage during refractive eye surgery

    NASA Astrophysics Data System (ADS)

    Schumacher, S.; Sander, M.; Dopke, C.; Grone, A.; Ertmer, W.; Lubatschowski, H.

    2005-04-01

    Ultrashort laser pulses are increasingly used in refractive eye surgery to cut inside transparent corneal tissue. This is exploited by the fs-LASIK procedure which affords the opportunity to correct ametropia without any mechanical effects. The cutting process is caused by the optical breakdown occurring in the laser focus. During this process only a certain amount of the pulse energy is deposited into the tissue. The remaining pulse energy propagates further through the eye and interacts with the retina and the strong absorbing tissue layers behind. Therefore this investigation shall clarify if the intensity of the remaining laser pulse and the resulting temperature field can damage the retina and the surrounding tissue. Threshold values of the retinal tissue and theoretical calculations of the temperature field will be presented.

  11. An optomechanical model eye for ophthalmological refractive studies.

    PubMed

    Arianpour, Ashkan; Tremblay, Eric J; Stamenov, Igor; Ford, Joseph E; Schanzlin, David J; Lo, Yuhwa

    2013-02-01

    To create an accurate, low-cost optomechanical model eye for investigation of refractive errors in clinical and basic research studies. An optomechanical fluid-filled eye model with dimensions consistent with the human eye was designed and fabricated. Optical simulations were performed on the optomechanical eye model, and the quantified resolution and refractive errors were compared with the widely used Navarro eye model using the ray-tracing software ZEMAX (Radiant Zemax, Redmond, WA). The resolution of the physical optomechanical eye model was then quantified with a complementary metal-oxide semiconductor imager using the image resolution software SFR Plus (Imatest, Boulder, CO). Refractive, manufacturing, and assembling errors were also assessed. A refractive intraocular lens (IOL) and a diffractive IOL were added to the optomechanical eye model for tests and analyses of a 1951 U.S. Air Force target chart. Resolution and aberrations of the optomechanical eye model and the Navarro eye model were qualitatively similar in ZEMAX simulations. Experimental testing found that the optomechanical eye model reproduced properties pertinent to human eyes, including resolution better than 20/20 visual acuity and a decrease in resolution as the field of view increased in size. The IOLs were also integrated into the optomechanical eye model to image objects at distances of 15, 10, and 3 feet, and they indicated a resolution of 22.8 cycles per degree at 15 feet. A life-sized optomechanical eye model with the flexibility to be patient-specific was designed and constructed. The model had the resolution of a healthy human eye and recreated normal refractive errors. This model may be useful in the evaluation of IOLs for cataract surgery. Copyright 2013, SLACK Incorporated.

  12. Differences between wavefront and subjective refraction for infrared light.

    PubMed

    Teel, Danielle F W; Jacobs, Robert J; Copland, James; Neal, Daniel R; Thibos, Larry N

    2014-10-01

    To determine the accuracy of objective wavefront refractions for predicting subjective refractions for monochromatic infrared light. Objective refractions were obtained with a commercial wavefront aberrometer (COAS, Wavefront Sciences). Subjective refractions were obtained for 30 subjects with a speckle optometer validated against objective Zernike wavefront refractions on a physical model eye (Teel et al., Design and validation of an infrared Badal optometer for laser speckle, Optom Vis Sci 2008;85:834-42). Both instruments used near-infrared (NIR) radiation (835 nm for COAS, 820 nm for the speckle optometer) to avoid correction for ocular chromatic aberration. A 3-mm artificial pupil was used to reduce complications attributed to higher-order ocular aberrations. For comparison with paraxial (Seidel) and minimum root-mean-square (Zernike) wavefront refractions, objective refractions were also determined for a battery of 29 image quality metrics by computing the correcting lens that optimizes retinal image quality. Objective Zernike refractions were more myopic than subjective refractions for 29 of 30 subjects. The population mean discrepancy was -0.26 diopters (D) (SEM = 0.03 D). Paraxial (Seidel) objective refractions tended to be hyperopically biased (mean discrepancy = +0.20 D, SEM = 0.06 D). Refractions based on retinal image quality were myopically biased for 28 of 29 metrics. The mean bias across all 31 measures was -0.24 D (SEM = 0.03). Myopic bias of objective refractions was greater for eyes with brown irises compared with eyes with blue irises. Our experimental results are consistent with the hypothesis that reflected NIR light captured by the aberrometer originates from scattering sources located posterior to the entrance apertures of cone photoreceptors, near the retinal pigment epithelium. The larger myopic bias for brown eyes suggests that a greater fraction of NIR light is reflected from choroidal melanin in brown eyes compared with blue eyes.

  13. Diode-pumped UV refractive surgery laser

    NASA Astrophysics Data System (ADS)

    Lin, Jui T.; Hwang, Ming-Yi; Huang, C. H.

    1993-07-01

    Ophthalmic applications of medical lasers have been extensively explored recently because of their market potential. Refractive surgical lasers represent one of the major development efforts due to the large population of eye disorders: about 160 million people in the USA and more than 2 billion worldwide. The first refractive laser developed was the ArF excimer laser at 193 nm in 1987 - 88 for a procedure called photorefractive keratectomy (PRK). More recently, solid state refractive lasers have also been explored for preliminary clinical trials. These lasers include Nd:YLF (picosecond at 1054 nm), doubled-Nd:YAG (nanosecond at 532 nm), Ho:YAG (microsecond at 2100 nm) and ultraviolet (UV) lasers generated from the harmonic of Ti:sapphire-laser (205 - 220 nm) and Nd:YAG (at 213 nm).

  14. Analysis and design of a refractive virtual image system

    NASA Technical Reports Server (NTRS)

    Kahlbaum, W. M.

    1977-01-01

    The optical performance of a virtual image display system is evaluated. Observation of a two-element (unachromatized doublet) refractive system led to the conclusion that the major source of image degradation was lateral chromatic aberration. This conclusion was verified by computer analysis of the system. The lateral chromatic aberration is given in terms of the resolution of the phosphor dots on a standard shadow mask color cathode ray tube. Single wavelength considerations include: astigmatism, apparent image distance from the observer, binocular disparities and differences of angular magnification of the images presented to each of the observer's eyes. Where practical, these results are related to the performance of the human eye. All these techniques are applied to the previously mentioned doublet and a triplet refractive system. The triplet provides a 50-percent reduction in lateral chromatic aberration which was the design goal. Distortion was also reduced to a minimum over the field of view. The methods used in the design of the triplet are presented along with a method of relating classical aberration curves to image distance and binocular disparity.

  15. Keratometry obtained by corneal mapping versus the IOLMaster in the prediction of postoperative refraction in routine cataract surgery.

    PubMed

    Dulku, Simon; Smith, Henry B; Antcliff, Richard J

    2013-01-01

    To establish whether simulated keratometry values obtained by corneal mapping (videokeratography) would provide a superior refractive outcome to those obtained by Zeiss IOLMaster (partial coherence interferometry) in routine cataract surgery. Prospective, non-randomized, single-surgeon study set at the The Royal United Hospital, Bath, UK, District General Hospital. Thirty-three patients undergoing routine cataract surgery in the absence of significant ocular comorbidity. Conventional biometry was recorded using the Zeiss IOLMaster. Postoperative refraction was calculated using the SRK/T formula and the most appropriate power of lens implanted. Preoperative keratometry values were also obtained using Humphrey Instruments Atlas Version A6 corneal mapping. Achieved refraction was compared with predicted refraction for the two methods of keratometry after the A-constants were optimized to obtain a mean arithmetic error of zero dioptres for each device. The mean absolute prediction error was 0.39 dioptres (standard deviation 0.29) for IOLMaster and 0.48 dioptres (standard deviation 0.31) for corneal mapping (P = 0.0015). Keratometry readings between the devices were highly correlated by Spearman correlation (0.97). The Bland-Altman plot demonstrated close agreement between keratometers, with a bias of 0.0079 dioptres and 95% limits of agreement of -0.48-0.49 dioptres. The IOLMaster was superior to Humphrey Atlas A6 corneal mapping in the prediction of postoperative refraction. This difference could not have been predicted from the keratometry readings alone. When comparing biometry devices, close agreement between readings should not be considered a substitute for actual postoperative refraction data. © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.

  16. Aberration-free FTIR spectroscopic imaging of live cells in microfluidic devices.

    PubMed

    Chan, K L Andrew; Kazarian, Sergei G

    2013-07-21

    The label-free, non-destructive chemical analysis offered by FTIR spectroscopic imaging is a very attractive and potentially powerful tool for studies of live biological cells. FTIR imaging of live cells is a challenging task, due to the fact that cells are cultured in an aqueous environment. While the synchrotron facility has proven to be a valuable tool for FTIR microspectroscopic studies of single live cells, we have demonstrated that high quality infrared spectra of single live cells using an ordinary Globar source can also be obtained by adding a pair of lenses to a common transmission liquid cell. The lenses, when placed on the transmission cell window, form pseudo hemispheres which removes the refraction of light and hence improve the imaging and spectral quality of the obtained data. This study demonstrates that infrared spectra of single live cells can be obtained without the focus shifting effect at different wavenumbers, caused by the chromatic aberration. Spectra of the single cells have confirmed that the measured spectral region remains in focus across the whole range, while spectra of the single cells measured without the lenses have shown some erroneous features as a result of the shift of focus. It has also been demonstrated that the addition of lenses can be applied to the imaging of cells in microfabricated devices. We have shown that it was not possible to obtain a focused image of an isolated cell in a droplet of DPBS in oil unless the lenses are applied. The use of the approach described herein allows for well focused images of single cells in DPBS droplets to be obtained.

  17. Interfaces detection after corneal refractive surgery by low coherence optical interferometry

    PubMed Central

    Verrier, I.; Veillas, C.; Lépine, T.; Nguyen, F.; Thuret, G.; Gain, P.

    2010-01-01

    The detection of refractive corneal surgery by LASIK, during the storage of corneas in Eye Banks will become a challenge when the numerous operated patients will arrive at the age of cornea donation. The subtle changes of corneal structure and refraction are highly suspected to negatively influence clinical results in recipients of such corneas. In order to detect LASIK cornea interfaces we developed a low coherence interferometry technique using a broadband continuum source. Real time signal recording, without moving any optical elements and without need of a Fourier Transform operation, combined with good measurement resolution is the main asset of this interferometer. The associated numerical processing is based on a method initially used in astronomy and offers an optimal correlation signal without the necessity to image the whole cornea that is time consuming. The detection of corneal interfaces - both outer and inner surface and the buried interface corresponding to the surgical wound – is then achieved directly by the innovative combination of interferometry and this original numerical process. PMID:21258562

  18. Role of the treating surgeon in the consent process for elective refractive surgery.

    PubMed

    Schallhorn, Steven C; Hannan, Stephen J; Teenan, David; Schallhorn, Julie M

    2016-01-01

    To compare patient's perception of consent quality, clinical and quality-of-life outcomes after laser vision correction (LVC) and refractive lens exchange (RLE) between patients who met their treating surgeon prior to the day of surgery (PDOS) or on the day of surgery (DOS). Retrospective, comparative case series. Optical Express, Glasgow, UK. Patients treated between October 2015 and June 2016 (3972 LVC and 979 RLE patients) who attended 1-day and 1-month postoperative aftercare and answered a questionnaire were included in this study. All patients had a thorough preoperative discussion with an optometrist, watched a video consent, and were provided with written information. Patients then had a verbal discussion with their treating surgeon either PDOS or on the DOS, according to patient preference. Preoperative and 1-month postoperative visual acuity, refraction, preoperative, 1-day and 1-month postoperative questionnaire were compared between DOS and PDOS patients. Multivariate regression model was developed to find factors associated with patient's perception of consent quality. Preoperatively, 8.0% of LVC and 17.1% of RLE patients elected to meet their surgeon ahead of the surgery day. In the LVC group, 97.5% of DOS and 97.2% of PDOS patients indicated they were properly consented for surgery ( P =0.77). In the RLE group, 97.0% of DOS and 97.0% of PDOS patients stated their consent process for surgery was adequate ( P =0.98). There was no statistically significant difference between DOS and PDOS patients in most of the postoperative clinical or questionnaire outcomes. Factors predictive of patient's satisfaction with consent quality were postoperative satisfaction with vision (46.7% of explained variance), difficulties with night driving, close-up vision or outdoor/sports activities (25.4%), visual phenomena (12.2%), dry eyes (7.5%), and patient's satisfaction with surgeon's care (8.2%). Perception of quality of consent was comparable between patients that

  19. Role of the treating surgeon in the consent process for elective refractive surgery

    PubMed Central

    Schallhorn, Steven C; Hannan, Stephen J; Teenan, David; Schallhorn, Julie M

    2016-01-01

    Purpose To compare patient’s perception of consent quality, clinical and quality-of-life outcomes after laser vision correction (LVC) and refractive lens exchange (RLE) between patients who met their treating surgeon prior to the day of surgery (PDOS) or on the day of surgery (DOS). Design Retrospective, comparative case series. Setting Optical Express, Glasgow, UK. Methods Patients treated between October 2015 and June 2016 (3972 LVC and 979 RLE patients) who attended 1-day and 1-month postoperative aftercare and answered a questionnaire were included in this study. All patients had a thorough preoperative discussion with an optometrist, watched a video consent, and were provided with written information. Patients then had a verbal discussion with their treating surgeon either PDOS or on the DOS, according to patient preference. Preoperative and 1-month postoperative visual acuity, refraction, preoperative, 1-day and 1-month postoperative questionnaire were compared between DOS and PDOS patients. Multivariate regression model was developed to find factors associated with patient’s perception of consent quality. Results Preoperatively, 8.0% of LVC and 17.1% of RLE patients elected to meet their surgeon ahead of the surgery day. In the LVC group, 97.5% of DOS and 97.2% of PDOS patients indicated they were properly consented for surgery (P=0.77). In the RLE group, 97.0% of DOS and 97.0% of PDOS patients stated their consent process for surgery was adequate (P=0.98). There was no statistically significant difference between DOS and PDOS patients in most of the postoperative clinical or questionnaire outcomes. Factors predictive of patient’s satisfaction with consent quality were postoperative satisfaction with vision (46.7% of explained variance), difficulties with night driving, close-up vision or outdoor/sports activities (25.4%), visual phenomena (12.2%), dry eyes (7.5%), and patient’s satisfaction with surgeon’s care (8.2%). Conclusion Perception of

  20. Corneal power evaluation after myopic corneal refractive surgery using artificial neural networks.

    PubMed

    Koprowski, Robert; Lanza, Michele; Irregolare, Carlo

    2016-11-15

    Efficacy and high availability of surgery techniques for refractive defect correction increase the number of patients who undergo to this type of surgery. Regardless of that, with increasing age, more and more patients must undergo cataract surgery. Accurate evaluation of corneal power is an extremely important element affecting the precision of intraocular lens (IOL) power calculation and errors in this procedure could affect quality of life of patients and satisfaction with the service provided. The available device able to measure corneal power have been tested to be not reliable after myopic refractive surgery. Artificial neural networks with error backpropagation and one hidden layer were proposed for corneal power prediction. The article analysed the features acquired from the Pentacam HR tomograph, which was necessary to measure the corneal power. Additionally, several billion iterations of artificial neural networks were conducted for several hundred simulations of different network configurations and different features derived from the Pentacam HR. The analysis was performed on a PC with Intel ® Xeon ® X5680 3.33 GHz CPU in Matlab ® Version 7.11.0.584 (R2010b) with Signal Processing Toolbox Version 7.1 (R2010b), Neural Network Toolbox 7.0 (R2010b) and Statistics Toolbox (R2010b). A total corneal power prediction error was obtained for 172 patients (113 patients forming the training set and 59 patients in the test set) with an average age of 32 ± 9.4 years, including 67% of men. The error was at an average level of 0.16 ± 0.14 diopters and its maximum value did not exceed 0.75 dioptres. The Pentacam parameters (measurement results) providing the above result are tangential anterial/posterior. The corneal net power and equivalent k-reading power. The analysis time for a single patient (a single eye) did not exceed 0.1 s, whereas the time of network training was about 3 s for 1000 iterations (the number of neurons in the hidden layer was 400).

  1. Aberration-free, all-reflective laser pulse stretcher

    DOEpatents

    Perry, Michael D.; Banks, Paul S.; Stuart, Brent C.; Fochs, Scott N.

    1999-09-28

    An all-reflective pulse stretcher for laser systems employing chirped-pulse amplification enables on-axis use of the focusing mirror which results in ease of use, significantly decreased sensitivity to alignment and near aberration-free performance. By using a new type of diffraction grating which contains a mirror incorporated into the grating, the stretcher contains only three elements: 1) the grating, 2) a spherical or parabolic focusing mirror, and 3) a flat mirror. Addition of a fourth component, a retro-reflector, enables multiple passes of the same stretcher resulting in stretching ratios beyond the current state of the art in a simple and compact design. The pulse stretcher has been used to stretch pulses from 20 fsec to over 600 psec (a stretching ratio in excess of 30,000).

  2. Comparison of the characteristics in hen and quail corneas as experimental models of refractive surgery.

    PubMed

    Gonçalves, G C; Pérez-Merino, P; Martínez-García, M C; Barcía, A; Merayo-Loves, J

    2016-07-01

    To compare the histological, morphological and the biophysical measurements between hen and quail corneas, in order to determine which of them were better suited for use as an animal model for research into corneal refractive surgery. A study was performed using the biophysical measurements of the cornea (curvature, thickness, refraction, and axial length) of 20 animals (10 hens and 10 quails). The corneas were then prepared for histological analysis under microscopy light. The analysis showed that both groups have the same number of corneal layers as the human cornea and with an evident Bowman's layer. The thickness of the hen cornea and axial length of the eye, 225.3±18.4μm and 12.8±0.25mm, respectively, were larger than that of the quail (P<.01 and P<.001, respectively). The radius of curvature for the hen central cornea, 3.65±0.08mm, was greater than that for the quail (P<.001), but the refractive power of each cornea was similar. The proportion of total corneal thickness of the hen stroma, 82.6%, was more similar to that of the human than was the quail stroma, 72.5%. Within the hen stroma, the density of keratocytes, 8.57±1.49 per 5,000μm(2), was about half that in the quail stroma (P<.005). Because of the large size of the hen cornea, the stromal thickness and proportional similarity of the corneal layers with human cornea, the hen maybe better than the quail as an alternative species suitable for use in studies of corneal refractive surgery. Copyright © 2016 Sociedad Española de Oftalmología. Published by Elsevier España, S.L.U. All rights reserved.

  3. Correlations between corneal and total wavefront aberrations

    NASA Astrophysics Data System (ADS)

    Mrochen, Michael; Jankov, Mirko; Bueeler, Michael; Seiler, Theo

    2002-06-01

    Purpose: Corneal topography data expressed as corneal aberrations are frequently used to report corneal laser surgery results. However, the optical image quality at the retina depends on all optical elements of the eye such as the human lens. Thus, the aim of this study was to investigate the correlations between the corneal and total wavefront aberrations and to discuss the importance of corneal aberrations for representing corneal laser surgery results. Methods: Thirty three eyes of 22 myopic subjects were measured with a corneal topography system and a Tschernig-type wavefront analyzer after the pupils were dilated to at least 6 mm in diameter. All measurements were centered with respect to the line of sight. Corneal and total wavefront aberrations were calculated up to the 6th Zernike order in the same reference plane. Results: Statistically significant correlations (p < 0.05) between the corneal and total wavefront aberrations were found for the astigmatism (C3,C5) and all 3rd Zernike order coefficients such as coma (C7,C8). No statistically significant correlations were found for all 4th to 6th order Zernike coefficients except for the 5th order horizontal coma C18 (p equals 0.003). On average, all Zernike coefficients for the corneal aberrations were found to be larger compared to Zernike coefficients for the total wavefront aberrations. Conclusions: Corneal aberrations are only of limited use for representing the optical quality of the human eye after corneal laser surgery. This is due to the lack of correlation between corneal and total wavefront aberrations in most of the higher order aberrations. Besides this, the data present in this study yield towards an aberration balancing between corneal aberrations and the optical elements within the eye that reduces the aberration from the cornea by a certain degree. Consequently, ideal customized ablations have to take both, corneal and total wavefront aberrations, into consideration.

  4. REFLECTION AND REFRACTION, VOLUME 2.

    ERIC Educational Resources Information Center

    KLAUS, DAVID J.; AND OTHERS

    THIS VOLUME 2 OF A TWO-VOLUME SET PROVIDES AUTOINSTRUCTION IN PHYSICS. THE UNITS COVERED IN THIS VOLUME ARE (1) REFLECTION OF LIGHT, (2) PHOTOMETRY, (3) POLARIZATION, (4) REFRACTION OF LIGHT, (5) SNELL'S LAW, (6) LENSES, FOCUS, AND FOCAL POINTS, (7) IMAGE FORMATION, AND (8) ABERRATIONS, THE EYE, AND MAGNIFICATION. THE INTRODUCTION AND UNITS ON…

  5. [Refractive Surgery in Children with Myopic Anisometropia and Amblyopia in Comparison with Conventional Treatment by Contact Lenses].

    PubMed

    Autrata, R; Krejčířová, I; Griščíková, L; Doležel, Z

    2016-01-01

    Our study evaluated the visual and refractive results of LASEK and anterior chamber phakic intraocular lens (pIOL) implantation performed for high myopic anisometropia with amblyopia and contact lens intolerance in children compared with conventional treatment by contact lenses.Fourty-three patients (Group A) aged 3 to 7 years (mean, 5,6 years) with high myopic anisometropia and amblyopia had performed multizonal LASEK (27 eyes) or pIOL Verisyse implantation (16 eyes) on the more myopic eye in general anesthesia. Surgery was followed by patching of the dominant eye. Postoperative visual and refractive outcomes were analyzed and all children had minimally two years follow-up after procedure. Refractive surgical data were reported in standard format to describe safety, efficacy, predictability and stability of the procedure. This Group A of 43 children was compared with control Group B of 37 children (mean age 5,4 years), in whom myopic anisometropia and amblyopia were treated conventionally by contact lenses (CL) and patching of the dominant eye. Visual acuity (VA) and binocular vision (BV) outcome were analyzed and compared in both groups.The mean preoperative spherical equivalent (SE) cycloplegic refraction in Group A was - 9,45 ± 2,47 diopters (D) (range -6.0 to -18.25 D) and the mean postoperative SE -1,48 ± 1,13 D (range + 0,75 to - 2,25 D). The mean preop. decimal uncorrected visual acuity (UCVA) 0,023 ± 0,017 increased to 0,46 ± 0,18. The mean preop.decimal best-corrected visual acuity (BCVA) in Group A was 0,28 ± 0.22 and changed to 0,78± 0,19 by 2 years after surgery. The mean BCVA in Group B was 0,23 ± 0,19, at start of CL correction and amblyopia therapy, and improved to 0,42 ± 0,15 after two years. The mean BCVA at final examination was significantly better in Group A (P < 0,05). Binocular vision improvement expressed by the proportions of subjects gained fusion and stereopsis, was overall better in Group A (81 %) than in Group B (33 %), (P < 0

  6. Assumption-free estimation of the genetic contribution to refractive error across childhood.

    PubMed

    Guggenheim, Jeremy A; St Pourcain, Beate; McMahon, George; Timpson, Nicholas J; Evans, David M; Williams, Cathy

    2015-01-01

    Studies in relatives have generally yielded high heritability estimates for refractive error: twins 75-90%, families 15-70%. However, because related individuals often share a common environment, these estimates are inflated (via misallocation of unique/common environment variance). We calculated a lower-bound heritability estimate for refractive error free from such bias. Between the ages 7 and 15 years, participants in the Avon Longitudinal Study of Parents and Children (ALSPAC) underwent non-cycloplegic autorefraction at regular research clinics. At each age, an estimate of the variance in refractive error explained by single nucleotide polymorphism (SNP) genetic variants was calculated using genome-wide complex trait analysis (GCTA) using high-density genome-wide SNP genotype information (minimum N at each age=3,404). The variance in refractive error explained by the SNPs ("SNP heritability") was stable over childhood: Across age 7-15 years, SNP heritability averaged 0.28 (SE=0.08, p<0.001). The genetic correlation for refractive error between visits varied from 0.77 to 1.00 (all p<0.001) demonstrating that a common set of SNPs was responsible for the genetic contribution to refractive error across this period of childhood. Simulations suggested lack of cycloplegia during autorefraction led to a small underestimation of SNP heritability (adjusted SNP heritability=0.35; SE=0.09). To put these results in context, the variance in refractive error explained (or predicted) by the time participants spent outdoors was <0.005 and by the time spent reading was <0.01, based on a parental questionnaire completed when the child was aged 8-9 years old. Genetic variation captured by common SNPs explained approximately 35% of the variation in refractive error between unrelated subjects. This value sets an upper limit for predicting refractive error using existing SNP genotyping arrays, although higher-density genotyping in larger samples and inclusion of interaction effects

  7. Stability of corneal topography and wavefront aberrations in young Singaporeans.

    PubMed

    Zhu, Mingxia; Collins, Michael J; Yeo, Anna C H

    2013-09-01

    The aim was to investigate the differences between and variations across time in corneal topography and ocular wavefront aberrations in young Singaporean myopes and emmetropes. We used a videokeratoscope and wavefront sensor to measure the ocular surface topography and wavefront aberrations of the total-eye optics in the morning, midday and late afternoon on two separate days. Topographic data were used to derive the corneal surface wavefront aberrations. Both the corneal and total wavefronts were analysed up to the fourth radial order of the Zernike polynomial expansion and were centred on the entrance pupil (5.0 mm). The participants included 12 young progressing myopes, 13 young stable myopes and 15 young age-matched emmetropes. For all subjects considered together, there were significant changes in some of the aberrations across the day, such as spherical aberration ( Z(4 0)) and vertical coma ( Z (3 - 1)) (repeated measures analysis of variance, p < 0.05). The magnitude of positive spherical aberration ( Z(4 0)) was significantly lower in the progressing myopic group than in the stable myopic (p = 0.04) and emmetropic (p = 0.02) groups. There were also significant interactions between refractive group and time of day for with and against-the-rule astigmatism ( Z(2 2)). Significantly lower fourth-order root mean square of ocular wavefront aberrations were found in the progressing myopic group compared with the stable myopes and emmetropes (p < 0.01). These differences and variations in the corneal and total aberrations may have significance for our understanding of refractive error development and for clinical applications requiring accurate wavefront measurements. © 2013 The Authors. Clinical and Experimental Optometry © 2013 Optometrists Association Australia.

  8. Dry eye disease after refractive surgery: comparative outcomes of small incision lenticule extraction versus LASIK.

    PubMed

    Denoyer, Alexandre; Landman, Elise; Trinh, Liem; Faure, Jean-François; Auclin, François; Baudouin, Christophe

    2015-04-01

    To compare small incision lenticule extraction (SMILE) versus LASIK for post-refractive dry eye disease. Prospective, comparative, nonrandomized clinical study. Thirty patients scheduled for bilateral myopic SMILE and 30 age-, sex-, and refraction-matched patients scheduled for bilateral myopic LASIK were enrolled and followed for 6 months after the surgery. Complete evaluation of dry eye disease was performed at 1 and 6 months postoperatively, which included vision-related quality of life (Ocular Surface Disease Index [OSDI]), clinical examinations (tear film breakup time [TBUT], Schirmer I test, corneal staining), and tear osmolarity measurements, together with an overall severity score. Function and morphology of the corneal innervation were evaluated by corneal esthesiometry and subbasal nerve imaging using in vivo confocal microscopy (IVCM). Overall analysis of dry eye disease and corneal innervation. High incidence of mild to moderate dry eye disease was observed in both groups 1 month postoperatively, which remained significantly higher in the LASIK group than in the SMILE group 6 months after surgery (overall severity score [0-4]: 1.2±1.1 vs. 0.2±0.4, respectively, P < 0.01), leading to more frequent use of tear substitutes over the long term. Corneal sensitivity was better in SMILE than in LASIK eyes 1 month postoperatively (3.5±1.79 vs. 2.45±2.48, respectively, P < 0.01) and then recovered to statistically similar values at 6 months. Corneal nerve density, number of long fibers, and branchings as assessed by IVCM were significantly higher in the SMILE group compared with the LASIK group 1 and 6 months after surgery. Corneal sensitivity was negatively correlated with dry eye-related corneal damage (R² = 0.48, P < 0.01), and the long fiber nerve density was independently correlated with the OSDI score (R² = 0.50, P < 0.01) and the Schirmer test (R² = 0.21, P < 0.01) 6 months postoperatively. The SMILE procedure has a less pronounced impact on the

  9. 3D resolved mapping of optical aberrations in thick tissues

    PubMed Central

    Zeng, Jun; Mahou, Pierre; Schanne-Klein, Marie-Claire; Beaurepaire, Emmanuel; Débarre, Delphine

    2012-01-01

    We demonstrate a simple method for mapping optical aberrations with 3D resolution within thick samples. The method relies on the local measurement of the variation in image quality with externally applied aberrations. We discuss the accuracy of the method as a function of the signal strength and of the aberration amplitude and we derive the achievable resolution for the resulting measurements. We then report on measured 3D aberration maps in human skin biopsies and mouse brain slices. From these data, we analyse the consequences of tissue structure and refractive index distribution on aberrations and imaging depth in normal and cleared tissue samples. The aberration maps allow the estimation of the typical aplanetism region size over which aberrations can be uniformly corrected. This method and data pave the way towards efficient correction strategies for tissue imaging applications. PMID:22876353

  10. Recovering fluorophore concentration profiles from confocal images near lateral refractive index step changes.

    PubMed

    Jonášová, Eleonóra Parelius; Bjørkøy, Astrid; Stokke, Bjørn Torger

    2016-12-01

    Optical aberrations due to refractive index mismatches occur in various types of microscopy due to refractive differences between the sample and the immersion fluid or within the sample. We study the effects of lateral refractive index differences by fluorescence confocal laser scanning microscopy due to glass or polydimethylsiloxane cuboids and glass cylinders immersed in aqueous fluorescent solution, thereby mimicking realistic imaging situations in the proximity of these materials. The reduction in fluorescence intensity near the embedded objects was found to depend on the geometry and the refractive index difference between the object and the surrounding solution. The observed fluorescence intensity gradients do not reflect the fluorophore concentration in the solution. It is suggested to apply a Gaussian fit or smoothing to the observed fluorescence intensity gradient and use this as a basis to recover the fluorophore concentration in the proximity of the refractive index step change. The method requires that the reference and sample objects have the same geometry and refractive index. The best results were obtained when the sample objects were also used for reference since small differences such as uneven surfaces will result in a different extent of aberration.

  11. Effect of Rebamipide Ophthalmic Suspension on Intraocular Light Scattering for Dry Eye After Corneal Refractive Surgery.

    PubMed

    Igarashi, Akihito; Kamiya, Kazutaka; Kobashi, Hidenaga; Shimizu, Kimiya

    2015-08-01

    To assess the changes in intraocular scattering before and after instillation of rebamipide ophthalmic suspension in patients with dry eye after corneal refractive surgery. This study enrolled 60 eyes of 30 dry eye patients undergoing corneal refractive surgery. Patients were randomly assigned to start topical administration of rebamipide ophthalmic suspension (rebamipide group) or artificial tears (control group) 4 times daily for 4 weeks. Tear secretion, tear break-up time (TBUT), and the fluorescein score were measured before and after treatment. Intraocular light scattering was also measured as the objective scattering index (OSI) at 0.5-second intervals over 10 seconds. In the rebamipide group, the Schirmer I test, TBUT, and fluorescein score improved significantly, from 11.4 ± 9.0 mm, 2.2 ± 0.7 seconds, and 4.3 ± 1.3 to 14.9 ± 7.4 mm, 4.5 ± 1.7 seconds, and 1.9 ± 1.0, respectively (P = 0.006, P < 0.001, P < 0.001, Wilcoxon signed rank test). We found significant improvements in OSI at 5.0 to 10.0 seconds after blinking (5-8 seconds, P = 0.01; 9 seconds, P = 0.02; 10 seconds, P < 0.001). The mean OSI, the OSI change rate, and the OSI slope of the linear regression line improved significantly, from 2.73 ± 1.52, 74.7 ± 69.5%, and 0.10 ± 0.12 to 2.19 ± 1.19, 28.6 ± 48.7%, and 0.04 ± 0.08, respectively (P = 0.02, 0.003, and 0.03). Rebamipide ophthalmic suspension was effective for improving both ocular surface parameters and optical quality in patients with dry eye undergoing corneal refractive surgery, suggesting that it may hold promise for the treatment of such patients.

  12. Transcranial phase aberration correction using beam simulations and MR-ARFI

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Vyas, Urvi, E-mail: urvi.vyas@gmail.com; Kaye, Elena; Pauly, Kim Butts

    2014-03-15

    Purpose: Transcranial magnetic resonance-guided focused ultrasound surgery is a noninvasive technique for causing selective tissue necrosis. Variations in density, thickness, and shape of the skull cause aberrations in the location and shape of the focal zone. In this paper, the authors propose a hybrid simulation-MR-ARFI technique to achieve aberration correction for transcranial MR-guided focused ultrasound surgery. The technique uses ultrasound beam propagation simulations with MR Acoustic Radiation Force Imaging (MR-ARFI) to correct skull-caused phase aberrations. Methods: Skull-based numerical aberrations were obtained from a MR-guided focused ultrasound patient treatment and were added to all elements of the InSightec conformal bone focusedmore » ultrasound surgery transducer during transmission. In the first experiment, the 1024 aberrations derived from a human skull were condensed into 16 aberrations by averaging over the transducer area of 64 elements. In the second experiment, all 1024 aberrations were applied to the transducer. The aberrated MR-ARFI images were used in the hybrid simulation-MR-ARFI technique to find 16 estimated aberrations. These estimated aberrations were subtracted from the original aberrations to result in the corrected images. Each aberration experiment (16-aberration and 1024-aberration) was repeated three times. Results: The corrected MR-ARFI image was compared to the aberrated image and the ideal image (image with zero aberrations) for each experiment. The hybrid simulation-MR-ARFI technique resulted in an average increase in focal MR-ARFI phase of 44% for the 16-aberration case and 52% for the 1024-aberration case, and recovered 83% and 39% of the ideal MR-ARFI phase for the 16-aberrations and 1024-aberration case, respectively. Conclusions: Using one MR-ARFI image and noa priori information about the applied phase aberrations, the hybrid simulation-MR-ARFI technique improved the maximum MR-ARFI phase of the beam's focus.« less

  13. Quality of vision in refractive and cataract surgery, indirect measurers: review article.

    PubMed

    Parede, Taís Renata Ribeira; Torricelli, André Augusto Miranda; Mukai, Adriana; Vieira Netto, Marcelo; Bechara, Samir Jacob

    2013-01-01

    Visual acuity is the measurement of an individual's ability to recognize details of an object in a space. Visual function measurements in clinical ophthalmology are limited by factors such as maximum contrast and so it might not adequately reflect the real vision conditions at that moment as well as the subjective aspects of the world perception by the patient. The objective of a successful vision-restoring surgery lies not only in gaining visual acuity lines, but also in vision quality. Therefore, refractive and cataract surgeries have the responsibility of achieving quality results. It is difficult to define quality of vision by a single parameter, and the main functional-vision tests are: contrast sensitivity, disability glare, intraocular stray light and aberrometry. In the current review the different components of the visual function are explained and the several available methods to assess the vision quality are described.

  14. Enhanced visual acuity and image perception following correction of highly aberrated eyes using an adaptive optics visual simulator.

    PubMed

    Rocha, Karolinne Maia; Vabre, Laurent; Chateau, Nicolas; Krueger, Ronald R

    2010-01-01

    To evaluate the changes in visual acuity and visual perception generated by correcting higher order aberrations in highly aberrated eyes using a large-stroke adaptive optics visual simulator. A crx1 Adaptive Optics Visual Simulator (Imagine Eyes) was used to correct and modify the wavefront aberrations in 12 keratoconic eyes and 8 symptomatic postoperative refractive surgery (LASIK) eyes. After measuring ocular aberrations, the device was programmed to compensate for the eye's wavefront error from the second order to the fifth order (6-mm pupil). Visual acuity was assessed through the adaptive optics system using computer-generated ETDRS opto-types and the Freiburg Visual Acuity and Contrast Test. Mean higher order aberration root-mean-square (RMS) errors in the keratoconus and symptomatic LASIK eyes were 1.88+/-0.99 microm and 1.62+/-0.79 microm (6-mm pupil), respectively. The visual simulator correction of the higher order aberrations present in the keratoconus eyes improved their visual acuity by a mean of 2 lines when compared to their best spherocylinder correction (mean decimal visual acuity with spherocylindrical correction was 0.31+/-0.18 and improved to 0.44+/-0.23 with higher order aberration correction). In the symptomatic LASIK eyes, the mean decimal visual acuity with spherocylindrical correction improved from 0.54+/-0.16 to 0.71+/-0.13 with higher order aberration correction. The visual perception of ETDRS letters was improved when correcting higher order aberrations. The adaptive optics visual simulator can effectively measure and compensate for higher order aberrations (second to fifth order), which are associated with diminished visual acuity and perception in highly aberrated eyes. The adaptive optics technology may be of clinical benefit when counseling patients with highly aberrated eyes regarding their maximum subjective potential for vision correction. Copyright 2010, SLACK Incorporated.

  15. Effect of biaxial versus coaxial microincision cataract surgery on optical quality of the cornea.

    PubMed

    Eliwa, Tamer Fahmy; Elsamkary, Mahmoud A; Hamza, Ismail

    2015-06-01

    Visual function is determined by a combination of the cornea, which has a larger effect and internal aberrations generated by the intraocular lens and those induced by the surgery. These corneal refractive changes are related to the location and size of the corneal incision. The smaller the incision, the lower the aberrations and the better the optical quality. To compare the effect of uneventful coaxial versus biaxial microincision cataract surgery (MICS) on the corneal aberrations. Retrospective interventional nonrandomized comparative case study comprised 40 eyes of 36 patients with primary senile cataract. They were divided into two groups: Group I (20 eyes) had operated by biaxial MICS and Group II (20 eyes) had operated by coaxial MICS. Each group were assessed by corneal topography and wavefront analysis over 6 mm pupil size preoperatively and 1-month postoperatively. Statistical analysis was performed using SPSS for Windows (version 17.0.1, SPSS, Inc.). The paired t-test was used to compare the mean values of corneal aberrations preoperatively and 1-month postoperatively in each group. There was a significant increase in trefoil and quatrefoil in biaxial MICS (P = 0.063, 0.032 respectively) while other aberrations insignificantly changed. The coaxial MICS showed a significant increase in root mean square (RMS) of total high order aberrations (HOAs) (P = 0.02) and coma (0.028), but not the others. In comparison to each other, there was the insignificant difference as regards astigmatism, RMS of individual and total HOAs. Coaxial and biaxial MICS are neutral on corneal astigmatism and aberrations.

  16. Effect of Free Jet on Refraction and Noise

    NASA Technical Reports Server (NTRS)

    Khavaran, Abbas; Georgiadis, Nicholas J.; Bridges, James E.; Dippold, Vance F., III

    2005-01-01

    This article investigates the role of a free jet on the sound radiated from a jet. In particular, the role of an infinite wind tunnel, which simulates the forward flight condition, is compared to that of a finite wind tunnel. The second configuration is usually used in experiments, where the microphones are located in a static ambient medium far outside the free jet. To study the effect of the free jet on noise, both propagation and source strength need to be addressed. In this work, the exact Green's function in a locally parallel flow is derived for a simulated flight case. Numerical examples are presented that show a reduction in the magnitude of the Green's function in the aft arc and an increase in the forward arc for the simulated flight condition. The effect of finite wind tunnel on refraction is sensitive to the source location and is most pronounced in the aft arc. A Reynolds-averaged Navier-Stokes solution (RANS) yields the required mean flow and turbulence scales that are used in the jet mixing noise spectrum calculations. In addition to the sound/flow interaction, the separate effect of source strength and elongation of the noise-generating region of the jet in a forward flight is studied. Comparisons are made with experiments for the static and finite tunnel cases. Finally, the standard free-jet shear corrections that convert the finite wind tunnel measurements to an ideal wind tunnel arrangement are evaluated.

  17. Saw-tooth refractive x-ray optics with sub-micron resolution

    NASA Astrophysics Data System (ADS)

    Cederstrom, Bjorn; Ribbing, Carolina; Lundqvist, Mats

    2002-11-01

    Saw-tooth refractive x-ray lenses have been used to focus a synchrotron beam to sub-μm line width. These lenses are free from spherical aberration and work in analogy with 1-D focusing parabolic compound refractive lenses. However, the focal length can be varied by a simple mechanical procedure. Silicon lenses were fabricated by wet anisotropic etching, and epoxy replicas were molded from the silicon masters. Theses lenses provided 1-D intensity gains up to a factor of 40 and the smallest focal line width was 0.74 μm, very close to the theoretical expectation. Two crossed lenses were put in series to obtain 2-D focusing and the 80 μm by 275 μm source was imaged to 1.0 μm by 5.4 μm. Beryllium lenses were fabricated using conventional computer-controlled milling. The focal line width was 1.7 μm, nearly 3 times larger than predicted by theory. This can be attributed to large surface roughness and a bent lens shape.

  18. Do outside temperature and sunlight duration influence the outcome of laser refractive surgery? Results from the Hamburg Weather Study

    PubMed Central

    Neuhaus-Richard, Ines; Frings, Andreas; Görsch, Isabel Caroline; Druchkiv, Vasyl; Katz, Toam; Linke, Stephan Johannes; Richard, Gisbert

    2014-01-01

    Purpose To examine the impact of temperature and sunlight duration on refractive and visual outcome of laser-assisted in situ keratomileusis (LASIK) in myopic eyes. Setting University Medical Center Hamburg-Eppendorf, Germany, and Care Vision Refractive Centers, Germany. Design Retrospective, cross-sectional data analysis. Methods This study comprised 1,052 eyes of 1,052 consecutive myopic patients (419 males, 633 females; mean age at surgery 35.0±9.0 years) with a mean preoperative refractive spherical equivalent (SE) of −3.88±1.85 diopters (D). Two subgroups were defined, comprising patients undergoing surgery during either meteorological winter or summer. Manifest refraction, uncorrected, and corrected distant visual acuity (UDVA and CDVA) were assessed pre- and postoperatively. We applied robust regression analysis with efficiency index (EI), safety index (SI), and postoperative SE (in D) as dependent variables. Results At the 1-month (33.0±5.0 days) follow-up, the mean postoperative SE was −0.18±0.44 D. Bivariate comparisons showed that statistically significant better EI was related to days with lower temperature. We obtained a significant difference for SI which suggested that low temperature had a positive influence on SI. No change by more than one line on LogMAR scale was obtained. Conclusion Although being statistically significant, there was no clinically relevant difference in the outcome of LASIK, which demonstrates its highly standardized quality. Prospective, longitudinal studies are warranted to address meteorotropic reactions through evaluating defined meteorological parameters. PMID:24966665

  19. Predictability of refraction following immediate sequential bilateral cataract surgery (ISBCS) performed under general anaesthesia.

    PubMed

    Guber, Ivo; Rémont, Laurent; Bergin, Ciara

    2015-01-01

    To evaluate the predictability of refraction following immediate sequential bilateral cataract surgery (ISBCS) performed under general anaesthesia. This is a retrospective review of all ISBCS performed at Kantonsspital Winterthur, Switzerland, between April 2000 and September 2013. The case notes of 250 patients were reviewed. Patients having full refraction reported (110 patients/220 eyes) were included. 210 (95 %) eyes had a straight forward phacoemulsification with posterior chamber intraocular lens implantation, seven eyes had a planned extracapsular cataract extraction (ECCE); three eyes had an intracapsular cataract extraction. Both eyes of 110 patients (64 women, 46 men) with a mean age of 79.0 years, standard deviation (SD) ±11.4 (range 26 to 97 years) were included. Median preoperative best corrected visual acuity (BCVA) was 0.5 LogMAR in the first eye, the interquartile range (IQR) was [0.4, 1.2]; 0.7 LogMAR in the second eye with IQR [0.4, 1.8]. At one month, the median BCVA was 0.2 LogMAR, IQR [0.1, 0.3] in the first eye, median BCVA was 0.1 LogMAR and IQR [0.0, 0.5] in the second eye. There were 3 eyes (3 %) that lost 3 lines or more in BCVA at one month (control vs. pre-operatively). In all three cases, poor visual acuity had been recorded pre-operatively (>1 LogMAR). Achieved refraction was within ±1.0 D of the target in 83 % of eyes. There were only 5 % (n = 6) of cases where if delayed sequential bilateral extraction had been performed could potentially intraocular lens (IOL) choice have been adjusted, in four of these cases, target refraction was within ±1.0 D in the second eye. ISBCS performed under general anaesthesia achieves target refraction in 83 % of eyes after consideration of complications, ocular co-morbidities and systemic restrictions. In the majority of cases where IOL power calculation could be considered, the achieved refraction of the second surgical eye was within ±1.0 D of intended refraction. This undermines the

  20. Visual simulation through an aspheric aberration-correcting intraocular lens in subjects with different corneal profiles using adaptive optics.

    PubMed

    Ruiz-Alcocer, Javier; Madrid-Costa, David; García-Lázaro, Santiago; Albarrán-Diego, César; Ferrer-Blasco, Teresa

    2013-07-01

    The aim of this study was to analyse the visual quality of the AcrySof IQ SN60WF(®) intraocular lens (IOL) when combined with different corneal profiles. Ten eyes of 10 participants with no prior history of refractive or cataract surgery were evaluated. An adaptive optics visual simulator was used to simulate the wavefront aberration pattern of an aspheric aberration-correcting IOL (AcrySof IQ SN60WF(®)). Normal corneas (group A), low and high myopic corneal ablations (groups B and C, respectively) and low and high hyperopic corneal ablations (groups D and E, respectively) were also simulated. Monocular distance visual acuities at 100, 50 and 10 per cent of contrast were measured. At 100, 50 and 10 per cent contrast, no differences were found between groups A and B (p > 0.06 for all contrasts). Group A obtained better values than groups C, D and E for all contrasts (p = 0.031, p = 0.038, p = 0.032 at 100, 50 and 10 per cent of contrast, respectively). At the same time, group B obtained better values than groups C, D and E (p = 0.041, p = 0.042, p = 0.036 at 100, 50 and 10 per cent of contrast, respectively). Within the five groups, the worst results were always obtained for group E (p = 0.017, p = 0.021 and p = 0.025 at 100, 50 and 10 per cent of contrast, respectively). The results suggest that the aspheric aberration-correcting IOL studied provides comparable results, when it is combined with normal corneas and with corneas with simulated low myopic ablations. When negative amounts of residual spherical aberration after cataract surgery are expected to be achieved, IOLs with more positive spherical aberration should be considered. © 2013 The Authors. Clinical and Experimental Optometry © 2013 Optometrists Association Australia.

  1. Improving axial resolution in confocal microscopy with new high refractive index mounting media.

    PubMed

    Fouquet, Coralie; Gilles, Jean-François; Heck, Nicolas; Dos Santos, Marc; Schwartzmann, Richard; Cannaya, Vidjeacoumary; Morel, Marie-Pierre; Davidson, Robert Stephen; Trembleau, Alain; Bolte, Susanne

    2015-01-01

    Resolution, high signal intensity and elevated signal to noise ratio (SNR) are key issues for biologists who aim at studying the localisation of biological structures at the cellular and subcellular levels using confocal microscopy. The resolution required to separate sub-cellular biological structures is often near to the resolving power of the microscope. When optimally used, confocal microscopes may reach resolutions of 180 nm laterally and 500 nm axially, however, axial resolution in depth is often impaired by spherical aberration that may occur due to refractive index mismatches. Spherical aberration results in broadening of the point-spread function (PSF), a decrease in peak signal intensity when imaging in depth and a focal shift that leads to the distortion of the image along the z-axis and thus in a scaling error. In this study, we use the novel mounting medium CFM3 (Citifluor Ltd., UK) with a refractive index of 1.518 to minimize the effects of spherical aberration. This mounting medium is compatible with most common fluorochromes and fluorescent proteins. We compare its performance with established mounting media, harbouring refractive indices below 1.500, by estimating lateral and axial resolution with sub-resolution fluorescent beads. We show furthermore that the use of the high refractive index media renders the tissue transparent and improves considerably the axial resolution and imaging depth in immuno-labelled or fluorescent protein labelled fixed mouse brain tissue. We thus propose to use those novel high refractive index mounting media, whenever optimal axial resolution is required.

  2. Improving Axial Resolution in Confocal Microscopy with New High Refractive Index Mounting Media

    PubMed Central

    Fouquet, Coralie; Gilles, Jean-François; Heck, Nicolas; Dos Santos, Marc; Schwartzmann, Richard; Cannaya, Vidjeacoumary; Morel, Marie-Pierre; Davidson, Robert Stephen; Trembleau, Alain; Bolte, Susanne

    2015-01-01

    Resolution, high signal intensity and elevated signal to noise ratio (SNR) are key issues for biologists who aim at studying the localisation of biological structures at the cellular and subcellular levels using confocal microscopy. The resolution required to separate sub-cellular biological structures is often near to the resolving power of the microscope. When optimally used, confocal microscopes may reach resolutions of 180 nm laterally and 500 nm axially, however, axial resolution in depth is often impaired by spherical aberration that may occur due to refractive index mismatches. Spherical aberration results in broadening of the point-spread function (PSF), a decrease in peak signal intensity when imaging in depth and a focal shift that leads to the distortion of the image along the z-axis and thus in a scaling error. In this study, we use the novel mounting medium CFM3 (Citifluor Ltd., UK) with a refractive index of 1.518 to minimize the effects of spherical aberration. This mounting medium is compatible with most common fluorochromes and fluorescent proteins. We compare its performance with established mounting media, harbouring refractive indices below 1.500, by estimating lateral and axial resolution with sub-resolution fluorescent beads. We show furthermore that the use of the high refractive index media renders the tissue transparent and improves considerably the axial resolution and imaging depth in immuno-labelled or fluorescent protein labelled fixed mouse brain tissue. We thus propose to use those novel high refractive index mounting media, whenever optimal axial resolution is required. PMID:25822785

  3. First clinicial results on the feasibility, quality and reproducibility of aberrometry-based intraoperative refraction during cataract surgery.

    PubMed

    Huelle, Jan O; Katz, Toam; Druchkiv, Vasyl; Pahlitzsch, Milena; Steinberg, Johannes; Richard, Gisbert; Linke, Stephan J

    2014-11-01

    To provide the first clinical data in determining the feasibility, quality and precision of intraoperative wavefront aberrometry (IWA)-based refraction in patients with cataract. IWA refraction was recorded at 7 defined measurement points during standardised cataract surgery in 74 eyes of 74 consecutive patients (mean age 69±11.3 years). Precision and measurement quality was evaluated by the 'limits of agreement' approach, regression analysis, correlation analysis, Analysis of variance (ANOVA) and ORs for predicting measurement failure. Wavefront map (WFM) quality was objectivised and compared with the Pentacam Nuclear Staging analysis. Out of 814 IWA measurement attempts, 462 WFMs could be obtained. The most successful readings (n=63) were achieved in aphakia with viscoelastic. The highest (50.63%, SD 20.23) and lowest (29.19%, SD 13.94) quality of WFMs across all measurement points were found after clear corneal incision and in pseudophakia with viscoelastic, respectively. High consistency across repeated measures were found for mean spherical equivalent (SE) differences in aphakia with -0.01D and pseudophakia with -0.01D, but ranges were high (limits of agreement +0.69 D and -0.72 D; +1.53 D and -1.54 D, respectively). With increasing WFM quality, higher precision in measurements was observed. This is the first report addressing quality and reproducibility of WA in a large sample. IWA refraction in aphakia, for instance, appears to be reliable once stable and pressurised anterior chamber conditions are achieved. More efforts are required to improve the precision and quality of measurements before IWA can be used to guide the surgical refractive plan in cataract surgery. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  4. Corneal perforation after conductive keratoplasty with previous refractive surgery.

    PubMed

    Kymionis, George D; Titze, Patrik; Markomanolakis, Marinos M; Aslanides, Ioannis M; Pallikaris, Ioannis G

    2003-12-01

    A 56-year-old woman had conductive keratoplasty (CK) for residual hyperopia and astigmatism. Three years before the procedure, the patient had arcuate keratotomy, followed by laser in situ keratomileusis 2 years later for high astigmatism correction in both eyes. During CK, a corneal perforation occurred in the right eye; during the postoperative examination, an iris perforation and anterior subcapsule opacification were seen beneath the perforation site. The perforation was managed with a bandage contact lens and an antibiotic-steroid ointment; it had a negative Seidel sign by the third day. The surgery in the left eye was uneventful. Three months after the procedure, the uncorrected visual acuity was 20/32 and the best corrected visual acuity 20/20 in both eyes with a significant improvement in corneal topography. Care must be taken to prevent CK-treated spots from coinciding with areas in the corneal stroma that might have been altered by previous refractive procedures.

  5. Total ocular, anterior corneal and lenticular higher order aberrations in hyperopic, myopic and emmetropic eyes.

    PubMed

    Philip, Krupa; Martinez, Aldo; Ho, Arthur; Conrad, Fabian; Ale, Jit; Mitchell, Paul; Sankaridurg, Padmaja

    2012-01-01

    Total ocular higher order aberrations and corneal topography of myopic, emmetropic and hyperopic eyes of 675 adolescents (16.9 ± 0.7 years) were measured after cycloplegia using COAS aberrometer and Medmont videokeratoscope. Corneal higher order aberrations were computed from the corneal topography maps and lenticular (internal) higher order aberrations derived by subtraction of corneal aberrations from total ocular aberrations. Aberrations were measured for a pupil diameter of 5mm. Multivariate analysis of variance followed by multiple regression analysis found significant difference in the fourth order aberrations (SA RMS, primary spherical aberration coefficient) between the refractive error groups. Hyperopic eyes (+0.083 ± 0.05 μm) had more positive total ocular primary spherical aberration compared to emmetropic (+0.036 ± 0.04 μm) and myopic eyes (low myopia=+0.038 ± 0.05 μm, moderate myopia=+0.026 ± 0.06 μm) (p<0.05). No difference was observed for the anterior corneal spherical aberration. Significantly less negative lenticular spherical aberration was observed for the hyperopic eyes (-0.038 ± 0.05 μm) than myopic (low myopia=-0.088 ± 0.04 μm, moderate myopia=-0.095 ± 0.05 μm) and emmetropic eyes (-0.081 ± 0.04 μm) (p<0.05). These findings suggest the existence of differences in the characteristics of the crystalline lens (asphericity, curvature and gradient refractive index) of hyperopic eyes versus other eyes. Crown Copyright © 2011. Published by Elsevier Ltd. All rights reserved.

  6. Femtosecond laser refractive surgery: small-incision lenticule extraction vs. femtosecond laser-assisted LASIK.

    PubMed

    Lee, Jimmy K; Chuck, Roy S; Park, Choul Yong

    2015-07-01

    Small-incision lenticule extraction (SMILE) is a novel technique devised to correct refractive errors. SMILE circumvents excimer laser photoablation of cornea, as the stromal lenticule cut by femtosecond laser is removed manually. Smaller incisions and preservation of anterior corneal biomechanical strength have been suggested as some of the advantages of SMILE over femtosecond laser-assisted LASIK (FS-LASIK). In this review, we compared previous published results of SMILE and FS-LASIK. The advantage, efficacy and safety of SMILE are compared with FS-LASIK. SMILE achieved similar efficacy, predictability and safety as FS-LASIK. Greater preservations of corneal biomechanical strength and corneal nerves were observed in SMILE when compared with LASIK or PRK. Additionally, the incidence of postoperative dry eye syndrome was found to be less problematic in SMILE than in FS-LASIK. SMILE is a promising new surgery for refractive error correction. Prospective and retrospective studies of SMILE have shown that results of SMILE are similar to FS-LASIK. With advances in femtosecond laser technology, SMILE may gain greater acceptance in the future.

  7. Autorefraction Versus Manifest Refraction in Patients With Keratoconus.

    PubMed

    Soeters, Nienke; Muijzer, Marc B; Molenaar, Jurrian; Godefrooij, Daniel A; Wisse, Robert P L

    2018-01-01

    To compare visual performance using autorefraction and manifest refraction assessments in patients with keratoconus and investigate whether autorefraction measurements lead to suboptimal visual performance. Corrected distance visual acuity (CDVA) was measured in 90 eyes of 61 patients with keratoconus with both autorefraction and manifest refraction, in a random order. Maximum keratometry (Kmax), cone location, and wavefront aberration were determined with Scheimpflug tomography. The difference between the autorefraction and manifest refraction outcomes was converted to vectors and a multivariable analysis was performed to identify potential underlying causes of this difference. A significantly better CDVA was achieved with manifest refraction (0.06 vs 0.29 logMAR [20/23 vs 20/38 Snellen], P < .001). After vector analysis, a mean difference of 4.83 diopters was found between autorefraction and manifest refraction. Increased Kmax was strongly and significantly associated with better visual performance of manifest refraction compared to autorefraction (B = 0.496, P = .002). This study showed that a superior CDVA is achieved with manifest refraction compared to autorefraction in patients with keratoconus. Furthermore, the difference between the two refraction methods increases as the cornea steepens. According to this study, autorefraction is unreliable in patients with keratoconus and should be avoided. [J Refract Surg. 2018;34(1):30-34.]. Copyright 2018, SLACK Incorporated.

  8. Visual outcome of cataract surgery; study from the European Registry of Quality Outcomes for Cataract and Refractive Surgery.

    PubMed

    Lundström, Mats; Barry, Peter; Henry, Ype; Rosen, Paul; Stenevi, Ulf

    2013-05-01

    To analyze the visual outcome after cataract surgery. Cataract surgery clinics in 15 European countries. Database study. Data were drawn from case series of cataract extractions reported to the European Registry of Quality Outcomes for Cataract and Refractive Surgery database. These data were entered into the database via the Web by surgeons or by transfer from existing national registries or electronic medical record systems. The database contains individual anonymous data on preoperative, intraoperative, and postoperative measurements. Data on 368,256 cataract extractions were available for analysis. The best visual outcome was achieved in age groups 40 to 74 years, and men showed a higher percentage of excellent vision (1.0 [20/20] or better) than women. A corrected distance visual acuity (CDVA) of 0.5 (20/40) or better and of 1.0 (20/20) or better was achieved in 94.3% and 61.3% of cases, respectively. Ocular comorbidity and postoperative complications were the strongest influences on the visual outcome; however, surgical complications and ocular changes requiring complex surgery also had a negative influence. Deterioration of visual acuity after the surgery (n= 6112 [1.7% of all cases]) was most common in patients with a good preoperative visual acuity. The visual outcomes of cataract surgery were excellent, with 61.3% of patients achieving a corrected distance visual acuity of 1.0 (20/20) or better. Age and sex influenced the visual outcomes, but the greatest influences were short-term postoperative complications, ocular comorbidity, surgical complications, and complex surgery. A weakness of the study could be that some of the data is self-reported to the registry. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  9. On-line pachymetry outcome of ablation in aberration free mode TransPRK.

    PubMed

    Adib-Moghaddam, Soheil; Arba-Mosquera, Samuel; Salmanian, Bahram; Omidvari, Amir-Houshang; Noorizadeh, Farsad

    2014-01-01

    There are many independent factors that influence the outcome of refractive surgeries, consisting of patient characteristics and environmental factors. We studied the accuracy of central ablation depth compared to online pachymetry results. A total of 153 eyes that underwent TransPRK at Bina Eye Hospital, Tehran, Iran, were evaluated from November 2010 to January 2012 in a retrospective cross-sectional study. The relevant data were registered and bivariate correlations and linear regression association were investigated statistically. The mean age was 29 ± 5 years. Distribution of refractive errors was as follows: compound myopic astigmatism 123 (80.4%), simple myopia 24 (15.7%), and mixed astigmatism 6 (3.9%). Mean ambient temperature and humidity levels intraoperatively were 23.49 ± 1.16°C and 28.91 ± 6.16%, respectively. There was a significant difference (p<0.001) between the preassumed central ablation depth (131.68 ± 32.72 µm) and the net level of ablation depth (measured by online pachymetry, 168.04 ± 41.47 µm). Temperature and humidity levels were not in any statistically significant correlation with the net amount of difference found. The backward linear regression was done to reveal the association between ablation depth and several variables. This study showed that there is deviation in optical coherence pachymetry online measurements done with SCHWIND AMARIS laser. Ambient temperature and humidity levels intraoperatively do not influence the outcome. However, basic structural characteristics of patients along with change in refractive index and corneal shrinkage because of corneal dehydration are associated with the differences.

  10. A spherical aberration-free microscopy system for live brain imaging.

    PubMed

    Ue, Yoshihiro; Monai, Hiromu; Higuchi, Kaori; Nishiwaki, Daisuke; Tajima, Tetsuya; Okazaki, Kenya; Hama, Hiroshi; Hirase, Hajime; Miyawaki, Atsushi

    2018-06-02

    The high-resolution in vivo imaging of mouse brain for quantitative analysis of fine structures, such as dendritic spines, requires objectives with high numerical apertures (NAs) and long working distances (WDs). However, this imaging approach is often hampered by spherical aberration (SA) that results from the mismatch of refractive indices in the optical path and becomes more severe with increasing depth of target from the brain surface. Whereas a revolving objective correction collar has been designed to compensate SA, its adjustment requires manual operation and is inevitably accompanied by considerable focal shift, making it difficult to acquire the best image of a given fluorescent object. To solve the problems, we have created an objective-attached device and formulated a fast iterative algorithm for the realization of an automatic SA compensation system. The device coordinates the collar rotation and the Z-position of an objective, enabling correction collar adjustment while stably focusing on a target. The algorithm provides the best adjustment on the basis of the calculated contrast of acquired images. Together, they enable the system to compensate SA at a given depth. As proof of concept, we applied the SA compensation system to in vivo two-photon imaging with a 25 × water-immersion objective (NA, 1.05; WD, 2 mm). It effectively reduced SA regardless of location, allowing quantitative and reproducible analysis of fine structures of YFP-labeled neurons in the mouse cerebral cortical layers. Interestingly, although the cortical structure was optically heterogeneous along the z-axis, the refractive index of each layer could be assessed on the basis of the compensation degree. It was also possible to make fully corrected three-dimensional reconstructions of YFP-labeled neurons in live brain samples. Our SA compensation system, called Deep-C, is expected to bring out the best in all correction-collar-equipped objectives for imaging deep regions of

  11. Perfect X-ray focusing via fitting corrective glasses to aberrated optics.

    PubMed

    Seiboth, Frank; Schropp, Andreas; Scholz, Maria; Wittwer, Felix; Rödel, Christian; Wünsche, Martin; Ullsperger, Tobias; Nolte, Stefan; Rahomäki, Jussi; Parfeniukas, Karolis; Giakoumidis, Stylianos; Vogt, Ulrich; Wagner, Ulrich; Rau, Christoph; Boesenberg, Ulrike; Garrevoet, Jan; Falkenberg, Gerald; Galtier, Eric C; Ja Lee, Hae; Nagler, Bob; Schroer, Christian G

    2017-03-01

    Due to their short wavelength, X-rays can in principle be focused down to a few nanometres and below. At the same time, it is this short wavelength that puts stringent requirements on X-ray optics and their metrology. Both are limited by today's technology. In this work, we present accurate at wavelength measurements of residual aberrations of a refractive X-ray lens using ptychography to manufacture a corrective phase plate. Together with the fitted phase plate the optics shows diffraction-limited performance, generating a nearly Gaussian beam profile with a Strehl ratio above 0.8. This scheme can be applied to any other focusing optics, thus solving the X-ray optical problem at synchrotron radiation sources and X-ray free-electron lasers.

  12. Perfect X-ray focusing via fitting corrective glasses to aberrated optics

    PubMed Central

    Seiboth, Frank; Schropp, Andreas; Scholz, Maria; Wittwer, Felix; Rödel, Christian; Wünsche, Martin; Ullsperger, Tobias; Nolte, Stefan; Rahomäki, Jussi; Parfeniukas, Karolis; Giakoumidis, Stylianos; Vogt, Ulrich; Wagner, Ulrich; Rau, Christoph; Boesenberg, Ulrike; Garrevoet, Jan; Falkenberg, Gerald; Galtier, Eric C.; Ja Lee, Hae; Nagler, Bob; Schroer, Christian G.

    2017-01-01

    Due to their short wavelength, X-rays can in principle be focused down to a few nanometres and below. At the same time, it is this short wavelength that puts stringent requirements on X-ray optics and their metrology. Both are limited by today's technology. In this work, we present accurate at wavelength measurements of residual aberrations of a refractive X-ray lens using ptychography to manufacture a corrective phase plate. Together with the fitted phase plate the optics shows diffraction-limited performance, generating a nearly Gaussian beam profile with a Strehl ratio above 0.8. This scheme can be applied to any other focusing optics, thus solving the X-ray optical problem at synchrotron radiation sources and X-ray free-electron lasers. PMID:28248317

  13. [Analysis of refractive status after cataract surgery in age-related cataract patients with shallow anterior chamber].

    PubMed

    Yang, Fei; Hou, Xianru; Wu, Huijuan; Bao, Yongzhen

    2014-02-01

    To evaluate the characteristics of postoperative refractive status in age-related cataract patients with shallow anterior chamber and the correlation between pre-operative anterior chamber depth and postoperative refractive status. Prospective case-control study. Sixty-eight cases (90 eyes) with age-related cataract were recruited from October 2010 to January 2012 in People's Hospital Peking University including 28 cases (34 eyes) in control group and 40 cases (56 eyes) in shallow anterior chamber group according to anterior chamber depth (ACD) measured by Pentacam system. Axial length and keratometer were measured by IOL Master and intraocular lens power was calculated using SRK/T formula. Postoperative refraction, ACD and comprehensive eye examination were performed at 1 month and 3 months after cataract surgery. Using SPSS13.0 software to establish a database, the two groups were compared with independent samples t-test and correlation analysis were performed with binary logical regression. The postoperative refractive deviation at 1 month were (-0.39 ± 0.62) D in control group and (+0.73 ± 0.26) D in shallow anterior chamber group respectively which present statistical significance between the two groups (P = 0.00, t = 3.67); the postoperative refractive deviation in 3 month was (-0.37 ± 0.62) D in control group and (+0.79 ± 0.28) D in shallow anterior chamber group operatively which present statistical significance between the two groups (P = 0.00, t = 3.33). In shallow anterior chamber group, with the shallower of ACD, the greater of refractive deviation (P = 0.00, r1 month = -0.57, r3 months = -0.61). Hyperopic shift existed in age-related cataract patients with shallow anterior chamber and the shallower of ACD was, the greater of hyperopic shift happened.

  14. [Impact of an Aspherical Aberration Correcting Monofocal Intraocular Lens on Patient Satisfaction for Daily Life Activities: The Heidelberg Daily Task Evaluation (DATE) Questionnaire].

    PubMed

    Kretz, F T A; Son, H; Liebing, S; Tandogan, T; Auffarth, G U

    2015-08-01

    A clinical evaluation of the functional results and its impact on daily activities of an aspherical, aberration correcting intraocular lens (IOL) was undertaken. Twenty-one patients aged from 50 to 83 years underwent cataract surgery with implantation of the aspheric IOL (Tecnis ZCB00, Abbott Medical Optics). They were evaluated 2 to 4 months after surgery for their subjective satisfaction of vision quality and its impact on performance of daily activities as well as functional results and refractive outcome. Patients were asked to fill out a questionnaire - the Heidelberg DATE (DAily Tasks Evaluation) questionnaire. Significant changes from pre- to postoperative results were found in refraction (p ≤ 0.03), with a mean prediction error of + 0.21 ± 0.43 D. UDVA and CDVA improved significantly (p < 0.01), with a postoperative CDVA of 0.0 logMAR or better in 97.1 % of eyes. All patients would recommend the procedure to a relative or a friend and 93.8 % of patients reported to be satisfied with the outcome. The implantation of the aspheric IOL Tecnis ZCB00 after cataract surgery allows the restoration of visual function, providing an optimised optical quality and a high level of patient satisfaction. Georg Thieme Verlag KG Stuttgart · New York.

  15. Postoperative Refractive Errors Following Pediatric Cataract Extraction with Intraocular Lens Implantation.

    PubMed

    Indaram, Maanasa; VanderVeen, Deborah K

    2018-01-01

    Advances in surgical techniques allow implantation of intraocular lenses (IOL) with cataract extraction, even in young children. However, there are several challenges unique to the pediatric population that result in greater degrees of postoperative refractive error compared to adults. Literature review of the techniques and outcomes of pediatric cataract surgery with IOL implantation. Pediatric cataract surgery is associated with several sources of postoperative refractive error. These include planned refractive error based on age or fellow eye status, loss of accommodation, and unexpected refractive errors due to inaccuracies in biometry technique, use of IOL power formulas based on adult normative values, and late refractive changes due to unpredictable eye growth. Several factors can preclude the achievement of optimal refractive status following pediatric cataract extraction with IOL implantation. There is a need for new technology to reduce postoperative refractive surprises and address refractive adjustment in a growing eye.

  16. Astigmatism and Refractive Outcome After Late In-The-Bag Intraocular Lens Dislocation Surgery: A Randomized Clinical Trial.

    PubMed

    Kristianslund, Olav; Østern, Atle Einar; Drolsum, Liv

    2017-09-01

    To compare surgically induced astigmatism (SIA) and refractive outcomes between two operation methods for late in-the-bag IOL dislocation. In this prospective, randomized, parallel-group clinical trial, 104 patients (eyes) were assigned to IOL repositioning by scleral suturing 1.5- to 2-mm posterior to limbus (n = 54) or IOL exchange with a retropupillar iris-claw IOL using a 5.5-mm scleral pocket incision (n = 50). The SIA was determined by vector analysis through conversion of corneal cylinders to Cartesian coordinates, and is presented as magnitude in diopters @ direction in degrees (D @ °). Follow-up was 6 months. The SIA was 0.24 D @ 8° for IOL repositioning and 0.65 D @ 171° for IOL exchange, which was a nonsignificant group difference (X coordinate: P = 0.08; Y coordinate: P = 0.16). Mean SIA magnitude was 0.60 ± 0.50 D and 1.12 ± 0.85 D, respectively (P < 0.001). Mean postoperative spherical equivalent was -1.6 ± 1.6 D after IOL repositioning and -0.5 ± 1.0 D after IOL exchange (P < 0.001). For IOL repositioning, this represented a mean myopic shift of -0.7 ± 1.1 D compared with before the IOL dislocation (P < 0.001). For IOL exchange, it was within ±1 D of target refraction in 83% of the patients. Surgically induced astigmatism was modest in both operation groups, albeit with a tendency of being more pronounced for IOL exchange. Repositioning surgery led to a myopic shift, whereas exchange surgery provided good refractive predictability.

  17. Repeatability and Reproducibility of Virtual Subjective Refraction.

    PubMed

    Perches, Sara; Collados, M Victoria; Ares, Jorge

    2016-10-01

    To establish the repeatability and reproducibility of a virtual refraction process using simulated retinal images. With simulation software, aberrated images corresponding with each step of the refraction process were calculated following the typical protocol of conventional subjective refraction. Fifty external examiners judged simulated retinal images until the best sphero-cylindrical refraction and the best visual acuity were achieved starting from the aberrometry data of three patients. Data analyses were performed to assess repeatability and reproducibility of the virtual refraction as a function of pupil size and aberrometric profile of different patients. SD values achieved in three components of refraction (M, J0, and J45) are lower than 0.25D in repeatability analysis. Regarding reproducibility, we found SD values lower than 0.25D in the most cases. When the results of virtual refraction with different pupil diameters (4 and 6 mm) were compared, the mean of differences (MoD) obtained were not clinically significant (less than 0.25D). Only one of the aberrometry profiles with high uncorrected astigmatism shows poor results for the M component in reproducibility and pupil size dependence analysis. In all cases, vision achieved was better than 0 logMAR. A comparison between the compensation obtained with virtual and conventional subjective refraction was made as an example of this application, showing good quality retinal images in both processes. The present study shows that virtual refraction has similar levels of precision as conventional subjective refraction. Moreover, virtual refraction has also shown that when high low order astigmatism is present, the refraction result is less precise and highly dependent on pupil size.

  18. Symbolic algebra approach to the calculation of intraocular lens power following cataract surgery

    NASA Astrophysics Data System (ADS)

    Hjelmstad, David P.; Sayegh, Samir I.

    2013-03-01

    We present a symbolic approach based on matrix methods that allows for the analysis and computation of intraocular lens power following cataract surgery. We extend the basic matrix approach corresponding to paraxial optics to include astigmatism and other aberrations. The symbolic approach allows for a refined analysis of the potential sources of errors ("refractive surprises"). We demonstrate the computation of lens powers including toric lenses that correct for both defocus (myopia, hyperopia) and astigmatism. A specific implementation in Mathematica allows an elegant and powerful method for the design and analysis of these intraocular lenses.

  19. Holographic Refraction and the Measurement of Spherical Ametropia.

    PubMed

    Nguyen, Nicholas Hoai Nam

    2016-10-01

    To evaluate the performance of a holographic logMAR chart for the subjective spherical refraction of the human eye. Bland-Altman analysis was used to assess the level of agreement between subjective spherical refraction using the holographic logMAR chart and conventional autorefraction and subjective spherical refraction. The 95% limits of agreement (LoA) were calculated between holographic refraction and the two standard methods (subjective and autorefraction). Holographic refraction has a lower mean spherical refraction when compared to conventional refraction (LoA 0.11 ± 0.65 D) and when compared to autorefraction (LoA 0.36 ± 0.77 D). After correcting for systemic bias, this is comparable between autorefraction and conventional subjective refraction (LoA 0.45 ± 0.79 D). After correcting for differences in vergence distance and chromatic aberration between holographic and conventional refraction, approximately 65% (group 1) of measurements between holography and conventional subjective refraction were similar (MD = 0.13 D, SD = 0.00 D). The remaining 35% (group 2) had a mean difference of 0.45 D (SD = 0.12 D) between the two subjective methods. Descriptive statistics showed group 2's mean age (21 years, SD = 13 years) was considerably lower than group 1's mean age (41 years, SD = 17), suggesting accommodation may have a role in the greater mean difference of group 2. Overall, holographic refraction has good agreement with conventional refraction and is a viable alternative for spherical subjective refraction. A larger bias between holographic and conventional refraction was found in younger subjects than older subjects, suggesting an association between accommodation and myopic over-correction during holographic refraction.

  20. Refractive Outcomes After Femtosecond Laser-Assisted Cataract Surgery in Eyes With Anterior Chamber Phakic Intraocular Lenses.

    PubMed

    Steinwender, Gernot; Shajari, Mehdi; Kohnen, Thomas

    2018-05-01

    To report the efficacy, predictability, and safety of femtosecond laser-assisted cataract surgery (FLACS) in eyes with anterior chamber phakic intraocular lenses (IOLs). This retrospective case series included eyes with previous implantation of an angle-supported and an iris-fixated phakic IOL for the correction of myopia that underwent a combined procedure of phakic IOL ex-plantation and FLACS with in-the-bag implantation of a posterior chamber IOL. Postoperative corrected distance visual acuity (CDVA), predictability of refractive outcome, and occurrence of intraoperative and postoperative complications were analyzed. Ten eyes of 7 patients with significant cataract were included: 5 eyes with an angle-supported foldable hydrophobic phakic IOL, 4 eyes with an angle-supported polymethylmethacrylate (PMMA) phakic IOL, and 1 eye with an iris-fixated PMMA phakic IOL. Mean follow-up after FLACS was 8.4 ± 5.8 months. Mean interval between phakic IOL implantation and FLACS was 11.9 ± 4.0 years. After the combined procedure of phakic IOL explantation and FLACS, mean manifest refractive spherical equivalent (MRSE) was -0.11 ± 0.49 diopters (D) and MRSE was within ± 0.75 D of target refraction in all eyes. Four eyes received a toric posterior chamber IOL after phacoemulsification. Mean preoperative CDVA of 0.40 ± 0.23 logMAR improved significantly to 0.22 ± 0.11 logMAR postoperatively (P = .027). No intraoperative or postoperative complications occurred. The results in this series showed that FLACS in eyes with previous implantation of both rigid and foldable anterior chamber phakic IOLs offers good refractive outcomes with a high level of predictability and safety. [J Refract Surg. 2018;34(5):338-342.]. Copyright 2018, SLACK Incorporated.

  1. Accuracy of refractive outcomes in myopic and hyperopic laser in situ keratomileusis: Manifest versus aberrometric refraction.

    PubMed

    Reinstein, Dan Z; Morral, Merce; Gobbe, Marine; Archer, Timothy J

    2012-11-01

    To compare the achieved refractive accuracy of laser in situ keratomileusis (LASIK) performed based on manifest refraction with the predicted accuracy that would have been achieved using WASCA aberrometric refraction with and without Seidel correction factor for sphere. London Vision Clinic, London, United Kingdom. Comparative case series. Myopic eyes and hyperopic eyes had LASIK based on manifest refraction. Two aberrometric refractions were obtained preoperatively: Seidel, which includes spherical aberration in the sphere calculation, and non-Seidel. Bland-Altman plots were used to show the agreement between aberrometric and manifest refractions. Predicted LASIK outcomes had aberrometric refraction been used were modeled by shifting the postoperative manifest refraction by the vector difference between the preoperative manifest and aberrometric refractions. This study included 869 myopic eyes and 413 hyperopic eyes. The mean differences (manifest minus aberrometric) in spherical equivalent were +0.03 diopters (D) ± 0.48 (SD) (Seidel aberrometric) and +0.45 ± 0.42 D (non-Seidel aberrometric) for myopia and -0.20 ± 0.39 D and +0.39 ± 0.34 D, respectively, for hyperopia. The mean differences in cylinder magnitude were -0.10 ± 0.27 D and 0.00 ± 0.25 D, respectively. The percentage of eyes within ±0.50 D of the attempted correction was 81% (manifest), 70% (Seidel), and 67% (non-Seidel) for myopia and 71% (manifest), 61% (Seidel), and 64% (non-Seidel) for hyperopia. The achieved refractive accuracy by manifest refraction was better than the predicted accuracy had Seidel or non-Seidel aberrometric refractions been used for surgical planning. Using the Seidel method improved the accuracy in myopic eyes but not in hyperopic eyes. Dr. Reinstein is a consultant to Carl Zeiss Meditec AG and has a proprietary interest in the Artemis technology (Arcscan Inc., Morrison, Colorado, USA) through patents administered by the Cornell Center for Technology Enterprise and

  2. Index mismatch aberration correction over long working distances using spatial light modulation.

    PubMed

    Gjonaj, Bergin; Johnson, Patrick; Bonn, Mischa; Domke, Katrin F

    2012-11-20

    For many microscopy applications, millimeters-long free working distances (LWD) are required. However, the high resolution and contrast of LWD objectives operated in air are lost when introducing glass and/or liquid with the sample. We propose to use spatial light modulation to correct for such beam aberrations caused by refractive index mismatches. Focusing a monochromatic laser beam with a 10 mm working distance air objective (50×, 0.5 NA) through air, glass, and water, we manage to restore a sharp, intense focus (FWHM<2λ) by adaptive beam phase shaping. Our approach offers a practical and cost-effective route to high resolution and contrast microscopy using LWD air objectives, extending their usage beyond applications in air.

  3. High spatial resolution with zoomable saw-tooth refractive lenses?

    NASA Astrophysics Data System (ADS)

    Jark, Werner

    2011-09-01

    Refractive x-ray lenses can be assembled from two opposing saw-tooth structures, when they are inclined with respect to each other and almost touch at one end. An incident plane wave will then traverse a varying number of triangular prisms, which direct the beam towards the optical axis and focus it. Optically speaking the plane wave traverses a parabolic lens profile, which is approximated by trapezoidal segments. The parabolic profile will focus ideally, when a lens can be discussed in the "thin lens" approximation. Now the saw-tooth refractive lens is found to be too "thick". The residual aberrations limit the focusing capability to just submicrometer focusing, significantly above the limit in diffraction limited focusing. It is shown that the aberrations can be removed by introducing a variation into the originally constant saw-tooth angle. After this modification the lens can be operated in the diffraction limited regime. Spot sizes even below 0.1 micrometer are then feasible. This performance in terms of spatial resolution is found to be limited to focusing to microspots and is not available, when the saw-tooth refractive lens is used in an imaging setup. In this case the spatial resolution deteriorates rapidly with increasing off axis distance of the object to be imaged.

  4. Accommodative Esotropia Treatment Plan Utilizing Simultaneous Strabismus Surgery and Photorefractive Keratectomy.

    PubMed

    Eustis, H Sprague; Shah, Pulin

    2018-03-01

    Accommodative esotropia is a common cause of acquired esotropia. Pathogenesis varies among patients but usually includes excessive hyperopia and a high accommodative convergence/accommodation ratio or tight medial recti. The present study reviews an individualized treatment plan combining photorefractive keratectomy (PRK) and strabismus surgery to correct these problems. This study is a retrospective, interventional case series. Records for 15 patients who were treated for accommodative esotropia were reviewed. Patient ages ranged from 11 to 19 years. PRK and strabismus surgery were performed on 11 patients, and PRK only on 4 patients. The goal was to create a physiologic refractive error, good visual acuity (VA), and straight eyes without correction. All patients were spectacle free at 6-month follow-up. Twenty-four of 30 eyes had VA equal to preoperative VA without correction. Three eyes had a 1-line reduction and 2-line reduction in VA. The alignment results were ±10 prism diopters in 13 of 15 patients. Spherical refractive outcomes were 18 of 30 eyes within 1 diopter (D) of target and 12 of 30 eyes within 2 D of target. Astigmatism refractive outcomes were 21 of 30 eyes <1 D, 7 eyes 1-2 D, and 2 eyes >2 D. Two patients complained of halos at night, and 1 patient had peripheral corneal haze. Simultaneous PRK and strabismus surgery is safe and effective in treating accommodative esotropia. An individualized treatment plan can result in a physiologic refractive error, good VA, and a spectacle-free existence. Copyright © 2018 Elsevier Inc. All rights reserved.

  5. Double-pass measurement of human eye aberrations: limitations and practical realization

    NASA Astrophysics Data System (ADS)

    Letfullin, Renat R.; Belyakov, Alexey I.; Cherezova, Tatyana Y.; Kudryashov, Alexis V.

    2004-11-01

    The problem of correct eye aberrations measurement is very important with the rising widespread of a surgical procedure for reducing refractive error in the eye, so called, LASIK (laser-assisted in situ keratomileusis). The double-pass technique commonly used for measuring aberrations of a human eye involves some uncertainties. One of them is loosing the information about odd human eye aberrations. We report about investigations of the applicability limit of the double-pass measurements depending upon the aberrations status introduced by human eye and actual size of the entrance pupil. We evaluate the double-pass effects for various aberrations and different pupil diameters. It is shown that for small pupils the double-pass effects are negligible. The testing and alignment of aberrometer was performed using the schematic eye, developed in our lab. We also introduced a model of human eye based on bimorph flexible mirror. We perform calculations to demonstrate that our schematic eye is capable of reproducing spatial-temporal statistics of aberrations of living eye with normal vision or even myopic or hypermetropic or with high aberrations ones.

  6. Perfect X-ray focusing via fitting corrective glasses to aberrated optics

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Seiboth, Frank; Schropp, Andreas; Scholz, Maria

    2017-03-01

    Due to their short wavelength, X-rays can in principle be focused down to a few nanometres and below. At the same time, it is this short wavelength that puts stringent requirements on X-ray optics and their metrology. Both are limited by today’s technology. In this work, we present accurate at wavelength measurements of residual aberrations of a refractive X-ray lens using ptychography to manufacture a corrective phase plate. Together with the fitted phase plate the optics shows diffraction-limited performance, generating a nearly Gaussian beam profile with a Strehl ratio above 0.8. As a result, this scheme can be applied tomore » any other focusing optics, thus solving the X-ray optical problem at synchrotron radiation sources and X-ray free-electron lasers.« less

  7. Higher-order aberrations after wavefront-optimized photorefractive keratectomy and laser in situ keratomileusis

    PubMed Central

    Randleman, J. Bradley; Perez-Straziota, Claudia E.; Hu, Michelle H.; White, Alfred J.; Loft, Evan S.; Stulting, R. Doyle

    2013-01-01

    PURPOSE To analyze the changes in higher-order aberrations (HOAs) that occur after wavefront-optimized photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK). SETTING Private practice, Atlanta, Georgia, USA. METHODS This retrospective analysis comprised eyes that had PRK or LASIK from June 2004 through October 2005. Postoperative outcome measures included 3-month uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), manifest refraction spherical equivalent (MRSE), changes in the root mean square (RMS) and grouped coefficient HOAs (microns) measured with a corneal analyzer, and subjective assessment of visual aberrations. RESULTS One hundred consecutive eyes of 54 patients had PRK, and 100 contemporaneous consecutive eyes of 71 patients had LASIK. The PRK and LASIK populations were similar in general demographics, preoperative HOAs, and postoperative UCVA and BSCVA. The mean MRSE was slightly hyperopic after PRK (mean +0.11 diopters [D]) and slightly myopic after LASIK (mean −0.19 D) (P<.0001). There were no statistically significant changes in RMS or grouped coefficient HOA values after PRK or LASIK, nor were there significant differences in postoperative RMS or grouped coefficient HOA values between PRK and LASIK. One percent of PRK and LASIK patients reported a subjective increase in postoperative visual aberrations; 5% reported a subjective improvement postoperatively. CONCLUSIONS Wavefront-optimized excimer laser surgery did not induce significant HOAs after PRK or LASIK. The 2 techniques were equally efficacious and had equivalent postoperative HOA profiles. PMID:19185240

  8. Active Correction of Aberrations of Low-Quality Telescope Optics

    NASA Technical Reports Server (NTRS)

    Hemmati, Hamid; Chen, Yijian

    2007-01-01

    A system of active optics that includes a wavefront sensor and a deformable mirror has been demonstrated to be an effective means of partly correcting wavefront aberrations introduced by fixed optics (lenses and mirrors) in telescopes. It is envisioned that after further development, active optics would be used to reduce wavefront aberrations of about one wave or less in telescopes having aperture diameters of the order of meters or tens of meters. Although this remaining amount of aberration would be considered excessive in scientific applications in which diffraction-limited performance is required, it would be acceptable for free-space optical- communication applications at wavelengths of the order of 1 m. To prevent misunderstanding, it is important to state the following: The technological discipline of active optics, in which the primary or secondary mirror of a telescope is directly and dynamically tilted, distorted, and/or otherwise varied to reduce wavefront aberrations, has existed for decades. The term active optics does not necessarily mean the same thing as does adaptive optics, even though active optics and adaptive optics are related. The term "adaptive optics" is often used to refer to wavefront correction at speeds characterized by frequencies ranging up to between hundreds of hertz and several kilohertz high enough to enable mitigation of adverse effects of fluctuations in atmospheric refraction upon propagation of light beams. The term active optics usually appears in reference to wavefront correction at significantly lower speeds, characterized by times ranging from about 1 second to as long as minutes. Hence, the novelty of the present development lies, not in the basic concept of active or adaptive optics, but in the envisioned application of active optics in conjunction with a deformable mirror to achieve acceptably small wavefront errors in free-space optical communication systems that include multi-meter-diameter telescope mirrors that are

  9. Measurement and design of refractive corrections using ultrafast laser-induced intra-tissue refractive index shaping in live cats

    NASA Astrophysics Data System (ADS)

    Brooks, Daniel R.; Wozniak, Kaitlin T.; Knox, Wayne; Ellis, Jonathan D.; Huxlin, Krystel R.

    2018-02-01

    Intra-Tissue Refractive Index Shaping (IRIS) uses a 405 nm femtosecond laser focused into the stromal region of the cornea to induce a local refractive index change through multiphoton absorption. This refractive index change can be tailored through scanning of the focal region and variations in laser power to create refractive structures, such as gradient index lenses for visual refractive correction. Previously, IRIS was used to create 2.5 mm wide, square, -1 D cylindrical refractive structures in living cats. In the present work, we first wrote 400 μm wide bars of refractive index change at varying powers in enucleated cat globes using a custom flexure-based scanning system. The cornea and surrounding sclera were then removed and mounted into a wet cell. The induced optical phase change was measured with a Mach- Zehnder Interferometer (MZI), and appeared as fringe displacement, whose magnitude was proportional to the refractive index change. The interferograms produced by the MZI were analyzed with a Fourier Transform based algorithm in order to extract the phase change. This provided a phase change versus laser power calibration, which was then used to design the scanning and laser power distribution required to create -1.5 D cylindrical Fresnel lenses in cat cornea covering an area 6 mm in diameter. This prescription was inscribed into the corneas of one eye each of two living cats, under surgical anesthesia. It was then verified in vivo by contrasting wavefront aberration measurements collected pre- IRIS with those obtained over six months post-IRIS using a Shack-Hartmann wavefront sensor.

  10. Corneal Biomechanics in Ectatic Diseases: Refractive Surgery Implications

    PubMed Central

    Ambrósio, Jr, Renato; Correia, Fernando Faria; Lopes, Bernardo; Salomão, Marcella Q.; Luz, Allan; Dawson, Daniel G.; Elsheikh, Ahmed; Vinciguerra, Riccardo; Vinciguerra, Paolo; Roberts, Cynthia J.

    2017-01-01

    Background: Ectasia development occurs due to a chronic corneal biomechanical decompensation or weakness, resulting in stromal thinning and corneal protrusion. This leads to corneal steepening, increase in astigmatism, and irregularity. In corneal refractive surgery, the detection of mild forms of ectasia pre-operatively is essential to avoid post-operative progressive ectasia, which also depends on the impact of the procedure on the cornea. Method: The advent of 3D tomography is proven as a significant advancement to further characterize corneal shape beyond front surface topography, which is still relevant. While screening tests for ectasia had been limited to corneal shape (geometry) assessment, clinical biomechanical assessment has been possible since the introduction of the Ocular Response Analyzer (Reichert Ophthalmic Instruments, Buffalo, USA) in 2005 and the Corvis ST (Oculus Optikgeräte GmbH, Wetzlar, Germany) in 2010. Direct clinical biomechanical evaluation is recognized as paramount, especially in detection of mild ectatic cases and characterization of the susceptibility for ectasia progression for any cornea. Conclusions: The purpose of this review is to describe the current state of clinical evaluation of corneal biomechanics, focusing on the most recent advances of commercially available instruments and also on future developments, such as Brillouin microscopy. PMID:28932334

  11. Corneal spherical aberration in Saudi population

    PubMed Central

    Al-Sayyari, Tarfah M.; Fawzy, Samah M.; Al-Saleh, Ahmed A.

    2014-01-01

    Purpose To find out the mean corneal spherical aberration and its changes with age in Saudi population. Setting AlHokama Eye Specialist Center, Riyadh, Saudi Arabia. Methods Three hundred (300) eyes of 185 Saudi subjects (97 men and 88 women), whose age ranged from 15 to 85 years old, with matched refractive errors, were divided into three groups according to their age, 100 for each. All the subjects were included in measuring the spherical aberration (SA) using pentacam HR (OCULUS, Germany) at the 6-mm optical zone. Results The mean corneal spherical aberration (CSA) of the fourth order (Z40) of the whole groups was 0.252 ± 0.1154 μm. Patients from 15 to 35 years old have root mean square (RMS) of CSA of 0.2068 ± 0.07151 μm, 0.2370 ± 0.08023 μm was the RMS of CSA of the patients from 35 to 50 years old, while those from 50 to 85 years old have a CSA-RMS of 0.31511 ± 0.1503 μm (P < 0.0001). A positive correlation was found between the spherical aberration (Z40) and the progress of age (r = 0.3429, P < 0.0001). The high order aberration (HOA) presented 28.1% of the total corneal aberrations. While the fourth order corneal spherical aberration constituted 57% of the HOA and 16% of the total aberration. The pupil diameter shows a negative correlation with the increase in age (P = 0.0012). Conclusion Our results showed a CSA (Z40) that is varied among the population, comparable to other studies, and significantly correlates to the progress of age. PMID:25278799

  12. Fluorescence microscopy point spread function model accounting for aberrations due to refractive index variability within a specimen.

    PubMed

    Ghosh, Sreya; Preza, Chrysanthe

    2015-07-01

    A three-dimensional (3-D) point spread function (PSF) model for wide-field fluorescence microscopy, suitable for imaging samples with variable refractive index (RI) in multilayered media, is presented. This PSF model is a key component for accurate 3-D image restoration of thick biological samples, such as lung tissue. Microscope- and specimen-derived parameters are combined with a rigorous vectorial formulation to obtain a new PSF model that accounts for additional aberrations due to specimen RI variability. Experimental evaluation and verification of the PSF model was accomplished using images from 175-nm fluorescent beads in a controlled test sample. Fundamental experimental validation of the advantage of using improved PSFs in depth-variant restoration was accomplished by restoring experimental data from beads (6  μm in diameter) mounted in a sample with RI variation. In the investigated study, improvement in restoration accuracy in the range of 18 to 35% was observed when PSFs from the proposed model were used over restoration using PSFs from an existing model. The new PSF model was further validated by showing that its prediction compares to an experimental PSF (determined from 175-nm beads located below a thick rat lung slice) with a 42% improved accuracy over the current PSF model prediction.

  13. Anterior Corneal, Posterior Corneal, and Lenticular Contributions to Ocular Aberrations.

    PubMed

    Atchison, David A; Suheimat, Marwan; Mathur, Ankit; Lister, Lucas J; Rozema, Jos

    2016-10-01

    To determine the corneal surfaces and lens contributions to ocular aberrations. There were 61 healthy participants with ages ranging from 20 to 55 years and refractions -8.25 diopters (D) to +3.25 D. Anterior and posterior corneal topographies were obtained with an Oculus Pentacam, and ocular aberrations were obtained with an iTrace aberrometer. Raytracing through models of corneas provided total corneal and surface component aberrations for 5-mm-diameter pupils. Lenticular contributions were given as differences between ocular and corneal aberrations. Theoretical raytracing investigated influence of object distance on aberrations. Apart from defocus, the highest aberration coefficients were horizontal astigmatism, horizontal coma, and spherical aberration. Most correlations between lenticular and ocular parameters were positive and significant, with compensation of total corneal aberrations by lenticular aberrations for 5/12 coefficients. Anterior corneal aberrations were approximately three times higher than posterior corneal aberrations and usually had opposite signs. Corneal topographic centers were displaced from aberrometer pupil centers by 0.32 ± 0.19 mm nasally and 0.02 ± 0.16 mm inferiorly; disregarding corneal decentration relative to pupil center was significant for oblique astigmatism, horizontal coma, and horizontal trefoil. An object at infinity, rather than at the image in the anterior cornea, gave incorrect aberration estimates of the posterior cornea. Corneal and lenticular aberration magnitudes are similar, and aberrations of the anterior corneal surface are approximately three times those of the posterior surface. Corneal decentration relative to pupil center has significant effects on oblique astigmatism, horizontal coma, and horizontal trefoil. When estimating component aberrations, it is important to use correct object/image conjugates and heights at surfaces.

  14. Perspectives of using the 223-nm wavelength of the KrCl excimer laser for refractive surgery and for the treatment of some eye diseases

    NASA Astrophysics Data System (ADS)

    Bagayev, Sergei N.; Chernikh, Valery V.; Razhev, Alexander M.; Zhupikov, Andrey A.

    2000-06-01

    The new surgical UV ophthalmic laser system Medilex based on the KrCl (223 nm) excimer laser for refractive surgery was created. The comparative analysis of using the UV ophthalmic laser systems Medilex based on the ArF (193 nm) and the KrCl (223 nm) excimer lasers for the correction of refractive errors was performed. The system with the radiation wavelength of 223 nanometer of the KrCl excimer laser for refractive surgery was shown to have several medical and technical advantages over the system with the traditionally used radiation wavelength of 193 nanometer of the ArF excimer laser. In addition the use of the wavelength of 223 nanometer extends functional features of the system, allowing to make not only standard for this type systems surgical and therapeutic procedures but also to treat such ocular diseases as the glaucoma and herpetic keratities. For the UV ophthalmic laser systems Medilex three variations of the beam delivery system including special rotating masks and different beam homogenize systems were developed. All created beam delivery systems are able to make the correction of myopia, hyperopia, astigmatism and myopic or hyperopic astigmatism and may be used for therapeutic procedures. The results of the initial treatments of refractive error corrections using the UV ophthalmic laser systems Medilex for both photorefractive keratectomy (PRK) and LASIK procedures are presented.

  15. Simultaneous versus sequential penetrating keratoplasty and cataract surgery.

    PubMed

    Hayashi, Ken; Hayashi, Hideyuki

    2006-10-01

    To compare the surgical outcomes of simultaneous penetrating keratoplasty and cataract surgery with those of sequential surgery. Thirty-nine eyes of 39 patients scheduled for simultaneous keratoplasty and cataract surgery and 23 eyes of 23 patients scheduled for sequential keratoplasty and secondary phacoemulsification surgery were recruited. Refractive error, regular and irregular corneal astigmatism determined by Fourier analysis, and endothelial cell loss were studied at 1 week and 3, 6, and 12 months after combined surgery in the simultaneous surgery group or after subsequent phacoemulsification surgery in the sequential surgery group. At 3 and more months after surgery, mean refractive error was significantly greater in the simultaneous surgery group than in the sequential surgery group, although no difference was seen at 1 week. The refractive error at 12 months was within 2 D of that targeted in 15 eyes (39%) in the simultaneous surgery group and within 2 D in 16 eyes (70%) in the sequential surgery group; the incidence was significantly greater in the sequential group (P = 0.0344). The regular and irregular astigmatism was not significantly different between the groups at 3 and more months after surgery. No significant difference was also found in the percentage of endothelial cell loss between the groups. Although corneal astigmatism and endothelial cell loss were not different, refractive error from target refraction was greater after simultaneous keratoplasty and cataract surgery than after sequential surgery, indicating a better outcome after sequential surgery than after simultaneous surgery.

  16. Enhanced vibrational spectroscopy, intracellular refractive indexing for label-free biosensing and bioimaging by multiband plasmonic-antenna array.

    PubMed

    Chen, Cheng-Kuang; Chang, Ming-Hsuan; Wu, Hsieh-Ting; Lee, Yao-Chang; Yen, Ta-Jen

    2014-10-15

    In this study, we report a multiband plasmonic-antenna array that bridges optical biosensing and intracellular bioimaging without requiring a labeling process or coupler. First, a compact plasmonic-antenna array is designed exhibiting a bandwidth of several octaves for use in both multi-band plasmonic resonance-enhanced vibrational spectroscopy and refractive index probing. Second, a single-element plasmonic antenna can be used as a multifunctional sensing pixel that enables mapping the distribution of targets in thin films and biological specimens by enhancing the signals of vibrational signatures and sensing the refractive index contrast. Finally, using the fabricated plasmonic-antenna array yielded reliable intracellular observation was demonstrated from the vibrational signatures and intracellular refractive index contrast requiring neither labeling nor a coupler. These unique features enable the plasmonic-antenna array to function in a label-free manner, facilitating bio-sensing and imaging development. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. Prevalence of Refractive Errors in Students with and without Color Vision Deficiency

    PubMed Central

    Ostadimoghaddam, Hadi; Yekta, Abbas Ali; Heravian, Javad; Azimi, Abbas; Hosseini, Seyed Mahdi Ahmadi; Vatandoust, Sakineh; Sharifi, Fatemeh; Abolbashari, Fereshteh

    2014-01-01

    Purpose: To evaluate refractive errors in school age children with color vision deficiency (CVD) and those with normal color vision (NCV) in order to make a better understanding of the emmetropization process. Methods: A total of 4,400 primary school students aged 7–12 years were screened for color vision using Ishihara pseudoisochromatic color vision plate sets. Of these, 160 (3.6%) students had CVD. A total of 400 age- and sex-matched students with NCV were selected as controls. Refractive status was evaluated using objective cyclorefraction. Results: The CVD group included 136 male (85%) and 24 female (15%) subjects with mean age of 10.1 ± 1.8 years. The NCV group comprised of 336 male (84%) and 64 female (16%) subjects with mean age of 10.5 ± 1.2 years. The prevalence of myopia (7.7% vs. 13.9%, P < 0.001) and hyperopia (41% vs. 57.4%, P = 0.03) was significantly lower in the CVD group. Furthermore, subjects with CVD subjects demonstrated a lower magnitude of refractive errors as compared to the CVD group (mean refractive error: +0.54 ± 0.19 D versus + 0.74 ± 1.12 D, P < 0.001). Conclusion: Although the lower prevalence of myopia in subjects with CVD group supports the role of longitudinal chromatic aberration in the development of refractive errors; the lower prevalence of hyperopia in this group is an opposing finding. Myopia is a multifactorial disorder and longitudinal chromatic aberration is not the only factor influencing the emmetropization process. PMID:25709775

  18. Refractive collimation beam shaper design and sensitivity analysis using a free-form profile construction method.

    PubMed

    Tsai, Chung-Yu

    2017-07-01

    A refractive laser beam shaper comprising two free-form profiles is presented. The profiles are designed using a free-form profile construction method such that each incident ray is directed in a certain user-specified direction or to a particular point on the target surface so as to achieve the required illumination distribution of the output beam. The validity of the proposed design method is demonstrated by means of ZEMAX simulations. The method is mathematically straightforward and easily implemented in computer code. It thus provides a convenient tool for the design and sensitivity analysis of laser beam shapers and similar optical components.

  19. A Evaluation of Optical Aberrations in Underwater Hologrammetry

    NASA Astrophysics Data System (ADS)

    Kilpatrick, J. M.

    Available from UMI in association with The British Library. An iterative ray-trace procedure is developed in conjunction with semi-analytic expressions for spherical aberration, coma, and astigmatism in the reconstructed holographic images of underwater objects. An exact expression for the astigmatic difference is obtained, based on the geometry of the caustic for refraction. The geometrical characteristics of the aberrated images associated with axial and non-axial field positions are represented by ray intersection diagrams. A third order expression for the wavefront aberration introduced at a planar air/water boundary is given. The associated third order aberration coefficients are used to obtain analytic expressions for the aberrations observed in underwater hologrammetry. The results of the third order treatment are shown to give good agreement with the results obtained by geometrical ray tracing and by direct measurement on the reconstructed real image. The third order aberration coefficients are employed to estimate the limit of resolution in the presence of the aberrations associated with reconstruction in air. In concurrence with practical observations it is found that the estimated resolution is primarily limited by astigmatism. The limitations of the planar window in underwater imaging applications are outlined and various schemes are considered to effect a reduction in the extent of aberration. The analogous problems encountered in underwater photography are examined in order to establish the grounds for a common solution based on a conventional optical corrector. The performance of one such system, the Ivanoff Corrector, is investigated. The spherical aberration associated with axial image formation is evaluated. The equivalence of the third order wavefront aberration introduced at a planar air/water boundary to that introduced upon reconstruction by an appropriate wavelength change is shown to provide a basis for the compensation of aberrations in

  20. Ocular higher-order aberrations and axial eye growth in young Hong Kong children.

    PubMed

    Lau, Jason K; Vincent, Stephen J; Collins, Michael J; Cheung, Sin-Wan; Cho, Pauline

    2018-04-30

    This retrospective longitudinal analysis aimed to investigate the association between ocular higher-order aberrations (HOAs) and axial eye growth in Hong Kong children. Measures of axial length and ocular HOAs under cycloplegia were obtained annually over a two-year period from 137 subjects aged 8.8 ± 1.4 years with mean spherical equivalent refraction of -2.04 ± 2.38 D. A significant negative association was observed between the RMS of total HOAs and axial eye growth (P = 0.03), after adjusting for other significant predictors of axial length including age, sex and refractive error. Similar negative associations with axial elongation were found for the RMS of spherical aberrations ([Formula: see text] and [Formula: see text] combined) (P = 0.037). Another linear mixed model also showed that greater levels of vertical trefoil [Formula: see text], primary spherical aberration [Formula: see text] and negative oblique trefoil [Formula: see text] were associated with slower axial elongation and longer axial length (all P < 0.05). These findings support the potential role of HOAs, image quality and a vision-dependent mechanism in childhood eye growth.

  1. Ophthalmic applications of confocal microscopy: diagnostics, refractive surgery, and eye banking

    NASA Astrophysics Data System (ADS)

    Masters, Barry R.

    1990-11-01

    Confocal microscopy of ocular tissue provides two advantages over traditional imaging techniques: increased range and transverse resolution and increased contrast. The semitransparent cornea and ocular lens in the living eye can be optically sectioned and observed by reflected light confocal microscopy. Within the cornea we observed various cell components nerve fibers nerve cell bodies and fibrous networks. The confocal microscopic images from the in-situ ocular lens show the lens capsule the lens epithelium and the individual lens fibrils. All of the reflected light confocal microscopic images have high contrast and high resolution. Some of the applications of confocal imaging in ophthalmology include: diagnostics of the cornea and the ocular lens examination prior to and after refractive surgery examination of intraocular lenses (IOL) and examination of eye bank material. Other ophthalmic uses of confocal imaging include: studies of wound healing therapeutics and the effects of contact lenses on the cornea. The proposed features of a clinical confocal microscope are reviewed. 2.

  2. Examination of tear film smoothness on corneae after refractive surgeries using a noninvasive interferometric method

    NASA Astrophysics Data System (ADS)

    Szczesna, Dorota H.; Kulas, Zbigniew; Kasprzak, Henryk T.; Stenevi, Ulf

    2009-11-01

    A lateral shearing interferometer was used to examine the smoothness of the tear film. The information about the distribution and stability of the precorneal tear film is carried out by the wavefront reflected from the surface of tears and coded in interference fringes. Smooth and regular fringes indicate a smooth tear film surface. On corneae after laser in situ keratomileusis (LASIK) or radial keratotomy (RK) surgery, the interference fringes are seldom regular. The fringes are bent on bright lines, which are interpreted as tear film breakups. The high-intensity pattern seems to appear in similar location on the corneal surface after refractive surgery. Our purpose was to extract information about the pattern existing under the interference fringes and calculate its shape reproducibility over time and following eye blinks. A low-pass filter was applied and correlation coefficient was calculated to compare a selected fragment of the template image to each of the following frames in the recorded sequence. High values of the correlation coefficient suggest that irregularities of the corneal epithelium might influence tear film instability and that tear film breakup may be associated with local irregularities of the corneal topography created after the LASIK and RK surgeries.

  3. Refractive regression after laser in situ keratomileusis.

    PubMed

    Yan, Mabel K; Chang, John Sm; Chan, Tommy Cy

    2018-04-26

    Uncorrected refractive errors are a leading cause of visual impairment across the world. In today's society, laser in situ keratomileusis (LASIK) has become the most commonly performed surgical procedure to correct refractive errors. However, regression of the initially achieved refractive correction has been a widely observed phenomenon following LASIK since its inception more than two decades ago. Despite technological advances in laser refractive surgery and various proposed management strategies, post-LASIK regression is still frequently observed and has significant implications for the long-term visual performance and quality of life of patients. This review explores the mechanism of refractive regression after both myopic and hyperopic LASIK, predisposing risk factors and its clinical course. In addition, current preventative strategies and therapies are also reviewed. © 2018 Royal Australian and New Zealand College of Ophthalmologists.

  4. Optical side-effects of fs-laser treatment in refractive surgery investigated by means of a model eye

    PubMed Central

    Ackermann, Roland; Kammel, Robert; Merker, Marina; Kamm, Andreas; Tünnermann, Andreas; Nolte, Stefan

    2013-01-01

    Optical side-effects of fs-laser treatment in refractive surgery are investigated by means of a model eye. We show that rainbow glare is the predominant perturbation, which can be avoided by randomly distributing laser spots within the lens. For corneal applications such as fs-LASIK, even a regular grid with spot-to-spot distances of ~3 µm is sufficient to minimize rainbow glare perception. Contrast sensitivity is affected, when the lens is treated with large 3D-patterns. PMID:23413236

  5. Validity of automated refraction after segmented refractive multifocal intraocular lens implantation.

    PubMed

    Albarrán-Diego, César; Muñoz, Gonzalo; Rohrweck, Stephanie; García-Lázaro, Santiago; Albero, José Ricardo

    2017-01-01

    To evaluate the clinical utility of automated refraction (AR) and keratometry (KR) compared with subjective or manifest refraction (MR) after cataract or refractive lens exchange surgery with implantation of Lentis Mplus X (Oculentis GmbH) refractive multifocal intraocular lens (IOL). Eighty-six eyes implanted with the Lentis Mplus X multifocal IOL were included. MR was performed in all patients followed by three consecutive AR measurements using the Topcon KR-8000 autorefractor. Assessment of repeatability of consecutive AR before and after dilation with phenylephrine 10%, and comparison of the AR and KR with MR using vector analysis were performed at 3mo follow-up. Analysis showed excellent repeatability of the AR measurements. Linear regression of AR versus MR showed good correlation for sphere and spherical equivalent, whereas the correlation for astigmatism was low. The mean difference AR-MR was -1.28±0.29 diopters (D) for sphere. Astigmatism showed better correlation between KR and MR. We suggest AR sphere plus 1.25 D and the KR cylinder as the starting point for MR in eyes with a Lentis Mplus X multifocal IOL. If AR measurements are equal to MR, decentration of the IOL should be suspected.

  6. Non-destructive geometric and refractive index characterization of single and multi-element lenses using optical coherence tomography

    NASA Astrophysics Data System (ADS)

    El-Haddad, Mohamed T.; Tao, Yuankai K.

    2018-02-01

    Design of optical imaging systems requires careful balancing of lens aberrations to optimize the point-spread function (PSF) and minimize field distortions. Aberrations and distortions are a result of both lens geometry and glass material. While most lens manufacturers provide optical models to facilitate system-level simulation, these models are often not reflective of true system performance because of manufacturing tolerances. Optical design can be further confounded when achromatic or proprietary lenses are employed. Achromats are ubiquitous in systems that utilize broadband sources due to their superior performance in balancing chromatic aberrations. Similarly, proprietary lenses may be custom-designed for optimal performance, but lens models are generally not available. Optical coherence tomography (OCT) provides non-contact, depth-resolved imaging with high axial resolution and sensitivity. OCT has been previously used to measure the refractive index of unknown materials. In a homogenous sample, the group refractive index is obtained as the ratio between the measured optical and geometric thicknesses of the sample. In heterogenous samples, a method called focus-tracking (FT) quantifies the effect of focal shift introduced by the sample. This enables simultaneous measurement of the thickness and refractive index of intermediate sample layers. Here, we extend the mathematical framework of FT to spherical surfaces, and describe a method based on OCT and FT for full characterization of lens geometry and refractive index. Finally, we validate our characterization method on commercially available singlet and doublet lenses.

  7. Algorithm for correcting the keratometric error in the estimation of the corneal power in eyes with previous myopic laser refractive surgery.

    PubMed

    Camps, Vicente J; Piñero, David P; Mateo, Veronica; Ribera, David; de Fez, Dolores; Blanes-Mompó, Francisco J; Alzamora-Rodríguez, Antonio

    2013-11-01

    To calculate theoretically the errors in the estimation of corneal power when using the keratometric index (nk) in eyes that underwent laser refractive surgery for the correction of myopia and to define and validate clinically an algorithm for minimizing such errors. Differences between corneal power estimation by using the classical nk and by using the Gaussian equation in eyes that underwent laser myopic refractive surgery were simulated and evaluated theoretically. Additionally, an adjusted keratometric index (nkadj) model dependent on r1c was developed for minimizing these differences. The model was validated clinically by retrospectively using the data from 32 myopic eyes [range, -1.00 to -6.00 diopters (D)] that had undergone laser in situ keratomileusis using a solid-state laser platform. The agreement between Gaussian (Pc) and adjusted keratometric (Pkadj) corneal powers in such eyes was evaluated. It was found that overestimations of corneal power up to 3.5 D were possible for nk = 1.3375 according to our simulations. The nk value to avoid the keratometric error ranged between 1.2984 and 1.3297. The following nkadj models were obtained: nkadj = -0.0064286r1c + 1.37688 (Gullstrand eye model) and nkadj = -0.0063804r1c + 1.37806 (Le Grand). The mean difference between Pkadj and Pc was 0.00 D, with limits of agreement of -0.45 and +0.46 D. This difference correlated significantly with the posterior corneal radius (r = -0.94, P < 0.01). The use of a single nk for estimating the corneal power in eyes that underwent a laser myopic refractive surgery can lead to significant errors. These errors can be minimized by using a variable nk dependent on r1c.

  8. Aberrations associated with rigid contact lenses.

    PubMed

    Atchison, D A

    1995-10-01

    A rigid contact lens on an eye can produce levels of spherical aberration very different from those produced by a spectacle lens in front of the eye. These levels are considerably affected by contact lens surface asphericity. Change in longitudinal spherical aberration associated with aspherizing a contact lens surface is well predicted by a simple equation for change in sagittal power of the surface. Displacing an aspheric contact lens on the eye can produce considerable defocus, which is well predicted by simple equations for change in sagittal and tangential surface powers. The best refractive correction with contact lenses can be determined only by overrefraction with a patient wearing a contact lens of power and characteristics similar to that which will be prescribed. An aspheric contact lens that moves to a considerable extent on the eye will cause more unstable vision than will a spherical lens that moves to the same extent.

  9. Professor Peter Choyce: an early pioneer of intraocular lenses and corneal/refractive surgery.

    PubMed

    Pandey, Suresh K; Apple, David J

    2005-06-01

    Professor Peter Choyce, FRCS, DOMS, MS, was one of the pioneers of intraocular lens implant surgery. He developed an interest in artificial lens implantation following cataract surgery, a procedure that was widely criticized by the ophthalmic establishment in the UK, Europe, North America and other countries. Owing to the opposition to the intraocular lenses, Peter Choyce together with Sir Harold Ridley co-founded the International Intraocular Implant Club in 1966, which was responsible for the gradual acceptance of artificial lens implantation. Peter Choyce developed several models of intraocular lens, but did not patent the majority of them. The Choyce Mark IX, manufactured by Rayner Intraocular Lenses, became the first US Food and Drug Administration-approved intraocular lens in 1981. A review of Peter Choyce's record confirms a significant number of original innovations in the field of anterior segment surgery, including many procedures taken for granted today, but not associated with his name. These include early work on both kerato- and intraocular lens-refractive procedures, keratoprosthesis, pioneering paediatric implant procedures and others. Unfortunately his tenacious adherence to anterior chamber lens technology, while in general clinically sound, caused many to question his influence and hence he remained poorly understood even until after his death. He passed away on 8 August 2001 after a long fight with colon cancer. In this article, we provide evidence and elaborate Peter Choyce's accomplishments, which places him as one of the most innovative ophthalmologist in his surgical field in the twentieth century.

  10. Parity-Time Symmetric Nonlocal Metasurfaces: All-Angle Negative Refraction and Volumetric Imaging

    NASA Astrophysics Data System (ADS)

    Monticone, Francesco; Valagiannopoulos, Constantinos A.; Alù, Andrea

    2016-10-01

    Lens design for focusing and imaging has been optimized through centuries of developments; however, conventional lenses, even in their most ideal realizations, still suffer from fundamental limitations, such as limits in resolution and the presence of optical aberrations, which are inherent to the laws of refraction. In addition, volume-to-volume imaging of three-dimensional regions of space is not possible with systems based on conventional refractive optics, which are inherently limited to plane-to-plane imaging. Although some of these limitations have been at least theoretically relaxed with the advent of metamaterials, several challenges still stand in the way of ideal imaging of three-dimensional regions of space. Here, we show that the concept of parity-time symmetry, combined with tailored nonlocal responses, enables overcoming some of these challenges, and we propose the design of a loss-immune, linear, transversely invariant, planarized metamaterial lens, with reduced aberrations and the potential to realize volume-to-volume imaging.

  11. An Eye-adapted Beamforming for Axial B-scans Free from Crystalline Lens Aberration: In vitro and ex vivo Results with a 20 MHz Linear Array

    NASA Astrophysics Data System (ADS)

    Matéo, Tony; Mofid, Yassine; Grégoire, Jean-Marc; Ossant, Frédéric

    In ophtalmic ultrasonography, axial B-scans are seriously deteriorated owing to the presence of the crystalline lens. This strongly aberrating medium affects both spatial and contrast resolution and causes important distortions. To deal with this issue, an adapted beamforming (BF) has been developed and experimented with a 20 MHz linear array working with a custom US research scanner. The adapted BF computes focusing delays that compensate for crystalline phase aberration, including refraction effects. This BF was tested in vitro by imaging a wire phantom through an eye phantom consisting of a synthetic gelatin lens, shaped according to the unaccommodated state of an adult human crystalline lens, anatomically set up in an appropriate liquid (turpentine) to approach the in vivo velocity ratio. Both image quality and fidelity from the adapted BF were assessed and compared with conventional delay-and-sum BF over the aberrating medium. Results showed 2-fold improvement of the lateral resolution, greater sensitivity and 90% reduction of the spatial error (from 758 μm to 76 μm) with adapted BF compared to conventional BF. Finally, promising first ex vivo axial B-scans of a human eye are presented.

  12. Precision of higher-order aberration measurements with a new Placido-disk topographer and Hartmann-Shack wavefront sensor.

    PubMed

    López-Miguel, Alberto; Martínez-Almeida, Loreto; González-García, María J; Coco-Martín, María B; Sobrado-Calvo, Paloma; Maldonado, Miguel J

    2013-02-01

    To assess the intrasession and intersession precision of ocular, corneal, and internal higher-order aberrations (HOAs) measured using an integrated topographer and Hartmann-Shack wavefront sensor (Topcon KR-1W) in refractive surgery candidates. IOBA-Eye Institute, Valladolid, Spain. Evaluation of diagnostic technology. To analyze intrasession repeatability, 1 experienced examiner measured eyes 9 times successively. To study intersession reproducibility, the same clinician obtained measurements from another set of eyes in 2 consecutive sessions 1 week apart. Ocular, corneal, and internal HOAs were obtained. Coma and spherical aberrations, 3rd- and 4th-order aberrations, and total HOAs were calculated for a 6.0 mm pupil diameter. For intrasession repeatability (75 eyes), excellent intraclass correlation coefficients (ICCs) were obtained (ICC >0.87), except for internal primary coma (ICC = 0.75) and 3rd-order (ICC = 0.72) HOAs. Repeatability precision (1.96 × S(w)) values ranged from 0.03 μm (corneal primary spherical) to 0.08 μm (ocular primary coma). For intersession reproducibility (50 eyes), ICCs were good (>0.8) for ocular primary spherical, 3rd-order, and total higher-order aberrations; reproducibility precision values ranged from 0.06 μm (corneal primary spherical) to 0.21 μm (internal 3rd order), with internal HOAs having the lowest precision (≥0.12 μm). No systematic bias was found between examinations on different days. The intrasession repeatability was high; therefore, the device's ability to measure HOAs in a reliable way was excellent. Under intersession reproducibility conditions, dependable corneal primary spherical aberrations were provided. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  13. Resident and young physician experience with complex cataract surgery and new cataract and refractive technology: Results of the ASCRS 2016 Young Eye Surgeons survey.

    PubMed

    Schallhorn, Julie M; Ciralsky, Jessica B; Yeu, Elizabeth

    2017-05-01

    A survey was offered to attendees of the 2016 annual meeting of the American Society of Cataract and Refractive Surgery (ASCRS) as well as online to ASCRS members. Of the 429 self-identified surgeons in training or those with fewer than 5 years in practice, 83% had performed complex cataract surgery using iris expansion devices or capsular tension rings (63%) and 70% had implanted a toric intraocular lens (IOL). A minority of respondents had performed laser-assisted cataract surgery (27%) or implanted presbyopia-correcting IOLs (39%), and only half (50%) had performed laser vision correction (LVC). Comfort with complex cataract and IOL procedures improved with increasing number of cases performed until greater than 10 cases. From this we can conclude that young surgeons have adequate exposure to complex cataracts but lack experience in refractive surgery and new IOL technology. Reported surgeon confidence improved with increased experience and exposure. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  14. Changes in Astigmatism, Densitometry, and Aberrations After SMILE for Low to High Myopic Astigmatism: A 12-Month Prospective Study.

    PubMed

    Pedersen, Iben Bach; Ivarsen, Anders; Hjortdal, Jesper

    2017-01-01

    To evaluate 12-month changes in refraction, visual outcome, corneal densitometry, and postoperative aberrations after small incision lenticule extraction (SMILE) for myopic astigmatism. This 12-month prospective clinical trial comprised 101 eyes (101 patients) treated with SMILE for myopic astigmatism with cylinder of 0.75 to 4.00 diopters (D). The preoperative, 1-week, and 1-, 3-, 6-, 9-, and 12-month examinations included measurement of manifest refraction, uncorrected distance visual acuity (UDVA), and corrected (CDVA) distance visual acuity. Astigmatic error vector analysis was performed using Al-pin's method. Densitometry and aberrations were evaluated with Pentacam HR (Oculus Optikgeräte, Wetzlar, Germany). Preoperative spherical equivalent averaged -6.78 ± 1.90 D with 1.81 ± 1.00 D in cylinder correction. After 12 months, 74% and 93% of the eyes were within ±0.50 and ±1.00 D of the attempted refraction, respectively. The logMAR UDVA and CDVA averaged 0.03 ± 0.16 and -0.08 ± 0.09, respectively. Vector analysis showed a with-the-rule undercorrection at 12 months with a mean difference vector of 0.31 D @ 91°. There was a minor counterclockwise rotation of the axis, with an arithmetic angle of error of 0.34° ± 14°. An undercorrection of approximately 11% per diopter of attempted correction was seen at 12 months. Spherical aberrations, coma, and higher order aberrations remained stable during the postoperative period (P < .09). After 12 months, no increase in densitometry could be identified. Treatment of astigmatism with SMILE seems to be predictable and effective, but with an astigmatic undercorrection of approximately 11% and a small counterclockwise rotation of the axis. [J Refract Surg. 2017;33(1):11-17.]. Copyright 2017, SLACK Incorporated.

  15. Aquaporin 0 plays a pivotal role in refractive index gradient development in mammalian eye lens to prevent spherical aberration

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kumari, S. Sindhu; Varadaraj, Kulandaiappan, E-mail: kulandaiappan.varadaraj@stonybrook.edu; SUNY Eye Institute, New York, NY

    Highlights: • Intact AQP0 functions as fiber cell-to-fiber cell adhesion protein. • AQP0 facilitates reduction in extracellular space and lens water content. • AQP0 adhesion function aids in lens refractive index gradient (RING) formation. • AQP0 prevents lens spherical aberration by establishing RING. • AQP0 is critical for lens transparency and homeostasis. - Abstract: Aquaporin 0 (AQP0) is a transmembrane channel that constitutes ∼45% of the total membrane protein of the fiber cells in mammalian lens. It is critical for lens transparency and homeostasis as mutations and knockout cause autosomal dominant lens cataract. AQP0 functions as a water channel andmore » as a cell-to-cell adhesion (CTCA) molecule in the lens. Our recent in vitro studies showed that the CTCA function of AQP0 could be crucial to establish lens refractive index gradient (RING). However, there is a lack of in vivo data to corroborate the role of AQP0 as a fiber CTCA molecule which is critical for creating lens RING. The present investigation is undertaken to gather in vivo evidence for the involvement of AQP0 in developing lens RING. Lenses of wild type (WT) mouse, AQP0 knockout (heterozygous, AQP0{sup +/−}) and AQP0 knockout lens transgenically expressing AQP1 (heterozygous AQP0{sup +/−}/AQP1{sup +/−}) mouse models were used for the study. Data on AQP0 protein profile of intact and N- and/or C-terminal cleaved AQP0 in the lens by MALDI-TOF mass spectrometry and SDS–PAGE revealed that outer cortex fiber cells have only intact AQP0 of ∼28 kDa, inner cortical and outer nuclear fiber cells have both intact and cleaved forms, and inner nuclear fiber cells have only cleaved forms (∼26–24 kDa). Knocking out of 50% of AQP0 protein caused light scattering, spherical aberration (SA) and cataract. Restoring the lost fiber cell membrane water permeability (P{sub f}) by transgene AQP1 did not reinstate complete lens transparency and the mouse lenses showed light scattering and

  16. Coagulase-negative staphylococci isolated from ocular wound infections after laser refractive surgery: attachment to and accumulation on soft contact lenses.

    PubMed

    Faghri, Jamshid; Razavi, Mohamad Reza

    2009-03-01

    Disposable soft contact lenses that are commonly used after laser refractive surgery are known to be colonized by bacteria and play a key role in Bacterial Keraitis (BK) pathogenesis. Coagulase-negative staphylococci (CoNS) have been found to be the most common pathogen involved in this postoperative infection. In this study a rapid and a simple assay was developed for studying attachment and accumulation of CoNS on soft contact lenses in vitro using [3H] thymidine. Thirty-five isolates of CoNS were obtained from 27 laser refractive surgery patients. Twenty-five of these thirty-five CoNS were isolated in multiple cultures. Ten CoNS were isolated in cultures from patients who underwent reoperation. The assay was optimized using a biofilm-producing strain, S. epidermidis RP62A, which was subcultured overnight at 37 degrees C on blood agar medium. Quantitative determination of biofilm production was tested. Presence of the genes icaADB and icaD was determined in all isolates. All isolates were biochemically analyzed using the Phene Plate (PhP) system modified for typing of CoNS. The CoNS isolates were further characterized to species level using ID32Staph.Mann-Whitney rank sum test and chi-square test were used to identify statistical differences in adherence, index, antibiotic susceptibility patterns, and biofilm production or presence of the ica operon between clinically significant isolates and non-postoperative BK isolates. No differences in attachment and accumulation were found between isolates causing BK after laser refractive surgery and contaminant isolates. In addition, there were no differences in the distribution of the ica operon between the two groups, as determined by polymerase chain reaction. Nevertheless, the ability to produce biofilm was found to be present significantly more frequently among BK isolates than among non-postoperative BK isolates. This study shows that the method using radioactive thymidine to analyze adherence of CoNS to soft

  17. Chromatic-aberration diagnostic based on a spectrally resolved lateral-shearing interferometer

    DOE PAGES

    Bahk, Seung -Whan; Dorrer, Christopher; Roides, Rick G.; ...

    2016-03-18

    Here, a simple diagnostic characterizing one-dimensional chromatic aberrations in a broadband beam is introduced. A Ronchi grating placed in front of a spectrometer entrance slit provides spectrally coupled spatial phase information. The radial-group delay of a refractive system and the pulse-front delay of a wedged glass plate have been characterized accurately in a demonstration experiment.

  18. Validity of automated refraction after segmented refractive multifocal intraocular lens implantation

    PubMed Central

    Albarrán-Diego, César; Muñoz, Gonzalo; Rohrweck, Stephanie; García-Lázaro, Santiago; Albero, José Ricardo

    2017-01-01

    AIM To evaluate the clinical utility of automated refraction (AR) and keratometry (KR) compared with subjective or manifest refraction (MR) after cataract or refractive lens exchange surgery with implantation of Lentis Mplus X (Oculentis GmbH) refractive multifocal intraocular lens (IOL). METHODS Eighty-six eyes implanted with the Lentis Mplus X multifocal IOL were included. MR was performed in all patients followed by three consecutive AR measurements using the Topcon KR-8000 autorefractor. Assessment of repeatability of consecutive AR before and after dilation with phenylephrine 10%, and comparison of the AR and KR with MR using vector analysis were performed at 3mo follow-up. RESULTS Analysis showed excellent repeatability of the AR measurements. Linear regression of AR versus MR showed good correlation for sphere and spherical equivalent, whereas the correlation for astigmatism was low. The mean difference AR-MR was -1.28±0.29 diopters (D) for sphere. Astigmatism showed better correlation between KR and MR. CONCLUSION We suggest AR sphere plus 1.25 D and the KR cylinder as the starting point for MR in eyes with a Lentis Mplus X multifocal IOL. If AR measurements are equal to MR, decentration of the IOL should be suspected. PMID:29181318

  19. [Intraoperative Measurement of Refraction with a Hand-Held Autorefractometer].

    PubMed

    Gesser, C; Küper, T; Richard, G; Hassenstein, A

    2015-07-01

    The aim of this study was to evaluate an intraoperative measurement of objective refraction with a hand-held retinomax instrument. At the end of cataract surgery objective refraction in a lying position was measured with a retinomax instrument. On the first postoperative day the same measurement was performed with a retinomax and a standard autorefractometer. To evaluate the differences between measurements, the spherical equivalent (SE) and Jackson's cross cylinder at 0° (J0) and 45° (J45) was used. 103 eyes were included. 95 of them had normal cataract surgery. Differences between retinomax at the operative day and the standard autorefractometer were 0.68 ± 2.58 D in SE, 0.05 ± 1.4D in J0 and 0.05 ± 1.4D in J45. There were no statistically significant differences between the groups. Intraoperative measurement of the refraction with a retinomax can predict the postoperative refraction. Nevertheless, in a few patients great differences may occur. Georg Thieme Verlag KG Stuttgart · New York.

  20. Measurement of specimen-induced aberrations of biological samples using phase stepping interferometry.

    PubMed

    Schwertner, M; Booth, M J; Neil, M A A; Wilson, T

    2004-01-01

    Confocal or multiphoton microscopes, which deliver optical sections and three-dimensional (3D) images of thick specimens, are widely used in biology. These techniques, however, are sensitive to aberrations that may originate from the refractive index structure of the specimen itself. The aberrations cause reduced signal intensity and the 3D resolution of the instrument is compromised. It has been suggested to correct for aberrations in confocal microscopes using adaptive optics. In order to define the design specifications for such adaptive optics systems, one has to know the amount of aberrations present for typical applications such as with biological samples. We have built a phase stepping interferometer microscope that directly measures the aberration of the wavefront. The modal content of the wavefront is extracted by employing Zernike mode decomposition. Results for typical biological specimens are presented. It was found for all samples investigated that higher order Zernike modes give only a small contribution to the overall aberration. Therefore, these higher order modes can be neglected in future adaptive optics sensing and correction schemes implemented into confocal or multiphoton microscopes, leading to more efficient designs.

  1. A statistical model to estimate refractivity turbulence structure constant C sub n sup 2 in the free atmosphere

    NASA Technical Reports Server (NTRS)

    Warnock, J. M.; Vanzandt, T. E.

    1986-01-01

    A computer program has been tested and documented (Warnock and VanZandt, 1985) that estimates mean values of the refractivity turbulence structure constant in the stable free atmosphere from standard National Weather Service balloon data or an equivalent data set. The program is based on the statistical model for the occurrence of turbulence developed by VanZandt et al. (1981). Height profiles of the estimated refractivity turbulence structure constant agree well with profiles measured by the Sunset radar with a height resolution of about 1 km. The program also estimates the energy dissipation rate (epsilon), but because of the lack of suitable observations of epsilon, the model for epsilon has not yet been evaluated sufficiently to be used in routine applications. Vertical profiles of the refractivity turbulence structure constant were compared with profiles measured by both radar and optical remote sensors and good agreement was found. However, at times the scintillometer measurements were less than both the radar and model values.

  2. Ocular higher-order aberrations in a school children population.

    PubMed

    Papamastorakis, George; Panagopoulou, Sophia; Tsilimbaris, Militadis K; Pallikaris, Ioannis G; Plainis, Sotiris

    2015-01-01

    The primary objective of the study was to explore the statistics of ocular higher-order aberrations in a population of primary and secondary school children. A sample of 557 children aged 10-15 years were selected from two primary and two secondary schools in Heraklion, Greece. Children were classified by age in three subgroups: group I (10.7±0.5 years), group II (12.4±0.5 years) and group III (14.5±0.5 years). Ocular aberrations were measured using a wavefront aberrometer (COAS, AMO Wavefront Sciences, USA) at mesopic light levels (illuminance at cornea was 4lux). Wavefront analysis was achieved for a 5mm pupil. Statistical analysis was carried out for the right eye only. The average coefficient of most high-order aberrations did not differ from zero with the exception of vertical (0.076μm) and horizontal (0.018μm) coma, oblique trefoil (-0.055μm) and spherical aberration (0.018μm). The most prominent change between the three groups was observed for the spherical aberration, which increased from 0.007μm (SE 0.005) in group I to 0.011μm (SE 0.004) in group II and 0.030μm (SE 0.004) in group III. Significant differences were also found for the oblique astigmatism and the third-order coma aberrations. Differences in the low levels of ocular spherical aberration in young children possibly reflect differences in lenticular spherical aberration and relate to the gradient refractive index of the lens. The evaluation of spherical aberration at certain stages of eye growth may help to better understand the underlying mechanisms of myopia development. Copyright © 2014 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  3. Ocular higher-order aberrations in a school children population

    PubMed Central

    Papamastorakis, George; Panagopoulou, Sophia; Tsilimbaris, Militadis K.; Pallikaris, Ioannis G.; Plainis, Sotiris

    2014-01-01

    Purpose The primary objective of the study was to explore the statistics of ocular higher-order aberrations in a population of primary and secondary school children. Methods A sample of 557 children aged 10–15 years were selected from two primary and two secondary schools in Heraklion, Greece. Children were classified by age in three subgroups: group I (10.7 ± 0.5 years), group II (12.4 ± 0.5 years) and group III (14.5 ± 0.5 years). Ocular aberrations were measured using a wavefront aberrometer (COAS, AMO Wavefront Sciences, USA) at mesopic light levels (illuminance at cornea was 4 lux). Wavefront analysis was achieved for a 5 mm pupil. Statistical analysis was carried out for the right eye only. Results The average coefficient of most high-order aberrations did not differ from zero with the exception of vertical (0.076 μm) and horizontal (0.018 μm) coma, oblique trefoil (−0.055 μm) and spherical aberration (0.018 μm). The most prominent change between the three groups was observed for the spherical aberration, which increased from 0.007 μm (SE 0.005) in group I to 0.011 μm (SE 0.004) in group II and 0.030 μm (SE 0.004) in group III. Significant differences were also found for the oblique astigmatism and the third-order coma aberrations. Conclusions Differences in the low levels of ocular spherical aberration in young children possibly reflect differences in lenticular spherical aberration and relate to the gradient refractive index of the lens. The evaluation of spherical aberration at certain stages of eye growth may help to better understand the underlying mechanisms of myopia development. PMID:25288226

  4. Negative refraction and planar focusing based on parity-time symmetric metasurfaces.

    PubMed

    Fleury, Romain; Sounas, Dimitrios L; Alù, Andrea

    2014-07-11

    We introduce a new mechanism to realize negative refraction and planar focusing using a pair of parity-time symmetric metasurfaces. In contrast to existing solutions that achieve these effects with negative-index metamaterials or phase conjugating surfaces, the proposed parity-time symmetric lens enables loss-free, all-angle negative refraction and planar focusing in free space, without relying on bulk metamaterials or nonlinear effects. This concept may represent a pivotal step towards loss-free negative refraction and highly efficient planar focusing by exploiting the largely uncharted scattering properties of parity-time symmetric systems.

  5. Transmissive liquid-crystal device for correcting primary coma aberration and astigmatism in biospecimen in two-photon excitation laser scanning microscopy

    NASA Astrophysics Data System (ADS)

    Tanabe, Ayano; Hibi, Terumasa; Ipponjima, Sari; Matsumoto, Kenji; Yokoyama, Masafumi; Kurihara, Makoto; Hashimoto, Nobuyuki; Nemoto, Tomomi

    2016-12-01

    All aberrations produced inside a biospecimen can degrade the quality of a three-dimensional image in two-photon excitation laser scanning microscopy. Previously, we developed a transmissive liquid-crystal device to correct spherical aberrations that improved the image quality of a fixed-mouse-brain slice treated with an optical clearing reagent. In this study, we developed a transmissive device that corrects primary coma aberration and astigmatism. The motivation for this study is that asymmetric aberration can be induced by the shape of a biospecimen and/or by a complicated refractive-index distribution in a sample; this can considerably degrade optical performance even near the sample surface. The device's performance was evaluated by observing fluorescence beads. The device was inserted between the objective lens and microscope revolver and succeeded in improving the spatial resolution and fluorescence signal of a bead image that was originally degraded by asymmetric aberration. Finally, we implemented the device for observing a fixed whole mouse brain with a sloping surface shape and complicated internal refractive-index distribution. The correction with the device improved the spatial resolution and increased the fluorescence signal by ˜2.4×. The device can provide a simple approach to acquiring higher-quality images of biospecimens.

  6. Wavefront aberration changes caused by a gradient of increasing accommodation stimuli

    PubMed Central

    Zhou, X-Y; Wang, L; Zhou, X-T; Yu, Z-Q

    2015-01-01

    Purpose The aim of this study was to investigate the wavefront aberration changes in human eyes caused by a gradient of increasing accommodation stimuli. Design This is a prospective, single-site study. Methods Healthy volunteers (n=22) aged 18–28 years whose refraction states were emmetropia or mild myopia, with astigmatism <1 diopter (D), were included in this study. After dilating the right pupil with 0.5% phenylephrine drops, the wavefront aberration of the right eye was measured continuously either without or with 1, 2, 3, 4, 5, or 6D accommodation stimuli (WFA1000B psychophysical aberrometer). The root mean square (RMS) values of the total wavefront aberrations, higher-order aberrations, and 35 individual Zernike aberrations under different accommodation stimuli were calculated and compared. Results The average induced accommodations using 1, 2, 3, 4, 5, or 6D accommodation stimuli were 0.848, 1.626, 2.375, 3.249, 4.181, or 5.085 D, respectively. The RMS of total wavefront aberrations, as well as higher-order aberrations, showed no significant effects with 1–3 D accommodation stimuli, but increased significantly under 4, 5, and 6 D accommodation stimuli compared with relaxed accommodation. Zernike coefficients of significantly decreased with increasing levels of accommodation. Conclusion Higher-order wavefront aberrations in human eyes changed with increased accommodation. These results are consistent with Schachar's accommodation theory. PMID:25341432

  7. Dizziness, but not falls rate, improves after routine cataract surgery: the role of refractive and spectacle changes.

    PubMed

    Supuk, Elvira; Alderson, Alison; Davey, Christopher J; Green, Clare; Litvin, Norman; Scally, Andrew J; Elliott, David B

    2016-03-01

    To determine whether dizziness and falls rates change due to routine cataract surgery and to determine the influence of spectacle type and refractive factors. Self-reported dizziness and falls were determined in 287 patients (mean age of 76.5 ± 6.3 years, 55% females) before and after routine cataract surgery for the first (81, 28%), second (109, 38%) and both eyes (97, 34%). Dizziness was determined using the short-form of the Dizziness Handicap Inventory. Six-month falls rates were determined using self-reported retrospective data. The number of patients with dizziness reduced significantly after cataract surgery (52% vs 38%; χ(2) = 19.14(,) p < 0.001), but the reduction in the number of patients who fell in the 6-months post surgery was not significant (23% vs 20%; χ(2) = 0.87, p = 0.35). Dizziness improved after first eye surgery (49% vs 33%, p = 0.01) and surgery on both eyes (58% vs 35%, p < 0.001), but not after second eye surgery (52% vs 45%, p = 0.68). Multivariate logistic regression analyses found significant links between post-operative falls and change in spectacle type (increased risk if switched into multifocal spectacles). Post-operative dizziness was associated with changes in best eye visual acuity and changes in oblique astigmatic correction. Dizziness is significantly reduced by first (or both) eye cataract surgery and this is linked with improvements in best eye visual acuity, although changes in oblique astigmatic correction increased dizziness. The lack of improvement in falls rate may be associated with switching into multifocal spectacle wear after surgery. © 2015 The Authors Ophthalmic and Physiological Optics published by John Wiley & Sons Ltd on behalf of College of Optometrists.

  8. A tunable refractive index matching medium for live imaging cells, tissues and model organisms

    PubMed Central

    Boothe, Tobias; Hilbert, Lennart; Heide, Michael; Berninger, Lea; Huttner, Wieland B; Zaburdaev, Vasily; Vastenhouw, Nadine L; Myers, Eugene W; Drechsel, David N; Rink, Jochen C

    2017-01-01

    In light microscopy, refractive index mismatches between media and sample cause spherical aberrations that often limit penetration depth and resolution. Optical clearing techniques can alleviate these mismatches, but they are so far limited to fixed samples. We present Iodixanol as a non-toxic medium supplement that allows refractive index matching in live specimens and thus substantially improves image quality in live-imaged primary cell cultures, planarians, zebrafish and human cerebral organoids. DOI: http://dx.doi.org/10.7554/eLife.27240.001 PMID:28708059

  9. Higher order aberrations and relative risk of symptoms after LASIK.

    PubMed

    Sharma, Munish; Wachler, Brian S Boxer; Chan, Colin C K

    2007-03-01

    To understand what level of higher order aberrations increases the relative risk of visual symptoms in patients after myopic LASIK. This study was a retrospective comparative analysis of 103 eyes of 62 patients divided in two groups, matched for age, gender, pupil size, and spherical equivalent refraction. The symptomatic group comprised 36 eyes of 24 patients after conventional LASIK with different laser systems evaluated in our referral clinic and the asymptomatic control group consisted of 67 eyes of 38 patients following LADARVision CustomCornea wavefront LASIK. Comparative analysis was performed for uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity (BSCVA), contrast sensitivity, refractive cylinder, and higher order aberrations. Wavefront analysis was performed with the LADARWave aberrometer at 6.5-mm analysis for all eyes. Blurring of vision was the most common symptom (41.6%) followed by double image (19.4%), halo (16.7%), and fluctuation in vision (13.9%) in symptomatic patients. A statistically significant difference was noted in UCVA (P = .001), BSCVA (P = .001), contrast sensitivity (P < .001), and manifest cylinder (P = .001) in the two groups. The percentage difference between the symptomatic and control group mean root-mean-square (RMS) values ranged from 157% to 206% or 1.57 to 2.06 times greater. Patients with visual symptoms after LASIK have significantly lower visual acuity and contrast sensitivity and higher mean RMS values for higher order aberrations than patients without symptoms. Root-mean-square values of greater than two times the normal after-LASIK population for any given laser platform may increase the relative risk of symptoms.

  10. Effect of Pupil Size on Wavefront Refraction during Orthokeratology.

    PubMed

    Faria-Ribeiro, Miguel; Navarro, Rafael; González-Méijome, José Manuel

    2016-11-01

    It has been hypothesized that central and peripheral refraction, in eyes treated with myopic overnight orthokeratology, might vary with changes in pupil diameter. The aim of this work was to evaluate the axial and peripheral refraction and optical quality after orthokeratology, using ray tracing software for different pupil sizes. Zemax-EE was used to generate a series of 29 semi-customized model eyes based on the corneal topography changes from 29 patients who had undergone myopic orthokeratology. Wavefront refraction in the central 80 degrees of the visual field was calculated using three different quality metrics criteria: Paraxial curvature matching, minimum root mean square error (minRMS), and the Through Focus Visual Strehl of the Modulation Transfer Function (VSMTF), for 3- and 6-mm pupil diameters. The three metrics predicted significantly different values for foveal and peripheral refractions. Compared with the Paraxial criteria, the other two metrics predicted more myopic refractions on- and off-axis. Interestingly, the VSMTF predicts only a marginal myopic shift in the axial refraction as the pupil changes from 3 to 6 mm. For peripheral refraction, minRMS and VSMTF metric criteria predicted a higher exposure to peripheral defocus as the pupil increases from 3 to 6 mm. The results suggest that the supposed effect of myopic control produced by ortho-k treatments might be dependent on pupil size. Although the foveal refractive error does not seem to change appreciably with the increase in pupil diameter (VSMTF criteria), the high levels of positive spherical aberration will lead to a degradation of lower spatial frequencies, that is more significant under low illumination levels.

  11. The Influence of the Aspheric Profiles for Transition Zone on Optical Performance of Human Eye After Conventional Ablation

    NASA Astrophysics Data System (ADS)

    Fang, L.

    2014-12-01

    The analysis in the impact of transition zone on the optical performance of human eye after laser refractive surgery is important for improving visual correction technology. By designing the ablation profiles of aspheric transition zone and creating the ablation profile for conventional refractive surgery in optical zone, the influence of aspheric transition zone on residual aberrations was studied. The results indicated that the ablation profiles of transition zone had a significant influence on the residual wavefront aberrations. For a hyperopia correction, the profile #9 shows a larger induced coma and spherical aberration when the translation of the centre of pupil remains constant. However, for a myopia astigmatism correction, the induced coma and spherical aberration in profile #1 shows relatively larger RMS values than those in other profiles. Therefore, the residual higher order aberrations may be decreased by optimizing ablation profiles of transition zone, but they cannot be eliminated. In order to achieve the best visual performance, the design of ablation pattern of transition zone played a crucial role.

  12. The effect of previous soft contact lens wear on corneal refractive surgery outcomes.

    PubMed

    Lloyd-McKernan, Aoife; Simo Mannion, Luisa; O'Dwyer, Veronica

    2017-10-01

    To examine the influence of previous soft contact lens (SCL) wear on corneal refractive surgery (CRS) outcomes when SCL wear is ceased for two weeks versus twenty-four hours, and also when compared to no wear, prior to CRS. A retrospective examination of CRS patient records was carried out for two groups of patients- who ceased SCL wear for two weeks (n=45) and for twenty-four hours (n=49) prior to CRS and compared to a non-contact lens (NCL) control group (n=45 and n=49, respectively). CRS outcomes (efficacy, predictability, visual acuity and refractive error) were compared pre-operatively and one and six months post-operatively. One month post-operative results found unaided distance visual acuity (UDVA) was significantly better for LASEK/PRK patients who had ceased SCL wear for two weeks prior to CRS (-0.05±0.09), compared with the NCL group (0.02±0.09; p=0.04). Furthermore, six month post-operative results found UDVA was significantly better for both LASIK and LASEK/PRK patients who had ceased SCL wear for two weeks prior to CRS, and for LASEK/PRK patients who had ceased SCL wear for twenty-four hours prior to CRS compared with the NCL group. Given the current setup and methods followed, it was concluded that previous SCL wear had no negative impact on visual outcomes following CRS compared with a NCL control group, regardless of previous SCL cessation time prior to CRS. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

  13. Uncorrected and corrected refractive error experiences of Nepalese adults: a qualitative study.

    PubMed

    Kandel, Himal; Khadka, Jyoti; Shrestha, Mohan Krishna; Sharma, Sadhana; Neupane Kandel, Sandhya; Dhungana, Purushottam; Pradhan, Kishore; Nepal, Bhagavat P; Thapa, Suman; Pesudovs, Konrad

    2018-04-01

    The aim of this study was to explore the impact of corrected and uncorrected refractive error (URE) on Nepalese people's quality of life (QoL), and to compare the QoL status between refractive error subgroups. Participants were recruited from Tilganga Institute of Ophthalmology and Dhulikhel Hospital, Nepal. Semi-structured in-depth interviews were conducted with 101 people with refractive error. Thematic analysis was used with matrices produced to compare the occurrence of themes and categories across participants. Themes were identified using an inductive approach. Seven major themes emerged that determined refractive error-specific QoL: activity limitation, inconvenience, health concerns, psycho-social impact, economic impact, general and ocular comfort symptoms, and visual symptoms. Activity limitation, economic impact, and symptoms were the most important themes for the participants with URE, whereas inconvenience associated with wearing glasses was the most important issue in glasses wearers. Similarly, possibilities of having side effects or complications were the major concerns for participants wearing contact lens. In general, refractive surgery addressed socio-emotional impact of wearing glasses or contact lens. However, the surgery participants had concerns such as possibility of having to wear glasses again due to relapse of refractive error. Impact of refractive error on people's QoL is multifaceted. Significance of the identified themes varies by refractive error subgroups. Refractive correction may not always address QoL impact of URE but often add unique QoL issues. This study findings also provide content for developing an item-bank for quantitatively measuring refractive error-specific QoL in developing country setting.

  14. Laser-induced scleral shrinkage for refractive surgery

    NASA Astrophysics Data System (ADS)

    Ren, Qiushi; Simon, Gabriel; Parel, Jean-Marie A.; Shen, Jin-Hui

    1994-06-01

    We investigate the laser refractive scleroplasty (LRS) as a potential minimal-invasive method for correcting post-operative astigmatism. The scleral shrinkage near limbus was induced on 6 cadaver eyes using a 200 micrometers fiber optic probe coupled to a pulsed Ho:YAG laser. The diameter of the treatment spot was 0.8 mm. The output energy measured at tip was 60.2+/- 0.6 mJ. The treatments consisted of multiple sector patterns placed along the major axis of astigmatism parallel to the limbus, and round patterns placed along the limbus. Three treatment spots were applied on each side of the sector. The separation among sectors and limbus is 1 mm. Keratometry and topography of the cornea were measured after each sector or round pattern treatment. Effect of 5 and 10 pulses at each treatment spot were compared. Histology was performed to evaluate laser tissue damage. The major axis of astigmatism was shifted 90 degrees after the sector pattern treatment and amount of dioptric change increased when adding a new treatment or using more treatment pulses. However, the spherical equivalent of the eyes was essentially unchanged. The keratometry of the corneas remained the same after the round pattern treatment. Laser refractive scleroplasty may be applied for the correction of post-operative astigmatism.

  15. Processes for manufacturing multifocal diffractive-refractive intraocular lenses

    NASA Astrophysics Data System (ADS)

    Iskakov, I. A.

    2017-09-01

    Manufacturing methods and design features of modern diffractive-refractive intraocular lenses are discussed. The implantation of multifocal intraocular lenses is the most optimal method of restoring the accommodative ability of the eye after removal of the natural lens. Diffractive-refractive intraocular lenses are the most widely used implantable multifocal lenses worldwide. Existing methods for manufacturing such lenses implement various design solutions to provide the best vision function after surgery. The wide variety of available diffractive-refractive intraocular lens designs reflects the demand for this method of vision correction in clinical practice and the importance of further applied research and development of new technologies for designing improved lens models.

  16. Pupil-segmentation-based adaptive optical correction of a high-numerical-aperture gradient refractive index lens for two-photon fluorescence endoscopy.

    PubMed

    Wang, Chen; Ji, Na

    2012-06-01

    The intrinsic aberrations of high-NA gradient refractive index (GRIN) lenses limit their image quality as well as field of view. Here we used a pupil-segmentation-based adaptive optical approach to correct the inherent aberrations in a two-photon fluorescence endoscope utilizing a 0.8 NA GRIN lens. By correcting the field-dependent aberrations, we recovered diffraction-limited performance across a large imaging field. The consequent improvements in imaging signal and resolution allowed us to detect fine structures that were otherwise invisible inside mouse brain slices.

  17. Eye aberration analysis with Zernike polynomials

    NASA Astrophysics Data System (ADS)

    Molebny, Vasyl V.; Chyzh, Igor H.; Sokurenko, Vyacheslav M.; Pallikaris, Ioannis G.; Naoumidis, Leonidas P.

    1998-06-01

    New horizons for accurate photorefractive sight correction, afforded by novel flying spot technologies, require adequate measurements of photorefractive properties of an eye. Proposed techniques of eye refraction mapping present results of measurements for finite number of points of eye aperture, requiring to approximate these data by 3D surface. A technique of wave front approximation with Zernike polynomials is described, using optimization of the number of polynomial coefficients. Criterion of optimization is the nearest proximity of the resulted continuous surface to the values calculated for given discrete points. Methodology includes statistical evaluation of minimal root mean square deviation (RMSD) of transverse aberrations, in particular, varying consecutively the values of maximal coefficient indices of Zernike polynomials, recalculating the coefficients, and computing the value of RMSD. Optimization is finished at minimal value of RMSD. Formulas are given for computing ametropia, size of the spot of light on retina, caused by spherical aberration, coma, and astigmatism. Results are illustrated by experimental data, that could be of interest for other applications, where detailed evaluation of eye parameters is needed.

  18. Variability of higher order wavefront aberrations after blinks.

    PubMed

    Hagyó, Krisztina; Csákány, Béla; Lang, Zsolt; Németh, János

    2009-01-01

    To investigate the rapid alterations in value and fluctuation of ocular wavefront aberrations during the interblink interval. Forty-two volunteers were examined with a WASCA Wavefront Analyzer (Carl Zeiss Meditec AG) using modified software. For each subject, 150 images (about 6 frames/second) were registered during an interblink period. The outcome measures were spherical and cylindrical refraction and root-mean-square (RMS) values for spherical, coma, and total higher order aberrations. Fifth order polynomials were fitted to the data and the fluctuation trends of the parameters were determined. We calculated the prevalence of the trends with an early local minimum (type 1). The tear production status (Schirmer test) and tear film break-up time (BUT) were also measured. Fluctuation trends with an early minimum (type 1) were significantly more frequent than trends with an early local maximum (type 2) for total higher order aberrations RMS (P=.036). The incidence of type 1 fluctuation trends was significantly greater for coma and total higher order aberrations RMS (P=.041 and P=.003, respectively) in subjects with normal results in the BUT or Schirmer test than in those with abnormal results. In the normal subjects, the first minimum of type 1 RMS fluctuation trends occurred, on average, between 3.8 and 5.1 seconds after blink. We suggest that wavefront aberrations can be measured most accurately at the time after blink when they exhibit a decreased degree of dispersion. We recommend that a snapshot of wavefront measurements be made 3 to 5 seconds after blink.

  19. Free radical development in phacoemulsification cataract surgery.

    PubMed

    Takahashi, Hiroshi

    2005-02-01

    Phacoemulsification and aspiration (PEA) has become the most popular cataract surgery, due to the establishment of safe surgical techniques and development of associated instruments. However, corneal endothelial damage still represents a serious complication, as excessive damage can lead to irreversible bullous keratopathy. In addition to causes such as mechanical or heat injuries, free radical formation due to ultrasound has been posited as another cause of corneal endothelium damage in PEA. Ultrasound in aqueous solution induces cavitation, directly causing water molecule disintegration and resulting in the formation of hydroxylradicals, the most potent of the reactive oxygen species. Considering the oxidative insult to endothelial cells caused by free radicals, their presence in the anterior chamber may represent one of the most harmful factors during these procedures. Indeed, some researchers have recently started to evaluate PEA from the perspective of oxidative stress. Conversely, the major ingredient in ophthalmic viscosurgical devices (OVDs), which are indispensable for maintaining the anterior chamber in PEA surgery, is sodium hyaluronate, a known free radical scavenger. OVDs can thus be expected to provide some anti-free radical effect during PEA procedures. In addition, since commercially available OVDs display different properties regarding retention in the anterior chamber during PEA, the anti-free radical effect of OVDs is likely to depend on behavior during irrigation and aspiration. The present study followed standard PEA procedures in an eye model and measured hydroxylradicals in the anterior chamber using electron spin resonance. The kinetics of free radical intensity and effects of several OVDs during clinical PEA were also demonstrated. These studies may be of significance in re-evaluating OVDs as a chemical protectant for corneal endothelium, since the OVD has thus far only been regarded as a physical barrier. In addition, many reports about

  20. Change in refraction after lens-sparing vitrectomy for rhegmatogenous retinal detachment and epiretinal membrane.

    PubMed

    Iwase, Takeshi; Yamamoto, Kentaro; Yanagida, Kosei; Kobayashi, Misato; Ra, Eimei; Murotani, Kenta; Terasaki, Hiroko

    2016-08-01

    The aim of this study was to compare changes in refraction following lens-sparing vitrectomy between patients with rhegmatogenous retinal detachment (RRD) and epiretinal membrane (ERM) and to investigate factors associated with the change in refraction.We reviewed medical records of 49 eyes of 49 patients with RRD (53.6 ± 7.8 years, mean ± standard deviation) and 24 eyes of 24 patients with ERM (50.9 ± 15.7 years) who underwent lens-sparing vitrectomy. Spherical equivalent refractive power was evaluated before and up to 18 months after surgery. The relationship between the change in refraction and several parameters was evaluated.A significant progressive myopic shift in refractive power was observed after vitrectomy in operated RRD and ERM eyes (P < 0.001, P = 0.016, respectively), with no significant difference in fellow eyes. The refraction values observed at ≥3 and ≥12 months following vitrectomy were significantly different as compared with those observed at baseline in the RRD group (P < 0.001) and the ERM group (P < 0.05), respectively. The change in refraction between the RRD and ERM groups was significant (P = 0.030). The multiple linear regression analysis showed that only age was significantly correlated with the change in refraction in RRD (P = 0.018) and ERM (P < 0.001) groups. The change in refraction was significantly and positively correlated with age in RRD (r = -0.461, P = 0.001) and ERM (r = -0.687, P < 0.001) groups. Following lens-sparing vitrectomy, cataract surgery was performed on 30 eyes after 0.89 ± 0.26 years in the RRD group and on 10 eyes after 1.11 ± 0.14 years in the ERM group; there was a significant difference in time to cataract surgery between the groups (P = 0.007). Kaplan-Meier survival analysis demonstrated that there was a significant difference in the rate of cataract surgeries between the RRD and ERM groups (P = 0.022).Following lens

  1. Change in refraction after lens-sparing vitrectomy for rhegmatogenous retinal detachment and epiretinal membrane

    PubMed Central

    Iwase, Takeshi; Yamamoto, Kentaro; Yanagida, Kosei; Kobayashi, Misato; Ra, Eimei; Murotani, Kenta; Terasaki, Hiroko

    2016-01-01

    Abstract The aim of this study was to compare changes in refraction following lens-sparing vitrectomy between patients with rhegmatogenous retinal detachment (RRD) and epiretinal membrane (ERM) and to investigate factors associated with the change in refraction. We reviewed medical records of 49 eyes of 49 patients with RRD (53.6 ± 7.8 years, mean ± standard deviation) and 24 eyes of 24 patients with ERM (50.9 ± 15.7 years) who underwent lens-sparing vitrectomy. Spherical equivalent refractive power was evaluated before and up to 18 months after surgery. The relationship between the change in refraction and several parameters was evaluated. A significant progressive myopic shift in refractive power was observed after vitrectomy in operated RRD and ERM eyes (P < 0.001, P = 0.016, respectively), with no significant difference in fellow eyes. The refraction values observed at ≥3 and ≥12 months following vitrectomy were significantly different as compared with those observed at baseline in the RRD group (P < 0.001) and the ERM group (P < 0.05), respectively. The change in refraction between the RRD and ERM groups was significant (P = 0.030). The multiple linear regression analysis showed that only age was significantly correlated with the change in refraction in RRD (P = 0.018) and ERM (P < 0.001) groups. The change in refraction was significantly and positively correlated with age in RRD (r = −0.461, P = 0.001) and ERM (r = −0.687, P < 0.001) groups. Following lens-sparing vitrectomy, cataract surgery was performed on 30 eyes after 0.89 ± 0.26 years in the RRD group and on 10 eyes after 1.11 ± 0.14 years in the ERM group; there was a significant difference in time to cataract surgery between the groups (P = 0.007). Kaplan–Meier survival analysis demonstrated that there was a significant difference in the rate of cataract surgeries between the RRD and ERM groups (P = 0

  2. Mechanisms of Corneal Pain and Implications for Postoperative Pain After Laser Correction of Refractive Errors.

    PubMed

    Garcia, Renato; de Andrade, Daniel C; Teixeira, Manoel J; Nozaki, Siro S; Bechara, Samir J

    2016-05-01

    The cornea is the target of most surgeries for refractive disorders, as myopia. It is estimated that almost 1 million patients undergo corneal refractive surgery each year in the United States. Refractive surgery includes photorefractive keratectomy (PRK) that produces intense postoperative pain. This review presents the main pain mechanisms behind PRK-related pain and the available therapeutic options for its management. Data sources included literature of cornea anatomy, treatment of PRK postoperative pain, mechanisms of corneal pain, in 3 electronic databases: Pubmed, Scopus, and Web of Science. Only double-blinded controlled trials on pain control after PRK were selected to show the endpoints, treatment, and control strategies. A total of 18 double-blind, controlled trials were identified. These studies have shown the use of topical nonsteroidal anti-inflammatory drugs, topical steroidal anti-inflammatory drugs, systemic analgesics, cold balanced saline solution, topical anesthetic, gabapentin, and morphine to treat postoperative pain in PRK. The percentage of responders has seldom been reported, and few studies allow for the formal calculation of the number necessary to treat. Postoperative intense pain after PRK laser surgery remains the main challenge to its widespread use for the correction of refractive errors.

  3. New advances in amblyopia therapy II: refractive therapies.

    PubMed

    Kraus, Courtney L; Culican, Susan M

    2018-06-05

    The treatment of anisometropic or ametropic amblyopia has traditionally enjoyed a high treatment success rate. Early initiation and consistent use of spectacle correction can completely resolve amblyopia in a majority of patients. For those with anisometropic amblyopia that fail to improve with glasses wear alone, patching or atropine penalisation can lead to equalisation of visual acuity. However, successful treatment requires full-time compliance with refractive correction and this can be a challenge for a patient population that often has one eye with good acuity without correction. Other barriers for a select population with high anisometropic or ametropic amblyopia include rejection of glasses for various reasons including discomfort, behavioural or sensory problems, postural issues and visually significant aniseikonia. When consistent wear of optical correction proves difficult and patching/atropine remains a major obstacle, surgical correction of refractive error has proven success in achieving vision improvement. Acting as a means to achieve spectacle independence or reducing the overall needed refractive correction, refractive surgery can offer a unique treatment option for this patient population. Laser surgery, phakic intraocular lenses and clear lens exchange are three approaches to altering the refractive state of the eye. Each has documented success in improving vision, particularly in populations where glasses wear has not been possible. Surgical correction of refractive error has a risk profile greater than that of more traditional therapies. However, its use in a specific population offers the opportunity for improving visual acuity in children who otherwise have poor outcomes with glasses and patching/atropine alone. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  4. In vivo longitudinal chromatic aberration of pseudophakic eyes.

    PubMed

    Siedlecki, Damian; Jóźwik, Agnieszka; Zając, Marek; Hill-Bator, Aneta; Turno-Kręcicka, Anna

    2014-02-01

    To present the results of longitudinal chromatic aberration measurements on two groups of pseudophakic eyes in comparison to healthy eyes. The longitudinal chromatic aberration of the eye, defined as chromatic difference of refraction with disabled accommodation, was measured with the use of a visual refractometer with a custom-designed target illuminator consisting of a narrow-band RGB diode (blue λb = 470 ± 15 nm; green λg = 525 ± 18 nm; red λr = 660 ± 10 nm). The measurements were performed on nine eyes implanted with AcrySof IQ SN60WF, 14 eyes implanted with AcrySof SA60AT, and 10 phakic eyes under cycloplegia. The mean values of the longitudinal chromatic aberration between 470 and 660 nm for the control group was 1.12 ± 0.14 D. For SA60AT group, it was 1.45 ± 0.42 D whereas for SN60WF it was 1.17 ± 0.52 D. The statistical test showed significant difference between SA60AT and the control group (p < 0.05) and no significant difference between SN60WF and the control groups (p = 0.64). The study showed that the longitudinal chromatic aberration in vivo can be easily and reliably estimated with an adapted visual refractometer. The two groups of pseudophakic eyes measured in this study showed different values of chromatic aberration. Its magnitude for SA60AT group was significantly larger than for the control group whereas for SN60WF the difference was not significant. The optical material used for intraocular lens design may have significant influence on the magnitude of the chromatic aberration of the pseudophakic eye, and therefore on its optical and visual performance in polychromatic light.

  5. A Novel Method of Diagnosing Aberrant Pancreas: Needle-based Confocal Laser Endomicroscopy.

    PubMed

    Yasuda, Muneji; Hara, Kazuo; Kurita, Yusuke; Tanaka, Hiroki; Obata, Masahiro; Kuraoka, Naosuke; Matsumoto, Shimpei; Ito, Ayako; Iwaya, Hiromichi; Toriyama, Kazuhiro; Okuno, Nozomi; Kuwahara, Takamichi; Hijioka, Susumu; Mizuno, Nobumasa; Onishi, Sachiyo; Hirayama, Yutaka; Ishihara, Makoto; Tanaka, Tsutomu; Tajika, Masahiro; Niwa, Yasumasa

    2018-05-18

    Aberrant pancreas is defined as pancreatic tissue present outside of the pancreas and is often found incidentally during esophagogastroduodenoscopy. Obtaining sufficient tissue to differentiate aberrant pancreas from other subepithelial lesions is sometimes difficult. Due to the lack of a definitive diagnosis, patients often undergo unnecessary surgery. We herein report the first case of aberrant pancreas in which the concomitant use of needle-based probe confocal laser endomicroscopy and fine-needle aspiration supported the final diagnosis. Needle-based probe confocal laser endomicroscopy provides a real-time in vivo histopathology evaluation and may be a feasible means of diagnosing aberrant pancreas.

  6. Optical designs of reflection and refraction collection optics for a JT-60SA core Thomson scattering system

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Tojo, H.; Hatae, T.; Hamano, T.

    2013-09-15

    Collection optics for core measurements in a JT-60SA Thomson scattering system were designed. The collection optics will be installed in a limited space and have a wide field of view and wide wavelength range. Two types of the optics are therefore suggested: refraction and reflection types. The reflection system, with a large primary mirror, avoids large chromatic aberrations. Because the size limit of the primary mirror and vignetting due to the secondary mirror affect the total collection throughput, conditions that provide the high throughput are found through an optimization. A refraction system with four lenses forming an Ernostar system ismore » also employed. The use of high-refractive-index glass materials enhances the freedom of the lens curvatures, resulting in suppression of the spherical and coma aberration. Moreover, sufficient throughput can be achieved, even with smaller lenses than that of a previous design given in [H. Tojo, T. Hatae, T. Sakuma, T. Hamano, K. Itami, Y. Aida, S. Suitoh, and D. Fujie, Rev. Sci. Instrum. 81, 10D539 (2010)]. The optical resolutions of the reflection and refraction systems are both sufficient for understanding the spatial structures in plasma. In particular, the spot sizes at the image of the optics are evaluated as ∼0.3 mm and ∼0.4 mm, respectively. The throughput for the two systems, including the pupil size and transmissivity, are also compared. The results show that good measurement accuracy (<10%) even at high electron temperatures (<30 keV) can be expected in the refraction system.« less

  7. Optical designs of reflection and refraction collection optics for a JT-60SA core Thomson scattering system.

    PubMed

    Tojo, H; Hatae, T; Hamano, T; Sakuma, T; Itami, K

    2013-09-01

    Collection optics for core measurements in a JT-60SA Thomson scattering system were designed. The collection optics will be installed in a limited space and have a wide field of view and wide wavelength range. Two types of the optics are therefore suggested: refraction and reflection types. The reflection system, with a large primary mirror, avoids large chromatic aberrations. Because the size limit of the primary mirror and vignetting due to the secondary mirror affect the total collection throughput, conditions that provide the high throughput are found through an optimization. A refraction system with four lenses forming an Ernostar system is also employed. The use of high-refractive-index glass materials enhances the freedom of the lens curvatures, resulting in suppression of the spherical and coma aberration. Moreover, sufficient throughput can be achieved, even with smaller lenses than that of a previous design given in [H. Tojo, T. Hatae, T. Sakuma, T. Hamano, K. Itami, Y. Aida, S. Suitoh, and D. Fujie, Rev. Sci. Instrum. 81, 10D539 (2010)]. The optical resolutions of the reflection and refraction systems are both sufficient for understanding the spatial structures in plasma. In particular, the spot sizes at the image of the optics are evaluated as ~0.3 mm and ~0.4 mm, respectively. The throughput for the two systems, including the pupil size and transmissivity, are also compared. The results show that good measurement accuracy (<10%) even at high electron temperatures (<30 keV) can be expected in the refraction system.

  8. Recurrent branchial sinus tract with aberrant extension.

    PubMed

    Barret, J P

    2004-01-01

    Second branchial cysts are the commonest lesions among congenital lateral neck anomalies. Good knowledge of anatomy and embryology are necessary for proper treatment. Surgical treatment involves resection of all branchial remnants, which extend laterally in the neck, medial to the sternocleidomastoid muscle with cranial extension to the pharynx and ipsilateral tonsillar fosa. However, infections and previous surgery can distort anatomy, making the approach to branchial anomalies more difficult. We present a case of a 17-year-old patient who presented with a second branchial tract anomaly with an aberrant extension to the midline and part of the contralateral neck. Previous surgical interventions and chronic infections may have been the primary cause for this aberrant tract. All head and neck surgeons should bear in mind that aberrant presentations may exist when reoperating on chronic branchial cysts fistulas.

  9. The Alvarez and Lohmann refractive lenses revisited.

    PubMed

    Barbero, Sergio

    2009-05-25

    Alvarez and Lohmann lenses are variable focus optical devices based on lateral shifts of two lenses with cubic-type surfaces. I analyzed the optical performance of these types of lenses computing the first order optical properties (applying wavefront refraction and propagation) without the restriction of the thin lens approximation, and the spot diagram using a ray tracing algorithm. I proposed an analytic and numerical method to select the most optimum coefficients and the specific configuration of these lenses. The results show that Lohmann composite lens is slightly superior to Alvarez one because the overall thickness and optical aberrations are smaller.

  10. High-energy x-ray optics with silicon saw-tooth refractive lenses.

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Shastri, S. D.; Almer, J. A.; Ribbing, C. R.

    2007-01-01

    Silicon saw-tooth refractive lenses have been in successful use for vertical focusing and collimation of high-energy X-rays (50-100 keV) at the 1-ID undulator beamline of the Advanced Photon Source. In addition to presenting an effectively parabolic thickness profile, as required for aberration-free refractive optics, these devices allow high transmission and continuous tunability in photon energy and focal length. Furthermore, the use of a single-crystal material (i.e. Si) minimizes small-angle scattering background. The focusing performance of such saw-tooth lenses, used in conjunction with the 1-ID beamline's bent double-Laue monochromator, is presented for both short ({approx}1:0.02) and long ({approx}1:0.6) focal-length geometries, givingmore » line-foci in the 2 {micro}m-25 {micro}m width range with 81 keV X-rays. In addition, a compound focusing scheme was tested whereby the radiation intercepted by a distant short-focal-length lens is increased by having it receive a collimated beam from a nearer (upstream) lens. The collimation capabilities of Si saw-tooth lenses are also exploited to deliver enhanced throughput of a subsequently placed small-angular-acceptance high-energy-resolution post-monochromator in the 50-80 keV range. The successful use of such lenses in all these configurations establishes an important detail, that the pre-monochromator, despite being comprised of vertically reflecting bent Laue geometry crystals, can be brilliance-preserving to a very high degree.« less

  11. Measurement of refractive index profile of non-symmetric, complex silica preforms with high refractive index differences

    NASA Astrophysics Data System (ADS)

    Probostova, Jana; Slanicka, Jiri; Mrazek, Jan; Podrazky, Ondrej; Benda, Adam; Peterka, Pavel

    2016-04-01

    Refractive index profile measurement is a key instrument for characterization of optical properties of preforms, which are used for drawing of high-quality optical fibers. Common industrial optical preform analyzers have been designed for measurement of simple symmetric structures such as step-index or graded-index preforms with refractive index close to the silica (n=1.457 at 633 nm). However, these conditions are usually far from more complex structures used in fiber lasers or in fiber sensor area. Preforms for the drawing of advanced optical fibers, such as Bragg, microstructure or photonic crystal fibers, are usually constituted from stacks with non-symmetric internal structure or composed of alternating layers with high refractive index contrasts. In this paper we present comparison of refractive index profile measurements of simple as well as complex structures with high refractive index differences simulating the Bragg structures. Commercial Photon Kinetics 2600 preform analyzer was used for the refractive index profile measurements. A set of concentrically arranged silica tubes was welded to form a complex preforms. Free space between the tubes was filled by immersion with varying refractive indices to simulate the Bragg structure. Up to three tubes were used for the analysis and the refractive indices of immersion were changed from 1.4 to 1.5. When refractive index of immersion was independently measured the structure of preform was defined. Profiles of these "known" structures were compared to measured data processed by originally proposed algorithm. The work provides an extension of issues of refractive index profile measurements in non-symmetric complex silica structures by a commercial preform analyzer and proposes more convenient methods of numeric data processing.

  12. Plasmon-negative refraction at the heterointerface of graphene sheet arrays.

    PubMed

    Huang, He; Wang, Bing; Long, Hua; Wang, Kai; Lu, Peixiang

    2014-10-15

    We demonstrate negative refraction of surface plasmon polaritons (SPPs) at the heterointerface of two monolayer graphene sheet arrays (MGSAs) with different periods. The refraction angle is specifically related to the period ratio of the two MGSAs. By varying the incident Bloch momentum, the SPPs might be refracted in the direction normal to the heterointerface. Moreover, both positive and negative refraction could appear simultaneously. Because of the linear diffraction relation, the incident and refracted SPP beams experience diffraction-free propagation. The heterostructures composed of the MGSAs may find great applications in deep-subwavelength spatial light modulators, optical splitters, and switches.

  13. Outcome Analysis Tool for Army Refractive Surgery Program

    DTIC Science & Technology

    2005-03-01

    analysis function produces reports on the following information: " Evaluation of the safety of PRK and LASIK for maintenance of optimal visual...performance and ocular integrity. " Evaluation of the efficacy of PRK and LASIK by assessing the improvement in uncorrected vision for target detection...discrimination and recognition. "* Evaluation of the efficacy of PRK and LASIK by evaluating the stability of the refractive error over time

  14. A Model of the Effect of Lens Development on Refraction in Schoolchildren.

    PubMed

    He, Ji C

    2017-12-01

    The study provides a new theory on the mechanism underlying myopia development, and it could be useful in clinical practice to control myopia development in schoolchildren. To model the effect of the crystalline lens on refractive development in schoolchildren. The Zemax 13 was used to calculate Zernike aberrations and refractions across 50° horizontal visual fields. Optical effects of the anterior chamber depth, lens thickness, and radii of curvature of the lens surfaces on refractions were modeled. Refractive changes induced by lens development in emmetropic and myopic eyes, based on a previous longitudinal study from literature, were calculated. A lens thickness reduction with an anterior chamber depth deepening caused a hyperopic shift over the visual fields and even more at the periphery. Opposite effects were found when the lens was thinned without any change of the anterior chamber depth. While a flattening of the anterior lens surface produced hyperopic refractions overall, a posterior lens flattening caused a myopic shift at the periphery, but a hyperopic shift of the central refraction. In the myopic eye, lens development induced refractive change toward more hyperopic over the visual fields and more at the periphery. Lens thinning and lens axial movement participate in peripheral refractive development in schoolchildren, and lens development with a deeper anterior chamber depth and a flatter lens surface in the myopic eye could generate extra hyperopia over visual fields. The myopic lens development could be due to a backward movement of the lens, driven by a backward growth of the ciliary process, which might be a causative factor of myopia development.

  15. Optical phase aberration generation using a Liquid Crystal Spatial Light Modulator

    NASA Astrophysics Data System (ADS)

    Wilcox, Christopher C.

    In this dissertation, a Liquid Crystal Spatial Light Modulator is used to simulate optical aberrations in an optical system. Any optical aberration can be simulated through the use of software developed for this project. A new method of simulating atmospheric turbulence is also presented. The Earth's atmosphere is a large, non-linear, non-homogeneous medium that is constantly flowing in a random fashion that affects light as it propagates through it. The Kolmogorov model for atmospheric turbulence is a description of the nature of the wavefront perturbations introduced by the atmosphere and it is one of the most accepted models. It is supported by a variety of experimental measurements and research and is quite widely used in simulations for atmospheric imaging. This model provides a statistical description of how random fluctuations in humidity and temperature affect the refractive index of the atmosphere for imaging through atmospheric turbulence. These refractive index fluctuations in turn affect the propagation of light through the atmosphere. An adaptive optical system can be developed to correct these wavefront perturbations for an optical system. However, prior to deployment, an adaptive optical system requires calibration and full characterization in the laboratory. Creating realistic atmospheric simulations is often expensive and computationally intensive using common techniques. To combat some of these issues often the temporal properties in the simulation are neglected. This dissertation outlines a new method developed for generating atmospheric turbulence and a testbed that simulates its aberrations far more inexpensively and with greater fidelity using a Liquid Crystal Spatial Light Modulator. This system allows the simulation of atmospheric seeing conditions ranging from very poor to very good and different algorithms may be easily employed on the device for comparison. These simulations can be dynamically generated and modified very quickly and

  16. [Character of refractive errors in population study performed by the Area Military Medical Commission in Lodz].

    PubMed

    Nowak, Michał S; Goś, Roman; Smigielski, Janusz

    2008-01-01

    To determine the prevalence of refractive errors in population. A retrospective review of medical examinations for entry to the military service from The Area Military Medical Commission in Lodz. Ophthalmic examinations were performed. We used statistic analysis to review the results. Statistic analysis revealed that refractive errors occurred in 21.68% of the population. The most commen refractive error was myopia. 1) The most commen ocular diseases are refractive errors, especially myopia (21.68% in total). 2) Refractive surgery and contact lenses should be allowed as the possible correction of refractive errors for military service.

  17. Refractive index and its impact on pseudophakic dysphotopsia.

    PubMed

    Radmall, Bryce R; Floyd, Anne; Oakey, Zack; Olson, Randall J

    2015-01-01

    It has been shown that the biggest dissatisfier for uncomplicated cataract surgery patients is pseudophakic dysphotopsia (PD). While edge design of an intraocular lens (IOL) impacts this problem, refractive index is still controversial as to its impact. This retrospective cohort study was designed to determine the role of increasing refractive index in PD. This study was conducted at the John A. Moran Eye Center, University of Utah, USA. A retrospective chart review identified patients who received one of two hydrophobic acrylic single piece IOLs (AcrySof WF SP [SN60WF] or Tecnis SP [ZCB00]), which differed mainly by refractive index (1.55 versus 1.47). Eighty-seven patients who had received implantation of a one-piece hydrophobic acrylic IOL were enrolled. Patients were included if the surgery had been uncomplicated and took place at least a year before study participation. All eligible patients had 20/20 best corrected vision, without any disease known to impact visual quality. In addition to conducting a record review, the enrolled patients were surveyed for PD, using a modified National Eye Institute Visual Function questionnaire, as well as for overall satisfaction with visual quality. Statistical analysis demonstrated no difference between the two cohorts regarding PD, general visual function, and overall visual satisfaction. The study suggests that with the two IOLs assessed, increasing the refractive index does not increase incidence of PD or decrease overall visual satisfaction.

  18. Optimization of the parameters for intrastromal refractive surgery with ultrashort laser pulses

    NASA Astrophysics Data System (ADS)

    Heisterkamp, Alexander; Ripken, Tammo; Lubatschowski, Holger; Welling, Herbert; Dommer, Wolfgang; Luetkefels, Elke; Mamom, Thanongsak; Ertmer, Wolfgang

    2001-06-01

    Focussing femtosecond laser pulses into a transparent media, such as corneal tissue, leads to optical breakdown, generation of a micro-plasma and, thus, a cutting effect inside the tissue. To proof the potential of fs-lasers in refractive surgery, three-dimensional cutting within the corneal stroma was evaluated. With the use of ultrashort laser pulses within the LASIK procedure (laser in situ keratomileusis) possible complications in handling of a mechanical knife, the microkeratome, can be reduced by using the treatment laser as the keratome itself. To study woundhealing effects, animal studies were carried out in rabbit specimen. The surgical outcome was analyzed by means of histological sections, as well as light and scanning electron microscopy. Dependencies on the dispersion caused by focussing optics were evaluated and optimized. Thus, pulse energies well below 1 (mu) J were sufficient to perform the intrastromal cuts. The laser pulses with a duration of 180 fs and energies of 0.5-100 (mu) J were provided by a modelocked frequency doubled erbium fiber-laser with subsequent chirped pulse amplification in a titanium sapphire amplifier at up to 3 kHz.

  19. Influence of the refractive index and dispersion of spectacle lens on its imaging properties

    NASA Astrophysics Data System (ADS)

    Miks, Antonin; Novak, Jiri; Novak, Pavel

    2007-12-01

    The paper shows an influence of the refractive index and dispersion of the spectacle lens on its imaging properties. Relations are presented for calculation of radii of curvature of anastigmatic spectacle lenses and their chromatic aberration. Moreover, the formulas are derived for calculation of the change of astigmatism of spectacle lens due to dispersion of spectacle lens material.

  20. Optical aberrations, retinal image quality and eye growth: Experimentation and modeling

    NASA Astrophysics Data System (ADS)

    Tian, Yibin

    2007-12-01

    subsequently elongated. The performance of some focus measures was very poor when non-defocus aberrations exceeded a certain level; presumably, these non-defocus aberrations might interfere with the eye's ability to interpret defocus. In anisomyopic human adults, more myopic eyes had larger anterior and vitreous chambers, greater astigmatism, and more positive spherical aberration. However, compared to isometropes, only interocular differences in spherical equivalent refractive errors were significantly increased.

  1. Comparison of two scanning instruments to measure peripheral refraction in the human eye.

    PubMed

    Jaeken, Bart; Tabernero, Juan; Schaeffel, Frank; Artal, Pablo

    2012-03-01

    To better understand how peripheral refraction affects development of myopia in humans, specialized instruments are fundamental for precise and rapid measurements of refraction over the visual field. We compare here two prototype instruments that measure in a few seconds the peripheral refraction in the eye with high angular resolution over a range of about ±45 deg. One instrument is based on the continuous recording of Hartmann-Shack (HS) images (HS scanner) and the other is based on the photorefraction (PR) principle (PR scanner). On average, good correlations were found between the refraction results provided by the two devices, although it varied across subjects. A detailed statistical analysis of the differences between both instruments was performed based on measurements in 35 young subjects. Both instruments have advantages and disadvantages. The HS scanner also provides the high-order aberration data, while the PR scanner is more compact and has a lower cost. Both instruments are current prototypes, and further optimization is possible to make them even more suitable tools for future visual optics and myopia research and also for different ophthalmic applications.

  2. Interocular high-order corneal wavefront aberration symmetry

    NASA Astrophysics Data System (ADS)

    Lombardo, Marco; Lombardo, Giuseppe; Serrao, Sebastiano

    2006-04-01

    The interocular symmetry of the high-order corneal wavefront aberration (WA) in a population of myopic eyes was analyzed before and after photorefractive keratectomy (PRK). The preoperative and one-year postoperative corneal aberration data (from third to seventh Zernike orders) for 4- and 7-mm pupils from right and left eyes were averaged after correcting for the effects of enantiomorphism to test for mirror symmetry. Also, the mean corneal point-spread function (PSF) for right and left eyes was calculated. Preoperatively, a moderate and high degree of correlation in the high-order corneal WA between eyes was found for 4- and 7-mm pupils, respectively. Myopic PRK did not significantly change the interocular symmetry of corneal high-order aberrations. No discernible differences in the orientation PSF between eyes were observed one year after surgery in comparison with the preoperative state over the two analyzed pupils.

  3. DISCRIMINATING BETWEEN CLOUDY, HAZY, AND CLEAR SKY EXOPLANETS USING REFRACTION

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Misra, Amit K.; Meadows, Victoria S.

    2014-11-01

    We propose a method to distinguish between cloudy, hazy, and clear sky (free of clouds and hazes) exoplanet atmospheres that could be applicable to upcoming large aperture space- and ground-based telescopes such as the James Webb Space Telescope (JWST) and the European Extremely Large Telescope (E-ELT). These facilities will be powerful tools for characterizing transiting exoplanets, but only after a considerable amount of telescope time is devoted to a single planet. A technique that could provide a relatively rapid means of identifying haze-free targets (which may be more valuable targets for characterization) could potentially increase the science return for thesemore » telescopes. Our proposed method utilizes broadband observations of refracted light in the out-of-transit spectrum. Light refracted through an exoplanet atmosphere can lead to an increase of flux prior to ingress and subsequent to egress. Because this light is transmitted at pressures greater than those for typical cloud and haze layers, the detection of refracted light could indicate a cloud- or haze-free atmosphere. A detection of refracted light could be accomplished in <10 hr for Jovian exoplanets with JWST and <5 hr for super-Earths/mini-Neptunes with E-ELT. We find that this technique is most effective for planets with equilibrium temperatures between 200 and 500 K, which may include potentially habitable planets. A detection of refracted light for a potentially habitable planet would strongly suggest the planet was free of a global cloud or haze layer, and therefore a promising candidate for follow-up observations.« less

  4. Efficacy of predictive wavefront control for compensating aero-optical aberrations

    NASA Astrophysics Data System (ADS)

    Goorskey, David J.; Schmidt, Jason; Whiteley, Matthew R.

    2013-07-01

    Imaging and laser beam propagation from airborne platforms are degraded by dynamic aberrations due to air flow around the aircraft, aero-mechanical distortions and jitter, and free atmospheric turbulence. For certain applications, like dim-object imaging, free-space optical communications, and laser weapons, adaptive optics (AO) is necessary to compensate for the aberrations in real time. Aero-optical flow is a particularly interesting source of aberrations whose flowing structures can be exploited by adaptive and predictive AO controllers, thereby realizing significant performance gains. We analyze dynamic aero-optical wavefronts to determine the pointing angles at which predictive wavefront control is more effective than conventional, fixed-gain, linear-filter control. It was found that properties of the spatial decompositions and temporal statistics of the wavefronts are directly traceable to specific features in the air flow. Furthermore, the aero-optical wavefront aberrations at the side- and aft-looking angles were the most severe, but they also benefited the most from predictive AO.

  5. Refractive Index of Sodium Iodide

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Jellison Jr, Gerald Earle; Boatner, Lynn A; Ramey, Joanne Oxendine

    2012-01-01

    The refractive index of sodium iodide, an important scintillator material that is widely used for radiation detection, is based on a single measurement made by Spangenberg at one wavelength using the index-matching liquid immersion method (Z. Kristallogr., 57, 494-534 (1923)). In the present paper, we present new results for the refractive index of sodium iodide as measured by the minimum deviation technique at six wavelengths between 436 nm (n=1.839 0.002) and 633 nm (n=1.786 0.002). These 6 measurements can be fit to a Sellmeier model, resulting in a 2 of 1.02, indicating a good fit to the data. In addition,more » we report on ellipsometry measurements, which suggest that the near-surface region of the air sensitive NaI crystal seriously degrades, even in a moisture-free environment, resulting in a significantly lower value of the refractive index near the surface. First-principles theoretical calculations of the NaI refractive index that agree with the measured values within 0.025-0.045 are also presented and discussed.« less

  6. Predictive factors for photic phenomena after refractive, rotationally asymmetric, multifocal intraocular lens implantation

    PubMed Central

    Tchah, Hungwon; Nam, Kiyeun; Yoo, Aeri

    2017-01-01

    AIM To investigate the independent factors associated with photic phenomena in patients implanted with refractive, rotationally asymmetric, multifocal intraocular lenses (MIOLs). METHODS Thirty-four eyes of 34 patients who underwent unilateral cataract surgery, followed by implantation of rotationally asymmetric MIOLs were included. Distance and near visual acuity outcomes, intraocular aberrations, preferred reading distances, preoperative and postoperative refractive errors, mesopic and photopic pupil diameters, and the mesopic and photopic kappa angles were assessed. Patients were also administered a satisfaction survey. Photic phenomena were graded by questionnaire. Independent-related factors were identified by correlation and bivariate logistic regression analyses. RESULTS The distance from the photopic to the mesopic pupil center (pupil center shift) was significantly associated with glare/halo symptoms [odds ratio (OR)=2.065, 95% confidence interval (CI)=0.916-4.679, P=0.006] and night vision problems (OR=1.832, 95% CI=0.721-2.158, P=0.007). The preoperative photopic angle kappa was significantly associated with glare/halo symptoms (OR=2.155, 95% CI=1.065-4.362, P=0.041). The photopic angle kappa was also significantly associated with glare/halo symptoms (OR=2.155, 95% CI=1.065-4.362, P=0.041) and with night vision problems (OR=1.832, 95% CI=0.721-2.158, P=0.007) in patients implanted with rotationally asymmetric MIOLs. CONCLUSION A large pupil center shift and misalignment between the visual and pupillary axis (angle kappa) may play a role in the occurrence of photic phenomena after implantation of rotationally asymmetric MIOLs. PMID:28251083

  7. Aberration-free superresolution imaging via binary speckle pattern encoding and processing

    NASA Astrophysics Data System (ADS)

    Ben-Eliezer, Eyal; Marom, Emanuel

    2007-04-01

    We present an approach that provides superresolution beyond the classical limit as well as image restoration in the presence of aberrations; in particular, the ability to obtain superresolution while extending the depth of field (DOF) simultaneously is tested experimentally. It is based on an approach, recently proposed, shown to increase the resolution significantly for in-focus images by speckle encoding and decoding. In our approach, an object multiplied by a fine binary speckle pattern may be located anywhere along an extended DOF region. Since the exact magnification is not known in the presence of defocus aberration, the acquired low-resolution image is electronically processed via a parallel-branch decoding scheme, where in each branch the image is multiplied by the same high-resolution synchronized time-varying binary speckle but with different magnification. Finally, a hard-decision algorithm chooses the branch that provides the highest-resolution output image, thus achieving insensitivity to aberrations as well as DOF variations. Simulation as well as experimental results are presented, exhibiting significant resolution improvement factors.

  8. Calculations of actual corneal astigmatism using total corneal refractive power before and after myopic keratorefractive surgery.

    PubMed

    Seo, Kyoung Yul; Yang, Hun; Kim, Wook Kyum; Nam, Sang Min

    2017-01-01

    To calculate actual corneal astigmatism using the total corneal refractive astigmatism for the 4-mm apex zone of the Pentacam (TCRP4astig) and keratometric astigmatism (Kastig) before and after photorefractive keratectomy or laser in situ keratomileusis. Uncomplicated 56 eyes after more than 6 months from the surgery were recruited by chart review. Various corneal astigmatisms were measured using the Pentacam and autokeratometer before and after surgery. Three eyes were excluded and 53 eyes of 38 subjects with with-the-rule astigmatism (WTR) were finally included. The astigmatisms were investigated using polar value analysis. When TCRP4astig was set as an actual astigmatism, the efficacy of arithmetic or coefficient adjustment of Kastig was evaluated using bivariate analysis. The difference between the simulated keratometer astigmatism of the Pentacam (SimKastig) and Kastig was strongly correlated with the difference between TCRP4astig and Kastig. TCRP4astig was different from Kastig in magnitude rather than meridian before and after surgery; the preoperative difference was due to the posterior cornea only; however, the postoperative difference was observed in both anterior and posterior parts. For arithmetic adjustment, 0.28 D and 0.27 D were subtracted from the preoperative and postoperative magnitudes of Kastig, respectively. For coefficient adjustment, the preoperative and postoperative magnitudes of Kastig were multiplied by 0.80 and 0.66, respectively. By arithmetic or coefficient adjustment, the difference between TCRP4astig and adjusted Kastig would be less than 0.75 D in magnitude for 95% of cases. Kastig was successfully adjusted to TCPR4astig before and after myopic keratorefractive surgery in cases of WTR. For use of TCRP4astig directly, SimKastig and Kastig should be matched.

  9. Calculations of actual corneal astigmatism using total corneal refractive power before and after myopic keratorefractive surgery

    PubMed Central

    Seo, Kyoung Yul; Yang, Hun; Kim, Wook Kyum; Nam, Sang Min

    2017-01-01

    Purpose To calculate actual corneal astigmatism using the total corneal refractive astigmatism for the 4-mm apex zone of the Pentacam (TCRP4astig) and keratometric astigmatism (Kastig) before and after photorefractive keratectomy or laser in situ keratomileusis Methods Uncomplicated 56 eyes after more than 6 months from the surgery were recruited by chart review. Various corneal astigmatisms were measured using the Pentacam and autokeratometer before and after surgery. Three eyes were excluded and 53 eyes of 38 subjects with with-the-rule astigmatism (WTR) were finally included. The astigmatisms were investigated using polar value analysis. When TCRP4astig was set as an actual astigmatism, the efficacy of arithmetic or coefficient adjustment of Kastig was evaluated using bivariate analysis. Results The difference between the simulated keratometer astigmatism of the Pentacam (SimKastig) and Kastig was strongly correlated with the difference between TCRP4astig and Kastig. TCRP4astig was different from Kastig in magnitude rather than meridian before and after surgery; the preoperative difference was due to the posterior cornea only; however, the postoperative difference was observed in both anterior and posterior parts. For arithmetic adjustment, 0.28 D and 0.27 D were subtracted from the preoperative and postoperative magnitudes of Kastig, respectively. For coefficient adjustment, the preoperative and postoperative magnitudes of Kastig were multiplied by 0.80 and 0.66, respectively. By arithmetic or coefficient adjustment, the difference between TCRP4astig and adjusted Kastig would be less than 0.75 D in magnitude for 95% of cases. Conclusions Kastig was successfully adjusted to TCPR4astig before and after myopic keratorefractive surgery in cases of WTR. For use of TCRP4astig directly, SimKastig and Kastig should be matched. PMID:28403194

  10. Integrated dual-tomography for refractive index analysis of free-floating single living cell with isotropic superresolution.

    PubMed

    B, Vinoth; Lai, Xin-Ji; Lin, Yu-Chih; Tu, Han-Yen; Cheng, Chau-Jern

    2018-04-13

    Digital holographic microtomography is a promising technique for three-dimensional (3D) measurement of the refractive index (RI) profiles of biological specimens. Measurement of the RI distribution of a free-floating single living cell with an isotropic superresolution had not previously been accomplished. To the best of our knowledge, this is the first study focusing on the development of an integrated dual-tomographic (IDT) imaging system for RI measurement of an unlabelled free-floating single living cell with an isotropic superresolution by combining the spatial frequencies of full-angle specimen rotation with those of beam rotation. A novel 'UFO' (unidentified flying object) like shaped coherent transfer function is obtained. The IDT imaging system does not require any complex image-processing algorithm for 3D reconstruction. The working principle was successfully demonstrated and a 3D RI profile of a single living cell, Candida rugosa, was obtained with an isotropic superresolution. This technology is expected to set a benchmark for free-floating single live sample measurements without labeling or any special sample preparations for the experiments.

  11. Prevalence of refractive error in Europe: the European Eye Epidemiology (E(3)) Consortium.

    PubMed

    Williams, Katie M; Verhoeven, Virginie J M; Cumberland, Phillippa; Bertelsen, Geir; Wolfram, Christian; Buitendijk, Gabriëlle H S; Hofman, Albert; van Duijn, Cornelia M; Vingerling, Johannes R; Kuijpers, Robert W A M; Höhn, René; Mirshahi, Alireza; Khawaja, Anthony P; Luben, Robert N; Erke, Maja Gran; von Hanno, Therese; Mahroo, Omar; Hogg, Ruth; Gieger, Christian; Cougnard-Grégoire, Audrey; Anastasopoulos, Eleftherios; Bron, Alain; Dartigues, Jean-François; Korobelnik, Jean-François; Creuzot-Garcher, Catherine; Topouzis, Fotis; Delcourt, Cécile; Rahi, Jugnoo; Meitinger, Thomas; Fletcher, Astrid; Foster, Paul J; Pfeiffer, Norbert; Klaver, Caroline C W; Hammond, Christopher J

    2015-04-01

    To estimate the prevalence of refractive error in adults across Europe. Refractive data (mean spherical equivalent) collected between 1990 and 2013 from fifteen population-based cohort and cross-sectional studies of the European Eye Epidemiology (E(3)) Consortium were combined in a random effects meta-analysis stratified by 5-year age intervals and gender. Participants were excluded if they were identified as having had cataract surgery, retinal detachment, refractive surgery or other factors that might influence refraction. Estimates of refractive error prevalence were obtained including the following classifications: myopia ≤-0.75 diopters (D), high myopia ≤-6D, hyperopia ≥1D and astigmatism ≥1D. Meta-analysis of refractive error was performed for 61,946 individuals from fifteen studies with median age ranging from 44 to 81 and minimal ethnic variation (98 % European ancestry). The age-standardised prevalences (using the 2010 European Standard Population, limited to those ≥25 and <90 years old) were: myopia 30.6 % [95 % confidence interval (CI) 30.4-30.9], high myopia 2.7 % (95 % CI 2.69-2.73), hyperopia 25.2 % (95 % CI 25.0-25.4) and astigmatism 23.9 % (95 % CI 23.7-24.1). Age-specific estimates revealed a high prevalence of myopia in younger participants [47.2 % (CI 41.8-52.5) in 25-29 years-olds]. Refractive error affects just over a half of European adults. The greatest burden of refractive error is due to myopia, with high prevalence rates in young adults. Using the 2010 European population estimates, we estimate there are 227.2 million people with myopia across Europe.

  12. Comparison of a new refractive multifocal intraocular lens with an inferior segmental near add and a diffractive multifocal intraocular lens.

    PubMed

    Alio, Jorge L; Plaza-Puche, Ana B; Javaloy, Jaime; Ayala, María José; Moreno, Luis J; Piñero, David P

    2012-03-01

    To compare the visual acuity outcomes and ocular optical performance of eyes implanted with a multifocal refractive intraocular lens (IOL) with an inferior segmental near add or a diffractive multifocal IOL. Prospective, comparative, nonrandomized, consecutive case series. Eighty-three consecutive eyes of 45 patients (age range, 36-82 years) with cataract were divided into 2 groups: group A, 45 eyes implanted with Lentis Mplus LS-312 (Oculentis GmbH, Berlin, Germany); group B, 38 eyes implanted with diffractive IOL Acri.Lisa 366D (Zeiss, Oberkochen, Germany). All patients underwent phacoemulsification followed by IOL implantation in the capsular bag. Distance corrected, intermediate, and near with the distance correction visual acuity outcomes and contrast sensitivity, intraocular aberrations, and defocus curve were evaluated postoperatively during a 3-month follow-up. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected near visual acuity (UNVA), corrected distance near and intermediate visual acuity (CDNVA), contrast sensitivity, intraocular aberrations, and defocus curve. A significant improvement in UDVA, CDVA, and UNVA was observed in both groups after surgery (P ≤ 0.04). Significantly better values of UNVA (P<0.01) and CDNVA (P<0.04) were found in group B. In the defocus curve, significantly better visual acuities were present in eyes in group A for intermediate vision levels of defocus (P ≤ 0.04). Significantly higher amounts of postoperative intraocular primary coma and spherical aberrations were found in group A (P<0.01). In addition, significantly better values were observed in photopic contrast sensitivity for high spatial frequencies in group A (P ≤ 0.04). The Lentis Mplus LS-312 and Acri.Lisa 366D IOLs are able to successfully restore visual function after cataract surgery. The Lentis Mplus LS-312 provided better intermediate vision and contrast sensitivity outcomes than the Acri.Lisa 366D. However, the

  13. Assessment of refractive outcome of femtosecond-assisted LASIK for hyperopia correction

    PubMed Central

    El-Naggar, Mohamed Tarek; Hovaghimian, Dikran Gilbert

    2017-01-01

    Introduction Laser vision correction for hyperopia is challenging. The purpose of the study was to assess the refractive outcomes of femtosecond-assisted laser in situ keratomileusis (LASIK) for hyperopic correction using wavefront-optimized ablation profiles. Methods This retrospective case series study included 20 Egyptian patients (40 eyes) with hyperopia or hyperopic astigmatism with a mean manifest refraction spherical equivalent (MRSE) of +2.55D±1.17 (range from +1.00 to +6.00) who had uneventful femtosecond-a assisted LASIK with wavefront-optimized aspheric ablation profile using refractive surgery suite (WaveLight FS200 Femtosecond Laser and WaveLight EX500 Excimer Laser) performed in the Research Institute of Ophthalmology and International Eye Hospital, Giza, Egypt. Statistical analysis was done using Microsoft Excel (Microsoft Corporation, Seattle, WA, USA). Results The procedure significantly reduced the MRSE and cylinder post-operatively (95% were ± 0.50D and 100% ± 1.00 D), with stability of refraction and UDVA over the follow-up period (up to 12 months) after surgery. No eye lost any line of the CDVA, which reflects the excellent safety profile of the procedure; on the other hand, one eye (5%) gained one line and one eye (5%) even gained two lines. There were no significant complications during the procedure. Conclusions Femtosecond-assisted laser in situ keratomileusis for hyperopia showed predictable, effective, and safe refractive outcomes that were stable through 12 months. Longer follow-up period is required to detect any further regression PMID:28461870

  14. Peripheral refraction and image blur in four meridians in emmetropes and myopes.

    PubMed

    Shen, Jie; Spors, Frank; Egan, Donald; Liu, Chunming

    2018-01-01

    The peripheral refractive error of the human eye has been hypothesized to be a major stimulus for the development of its central refractive error. The purpose of this study was to investigate the changes in the peripheral refractive error across horizontal, vertical and two diagonal meridians in emmetropic and low, moderate and high myopic adults. Thirty-four adult subjects were recruited and aberration was measured using a modified commercial aberrometer. We then computed the refractive error in power vector notation from second-order Zernike terms. Statistical analysis was performed to evaluate the statistical differences in refractive error profiles between the subject groups and across all measured visual field meridians. Small amounts of relative myopic shift were observed in emmetropic and low myopic subjects. However, moderate and high myopic subjects exhibited a relative hyperopic shift in all four meridians. Astigmatism J 0 and J 45 had quadratic or linear changes dependent on the visual field meridians. Peripheral Sphero-Cylindrical Retinal Image Blur increased in emmetropic eyes in most of the measured visual fields. The findings indicate an overall emmetropic or slightly relative myopic periphery (spherical or oblate retinal shape) formed in emmetropes and low myopes, while moderate and high myopes form relative hyperopic periphery (prolate, or less oblate, retinal shape). In general, human emmetropic eyes demonstrate higher amount of peripheral retinal image blur.

  15. Change in peripheral refraction and curvature of field of the human eye with accommodation

    NASA Astrophysics Data System (ADS)

    Ho, Arthur; Zimmermann, Frederik; Whatham, Andrew; Martinez, Aldo; Delgado, Stephanie; Lazon de la Jara, Percy; Sankaridurg, Padmaja

    2009-02-01

    Recent research showed that the peripheral refractive state is a sufficient stimulus for myopia progression. This finding led to the suggestion that devices that control peripheral refraction may be efficacious in controlling myopia progression. This study aims to understand whether the optical effect of such devices may be affected by near focus. In particular, we seek to understand the influence of accommodation on peripheral refraction and curvature of field of the eye. Refraction was measured in twenty young subjects using an autorefractor at 0° (i.e. along visual axis), and 20°, 30° and 40° field angles both nasal and temporal to the visual axis. All measurements were conducted at 2.5 m, 40 cm and 30 cm viewing distances. Refractive errors were corrected using a soft contact lens during all measurements. As field angle increased, refraction became less hyperopic. Peripheral refraction also became less hyperopic at nearer viewing distances (i.e. with increasing accommodation). Astigmatism (J180) increased with field angle as well as with accommodation. Adopting a third-order aberration theory approach, the position of the Petzval surface relative to the retinal surface was estimated by considering the relative peripheral refractive error (RPRE) and J180 terms of peripheral refraction. Results for the estimated dioptric position of the Petzval surface relative to the retina showed substantial asymmetry. While temporal field tended to agree with theoretical predictions, nasal response departed dramatically from the model eye predictions. With increasing accommodation, peripheral refraction becomes less hyperopic while the Petzval surface showed asymmetry in its change in position. The change in the optical components (i.e. cornea and/or lens as opposed to retinal shape or position) is implicated as at least one of the contributors of this shift in peripheral refraction during accommodation.

  16. Refractive index dependence of L3 photonic crystal nano-cavities.

    PubMed

    Adawi, A M; Chalcraft, A R; Whittaker, D M; Lidzey, D G

    2007-10-29

    We model the optical properties of L3 photonic crystal nano-cavities as a function of the photonic crystal membrane refractive index n using a guided mode expansion method. Band structure calculations revealed that a TE-like full band-gap exists for materials of refractive index as low as 1.6. The Q-factor of such cavities showed a super-linear increase with refractive index. By adjusting the relative position of the cavity side holes, the Q-factor was optimised as a function of the photonic crystal membrane refractive index n over the range 1.6 to 3.4. Q-factors in the range 3000-8000 were predicted from absorption free materials in the visible range with refractive index between 2.45 and 2.8.

  17. Carrier and aberrations removal in interferometric fringe projection profilometry

    NASA Astrophysics Data System (ADS)

    Blain, P.; Michel, F.; Renotte, Y.; Habraken, S.

    2012-04-01

    A profilometer which takes advantage of polarization states splitting technique and monochromatic light projection method as a way to overcome ambient lighting for in-situ measurement is under development [1, 2]. Because of the Savart plate which refracts two out of axis beams, the device suffers from aberrations (mostly coma and astigmatism). These aberrations affect the quality of the sinusoidal fringe pattern. In fringe projection profilometry, the unwrapped phase distribution map contains the sum of the object's shape-related phase and carrier-fringe-related phase. In order to extract the 3D shape of the object, the carrier phase has to be removed [3, 4]. An easy way to remove both the fringe carrier and the aberrations of the optical system is to measure the phases of the test object and to measure the phase of a reference plane with the same set up and to subtract both phase maps. This time consuming technique is suitable for laboratory but not for industry. We propose a method to numerically remove both the fringe carrier and the aberrations. A first reference phase of a calibration plane is evaluated knowing the position of the different elements in the set up and the orientation of the fringes. Then a fitting of the phase map by Zernike polynomials is computed [5]. As the triangulation parameters are known during the calibration, the computation of Zernike coefficients has only to be made once. The wavefront error can be adjusted by a scale factor which depends on the position of the test object.

  18. Modulation of polymer refractive indices with diamond nanoparticles for metal-free multilayer film mirrors.

    PubMed

    Ogata, Tomonari; Yagi, Ryohei; Nakamura, Nozomi; Kuwahara, Yutaka; Kurihara, Seiji

    2012-08-01

    Modulation of the refractive index of a polymer was achieved by combining it with diamond nanoparticles (NDs). The increase in the refractive index was controlled by the amount of NDs added, according to the Lorentz-Lorenz equation. The refractive index of poly(vinyl alcohol) (PVA), which was used as the base polymer, increased from 1.52 to 1.88. A multilayer film consisting of alternating layers of ND-PVA composite and poly(methyl methacrylate) exhibited ca. 80% reflectance with 10 bilayers.

  19. Refractive eye surgery - what to ask your doctor

    MedlinePlus

    ... surgery; Nearsightedness surgery - what to ask your doctor; LASIK - what to ask your doctor; Laser-Assisted In ... Academy of Ophthalmology. Questions to ask when considering LASIK. San Francisco, CA. American Academy of Ophthalmology. December ...

  20. The inverse problem of refraction travel times, part II: Quantifying refraction nonuniqueness using a three-layer model

    USGS Publications Warehouse

    Ivanov, J.; Miller, R.D.; Xia, J.; Steeples, D.

    2005-01-01

    This paper is the second of a set of two papers in which we study the inverse refraction problem. The first paper, "Types of Geophysical Nonuniqueness through Minimization," studies and classifies the types of nonuniqueness that exist when solving inverse problems depending on the participation of a priori information required to obtain reliable solutions of inverse geophysical problems. In view of the classification developed, in this paper we study the type of nonuniqueness associated with the inverse refraction problem. An approach for obtaining a realistic solution to the inverse refraction problem is offered in a third paper that is in preparation. The nonuniqueness of the inverse refraction problem is examined by using a simple three-layer model. Like many other inverse geophysical problems, the inverse refraction problem does not have a unique solution. Conventionally, nonuniqueness is considered to be a result of insufficient data and/or error in the data, for any fixed number of model parameters. This study illustrates that even for overdetermined and error free data, nonlinear inverse refraction problems exhibit exact-data nonuniqueness, which further complicates the problem of nonuniqueness. By evaluating the nonuniqueness of the inverse refraction problem, this paper targets the improvement of refraction inversion algorithms, and as a result, the achievement of more realistic solutions. The nonuniqueness of the inverse refraction problem is examined initially by using a simple three-layer model. The observations and conclusions of the three-layer model nonuniqueness study are used to evaluate the nonuniqueness of more complicated n-layer models and multi-parameter cell models such as in refraction tomography. For any fixed number of model parameters, the inverse refraction problem exhibits continuous ranges of exact-data nonuniqueness. Such an unfavorable type of nonuniqueness can be uniquely solved only by providing abundant a priori information

  1. Atmospheric microwave refractivity and refraction

    NASA Technical Reports Server (NTRS)

    Yu, E.; Hodge, D. B.

    1980-01-01

    The atmospheric refractivity can be expressed as a function of temperature, pressure, water vapor content, and operating frequency. Based on twenty-year meteorological data, statistics of the atmospheric refractivity were obtained. These statistics were used to estimate the variation of dispersion, attenuation, and refraction effects on microwave and millimeter wave signals propagating along atmospheric paths. Bending angle, elevation angle error, and range error were also developed for an exponentially tapered, spherical atmosphere.

  2. Ocular Aberrations Across the Visual Field During Accommodation

    NASA Astrophysics Data System (ADS)

    Liu, Tao

    Myopia is classically defined as a mismatch between the optical power of the relaxed eye and its dioptric length. This definition is entirely foveocentric without concern for the contributions of peripheral refractive errors to myopia development. Long periods of steady near-work was considered to cause myopia development due to inadequate accommodation. Consequently, not only the on-axis optical features but also off-axis ones should be probed to gain insight about myopia progression. Moreover, these features need to be understood not only for the relaxed eye, but also for the accommodating eye. To acquire complete data set, a custom-built Indiana Scanning Aberrometer for Wavefront (I SAW) was developed to measure wavefront aberration along 37 line-of-sights at 8 different accommodation states in the central 30 degree visual field. We found that ocular refractive state changed uniformly over the central visual field as the eye accommodates up to 6D, and the accuracy of accommodation across the central visual field is similar to that measured in the fovea. No systematic difference between emmetropic and myopic eyes was evident. Then, a linear vector-summation rule for axial and oblique astigmatism was found to account for their interaction over the central visual field. Using this combination rule, our experimental evidence revealed no systematic effect of accommodation on axial or oblique astigmatism for two adult populations. The axial and oblique astigmatism of the whole eye is less than for the cornea alone, indicating a compensatory role for internal optics at all accommodative states. This compensation mechanism was further validated theoretically with schematic eye model. Lastly, we developed a hybrid method yielding customized eye models that accurately reproduce the empirical measurements and reasonably represent the anatomical structure, thus providing a mechanistic explanation for the changes in the eye's aberration structure that occur over the central

  3. Meta-analysis of aberrant lymphatic drainage in recurrent breast cancer.

    PubMed

    Ahmed, M; Baker, R; Rubio, I T

    2016-11-01

    Sentinel node biopsy (SNB) in recurrent breast cancer offers targeted axillary staging compared with axillary lymph node dissection (ALND) or no treatment. The evidence for lymphatic mapping in recurrent breast cancer is reviewed, focusing on aberrant drainage and its implications for patient management. A meta-analysis of studies evaluating lymphatic mapping in recurrent breast cancer was performed. Outcomes included sentinel node identification, aberrant lymphatic pathways and metastatic node rates in aberrant drainage and ipsilateral axilla. Pooled odds ratios (ORs) and 95 per cent confidence intervals (c.i.) were estimated using fixed-effect analyses, or random-effects analyses in the event of statistically significant heterogeneity. Seven studies reported data on lymphatic mapping in 1053 patients with recurrent breast cancer. The intraoperative sentinel node identification rate was 59·6 (95 per cent c.i. 56·7 to 62·6) per cent, and significantly greater when the original axillary surgery was SNB compared with ALND (OR 2·97, 95 per cent c.i. 1·66 to 5·32). The rate of aberrant lymphatic drainage identification was 25·7 (23·0 to 28·3) per cent, and significantly greater when the original axillary surgery was ALND (OR 0·27, 0·19 to 0·38). The metastatic sentinel node rate was 10·4 (8·6 to 12·3) per cent, and a significantly greater metastatic nodal burden was identified in the ipsilateral axilla (OR 6·31, 1·03 to 38·79). Lymphatic mapping is feasible in recurrent breast cancer. It avoids ALND in over 50 per cent of patients who have undergone SNB, and allows the 4 per cent of patients with metastatically involved aberrant nodes to receive targeted surgical and adjuvant therapies. © 2016 BJS Society Ltd Published by John Wiley & Sons Ltd.

  4. Surface Modifier-Free Organic-Inorganic Hybridization To Produce Optically Transparent and Highly Refractive Bulk Materials Composed of Epoxy Resins and ZrO2 Nanoparticles.

    PubMed

    Enomoto, Kazushi; Kikuchi, Moriya; Narumi, Atsushi; Kawaguchi, Seigou

    2018-04-25

    Surface modifier-free hybridization of ZrO 2 nanoparticles (NPs) with epoxy-based polymers is demonstrated for the first time to afford highly transparent and refractive bulk materials. This is achieved by a unique and versatile hybridization via the one-pot direct phase transfer of ZrO 2 NPs from water to epoxy monomers without any aggregation followed by curing with anhydride. Three types of representative epoxy monomers, bisphenol A diglycidyl ether (BADGE), 3,4-epoxycyclohexylmethyl-3',4'-epoxycyclohexane carboxylate (CEL), and 1,3,5-tris(3-(oxiran-2-yl)propyl)-1,3,5-triazinane-2,4,6-trione (TEPIC), are used to produce transparent viscous dispersions. The resulting ZrO 2 NPs are thoroughly characterized using dynamic light scattering (DLS), transmission electron microscopy (TEM), Fourier transform infrared (FT-IR), and solid-state 13 C CP/MAS NMR measurements. The results from DLS and TEM analyses indicate nanodispersion of ZrO 2 into epoxy monomers as a continuous medium. A surface modification mechanism and the binding fashion during phase transfer are proposed based on the FT-IR and solid-state 13 C CP/MAS NMR measurements. Epoxy-based hybrid materials with high transparency and refractive index are successfully fabricated by heat curing or polymerizing a mixture of monomers containing epoxy-functionalized ZrO 2 NPs and methylhexahydrophthalic anhydride in the presence of a phosphoric catalyst. The TEM and small-angle X-ray scattering measurements of the hybrids show a nanodispersion of ZrO 2 in the epoxy networks. The refractive index at 594 nm ( n 594 ) increases up to 1.765 for BADGE-based hybrids, 1.667 for CEL-based hybrids, and 1.693 for TEPIC-based hybrids. Their refractive indices and Abbe's numbers are quantitatively described by the Lorentz-Lorenz effective medium expansion theory. Their transmissivity is also reasonably explained using Fresnel refraction, Rayleigh scattering, and the Lambert-Beer theories. This surface modifier-free hybridization

  5. Aberration correction for charged particle lithography

    NASA Astrophysics Data System (ADS)

    Munro, Eric; Zhu, Xieqing; Rouse, John A.; Liu, Haoning

    2001-12-01

    At present, the throughput of projection-type charge particle lithography systems, such as PREVAIL and SCALPEL, is limited primarily by the combined effects of field curvature in the projection lenses and Coulomb interaction in the particle beam. These are fundamental physical limitations, inherent in charged particle optics, so there seems little scope for significantly improving the design of such systems, using conventional rotationally symmetric electron lenses. This paper explores the possibility of overcoming the field aberrations of round electron lense, by using a novel aberration corrector, proposed by Professor H. Rose of University of Darmstadt, called a hexapole planator. In this scheme, a set of round lenses is first used to simultaneously correct distortion and coma. The hexapole planator is then used to correct the field curvature and astigmatism, and to create a negative spherical aberration. The size of the transfer lenses around the planator can then be adjusted to zero the residual spherical aberration. In a way, an electron optical projection system is obtained that is free of all primary geometrical aberrations. In this paper, the feasibility of this concept has been studied with a computer simulation. The simulations verify that this scheme can indeed work, for both electrostatic and magnetic projection systems. Two design studies have been carried out. The first is for an electrostatic system that could be used for ion beam lithography, and the second is for a magnetic projection system for electron beam lithography. In both cases, designs have been achieved in which all primary third-order geometrical aberrations are totally eliminated.

  6. Contralateral comparison of wavefront-guided LASIK surgery with iris recognition versus without iris recognition using the MEL80 Excimer laser system.

    PubMed

    Wu, Fang; Yang, Yabo; Dougherty, Paul J

    2009-05-01

    To compare outcomes in wavefront-guided LASIK performed with iris recognition software versus without iris recognition software in different eyes of the same patient. A randomised, prospective study of 104 myopic eyes of 52 patients undergoing LASIK surgery with the MEL80 excimer laser system was performed. Iris recognition software was used in one eye of each patient (study group) and not used in the other eye (control group). Higher order aberrations (HOAs), contrast sensitivity, uncorrected vision (UCV), visual acuity (VA) and corneal topography were measured and recorded pre-operatively and at one month and three months post-operatively for each eye. The mean post-operative sphere and cylinder between groups was similar, however the post-operative angles of error (AE) by refraction were significantly smaller in the study group compared to the control group both in arithmetic and absolute means (p = 0.03, p = 0.01). The mean logMAR UCV was significantly better in the study group than in the control group at one month (p = 0.01). The mean logMAR VA was significantly better in the study group than in control group at both one and three months (p = 0.01, p = 0.03). In addition, mean trefoil, total third-order aberration, total fourth-order aberration and the total scotopic root-mean-square (RMS) HOAs were significantly less in the study group than those in the control group at the third (p = 0.01, p = 0.05, p = 0.04, p = 0.02). By three months, the contrast sensitivity had recovered in both groups but the study group performed better at 2.6, 4.2 and 6.6 cpd (cycles per degree) than the control group (p = 0.01, p < 0.01, p = 0.01). LASIK performed with iris recognition results in better VA, lower mean higher-order aberrations, lower refractive post-operative angles of error and better contrast sensitivity at three months post-operatively than LASIK performed without iris recognition.

  7. [Peripheral refraction: cause or effect of refraction development?

    PubMed

    Tarutta, E P; Iomdina, E N; Kvaratskheliya, N G; Milash, S V; Kruzhkova, G V

    to study peripheral refraction and the shape of the eyeball in children with different clinical refraction. Using an original method, peripheral refraction was measured at 10-12 degrees temporally and nasally from the fovea in 56 right eyes with different clinical, or axial, refraction of 20 boys and 36 girls aged 7 to 16 years (11.9±1.17 years on average). The shape of the eyeball was judged of by the ratio of its anterior-posterior axial length (AL) to horizontal diameter (HD). The incidence and value of peripheral myopic defocus in children appeared to decrease with clinical refraction increasing from high hyperopia to high myopia. This was the first time, mixed peripheral refraction was found in children, occurring more frequently in higher myopia. This mixed peripheral defocus, shown to be a transitional stage between relative peripheral myopia and relative hyperopia, indicates non-uniform stretching of posterior pole tissues in the course of refraction development and myopia progression. As ocular refraction increases from high hyperopia to high myopia, the growth of AL outpaces that of HD. Obviously, natural peripheral defocus results from changes in size and shape of the eyeball in the course of refraction development.

  8. Effect of a contact lens on mouse retinal in vivo imaging: Effective focal length changes and monochromatic aberrations.

    PubMed

    Zhang, Pengfei; Mocci, Jacopo; Wahl, Daniel J; Meleppat, Ratheesh Kumar; Manna, Suman K; Quintavalla, Martino; Muradore, Riccardo; Sarunic, Marinko V; Bonora, Stefano; Pugh, Edward N; Zawadzki, Robert J

    2018-03-28

    For in vivo mouse retinal imaging, especially with Adaptive Optics instruments, application of a contact lens is desirable, as it allows maintenance of cornea hydration and helps to prevent cataract formation during lengthy imaging sessions. However, since the refractive elements of the eye (cornea and lens) serve as the objective for most in vivo retinal imaging systems, the use of a contact lens, even with 0 Dpt. refractive power, can alter the system's optical properties. In this investigation we examined the effective focal length change and the aberrations that arise from use of a contact lens. First, focal length changes were simulated with a Zemax mouse eye model. Then ocular aberrations with and without a 0 Dpt. contact lens were measured with a Shack-Hartmann wavefront sensor (SHWS) in a customized AO-SLO system. Total RMS wavefront errors were measured for two groups of mice (14-month, and 2.5-month-old), decomposed into 66 Zernike aberration terms, and compared. These data revealed that vertical coma and spherical aberrations were increased with use of a contact lens in our system. Based on the ocular wavefront data we evaluated the effect of the contact lens on the imaging system performance as a function of the pupil size. Both RMS error and Strehl ratios were quantified for the two groups of mice, with and without contact lenses, and for different input beam sizes. These results provide information for determining optimum pupil size for retinal imaging without adaptive optics, and raise critical issues for design of mouse optical imaging systems that incorporate contact lenses. Copyright © 2018. Published by Elsevier Ltd.

  9. Surgical treatment for the aberrant internal carotid artery in the middle ear with pulsatile tinnitus.

    PubMed

    Honkura, Yohei; Hidaka, Hiroshi; Ohta, Jun; Gorai, Shigeki; Katori, Yukio; Kobayashi, Toshimitsu

    2014-04-01

    Many previous reports have indicated that pulsatile tinnitus caused by an aberrant internal carotid artery (ICA) should not be treated surgically because of the risk of infection or aneurysm formation. We herein describe a case of aberrant ICA treated by middle ear surgery for which we introduced a novel approach. An 84-year-old man was presented with a one-year history of tinnitus in his right ear. Otoscopic examination demonstrated a whitish mass in the antero-inferior quadrant of the tympanic membrane associated with rhythmic pulsation. Images obtained by CT, MRI and MRA revealed protrusion of the ICA into the tympanic cavity, making contact with the tympanic membrane. Surgery to separate the tympanic membrane from the ICA was performed in order to relieve the pulsatile tinnitus. After the operation, the patient's aural activity was preserved and the tinnitus did not recur within a follow-up period of one year. In the present case, delicate middle ear surgery was effective for relief of the tinnitus. When treating patients with aberrant IAC showing features similar to the present case, the surgical approach we have described is worth attempting. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  10. Plasmas with an index of refraction greater than 1.

    PubMed

    Nilsen, Joseph; Scofield, James H

    2004-11-15

    Over the past decade, x-ray lasers in the wavelength range 14-47 nm have been used for interferometry of plasmas. As in optical interferometry of plasmas, the experimental analysis assumed that the index of refraction is due only to free electrons. This makes the index of refraction less than 1. Recent experiments in A1 plasmas have shown fringe lines bending the wrong way as though the electron density were negative. We show how the bound electrons can dominate the index of refraction in many plasmas and make the index greater than 1 or enhance the index such that one would greatly overestimate the density of the plasma using interferometry.

  11. Predictable dental rehabilitation in maxillomandibular reconstruction with free flaps. The role of implant guided surgery

    PubMed Central

    Cebrian-Carretero, José L.; Sobrino, José A.; Yu, Tomás; Burgueño-García, Miguel

    2014-01-01

    The reconstruction of maxillomandibular defects secondary to oral cancer surgery, represent a great challenge for Maxillofacial surgeons. During the last decades the reconstructive surgery has experimented a big advance due to the development of the microsurgical techniques. At present, we are able to reconstruct complex defects using free flaps that provide both soft and bone tissue. Fibula, iliac crest and scapula free flaps have been the three classic options for the maxillomandibular reconstruction owing to the amount of bone that this flaps provide, allowing the posterior dental rehabilitation with implants. Today, our objective it is not only the aesthetic reconstruction, but also the functional reconstruction of the patients enhancing their life quality. Guided implant surgery in free flap reconstructed patients has become an essential tool, helping to define the exact position of the dental implant in the flap. In this way it is possible to look for the areas with better bone conditions, avoiding the osteosynthesis material used to fixate the flap with the native bone and deciding the best biomechanical option, in terms of number and situation of the implants, for the future dental prostheses. In summary, using the guided implant surgery, it is possible to design an exact and predictable dental implant rehabilitation in patients with oral cancer who are reconstructed with free microvascular flap, resulting in an optimal aesthetic and functional result. Key words:Oral cancer, mandibulectomy, maxillectomy, microvascular reconstruction, fibula flap, dental implant, guided surgery. PMID:25129241

  12. A discussion of refractive medical behavior from an experiential marketing viewpoint.

    PubMed

    Ho, Yung-Ching; Li, Ye-Chuen; Su, Tzu-Hsin

    2006-01-01

    Since the launch of National Health Insurance System, the financial source of funding for hospital financing has been reduced. Meanwhile, more and more customers attach importance to the experience of the medical process. Our study adopts "strategic modules of experiential marketing" by Schmitt to be the theoretical basis and proceed with in-depth interviews to discuss the influence of "medical behavior" on customers' experiences. We interviewed 32 patients who had a refractive surgery experience. The results show there are 10 propositions, which could be developed from 5 experiential modules - SENSE, FEEL, THINK, ACT, and RELATE - of customers' medical experiences. This study clarifies the experiences of customers during the process of a refractive surgery experience in order to provide medical institutions with the direction of experiential marketing to consider how to use experiential providers to reinforce customers' experiences.

  13. [Determining factors for deciding whether or not to treat refractive errors and cataract in people with a learning disability].

    PubMed

    van Isterdael, C E D; Stilma, J S; Bezemer, P D; Tijmes, N T

    2008-05-03

    A study into the treatment of refractive errors and cataract in a selected population with learning disabilities. Design. Retrospective. In the years 1993-2003, 5205 people (mean age: 39 years) were referred to the visual advisory centre of Bartiméus (one of three institutes for the visually impaired in the Netherlands) by learning disability physicians and were assessed ophthalmologically. This assessment consisted of a measurement of visual acuity and refractive error, slitlamp examination and retinoscopy, and was performed at the client's accommodation. Advised treatment for spectacle prescriptions and referral for cataract surgery were registered. Refractive errors were found in 35% (1845/5205) of the patients with learning disabilities; 49% (905/1845) already wore spectacles; another 14% (265/1845) were prescribed spectacles for the first time. Of those with presbyopia, 12% (232/1865) had reading glasses and 10% (181/1865) were given a first prescription for spectacles. The most important determinant for not prescribing spectacles was: presence of severe learning disability (odds ratio (OR): 3.7). Cataract was present in 10% (497/5205) of the population; 399 patients were advised to be referred for surgery, 55% (219/399) were referred ofwhom 26% (57/219) had surgery. Moderately severe bilateral cataract was the only determinant of cataract surgery (OR: 7.8). Refractive errors and cataract were not always treated in this group. One of the reasons for non-treatment of refractive errors was a severe learning disability. The reason for treatment or non-treatment in patients with cataract was less clear.

  14. Influence of the difference between corneal and refractive astigmatism on LASIK outcomes using solid-state technology.

    PubMed

    Piñero, David P; Ribera, David; Pérez-Cambrodí, Rafael J; Ruiz-Fortes, Pedro; Blanes-Mompó, Francisco J; Alzamora-Rodríguez, Antonio; Artola, Alberto

    2014-12-01

    To evaluate the influence of the difference between preoperative corneal and refractive astigmatism [ocular residual astigmatism (ORA)] on outcomes obtained after laser in situ keratomileusis (LASIK) surgery for correction of myopic astigmatism using the solid-state laser technology. One hundred one consecutive eyes with myopia or myopic astigmatism of 55 patients undergoing LASIK surgery using the Pulzar Z1 solid-state laser (CustomVis Laser Pty Ltd, currently CV Laser) were included. Visual and refractive changes at 6 months postoperatively and changes in ORA and anterior corneal astigmatism and posterior corneal astigmatism (PCA) were analyzed. Postoperatively, uncorrected distance visual acuity improved significantly (P < 0.01). Likewise, refractive cylinder magnitude and spherical equivalent were reduced significantly (P < 0.01). In contrast, no significant changes were observed in ORA magnitude (P = 0.81) and anterior corneal astigmatism (P = 0.12). The mean overall efficacy and safety indices were 0.96 and 1.01, respectively. These indices were not correlated with preoperative ORA (r = -0.15, P = 0.15). Furthermore, a significant correlation was found between ORA (r = 0.81, P < 0.01) and PCA postoperatively, but not preoperatively (r = 0.12, P = 0.25). Likewise, a significant correlation of ORA with manifest refraction was only found postoperatively (r = -0.38, P < 0.01). The magnitude of ORA does not seem to be a predictive factor of efficacy and safety of myopic LASIK using a solid-state laser platform. The higher relevance of PCA after surgery in some cases may explain the presence of unexpected astigmatic residual refractive errors.

  15. Effects of longitudinal chromatic aberration on accommodation and emmetropization.

    PubMed

    Seidemann, Anne; Schaeffel, Frank

    2002-09-01

    Less accommodation was found when human subjects read in blue (peak at about 440 nm) than when they read in red light (above 600 nm; [Kroger & Binder, British Journal of Ophthalmology 84 (2000) 890]). On the other hand, emmetropization in chickens did not appear to compensate for the chromatic defocus (385 nm versus 665 nm; [Rohrer, Schaeffel & Zrenner, Journal of Physiology 449 (1992) 363]). The apparently contradictory result was studied in more detail in humans and chickens. Accommodation was measured with an eccentric infrared photorefractor, the PowerRefractor, in human subjects reading under quasi-monochromatic illumination conditions. Chickens were refracted in quasi-monochromatic ambient illumination but with no particular fixation target. In a second experiment, they were also raised in monochromatic light for two days and subsequently refracted both in complete darkness, in monochromatic light, and in white light, both without and with cycloplegia. Consistent with the initial report by Kroger and Binder [British Journal of Ophthalmology 84 (2000) 890], accommodation in human subjects was found to shift in accordance with the chromatic aberration function. An immediate shift in accommodation tonus was also found in the chickens when they were refracted under red and in blue ambient illumination (average difference between refractions in both conditions: 1.26+/-0.54 D, p<0.001 paired t-test). This value is close to the chromatic focus difference between the two wavelengths (1.5 D [Mandelman & Sivak, Vision Research 23 (1983) 1555]). When chickens were raised in blue or red light for two days, and their refractions were subsequently measured in complete darkness, they showed also a difference in refractions (1.41+/-1.00 D; ANOVA: p<0.0012, post hoc t-test: at least p<0.05 among different groups). This difference was no longer significant when they were refracted in white light but became again significant when they were cyclopleged (0.57+/-0.58 D, p=0

  16. Clinical Outcomes of SMILE With a Triple Centration Technique and Corneal Wavefront-Guided Transepithelial PRK in High Astigmatism.

    PubMed

    Jun, Ikhyun; Kang, David Sung Yong; Reinstein, Dan Z; Arba-Mosquera, Samuel; Archer, Timothy J; Seo, Kyoung Yul; Kim, Tae-Im

    2018-03-01

    To comparatively investigate the clinical outcomes, vector parameters, and corneal aberrations of small incision lenticule extraction (SMILE) with a triple centration technique and corneal wavefront-guided transepithelial photorefractive keratectomy (PRK) for the correction of high astigmatism. This retrospective, comparative case series study included 89 eyes (89 patients) that received treatment for myopia with high astigmatism (≥ 2.50 diopters) using SMILE with a triple centration technique (SMILE group; 45 eyes) and corneal wavefront-guided transepithelial PRK (transepithelial PRK group; 44 eyes). Visual acuity measurement, manifest refraction, slit-lamp examination, autokeratometry, corneal topography, and evaluation of corneal wavefront aberration were performed preoperatively and at 1, 3, and 6 months after surgery. The safety, efficacy, vector parameters, and corneal aberrations at 6 months after surgery were compared between the two groups. At 6 months after surgery, the transepithelial PRK and SMILE groups exhibited comparable mean uncorrected distance visual acuities (-0.06 ± 0.07 and -0.05 ± 0.07 logMAR, respectively), safety, efficacy, and predictability of refractive and visual outcomes. There was a slight but statistically significant difference in the correction index between the transepithelial PRK and SMILE groups (0.96 ± 0.11 and 0.91 ± 0.10, respectively). Whereas the transepithelial PRK group exhibited increased corneal spherical aberration and significantly reduced corneal coma and trefoil, no changes in aberrometric values were noted in the SMILE group. Both SMILE with a triple centration technique and corneal wavefront-guided transepithelial PRK are effective and provide predictable outcomes for the correction of high myopic astigmatism, although slight undercorrection was observed in the SMILE group. The triple centration technique was helpful in astigmatism correction by SMILE. [J Refract Surg. 2018;34(3):156-163.]. Copyright 2018

  17. Outcome of cataract surgery at one year in Kenya, the Philippines and Bangladesh.

    PubMed

    Lindfield, R; Kuper, H; Polack, S; Eusebio, C; Mathenge, W; Wadud, Z; Rashid, A M; Foster, A

    2009-07-01

    To assess the change in vision following cataract surgery in Kenya, Bangladesh and the Philippines and to identify causes and predictors of poor outcome. Cases were identified through surveys, outreach and clinics. They underwent preoperative visual acuity measurement and ophthalmic examination. Cases were re-examined 8-15 months after cataract surgery. Information on age, gender, poverty and literacy was collected at baseline. 452 eyes of 346 people underwent surgery. 124 (27%) eyes had an adverse outcome. In Kenya and the Philippines, the main cause of adverse outcome was refractive error (37% and 49% respectively of all adverse outcomes) then comorbid ocular disease (26% and 27%). In Bangladesh, this was comorbid disease (58%) then surgical complications (21%). There was no significant association between adverse outcome and gender, age, literacy, poverty or preoperative visual acuity. Adverse outcomes following cataract surgery were frequent in the three countries. Main causes were refractive error and preoperative comorbidities. Many patients are not attaining the outcomes available with modern surgery. Focus should be on correcting refractive error, through operative techniques or postoperative refraction, and on a system for assessing comorbidities and communicating risk to patients. These are only achievable with a commitment to ongoing surgical audit.

  18. Cycloplegic autorefraction versus subjective refraction: the Tehran Eye Study.

    PubMed

    Hashemi, Hassan; Khabazkhoob, Mehdi; Asharlous, Amir; Soroush, Sara; Yekta, AbbasAli; Dadbin, Nooshin; Fotouhi, Akbar

    2016-08-01

    To compare cycloplegic autorefraction with non-cycloplegic subjective refraction across all age and refractive error groups. In a cross-sectional study with random stratified cluster sampling, 160 clusters were chosen from various districts proportionate to the population of each district in Tehran. Following retinoscopy and autorefraction with the 0.25 D bracketing (Topcon KR-8000, Topcon, Tokyo, Japan), all participants had a subjective refraction. Then all participants underwent cycloplegic autorefraction. The final analysis was performed on 3482 participants with a mean age of 31.7 years (range 5-92 years). Based on cycloplegic and subjective refraction, mean spherical equivalent (SE) was +0.31±1.80 and -0.32±1.61 D, respectively (p<0.001). The 95% limits of agreement (LoA) between these two types of refraction were from -0.40 to 1.70 D. The largest difference between these two types of refraction was seen in the age group of 5-10 years (1.11±0.60 D), and the smallest difference was in the age group of >70 years (0.34±0.45 D). The 95% LoA was -0.52 to 0.89 D in patients with myopia and -0.12 to 2.04 D in patients with hyperopia. We found that female gender (coefficients=0.048), older age (coefficients=-0.247), higher education (coefficients=-0.043) and cycloplegic SE (coefficients=-0.472) significantly correlated with lower intermethod differences. The cycloplegic refraction is more sensitive than the subjective one to measure refractive error at all age groups especially in children and young adults. The cyclorefraction technique is highly recommended to exactly measure the refractive error in momentous conditions such as refractive surgery, epidemiological researches and amblyopia therapy, especially in hypermetropic eyes and paediatric cases. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  19. Single-shot measurement of nonlinear absorption and nonlinear refraction.

    PubMed

    Jayabalan, J; Singh, Asha; Oak, Shrikant M

    2006-06-01

    A single-shot method for measurement of nonlinear optical absorption and refraction is described and analyzed. A spatial intensity variation of an elliptical Gaussian beam in conjugation with an array detector is the key element of this method. The advantages of this single-shot technique were demonstrated by measuring the two-photon absorption and free-carrier absorption in GaAs as well as the nonlinear refractive index of CS2 using a modified optical Kerr setup.

  20. Pattern of refractive errors among the Nepalese population: a retrospective study.

    PubMed

    Shrestha, S P; Bhat, K S; Binu, V S; Barthakur, R; Natarajan, M; Subba, S H

    2010-01-01

    Refractive errors are a major cause of visual impairment in the population. To find the pattern of refractive errors among patients evaluated in a tertiary care hospital in the western region of Nepal. The present hospital-based retrospective study was conducted in the Department of Ophthalmology of the Manipal Teaching Hospital, situated in Pokhara, Nepal. Patients who had refractive error of at least 0.5 D (dioptre) were included for the study. During the study period, 15,410 patients attended the outpatient department and 10.8% of the patients were identified as having refractive error. The age of the patients in the present study ranged between 5 - 90 years. Myopia was the commonest refractive error followed by hypermetropia. There was no difference in the frequency of the type of refractive errors when they were defined using right the eye, the left eye or both the eyes. Males predominated among myopics and females predominated among hypermetropics. The majority of spherical errors was less than or equal to 2 D. Astigmatic power above 1D was rarely seen with hypermetropic astigmatism and was seen in around 13 % with myopic astigmatism. "Astigmatism against the rule" was more common than "astigmatism with the rule", irrespective of age. Refractive errors progressively shift along myopia up to the third decade and change to hypermetropia till the seventh decade. Hyperopic shift in the refractive error in young adults should be well noted while planning any refractive surgery in younger patients with myopia. © Nepal Ophthalmic Society.

  1. The quality of systematic reviews about interventions for refractive error can be improved: a review of systematic reviews.

    PubMed

    Mayo-Wilson, Evan; Ng, Sueko Matsumura; Chuck, Roy S; Li, Tianjing

    2017-09-05

    Systematic reviews should inform American Academy of Ophthalmology (AAO) Preferred Practice Pattern® (PPP) guidelines. The quality of systematic reviews related to the forthcoming Preferred Practice Pattern® guideline (PPP) Refractive Errors & Refractive Surgery is unknown. We sought to identify reliable systematic reviews to assist the AAO Refractive Errors & Refractive Surgery PPP. Systematic reviews were eligible if they evaluated the effectiveness or safety of interventions included in the 2012 PPP Refractive Errors & Refractive Surgery. To identify potentially eligible systematic reviews, we searched the Cochrane Eyes and Vision United States Satellite database of systematic reviews. Two authors identified eligible reviews and abstracted information about the characteristics and quality of the reviews independently using the Systematic Review Data Repository. We classified systematic reviews as "reliable" when they (1) defined criteria for the selection of studies, (2) conducted comprehensive literature searches for eligible studies, (3) assessed the methodological quality (risk of bias) of the included studies, (4) used appropriate methods for meta-analyses (which we assessed only when meta-analyses were reported), (5) presented conclusions that were supported by the evidence provided in the review. We identified 124 systematic reviews related to refractive error; 39 met our eligibility criteria, of which we classified 11 to be reliable. Systematic reviews classified as unreliable did not define the criteria for selecting studies (5; 13%), did not assess methodological rigor (10; 26%), did not conduct comprehensive searches (17; 44%), or used inappropriate quantitative methods (3; 8%). The 11 reliable reviews were published between 2002 and 2016. They included 0 to 23 studies (median = 9) and analyzed 0 to 4696 participants (median = 666). Seven reliable reviews (64%) assessed surgical interventions. Most systematic reviews of interventions for

  2. Reading ability with pseudophakic monovision and with refractive multifocal intraocular lenses: comparative study.

    PubMed

    Ito, Misae; Shimizu, Kimiya

    2009-09-01

    To the compare the reading ability after bilateral cataract surgery in patients who had pseudophakic monovision achieved by monofocal intraocular lens (IOL) implantation and patients who had refractive multifocal IOL implantation. Department of Ophthalmology, Kitasato University Hospital, Kanagawa, Japan. This study evaluated patients who had bilateral cataract surgery using the monovision method with monofocal IOL implantation to correct presbyopia (monovision group) or who had bilateral cataract surgery with refractive multifocal IOL implantation (multifocal group). In the monovision group, the dominant eye was corrected for distance vision and the nondominant eye for near vision. The maximum reading speed, critical character size, and reading acuity were measured binocularly without refractive correction using MNREAD-J acuity charts. The monovision group comprised 38 patients and the multifocal group, 22 patients. The mean maximum reading speed was 350.5 characters per minute (cpm) +/- 62.3 (SD) in the monovision group and 355.0 +/- 53.3 cpm in the multifocal group; the difference was not statistically significant. The mean critical character size was 0.24 +/- 0.12 logMAR and 0.40 +/- 0.16 logMAR, respectively (P<.05). The mean reading acuity was 0.05 +/- 0.12 logMAR and 0.19 +/- 0.11 logMAR, respectively (P<.01). The monovision group had better critical character size and reading acuity results. The monovision method group had better reading ability; however, careful patient selection is essential.

  3. Experimental verification and simulation of negative index of refraction using Snell's law.

    PubMed

    Parazzoli, C G; Greegor, R B; Li, K; Koltenbah, B E C; Tanielian, M

    2003-03-14

    We report the results of a Snell's law experiment on a negative index of refraction material in free space from 12.6 to 13.2 GHz. Numerical simulations using Maxwell's equations solvers show good agreement with the experimental results, confirming the existence of negative index of refraction materials. The index of refraction is a function of frequency. At 12.6 GHz we measure and compute the real part of the index of refraction to be -1.05. The measurements and simulations of the electromagnetic field profiles were performed at distances of 14lambda and 28lambda from the sample; the fields were also computed at 100lambda.

  4. Changes in Monkey Crystalline Lens Spherical Aberration During Simulated Accommodation in a Lens Stretcher

    PubMed Central

    Maceo Heilman, Bianca; Manns, Fabrice; de Castro, Alberto; Durkee, Heather; Arrieta, Esdras; Marcos, Susana; Parel, Jean-Marie

    2015-01-01

    Purpose. The purpose of this study was to quantify accommodation-induced changes in the spherical aberration of cynomolgus monkey lenses. Methods. Twenty-four lenses from 20 cynomolgus monkeys (Macaca fascicularis; 4.4–16.0 years of age; postmortem time 13.5 ± 13.0 hours) were mounted in a lens stretcher. Lens spherical aberration was measured in the unstretched (accommodated) and stretched (relaxed) states with a laser ray tracing system that delivered 51 equally spaced parallel rays along 1 meridian of the lens over the central 6-mm optical zone. A camera mounted below the lens was used to measure the ray height at multiple positions along the optical axis. For each entrance ray, the change in ray height with axial position was fitted with a third-order polynomial. The effective paraxial focal length and Zernike spherical aberration coefficients corresponding to a 6-mm pupil diameter were extracted from the fitted values. Results. The unstretched lens power decreased with age from 59.3 ± 4.0 diopters (D) for young lenses to 45.7 ± 3.1 D for older lenses. The unstretched lens shifted toward less negative spherical aberration with age, from −6.3 ± 0.7 μm for young lenses to −5.0 ± 0.5 μm for older lenses. The power and spherical aberration of lenses in the stretched state were independent of age, with values of 33.5 ± 3.4 D and −2.6 ± 0.5 μm, respectively. Conclusions. Spherical aberration is negative in cynomolgus monkey lenses and becomes more negative with accommodation. These results are in good agreement with the predicted values using computational ray tracing in a lens model with a reconstructed gradient refractive index. The spherical aberration of the unstretched lens becomes less negative with age. PMID:25670492

  5. Changes in monkey crystalline lens spherical aberration during simulated accommodation in a lens stretcher.

    PubMed

    Maceo Heilman, Bianca; Manns, Fabrice; de Castro, Alberto; Durkee, Heather; Arrieta, Esdras; Marcos, Susana; Parel, Jean-Marie

    2015-02-10

    The purpose of this study was to quantify accommodation-induced changes in the spherical aberration of cynomolgus monkey lenses. Twenty-four lenses from 20 cynomolgus monkeys (Macaca fascicularis; 4.4-16.0 years of age; postmortem time 13.5 ± 13.0 hours) were mounted in a lens stretcher. Lens spherical aberration was measured in the unstretched (accommodated) and stretched (relaxed) states with a laser ray tracing system that delivered 51 equally spaced parallel rays along 1 meridian of the lens over the central 6-mm optical zone. A camera mounted below the lens was used to measure the ray height at multiple positions along the optical axis. For each entrance ray, the change in ray height with axial position was fitted with a third-order polynomial. The effective paraxial focal length and Zernike spherical aberration coefficients corresponding to a 6-mm pupil diameter were extracted from the fitted values. The unstretched lens power decreased with age from 59.3 ± 4.0 diopters (D) for young lenses to 45.7 ± 3.1 D for older lenses. The unstretched lens shifted toward less negative spherical aberration with age, from -6.3 ± 0.7 μm for young lenses to -5.0 ± 0.5 μm for older lenses. The power and spherical aberration of lenses in the stretched state were independent of age, with values of 33.5 ± 3.4 D and -2.6 ± 0.5 μm, respectively. Spherical aberration is negative in cynomolgus monkey lenses and becomes more negative with accommodation. These results are in good agreement with the predicted values using computational ray tracing in a lens model with a reconstructed gradient refractive index. The spherical aberration of the unstretched lens becomes less negative with age. Copyright 2015 The Association for Research in Vision and Ophthalmology, Inc.

  6. Changes in higher order aberrations after wavefront-guided PRK for correction of low to moderate myopia and myopic astigmatism: two-year follow-up.

    PubMed

    Wigledowska-Promienska, D; Zawojska, I

    2007-01-01

    To assess efficacy, safety, and changes in higher order aberrations after wavefront-guided photorefractive keratectomy (PRK) in comparison with conventional PRK for low to moderate myopia with myopic astigmatism using a WASCA Workstation with the MEL 70 G-Scan excimer laser. A total of 126 myopic or myopic-astigmatic eyes of 112 patients were included in this retrospective study. Patients were divided into two groups: Group 1, the study group; and Group 2, the control group. Group 1 consisted of 78 eyes treated with wavefront-guided PRK. Group 2 consisted of 48 eyes treated with spherocylindrical conventional PRK. Two years postoperatively, in Group 1, 5% of eyes achieved an uncorrected visual acuity (UCVA) of 0.05; 69% achieved a UCVA of 0.00; 18% of eyes experienced enhanced visual acuity of -0.18 and 8% of -0.30. In Group 2, 8% of eyes achieved a UCVA of 0.1; 25% achieved a UCVA of 0.05; and 67% achieved a UCVA of 0.00 according to logMAR calculation method. Total higher-order root-mean square increased by a factor 1.18 for Group 1 and 1.6 for Group 2. There was a significant increase of coma by a factor 1.74 in Group 2 and spherical aberration by a factor 2.09 in Group 1 and 3.56 in Group 2. The data support the safety and effectiveness of the wavefront-guided PRK using a WASCA Workstation for correction of low to moderate refractive errors. This method reduced the number of higher order aberrations induced by excimer laser surgery and improved uncorrected and spectacle-corrected visual acuity when compared to conventional PRK.

  7. Lowered threshold energy for femtosecond laser induced optical breakdown in a water based eye model by aberration correction with adaptive optics.

    PubMed

    Hansen, Anja; Géneaux, Romain; Günther, Axel; Krüger, Alexander; Ripken, Tammo

    2013-06-01

    In femtosecond laser ophthalmic surgery tissue dissection is achieved by photodisruption based on laser induced optical breakdown. In order to minimize collateral damage to the eye laser surgery systems should be optimized towards the lowest possible energy threshold for photodisruption. However, optical aberrations of the eye and the laser system distort the irradiance distribution from an ideal profile which causes a rise in breakdown threshold energy even if great care is taken to minimize the aberrations of the system during design and alignment. In this study we used a water chamber with an achromatic focusing lens and a scattering sample as eye model and determined breakdown threshold in single pulse plasma transmission loss measurements. Due to aberrations, the precise lower limit for breakdown threshold irradiance in water is still unknown. Here we show that the threshold energy can be substantially reduced when using adaptive optics to improve the irradiance distribution by spatial beam shaping. We found that for initial aberrations with a root-mean-square wave front error of only one third of the wavelength the threshold energy can still be reduced by a factor of three if the aberrations are corrected to the diffraction limit by adaptive optics. The transmitted pulse energy is reduced by 17% at twice the threshold. Furthermore, the gas bubble motions after breakdown for pulse trains at 5 kilohertz repetition rate show a more transverse direction in the corrected case compared to the more spherical distribution without correction. Our results demonstrate how both applied and transmitted pulse energy could be reduced during ophthalmic surgery when correcting for aberrations. As a consequence, the risk of retinal damage by transmitted energy and the extent of collateral damage to the focal volume could be minimized accordingly when using adaptive optics in fs-laser surgery.

  8. Lowered threshold energy for femtosecond laser induced optical breakdown in a water based eye model by aberration correction with adaptive optics

    PubMed Central

    Hansen, Anja; Géneaux, Romain; Günther, Axel; Krüger, Alexander; Ripken, Tammo

    2013-01-01

    In femtosecond laser ophthalmic surgery tissue dissection is achieved by photodisruption based on laser induced optical breakdown. In order to minimize collateral damage to the eye laser surgery systems should be optimized towards the lowest possible energy threshold for photodisruption. However, optical aberrations of the eye and the laser system distort the irradiance distribution from an ideal profile which causes a rise in breakdown threshold energy even if great care is taken to minimize the aberrations of the system during design and alignment. In this study we used a water chamber with an achromatic focusing lens and a scattering sample as eye model and determined breakdown threshold in single pulse plasma transmission loss measurements. Due to aberrations, the precise lower limit for breakdown threshold irradiance in water is still unknown. Here we show that the threshold energy can be substantially reduced when using adaptive optics to improve the irradiance distribution by spatial beam shaping. We found that for initial aberrations with a root-mean-square wave front error of only one third of the wavelength the threshold energy can still be reduced by a factor of three if the aberrations are corrected to the diffraction limit by adaptive optics. The transmitted pulse energy is reduced by 17% at twice the threshold. Furthermore, the gas bubble motions after breakdown for pulse trains at 5 kilohertz repetition rate show a more transverse direction in the corrected case compared to the more spherical distribution without correction. Our results demonstrate how both applied and transmitted pulse energy could be reduced during ophthalmic surgery when correcting for aberrations. As a consequence, the risk of retinal damage by transmitted energy and the extent of collateral damage to the focal volume could be minimized accordingly when using adaptive optics in fs-laser surgery. PMID:23761849

  9. Stereo Refractive Imaging of Breaking Free-Surface Waves in the Surf Zone

    NASA Astrophysics Data System (ADS)

    Mandel, Tracy; Weitzman, Joel; Koseff, Jeffrey; Environmental Fluid Mechanics Laboratory Team

    2014-11-01

    Ocean waves drive the evolution of coastlines across the globe. Wave breaking suspends sediments, while wave run-up, run-down, and the undertow transport this sediment across the shore. Complex bathymetric features and natural biotic communities can influence all of these dynamics, and provide protection against erosion and flooding. However, our knowledge of the exact mechanisms by which this occurs, and how they can be modeled and parameterized, is limited. We have conducted a series of controlled laboratory experiments with the goal of elucidating these details. These have focused on quantifying the spatially-varying characteristics of breaking waves and developing more accurate techniques for measuring and predicting wave setup, setdown, and run-up. Using dynamic refraction stereo imaging, data on free-surface slope and height can be obtained over an entire plane. Wave evolution is thus obtained with high spatial precision. These surface features are compared with measures of instantaneous turbulence and mean currents within the water column. We then use this newly-developed ability to resolve three-dimensional surface features over a canopy of seagrass mimics, in order to validate theoretical formulations of wave-vegetation interactions in the surf zone.

  10. Excimer laser photorefractive surgery of the cornea

    NASA Astrophysics Data System (ADS)

    Gaster, Ronald N.

    1998-09-01

    The 193 nm argon fluoride (ArF) excimer laser can effectively be used to change the radius of curvature of the cornea and thus alter the refractive state of the eye. This change allows myopic (nearsighted) patients to see well with less dependence on glasses or contact lenses. The two major techniques of laser refractive surgery currently in effect in the United States are photorefractive keratectomy (PRK) and laser in situ keratomileusis (LASIK). This paper will discuss these refractive cornea surgical techniques.

  11. Wavefront aberrations and retinal image quality in different lenticular opacity types and densities.

    PubMed

    Wu, Cheng-Zhe; Jin, Hua; Shen, Zhen-Nv; Li, Ying-Jun; Cui, Xun

    2017-11-10

    To investigate wavefront aberrations in the entire eye and in the internal optics (lens) and retinal image qualities according to different lenticular opacity types and densities. Forty-one eyes with nuclear cataract, 33 eyes with cortical cataract, and 29 eyes with posterior subcapsular cataract were examined. In each group, wavefront aberrations in the entire eye and in the internal optics and retinal image quality were measured using a raytracing aberrometer. Eyes with cortical cataracts showed significantly higher coma-like aberrations compared to the other two groups in both entire eye and internal optic aberrations (P = 0.012 and P = 0.007, respectively). Eyes with nuclear cataract had lower spherical-like aberrations than the other two groups in both entire eye and internal optics aberrations (P < 0.001 and P < 0.001, respectively). In the nuclear cataract group, nuclear lens density was negatively correlated with internal spherical aberrations (r = -0.527, P = 0.005). Wavefront technology is useful for objective and quantitative analysis of retinal image quality deterioration in eyes with different early lenticular opacity types and densities. Understanding the wavefront optical properties of different crystalline lens opacities may help ophthalmic surgeons determine the optimal time to perform cataract surgery.

  12. Visual and Refractive Outcomes in Manual versus Femtosecond Laser-Assisted Cataract Surgery: A Single-Center Retrospective Cohort Analysis of 1838 Eyes.

    PubMed

    Berk, Thomas A; Schlenker, Matthew B; Campos-Möller, Xavier; Pereira, Austin M; Ahmed, Iqbal Ike K

    2018-03-06

    Femtosecond laser-assisted cataract surgery (FLACS) has emerged as an alternative to manual cataract surgery (MCS) for corneal incision and capsulorhexis creation, as well as nuclear fragmentation. This study compares postoperative refractive and visual outcomes in eyes receiving MCS or FLACS. Single-center, comparative, retrospective cohort analysis. Consecutive eyes receiving FLACS and MCS from July 1, 2012, to July 31, 2015, at a single tertiary care center. Demographic data, ocular history, preoperative measurements and biometry, and postoperative surgical results were retrospectively obtained and statistically analyzed using a generalized linear mixed model adjusting for differences in baseline characteristics and within-patient correlation. A 2-tailed P value <0.05 was considered statistically significant throughout the study. Percentage of eyes achieving absolute error (AE) ≤0.5 diopters (D). Secondary outcomes included percentage of eyes with AE ≤0.25 D and ≤1.0 D, and percentage of distance-targeted eyes achieving uncorrected distance visual acuity (UDVA) of 20/20 or better, 20/25 or better, and 20/30 or better. A total of 883 eyes received MCS and 955 received FLACS among 1089 patients. Some 82.6% of FLACS eyes and 78.8% of MCS eyes had ≤0.5 D of AE at 3 weeks, representing an adjusted odds ratio (OR) of 1.28 (95% confidence interval [CI], 0.98-1.66) of FLACS relative to MCS being within target. Some 97.1% of FLACS and 97.2% of MCS eyes had ≤1.0 D of AE (OR, 0.96; 95% CI, 0.57-1.60) and 49.3% of FLACS and 46.3% of MCS eyes, ≤0.25 D of AE (OR, 1.13; 95% CI, 0.91-1.39). Factors predictive of a favorable refractive outcome included axial length between 22 and 24.8 mm, receiving a toric intraocular lens, less preoperative cylinder, and greater preoperative average keratometry. There was no significant difference in the percentage of patients targeted for distance who achieved UDVA of 20/20 or better (P = 0.30), 20/25 or better (P = 0.06), or 20

  13. Explaining negative refraction without negative refractive indices.

    PubMed

    Talalai, Gregory A; Garner, Timothy J; Weiss, Steven J

    2018-03-01

    Negative refraction through a triangular prism may be explained without assigning a negative refractive index to the prism by using array theory. For the case of a beam incident upon the wedge, the array theory accurately predicts the beam transmission angle through the prism and provides an estimate of the frequency interval at which negative refraction occurs. The hypotenuse of the prism has a staircase shape because it is built of cubic unit cells. The large phase delay imparted by each unit cell, combined with the staircase shape of the hypotenuse, creates the necessary conditions for negative refraction. Full-wave simulations using the finite-difference time-domain method show that array theory accurately predicts the beam transmission angle.

  14. Multimodal label-free ex vivo imaging using a dual-wavelength microscope with axial chromatic aberration compensation.

    PubMed

    Filippi, Andrea; Dal Sasso, Eleonora; Iop, Laura; Armani, Andrea; Gintoli, Michele; Sandri, Marco; Gerosa, Gino; Romanato, Filippo; Borile, Giulia

    2018-03-01

    Label-free microscopy is a very powerful technique that can be applied to study samples with no need for exogenous fluorescent probes, keeping the main benefits of multiphoton microscopy, such as longer penetration depths and intrinsic optical sectioning while enabling serial multitechniques examinations on the same specimen. Among the many label-free microscopy methods, harmonic generation (HG) is one of the most intriguing methods due to its generally low photo-toxicity and relative ease of implementation. Today, HG and common two-photon microscopy (TPM) are well-established techniques, and are routinely used in several research fields. However, they require a significant amount of fine-tuning to be fully exploited, making them quite difficult to perform in parallel. Here, we present our designed multimodal microscope, capable of performing simultaneously TPM and HG without any kind of compromise thanks to two, separate, individually optimized laser sources with axial chromatic aberration compensation. We also apply our setup to the examination of a plethora of ex vivo samples to prove its capabilities and the significant advantages of a multimodal approach. (2018) COPYRIGHT Society of Photo-Optical Instrumentation Engineers (SPIE).

  15. Research of the aberrations of human eyes with accommodation based on eye model

    NASA Astrophysics Data System (ADS)

    Quan, Wei; Wang, Feng-lin; Wang, Zhao-qi

    2011-06-01

    The variation of the wavefront aberration with accommodation was investigated based on the eye model of Gullstrand-Le Grand. The anterior lens radius was optimized at different accommodation to focus the image at the retina, and the RMS and PV wave-front error of human eye were compared at different accommodation. The PV value of wavefront aberration from 0.718 waves increases gradually to 0.904 waves and RMS value from 0.21 waves to 0.26 waves when accommodative stimuli varies from 0 to - 5 diopters. The change of PV value is 0.186 waves which is less than the Rayleigh diffraction limit λ/4, and the change of RMS is 0.05 which under Marechal diffraction limit λ/14. Therefore, the change of the wavefront aberration caused accommodation can be ignored when wavefront aberrations in the human eye are corrected with surgery or wearing glasses.

  16. Gender differences in a refractive surgery population of civilian aviators : final report.

    DOT National Transportation Integrated Search

    2000-07-01

    INTRODUCTION. Refractive surgical procedures performed in the United States have increased in recent years and : continued growth is projected. Postoperative side effects can affect the quality of vision and may be unacceptable in a : cockpit environ...

  17. Gender differences in a refractive surgery population of civilian aviators : final report.

    DOT National Transportation Integrated Search

    2000-07-01

    INTRODUCTION. Refractive surgical procedures performed in the United States have increased in recent years and continued growth is projected. Postoperative side effects can affect the quality of vision and may be unacceptable in a cockpit environment...

  18. Aberration corrections for free-space optical communications in atmosphere turbulence using orbital angular momentum states.

    PubMed

    Zhao, S M; Leach, J; Gong, L Y; Ding, J; Zheng, B Y

    2012-01-02

    The effect of atmosphere turbulence on light's spatial structure compromises the information capacity of photons carrying the Orbital Angular Momentum (OAM) in free-space optical (FSO) communications. In this paper, we study two aberration correction methods to mitigate this effect. The first one is the Shack-Hartmann wavefront correction method, which is based on the Zernike polynomials, and the second is a phase correction method specific to OAM states. Our numerical results show that the phase correction method for OAM states outperforms the Shark-Hartmann wavefront correction method, although both methods improve significantly purity of a single OAM state and the channel capacities of FSO communication link. At the same time, our experimental results show that the values of participation functions go down at the phase correction method for OAM states, i.e., the correction method ameliorates effectively the bad effect of atmosphere turbulence.

  19. Glaucoma surgery and induced astigmatism: a systematic review.

    PubMed

    Chan, Helen H L; Kong, Yu Xiang G

    2017-01-01

    The refractive outcomes of glaucoma surgeries, particularly their effect on astigmatism, are incompletely understood. Trabeculectomy is associated with a considerable amount of with-the-rule astigmatic change in the immediate postoperative period. This is followed by a gradual against-the-rule shift. These changes are altered with the use of mitomycin C (MMC). Non-penetrating surgery such as deep sclerectomy is also associated with a similar or smaller degree of induced astigmatism. Minimally invasive glaucoma surgery appears to be astigmatically neutral. There is no clear evidence regarding refractive outcomes of glaucoma drainage device surgery. Induced astigmatism may account for a reduction in unaided visual acuity in the early postoperative period following a successful trabeculectomy. These changes appear to stabilise at 3 months, and it would be prudent to defer the prescription of new glasses until this time. If sequential cataract surgery is to be performed, toric intraocular lenses can be a useful option for astigmatic correction.

  20. Comparison of the VISX wavescan and OPD-scan III with the subjective refraction.

    PubMed

    Zhu, R; Long, K-L; Wu, X-M; Li, Q-D

    2016-07-01

    To compare the refractive errors measured by the VISX WaveScan, OPD-Scan III and the subjective refraction. The optometry accuracy of computer operated aberrometer used before refractive surgery has been debatable. Hence, a clear study on the role of such automated equipment in optometry is the need of the hour as compared to subjective refraction. Seventy-six patients (152 eyes) were recruited from January 2013 to December 2013. All patients were measured with subjective refraction by the phoropter (NIDEK, RT-5100), objective refraction by the WaveScan (AMO Company, USA), OPD-Scan III (Nidek Technologies, Japan). The sphere, cylinder, axis of the three methods were compared and analyzed. The diopter of sphere power measured by WaveScan was lower than that of the subjective refraction and the difference was 0.13 ± 0. 30D (t = 3. 753, p <0. 001). While the diopter of cylinder power was higher and the difference was 0.13 ±0.43D (t = 3. 664, p <0. 001). There was no significance for sphere, cylinder and spherical equivalent between OPD-Scan III and subjective refraction (p >0. 05). The value of the difference between WaveScan and subjective refraction was 5.87°±6.19°on average, while the difference between OPD-Scan III and subjective refraction was 3.82°±3.95°on average. The differences between the two were statistically significant (t =2. 817, p =0. 006). The results of sphere and cylinder measured by WaveScan and subjective refraction were different. As the latest integrated equipment, the Nidek OPD-Scan III gives a more accurate measurement of objective refraction when compared with subjective refraction. The latest Nidek OPD-Scan III may prove to be an useful tool for preoperative optometry deviation based on objective refraction.

  1. Measurement of wavefront aberrations and lens deformation in the accommodated eye with optical coherence tomography-equipped wavefront system.

    PubMed

    He, Ji C; Wang, Jianhua

    2014-04-21

    To quantitatively approach the relationship between optical changes in an accommodated eye and the geometrical deformation of its crystalline lens, a long scan-depth anterior segment OCT equipped wavefront sensor was developed and integrated with a Badal system. With this system, accommodation was stimulated up to 6.0D in the left eye and also measured in the same eye for three subjects. High correlations between the accommodative responses of refractive power and the radius of the anterior lens surface were found for the three subjects (r>0.98). The change in spherical aberration was also highly correlated with the change in lens thickness (r>0.98). The measurement was very well repeated at a 2nd measurement session on the same day for the three subjects and after two weeks for one subject. The novelty of incorporating the Badal system into the OCT equipped wavefront sensor eliminated axial misalignment of the measurement system with the test eye due to accommodative vergence, as in the contralateral paradigm. The design also allowed the wavefront sensor to capture conjugated sharp Hartmann-Shack images in accommodated eyes to accurately analyze wavefront aberrations. In addition, this design extended the accommodation range up to 10.0D. By using this system, for the first time, we demonstrated linear relationships of the changes between the refractive power and the lens curvature and also between the spherical aberration and the lens thickness during accommodation in vivo. This new system provides an accurate and useful technique to quantitatively study accommodation.

  2. Measurement of wavefront aberrations and lens deformation in the accommodated eye with optical coherence tomography-equipped wavefront system

    PubMed Central

    He, Ji C.; Wang, Jianhua

    2014-01-01

    To quantitatively approach the relationship between optical changes in an accommodated eye and the geometrical deformation of its crystalline lens, a long scan-depth anterior segment OCT equipped wavefront sensor was developed and integrated with a Badal system. With this system, accommodation was stimulated up to 6.0D in the left eye and also measured in the same eye for three subjects. High correlations between the accommodative responses of refractive power and the radius of the anterior lens surface were found for the three subjects (r>0.98). The change in spherical aberration was also highly correlated with the change in lens thickness (r>0.98). The measurement was very well repeated at a 2nd measurement session on the same day for the three subjects and after two weeks for one subject. The novelty of incorporating the Badal system into the OCT equipped wavefront sensor eliminated axial misalignment of the measurement system with the test eye due to accommodative vergence, as in the contralateral paradigm. The design also allowed the wavefront sensor to capture conjugated sharp Hartmann-Shack images in accommodated eyes to accurately analyze wavefront aberrations. In addition, this design extended the accommodation range up to 10.0D. By using this system, for the first time, we demonstrated linear relationships of the changes between the refractive power and the lens curvature and also between the spherical aberration and the lens thickness during accommodation in vivo. This new system provides an accurate and useful technique to quantitatively study accommodation. PMID:24787861

  3. Nonlinear refraction at the absorption edge in InAs.

    PubMed

    Poole, C D; Garmire, E

    1984-08-01

    The results of measurements of nonlinear refraction at the absorption edge in InAs between 68 and 90 K taken with an HF laser are compared with those of a band-gap resonant model in which the contribution of the light-hole band is included and found to account for more than 40% of the observed nonlinear refraction. A generalized expression for the nonlinear index is derived by using the complete Fermi-Dirac distribution function. Good agreement between theory and experiment is obtained, with no free parameters.

  4. Chromosome aberrations and cell death by ionizing radiation: Evolution of a biophysical model

    NASA Astrophysics Data System (ADS)

    Ballarini, Francesca; Carante, Mario P.

    2016-11-01

    The manuscript summarizes and discusses the various versions of a radiation damage biophysical model, implemented as a Monte Carlo simulation code, originally developed for chromosome aberrations and subsequently extended to cell death. This extended version has been called BIANCA (BIophysical ANalysis of Cell death and chromosome Aberrations). According to the basic assumptions, complex double-strand breaks (called ;Cluster Lesions;, or CLs) produce independent chromosome free-ends, mis-rejoining within a threshold distance d (or un-rejoining) leads to chromosome aberrations, and ;lethal aberrations; (i.e., dicentrics plus rings plus large deletions) lead to clonogenic cell death. The mean number of CLs per Gy and per cell is an adjustable parameter. While in BIANCA the threshold distance d was the second parameter, in a subsequent version, called BIANCA II, d has been fixed as the mean distance between two adjacent interphase chromosome territories, and a new parameter, f, has been introduced to represent the chromosome free-end un-rejoining probability. Simulated dose-response curves for chromosome aberrations and cell survival obtained by the various model versions were compared with literature experimental data. Such comparisons provided indications on some open questions, including the role of energy deposition clustering at the nm and the μm level, the probability for a chromosome free-end to remain un-rejoined, and the relationship between chromosome aberrations and cell death. Although both BIANCA and BIANCA II provided cell survival curves in general agreement with human and hamster fibroblast survival data, BIANCA II allowed for a better reproduction of dicentrics, rings and deletions considered separately. Furthermore, the approach adopted in BIANCA II for d is more consistent with estimates reported in the literature. After testing against aberration and survival data, BIANCA II was applied to investigate the depth-dependence of the radiation

  5. Is neoadjuvant chemoradiation with dose-escalation and consolidation chemotherapy sufficient to increase surgery-free and distant metastases-free survival in baseline cT3 rectal cancer?

    PubMed

    São Julião, Guilherme Pagin; Habr-Gama, Angelita; Vailati, Bruna Borba; Aguilar, Patricia Bailão; Sabbaga, Jorge; Araújo, Sérgio Eduardo Alonso; Mattacheo, Adrian; Alexandre, Flavia Andrea; Fernandez, Laura Melina; Gomes, Diogo Bugano; Gama-Rodrigues, Joaquim; Perez, Rodrigo Oliva

    2018-01-01

    Patients with cT3 rectal cancer are less likely to develop complete response to neoadjuvant chemoradiation (nCRT) and still face significant risk for systemic relapse. In this setting, radiation (RT) dose-escalation and consolidation chemotherapy in "extended" nCRT regimens have been suggested to improve primary tumor response and decrease the risks of systemic recurrences. For these reasons we compared surgery-free and distant-metastases free survival among cT3 patients undergoing standard or extended nCRT. Patients with distal and non-metastatic T3 rectal cancer managed by nCRT were retrospectively reviewed. Patients undergoing standard CRT (50.4 Gy and 2 cycles of 5FU-based chemotherapy) were compared to those undergoing extended CRT (54 Gy and 6 cycles of 5FU-based chemotherapy). Patients were assessed for tumor response at 8-10 weeks. Patients with complete clinical response (cCR) underwent organ-preservation strategy (Watch & Wait). Patients were referred to salvage surgery in the event of local recurrence during follow-up. Cox's logistic regression was performed to identify independent features associated with improved surgery-free survival after cCR and distant-metastases-free survival. 155 patients underwent standard and 66 patients extended CRT. Patients undergoing extended CRT were more likely to harbor larger initial tumor size (p = 0.04), baseline nodal metastases (cN+; p < 0.001) and higher tumor location (p = 0.02). Cox-regression analysis revealed that the type of nCRT regimen was not independently associated with distinct surgery-free survival after cCR or distant-metastases-free survival (p > 0.05). Dose-escalation and consolidation chemotherapy are insufficient to increase long-term surgery-free survival among cT3 rectal cancer patients and provides no advantage in distant metastases-free survival. Copyright © 2017 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights

  6. Brain refractive index measured in vivo with high-NA defocus-corrected full-field OCT and consequences for two-photon microscopy.

    PubMed

    Binding, Jonas; Ben Arous, Juliette; Léger, Jean-François; Gigan, Sylvain; Boccara, Claude; Bourdieu, Laurent

    2011-03-14

    Two-photon laser scanning microscopy (2PLSM) is an important tool for in vivo tissue imaging with sub-cellular resolution, but the penetration depth of current systems is potentially limited by sample-induced optical aberrations. To quantify these, we measured the refractive index n' in the somatosensory cortex of 7 rats in vivo using defocus optimization in full-field optical coherence tomography (ff-OCT). We found n' to be independent of imaging depth or rat age. From these measurements, we calculated that two-photon imaging beyond 200 µm into the cortex is limited by spherical aberration, indicating that adaptive optics will improve imaging depth.

  7. Demonstration of versatile whispering-gallery micro-lasers for remote refractive index sensing.

    PubMed

    Wan, Lei; Chandrahalim, Hengky; Zhou, Jian; Li, Zhaohui; Chen, Cong; Cho, Sangha; Zhang, Hui; Mei, Ting; Tian, Huiping; Oki, Yuji; Nishimura, Naoya; Fan, Xudong; Guo, L Jay

    2018-03-05

    We developed chip-scale remote refractive index sensors based on Rhodamine 6G (R6G)-doped polymer micro-ring lasers. The chemical, temperature, and mechanical sturdiness of the fused-silica host guaranteed a flexible deployment of dye-doped polymers for refractive index sensing. The introduction of the dye as gain medium demonstrated the feasibility of remote sensing based on the free-space optics measurement setup. Compared to the R6G-doped TZ-001, the lasing behavior of R6G-doped SU-8 polymer micro-ring laser under an aqueous environment had a narrower spectrum linewidth, producing the minimum detectable refractive index change of 4 × 10 -4 RIU. The maximum bulk refractive index sensitivity (BRIS) of 75 nm/RIU was obtained for SU-8 laser-based refractive index sensors. The economical, rapid, and simple realization of polymeric micro-scale whispering-gallery-mode (WGM) laser-based refractive index sensors will further expand pathways of static and dynamic remote environmental, chemical, biological, and bio-chemical sensing.

  8. Analysis of pupil and corneal wave aberration data supplied by the SN CT 1000 topography system

    NASA Astrophysics Data System (ADS)

    Comastri, S. A.; Martin, G.; Pfortner, T.

    2006-11-01

    Ocular aberrations depend on pupil size and centring and the retinal image quality under natural conditions differs from that corresponding to laboratory ones. In the present article, pupil and wave aberration data supplied by the Shin Nippon CT 1000 (SN CT 1000) topography system are analysed. Two groups of eyes under natural viewing conditions are considered ((260+/-20) lux at the eye under study). The first group consists of 10 normal eyes (-1.25 to 3 D sphere; 0 to -1.75 D cylinder) of five young subjects (age between 18 and 33 years). For this group, five determinations per eye are performed and the repeatability of results is analysed. Pupil centre is displaced from corneal vertex towards the temporal region, the largest displacement being (0.5+/-0.1) mm. The variation of pupil diameter in each eye is less than 21% while the inter-subject variability is large since diameters are between (3+/-0.3) and (5.3+/-0.6) mm. Aberrations are evaluated for two different pupil sizes, the natural one and a fictitious one of 6 mm. The corneal higher-order root-mean square wavefront error (RMSHO) for a 6 mm pupil centred in the corneal vertex, averaged across all eyes, is (0.37+/-0.06) [mu]m while, considering the natural pupil diameter, the average in each eye is significantly lower, up to eight times smaller. The fourth-order spherical aberration is an important aberration in the considered eyes, its maximum value for a 6 mm pupil being (0.38+/-0.02) [mu]m. The second group consists of 24 eyes of 12 subjects (age between 25 and 68 years) such that four eyes are of normal adults (1.25 to +6 D sphere; 0 to -0.5 D cylinder), eight have astigmatisms (-5.5 to +3.25 D sphere; -1.5 to -4.5 D cylinder), six have post-refractive surgery (+0.5 to +3.5 D sphere; -0.5 to -4 D cylinder) and six have keratoconus (-9.5 to +1 D sphere; -1 to -4.5 D cylinder). For this group only one determination per eye is performed. Pupil centre is displaced from corneal vertex towards the temporal

  9. Management of irregular astigmatism.

    PubMed

    Goggin, M; Alpins, N; Schmid, L M

    2000-08-01

    Using a liberal definition of corneal irregularity, modern videokeratoscopy may define approximately 40% of normal corneas with a toric refractive error as possessing primary irregular astigmatism. The causes of secondary forms of irregular astigmatism include corneal surgery, trauma, dystrophies, and infections. Internal refractive surface and media irregularity or noncorneal astigmatism (ocular residual astigmatism) contribute to irregular astigmatism of the entire refractive path of which crystaline lenticular astigmatism is usually the principal contributing component. Treatment options have increased in recent years, particularly, though not exclusively, through the advent of tailored corneal excimer laser ablations. However, discussion continues concerning the systematic approach necessary to enable treatment to achieve an optimal optical surface for the eye. Discussion also continues as to what constitutes the optimal corneal shape. Some refractive procedures may increase higher order aberrations in the attempt to neutralize refractive astigmatism. The way to further refinement of the commonly performed refractive techniques will ultimately lie in the integrated inclusion of a trio of technologies: topographic analysis of the corneal surface, wavefront analysis of ocular refractive aberrations, and vector planning to enable the appropriate balance in emphasis between these two diagnostic modalities. For the uncommon, irregularly roughened corneas, the ablatable polymer techniques show some promise.

  10. Aberration correction considering curved sample surface shape for non-contact two-photon excitation microscopy with spatial light modulator.

    PubMed

    Matsumoto, Naoya; Konno, Alu; Inoue, Takashi; Okazaki, Shigetoshi

    2018-06-18

    In this paper, excitation light wavefront modulation is performed considering the curved sample surface shape to demonstrate high-quality deep observation using two-photon excitation microscopy (TPM) with a dry objective lens. A large spherical aberration typically occurs when the refractive index (RI) interface between air and the sample is a plane perpendicular to the optical axis. Moreover, the curved sample surface shape and the RI mismatch cause various aberrations, including spherical ones. Consequently, the fluorescence intensity and resolution of the obtained image are degraded in the deep regions. To improve them, we designed a pre-distortion wavefront for correcting the aberration caused by the curved sample surface shape by using a novel, simple optical path length difference calculation method. The excitation light wavefront is modulated to the pre-distortion wavefront by a spatial light modulator incorporated in the TPM system before passing through the interface, where the RI mismatch occurs. Thus, the excitation light is condensed without aberrations. Blood vessels were thereby observed up to an optical depth of 2,000 μm in a cleared mouse brain by using a dry objective lens.

  11. Peripheral refraction profiles in subjects with low foveal refractive errors.

    PubMed

    Tabernero, Juan; Ohlendorf, Arne; Fischer, M Dominik; Bruckmann, Anna R; Schiefer, Ulrich; Schaeffel, Frank

    2011-03-01

    To study the variability of peripheral refraction in a population of 43 subjects with low foveal refractive errors. A scan of the refractive error in the vertical pupil meridian of the right eye of 43 subjects (age range, 18 to 80 years, foveal spherical equivalent, < ± 2.5 diopter) over the central ± 45° of the visual field was performed using a recently developed angular scanning photorefractor. Refraction profiles across the visual field were fitted with four different models: (1) "flat model" (refractions about constant across the visual field), (2) "parabolic model" (refractions follow about a parabolic function), (3) "bi-linear model" (linear change of refractions with eccentricity from the fovea to the periphery), and (4) "box model" ("flat" central area with a linear change in refraction from a certain peripheral angle). Based on the minimal residuals of each fit, the subjects were classified into one of the four models. The "box model" accurately described the peripheral refractions in about 50% of the subjects. Peripheral refractions in six subjects were better characterized by a "linear model," in eight subjects by a "flat model," and in eight by the "parabolic model." Even after assignment to one of the models, the variability remained strikingly large, ranging from -0.75 to 6 diopter in the temporal retina at 45° eccentricity. The most common peripheral refraction profile (observed in nearly 50% of our population) was best described by the "box model." The high variability among subjects may limit attempts to reduce myopia progression with a uniform lens design and may rather call for a customized approach.

  12. Uniform refraction in negative refractive index materials.

    PubMed

    Gutiérrez, Cristian E; Stachura, Eric

    2015-11-01

    We study the problem of constructing an optical surface separating two homogeneous, isotropic media, one of which has a negative refractive index. In doing so, we develop a vector form of Snell's law, which is used to study surfaces possessing a certain uniform refraction property, in both the near- and far-field cases. In the near-field problem, unlike the case when both materials have positive refractive indices, we show that the resulting surfaces can be neither convex nor concave.

  13. Building achromatic refractive beam shapers

    NASA Astrophysics Data System (ADS)

    Laskin, Alexander; Shealy, David

    2014-10-01

    Achromatic beam shapers can provide beam shaping in a certain spectral band and are very important for various laser techniques, such as, applications based on ultra-short pulse lasers with pulse width <100 fs, confocal microscopy, multicolour holography, life sciences fluorescence techniques, where several lasers in spectrum 405-650 nm are used simultaneously, for example 405-650 nm. Conditions of energy re-distribution and zero wave aberration are strictly fulfilled in ordinary plano-aspheric lens pair beam shapers for a definite wavelength only. Hence, these beam shapers work efficiently in relatively narrow, few nm spectrum. To provide acceptable beam quality for refractive beam shaping over a wide spectrum, an achromatizing design condition should be added. Consequently, the typical beam shaper design contains more than two-lenses, to avoid any damaging and other undesirable effects the lenses of beam shaper should be air-spaced. We suggest a two-step method of designing the beam shaper: 1) achromatizing of each plano-aspheric lens using a buried achromatizing surface ("chromatic radius"), then each beam shaper component presents a cemented doublet lens, 2) "splitting" the cemented lenses and realizing air-spaced lens design using optical systems design software. This method allows for using an achromatic design principle during the first step of the design, and then, refining the design by using optimization software. We shall present examples of this design procedure for an achromatic Keplerian beam shaper and for the design of an achromatic Galilean type of beam shaper. Experimental results of operation of refractive beam shapers will be presented as well.

  14. The prevalence of refractive conditions in Puerto Rican adults attending an eye clinic system

    PubMed Central

    Rodriguez, Neisha M.; Romero, Angel. F.

    2014-01-01

    Purpose To determine the prevalence of refractive conditions in the adult population that visited primary care optometry clinics in Puerto Rico. Methods A retrospective cross-sectional study of patients examined at the Inter American University of Puerto Rico School of Optometry Eye Institute Clinics between 2004 and 2010. Subjects considered had best corrected visual acuity by standardized subjective refraction of 20/40 or better. The refractive errors were classified by the spherical equivalent (SE): sphere+½ cylinder. Myopia was classified as a SE>−0.50 D, hyperopia as a SE>+0.50  D, and emmetropia as a SE between −0.50 and +0.50, both included. Astigmatism equal or higher than 0.25 D in minus cylinder form was used. Patients with documented history of cataract extraction (pseudophakia or aphakia), amblyopia, refractive surgery or other corneal/ocular surgery were excluded from the study. Results A total of 784 randomly selected subjects older than 40 years of age were selected. The estimated prevalence (95%, confidence interval) among all subjects was hyperopia 51.5% (48.0–55.0), emmetropia 33.8% (30.5–37.2), myopia 14.7% (12.1–17.2) and astigmatism 69.6% (68.8–73.3). Hyperopia was more common in females than males although the difference was not statistically significant. The mean spherical equivalent values was hyperopic until 70 y/o and decreased slightly as the population ages. Conclusion Hyperopia is the most common refractive error and its prevalence and seems to increase among the aging population who visited the clinics. Further programs and studies must be developed to address the refractive errors needs of the adult Puerto Rican population. PMID:25000872

  15. Racial Variations in the Prevalence of Refractive Errors in the United States: The Multi-Ethnic Study of Atherosclerosis

    PubMed Central

    PAN, CHEN-WEI; KLEIN, BARBARA E.K.; COTCH, MARY FRANCES; SHRAGER, SANDI; KLEIN, RONALD; FOLSOM, AARON; KRONMAL, RICHARD; SHEA, STEVEN J.; BURKE, GREGORY L.; SAW, SEANG-MEI; WONG, TIEN Y.

    2013-01-01

    PURPOSE To describe racial variations in the prevalence of refractive errors among adult white, Chinese, Hispanic, and black subjects in the United States. DESIGN Cross-sectional data from a prospective cohort study—the Multi-Ethnic Study of Atherosclerosis (MESA). METHODS A total of 6000 adults aged 45 to 84 years living in the United States participated in the study. Refractive error was assessed, without cycloplegia, in both eyes of all participants using an autorefractor. After excluding eyes with cataract, cataract surgery, or previous refractive surgery, the eye with the larger absolute spherical equivalent (SE) value for each participant was used to classify refractive error. Any myopia was defined as SE of −1.0 diopters (D) or less; high myopia was defined as SE of −5.0 D or less; any hyperopia was defined as SE of +1.0 D or more; clinically significant hyperopia was defined as SE of +3.0 D or more. Astigmatism was defined as a cylinder value of +1.0 D or more. RESULTS After excluding 508 participants with cataracts in both eyes, 838 participants with cataract surgery, 90 participants with laser refractive surgery, and 134 participants who refused to remove their contact lenses for the refraction measurement, 4430 adults with refractive error assessment in at least 1 eye contributed to the analysis. The prevalence of myopia among MESA participants was 25.1%, with lowest rates in Hispanic participants (14.2%), followed by black (21.5%) and white participants (31.0%), and highest rates in Chinese participants (37.2%). The overall rates of high myopia and astigmatism were 4.6% and 45.0%, respectively, with Chinese subjects also having the highest rates of high myopia (11.8%) and astigmatism (53.4%). The overall prevalence of any hyperopia was 38.2% and clinically significant hyperopia was 6.1%, with Hispanic participants having the highest rates of hyperopia (50.2%) and clinically significant hyperopia (8.8%). In multivariate analyses adjusting for age

  16. Racial variations in the prevalence of refractive errors in the United States: the multi-ethnic study of atherosclerosis.

    PubMed

    Pan, Chen-Wei; Klein, Barbara E K; Cotch, Mary Frances; Shrager, Sandi; Klein, Ronald; Folsom, Aaron; Kronmal, Richard; Shea, Steven J; Burke, Gregory L; Saw, Seang-Mei; Wong, Tien Y

    2013-06-01

    To describe racial variations in the prevalence of refractive errors among adult white, Chinese, Hispanic, and black subjects in the United States. Cross-sectional data from a prospective cohort study-the Multi-Ethnic Study of Atherosclerosis (MESA). A total of 6000 adults aged 45 to 84 years living in the United States participated in the study. Refractive error was assessed, without cycloplegia, in both eyes of all participants using an autorefractor. After excluding eyes with cataract, cataract surgery, or previous refractive surgery, the eye with the larger absolute spherical equivalent (SE) value for each participant was used to classify refractive error. Any myopia was defined as SE of -1.0 diopters (D) or less; high myopia was defined as SE of -5.0 D or less; any hyperopia was defined as SE of +1.0 D or more; clinically significant hyperopia was defined as SE of +3.0 D or more. Astigmatism was defined as a cylinder value of +1.0 D or more. After excluding 508 participants with cataracts in both eyes, 838 participants with cataract surgery, 90 participants with laser refractive surgery, and 134 participants who refused to remove their contact lenses for the refraction measurement, 4430 adults with refractive error assessment in at least 1 eye contributed to the analysis. The prevalence of myopia among MESA participants was 25.1%, with lowest rates in Hispanic participants (14.2%), followed by black (21.5%) and white participants (31.0%), and highest rates in Chinese participants (37.2%). The overall rates of high myopia and astigmatism were 4.6% and 45.0%, respectively, with Chinese subjects also having the highest rates of high myopia (11.8%) and astigmatism (53.4%). The overall prevalence of any hyperopia was 38.2% and clinically significant hyperopia was 6.1%, with Hispanic participants having the highest rates of hyperopia (50.2%) and clinically significant hyperopia (8.8%). In multivariate analyses adjusting for age, sex, race, and study site, higher

  17. Microvascular Reconstructive Surgery in Operations Iraqi and Enduring Freedom: the US Military Experience Performing Free Flaps in a Combat Zone

    DTIC Science & Technology

    2013-01-01

    Microvascular reconstructive surgery in Operations Iraqi and Enduring Freedom: The US military experience performing free flaps in a combat zone...usually must undergo reconstructive surgery in the combat zone. While the use of microvascular free-tissue transfer (free flaps) for traumatic... reconstruction iswell documented in the literature, various complicating factors exist when these intricate surgical procedures are performed in a theater of

  18. Design and fabrication of a miniature objective consisting of high refractive index zinc sulfide lenses for laser surgery

    NASA Astrophysics Data System (ADS)

    Shadfan, Adam; Pawlowski, Michal; Wang, Ye; Subramanian, Kaushik; Gabay, Ilan; Ben-Yakar, Adela; Tkaczyk, Tomasz

    2016-02-01

    A miniature laser ablation probe relying on an optical fiber to deliver light requires a high coupling efficiency objective with sufficient magnification in order to provide adequate power and field for surgery. A diffraction-limited optical design is presented that utilizes high refractive index zinc sulfide to meet specifications while reducing the miniature objective down to two lenses. The design has a hypercentric conjugate plane on the fiber side and is telecentric on the tissue end. Two versions of the objective were built on a diamond lathe-a traditional cylindrical design and a custom-tapered mount. Both received an antireflective coating. The objectives performed as designed in terms of observable resolution and field of view as measured by imaging a 1951 USAF resolution target. The slanted edge technique was used to find Strehl ratios of 0.75 and 0.78, respectively, indicating nearly diffraction-limited performance. Finally, preliminary ablation experiments indicated threshold fluence of gold film was comparable to similar reported probes.

  19. Design and fabrication of a miniature objective consisting of high refractive index zinc sulfide lenses for laser surgery

    PubMed Central

    Shadfan, Adam; Pawlowski, Michal; Wang, Ye; Subramanian, Kaushik; Gabay, Ilan; Ben-Yakar, Adela; Tkaczyk, Tomasz

    2016-01-01

    A miniature laser ablation probe relying on an optical fiber to deliver light requires a high coupling efficiency objective with sufficient magnification in order to provide adequate power and field for surgery. A diffraction-limited optical design is presented that utilizes high refractive index zinc sulfide to meet specifications while reducing the miniature objective down to two lenses. The design has a hypercentric conjugate plane on the fiber side and is telecentric on the tissue end. Two versions of the objective were built on a diamond lathe—a traditional cylindrical design and a custom-tapered mount. Both received an antireflective coating. The objectives performed as designed in terms of observable resolution and field of view as measured by imaging a 1951 USAF resolution target. The slanted edge technique was used to find Strehl ratios of 0.75 and 0.78, respectively, indicating nearly diffraction-limited performance. Finally, preliminary ablation experiments indicated threshold fluence of gold film was comparable to similar reported probes. PMID:28579656

  20. Spherical aberration correction with threefold symmetric line currents.

    PubMed

    Hoque, Shahedul; Ito, Hiroyuki; Nishi, Ryuji; Takaoka, Akio; Munro, Eric

    2016-02-01

    It has been shown that N-fold symmetric line current (henceforth denoted as N-SYLC) produces 2N-pole magnetic fields. In this paper, a threefold symmetric line current (N3-SYLC in short) is proposed for correcting 3rd order spherical aberration of round lenses. N3-SYLC can be realized without using magnetic materials, which makes it free of the problems of hysteresis, inhomogeneity and saturation. We investigate theoretically the basic properties of an N3-SYLC configuration which can in principle be realized by simple wires. By optimizing the parameters of a system with beam energy of 5.5keV, the required excitation current for correcting 3rd order spherical aberration coefficient of 400 mm is less than 1AT, and the residual higher order aberrations can be kept sufficiently small to obtain beam size of less than 1 nm for initial slopes up to 5 mrad. Copyright © 2015 Elsevier B.V. All rights reserved.

  1. Quantitation of free polyethylene glycol in PEGylated protein conjugate by size exclusion HPLC with refractive index (RI) detection.

    PubMed

    Li, Ning; Ziegemeier, Daisy; Bass, Laura; Wang, Wei

    2008-12-15

    In this study, size exclusion high performance liquid chromatography was evaluated for its application in separation and quantitation of free polyethylene glycol (PEG) and its PEGylated-protein-conjugate (PEG-conjugate). Although the large mass of the free PEG (2-fold greater than the protein) made separation difficult, chromatographic conditions were identified enabling resolution and quantitation of the free PEG, PEG-conjugate and non-PEGylated protein with Shodex Protein KW803 and KW804 columns in series and refractive index detection. The optimum resolution of 1.7 and 2.0 was achieved for the free PEG and PEG-conjugate as well as the free PEG and non-PEGylated protein using 20mM HEPES buffer at pH 6.5. Under this condition, the plot of log(10)MW of all the pertinent analytes against retention time showed a linear relationship with a correlation coefficient of 1. Limited assay performance evaluation demonstrated that the method was linear in the concentration range of 10 to 250 microg/mL of free PEG with correlation coefficients of > or = 0.99. When free PEG in this concentration range was spiked into PEG-conjugate samples at 1mg/mL, the recovery was in the range of 78%-120%. Detection and quantitation limits were determined to be, respectively, 10 and 25 microg/mL for free PEG. The R.S.D. for intra- and inter-day precision was 0.09% or less for retention time measurements and 2.9% or less for area count measurements. Robustness testing was performed by deliberately deviating +/-0.2 pH units away from the desired pH as well as by increasing the flow rate. These deviations resulted in no significant impact on area percent distribution of all species. However, separation was found to be sensitive to high ionic strength and buffer species.

  2. A model of chromosome aberration induction: applications to space research.

    PubMed

    Ballarini, Francesca; Ottolenghi, Andrea

    2005-10-01

    A mechanistic model and Monte Carlo code simulating chromosome aberration induction in human lymphocytes is presented. The model is based on the assumption that aberrations arise from clustered DNA lesions and that only the free ends of clustered lesions created in neighboring chromosome territories or in the same territory can join and produce exchanges. The lesions are distributed in the cell nucleus according to the radiation track structure. Interphase chromosome territories are modeled as compact intranuclear regions with volumes proportional to the chromosome DNA contents. Both Giemsa staining and FISH painting can be simulated, and background aberrations can be taken into account. The good agreement with in vitro data provides validation of the model in terms of both the assumptions adopted and the simulation techniques. As an application in the field of space research, the model predictions were compared with aberration yields measured among crew members of long-term missions on board Mir and ISS, assuming an average radiation quality factor of 2.4. The agreement obtained also validated the model for in vivo exposure scenarios and suggested possible applications to the prediction of other relevant aberrations, typically translocations.

  3. Prevalence of refractive errors in the European adult population: the Gutenberg Health Study (GHS).

    PubMed

    Wolfram, Christian; Höhn, René; Kottler, Ulrike; Wild, Philipp; Blettner, Maria; Bühren, Jens; Pfeiffer, Norbert; Mirshahi, Alireza

    2014-07-01

    To study the distribution of refractive errors among adults of European descent. Population-based eye study in Germany with 15010 participants aged 35-74 years. The study participants underwent a detailed ophthalmic examination according to a standardised protocol. Refractive error was determined by an automatic refraction device (Humphrey HARK 599) without cycloplegia. Definitions for the analysis were myopia <-0.5 dioptres (D), hyperopia >+0.5 D, astigmatism >0.5 cylinder D and anisometropia >1.0 D difference in the spherical equivalent between the eyes. Exclusion criterion was previous cataract or refractive surgery. 13959 subjects were eligible. Refractive errors ranged from -21.5 to +13.88 D. Myopia was present in 35.1% of this study sample, hyperopia in 31.8%, astigmatism in 32.3% and anisometropia in 13.5%. The prevalence of myopia decreased, while the prevalence of hyperopia, astigmatism and anisometropia increased with age. 3.5% of the study sample had no refractive correction for their ametropia. Refractive errors affect the majority of the population. The Gutenberg Health Study sample contains more myopes than other study cohorts in adult populations. Our findings do not support the hypothesis of a generally lower prevalence of myopia among adults in Europe as compared with East Asia.

  4. The Use of Harmonic Scalpel for Free Flap Dissection in Head and Neck Reconstructive Surgery

    PubMed Central

    Albert, Sebastien; Guedon, Charles; Halimi, Caroline; Cristofari, Jean Pierre; Barry, Beatrix

    2012-01-01

    Surgeons conventionally use electrocautery dissection and surgical clip appliers to harvest free flaps. The ultrasonic Harmonic Scalpel is a new surgical instrument that provides high-quality dissection and hemostasis and minimizes tissue injury. The aim of this study was to evaluate the effectiveness and advantages of the ultrasonic Harmonic Scalpel compared to conventional surgical instruments in free flap surgery. This prospective study included 20 patients who underwent head and neck reconstructive surgery between March 2009 and May 2010. A forearm free flap was used for reconstruction in 12 patients, and a fibular flap was used in 8 patients. In half of the patients, electrocautery and surgical clips were used for free flap harvesting (the EC group), and in the other half of the patients, ultrasonic dissection was performed using the Harmonic Scalpel (the HS group). The following parameters were significantly lower in the HS group compared to the EC group: the operative time of flap dissection (35% lower in the HS group), blood loss, number of surgical clips and cost of surgical materials. This study demonstrated the effectiveness of the Harmonic Scalpel in forearm and fibular free flap dissections that may be extended to other free flaps. PMID:22693666

  5. Nano-imprint gold grating as refractive index sensor

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Kumari, Sudha; Mohapatra, Saswat; Moirangthem, Rakesh S.

    Large scale of fabrication of plasmonic nanostructures has been a challenging task due to time consuming process and requirement of expensive nanofabrication tools such as electron beam lithography system, focused ion beam system, and extreme UV photolithography system. Here, we present a cost-effective fabrication technique so called soft nanoimprinting to fabricate nanostructures on the larger sample area. In our fabrication process, a commercially available optical DVD disc was used as a template which was imprinted on a polymer glass substrate to prepare 1D polymer nano-grating. A homemade nanoimprinting setup was used in this fabrication process. Further, a label-free refractive indexmore » sensor was developed by utilizing the properties of surface plasmon resonance (SPR) of a gold coated 1D polymer nano-grating. Refractive index sensing was tested by exposing different solutions of glycerol-water mixture on the surface of gold nano-grating. The calculated bulk refractive index sensitivity was found to be 751nm/RIU. We believed that our proposed SPR sensor could be a promising candidate for developing low-cost refractive index sensor with high sensitivity on a large scale.« less

  6. A web-based information system for management and analysis of patient data after refractive eye surgery.

    PubMed

    Zuberbuhler, Bruno; Galloway, Peter; Reddy, Aravind; Saldana, Manuel; Gale, Richard

    2007-12-01

    The aim was to develop a software tool for refractive surgeons using a standard user-friendly web-based interface, providing the user with a secure environment to protect large volumes of patient data. The software application was named "Internet-based refractive analysis" (IBRA), and was programmed with the computer languages PHP, HTML and JavaScript, attached to the opensource MySQL database. IBRA facilitated internationally accepted presentation methods including the stability chart, the predictability chart and the safety chart; it was able to perform vector analysis for the course of a single patient or for group data. With the integrated nomogram calculation, treatment could be customised to reduce the postoperative refractive error. Multicenter functions permitted quality-control comparisons between different surgeons and laser units.

  7. Femtosecond laser-induced refractive index modification in multicomponent glasses

    NASA Astrophysics Data System (ADS)

    Bhardwaj, V. R.; Simova, E.; Corkum, P. B.; Rayner, D. M.; Hnatovsky, C.; Taylor, R. S.; Schreder, B.; Kluge, M.; Zimmer, J.

    2005-04-01

    We present a comprehensive study on femtosecond laser-induced refractive index modification in a wide variety of multicomponent glasses grouped as borosilicate, aluminum-silicate, and heavy-metal oxide glasses along with lanthanum-borate and sodium-phosphate glasses. By using high-spatial resolution refractive index profiling techniques, we demonstrate that under a wide range of writing conditions the refractive index modification in multicomponent glasses can be positive, negative, or nonuniform, and exhibits a strong dependence on the glass composition. With the exception of some aluminum-silicate glasses all other glasses exhibited a negative/nonuniform index change. We also demonstrate direct writing of waveguides in photosensitive Foturan® glass with a femtosecond laser without initiating crystallization by thermal treatment. Upon ceramization of lithium-aluminum-silicate glasses such as Foturan®, Zerodur®, and Robax® we observe switching of laser-induced refractive index change from being positive to negative. The measured transmission losses in the waveguides at 1550nm agree with the index profile measurements in alkali-free aluminum-silicate glasses.

  8. [Epidemiology of refractive errors].

    PubMed

    Wolfram, C

    2017-07-01

    Refractive errors are very common and can lead to severe pathological changes in the eye. This article analyzes the epidemiology of refractive errors in the general population in Germany and worldwide and describes common definitions for refractive errors and clinical characteristics for pathologicaal changes. Refractive errors differ between age groups due to refractive changes during the life time and also due to generation-specific factors. Current research about the etiology of refractive errors has strengthened the influence of environmental factors, which led to new strategies for the prevention of refractive pathologies.

  9. Refractive index, molar refraction and comparative refractive index study of propylene carbonate binary liquid mixtures.

    PubMed

    Wankhede, Dnyaneshwar Shamrao

    2012-06-01

    Refractive indices (n) have been experimentally determined for the binary liquid-liquid mixtures of Propylene carbonate (PC) (1) with benzene, ethylbenzene, o-xylene and p-xylene (2) at 298.15, 303.15 and 308.15 K over the entire mole fraction range. The experimental values of n are utilised to calculate deviation in refractive index (Δn), molar refraction (R) and deviation in molar refraction (ΔR). A comparative study of Arago-Biot (A-B), Newton (NW), Eyring and John (E-J) equations for determining refractive index of a liquid has been carried out to test their validity for all the binary mixtures over the entire composition range at 298.15 K. Comparison of various mixing relations is represented in terms of average deviation (AVD). The Δn and ΔR values have been fitted to Redlich-Kister equation at 298.15 K and standard deviations have been calculated. The results are discussed in terms of intermolecular interactions present amongst the components.

  10. Composition of the excimer laser-induced plume produced during LASIK refractive surgery

    NASA Astrophysics Data System (ADS)

    Glickman, Randolph D.; Liu, Yun; Mayo, George L.; Baribeau, Alan D.; Starck, Tomy; Bankhead, Tom

    2003-07-01

    Because of concerns about potential hazards to surgical personnel of the plume associated with laser refractive surgery, this study was performed to characterize the composition of such plumes. Filter elements were removed from the smoke evacuator of a VISX S3 excimer laser (filter pore size ~0.3 microns) and from a Mastel Clean Room ( filter pore size ~0.2 microns) used with a LADARVISION excimer laser. The filters from both laser systems captured the laser-induced plumes from multiple, routine, LASIK patient procedures. Some filters were processed for scanning electron microscopy, while others were extracted with methanol and chloroform for biochemical analysis. Both the VISX "Final Air" filter and the Mastel "Clean Room" filter captured material that was not observed in filters that had clean operating room air only passed through them. In the VISX system, air flows through the filter unit parallel to the filter matrix. SEM analysis showed these filters captured discrete particles of 0.3 to 3.0 microns in size. In the Mastel Clean Room unit, air flows orthogonally through the filter, and the filter matrix was heavily layered with captured debris so that individual particles were not readily distinguished. Amino acid analysis and gel electrophoresis of extracted material revealed proteinaceous molecules as large as 5000 molecular weight. Such large molecules in the laser plume are not predicted by the existing theory of photochemical ablation. The presence of relatively large biomolecules may constitute a risk of allergenic reactions in personnel exposed to the plume, and also calls into question the precise mechanism of excimer laser photochemical ablation. Supported by the RMG Research Endowment, and Research to Prevent Blindness

  11. Laser technologies in ophthalmic surgery

    NASA Astrophysics Data System (ADS)

    Atezhev, V. V.; Barchunov, B. V.; Vartapetov, S. K.; Zav'yalov, A. S.; Lapshin, K. E.; Movshev, V. G.; Shcherbakov, I. A.

    2016-08-01

    Excimer and femtosecond lasers are widely used in ophthalmology to correct refraction. Laser systems for vision correction are based on versatile technical solutions and include multiple hard- and software components. Laser characteristics, properties of laser beam delivery system, algorithms for cornea treatment, and methods of pre-surgical diagnostics determine the surgical outcome. Here we describe the scientific and technological basis for laser systems for refractive surgery developed at the Physics Instrumentation Center (PIC) at the Prokhorov General Physics Institute (GPI), Russian Academy of Sciences.

  12. Comparison of objective refraction in darkness to cycloplegic refraction: a pilot study.

    PubMed

    Vasudevan, Balamurali; Ciuffreda, Kenneth J; Meehan, Kelly; Grk, Dejana; Cox, Misty

    2016-03-01

    The aim was to assess non-cycloplegic objective refraction in darkness using an open-field auto-refractor, and furthermore to compare it with distance cycloplegic subjective refraction and distance cycloplegic retinoscopy in the light, in children and young adults. Twenty-three, visually-normal, young-adults (46 eyes) ages 23 to 31 years, and five children (10 eyes) ages five to 12 years, participated in the study. The spherical component of their refraction ranged from -2.25 D to +3.75 D with a mean of +1.80 D, and a mean cylinder of -0.70 D. Three techniques were used to assess refractive error. An objective measure of the non-cycloplegic refractive state was obtained using an open-field autorefractor (WAM-5500) after five minutes in the dark to allow for dissipation of accommodative transients and relaxation of accommodation. In addition, both distance retinoscopy and subjective distance refraction were performed following cycloplegia (Cyclopentolate, 1%) using conventional clinical procedures. All measurements were obtained on the same day within a single session. The spherical component of the refraction was compared among the three techniques in both the children and adults. There was no significant difference in spherical refraction among the three techniques: non-cycloplegic objective refraction in the dark, distance cycloplegic retinoscopy and distance cycloplegic subjective refraction, in either the adults [F(2, 137) = 0.79, p = 0.45] or the children [F(2, 27) = 0.47, p = 0.62]. Mean difference in the spherical component between refraction in the dark and the cycloplegic distance retinoscopy was -0.34 D (r = 0.89) in the adults and +0.14 D (r = 0.96) in the children. The mean difference in spherical component between refraction in the dark and the cycloplegic distance subjective refraction was -0.25 D (r = 0.92) in the adults and -0.05 D (r = 0.95) in the children. Comparison of the spherical refractive component between the three techniques was not

  13. Effect of Cycloplegia on Corneal Biometrics and Refractive State

    PubMed Central

    Bagheri, Abbas; Feizi, Mohadeseh; Shafii, Aliakbar; Faramarzi, Amir; Tavakoli, Mehdi; Yazdani, Shahin

    2018-01-01

    Purpose: To determine changes in refractive state and corneal parameters after cycloplegia with cyclopentolate hydrochloride 1% using a dual Scheimpflug imaging system. Methods: In this prospective cross-sectional study patients aged 10 to 40 years who were referred for optometric evaluation enrolled and underwent autorefraction and corneal imaging with the Galilei dual Scheimpflug system before and 30 minutes after twice instillation of medication. Changes in refraction and astigmatism were investigated. Corneal biometrics including anterior and posterior corneal curvatures, total corneal power and corneal pachymetry were compared before and after cycloplegia. Results: Two hundred and twelve eyes of 106 subjects with mean age of 28 ± 5 years including 201 myopic and 11 hyperopic eyes were evaluated. Mean spherical equivalent refractive error before cycloplegia was -3.4 ± 2.6 D. A mean hyperopic shift of 0.4 ± 0.5 D occurred after cycloplegia (P < 0.001). The astigmatism power did not significantly change (P = 0.8), however, 26.8% of eyes with significant astigmatism experienced a change of more than 5 degrees in the axis of astigmatism. Changes in posterior corneal curvature were scant but statistically significant (P = 0.001). Moreover, corneal thickness was slightly increased in the central and paracentral regions (P < 0.001 and P < 0.001, respectively). Conclusion: Cycloplegia causes a hyperopic shift and astigmatism axis changes, along with an increase in central and paracentral corneal thickness and change in posterior corneal curvature. The effects of cycloplegia on refraction and corneal biometrics should be considered before cataract and refractive surgeries. PMID:29719636

  14. Effect of Cycloplegia on Corneal Biometrics and Refractive State.

    PubMed

    Bagheri, Abbas; Feizi, Mohadeseh; Shafii, Aliakbar; Faramarzi, Amir; Tavakoli, Mehdi; Yazdani, Shahin

    2018-01-01

    To determine changes in refractive state and corneal parameters after cycloplegia with cyclopentolate hydrochloride 1% using a dual Scheimpflug imaging system. In this prospective cross-sectional study patients aged 10 to 40 years who were referred for optometric evaluation enrolled and underwent autorefraction and corneal imaging with the Galilei dual Scheimpflug system before and 30 minutes after twice instillation of medication. Changes in refraction and astigmatism were investigated. Corneal biometrics including anterior and posterior corneal curvatures, total corneal power and corneal pachymetry were compared before and after cycloplegia. Two hundred and twelve eyes of 106 subjects with mean age of 28 ± 5 years including 201 myopic and 11 hyperopic eyes were evaluated. Mean spherical equivalent refractive error before cycloplegia was -3.4 ± 2.6 D. A mean hyperopic shift of 0.4 ± 0.5 D occurred after cycloplegia ( P < 0.001). The astigmatism power did not significantly change ( P = 0.8), however, 26.8% of eyes with significant astigmatism experienced a change of more than 5 degrees in the axis of astigmatism. Changes in posterior corneal curvature were scant but statistically significant ( P = 0.001). Moreover, corneal thickness was slightly increased in the central and paracentral regions ( P < 0.001 and P < 0.001, respectively). Cycloplegia causes a hyperopic shift and astigmatism axis changes, along with an increase in central and paracentral corneal thickness and change in posterior corneal curvature. The effects of cycloplegia on refraction and corneal biometrics should be considered before cataract and refractive surgeries.

  15. Military target task performance after wavefront-guided (WFG) and wavefront-optimized (WFO) photorefractive keratectomy (PRK)

    NASA Astrophysics Data System (ADS)

    Maurer, Tana; Deaver, Dawne; Howell, Christopher; Moyer, Steve; Nguyen, Oanh; Mueller, Greg; Ryan, Denise; Sia, Rose K.; Stutzman, Richard; Pasternak, Joseph; Bower, Kraig

    2014-06-01

    Major decisions regarding life and death are routinely made on the modern battlefield, where visual function of the individual soldier can be of critical importance in the decision-making process. Glasses in the combat environment have considerable disadvantages: degradation of short term visual performance can occur as dust and sweat accumulate on lenses during a mission or patrol; long term visual performance can diminish as lenses become increasingly scratched and pitted; during periods of intense physical trauma, glasses can be knocked off the soldier's face and lost or broken. Although refractive surgery offers certain benefits on the battlefield when compared to wearing glasses, it is not without potential disadvantages. As a byproduct of refractive surgery, elevated optical aberrations can be induced, causing decreases in contrast sensitivity and increases in the symptoms of glare, halos, and starbursts. Typically, these symptoms occur under low light level conditions, the same conditions under which most military operations are initiated. With the advent of wavefront aberrometry, we are now seeing correction not only of myopia and astigmatism but of other, smaller optical aberrations that can cause the above symptoms. In collaboration with the Warfighter Refractive Eye Surgery Program and Research Center (WRESP-RC) at Fort Belvoir and Walter Reed National Military Medical Center (WRNMMC), the overall objective of this study is to determine the impact of wavefront guided (WFG) versus wavefront-optimized (WFO) photorefractive keratectomy (PRK) on military task visual performance. Psychophysical perception testing was conducted before and after surgery to measure each participant's performance regarding target detection and identification using thermal imagery. The results are presented here.

  16. Postoperative ocular higher-order aberrations and contrast sensitivity: femtosecond lenticule extraction versus pseudo small-incision lenticule extraction.

    PubMed

    Tan, Deborah K L; Tay, Wan Ting; Chan, Cordelia; Tan, Donald T H; Mehta, Jodhbir S

    2015-03-01

    To evaluate and compare changes in contrast sensitivity and ocular higher-order aberrations (HOAs) after femtosecond lenticule extraction (FLEx) and pseudo small-incision lenticule extraction (SMILE). Singapore National Eye Centre, Singapore. Retrospective case series. Patients had femtosecond lenticule extraction (Group 1) or pseudo small-incision lenticule extraction (Group 2) between March 2010 and December 2011. The main outcome measures were manifest refraction, HOAs, and contrast sensitivity 1, 3, 6, and 12 months postoperatively. Fifty-two consecutive patients (102 eyes) were recruited, 21 patients (42 eyes) in Group 1 and the 31 patients (60 eyes) in Group 2. The uncorrected and corrected distance visual acuities were significantly better in Group 2 than in Group 1 at 12 months (P = .032). There was no significant increase in 3rd- or 4th-order aberrations at 1 year and no significant difference between the 2 groups preoperatively or postoperatively. At 1 year, there was a significant increase in mesopic contrast sensitivity in Group 2 at 1.5 cycles per degree (cpd) (P = .008) that was not found in Group 1, and photopic contrast sensitivity at 6.0 cpd was higher in Group 2 (P = .027). These results indicate that refractive lenticule extraction is safe and effective with no significant induction of HOAs or deterioration in contrast sensitivity at 1 year. Induction of HOAs was not significantly different between both variants of refractive lenticule extraction. However, there was significant improvement in photopic contrast sensitivity after pseudo small-incision lenticule extraction, which persisted through 1 year. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  17. Rotationally asymmetric multifocal IOL implantation with and without capsular tension ring: refractive and visual outcomes and intraocular optical performance.

    PubMed

    Alió, Jorge L; Plaza-Puche, Ana B; Piñero, David P

    2012-04-01

    To ascertain whether the refractive, visual, and intraocular optical quality outcomes of a rotationally asymmetric multifocal intraocular lens (IOL) are enhanced by the use of a capsular tension ring. Ninety consecutive eyes from 53 patients (age range: 36 to 82 years) were divided into two groups: the no ring group comprised 43 eyes implanted with the multifocal rotationally asymmetric Lentis Mplus LS-312 (Oculentis GmbH) without a capsular tension ring; and the ring group comprised 47 eyes with the same IOL with a capsular tension ring. Distance and near visual acuity and refractive outcomes were evaluated pre- and postoperatively. Contrast sensitivity, intraocular aberrations, and defocus curve were evaluated postoperatively. Significant postoperative differences between groups were found in sphere, spherical equivalent refraction, and near addition (P<.02). Regarding defocus curve, significantly better visual acuity was present in eyes with the capsular tension ring for intermediate vision conditions (P<.05). Intraocular aberrometry did not differ significantly between groups (P<.09). Refractive predictability and intermediate visual outcomes with the Lentis Mplus LS-312 IOL improved significantly when implanted in combination with a capsular tension ring. Copyright 2012, SLACK Incorporated.

  18. Determination of aberration center of Ronchigram for automated aberration correctors in scanning transmission electron microscopy.

    PubMed

    Sannomiya, Takumi; Sawada, Hidetaka; Nakamichi, Tomohiro; Hosokawa, Fumio; Nakamura, Yoshio; Tanishiro, Yasumasa; Takayanagi, Kunio

    2013-12-01

    A generic method to determine the aberration center is established, which can be utilized for aberration calculation and axis alignment for aberration corrected electron microscopes. In this method, decentering induced secondary aberrations from inherent primary aberrations are minimized to find the appropriate axis center. The fitness function to find the optimal decentering vector for the axis was defined as a sum of decentering induced secondary aberrations with properly distributed weight values according to the aberration order. Since the appropriate decentering vector is determined from the aberration values calculated at an arbitrary center axis, only one aberration measurement is in principle required to find the center, resulting in /very fast center search. This approach was tested for the Ronchigram based aberration calculation method for aberration corrected scanning transmission electron microscopy. Both in simulation and in experiments, the center search was confirmed to work well although the convergence to find the best axis becomes slower with larger primary aberrations. Such aberration center determination is expected to fully automatize the aberration correction procedures, which used to require pre-alignment of experienced users. This approach is also applicable to automated aperture positioning. Copyright © 2013 Elsevier B.V. All rights reserved.

  19. Liquid refractive index sensing independent of opacity using an optofluidic diffraction sensor.

    PubMed

    Xu, Zhida; Han, Kevin; Khan, Ibrahim; Wang, Xinhao; Liu, G Logan

    2014-10-15

    We have implemented a multifunctional optofluidic sensor that can monitor changes in the refractive index and pressure of biofluid simultaneously and can detect free-solution molecular interaction in situ. In this Letter, we demonstrate two major improvements of this sensor proven by both simulation and experiments. One improvement is the broader measurement range of refractive index by making the diffraction grating with high-index polymer. The other improvement is the separation of refractive index sensing from opacity sensing by using the relative power ratio of diffraction orders. This simple, compact and low-cost multifunctional optofluidic sensor has the potential to be used for in situ biofluid monitoring.

  20. Simulation of imperfections in plastic lenses - transferring local refractive index changes into surface shape modifications

    NASA Astrophysics Data System (ADS)

    Arasa, Josep; Pizarro, Carles; Blanco, Patricia

    2016-06-01

    Injection molded plastic lenses have continuously improved their performance regarding optical quality and nowadays are as usual as glass lenses in image forming devices. However, during the manufacturing process unavoidable fluctuations in material density occur, resulting in local changes in the distribution of refractive index, which degrade the imaging properties of the polymer lens. Such material density fluctuations correlate to phase delays, which opens a path for their mapping. However, it is difficult to transfer the measured variations in refractive index into conventional optical simulation tool. Thus, we propose a method to convert the local variations in refractive index into local changes of one surface of the lens, which can then be described as a free-form surface, easy to introduce in conventional simulation tools. The proposed method was tested on a commercial gradient index (GRIN) lens for a set of six different object positions, using the MTF sagittal and tangential cuts to compare the differences between the real lens and a lens with homogenous refractive index, and the last surface converted into a free-form shape containing the internal refractive index changes. The same procedure was used to reproduce the local refractive index changes of an injected plastic lens with local index changes measured using an in-house built polariscopic arrangement, showing the capability of the method to provide successful results.

  1. Is LASIK for Me? A Patient's Guide to Refractive Surgery

    MedlinePlus

    ... whether LASIK would be appropriate for you are: • dry eye syndrome . If dry eye is left untreated prior to surgery, patients may be disappointed with their LASIK results. If dry eye is diagnosed and adequately treated before surgery, you ...

  2. Comparison of self-refraction using a simple device, USee, with manifest refraction in adults.

    PubMed

    Annadanam, Anvesh; Varadaraj, Varshini; Mudie, Lucy I; Liu, Alice; Plum, William G; White, J Kevin; Collins, Megan E; Friedman, David S

    2018-01-01

    The USee device is a new self-refraction tool that allows users to determine their own refractive error. We evaluated the ease of use of USee in adults, and compared the refractive error correction achieved with USee to clinical manifest refraction. Sixty adults with uncorrected visual acuity <20/30 and spherical equivalent between -6.00 and +6.00 diopters completed manifest refraction and self-refraction. Subjects had a mean (±SD) age of 53.1 (±18.6) years, and 27 (45.0%) were male. Mean (±SD) spherical equivalent measured by manifest refraction and self-refraction were -0.90 D (±2.53) and -1.22 diopters (±2.42), respectively (p = 0.001). The proportion of subjects correctable to ≥20/30 in the better eye was higher for manifest refraction (96.7%) than self-refraction (83.3%, p = 0.005). Failure to achieve visual acuity ≥20/30 with self-refraction in right eyes was associated with increasing age (per year, OR: 1.05; 95% CI: 1.00-1.10) and higher cylindrical power (per diopter, OR: 7.26; 95% CI: 1.88-28.1). Subjectively, 95% of participants thought USee was easy to use, 85% thought self-refraction correction was better than being uncorrected, 57% thought vision with self-refraction correction was similar to their current corrective lenses, and 53% rated their vision as "very good" or "excellent" with self-refraction. Self-refraction provides acceptable refractive error correction in the majority of adults. Programs targeting resource-poor settings could potentially use USee to provide easy on-site refractive error correction.

  3. Comparison of self-refraction using a simple device, USee, with manifest refraction in adults

    PubMed Central

    Annadanam, Anvesh; Mudie, Lucy I.; Liu, Alice; Plum, William G.; White, J. Kevin; Collins, Megan E.; Friedman, David S.

    2018-01-01

    Background The USee device is a new self-refraction tool that allows users to determine their own refractive error. We evaluated the ease of use of USee in adults, and compared the refractive error correction achieved with USee to clinical manifest refraction. Methods Sixty adults with uncorrected visual acuity <20/30 and spherical equivalent between –6.00 and +6.00 diopters completed manifest refraction and self-refraction. Results Subjects had a mean (±SD) age of 53.1 (±18.6) years, and 27 (45.0%) were male. Mean (±SD) spherical equivalent measured by manifest refraction and self-refraction were –0.90 D (±2.53) and –1.22 diopters (±2.42), respectively (p = 0.001). The proportion of subjects correctable to ≥20/30 in the better eye was higher for manifest refraction (96.7%) than self-refraction (83.3%, p = 0.005). Failure to achieve visual acuity ≥20/30 with self-refraction in right eyes was associated with increasing age (per year, OR: 1.05; 95% CI: 1.00–1.10) and higher cylindrical power (per diopter, OR: 7.26; 95% CI: 1.88–28.1). Subjectively, 95% of participants thought USee was easy to use, 85% thought self-refraction correction was better than being uncorrected, 57% thought vision with self-refraction correction was similar to their current corrective lenses, and 53% rated their vision as “very good” or “excellent” with self-refraction. Conclusion Self-refraction provides acceptable refractive error correction in the majority of adults. Programs targeting resource-poor settings could potentially use USee to provide easy on-site refractive error correction. PMID:29390026

  4. Evaluation of the True Wavefront Aberrations in Eyes Implanted With a Rotationally Asymmetric Multifocal Intraocular Lens.

    PubMed

    Akondi, Vyas; Pérez-Merino, Pablo; Martinez-Enriquez, Eduardo; Dorronsoro, Carlos; Alejandre, Nicolás; Jiménez-Alfaro, Ignacio; Marcos, Susana

    2017-04-01

    Standard evaluation of aberrations from wavefront slope measurements in patients implanted with a rotationally asymmetric multifocal intraocular lens (IOL), the Lentis Mplus (Oculentis GmbH, Berlin, Germany), results in large magnitude primary vertical coma, which is attributed to the intrinsic IOL design. The new proposed method analyzes aberrometry data, allowing disentangling the IOL power pupillary distribution from the true higher order aberrations of the eye. The new method of wavefront reconstruction uses retinal spots obtained at both the near and far foci. The method was tested using ray tracing optical simulations in a computer eye model virtually implanted with the Lentis Mplus IOL, with a generic cornea or with anterior segment geometry obtained from custom quantitative spectral-domain optical coherence tomography in a real patient. The method was applied to laser ray tracing aberrometry data at near and far fixation obtained in a patient implanted with the Lentis Mplus IOL. Higher order aberrations evaluated from simulated and real retinal spot diagrams following the new reconstruction approach matched the nominal aberrations (approximately 98%). Previously reported primary vertical coma in patients implanted with this IOL lost significance with the application of the proposed reconstruction. Custom analysis of ray tracing-based retinal spot diagrams allowed decoupling of the true higher order aberrations of the patient's eye from the power pupillary distribution of a rotationally asymmetric multifocal IOL, therefore providing the appropriate phase map to accurately evaluate through-focus optical quality. [J Refract Surg. 2017;33(4):257-265.]. Copyright 2017, SLACK Incorporated.

  5. Corrective lens use and refractive error among United States Air Force aircrew.

    PubMed

    Wright, Steve T; Ivan, Douglas J; Clark, Patrick J; Gooch, John M; Thompson, William

    2010-03-01

    Corrective lens use by military aviators is an important consideration in the design of head-mounted equipment. The United States Air Force (USAF) has periodically monitored lens use by aviators; however, it has been over a decade since the last study. We provide an update on the prevalence of corrective lenses and refractive error among USAF aircrew based on eyeglass orders processed through the Spectacle Request Transmission System (SRTS). Currently, 41% of active duty USAF pilots and 54% of other aircrew require corrective lenses to perform flight duties. Refractive errors are characterized by low to moderate levels of myopia with a mean spherical equivalent power of -1.01 diopters (D) for pilots and -1.68 D for others. Contact lenses, and more recently refractive surgery, reduce the number of aircrew that must rely on spectacles when flying; however, spectacle compatibility remains an important consideration in the cockpit.

  6. Laser parameters, focusing optics, and side effects in femtosecond laser corneal surgery

    NASA Astrophysics Data System (ADS)

    Plamann, Karsten; Nuzzo, Valeria; Peyrot, Donald A.; Deloison, Florent; Savoldelli, Michèle; Legeais, Jean-Marc

    2008-02-01

    Nowadays, femtosecond lasers are routinely used in refractive eye surgery. Until recently, commercialised clinical systems were exclusively based on ytterbium or neodymium-doped solid state lasers emitting sub-picosecond pulses at a wavelength of about 1 μm and repetition rates of a few 10 kHz. These systems use pulse energies in the μJ range and focussing optics of NA = 0.3 to 0.5. Recent developments have provided a variety of alternative and equally viable approaches: systems are now available using nJ pulses at high numerical apertures and MHz repetition rates - an approach so far only used for femtosecond cell surgery - and fibre laser technology is now being used for femtosecond laser corneal surgery. Recent research has also provided more insight in side effects occurring in present systems: self focusing phenomena and so far unexplained periodical structures have been observed even at high numerical apertures (NA >> 0.5) and moderate pulse energies. The interaction of femtosecond laser pulses with strongly scattering tissue has been studied in view of extending the application of femtosecond lasers to keratoplasty for opaque corneas and to glaucoma surgery. The use of new laser wavelengths and adaptive optics has been proposed. Despite the reputation of femtosecond surgical systems for their precision, repeatability and the absence of secondary effects or complications, a closer examination reveals the presence of subtle phenomena which merit further investigation. We present three of these phenomena: the influence of optical aberration on the quality of the incision, the occurrence of filamentation effects, and the deposit of microscopic glass fragments when performing penetrating incisions.

  7. Comparison of postoperative refractive outcomes: IOLMaster® versus immersion ultrasound.

    PubMed

    Whang, Woong-Joo; Jung, Byung-Ju; Oh, Tae-Hoon; Byun, Yong-Soo; Joo, Choun-Ki

    2012-01-01

    To compare the postoperative refractive outcomes between IOLMaster biometry (Carl Zeiss Meditec, Inc., Dublin, CA) and immersion ultrasound biometry for axial length measurements. Refractive outcomes in 354 eyes were compared using the IOLMaster and the immersion ultrasound biometry. Predicted refraction was determined using manual keratometry and the SRK-T formula with personalized A-constant. The axial lengths measured using the IOLMaster and immersion ultrasound were 24.49 ± 2.11 and 24.46 ± 2.11 mm, respectively, and the difference was significant (P < .05). The mean errors were 0.000 ± 0.578 D with the IOLMaster, and 0.000 ± 0.599 D with the immersion ultrasound, but the difference was not significant. The mean absolute error was smaller with the IOLMaster than with immersion ultrasound (0.463 ± 0.341 vs 0.479 ± 0.359 D), but the difference was not significant. IOLMaster biometry yields highly accurate results in cataract surgery. However, if the IOLMaster is unavailable, immersion ultrasound biometry with personalized intraocular lens constants is an acceptable alternative. Copyright 2012, SLACK Incorporated.

  8. SwiftLase: a new technology for char-free ablation in rectal surgery

    NASA Astrophysics Data System (ADS)

    Arnold, David A.

    1995-05-01

    We describe layer-by-layer char-free ablation of hemorrhoids and other rectal lesions at very low CO2 laser power levels with a miniature `SwiftLaser' optomechanical flashscanner. Increased speed with excellent control, very shallow thermal damage, and less postoperative pain are the main advantages of the flashscan technology in rectal surgery.

  9. Terahertz metasurfaces with a high refractive index enhanced by the strong nearest neighbor coupling.

    PubMed

    Tan, Siyu; Yan, Fengping; Singh, Leena; Cao, Wei; Xu, Ningning; Hu, Xiang; Singh, Ranjan; Wang, Mingwei; Zhang, Weili

    2015-11-02

    The realization of high refractive index is of significant interest in optical imaging with enhanced resolution. Strongly coupled subwavelength resonators were proposed and demonstrated at both optical and terahertz frequencies to enhance the refractive index due to large induced dipole moment in meta-atoms. Here, we report an alternative design for flexible free-standing terahertz metasurface in the strong coupling regime where we experimentally achieve a peak refractive index value of 14.36. We also investigate the impact of the nearest neighbor coupling in the form of frequency tuning and enhancement of the peak refractive index. We provide an analytical circuit model to explain the impact of geometrical parameters and coupling on the effective refractive index of the metasurface. The proposed meta-atom structure enables tailoring of the peak refractive index based on nearest neighbor coupling and this property offers tremendous design flexibility for transformation optics and other index-gradient devices at terahertz frequencies.

  10. Refractive errors.

    PubMed

    Schiefer, Ulrich; Kraus, Christina; Baumbach, Peter; Ungewiß, Judith; Michels, Ralf

    2016-10-14

    All over the world, refractive errors are among the most frequently occuring treatable distur - bances of visual function. Ametropias have a prevalence of nearly 70% among adults in Germany and are thus of great epidemiologic and socio-economic relevance. In the light of their own clinical experience, the authors review pertinent articles retrieved by a selective literature search employing the terms "ametropia, "anisometropia," "refraction," "visual acuity," and epidemiology." In 2011, only 31% of persons over age 16 in Germany did not use any kind of visual aid; 63.4% wore eyeglasses and 5.3% wore contact lenses. Refractive errors were the most common reason for consulting an ophthalmologist, accounting for 21.1% of all outpatient visits. A pinhole aperture (stenopeic slit) is a suitable instrument for the basic diagnostic evaluation of impaired visual function due to optical factors. Spherical refractive errors (myopia and hyperopia), cylindrical refractive errors (astigmatism), unequal refractive errors in the two eyes (anisometropia), and the typical optical disturbance of old age (presbyopia) cause specific functional limitations and can be detected by a physician who does not need to be an ophthalmologist. Simple functional tests can be used in everyday clinical practice to determine quickly, easily, and safely whether the patient is suffering from a benign and easily correctable type of visual impairment, or whether there are other, more serious underlying causes.

  11. Experimental assessment of theory for refraction of sound by a shear layer

    NASA Technical Reports Server (NTRS)

    Schlinker, R. H.; Amiet, R. K.

    1978-01-01

    The refraction angle and amplitude changes associated with sound transmission through a circular, open-jet shear layer were studied in a 0.91 m diameter open jet acoustic research tunnel. Free stream Mach number was varied from 0.1 to 0.4. Good agreement between refraction angle correction theory and experiment was obtained over the test Mach number, frequency and angle measurement range for all on-axis acoustic source locations. For off-axis source positions, good agreement was obtained at a source-to-shear layer separation distance greater than the jet radius. Measureable differences between theory and experiment occurred at a source-to-shear layer separation distance less than one jet radius. A shear layer turbulence scattering experiment was conducted at 90 deg to the open jet axis for the same free stream Mach numbers and axial source locations used in the refraction study. Significant discrete tone spectrum broadening and tone amplitude changes were observed at open jet Mach numbers above 0.2 and at acoustic source frequencies greater than 5 kHz. More severe turbulence scattering was observed for downstream source locations.

  12. Aberrant tendinous chords with tethering of the tricuspid leaflets: a congenital anomaly causing severe tricuspid regurgitation.

    PubMed

    Kobza, R; Kurz, D J; Oechslin, E N; Prêtre, R; Zuber, M; Vogt, P; Jenni, R

    2004-03-01

    To define the entity of tricuspid regurgitation caused by tethering of the tricuspid valve leaflets by aberrant tendinous chords. Retrospective study. Tertiary care centre (university teaching hospital). 10 patients with unexplained severe tricuspid regurgitation. The last 13 500 echocardiographic studies from our facility were reviewed to identify patients with severe unexplained tricuspid regurgitation. Tethering was defined by the presence of aberrant tendinous chords to the tricuspid valve leaflets limiting the mobility of the tricuspid leaflet and resulting in incomplete coaptation and apical displacement of the regurgitant jet origin. Aberrant tendinous chords were defined as those inserting at the clear zone of the tricuspid leaflet and not originating from the papillary muscle. Patients fulfilling the diagnostic criteria for Ebstein's anomaly were excluded. 10 patients with aberrant tendinous chords tethering one or more tricuspid valve leaflets were identified. There were short non-aberrant tendinous chords in seven patients, five of whom also had right ventricular or tricuspid annulus dilatation. Tethering of the tricuspid valve leaflets by aberrant tendinous chords can be the sole mechanism of congenital tricuspid regurgitation. It is often associated with short non-aberrant tendinous chords, which may develop secondary to right ventricular or tricuspid annulus dilatation. Awareness of tethering as a cause of tricuspid regurgitation may be important in planning reconstructive surgery.

  13. Focusing hard X-rays with old LPs

    NASA Astrophysics Data System (ADS)

    Cederström, Björn; Cahn, Robert N.; Danielsson, Mats; Lundqvist, Mats; Nygren, David R.

    2000-04-01

    We have found that two sections cut from a vinyl long-playing record can form a spherical aberration-free refractive lens for hard X-rays. Our manufactured saw-tooth refractive lens has a focal length of 22 cm for 23-keV X-rays. The low cost and short focal length of this lens make it feasible for use in small-scale experiments with conventional X-ray tubes.

  14. Refractive errors in children and adolescents in Bucaramanga (Colombia).

    PubMed

    Galvis, Virgilio; Tello, Alejandro; Otero, Johanna; Serrano, Andrés A; Gómez, Luz María; Castellanos, Yuly

    2017-01-01

    The aim of this study was to establish the frequency of refractive errors in children and adolescents aged between 8 and 17 years old, living in the metropolitan area of Bucaramanga (Colombia). This study was a secondary analysis of two descriptive cross-sectional studies that applied sociodemographic surveys and assessed visual acuity and refraction. Ametropias were classified as myopic errors, hyperopic errors, and mixed astigmatism. Eyes were considered emmetropic if none of these classifications were made. The data were collated using free software and analyzed with STATA/IC 11.2. One thousand two hundred twenty-eight individuals were included in this study. Girls showed a higher rate of ametropia than boys. Hyperopic refractive errors were present in 23.1% of the subjects, and myopic errors in 11.2%. Only 0.2% of the eyes had high myopia (≤-6.00 D). Mixed astigmatism and anisometropia were uncommon, and myopia frequency increased with age. There were statistically significant steeper keratometric readings in myopic compared to hyperopic eyes. The frequency of refractive errors that we found of 36.7% is moderate compared to the global data. The rates and parameters statistically differed by sex and age groups. Our findings are useful for establishing refractive error rate benchmarks in low-middle-income countries and as a baseline for following their variation by sociodemographic factors.

  15. Prosthetic Rehabilitation After Fibular Free Flap Surgery of Mandibular Defects in a Patient With Oral Squamous Cell Carcinoma.

    PubMed

    Yoon, Hyung-In

    2016-10-01

    This report is to present the treatment procedure and clinical considerations of prosthodontic management of a patient who had undergone a partial mandibulectomy and fibular free flap surgery. A 59-year-old man with a squamous cell carcinoma received a partial mandibular resection. Microsurgical reconstruction with a fibular free flap surgery and implant-supported zirconia-fixed prosthesis produced by computer-aided manufacturing led to successful results for the oral rehabilitation of mandibular defects. The implant-supported zirconia-fixed prosthesis can be recommended for use in patients with mandibulectomy and fibular free flaps. Close cooperation between the surgeon and the prosthodontist is mandatory for the satisfaction of the patient.

  16. Refractive Errors

    MedlinePlus

    ... and lens of your eye helps you focus. Refractive errors are vision problems that happen when the shape ... cornea, or aging of the lens. Four common refractive errors are Myopia, or nearsightedness - clear vision close up ...

  17. Refraction test

    MedlinePlus

    ... purpose is to determine whether you have a refractive error (a need for glasses or contact lenses). For ... glasses or contact lenses) is normal, then the refractive error is zero (plano) and your vision should be ...

  18. Graphical Approach to Fresnel's Equations for Reflection and Refraction of Light.

    ERIC Educational Resources Information Center

    Doyle, William T.

    1980-01-01

    Develops a coordinate-free approach to Fresnel's equations for the reflection and refraction of light at a plane interface. Describes a graphical construction for finding the vector amplitudes of the reflected and transmitted waves. (Author/CS)

  19. Optimal Perioperative Care in Major Head and Neck Cancer Surgery With Free Flap Reconstruction: A Consensus Review and Recommendations From the Enhanced Recovery After Surgery Society.

    PubMed

    Dort, Joseph C; Farwell, D Gregory; Findlay, Merran; Huber, Gerhard F; Kerr, Paul; Shea-Budgell, Melissa A; Simon, Christian; Uppington, Jeffrey; Zygun, David; Ljungqvist, Olle; Harris, Jeffrey

    2017-03-01

    Head and neck cancers often require complex, labor-intensive surgeries, especially when free flap reconstruction is required. Enhanced recovery is important in this patient population but evidence-based protocols on perioperative care for this population are lacking. To provide a consensus-based protocol for optimal perioperative care of patients undergoing head and neck cancer surgery with free flap reconstruction. Following endorsement by the Enhanced Recovery After Surgery (ERAS) Society to develop this protocol, a systematic review was conducted for each topic. The PubMed and Cochrane databases were initially searched to identify relevant publications on head and neck cancer surgery from 1965 through April 2015. Consistent key words for each topic included "head and neck surgery," "pharyngectomy," "laryngectomy," "laryngopharyngectomy," "neck dissection," "parotid lymphadenectomy," "thyroidectomy," "oral cavity resection," "glossectomy," and "head and neck." The final selection of literature included meta-analyses and systematic reviews as well as randomized controlled trials where available. In the absence of high-level data, case series and nonrandomized studies in head and neck cancer surgery patients or randomized controlled trials and systematic reviews in non-head and neck cancer surgery patients, were considered. An international panel of experts in major head and neck cancer surgery and enhanced recovery after surgery reviewed and assessed the literature for quality and developed recommendations for each topic based on the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) system. All recommendations were graded following a consensus discussion among the expert panel. The literature search, including a hand search of reference lists, identified 215 relevant publications that were considered to be the best evidence for the topic areas. A total of 17 topic areas were identified for inclusion in the protocol for the perioperative

  20. Uncorrected refractive errors.

    PubMed

    Naidoo, Kovin S; Jaggernath, Jyoti

    2012-01-01

    Global estimates indicate that more than 2.3 billion people in the world suffer from poor vision due to refractive error; of which 670 million people are considered visually impaired because they do not have access to corrective treatment. Refractive errors, if uncorrected, results in an impaired quality of life for millions of people worldwide, irrespective of their age, sex and ethnicity. Over the past decade, a series of studies using a survey methodology, referred to as Refractive Error Study in Children (RESC), were performed in populations with different ethnic origins and cultural settings. These studies confirmed that the prevalence of uncorrected refractive errors is considerably high for children in low-and-middle-income countries. Furthermore, uncorrected refractive error has been noted to have extensive social and economic impacts, such as limiting educational and employment opportunities of economically active persons, healthy individuals and communities. The key public health challenges presented by uncorrected refractive errors, the leading cause of vision impairment across the world, require urgent attention. To address these issues, it is critical to focus on the development of human resources and sustainable methods of service delivery. This paper discusses three core pillars to addressing the challenges posed by uncorrected refractive errors: Human Resource (HR) Development, Service Development and Social Entrepreneurship.

  1. Uncorrected refractive errors

    PubMed Central

    Naidoo, Kovin S; Jaggernath, Jyoti

    2012-01-01

    Global estimates indicate that more than 2.3 billion people in the world suffer from poor vision due to refractive error; of which 670 million people are considered visually impaired because they do not have access to corrective treatment. Refractive errors, if uncorrected, results in an impaired quality of life for millions of people worldwide, irrespective of their age, sex and ethnicity. Over the past decade, a series of studies using a survey methodology, referred to as Refractive Error Study in Children (RESC), were performed in populations with different ethnic origins and cultural settings. These studies confirmed that the prevalence of uncorrected refractive errors is considerably high for children in low-and-middle-income countries. Furthermore, uncorrected refractive error has been noted to have extensive social and economic impacts, such as limiting educational and employment opportunities of economically active persons, healthy individuals and communities. The key public health challenges presented by uncorrected refractive errors, the leading cause of vision impairment across the world, require urgent attention. To address these issues, it is critical to focus on the development of human resources and sustainable methods of service delivery. This paper discusses three core pillars to addressing the challenges posed by uncorrected refractive errors: Human Resource (HR) Development, Service Development and Social Entrepreneurship. PMID:22944755

  2. Automatic phase aberration compensation for digital holographic microscopy based on deep learning background detection.

    PubMed

    Nguyen, Thanh; Bui, Vy; Lam, Van; Raub, Christopher B; Chang, Lin-Ching; Nehmetallah, George

    2017-06-26

    We propose a fully automatic technique to obtain aberration free quantitative phase imaging in digital holographic microscopy (DHM) based on deep learning. The traditional DHM solves the phase aberration compensation problem by manually detecting the background for quantitative measurement. This would be a drawback in real time implementation and for dynamic processes such as cell migration phenomena. A recent automatic aberration compensation approach using principle component analysis (PCA) in DHM avoids human intervention regardless of the cells' motion. However, it corrects spherical/elliptical aberration only and disregards the higher order aberrations. Traditional image segmentation techniques can be employed to spatially detect cell locations. Ideally, automatic image segmentation techniques make real time measurement possible. However, existing automatic unsupervised segmentation techniques have poor performance when applied to DHM phase images because of aberrations and speckle noise. In this paper, we propose a novel method that combines a supervised deep learning technique with convolutional neural network (CNN) and Zernike polynomial fitting (ZPF). The deep learning CNN is implemented to perform automatic background region detection that allows for ZPF to compute the self-conjugated phase to compensate for most aberrations.

  3. EDITORIAL: Sensitive structures: refractive indices in nanotechnology Sensitive structures: refractive indices in nanotechnology

    NASA Astrophysics Data System (ADS)

    Demming, Anna

    2012-12-01

    Refractive index effects using nanoscale systems are frequently applied in new imaging, sensing and even visibility cloaking technology. In this issue, researchers in Japan use simulations and experiments to describe the confinement of optical vortices in nanoscale fin structures and the sensitivity of these systems to the refractive index of the surrounding media [1]. The effects of refraction as light rays pass between different media were recorded as long ago as the first century AD, by Ptolemy [2]. Over the following centuries the phenomena inspired Ibn Sahl in 984 [3], Thomas Harriot in 1602 [4], Willebrord Snellius in 1621 [5] and Rene Descartes in 1637 [6] to independently derive the more accurate and elegant equation for refraction so familiar to us today. Recent studies of the interactions between light and matter continue to reveal a wealth of phenomena that originate in the effects of the refractive indices of materials. Nanostructures can be used to manipulate conditions that affect the refractive indices of materials, such as temperature. A E Aliev et al at the University of Texas reported a striking demonstration of temperature-dependent refractive index effects using a free-standing, highly aligned carbon nanotube aerogel sheet [7]. They used the extremely low thermal capacitance and high heat transfer ability of transparent carbon nanotube sheets to enable high-frequency modulation of the sheet temperature over an enormous temperature range. The resulting sharp, rapidly changing gradient of the refractive index in the surrounding liquid or gas makes objects seem to disappear and can be used for visibility cloaking. Light-matter interaction resonances, where light is confined at the nanoscale, can be extremely sensitive to changes in the refractive index of the surrounding media [8], even allowing single-molecule detection [9]. Plasmons, the collective oscillations of electrons in response to incident light, are a typical example. Researchers at Rice

  4. A comparison of preservative-free diclofenac and preserved diclofenac eye drops after cataract surgery in patients with diabetic retinopathy.

    PubMed

    Yasuda, Kanako; Miyazawa, Akiko; Shimura, Masahiko

    2012-06-01

    The aim of this study was to compare the anti-inflammatory efficacy of preservative-free and preserved 0.1% diclofenac eye drops for the management of postoperative inflammation after cataract surgery in patients with nonproliferative diabetic retinopathy and in normal controls. Forty-two diabetic patients and 50 normal control patients who underwent small-incision phacoemulsification cataract surgery bilaterally received topical preservative-free diclofenac in 1 eye and preserved diclofenac in the other eye. The corrected distance visual acuity (CDVA) as determined by a logarithm of the minimum angle of resolution (logMAR) chart, intraocular pressure (IOP), foveal thickness (FT) using optical coherence tomography (OCT), and the anterior chamber flare (ACF) score measured with a laser flare cell meter were monitored for 12 weeks after surgery. In the eyes with diabetic retinopathy, there were no significant differences in CDVA, IOP, FT, and ACF score between the right and left eyes at the initial exam. After cataract surgery, changes in CDVA, IOP, and FT were not influenced by the preservative in the diclofenac eye drops. In contrast, the ACF score in the eyes treated with preserved diclofenac showed slower recovery from postoperative inflammation than the eyes treated with preservative-free diclofenac. In the normal control eyes, similar but milder changes were observed in each of the clinical parameters. Because preservative suppressed the anti-inflammatory efficacy of topical diclofenac after cataract surgery, preservative-free diclofenac may have an improved safety profile during postoperative treatment, especially in patients with diabetic retinopathy.

  5. All-angle negative refraction and active flat lensing of ultraviolet light.

    PubMed

    Xu, Ting; Agrawal, Amit; Abashin, Maxim; Chau, Kenneth J; Lezec, Henri J

    2013-05-23

    Decades ago, Veselago predicted that a material with simultaneously negative electric and magnetic polarization responses would yield a 'left-handed' medium in which light propagates with opposite phase and energy velocities--a condition described by a negative refractive index. He proposed that a flat slab of left-handed material possessing an isotropic refractive index of -1 could act like an imaging lens in free space. Left-handed materials do not occur naturally, and it has only recently become possible to achieve a left-handed response using metamaterials, that is, electromagnetic structures engineered on subwavelength scales to elicit tailored polarization responses. So far, left-handed responses have typically been implemented using resonant metamaterials composed of periodic arrays of unit cells containing inductive-capacitive resonators and conductive wires. Negative refractive indices that are isotropic in two or three dimensions at microwave frequencies have been achieved in resonant metamaterials with centimetre-scale features. Scaling the left-handed response to higher frequencies, such as infrared or visible, has been done by shrinking critical dimensions to submicrometre scales by means of top-down nanofabrication. This miniaturization has, however, so far been achieved at the cost of reduced unit-cell symmetry, yielding a refractive index that is negative along only one axis. Moreover, lithographic scaling limits have so far precluded the fabrication of resonant metamaterials with left-handed responses at frequencies beyond the visible. Here we report the experimental implementation of a bulk metamaterial with a left-handed response to ultraviolet light. The structure, based on stacked plasmonic waveguides, yields an omnidirectional left-handed response for transverse magnetic polarization characterized by a negative refractive index. By engineering the structure to have a refractive index close to -1 over a broad angular range, we achieve Veselago

  6. Interpreting Chromosome Aberration Spectra

    NASA Technical Reports Server (NTRS)

    Levy, Dan; Reeder, Christopher; Loucas, Bradford; Hlatky, Lynn; Chen, Allen; Cornforth, Michael; Sachs, Rainer

    2007-01-01

    Ionizing radiation can damage cells by breaking both strands of DNA in multiple locations, essentially cutting chromosomes into pieces. The cell has enzymatic mechanisms to repair such breaks; however, these mechanisms are imperfect and, in an exchange process, may produce a large-scale rearrangement of the genome, called a chromosome aberration. Chromosome aberrations are important in killing cells, during carcinogenesis, in characterizing repair/misrepair pathways, in retrospective radiation biodosimetry, and in a number of other ways. DNA staining techniques such as mFISH ( multicolor fluorescent in situ hybridization) provide a means for analyzing aberration spectra by examining observed final patterns. Unfortunately, an mFISH observed final pattern often does not uniquely determine the underlying exchange process. Further, resolution limitations in the painting protocol sometimes lead to apparently incomplete final patterns. We here describe an algorithm for systematically finding exchange processes consistent with any observed final pattern. This algorithm uses aberration multigraphs, a mathematical formalism that links the various aspects of aberration formation. By applying a measure to the space of consistent multigraphs, we will show how to generate model-specific distributions of aberration processes from mFISH experimental data. The approach is implemented by software freely available over the internet. As a sample application, we apply these algorithms to an aberration data set, obtaining a distribution of exchange cycle sizes, which serves to measure aberration complexity. Estimating complexity, in turn, helps indicate how damaging the aberrations are and may facilitate identification of radiation type in retrospective biodosimetry.

  7. Clinical outcomes of laser in situ keratomileusis with an aberration-neutral profile centered on the corneal vertex comparing vector planning with manifest refraction planning for the treatment of myopic astigmatism.

    PubMed

    Arbelaez, Maria Clara; Alpins, Noel; Verma, Shwetabh; Stamatelatos, George; Arbelaez, Juan Guillermo; Arba-Mosquera, Samuel

    2017-12-01

    To evaluate clinical outcomes of laser in situ keratomileusis (LASIK) with an aberration-neutral profile centered on the estimated visual axis (considering 70% of the pupil offset toward the corneal vertex) comparing vector planning with manifest refraction planning for the treatment of myopic astigmatism. Muscat Eye Laser Center, Muscat, Sultanate of Oman, Muscat, Oman. Retrospective case series. The outcomes were evaluated at a 6-month follow-up in eyes showing ocular residual astigmatism (ORA) over 0.75 diopters (D) preoperatively. Eighty-five treatments were based on manifest astigmatism (preoperative sphere -2.11 D ± 1.3 [SD], cylinder -0.90 ± 1.0 D), and 79 treatments were based on vector planning (preoperative sphere -2.46 ± 1.5 D, cylinder -0.78 ± 0.79 D). At a 6-month follow-up, 128 patients (164 eyes) were evaluated and no significant differences were observed between the 2 groups in terms of difference between corrected distance visual acuity and uncorrected distance visual acuity (UDVA) (P = .1, t test and Fisher exact test Snellen lines 1 or better, P = .4) and postoperative UDVA (P = .05, t test and Fisher exact test for UDVA 20/16 or better, P = .3). Significant differences were observed between the 2 groups in terms of achieved spherical equivalent (P = .04), corneal toricity, and ORA (P < .001, t test and Fisher exact test for ORA ≤0.75 D, P < .001). Performing LASIK for myopic astigmatism with the vector planning approach resulted in comparable visual outcomes to manifest refraction planning. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  8. Computerized Scheimpflug densitometry as a measure of corneal optical density after excimer laser refractive surgery in myopic eyes.

    PubMed

    Cennamo, Gilda; Forte, Raimondo; Aufiero, Bernardino; La Rana, Agostino

    2011-08-01

    To evaluate changes in anterior corneal optical density and the refractive index after photorefractive keratectomy (PRK) using a rotating Scheimpflug system. Department of Ophthalmology, University Federico II, Naples, Italy. Comparative case series. Anterior corneal optical density was evaluated with a rotating Scheimpflug system at baseline and 3 months and 12 months after PRK in eyes with a refractive error between -6.00 diopters (D) and -12.00 D (study group). A control group of unoperated eyes with the same refraction range was used to calculate corneal optical density and the Gladstone-Dale constant in unoperated eyes using the Gladstone-Dale formula. In the study group, changes in the anterior corneal optical density were evaluated over time and variations in the anterior corneal refractive index were obtained using the Gladstone-Dale constant. The study group comprised 37 eyes and the control group, 200 eyes. In the study group, the mean anterior corneal optical density and refractive index, respectively, were 27.71 ± 4.39 and 1.360 ± 0.05 at baseline, 37.812 ± 12.31 and 1.491 ± 0.16 after 3 months (P<.001 compared with baseline), and 26.29 ± 4.93 and 1.341 ± 0.06 after 12 months (P=.03 compared with baseline). The mean corneal optical density in the control group was 27.71 ± 4.31 (SD), and the resultant Gladstone-Dale constant was 0.013. An early increase and a subsequent reduction in anterior corneal optical density and the refractive index were present in myopic eyes during 1 year after PRK. Copyright © 2011 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  9. Three-dimensional ray tracing for refractive correction of human eye ametropies

    NASA Astrophysics Data System (ADS)

    Jimenez-Hernandez, J. A.; Diaz-Gonzalez, G.; Trujillo-Romero, F.; Iturbe-Castillo, M. D.; Juarez-Salazar, R.; Santiago-Alvarado, A.

    2016-09-01

    Ametropies of the human eye, are refractive defects hampering the correct imaging on the retina. The most common ways to correct them is by means of spectacles, contact lenses, and modern methods as laser surgery. However, in any case it is very important to identify the ametropia grade for designing the optimum correction action. In the case of laser surgery, it is necessary to define a new shape of the cornea in order to obtain the wanted refractive correction. Therefore, a computational tool to calculate the focal length of the optical system of the eye versus variations on its geometrical parameters is required. Additionally, a clear and understandable visualization of the evaluation process is desirable. In this work, a model of the human eye based on geometrical optics principles is presented. Simulations of light rays coming from a punctual source at six meter from the cornea are shown. We perform a ray-tracing in three dimensions in order to visualize the focusing regions and estimate the power of the optical system. The common parameters of ametropies can be easily modified and analyzed in the simulation by an intuitive graphic user interface.

  10. Prevention of Oral Candidiasis After Free Flap Surgery: Role of 3% Sodium Bicarbonate Saline in Oral Care.

    PubMed

    Yang, Yue; Zhang, Fang; Lyu, Xin; Yan, Zhimin; Hua, Hong; Peng, Xin

    2017-03-01

    Relevant reports about oral candidiasis status and prevention measures after free flap surgery for the oral and maxillofacial region are limited. The present study explored oral candidiasis status after free flap surgery and its prevention through a prospective comparative study. One hundred four patients were randomized to a control group (n = 54) and an experimental group (n = 50). Compared with the control group, the experimental group was provided an additional 3% sodium bicarbonate saline solution for oral care after free flap surgery. The incidence of oral candidiasis was evaluated by objective examination (saliva culture and salivary pH measurement) and subjective evaluation (clinical signs of oral candidiasis) at admission and from postoperative days 1 to 14. The salivary pH values of the 2 groups were lower than the normal salivary pH, and postoperative salivary pH values were always lower than the active range of oral lysozymes in the control group. The salivary pH values of the experimental group were higher than those of the control group from postoperative days 6 to 14 (P < .05). The incidence of oral candidiasis was 13.0% in the control group, which was higher than that in the experimental group (2.0%; P < .05). In addition, advanced age, use of a free flap for the simultaneous repair of intraoral and paraoral defects, and a combination of 2 antibiotic types were risk factors for oral candidiasis. Oral candidiasis was common in patients after free flap reconstruction surgery, and the use of 3% sodium bicarbonate saline solution for oral care effectively prevented it. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  11. Nonlocal nonlinear refractive index of gold nanoparticles synthesized by ascorbic acid reduction: comparison of fitting models.

    PubMed

    Balbuena Ortega, A; Arroyo Carrasco, M L; Méndez Otero, M M; Gayou, V L; Delgado Macuil, R; Martínez Gutiérrez, H; Iturbe Castillo, M D

    2014-12-12

    In this paper, the nonlinear refractive index of colloidal gold nanoparticles under continuous wave illumination is investigated with the z -scan technique. Gold nanoparticles were synthesized using ascorbic acid as reductant, phosphates as stabilizer and cetyltrimethylammonium chloride (CTAC) as surfactant agent. The nanoparticle size was controlled with the CTAC concentration. Experiments changing incident power and sample concentration were done. The experimental z -scan results were fitted with three models: thermal lens, aberrant thermal lens and the nonlocal model. It is shown that the nonlocal model reproduces with exceptionally good agreement; the obtained experimental behaviour.

  12. Refractive errors in a Brazilian population: age and sex distribution.

    PubMed

    Ferraz, Fabio H; Corrente, José E; Opromolla, Paula; Padovani, Carlos Roberto; Schellini, Silvana A

    2015-01-01

    To determine the prevalence of refractive errors and their distribution according to age and sex in a Brazilian population. This population-based cross-sectional study involved 7654 Brazilian inhabitants of nine municipalities of Sao Paulo State, Brazil, between March 2004 and July 2005. Participants aged >1 year were selected using a random, stratified, household cluster sampling technique, excluding individuals with previous refractive or cataract surgery. Myopia was defined as spherical equivalent (SE) ≤-0.5D, high myopia as SE ≤-3.0D, hyperopia as SE ≥+0.5D, high hyperopia as SE ≥+3D, astigmatism as ≤-0.5DC and anisometropia as ≥1.0D difference between eyes. Age, sex, complaints and a comprehensive eye examination including cycloplegic refraction test were collected and analysed using descriptive analysis, univariate and multivariate methods. The prevalence of astigmatism was 59.7%, hyperopia 33.8% and myopia was 25.3%. Astigmatism had a progressive increase with age. With-the-rule (WTR) axes of astigmatism were more frequently observed in the young participants and the against-the-rule (ATR) axes were more frequent in the older subjects. The onset of myopia occurred more frequently between the 2nd and 3rd decades of life. Anisometropia showed a prevalence of 13.2% (95% CI 12.4-13.9; p < 0.001). There was an association between age and all types of refractive error and hyperopia was also associated with sex. Hyperopia was associated with WTR axes (odds ratio 0.73; 95% CI: 0.6-0.8; p < 0.001) and myopia with ATR axes (odds ratio 0.66; 95% CI: 0.6-0.8; p < 0.001). Astigmatism was the most prevalent refractive error in a Brazilian population. There was a strong relationship between age and all refractive errors and between hyperopia and sex. WTR astigmatism was more frequently associated with hyperopia and ATR astigmatism with myopia. The vast majority of participants had low-grade refractive error, which favours planning aimed at correction of

  13. Tuberous sclerosis: aberrant metabolism of ornithine, proline and glutamate in cultured fibroblasts.

    PubMed

    Tanaka, H; Nakazawa, K; Arima, M; Hayashi, A

    1987-01-01

    To investigate aberrant metabolism of proline (Pro) and its precursors in tuberous sclerosis (TS), 6, 7 and 5 strains of control, TS (normal skin) and TS (tumor) fibroblasts, respectively, were cultured in Eagle's MEM containing dialyzed fetal bovine serum with or without 0.1 mM ornithine (Orn). Ornithine aminotransferase (OAT) activity was decreased in TS, especially in TS (tumor) after mild sonication treatment. The yield of the OAT protein was inhibited in TS (tumor) when cultured without Orn. Free glutamate (Glu) in the medium was significantly increased in TS (tumor). Free proline (Pro) in cells was significantly decreased in TS (tumor) when cultured with Orn, but protein-bound Pro was not. The relative concentration of free Glu to glutamine (Gln) in the medium and that of free Glu to Pro in cells cultured with Orn were increased in TS (tumor). These results suggest that the requirement for Orn, increased turnover of Pro to Glu and increased elimination of Glu into the medium occur in TS (tumor). Aberrant regulation or turnover of Pro and Glu metabolism may occur in TS, especially in tumor cells.

  14. Cataract Surgery From 1918 to the Present and Future-Just Imagine!

    PubMed

    Olson, Randall J

    2018-01-01

    To review the history of cataract surgery over the past 100 years, and to offer predictions about new developments that may occur during the next 50 years. Interpretive essay. Review of historical literature and author experiences pertaining to cataract surgery, with commentary and perspective. By this time, cataract surgery has advanced to the point that Kelman's introduction of phacoemulsification and use of intraocular lenses (IOLs), both very controversial when initially introduced, have become state of the art. Outpatient surgery, minimally limited mobility, sutureless incisions, and topical anesthesia also have become key components of standard treatment. The author envisions availability of medications for nuclear sclerosis and presbyopia, expansion of lens surgery for refractive purposes with postsurgical adjustment and unprecedented precision, increased mechanization of lens removal with emphasis on uncomplicated surgery rather than refractive precision, and accommodating IOLs all becoming standard. Acknowledging and appreciating the past contributions of pioneers in cataract surgery is vital to understanding the development of today's clinical care. Clues as to the future do help give us a possible scenario worthy of such conjecture. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Aberrant tendinous chords with tethering of the tricuspid leaflets: a congenital anomaly causing severe tricuspid regurgitation

    PubMed Central

    Kobza, R; Kurz, D J; Oechslin, E N; Prêtre, R; Zuber, M; Vogt, P; Jenni, R

    2004-01-01

    Objective: To define the entity of tricuspid regurgitation caused by tethering of the tricuspid valve leaflets by aberrant tendinous chords. Design: Retrospective study. Setting: Tertiary care centre (university teaching hospital). Patients: 10 patients with unexplained severe tricuspid regurgitation. Methods: The last 13 500 echocardiographic studies from our facility were reviewed to identify patients with severe unexplained tricuspid regurgitation. Tethering was defined by the presence of aberrant tendinous chords to the tricuspid valve leaflets limiting the mobility of the tricuspid leaflet and resulting in incomplete coaptation and apical displacement of the regurgitant jet origin. Aberrant tendinous chords were defined as those inserting at the clear zone of the tricuspid leaflet and not originating from the papillary muscle. Patients fulfilling the diagnostic criteria for Ebstein’s anomaly were excluded. Results: 10 patients with aberrant tendinous chords tethering one or more tricuspid valve leaflets were identified. There were short non-aberrant tendinous chords in seven patients, five of whom also had right ventricular or tricuspid annulus dilatation. Conclusions: Tethering of the tricuspid valve leaflets by aberrant tendinous chords can be the sole mechanism of congenital tricuspid regurgitation. It is often associated with short non-aberrant tendinous chords, which may develop secondary to right ventricular or tricuspid annulus dilatation. Awareness of tethering as a cause of tricuspid regurgitation may be important in planning reconstructive surgery. PMID:14966058

  16. An analysis of the factors influencing the residual refractive astigmatism after cataract surgery with toric intraocular lenses.

    PubMed

    Savini, Giacomo; Næser, Kristian

    2015-01-13

    To investigate the influence of posterior corneal astigmatism, surgically-induced corneal astigmatism (SICA), intraocular lens (IOL) orientation, and effective lens position on the refractive outcome of toric IOLs. Five models were prospectively investigated. Keratometric astigmatism and an intended SICA of 0.2 diopters (D) were entered into model 1. Total corneal astigmatism, measured by a rotating Scheimpflug camera, was used instead of keratometric astigmatism in model 2. The mean postoperative SICA, the actual postoperative IOL orientation, and the influence of the effective lens position were added, respectively, into models 3, 4, and 5. Astigmatic data were vectorially described by meridional and torsional powers. A set of equations was developed to describe the error in refractive astigmatism (ERA) as the difference between the postoperative refractive astigmatism and the target refractive astigmatism. We enrolled 40 consecutive eyes. In model 1, ERA calculations revealed significant cylinder overcorrection in with-the-rule (WTR) eyes (meridional power = -0.59 ± 0.34 D, P < 0.0001) and undercorrection in against-the-rule (ATR) eyes (0.32 ± 0.42 D, P = 0.01). When total corneal astigmatism was used instead of keratometric astigmatism (model 2), the ERA meridional power decreased in WTR (-0.13 ± 0.42 D) and ATR (0.07 ± 0.59 D) eyes, both values being not statistically significant. Models 3 to 5 did not lead to significant improvement. Posterior corneal astigmatism exerts the highest influence on the ERA after toric IOL implantation. Basing calculations on total corneal astigmatism rather than keratometric astigmatism improves the prediction of the residual refractive astigmatism. Copyright 2015 The Association for Research in Vision and Ophthalmology, Inc.

  17. Astigmatic Changes after Horizontal Rectus Muscle Surgery in Intermittent Exotropia

    PubMed Central

    Hong, Seung Woo

    2012-01-01

    Purpose To evaluate the changes of refractive astigmatism after horizontal rectus muscle surgery in intermittent exotropic children. Methods Sixty-nine exotropic patients were retrospectively reviewed. Of those, 35 patients received unilateral lateral rectus recession (BLR group, 35 eyes) and 34 patients received unilateral lateral rectus recession and medial rectus resection (R&R group, 34 eyes). Non-cycloplegic refractions were measured until 6 months postoperatively. Spherical equivalent (SE), J0 and J45 using power vectors were calculated to determine and compare the changes of refractive astigmatism and axis in both groups. Results SE significantly decreased after surgery for the first week and did not changed thereafter in both groups (p = 0.000 and p = 0.018, respectively). In BLR group, J0 showed significant changes at the first week and 1 month after surgery (p = 0.005 and p = 0.016, respectively), but in R&R group, J0 changed significantly between 1 week and 3 months postoperatively (p = 0.023 and p = 0.016, respectively). J45 did not change significantly as time passed in both groups (all p > 0.05). There was no statistically significant difference in the magnitude of changes in SE, J0 and J45 between the two groups after the 6-month follow-up (p = 0.500, p = 0.244 and p = 0.202, respectively). Conclusions Horizontal rectus muscle surgery in intermittent exotropic children tends to induce a statistically significant change in astigmatism in the with-the-rule direction and myopic shift in SE. This astigmatism change seems to occur within the first 3 months after surgery. Thus, astigmatism induced by surgery should be checked and corrected at least 3 months after horizontal strabismus surgery. PMID:23204799

  18. Association of Body Mass Index With Infectious Complications in Free Tissue Transfer for Head and Neck Reconstructive Surgery

    PubMed Central

    Khan, Mohemmed N.; Russo, Jack; Spivack, John; Pool, Christopher; Likhterov, Ilya; Teng, Marita; Genden, Eric M.

    2017-01-01

    Importance Elevated body mass index (BMI) has been proposed as a risk factor for morbidity and mortality among patients undergoing surgery. Conversely, an elevated BMI may confer a protective effect on perioperative morbidity. Objective To examine whether an elevated BMI is an independent risk factor for perioperative and postoperative infectious complications after free tissue transfer in head and neck reconstructive surgery. Design, Setting, and Participants This cohort study included patients undergoing major head and neck surgery requiring free tissue transfer at a tertiary care center. Data were collected for 415 patients treated from January 1, 2007, through December 31, 2014. Main Outcomes and Measures The outcome of interest was postoperative infection and complications after head and neck surgery using free flaps. Covariates considered for adjustment in the statistical model included alcohol consumption (defined as >5 drinks per day [eg, 360 mL of beer, 150 mL of wine, or 45 mL of 80-proof spirits]), type 2 diabetes, prior radiotherapy, anesthesia time, hypothyroidism, smoking, American Society of Anesthesiologists classification, antibiotic regimen received (defined as a standard regimen of a first- or second-generation cephalosporin with or without metronidazole hydrochloride vs an alternative antibiotic regimen for patients allergic to penicillin), and primary surgeon. A multiple logistic regression model was developed for the incidence of the infection end point as a function of elevated BMI (>30.0). Results Among the 415 patients included in this study (277 men [66.7%] and 138 women [33.2%]; mean [SD] age, 61.5 [13.9] years), type 2 diabetes and use of an alternative antibiotic regimen were found to be independently associated with increased infectious complications after free flap surgery of the head and neck, with estimated odds ratios of 2.78 (95% CI, 1.27-6.09) and 2.67 (95% CI, 1.14-6.25), respectively, in the multiple logistic regression model

  19. [Value the correction of corneal astigmatism in cataract surgery].

    PubMed

    Wang, J; Cao, Y X

    2018-05-11

    The aim of modern micro-incision phacoemulsification combined with foldable intraocular lens implantation and femtosecond laser-assisted cataract surgery is evolving from a simple pursuit of recuperation to a refractive procedure, which involves the correction of ametropia according to preoperative and postoperative refractive conditions, especially corneal astigmatism, in order to achieve the goal of optimized postoperative uncorrected full range of vision. Nowadays, due attention to the effect of preoperative corneal astigmatism, surgery-induced astigmatism and residual astigmatism after operation is lacked, which affect postoperative visual acuity significantly. There are many effective ways to reduce corneal astigmatism after cataract surgery including selecting appropriate size and location of clear corneal incision, employing astigmatism keratotomy and the implantation of Toric intraocular lenses, which need to be appropriately applied and popularized. At the same time, surgical indications, predictability and safety should also be taken into account. (Chin J Ophthalmol, 2018, 54: 321-323) .

  20. Microvascular anastomosis using the vascular closure device in free flap reconstructive surgery: A 13-year experience.

    PubMed

    Reddy, Chaitan; Pennington, David; Stern, Harvey

    2012-02-01

    The achievement of patency of the microvascular anastomosis in free flap surgery is dependent on a number of factors, central to which is atraumatic handling of the vessel lumen, and intimal apposition. Initial laboratory studies demonstrating the superiority of the non-penetrating vascular closure staple (VCS - Anastoclip ®) were followed by our report in 1999 on a series of free flaps. There is still a paucity of data in the literature on the use of non-penetrating devices for microvascular anastomosis, and our review gives evidence to support the routine use of the VCS in microsurgical free flap surgery. We now report on its successful use over a thirteen year period in 819 free flap reconstructions. Our data indicates the VCS device to be as effective as sutured anastomoses in free tissue transfer surgery. There is also statistically significant data (Barnard's Exact Test) to demonstrate a higher vascular patency rate of the VCS device over sutured anastomoses when sub group analysis is performed. 'Take-back' revision rates were lower amongst flaps that employed VCS use. For arterial anastomoses, this equated to 3/654(0.05%) vs 4/170(2.4%) with hand-sewn anastomoses (p = 0.02). Similarly, for venous anastomoses the 'take-back' revision rate was 7/661(1.1%) vs 8/165(4.8%) with hand-sewn anastomoses (p = 0.003). Furthermore, the major advantage of the VCS is reduction in anastomosis time, from approximately 25 min per anastomosis for sutures to between five and 10 min for staples. Copyright © 2011 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

  1. Higher-order aberrations and best-corrected visual acuity in Native American children with a high prevalence of astigmatism

    PubMed Central

    Miller, Joseph M.; Harvey, Erin M.; Schwiegerling, Jim

    2016-01-01

    Purpose To determine whether higher-order aberrations (HOAs) in children from a highly astigmatic population differ from population norms and whether HOAs are associated with astigmatism and reduced best-corrected visual acuity. Methods Subjects were 218 Tohono O’odham Native American children 5–9 years of age. Noncycloplegic HOA measurements were obtained with a handheld Shack-Hartmann sensor (SHS). Signed (z06s to z14s) and unsigned (z06u to z14u) wavefront aberration Zernike coefficients Z(3,−3) to Z(4,4) were rescaled for a 4 mm diameter pupil and compared to adult population norms. Cycloplegic refraction and best-corrected logMAR letter visual acuity (BCVA) were also measured. Regression analyses assessed the contribution of astigmatism (J0) and HOAs to BCVA. Results The mean root-mean-square (RMS) HOA of 0.191 ± 0.072 μm was significantly greater than population norms (0.100 ± 0.044 μm. All unsigned HOA coefficients (z06u to z14u) and all signed coefficients except z09s, z10s, and z11s were significantly larger than population norms. Decreased BCVA was associated with astigmatism (J0) and spherical aberration (z12u) but not RMS coma, with the effect of J0 about 4 times as great as z12u. Conclusions Tohono O’odham children show elevated HOAs compared to population norms. Astigmatism and unsigned spherical aberration are associated with decreased acuity, but the effects of spherical aberration are minimal and not clinically significant. PMID:26239206

  2. Screening for previous refractive surgery in eye bank corneas by using optical coherence tomography.

    PubMed

    Lin, Roger C; Li, Yan; Tang, Maolong; McLain, Marcy; Rollins, Andrew M; Izatt, Joseph A; Huang, David

    2007-06-01

    To use optical coherence tomography (OCT) to detect previous refractive surgery in donor corneas. We constructed a tabletop OCT scanner operating at 1310-nm wavelength. Donor corneas at the Cleveland Eye Bank were scanned while sealed within the sterile container immersed in Optisol GS. OCT scanning was performed with 7.6-mm-long lines (512 axial scans) along 8 meridians. Anterior and posterior corneal surfaces were automatically mapped using image processing software that we developed. Curvature was computed from the best parabolic fit in the central 5-mm diameter. Layered analysis of the stromal reflectivity was also performed. Twenty-nine corneas from 19 donors were examined. Five had a history of laser in situ keratomileusis (LASIK). The flap interfaces could not be visualized on slit-lamp or OCT images but were confirmed by histology. The death-to-scan time was 22.1 +/- 11.4 (SD) hours for normal corneas and 100.6 +/- 57.5 hours for LASIK corneas. The anterior surface power was 67.5 +/- 2.5 D in control corneas and 64.5 +/- 2.4 D in LASIK corneas (P = 0.023). There was no significance between the 2 groups in terms of posterior curvature and thickness parameters. The anterior/posterior reflectivity ratio in the central 4-mm diameter was significantly lower in post-LASIK corneas than in control (P < 0.05). OCT provides thickness, topography, and reflectivity maps of donor corneas without taking them out of preservation medium and container. The anterior curvature and the anterior/posterior stromal reflectivity ratio may be useful for detecting previous LASIK.

  3. Femtosecond laser-induced inverted microstructures inside glasses by tuning refractive index of objective's immersion liquid.

    PubMed

    Luo, Fangfang; Song, Juan; Hu, Xiao; Sun, Haiyi; Lin, Geng; Pan, Huaihai; Cheng, Ya; Liu, Li; Qiu, Jianrong; Zhao, Quanzhong; Xu, Zhizhan

    2011-06-01

    We report the formation of inverted microstructures inside glasses after femtosecond laser irradiation by tuning the refractive index contrast between the immersion liquid and the glass sample. By using water as well as 1-bromonaphthalene as immersion liquids, microstructures with similar shape but opposite directions are induced after femtosecond laser irradiation. Interestingly, the elemental distribution in the induced structures is also inverted. The simulation of laser intensity distribution along the laser propagation direction indicates that the interfacial spherical aberration effect is responsible for the inversion of microstructures and elemental distribution. © 2011 Optical Society of America

  4. Refractive multiple optical tweezers for parallel biochemical analysis in micro-fluidics

    NASA Astrophysics Data System (ADS)

    Merenda, Fabrice; Rohner, Johann; Pascoal, Pedro; Fournier, Jean-Marc; Vogel, Horst; Salathé, René-Paul

    2007-02-01

    We present a multiple laser tweezers system based on refractive optics. The system produces an array of 100 optical traps thanks to a refractive microlens array, whose focal plane is imaged into the focal plane of a high-NA microscope objective. This refractive multi-tweezers system is combined to micro-fluidics, aiming at performing simultaneous biochemical reactions on ensembles of free floating objects. Micro-fluidics allows both transporting the particles to the trapping area, and conveying biochemical reagents to the trapped particles. Parallel trapping in micro-fluidics is achieved with polystyrene beads as well as with native vesicles produced from mammalian cells. The traps can hold objects against fluid flows exceeding 100 micrometers per second. Parallel fluorescence excitation and detection on the ensemble of trapped particles is also demonstrated. Additionally, the system is capable of selectively and individually releasing particles from the tweezers array using a complementary steerable laser beam. Strategies for high-yield particle capture and individual particle release in a micro-fluidic environment are discussed. A comparison with diffractive optical tweezers enhances the pros and cons of refractive systems.

  5. Characterising a holographic modal phase mask for the detection of ocular aberrations

    NASA Astrophysics Data System (ADS)

    Corbett, A. D.; Leyva, D. Gil; Diaz-Santana, L.; Wilkinson, T. D.; Zhong, J. J.

    2005-12-01

    The accurate measurement of the double-pass ocular wave front has been shown to have a broad range of applications from LASIK surgery to adaptively corrected retinal imaging. The ocular wave front can be accurately described by a small number of Zernike circle polynomials. The modal wave front sensor was first proposed by Neil et al. and allows the coefficients of the individual Zernike modes to be measured directly. Typically the aberrations measured with the modal sensor are smaller than those seen in the ocular wave front. In this work, we investigated a technique for adapting a modal phase mask for the sensing of the ocular wave front. This involved extending the dynamic range of the sensor by increasing the pinhole size to 2.4mm and optimising the mask bias to 0.75λ. This was found to decrease the RMS error by up to a factor of three for eye-like aberrations with amplitudes up to 0.2μm. For aberrations taken from a sample of real-eye measurements a 20% decrease in the RMS error was observed.

  6. Objective measurement of the optical image quality in the human eye

    NASA Astrophysics Data System (ADS)

    Navarro, Rafael M.

    2001-05-01

    This communication reviews some recent studies on the optical performance of the human eye. Although the retinal image cannot be recorded directly, different objective methods have been developed, which permit to determine optical quality parameters, such as the Point Spread Function (PSF), the Modulation Transfer Function (MTF), the geometrical ray aberrations or the wavefront distortions, in the living human eye. These methods have been applied in both basic and applied research. This includes the measurement of the optical performance of the eye across visual field, the optical quality of eyes with intraocular lens implants, the aberrations induced by LASIK refractive surgery, or the manufacture of customized phase plates to compensate the wavefront aberration in the eye.

  7. PSF and MTF comparison of two different surface ablation techniques for laser visual correction

    NASA Astrophysics Data System (ADS)

    Cruz Félix, Angel Sinue; López Olazagasti, Estela; Rosales, Marco A.; Ibarra, Jorge; Tepichín Rodríguez, Eduardo

    2009-08-01

    It is well known that the Zernike expansion of the wavefront aberrations has been extensively used to evaluate the performance of image forming optical systems. Recently, these techniques were adopted in the field of Ophthalmology to evaluate the objective performance of the human ocular system. We have been working in the characterization and evaluation of the performance of normal human eyes; i.e., eyes which do not require any refractive correction (20/20 visual acuity). These data provide us a reference model to analyze Pre- and Post-Operated results from eyes that have been subjected to laser refractive surgery. Two different ablation techniques are analyzed in this work. These techniques were designed to correct the typical refractive errors known as myopia, hyperopia, and presbyopia. When applied to the corneal surface, these techniques provide a focal shift and, in principle, an improvement of the visual performance. These features can be suitably described in terms of the PSF and MTF of the corresponding Pre- and Post-Operated wavefront aberrations. We show the preliminary results of our comparison.

  8. Simulation of Ametropic Human Eyes

    NASA Astrophysics Data System (ADS)

    Tan, Bo; Chen, Ying-Ling; Lewis, James W. L.

    2004-11-01

    The computational simulation of the performance of human eyes is complex because the optical parameters of the eye depend on many factors, including age, gender, race, refractive status (accommodation and near- or far-sightedness). This task is made more difficult by the inadequacy of the population statistical characteristics of these parameters. Previously we simulated ametropic (near- or far-sighted) eyes using three independent variables: the axial length of the eye, the corneal surface curvature, and the intraocular refractive index gradient. The prescription for the correction of an ametropic eye is determined by its second-order coefficients of the wavefront aberrations. These corrections are typically achieved using contact lens, spectacle lens, or laser surgery (LASIK). However, the higher order aberrations, which are not corrected and are likely complicated or enhanced by the lower-order correction, could be important for visual performance in a darkened environment. In this paper, we investigate the higher order wavefront aberrations of synthetic ametropic eyes and compare results with measured data published in the past decade. The behavior of three types of ametropes is discussed.

  9. Refraction near the horizon

    NASA Technical Reports Server (NTRS)

    Schaefer, Bradley E.; Liller, William

    1990-01-01

    Variations in astronomical refraction near the horizon are examined. Sunset timings, a sextant mounted on a tripod, and a temperature profile are utilized to derive the variations in refraction data, collected from 7 locations. It is determined that the refraction ranges from 0.234 to 1.678 deg with an rms deviation of 0.16, and it is observed that the variation is larger than previously supposed. Some applications for the variation of refraction value are discussed.

  10. LED surgical lighting system with multiple free-form surfaces for highly sterile operating theater application.

    PubMed

    Liu, Peng; Zhang, Yaqin; Zheng, Zhenrong; Li, Haifeng; Liu, Xu

    2014-06-01

    Although the ventilation system is widely employed in the operating theater, a strictly sterile surgical environment still cannot be ensured because of laminar disturbance, which is mainly caused by the surgical lighting system. Abandoning traditional products, we propose an LED surgical lighting system, which can alleviate the laminar disturbance and provide an appropriate lighting condition for surgery. It contains a certain amount of LED lens units, which are embedded in the ceiling and arranged around the air supply smallpox. The LED lens unit integrated with an LED light source and a free-form lens is required to produce a uniform circular illumination with a large tolerance to the change of lighting distance. To achieve such a dedicated lens, two free-form refractive surfaces, which are converted into two ordinary differential equations by the design method presented in this paper, are used to deflect the rays. The results show that the LED surgical lighting system can provide an excellent illumination environment for surgery, and, apparently, the laminar disturbance also can be relieved.

  11. Refractive errors and schizophrenia.

    PubMed

    Caspi, Asaf; Vishne, Tali; Reichenberg, Abraham; Weiser, Mark; Dishon, Ayelet; Lubin, Gadi; Shmushkevitz, Motti; Mandel, Yossi; Noy, Shlomo; Davidson, Michael

    2009-02-01

    Refractive errors (myopia, hyperopia and amblyopia), like schizophrenia, have a strong genetic cause, and dopamine has been proposed as a potential mediator in their pathophysiology. The present study explored the association between refractive errors in adolescence and schizophrenia, and the potential familiality of this association. The Israeli Draft Board carries a mandatory standardized visual accuracy assessment. 678,674 males consecutively assessed by the Draft Board and found to be psychiatrically healthy at age 17 were followed for psychiatric hospitalization with schizophrenia using the Israeli National Psychiatric Hospitalization Case Registry. Sib-ships were also identified within the cohort. There was a negative association between refractive errors and later hospitalization for schizophrenia. Future male schizophrenia patients were two times less likely to have refractive errors compared with never-hospitalized individuals, controlling for intelligence, years of education and socioeconomic status [adjusted Hazard Ratio=.55; 95% confidence interval .35-.85]. The non-schizophrenic male siblings of schizophrenia patients also had lower prevalence of refractive errors compared to never-hospitalized individuals. Presence of refractive errors in adolescence is related to lower risk for schizophrenia. The familiality of this association suggests that refractive errors may be associated with the genetic liability to schizophrenia.

  12. Fixed mydriatic pupil associated with an intraocular pressure rise as a complication of the implant of a Phakic Refractive Lens (PRL).

    PubMed

    Pérez-Cambrodí, Rafael José; Piñero-Llorens, David Pablo; Ruiz-Fortes, Juan Pedro; Blanes-Mompó, Francisco Javier; Cerviño-Expósito, Alejandro

    2014-07-01

    We describe a case report of a patient that was implanted with a posterior chamber phakic intraocular lens (Phakic Refractive Lens, PRL) for the correction of moderate myopia and who developed postoperatively a fixed mydriasis compatible with an Urrets-Zavalia Syndrome (UZS). Specifically, a sudden acute increase of IOP in the left eye was observed in the immediate postoperative period. After IOP stabilization, the refractive result was good, but a fixed and mydriatic pupil appeared. This condition led the patient to experience visual discomfort, halos, and glare associated with high levels of higher-order aberrations in spite of the good visual result. A tinted-contact lens was fitted in order to minimize those symptoms. The UZS should be considered as a possible complication after implantation of posterior chamber phakic intraocular lenses.

  13. Contemporary management of aberrant right subclavian arteries.

    PubMed

    Stone, William M; Ricotta, Joseph J; Fowl, Richard J; Garg, Nitin; Bower, Thomas C; Money, Samuel R

    2011-05-01

    Aberrant origin of right subclavian arteries represents the most common of the aortic arch anomalies. This variant has few published series to guide management. Our goal was to review treatment options and results for these potentially complex reconstructions. A retrospective review was performed on all patients with a diagnosis of aberrant right subclavian artery at our institution between January 2003 and July 2009. A total of 24 patients, which comprises one of the largest series reported, including 10 males and 14 females (mean age: 46.6 years, range: 7-77), were diagnosed with an aberrant right subclavian artery. Sixteen (66%) were diagnosed incidentally, but eight (33%) had symptoms of either dysphagia, upper extremity ischemia, or both. Computed tomography was most commonly used to establish the diagnosis (19 patients, 79%). Magnetic resonance imaging established the diagnosis in three patients (12%), upper gastrointestinal barium study in one (4%), and standard angiography in one (4%). A Kommerell's diverticulum (KD) was the most common associated anomaly (seven patients, 29%). All seven patients (100%) with a KD required intervention for either symptoms or aneurysmal degeneration. Intervention was performed in 10 patients (42%), including carotid subclavian bypass in five (50%), carotid subclavian transposition in three (30%), and ascending aorta to subclavian bypass in two (20%). Four patients (40%) had additional intervention for management of aneurysmal disease of the aorta or KD, with open aortic replacement in two (20%) and aortic endografting in two (20%). There was one perioperative death (10%) in a patient undergoing aortic arch debranching with placement of an aortic endograft. In all, 18 patients survived without symptoms after a mean follow-up of 38 months. Aberrant right subclavian arteries are most commonly found incidentally with computed tomography. The presence of a KD seemed to correlate with the need for intervention. Patients with no

  14. Ultraprecise medical applications with ultrafast lasers: corneal surgery with femtosecond lasers

    NASA Astrophysics Data System (ADS)

    Loesel, Frieder H.; Kurtz, Ron M.; Horvath, Christopher; Sayegh, Samir I.; Mourou, Gerard A.; Bille, Josef F.; Juhasz, Tibor

    1999-02-01

    We investigated refractive corneal surgery in vivo and in vitro by intrastromal photodisruption using a compact ultrafast femtosecond laser system. Ultrashort-pulsed lasers operating in the femtosecond time regime are associated with significantly smaller and deterministic threshold energies for photodisruption, as well as reduced shock waves and smaller cavitation bubbles than the nanosecond or picosecond lasers. Our reliable all-solid-state laser system was specifically designed for real world medical applications. By scanning the 5 micron focus spot of the laser below the corneal surface, the overlapping small ablation volumes of single pulses resulted in contiguous tissue cutting and vaporization. Pulse energies were typically in the order of a few microjoules. Combination of different scanning patterns enabled us to perform corneal flap cutting, femtosecond-LASIK, and femtosecond intrastromal keratectomy in porcine, rabbit, and primate eyes. The cuts proved to be highly precise and possessed superior dissection and surface quality. Preliminary studies show consistent refractive changes in the in vivo studies. We conclude that the technology is capable to perform a variety of corneal refractive procedures at high precision, offering advantages over current mechanical and laser devices and enabling entirely new approaches for refractive surgery.

  15. Refraction in Adults with Diabetes

    PubMed Central

    Klein, Barbara E. K.; Lee, Kristine E.; Klein, Ronald

    2010-01-01

    Objective(s) Examine refraction, change in refraction, and risk factors for change in refraction in adults with type 1 and type 2 diabetes. Methods Population based study. Modified Early Treatment of Diabetic Retinopathy Study refractions and a standard history were obtained for all participants. Baseline and ten-year follow-up data were available. Results Age was significantly associated with refraction in persons with younger-onset diabetes (T1D) and those with older-onset diabetes (T2D); refractions were similar for both groups. Persons of similar age with T1D were likely to be more myopic than those with T2D (P<.01). Years of education were significantly associated with more myopic refraction (P<.0001). In those with T1D on average there was a −.35 diopter (D) change in refraction over 10 years. However, there was a systematic decrease in myopic shift with increasing age at baseline. Those with longer duration of diabetes and with proliferative retinopathy were more likely to have hyperopic shifts in refraction. In those with T2D there was, on average, a +.25D change in refraction over the 10 years but there was little consistency in the amount of change by age at baseline. There were no other significant effects on change in refraction in this group. Conclusions In persons of similar age, those with T1D are likely to be slightly more myopic than those with T2D. Overall, mean refractions and the important risk factors of age and education are similar to those reported in non-diabetic populations. PMID:21220629

  16. Aberration-Corrected Stem of Q-Rich Separates from the Saratov (L4) Meteorite

    NASA Astrophysics Data System (ADS)

    Stroud, R. M.; Chisholm, M. F.; Amari, A.; Matsuda, J.

    2012-09-01

    TEM and aberration-corrected STEM analysis of two nanodiamond- and SiC-free Saratov (L4) separates, AJ (most Q-rich) and AI (Q-rich), show that the carrier is porous carbon consisting of nanoscale graphene platelets.

  17. Understanding refraction contrast using a comparison of absorption and refraction computed tomographic techniques

    NASA Astrophysics Data System (ADS)

    Wiebe, S.; Rhoades, G.; Wei, Z.; Rosenberg, A.; Belev, G.; Chapman, D.

    2013-05-01

    Refraction x-ray contrast is an imaging modality used primarily in a research setting at synchrotron facilities, which have a biomedical imaging research program. The most common method for exploiting refraction contrast is by using a technique called Diffraction Enhanced Imaging (DEI). The DEI apparatus allows the detection of refraction between two materials and produces a unique ''edge enhanced'' contrast appearance, very different from the traditional absorption x-ray imaging used in clinical radiology. In this paper we aim to explain the features of x-ray refraction contrast as a typical clinical radiologist would understand. Then a discussion regarding what needs to be considered in the interpretation of the refraction image takes place. Finally we present a discussion about the limitations of planar refraction imaging and the potential of DEI Computed Tomography. This is an original work that has not been submitted to any other source for publication. The authors have no commercial interests or conflicts of interest to disclose.

  18. Linkage analysis of quantitative refraction and refractive errors in the Beaver Dam Eye Study.

    PubMed

    Klein, Alison P; Duggal, Priya; Lee, Kristine E; Cheng, Ching-Yu; Klein, Ronald; Bailey-Wilson, Joan E; Klein, Barbara E K

    2011-07-13

    Refraction, as measured by spherical equivalent, is the need for an external lens to focus images on the retina. While genetic factors play an important role in the development of refractive errors, few susceptibility genes have been identified. However, several regions of linkage have been reported for myopia (2q, 4q, 7q, 12q, 17q, 18p, 22q, and Xq) and for quantitative refraction (1p, 3q, 4q, 7p, 8p, and 11p). To replicate previously identified linkage peaks and to identify novel loci that influence quantitative refraction and refractive errors, linkage analysis of spherical equivalent, myopia, and hyperopia in the Beaver Dam Eye Study was performed. Nonparametric, sibling-pair, genome-wide linkage analyses of refraction (spherical equivalent adjusted for age, education, and nuclear sclerosis), myopia and hyperopia in 834 sibling pairs within 486 extended pedigrees were performed. Suggestive evidence of linkage was found for hyperopia on chromosome 3, region q26 (empiric P = 5.34 × 10(-4)), a region that had shown significant genome-wide evidence of linkage to refraction and some evidence of linkage to hyperopia. In addition, the analysis replicated previously reported genome-wide significant linkages to 22q11 of adjusted refraction and myopia (empiric P = 4.43 × 10(-3) and 1.48 × 10(-3), respectively) and to 7p15 of refraction (empiric P = 9.43 × 10(-4)). Evidence was also found of linkage to refraction on 7q36 (empiric P = 2.32 × 10(-3)), a region previously linked to high myopia. The findings provide further evidence that genes controlling refractive errors are located on 3q26, 7p15, 7p36, and 22q11.

  19. Linkage Analysis of Quantitative Refraction and Refractive Errors in the Beaver Dam Eye Study

    PubMed Central

    Duggal, Priya; Lee, Kristine E.; Cheng, Ching-Yu; Klein, Ronald; Bailey-Wilson, Joan E.; Klein, Barbara E. K.

    2011-01-01

    Purpose. Refraction, as measured by spherical equivalent, is the need for an external lens to focus images on the retina. While genetic factors play an important role in the development of refractive errors, few susceptibility genes have been identified. However, several regions of linkage have been reported for myopia (2q, 4q, 7q, 12q, 17q, 18p, 22q, and Xq) and for quantitative refraction (1p, 3q, 4q, 7p, 8p, and 11p). To replicate previously identified linkage peaks and to identify novel loci that influence quantitative refraction and refractive errors, linkage analysis of spherical equivalent, myopia, and hyperopia in the Beaver Dam Eye Study was performed. Methods. Nonparametric, sibling-pair, genome-wide linkage analyses of refraction (spherical equivalent adjusted for age, education, and nuclear sclerosis), myopia and hyperopia in 834 sibling pairs within 486 extended pedigrees were performed. Results. Suggestive evidence of linkage was found for hyperopia on chromosome 3, region q26 (empiric P = 5.34 × 10−4), a region that had shown significant genome-wide evidence of linkage to refraction and some evidence of linkage to hyperopia. In addition, the analysis replicated previously reported genome-wide significant linkages to 22q11 of adjusted refraction and myopia (empiric P = 4.43 × 10−3 and 1.48 × 10−3, respectively) and to 7p15 of refraction (empiric P = 9.43 × 10−4). Evidence was also found of linkage to refraction on 7q36 (empiric P = 2.32 × 10−3), a region previously linked to high myopia. Conclusions. The findings provide further evidence that genes controlling refractive errors are located on 3q26, 7p15, 7p36, and 22q11. PMID:21571680

  20. Malignant glaucoma after cataract surgery.

    PubMed

    Varma, Devesh K; Belovay, Graham W; Tam, Diamond Y; Ahmed, Iqbal Ike K

    2014-11-01

    To report a series of eyes that developed malignant glaucoma after cataract surgery. Private academic practice, Toronto, Ontario, Canada. Retrospective case series. Eyes that developed malignant glaucoma after cataract surgery were treated with medical therapy. This was followed by laser iridozonulohyaloidotomy, anterior chamber reformation and intraocular lens (IOL) pushback, and finally with surgical iridozonulohyaloidovitrectomy if all other measures were unsuccessful. Refraction, intraocular pressure (IOP), gonioscopy, and anterior chamber depth (ACD) by anterior segment optical coherence tomography were analyzed before treatment and after treatment. The study evaluated 20 eyes of 18 female patients aged 44 to 86 years. Preoperatively, the mean refraction was +3.11 diopters (D) ± 2.89 (SD), the mean axial length was 21.30 ± 1.40 mm, and all eyes had narrow or closed angles. Malignant glaucoma was diagnosed a mean of 5.8 ± 7.1 weeks postoperatively. At diagnosis, the mean refraction was -2.15 ± 2.95 D; the mean ACD, 2.49 ± 0.72 mm; and the mean IOP, 28.3 ± 10.8 mm Hg on a mean of 1.3 ± 1.6 medications. Two eyes responded to cycloplegia, 7 to laser iridozonulohyaloidotomy, and 6 to anterior chamber reformation-IOL pushback; 5 eyes required vitrectomy. Posttreatment, the mean refraction was -0.56 ± 1.07 D; the mean ACD, 3.30 ± 0.50 mm; and the mean IOP, 14.4 ± 4.60 mm Hg on a mean of 1.2 ± 1.4 medications. Cycloplegia was discontinued in 17 eyes. Malignant glaucoma can occur after phacoemulsification and presents with myopic surprise, anterior chamber shallowing and, possibly, elevated IOP. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

  1. Prediction and observation of tin and silver plasmas with index of refraction greater than one in the soft x-ray range.

    PubMed

    Filevich, Jorge; Grava, Jonathan; Purvis, Mike; Marconi, Mario C; Rocca, Jorge J; Nilsen, Joseph; Dunn, James; Johnson, Walter R

    2006-07-01

    We present the calculated prediction and the experimental confirmation that doubly ionized Ag and Sn plasmas can have an index of refraction greater than one for soft x-ray wavelengths. Interferometry experiments conducted using a capillary discharge soft x-ray laser operating at a wavelength of confirm that in few times ionized laser-created plasmas of these elements the anomalous dispersion from bound electrons can dominate the free electron contribution, making the index of refraction greater than one. The results confirm that bound electrons can strongly influence the index of refraction of numerous plasmas over a broad range of soft x-ray wavelengths confirming recent observations. The understanding of index of refraction at short wavelengths will become even more essential during the next decade as x-ray free electron lasers will become available to probe a wider variety of plasmas at higher densities and shorter wavelengths.

  2. Measuring the Refractive Index of Bovine Corneal Stromal Cells Using Quantitative Phase Imaging

    PubMed Central

    Gardner, Steven J.; White, Nick; Albon, Julie; Knupp, Carlo; Kamma-Lorger, Christina S.; Meek, Keith M.

    2015-01-01

    The cornea is the primary refractive lens in the eye and transmits >90% of incident visible light. It has been suggested that the development of postoperative corneal haze could be due to an increase in light scattering from activated corneal stromal cells. Quiescent keratocytes are thought to produce crystallins that match the refractive index of their cytoplasm to the surrounding extracellular material, reducing the amount of light scattering. To test this, we measured the refractive index (RI) of bovine corneal stromal cells, using quantitative phase imaging of live cells in vitro, together with confocal microscopy. The RI of quiescent keratocytes (RI = 1.381 ± 0.004) matched the surrounding matrix, thus supporting the hypothesis that keratocyte cytoplasm does not scatter light in the normal cornea. We also observed that the RI drops after keratocyte activation (RI = 1.365 ± 0.003), leading to a mismatch with the surrounding intercellular matrix. Theoretical scattering models showed that this mismatch would reduce light transmission in the cornea. We conclude that corneal transparency depends on the matching of refractive indices between quiescent keratocytes and the surrounding tissue, and that after surgery or wounding, the resulting RI mismatch between the activated cells and their surrounds significantly contributes to light scattering. PMID:26488650

  3. Three-dimensional negative index of refraction at optical frequencies by coupling plasmonic waveguides.

    PubMed

    Verhagen, Ewold; de Waele, René; Kuipers, L; Polman, Albert

    2010-11-26

    We identify a route towards achieving a negative index of refraction at optical frequencies based on coupling between plasmonic waveguides that support backwards waves. We show how modal symmetry can be exploited in metal-dielectric waveguide pairs to achieve negative refraction of both phase and energy. Control of waveguide coupling yields a metamaterial consisting of a one-dimensional multilayer stack that exhibits an isotropic index of -1 at a free-space wavelength of 400 nm. The concepts developed here may inspire new low-loss metamaterial designs operating close to the metal plasma frequency.

  4. Analytical transmission cross-coefficients for pink beam X-ray microscopy based on compound refractive lenses.

    PubMed

    Falch, Ken Vidar; Detlefs, Carsten; Snigirev, Anatoly; Mathiesen, Ragnvald H

    2018-01-01

    Analytical expressions for the transmission cross-coefficients for x-ray microscopes based on compound refractive lenses are derived based on Gaussian approximations of the source shape and energy spectrum. The effects of partial coherence, defocus, beam convergence, as well as lateral and longitudinal chromatic aberrations are accounted for and discussed. Taking the incoherent limit of the transmission cross-coefficients, a compact analytical expression for the modulation transfer function of the system is obtained, and the resulting point, line and edge spread functions are presented. Finally, analytical expressions for optimal numerical aperture, coherence ratio, and bandwidth are given. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Refractive index measurements of single, spherical cells using digital holographic microscopy.

    PubMed

    Schürmann, Mirjam; Scholze, Jana; Müller, Paul; Chan, Chii J; Ekpenyong, Andrew E; Chalut, Kevin J; Guck, Jochen

    2015-01-01

    In this chapter, we introduce digital holographic microscopy (DHM) as a marker-free method to determine the refractive index of single, spherical cells in suspension. The refractive index is a conclusive measure in a biological context. Cell conditions, such as differentiation or infection, are known to yield significant changes in the refractive index. Furthermore, the refractive index of biological tissue determines the way it interacts with light. Besides the biological relevance of this interaction in the retina, a lot of methods used in biology, including microscopy, rely on light-tissue or light-cell interactions. Hence, determining the refractive index of cells using DHM is valuable in many biological applications. This chapter covers the main topics that are important for the implementation of DHM: setup, sample preparation, and analysis. First, the optical setup is described in detail including notes and suggestions for the implementation. Following that, a protocol for the sample and measurement preparation is explained. In the analysis section, an algorithm for the determination of quantitative phase maps is described. Subsequently, all intermediate steps for the calculation of the refractive index of suspended cells are presented, exploiting their spherical shape. In the last section, a discussion of possible extensions to the setup, further measurement configurations, and additional analysis methods are given. Throughout this chapter, we describe a simple, robust, and thus easily reproducible implementation of DHM. The different possibilities for extensions show the diverse fields of application for this technique. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Simulation of the impact of refractive surgery ablative laser pulses with a flying-spot laser beam on intrasurgery corneal temperature.

    PubMed

    Shraiki, Mario; Arba-Mosquera, Samuel

    2011-06-01

    To evaluate ablation algorithms and temperature changes in laser refractive surgery. The model (virtual laser system [VLS]) simulates different physical effects of an entire surgical process, simulating the shot-by-shot ablation process based on a modeled beam profile. The model is comprehensive and directly considers applied correction; corneal geometry, including astigmatism; laser beam characteristics; and ablative spot properties. Pulse lists collected from actual treatments were used to simulate the temperature increase during the ablation process. Ablation efficiency reduction in the periphery resulted in a lower peripheral temperature increase. Steep corneas had lesser temperature increases than flat ones. The maximum rise in temperature depends on the spatial density of the ablation pulses. For the same number of ablative pulses, myopic corrections showed the highest temperature increase, followed by myopic astigmatism, mixed astigmatism, phototherapeutic keratectomy (PTK), hyperopic astigmatism, and hyperopic treatments. The proposed model can be used, at relatively low cost, for calibration, verification, and validation of the laser systems used for ablation processes and would directly improve the quality of the results.

  7. Mask-induced aberration in EUV lithography

    NASA Astrophysics Data System (ADS)

    Nakajima, Yumi; Sato, Takashi; Inanami, Ryoichi; Nakasugi, Tetsuro; Higashiki, Tatsuhiko

    2009-04-01

    We estimated aberrations using Zernike sensitivity analysis. We found the difference of the tolerated aberration with line direction for illumination. The tolerated aberration of perpendicular line for illumination is much smaller than that of parallel line. We consider this difference to be attributable to the mask 3D effect. We call it mask-induced aberration. In the case of the perpendicular line for illumination, there was a difference in CD between right line and left line without aberration. In this report, we discuss the possibility of pattern formation in NA 0.25 generation EUV lithography tool. In perpendicular pattern for EUV light, the dominant part of aberration is mask-induced aberration. In EUV lithography, pattern correction based on the mask topography effect will be more important.

  8. Increased Free Testosterone Levels in Men with Uncontrolled Type 2 Diabetes Five Years After Randomization to Bariatric Surgery.

    PubMed

    Pham, Nathan H; Bena, James; Bhatt, Deepak L; Kennedy, Laurence; Schauer, Philip R; Kashyap, Sangeeta R

    2018-01-01

    Hypogonadism frequently occurs in male patients with type 2 diabetes (T2DM) and is linked to insulin resistance and inflammation. Testosterone levels rise acutely in obese patients following bariatric surgery, though long-term changes have not been investigated in a randomized controlled trial. This study evaluated obese men with T2DM randomized to either bariatric surgery or medical therapy. Testosterone, gonadotropins, body composition, insulin sensitivity, and inflammatory markers were evaluated in 32 patients at baseline and at 5 years. Surgical patients had 47.4% increase in free testosterone compared to medical therapy patients who had 2.2% decrease (P = 0.013). Increase in free testosterone correlated with reduction in body weight, high-sensitivity C-reactive protein (hsCRP), and leptin levels. Prolonged improvements in testosterone levels after bariatric surgery in T2DM are found to be related to reduction in body weight and adipogenic inflammation.

  9. Crystalline lens power and refractive error.

    PubMed

    Iribarren, Rafael; Morgan, Ian G; Nangia, Vinay; Jonas, Jost B

    2012-02-01

    To study the relationships between the refractive power of the crystalline lens, overall refractive error of the eye, and degree of nuclear cataract. All phakic participants of the population-based Central India Eye and Medical Study with an age of 50+ years were included. Calculation of the refractive lens power was based on distance noncycloplegic refractive error, corneal refractive power, anterior chamber depth, lens thickness, and axial length according to Bennett's formula. The study included 1885 subjects. Mean refractive lens power was 25.5 ± 3.0 D (range, 13.9-36.6). After adjustment for age and sex, the standardized correlation coefficients (β) of the association with the ocular refractive error were highest for crystalline lens power (β = -0.41; P < 0.001) and nuclear lens opacity grade (β = -0.42; P < 0.001), followed by axial length (β = -0.35; P < 0.001). They were lowest for corneal refractive power (β = -0.08; P = 0.001) and anterior chamber depth (β = -0.05; P = 0.04). In multivariate analysis, refractive error was significantly (P < 0.001) associated with shorter axial length (β = -1.26), lower refractive lens power (β = -0.95), lower corneal refractive power (β = -0.76), higher lens thickness (β = 0.30), deeper anterior chamber (β = 0.28), and less marked nuclear lens opacity (β = -0.05). Lens thickness was significantly lower in eyes with greater nuclear opacity. Variations in refractive error in adults aged 50+ years were mostly influenced by variations in axial length and in crystalline lens refractive power, followed by variations in corneal refractive power, and, to a minor degree, by variations in lens thickness and anterior chamber depth.

  10. Influence of Sodium Hyaluronate Concentration on Corneal Aberrations in Soft Contact Lens Wearers

    PubMed Central

    Lee, Jong Soo; Park, Jong Moon; Cho, Hyun Kyung; Kim, Su Jin; Huh, Hyoun Do

    2018-01-01

    Purpose This study aimed to evaluate the influence of varying concentrations of sodium hyaluronate (SH) eye drops on corneal aberrations in normal individuals wearing silicone hydrogel contact lenses. Methods Normal individuals wearing silicone hydrogel contact lenses were enrolled in this study. Subjects were classified into two groups depending on the concentration of the preservative-free SH used (group 1, 0.1% SH; group 2, 0.3% SH). All subjects were asked to blink five times after instillation of the SH eye drop and before the Galilei measurements. Corneal aberrations were measured over the contact lenses before and after SH eye drop instillation. Visual acuity (VA) over the contact lenses was also measured both before instillation of the SH eye drop and after the subjects completed the five blinks. Results There was no change in VA after SH instillation in group 1; however, group 2's VA significantly deteriorated after SH instillation. Changes in VA after SH instillation compared to baseline were significantly higher in group 2 than in group 1. Similarly, the increase in corneal aberrations after SH instillation was significant in group 2 but not significant in group 1. Among the significantly increased corneal aberration parameters, defocus was the main type in group 2. Changes in corneal aberrations after SH instillation compared to baseline were significantly higher in group 2 than in group 1. Conclusions A 0.3%-concentration of SH increases corneal aberration and decreases VA in soft contact lens wearers. Defocus is the main type of aberration that increased in the 0.3% SH instillation group. PMID:29611370

  11. Mathematics of Zernike polynomials: a review.

    PubMed

    McAlinden, Colm; McCartney, Mark; Moore, Jonathan

    2011-11-01

    Monochromatic aberrations of the eye principally originate from the cornea and the crystalline lens. Aberrometers operate via differing principles but function by either analysing the reflected wavefront from the retina or by analysing an image on the retina. Aberrations may be described as lower order or higher order aberrations with Zernike polynomials being the most commonly employed fitting method. The complex mathematical aspects with regards the Zernike polynomial expansion series are detailed in this review. Refractive surgery has been a key clinical application of aberrometers; however, more recently aberrometers have been used in a range of other areas ophthalmology including corneal diseases, cataract and retinal imaging. © 2011 The Authors. Clinical and Experimental Ophthalmology © 2011 Royal Australian and New Zealand College of Ophthalmologists.

  12. Aberrations for Grazing Incidence Optics

    NASA Technical Reports Server (NTRS)

    Saha, Timo T.

    2008-01-01

    Large number of grazing incidence telescope configurations have been designed and studied. Wolte1 telescopes are commonly used in astronomical applications. Wolter telescopes consist of a paraboloidal primary mirror and a hyperboloidal or an ellipsoidal secondary mirror. There are 8 possible combinations of Wolter telescopes. Out of these possible designs only type 1 and type 2 telescopes are widely used. Type 1 telescope is typically used for x-ray applications and type 2 telescopes are used for EUV applications. Wolter-Schwarzshild (WS) telescopes offer improved image quality over a small field of view. The WS designs are stigmatic and free of third order coma and, therefore, the PSF is significantly better over a small field of view. Typically the image is more symmetric about its centroid. As for the Wolter telescopes there are 8 possible combinations of WS telescopes. These designs have not been widely used because the surface equations are complex parametric equations complicating the analysis and typically the resolution requirements are too low to take full advantage of the WS designs. There are several other design options. Most notable are wide field x-ray telescope designs. Polynomial designs were originally suggested by Burrows4 and hyperboloid-hyperboloid designs for solar physics applications were designed by Harvey5. No general aberration theory exists for grazing incidence telescopes that would cover all the design options. Several authors have studied the aberrations of grazing incidence telescopes. A comprehensive theory of Wolter type 1 and 2 telescopes has been developed. Later this theory was expanded to include all possible combinations of grazing incidence and also normal incidence paraboloid-hyperboloid and paraboloid-ellipsoid telescopes. In this article the aberration theory of Wolter type telescopes is briefly reviewed.

  13. Free-Standing Biodegradable Poly(lactic acid) Nanosheet for Sealing Operations in Surgery.

    PubMed

    Okamura, Yosuke; Kabata, Koki; Kinoshita, Manabu; Saitoh, Daizoh; Takeoka, Shinji

    2009-11-20

    A free-standing biodegradable nanosheet composed of poly(L-lactic acid) (PLLA) was shown to have excellent sealing efficacy for a gastric incision as a novel wound dressing material that did not require adhesive agents, and the PLLA nanosheet-induced wound repair showed neither scars nor tissue adhesion. This material may, therefore, be an ideal alternative to conventional tissue repairing procedures using suture/ligation in surgery. Copyright © 2009 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim.

  14. Dry Eye Disease following Refractive Surgery: A 12-Month Follow-Up of SMILE versus FS-LASIK in High Myopia

    PubMed Central

    Wang, Bingjie; Chu, Renyuan; Dai, Jinhui; Qu, Xiaomei; Zhou, Hao

    2015-01-01

    Purpose. To compare dry eye disease following SMILE versus FS-LASIK. Design. Prospective, nonrandomised, observational study. Patients. 90 patients undergoing refractive surgery for myopia were included. 47 eyes underwent SMILE and 43 eyes underwent FS-LASIK. Methods. Evaluation of dry eye disease was conducted preoperatively and at 1, 3, 6, and 12 months postoperatively, using the Salisbury Eye Evaluation Questionnaire (SEEQ) and TBUT. Results. TBUT reduced following SMILE at 1 and 3 months (p < 0.001) and at 1, 3, and 6 months following FS-LASIK (p < 0.001). TBUT was greater following SMILE than FS-LASIK at 3, 6, and 12 months (p < 0.001, p < 0.001, and p = 0.009, resp.). SEEQ scores increased (greater symptoms) following SMILE at 1 month (p < 0.001) and 3 months (p = 0.003) and at 1, 3, and 6 months following FS-LASIK (p < 0.001). SMILE produced lower SEEQ scores (fewer symptoms) than FS-LASIK at 1, 3, and 6 months (p < 0.001). Conclusion. SMILE produces less dry eye disease than FS-LASIK at 6 months postoperatively but demonstrates similar degrees of dry eye disease at 12 months. PMID:26649190

  15. Studies of intrastromal corneal ring segments for the correction of low to moderate myopic refractive errors.

    PubMed Central

    Schanzlin, D J

    1999-01-01

    PURPOSE: Intrastromal corneal ring segments (ICRS) were investigated for safety and reliability in the correction of low to moderate myopic refractive errors. METHODS: Initially, 74 patients with spherical equivalent refractive errors between -1.00 and -4.25 diopters (D) received the ICRS in 1 eye. After 6 months, 51 of these patients received the ICRS in the contralateral eye. The total number of eyes investigated was 125. The outcome measures were uncorrected and best-corrected visual acuity, predictability and stability of the refraction, refractive astigmatism, contrast sensitivity, and endothelial cell morphology. RESULTS: The 89 eyes with 12-month follow-up showed significant improvement with uncorrected visual acuities of 20/16 or better in 37%, 20/20 or better in 62%, and 20/40 or better in 97%. Cycloplegic refraction spherical equivalents showed that 68% of the eyes were within +/- 0.50 D and 90% within +/- 1.00 D of the intended correction. Refractive stability was present by 3 months after the surgery. Only 1 patients had a loss greater than 2 lines or 10 letters of best spectacle-corrected visual acuity, but the patient's acuity was 20/20. Refractive cylinder, contrast sensitivity, and endothelial cell morphology were not adversely affected. The ICRS was removed from the eyes of 6 patients. Three removals were prompted by glare and double images occurring at night; 3 were for nonmedical reasons. All patients returned to within +/- 1.00 D of their preoperative refractive spherical equivalent, and no patients lost more than 1 line of best corrected visual acuity by 3 months after ICRS removal. CONCLUSION: The ICRS safely and reliably corrects myopic refractive errors between -1.00 and -4.50 D. Images FIGURE 1 FIGURE 2 FIGURE 3 FIGURE 6 FIGURE 7 FIGURE 8 FIGURE 9 FIGURE 10 FIGURE 11 FIGURE 12 PMID:10703146

  16. Incidence and Outcomes of Optical Zone Enlargement and Recentration After Previous Myopic LASIK by Topography-Guided Custom Ablation.

    PubMed

    Reinstein, Dan Z; Archer, Timothy J; Carp, Glenn I; Stuart, Alastair J; Rowe, Elizabeth L; Nesbit, Andrew; Moore, Tara

    2018-02-01

    To report the incidence, visual and refractive outcomes, optical zone enlargement, and recentration using topography-guided CRS-Master TOSCA II software with the MEL 80 excimer laser (Carl Zeiss Meditec AG, Jena, Germany) after primary myopic laser refractive surgery. Retrospective analysis of 73 eyes (40 patients) with complaints of night vision disturbances due to either a decentration or small optical zone following a primary myopic laser refractive surgery procedure using the MEL 80 laser. Multiple ATLAS topography scans were imported into the CRS-Master software for topography-guided ablation planning. The topography-guided re-treatment procedure was performed as either a LASIK flap lift, a new LASIK flap, a side cut only, or photorefractive keratectomy. Axial curvature maps were analyzed using a fixed grid and set of concentric circles superimposed to measure the topographic optical zone diameter and centration. Follow-up was 12 months. The incidence of use in the population of myopic treatments during the study period was 0.79% (73 of 9,249). The optical zone diameter was increased by 11% from a mean of 5.65 to 6.32 mm, with a maximum change of 2 mm in one case. Topographic decentration was reduced by 64% from a mean of 0.58 to 0.21 mm. There was a 44% reduction in spherical aberration, 53% reduction in coma, and 39% reduction in total higher order aberrations. A subjective improvement in night vision symptoms was reported by 93%. Regarding efficacy, 82% of eyes reached 20/20 and 100% reached 20/32 (preoperative CDVA was 20/20 or better in 90%). Regarding safety, no eyes lost two lines of CDVA and 27% gained one line. Regarding predictability, 71% of re-treatments were within ±0.50 diopters. Topography-guided ablation was effective in enlarging the optical zone, recentering the optical zone, and reducing higher order aberrations. Topography-guided custom ablation appears to be an effective method for re-treatment procedures of symptomatic patients after

  17. Clinical features of subepithelial layer irregularities of cornea.

    PubMed

    Lee, Yong Woo; Gye, Hyo Jung; Choi, Chul Young

    2015-07-01

    To illustrate surgical outcomes of subepithelial irregularities that were identified incidentally during laser refractive surgery. The study group consisted of 406 patients who underwent 787 surface ablation refractive surgeries. Ophthalmologic evaluations were performed before each procedure and at 1, 3 and 6 months post-operatively. Subepithelial irregularities were evaluated by analyzing still photographs captured from video recordings. Sizes and locations were determined by a calibrated scale located at the major axis of the tracking system's reticle. Subepithelial irregularities were identified in 27 eyes during 787 surface ablation refractive surgeries. Most of the subepithelial irregularities did not show any abnormalities in the wavefront aberrometer. However, one case with diameter greater than 1.00 mm and one case of clustered multiple subepithelial irregularities with moderate size were corresponded significant coma (Z31) and increased higher order aberration (HOA) in the HOA gradient map. Corneal subepithelial irregularities may be related to problems that include significantly increased localized HOA and remaining permanent subepithelial opacity. Subepithelial irregularity should be considered even if the surface of the cornea is intact and there are no specific findings measured by corneal topography.

  18. Lower- and higher-order aberrations predicted by an optomechanical model of arcuate keratotomy for astigmatism.

    PubMed

    Navarro, Rafael; Palos, Fernando; Lanchares, Elena; Calvo, Begoña; Cristóbal, José A

    2009-01-01

    To develop a realistic model of the optomechanical behavior of the cornea after curved relaxing incisions to simulate the induced astigmatic change and predict the optical aberrations produced by the incisions. ICMA Consejo Superior de Investigaciones Científicas and Universidad de Zaragoza, Zaragoza, Spain. A 3-dimensional finite element model of the anterior hemisphere of the ocular surface was used. The corneal tissue was modeled as a quasi-incompressible, anisotropic hyperelastic constitutive behavior strongly dependent on the physiological collagen fibril distribution. Similar behaviors were assigned to the limbus and sclera. With this model, some corneal incisions were computer simulated after the Lindstrom nomogram. The resulting geometry of the biomechanical simulation was analyzed in the optical zone, and finite ray tracing was performed to compute refractive power and higher-order aberrations (HOAs). The finite-element simulation provided new geometry of the corneal surfaces, from which elevation topographies were obtained. The surgically induced astigmatism (SIA) of the simulated incisions according to the Lindstrom nomogram was computed by finite ray tracing. However, paraxial computations would yield slightly different results (undercorrection of astigmatism). In addition, arcuate incisions would induce significant amounts of HOAs. Finite-element models, together with finite ray-tracing computations, yielded realistic simulations of the biomechanical and optical changes induced by relaxing incisions. The model reproduced the SIA indicated by the Lindstrom nomogram for the simulated incisions and predicted a significant increase in optical aberrations induced by arcuate keratotomy.

  19. Analytical model for thermal lensing and spherical aberration in diode side-pumped Nd:YAG laser rod having Gaussian pump profile

    NASA Astrophysics Data System (ADS)

    M, H. Moghtader Dindarlu; M Kavosh, Tehrani; H, Saghafifar; A, Maleki

    2015-12-01

    In this paper, according to the temperature and strain distribution obtained by considering the Gaussian pump profile and dependence of physical properties on temperature, we derive an analytical model for refractive index variations of the diode side-pumped Nd:YAG laser rod. Then we evaluate this model by numerical solution and our maximum relative errors are 5% and 10% for variations caused by thermo-optical and thermo-mechanical effects; respectively. Finally, we present an analytical model for calculating the focal length of the thermal lens and spherical aberration. This model is evaluated by experimental results.

  20. Refractive index sensor based on total scattering of plasmonic nanotube

    NASA Astrophysics Data System (ADS)

    Yao, Kaiqiang; Zeng, Qingbing; Hu, Zengrong; Zhan, Yaohui

    2018-03-01

    Plasmonic nanostructures can couple free space light into anultrafine space; therefore,they are employed extensively in the refractive index sensors to minimize the device size or further improve the detection sensitivity. In this work, the optical response of the plasmonic nanotube are investigated comprehensively by using full wave finite element method. With a subwavelength scale, the silver nanotube have prominent scattering peaks in the visible range, which is very suitable for observing through the dark field microscope. The geometric dependence of the scattering spectra and the sensing performance are evaluated carefully. Results show that the scattering peaks are in linear relationship to the circumstance refractive index and a sensitivity of 337 nm/RIUcan be achieved easily by such a plasmonicnanotube with an optimized size.

  1. INTEGRATED AND FIBER OPTICS: Investigation of the refractive index profile of inhomogeneous iron garnet films containing bismuth

    NASA Astrophysics Data System (ADS)

    Arzamastseva, G. V.; Kravchenko, V. B.; Filimonova, L. M.

    1989-02-01

    The refractive index n of quasihomogeneous iron garnet films with the composition (YGdYb)3 - xBixFe5 - yAlyO12 increased considerably as a result of reduction in the growth temperature Tg. This was attributed mainly by an increase in x and a reduction in y. The dependences n(Tg) were used to select the conditions for growth of inhomogeneous (across the thickness) films and to predict the refractive index profile n(z), where z was measured from the free surface along the normal to the film. The spectra of optical modes were analyzed in the WKB approximation and this yielded the n(z) profiles for films with a refractive index n decreasing monotonically from the free surface and for films with the symmetric profile n(z) (buried waveguides). The n(z) profiles were compared with the distributions of the compensation temperature Tc(z), and of x(z) and y(z) across the thickness.

  2. Design of refractive fore-optics with wide field of view and waveband for miniature imaging spectrometer

    NASA Astrophysics Data System (ADS)

    Mao, Jingchao; Xu, Minyi; Liu, Qinghan; Shen, Weimin

    2016-10-01

    With the development of unmanned airborne vehicle (UAV) remote sensing technology, miniature high-resolution imaging spectrometers are greatly needed. In order to improve remote sensing efficiency and get wider coverage, it's urgent to design and develop fore-optics with wide field of view and waveband for imaging spectrometer. As the refractive system has no central obscuration and it's conducive to manufacture and assemble, so it's used for our fore-optics. The key is the correction of secondary spectrum of systems working in broad waveband and meeting the requirement of imagery telecentricity to be appropriate for linear pushbroom imaging system. Suitable glasses are selected on the Glass Map, from where each glass has an Abbe number υd and Partial Dispersion. Based on the theory of Gaussian Optics and Seidel third-order aberration theory, the paper derives apochromatic formula, and the power of individual lenses can be calculated. Then with a required value of spherical aberration and coma, this paper derives equations to calculate the initial structure of apochromatic optical systems. Finally, optimized refractive SWIR fore-optics working in 1μm-2.5μm with effective focal length (EFFL) of 11mm is reported. Its full field and F-number are respectively 40°, F/2.8. The system has many advantages such as simple and compact structure, small size, near diffraction-limited imaging quality, small secondary spectrum and imagery telecentricity. Especially it consists of spherical surfaces that can greatly reduce the difficulty and the cost of manufacture as well as test, which is applicable for SWIR imaging spectrometer with wide field of view.

  3. Quantitative refractive index distribution of single cell by combining phase-shifting interferometry and AFM imaging.

    PubMed

    Zhang, Qinnan; Zhong, Liyun; Tang, Ping; Yuan, Yingjie; Liu, Shengde; Tian, Jindong; Lu, Xiaoxu

    2017-05-31

    Cell refractive index, an intrinsic optical parameter, is closely correlated with the intracellular mass and concentration. By combining optical phase-shifting interferometry (PSI) and atomic force microscope (AFM) imaging, we constructed a label free, non-invasive and quantitative refractive index of single cell measurement system, in which the accurate phase map of single cell was retrieved with PSI technique and the cell morphology with nanoscale resolution was achieved with AFM imaging. Based on the proposed AFM/PSI system, we achieved quantitative refractive index distributions of single red blood cell and Jurkat cell, respectively. Further, the quantitative change of refractive index distribution during Daunorubicin (DNR)-induced Jurkat cell apoptosis was presented, and then the content changes of intracellular biochemical components were achieved. Importantly, these results were consistent with Raman spectral analysis, indicating that the proposed PSI/AFM based refractive index system is likely to become a useful tool for intracellular biochemical components analysis measurement, and this will facilitate its application for revealing cell structure and pathological state from a new perspective.

  4. Toric vs aspherical control intraocular lenses in patients with cataract and corneal astigmatism: a randomized clinical trial.

    PubMed

    Visser, Nienke; Beckers, Henny J M; Bauer, Noel J C; Gast, Sacha T J M; Zijlmans, Bart L M; Berenschot, Tos T J M; Webers, Carroll A; Nuijts, Rudy M M A

    2014-12-01

    Spectacle independence is becoming increasingly important in cataract surgery. Not correcting corneal astigmatism at the time of cataract surgery will fail to achieve spectacle independency in 20% to 30% of patients. To compare bilateral aspherical toric with bilateral aspherical control intraocular lens (IOL) implantation in patients with cataract and corneal astigmatism. A multicenter, hospital-based, randomized clinical trial was conducted. The participants included 86 individuals with bilateral cataract and bilateral corneal astigmatism of at least 1.25 diopters (D) who were randomized to receive either bilateral toric (n = 41) or bilateral control (n = 45) IOL implantation. Bilateral implantation of an aspherical toric IOL or an aspherical control IOL. Spectacle independency for distance vision, uncorrected distance visual acuity, refractive astigmatism, contrast sensitivity, wavefront aberrations, and refractive error-related quality-of-life questionnaire. Preoperatively, mean (SD) corneal astigmatism was 2.02 (0.95) D and 2.00 (0.84) D in the toric and control groups, respectively. Four patients (5%) were lost to follow-up. At 6 months postoperatively, 26 (70%) of the patients in the toric group achieved an uncorrected distance visual acuity of 20/25 or better compared with 14 (31%) in the control group (P < .001; odds ratio, 5.23; 95% CI, 2.03-13.48). Spectacle independency for distance vision was achieved in 31 patients (84%) in the toric group compared with 14 patients (31%) in the control group (P < .001; odds ratio, 11.44; 95% CI, 3.89- 33.63). Mean refractive astigmatism was -0.77 (0.52) D and -1.89 D (1.00) D, respectively. Vector analysis of toric IOLs showed a mean magnitude of error of +0.38 D, indicative of overcorrection. No significant differences were found in contrast sensitivity, higher-order aberrations, or refractive error-related quality of life. In patients with cataract and corneal astigmatism, bilateral toric IOL implantation results in

  5. On- and off-eye spherical aberration of soft contact lenses and consequent changes of effective lens power.

    PubMed

    Dietze, Holger H; Cox, Michael J

    2003-02-01

    Soft contact lenses produce a significant level of spherical aberration affecting their power on-eye. A simple model assuming that a thin soft contact lens aligns to the cornea predicts that these effects are similar on-eye and off-eye. The wavefront aberration for 17 eyes and 33 soft contact lenses on-eye was measured with a Shack-Hartmann wavefront sensor. The Zernike coefficients describing the on-eye spherical aberration of the soft contact lens were compared with off-eye ray-tracing results. Paraxial and effective lens power changes were determined. The model predicts the on-eye spherical aberration of soft contact lenses closely. The resulting power change for a +/- 7.00 D spherical soft contact lens is +/- 0.5 D for a 6-mm pupil diameter and +/- 0.1 D for a 3-mm pupil diameter. Power change is negligible for soft contact lenses corrected for off-eye spherical aberration. For thin soft contact lenses, the level of spherical aberration and the consequent power change is similar on-eye and off-eye. Soft contact lenses corrected for spherical aberration in air will be expected to be aberration-free on-eye and produce only negligibly small power changes. For soft contact lenses without aberration correction, for higher levels of ametropia and large pupils, the soft contact lens power should be determined with trial lenses with their power and p value similar to the prescribed lens. The benefit of soft contact lenses corrected for spherical aberration depends on the level of ocular spherical aberration.

  6. Atmospheric refraction: a history.

    PubMed

    Lehn, Waldemar H; van der Werf, Siebren

    2005-09-20

    We trace the history of atmospheric refraction from the ancient Greeks up to the time of Kepler. The concept that the atmosphere could refract light entered Western science in the second century B.C. Ptolemy, 300 years later, produced the first clearly defined atmospheric model, containing air of uniform density up to a sharp upper transition to the ether, at which the refraction occurred. Alhazen and Witelo transmitted his knowledge to medieval Europe. The first accurate measurements were made by Tycho Brahe in the 16th century. Finally, Kepler, who was aware of unusually strong refractions, used the Ptolemaic model to explain the first documented and recognized mirage (the Novaya Zemlya effect).

  7. Induced Higher-order aberrations after Laser In Situ Keratomileusis (LASIK) Performed with Wavefront-Guided IntraLase Femtosecond Laser in moderate to high Astigmatism.

    PubMed

    Al-Zeraid, Ferial M; Osuagwu, Uchechukwu L

    2016-03-22

    Wavefront-guided Laser-assisted in situ keratomileusis (LASIK) is a widespread and effective surgical treatment for myopia and astigmatic correction but whether it induces higher-order aberrations remains controversial. The study was designed to evaluate the changes in higher-order aberrations after wavefront-guided ablation with IntraLase femtosecond laser in moderate to high astigmatism. Twenty-three eyes of 15 patients with moderate to high astigmatism (mean cylinder, -3.22 ± 0.59 dioptres) aged between 19 and 35 years (mean age, 25.6 ± 4.9 years) were included in this prospective study. Subjects with cylinder ≥ 1.5 and ≤2.75 D were classified as moderate astigmatism while high astigmatism was ≥3.00 D. All patients underwent a femtosecond laser-enabled (150-kHz IntraLase iFS; Abbott Medical Optics Inc) wavefront-guided ablation. Uncorrected (UDVA), corrected (CDVA) distance visual acuity in logMAR, keratometry, central corneal thickness (CCT) and higher-order aberrations (HOAs) over a 6 mm pupil, were assessed before and 6 months, postoperatively. The relationship between postoperative change in HOA and preoperative mean spherical equivalent refraction, mean astigmatism, and postoperative CCT were tested. At the last follow-up, the mean UDVA was increased (P < 0.0001) but CDVA remained unchanged (P = 0.48) and no eyes lost ≥2 lines of CDVA. Mean spherical equivalent refraction was reduced (P < 0.0001) and was within ±0.50 D range in 61% of eyes. The average corneal curvature was flatter by 4 D and CCT was reduced by 83 μm (P < 0.0001, for all), postoperatively. Coma aberrations remained unchanged (P = 0.07) while the change in trefoil (P = 0.047) postoperatively, was not clinically significant. The 4th order HOAs (spherical aberration and secondary astigmatism) and the HOA root mean square (RMS) increased from -0.18 ± 0.07 μm, 0.04 ± 0.03 μm and 0.47 ± 0.11 μm, preoperatively, to 0.33 ± 0

  8. Femtosecond (FS) laser vision correction procedure for moderate to high myopia: a prospective study of ReLEx(®) flex and comparison with a retrospective study of FS-laser in situ keratomileusis.

    PubMed

    Vestergaard, Anders; Ivarsen, Anders; Asp, Sven; Hjortdal, Jesper Ø

    2013-06-01

    To present our initial clinical experience with ReLEx(®) flex (ReLEx) for moderate to high myopia. We compare efficacy, safety and corneal higher-order aberrations after ReLEx with femtosecond laser in situ keratomileusis (FS-LASIK). Prospective study of ReLEx compared with a retrospective study of FS-LASIK. ReLEx is a new keratorefractive procedure, where a stromal lenticule is cut by a femtosecond laser and manually extracted. Forty patients were treated with ReLEx on both eyes. A comparable group of 41 FS-LASIK patients were retrospectively identified. Visual acuity, spherical equivalent (SE) and corneal tomography were measured before and 3 months after surgery. Preoperative SE averaged -7.50 ± 1.16 D (ReLEx) and -7.32 ± 1.09 D (FS-LASIK). For all eyes, mean corrected distance visual acuity remained unchanged in both groups. For eyes with emmetropia as target refraction, 41% of ReLEx and 61% of FS-LASIK eyes had an uncorrected distance visual acuity of logMAR ≤ 0.10 at day 1 after surgery, increasing to, respectively, 88% and 69% at 3 months. Mean SE was -0.06 ± 0.35 D 3 months after ReLEx and -0.53 ± 0.60 D after FS-LASIK. The proportion of eyes within ±1.00 D after 3 months was 100% (ReLEx) and 85% (FS-LASIK). For a 6.0-mm pupil, corneal spherical aberrations increased significantly less in ReLEx than FS-LASIK eyes. ReLEx is an all-in-one femtosecond laser refractive procedure, and in this study, results were comparable to FS-LASIK. Refractive predictability and corneal aberrations at 3 months seemed better than or equal to FS-LASIK, whereas visual recovery after ReLEx was slower. © 2012 The Authors. Acta Ophthalmologica © 2012 Acta Ophthalmologica Scandinavica Foundation.

  9. Femtosecond-LASIK outcomes using the VisuMax®-MEL® 80 platform for mixed astigmatism refractive surgery.

    PubMed

    Stanca, Horia Tudor; Munteanu, Mihnea; Jianu, Dragoş Cătălin; Motoc, Andrei Gheorghe Marius; Jecan, Cristian Radu; Tăbăcaru, Bogdana; Stanca, Simona; Preda, Maria Alexandra

    2018-01-01

    To evaluate the predictability, efficacy and safety of Femtosecond-laser-assisted in situ keratomileusis (LASIK) procedure for mixed astigmatism. We prospectively evaluated for 12 months 74 eyes (52 patients) with mixed astigmatism that underwent Femtosecond-LASIK treatment. The preoperative mean refractive sphere value was +1.879±1.313 diopters (D) and the mean refractive cylinder value was -4.169±1.091 D. The anterior corneal flap was cut using the VisuMax® femtosecond laser and then the stromal ablation was done using the MEL® 80 excimer laser. Mean age was 30.22±6.421 years with 61.53% female patients. Postoperative spherical equivalent at 12 months was within ±0.5D of emmetropia in 75.8% of eyes and within ±1D in 97.3% of eyes. Postoperative uncorrected distance visual acuity was equivalent to or better than the preoperative corrected distance visual acuity in 91.9% of eyes. Compared to the preoperative corrected distance visual acuity (CDVA), 8.1% of eyes gained one line, 2.7% gained two lines and 2.7% gained three lines of visual acuity. Femtosecond-LASIK using the VisuMax®-MEL® 80 platform appears to have safe, effective and predictable results in mixed astigmatic eyes. The results are impressive for high refractive error treatment and for improvement of both uncorrected and corrected distance visual acuity.

  10. [Femtosecond laser in cataract surgery. A critical appraisal].

    PubMed

    Menapace, R M; Dick, H B

    2014-01-01

    The use of femtosecond lasers (FSL) is increasingly spreading in cataract surgery. Potential advantages over standard manual cataract surgery are the superior precision of corneal incisions and capsular openings as well as the reduction of ultrasound energy for lens nucleus work-up. Exact positioning and dimensioning of the anterior capsular opening should help reduce decentration and tilt of the intraocular lens (IOL) optics and thus achieve better target refraction. Together with the possibility to correct low-grade corneal astigmatism by precise arcuate incision, FSL technology is expected to convert cataract surgery from a purely curative into a refractive procedure. Apart from own experiences this review article critically analyses the pertinent literature published so far as well as congress presentations and personal reports of other FSL surgeons. The advantages and disadvantages are scrutinized with regard to their impact on the surgical and refractive results and compared with those experienced by the authors with manual cataract surgery over several decades. Economic and healthcare political aspects are also addressed. The use of FSL surgery improves the precision and reproducibility of corneal incisions and the capsular opening and reduces the amount of ultrasound energy required for lens nucleus work-up. However, the clinical benefits must be put into perspective due to the subsequent surgical manipulation of the incisions (during lens emulsification, aspiration and IOL injection), the lacking possibility to visualize the crystalline lens equator as the reference for correct capsulotomy centration and the relativity of ultrasound energy consumption on the corneal endothelial trauma. This is of particular relevance against the background of the significantly higher costs. Conversely, tears of the anterior capsule edge which, apart from interfering with correct IOL positioning, may entail serious complications presently occur more frequently with all FSL

  11. Comparison of single-step reverse transepithelial all-surface laser ablation (ASLA) to alcohol-assisted photorefractive keratectomy.

    PubMed

    Aslanides, Ioannis M; Padroni, Sara; Arba Mosquera, Samuel; Ioannides, Antonis; Mukherjee, Achyut

    2012-01-01

    To evaluate postoperative pain, corneal epithelial healing, development of corneal haze, refractive outcomes, and corneal aberrations in a novel one-step, modified transepithelial photorefractive keratectomy (PRK), termed All-surface laser ablation (ASLA), compared to conventional, alcohol-assisted PRK. Sixty eyes of 30 myopic patients were prospectively recruited to a randomized fellow eye study. Patients underwent conventional alcohol-assisted PRK in one eye (control group) and ASLA-modified transepithelial PRK in the other (30 eyes in each treatment arm). Primary endpoints were postoperative pain and haze scores at 1 day, 3 days, 1 week, and 1, 3, 6, and 12 months. Secondary endpoints included visual acuity at 1, 3, 6, and 12 months, corneal aberrations at 3, 6, and 12 months, and early and late onset haze. Refractive predictability, safety, and efficacy of the two methods were considered. The average age of the cohort was 29 years (standard deviation [SD]: 9; range: 18-46), and the average spherical equivalent refractive error was -4.18 diopters (SD: 1.9). At 3 days after surgery, the average pain score was 64% lower in the ASLA group (P < 0.0005). At this point, 96% of ASLA eyes had no epithelial defect, whereas 43% in the alcohol-assisted group did not achieve complete epithelial healing, and required replacement of bandage contact lens. The haze level was consistently lower in the ASLA group at all time points from 1 to 6 months. This study shows that the ASLA technique may have a future role in refractive surgery, due to the fact that it offers faster epithelial healing, lower pain scores, and significantly less haze formation.

  12. Comparison of single-step reverse transepithelial all-surface laser ablation (ASLA) to alcohol-assisted photorefractive keratectomy

    PubMed Central

    Aslanides, Ioannis M; Padroni, Sara; Mosquera, Samuel Arba; Ioannides, Antonis; Mukherjee, Achyut

    2012-01-01

    Purpose To evaluate postoperative pain, corneal epithelial healing, development of corneal haze, refractive outcomes, and corneal aberrations in a novel one-step, modified transepithelial photorefractive keratectomy (PRK), termed All-surface laser ablation (ASLA), compared to conventional, alcohol-assisted PRK. Materials and methods Sixty eyes of 30 myopic patients were prospectively recruited to a randomized fellow eye study. Patients underwent conventional alcohol-assisted PRK in one eye (control group) and ASLA-modified transepithelial PRK in the other (30 eyes in each treatment arm). Primary endpoints were postoperative pain and haze scores at 1 day, 3 days, 1 week, and 1, 3, 6, and 12 months. Secondary endpoints included visual acuity at 1, 3, 6, and 12 months, corneal aberrations at 3, 6, and 12 months, and early and late onset haze. Refractive predictability, safety, and efficacy of the two methods were considered. Results The average age of the cohort was 29 years (standard deviation [SD]: 9; range: 18–46), and the average spherical equivalent refractive error was −4.18 diopters (SD: 1.9). At 3 days after surgery, the average pain score was 64% lower in the ASLA group (P < 0.0005). At this point, 96% of ASLA eyes had no epithelial defect, whereas 43% in the alcohol-assisted group did not achieve complete epithelial healing, and required replacement of bandage contact lens. The haze level was consistently lower in the ASLA group at all time points from 1 to 6 months. Conclusion This study shows that the ASLA technique may have a future role in refractive surgery, due to the fact that it offers faster epithelial healing, lower pain scores, and significantly less haze formation. PMID:22815640

  13. Photorefractive keratectomy in the cat eye: biological and optical outcomes

    PubMed Central

    Nagy, Lana J.; MacRae, Scott; Yoon, Geunyoung; Wyble, Matthew; Wang, Jianhua; Cox, Ian; Huxlin, Krystel R.

    2007-01-01

    PURPOSE To quantify optical and biomechanical properties of the feline cornea before and after photorefractive keratectomy (PRK) and assess the relative contribution of different biological factors to refractive outcome. SETTING Dept. Ophthalmology, University of Rochester, Rochester, New York, U.S.A. METHODS Adult cats underwent 6D myopic or 4D hyperopic PRK over 6 or 8mm optical zones (OZ). Pre- and post-operative wavefront aberrations were measured, along with intraocular pressure, corneal hysteresis (CH), corneal resistance factor (CRF), axial length, corneal thickness and radii of curvature. Finally, post-mortem imunohistochemistry for Vimentin and α-smooth muscle actin was performed. RESULTS PRK changed ocular defocus, increased higher order aberrations and induced myofibroblast differentiation in cats. However, the intended defocus corrections were only achieved with 8mm OZs. Long-term flattening of the epithelial and stromal surfaces was noted following myopic, but nor hyperopic PRKs. Feline intraocular pressure was unaltered by PRK, but CH and CRF decreased. Over the ensuing 6 months, ocular aberrations and intraocular pressure remained stable, while central corneal thickness, CH and CRF increased back towards normal levels. CONCLUSIONS Cat corneas exhibited optical, histological and biomechanical reactions to PRK that resembled those previously described in humans, especially when optical zone size was normalized to total corneal area. However, cats exhibited significant stromal regeneration, causing a return to pre-operative corneal thickness, CH and CRF without significant regression of optical changes induced by the surgery. Thus, the principal effects of laser refractive surgery on ocular wavefront aberrations can be achieved in spite of clear, inter-species differences in corneal biology. PMID:17531702

  14. Photorefractive keratectomy in the cat eye: biological and optical outcomes.

    PubMed

    Nagy, Lana J; MacRae, Scott; Yoon, Geunyoung; Wyble, Matthew; Wang, Jianhua; Cox, Ian; Huxlin, Krystel R

    2007-06-01

    To quantify optical and biomechanical properties of the feline cornea before and after photorefractive keratectomy (PRK) and assess the relative contribution of different biological factors to refractive outcome. Department of Ophthalmology, University of Rochester, Rochester, New York, USA. Adult cats had 6.0 diopter (D) myopic or 4.0 D hyperopic PRK over 6.0 or 8.0 mm optical zones (OZ). Preoperative and postoperative wavefront aberrations were measured, as were intraocular pressure (IOP), corneal hysteresis, the corneal resistance factor, axial length, corneal thickness, and radii of curvature. Finally, postmortem immunohistochemistry for vimentin and alpha-smooth muscle actin was performed. Photorefractive keratectomy changed ocular defocus, increased higher-order aberrations, and induced myofibroblast differentiation in cats. However, the intended defocus corrections were only achieved with 8.0 mm OZs. Long-term flattening of the epithelial and stromal surfaces was noted after myopic, but not after hyperopic, PRK. The IOP was unaltered by PRK; however, corneal hysteresis and the corneal resistance factor decreased. Over the ensuing 6 months, ocular aberrations and the IOP remained stable, while central corneal thickness, corneal hysteresis, and the corneal resistance factor increased toward normal levels. Cat corneas exhibited optical, histological, and biomechanical reactions to PRK that resembled those previously described in humans, especially when the OZ size was normalized to the total corneal area. However, cats exhibited significant stromal regeneration, causing a return to preoperative corneal thickness, corneal hysteresis and the corneal resistance factor without significant regression of optical changes induced by the surgery. Thus, the principal effects of laser refractive surgery on ocular wavefront aberrations can be achieved despite clear interspecies differences in corneal biology.

  15. Evaluation of Topical Lignocaine Jelly 2% for Recurrent Pterygium Surgery with Glue-free Autologous Conjunctival Graft

    PubMed Central

    Joshi, Rajesh Subhash

    2017-01-01

    AIM: This study aims to evaluate the efficacy of lignocaine 2% jelly as a topical anesthesia in recurrent pterygium surgery with glue-free conjunctival limbal autograft. MATERIALS AND METHODS: A prospective, nonrandomized, observational study, comprising of 51 patients (51 eyes) having recurrent pterygium, was conducted at a tertiary eye care center in central India. Pterygium excision with glue-free autologous conjunctival grafting was done under 2% lignocaine jelly. The visual analog scale was utilized to record the intra- and post-operative pain score. Patient comfort, intraoperative painful sensations perceived by the patient, supplemental anesthesia, complications, and surgeon discomfort were noted. Anesthetist also noted vital parameters and any intravenous drugs required. RESULTS: No difference in intra- and post-operative pain score (P = 0.24) was observed in the patients. Zero score, i.e. no pain was noticed in 30 patients (58.8%) patients. The average surgical time was 29.20 min (+1.11). The average surgeon discomfort score was 0.18 + 0.51. Inadvertent eye movement was seen in 3 patients (5.9%). Lid squeeze was noted in 45 patients (88.2%) during placement of lid speculum. Forty-eight patients (94.1%) gave preference to the topical anesthesia of 2% lignocaine jelly compared to the previous mode of anesthesia. CONCLUSION: Pterygium surgery with glue-free autogenous conjunctival grafting can be performed successfully by preoperative local application of 2% lignocaine jelly. The ease of application, lack of toxicity and sufficient effect to complete the surgery make it an efficient alternative to injectable anesthetics. PMID:29279652

  16. Metal-Free Poly-Cycloaddition of Activated Azide and Alkynes toward Multifunctional Polytriazoles: Aggregation-Induced Emission, Explosive Detection, Fluorescent Patterning, and Light Refraction.

    PubMed

    Wu, Yongwei; He, Benzhao; Quan, Changyun; Zheng, Chao; Deng, Haiqin; Hu, Rongrong; Zhao, Zujin; Huang, Fei; Qin, Anjun; Tang, Ben Zhong

    2017-09-01

    The metal-free click polymerization (MFCP) of activated alkynes and azides or activated azide and alkynes have been developed into powerful techniques for the construction of polytriazoles without the obsession of metallic catalyst residues problem. However, the MFCP of activated azides and alkynes is rarely applied in preparation of functional polytriazoles. In this paper, soluble multifunctional polytriazoles (PIa and PIb) with high weight-average molecular weights (M w up to 32 000) are prepared via the developed metal-free poly-cycloaddition of activated azide and alkynes in high yields (up to 90%). The resultant PIa and PIb are thermally stable, and show aggregation-induced emission characteristics, enabling their aggregates to detect explosives with superamplification effect. Moreover, thanks to their containing aromatic rings and polar moieties, PIa and PIb exhibit high refractive indices. In addition, they can also be cross-linked upon UV irradiation to generate 2D fluorescent patterning due to their remaining azide groups and containing ester groups. Thus, these multifunctional polytriazoles are potentially applicable in the optoelectronic and sensing fields. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  17. Interferometric Methods of Measuring Refractive Indices and Double-Refraction of Fibres.

    ERIC Educational Resources Information Center

    Hamza, A. A.; El-Kader, H. I. Abd

    1986-01-01

    Presents two methods used to measure the refractive indices and double-refraction of fibers. Experiments are described, with one involving the use of Pluta microscope in the double-beam interference technique, the other employing the multiple-beam technique. Immersion liquids are discussed that can be used in the experiments. (TW)

  18. Refraction in the lower troposphere: Higher order image distortion effects due to refractive profile curvature

    NASA Astrophysics Data System (ADS)

    Short, Daniel J.

    There are many applications that rely on the propagation of light through the atmosphere - all of which are subject to atmospheric conditions. While there are obvious processes such as scattering due to particulates like clouds and dust that affect the received intensity of the radiation, the clear atmosphere can also cause significant effects. Refraction is a clear air effect that can cause a variety of phenomena such as apparent relocation, stretching and compression of objects when viewed through the atmosphere. Recently, there has been significant interest in studying the refractive effects for low angle paths within the troposphere, and in particular, near-horizontal paths in the Earth's boundary layer, which is adjacent to the ground. Refractive effects in this case become problematic for many terrestrial optical applications. For example, the pointing of a free space optical communication or a remote sensing system can suffer wandering effects, high-resolution imagery can present distorted and/or dislocated targets, optical tracking of targets can be inaccurate, and optical geodetic surveying accuracy is also very sensitive to the effects of refraction. The work in this dissertation was inspired by data from a time-lapse camera system that collects images of distant targets over a near-horizontal path along the ground. This system was used previously to study apparent diurnal image displacement and this dissertation extends that work by exploring the higher order effects that result from curvature in the vertical refractive index profile of the atmosphere. There are surprisingly few experiments involving atmospheric refractive effects that carefully correlate field data to analytical expressions and other factors such as meteorological data. In working with the time-lapse data, which is comprised of sequences of hundreds or thousands of images collected over durations of weeks or months, it is important to develop straightforward analysis techniques that can

  19. Headache and refractive errors in children.

    PubMed

    Roth, Zachary; Pandolfo, Katie R; Simon, John; Zobal-Ratner, Jitka

    2014-01-01

    To investigate the association between uncorrected or miscorrected refractive errors in children and headache, and to determine whether correction of refractive errors contributes to headache resolution. Results of ophthalmic examination, including refractive error, were recorded at initial visit for headache. If resolution of headache on subsequent visits was not documented, a telephone call was placed to their caregivers to inquire whether headache had resolved. Of the 158 patients, 75.3% had normal or unchanged eye examinations, including refractions.Follow-up data were available for 110 patients. Among those, 32 received new or changed spectacle correction and 78 did not require a change in refraction.Headaches improved in 76.4% of all patients, whether with (71.9%) or without (78.2%) a change in refractive correction. The difference between these two groups was not statistically significant (P = .38). Headaches in children usually do not appear to be caused by ophthalmic disease, including refractive error. The prognosis for improvement is favorable, regardless of whether refractive correction is required. Copyright 2014, SLACK Incorporated.

  20. Gradients of refractive index in the crystalline lens and transient changes in refraction among patients with diabetes.

    PubMed

    Charman, W Neil; Adnan; Atchison, David A

    2012-12-01

    Transient hyperopic refractive shifts occur on a timescale of weeks in some patients after initiation of therapy for hyperglycemia, and are usually followed by recovery to the original refraction. Possible lenticular origin of these changes is considered in terms of a paraxial gradient index model. Assuming that the lens thickness and curvatures remain unchanged, as observed in practice, it appears possible to account for initial hyperopic refractive shifts of up to a few diopters by reduction in refractive index near the lens center and alteration in the rate of change between center and surface, so that most of the index change occurs closer to the lens surface. Restoration of the original refraction depends on further change in the refractive index distribution with more gradual changes in refractive index from the lens center to its surface. Modeling limitations are discussed.

  1. Gradients of refractive index in the crystalline lens and transient changes in refraction among patients with diabetes

    PubMed Central

    Charman, W. Neil; Adnan; Atchison, David A.

    2012-01-01

    Transient hyperopic refractive shifts occur on a timescale of weeks in some patients after initiation of therapy for hyperglycemia, and are usually followed by recovery to the original refraction. Possible lenticular origin of these changes is considered in terms of a paraxial gradient index model. Assuming that the lens thickness and curvatures remain unchanged, as observed in practice, it appears possible to account for initial hyperopic refractive shifts of up to a few diopters by reduction in refractive index near the lens center and alteration in the rate of change between center and surface, so that most of the index change occurs closer to the lens surface. Restoration of the original refraction depends on further change in the refractive index distribution with more gradual changes in refractive index from the lens center to its surface. Modeling limitations are discussed. PMID:23243557

  2. Clinical outcomes of wavefront-guided laser in situ keratomileusis: 6-month follow-up.

    PubMed

    Aizawa, Daisuke; Shimizu, Kimiya; Komatsu, Mari; Ito, Misae; Suzuki, Masanobu; Ohno, Koji; Uozato, Hiroshi

    2003-08-01

    To evaluate the clinical outcomes 6 months after wavefront-guided laser in situ keratomileusis (LASIK) for myopia in Japan. Department of Ophthalmology, Sanno Hospital, Tokyo, Japan. This prospective study comprised 22 eyes of 12 patients treated with wavefront-guided LASIK who were available for evaluation at 6 months. The mean patient age was 31.2 years +/- 8.4 (SD) (range 23 to 50 years), and the mean preoperative spherical equivalent refraction was -7.30 +/- 2.72 diopters (D) (range -2.75 to -11.88 D). In all cases, preoperative wavefront analysis was performed with a Hartmann-Shack aberrometer and the Technolas 217z flying-spot excimer laser system (Bausch & Lomb) was used with 1.0 mm and 2.0 mm spot sizes and an active eye tracker with a 120 Hz tracking rate. The clinical outcomes of wavefront-guided LASIK were evaluated in terms of safety, efficacy, predictability, stability, complications, and preoperative and postoperative aberrations. At 6 months, 10 eyes had no change in best spectacle-correct visual acuity and 10 gained 1 or more lines. The safety index was 1.11 and the efficacy index, 0.82. Slight undercorrections were observed in highly myopic eyes. In all eyes, the postoperative refraction tended slightly toward myopia for 3 months and stabilized after that. No complication such as epithelial ingrowth, diffuse lamellar keratitis, or infection was observed. Comparison of the preoperative and postoperative aberrations showed that 2nd-order aberrations decreased and higher-order aberrations increased. In the 3rd order, aberrations increased in the high-myopia group (-6.0 D or worse) and decreased in the low to moderate-myopia group (better than -6.0 D). Wavefront-guided LASIK was a good option for refractive surgery, although a longer follow-up in a larger study is required.

  3. Negative refraction in molybdenum disulfide.

    PubMed

    Wang, Wenhui; Cui, Xudong; Yang, Erchan; Fan, Quanping; Xiang, Bin

    2015-08-24

    Recently, negative refractions have been demonstrated in uniaxial crystals with no necessary of negative permittivity and permeability. However, the small anisotropy parameterγin the uniaxial crystals limits the negative refraction occurrence only in a small range of the incident light angle, retarding its practical applications. In this paper, we report negative refraction induced by a pronounced anisotropic behavior in the bulk MoS(2). Using the first-principles, the dielectric function and refractive index calculations confirm a uniaxial trait of MoS(2) with a calculated anisotropy parameterγlarger than 2.5 in the entire range of visible wavelength. The critical incident angle to trigger a negative refraction in the bulk MoS(2) is calculated up to 90°. The finite-difference time-domain simulations prove that the incident light with a density of 59.5% can be negatively refracted in a MoS(2) slab with a thickness of 0.1 µm. Our results open up a new pathway for MoS(2)-like materials to a novel field of optical integration.

  4. Baseline peripheral refractive error and changes in axial refraction during one year in a young adult population.

    PubMed

    Hartwig, Andreas; Charman, William Neil; Radhakrishnan, Hema

    2016-01-01

    To determine whether the initial characteristics of individual patterns of peripheral refraction relate to subsequent changes in refraction over a one-year period. 54 myopic and emmetropic subjects (mean age: 24.9±5.1 years; median 24 years) with normal vision were recruited and underwent conventional non-cycloplegic subjective refraction. Peripheral refraction was also measured at 5° intervals over the central 60° of horizontal visual field, together with axial length. After one year, measurements of subjective refraction and axial length were repeated on the 43 subjects who were still available for examination. In agreement with earlier studies, higher myopes tended to show greater relative peripheral hyperopia. There was, however, considerable inter-subject variation in the pattern of relative peripheral refractive error (RPRE) at any level of axial refraction. Across the group, mean one-year changes in axial refraction and axial length did not differ significantly from zero. There was no correlation between changes in these parameters for individual subjects and any characteristic of their RPRE. No evidence was found to support the hypothesis that the pattern of RPRE is predictive of subsequent refractive change in this age group. Copyright © 2015 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

  5. Objective functional visual outcomes of cataract surgery in patients with good preoperative visual acuity

    PubMed Central

    Zhu, X; Ye, H; He, W; Yang, J; Dai, J; Lu, Y

    2017-01-01

    Purpose To explore the objective functional visual outcomes of cataract surgery in patients with good preoperative visual acuity. Methods We enrolled 130 cataract patients whose best-corrected visual acuity (BCVA) was 20/40 or better preoperatively. Objective visual functions were evaluated with a KR-1W analyzer before and at 1 month after cataract surgery. Results The nuclear (N), cortical (C), and N+C groups had very high preoperative ocular and internal total high-order aberrations (HOAs), coma, and abnormal spherical aberrations. At 1 month after cataract surgery, in addition to the remarkable increase of both uncorrected visual acuity and BCVA, both ocular and internal HOAs in the three groups decreased significantly after cataract surgery (all P<0.05). Point spread function and modulation transfer functions were also improved significantly in these patients (all P<0.05). Conclusions The objective functional vision of patients with 20/40 or better preoperative BCVA improved significantly after cataract surgery. This finding shows that the arbitrary threshold of BCVA worse than 20/40 in China cannot always be used to determine who will benefit from cataract surgery. PMID:27858933

  6. Diffractive Optical Analysis for Refractive Index Sensing using Transparent Phase Gratings

    PubMed Central

    Kumawat, Nityanand; Pal, Parama; Varma, Manoj

    2015-01-01

    We report the implementation of a micro-patterned, glass-based photonic sensing element that is capable of label-free biosensing. The diffractive optical analyzer is based on the differential response of diffracted orders to bulk as well as surface refractive index changes. The differential read-out suppresses signal drifts and enables time-resolved determination of refractive index changes in the sample cell. A remarkable feature of this device is that under appropriate conditions, the measurement sensitivity of the sensor can be enhanced by more than two orders of magnitude due to interference between multiply reflected diffracted orders. A noise-equivalent limit of detection (LoD) of 6 × 10−7 was achieved with this technique with scope for further improvement. PMID:26578408

  7. [Trends of refractive correction in the Japanese Ground Self-Defense Forces: examination after the Great East Japan earthquake].

    PubMed

    Harimoto, Kouzo; Kato, Naoko; Shoji, Takuhei; Goto, Hiroya; Tokuno, Shinichi; Fujii, Manabu; Takeuchi, Masaru

    2014-02-01

    To investigate the trends in refractive correction in Japanese Ground Self-Defense Forces' (JGSDF) soldiers. A questionnaire was distributed to 519 soldiers of the Camp Funaoka in the northeastern region. Five hundred and sixteen subjects (99.4%) responded. In total, 246 soldiers (47.7%) wore spectacles or contact lenses. Among the contact lens wearers, 52 had experienced problems previously and 35 reported problems that occurred during military exercises. With regard to military exercises, 66.9% and 63.5% of the spectacle or disposable soft contact lens-users reported inconvenience. Among contact lens users, 33.1% reported that they changed to new sterilized contact lenses only occasionally and 61.9% did not change their contact lenses at all during exercises. During disaster-relief work, subjects worried 'very' (21.5%) or 'somewhat' (46.9%) about problems associated with their spectacles or contact lenses. Twenty-four had undergone refractive surgery (4.9%). About one-half of the JGSDF soldiers surveyed required refractive correction. Attention to convenient and safe refractive correction in the military is warranted.

  8. Refraction and scattering of sound by a shear layer

    NASA Technical Reports Server (NTRS)

    Schlinker, R. H.; Amiet, R. K.

    1980-01-01

    The angle and amplitude changes for acoustic waves refracted by a circular open jet shear layer were determined. The generalized refraction theory was assessed experimentally for on axis and off axis acoustic source locations as source frequency varied from 1 kHz to 10 kHz and free stream Mach number varied from 0.1 to 0.4. Angle and amplitude changes across the shear layer show good agreement with theory. Experiments confirm that the refraction theory is independent of shear layer thickness, acoustic source frequency, and source type. A generalized theory is, thus, available for correcting far field noise data acquired in open jet test facilities. The effect of discrete tone scattering by the open jet turbulent shear layer was also studied. Scattering effects were investigated over the same Mach number range as frequency varied from 5 kHz to 15 kHz. Attenuation of discrete tone amplitude and tone broadening were measured as a function of acoustic source position and radiation angle. Scattering was found to be stronger at angles close to the open jet axis than at 90 deg, and becomes stronger as the acoustic source position shifts downstream. A scattering analysis provided an estimate of the onset of discrete tone scattering.

  9. Two-dimensional single crystal diamond refractive x-ray lens

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Antipov, S., E-mail: s.antipov@euclidtechlabs.com; Baryshev, S. V.; Butler, J. E.

    2016-07-27

    The next generation light sources such as diffraction-limited storage rings and high repetition rate x-ray free-electron lasers will generate x-ray beams with significantly increased brilliance. These future machines will require X-ray optical components that are capable of handling higher instantaneous and average power densities while tailoring the properties of the x-ray beams for a variety of scientific experiments. Single crystal diamond is one of the best bulk materials for this application, because it is radiation hard, has a suitable uniform index of refraction and the best available thermal properties. In this paper we report on fabrication and experimental testing ofmore » a two-dimensional (2D) single crystal diamond compound refractive X-ray lenses (CRL). These lenses were manufactured using femto-second laser cutting and tested at the Advanced Photon Source of Argonne National Laboratory.« less

  10. Causality, Nonlocality, and Negative Refraction.

    PubMed

    Forcella, Davide; Prada, Claire; Carminati, Rémi

    2017-03-31

    The importance of spatial nonlocality in the description of negative refraction in electromagnetic materials has been put forward recently. We develop a theory of negative refraction in homogeneous and isotropic media, based on first principles, and that includes nonlocality in its full generality. The theory shows that both dissipation and spatial nonlocality are necessary conditions for the existence of negative refraction. It also provides a sufficient condition in materials with weak spatial nonlocality. These fundamental results should have broad implications in the theoretical and practical analyses of negative refraction of electromagnetic and other kinds of waves.

  11. [Application and development of free composite tissue flap in plastic surgery].

    PubMed

    Lu, Kaihua; Han, Yan; Guo, Shuzhong

    2007-09-01

    To summarize and review the development and experience of anastomosis vascular pedicle free composite tissue flap. From July 1987 to March 2007, 321 patients with complete records were treated. Fourteen tissue flaps were applied for the repair of trauma or tumor excision defects of the body, and for organ reconstruction. Vascular crisis occurred in 20 patients within 48 hours postoperatively. Necrosis occurred at flap end in 6 patients. The total survival rate was 94.8%. The main experience was: (1) Training to grasp the basic micro-vascular anastomosis technique was very important starting up period for surgeons. The basic technique should be often practiced to ensure the safty of clinical application. (2) Restoring appearance and function were equally important in practice. (3) Utilizing the minimal invasive methods and decreasing the loss of function of donor site were important for improvement of reconstruction quality. The purpose was to achieve functional and esthetic restoration in the condition of lowest donor site scarification. The application of free composite tissue flap is important for the development of plastic surgery. There are extensive applications for free flap, especially for those critical patients. The application of free flap could decrease the mobility rate, shorten the treatment period, ease the pain of patients and improve the reconstruction effect. The experience of donor site selection, the strategy of poor recipient site condition, the advantages and disadvantages of muscle flap, the applications time, infections wound treatment and application, are helpful for the future application.

  12. Prevalence of refractive errors among schoolchildren in rural central Ethiopia.

    PubMed

    Mehari, Zelalem Addisu; Yimer, Abdirahman Wollie

    2013-01-01

    The aim of the present study was to assess the prevalence of refractive errors and visual impairment among schoolchildren in rural central Ethiopia. A cross-sectional study was conducted from November 2010 to January 2011 among 5,470 schoolchildren from 14 schools, of whom 4,238 (aged 7-18 years) were screened for refractive errors. In all participants, uncorrected vision and best corrected visual acuity were determined and those with a visual acuity of 6/12 or worse, underwent a complete ophthalmic examination to determine the cause of visual impairment. Myopia was defined as a spherical equivalent of -0.50 dioptre (D) or greater in one or both eyes and hyperopia as a spherical equivalent of +2.00 D or greater. A cylindrical power of -0.50 DC (D cylinder) or greater was considered as astigmatism. Chi-square was used to test differences in proportions. Differences were considered to be statistically significant at the five per cent level. Of the 4,238 children, 405 (9.5 per cent) were visually impaired and of these 267 children were diagnosed as having refractive errors, with an overall prevalence of 6.3 per cent, comprised of 6.1 per cent in boys and 6.6 per cent in girls. Myopia is the most prevalent refractive error; accounting for 6.0 per cent, followed by compound myopic astigmatism 1.2 per cent, then simple myopic astigmatism 0.5 per cent, mixed astigmatism 0.26 per cent and finally hyperopia 0.33 per cent. Reasons for visual acuity of 6/12 or worse in the better eye were found to be refractive error (65.9 per cent), corneal problems (12.8 per cent) and amblyopia (9.6 per cent). The prevalence of manifest strabismus in the study group was 1.1 per cent (n = 45). The study concluded that uncorrected refractive error is a common cause of visual impairment among schoolchildren in rural central Ethiopia. This indicates the need for regular school-screening programs that provide glasses at low cost or free of charge for those who have refractive errors. © 2012 The

  13. OF TRYPANOSOMATIDS. ENDOTRANSFORMATIONS AND ABERRATIONS].

    PubMed

    Frolov, A O; Malysheva, M N; Kostygov, A Yu

    2016-01-01

    Endotransformations and aberrations of the life cycle in the evolutionary history of trypanosomatids (Kinetoplastea: Trypanosomatidae) are analyzed. We treat the term "endotransformations" as evolutionarily fixed changes of phases and/or developmental stages of parasites. By contrast, we treat aberrations as evolutionary unstable, periodically arising deformations of developmental phases of trypanosomatids, never leading to life cycle changes. Various examples of life cycle endotransformations and aberrations in representatives of the family Trypanosomatidae are discussed.

  14. High transmission Ni compound refractive lens for high energy X-rays

    DOE Office of Scientific and Technical Information (OSTI.GOV)

    Brancewicz, M., E-mail: brancew@spring8.or.jp; Itou, M.; Sakurai, Y.

    We present a new planar Ni compound refractive lens for high energy X-rays (116 keV). The lens is composed of identical plano-concave elements with longitudinal parabolic grooves manufactured by a punch technique. In order to increase the lens transmission, the thickness of the single lens at the parabolic groove vertex was reduced to less than 5 μm and the radius of curvature was reduced to about 20 μm. The small radius of curvature allowed us to reduce the number of single elements needed to get the focal length of 3 m to 54 single lenses. The gain parameter has beenmore » significantly improved compared to the previous lenses due to higher transmission, but the focused beam size and its gain are not as good as expected, mostly due to the aberrations caused by the lens shape imperfections.« less

  15. [Reproducibility of subjective refraction measurement].

    PubMed

    Grein, H-J; Schmidt, O; Ritsche, A

    2014-11-01

    Reproducibility of subjective refraction measurement is limited by various factors. The main factors affecting reproducibility include the characteristics of the measurement method and of the subject and the examiner. This article presents the results of a study on this topic, focusing on the reproducibility of subjective refraction measurement in healthy eyes. The results of previous studies are not all presented in the same way by the respective authors and cannot be fully standardized without consulting the original scientific data. To the extent that they are comparable, the results of our study largely correspond largely with those of previous investigations: During repeated subjective refraction measurement, 95% of the deviation from the mean value was approximately ±0.2 D to ±0.65 D for the spherical equivalent and cylindrical power. The reproducibility of subjective refraction measurement in healthy eyes is limited, even under ideal conditions. Correct assessment of refraction results is only feasible after identifying individual variability. Several measurements are required. Refraction cannot be measured without a tolerance range. The English full-text version of this article is available at SpringerLink (under supplemental).

  16. Efficacy, safety, predictability, aberrations and corneal biomechnical parameters after SMILE and FLEx: Meta-analysis.

    PubMed

    Ma, Jing; Cao, Nan-Jue; Xia, Li-Kun

    2016-01-01

    To identify possible differences of efficacy, safety, predictability, higher-order aberrations and corneal biomechnical parameters after small-incision lenticule extraction (SMILE) and femtosecond lenticule extraction (FLEx). A systematic literature retrieval was conducted in Medline, Embase and the Cochrane Library, up to October, 2015. The included studies were subject to a Meta-analysis. Comparison between SMILE and FLEx was measured as pooled odds ratio (OR) or weighted mean differences (WMD). Of 95% confidence intervals (CI) were used to analyze data. A total of seven studies were included. Firstly, there were no differences in uncorrected distance visual acuity (UDVA) 20/20 or better (OR, 1.37; 95% CI, 0.69 to 2.69; P=0.37) and logMAR UDVA (WMD, -0.02; 95% CI, -0.05 to 0.01; P=0.17) after SMILE versus FLEx. We found no differences in corrected distance visual acuity (CDVA) unchanged (OR, 0.98; 95% CI, 0.46 to 2.11; P=0.97) and logMAR CDVA (WMD, -0.00; 95% CI, -0.01 to 0.01; P=0.90) either. Secondly, we found no differences in refraction within ±1.00 D (OR, 0.98; 95% CI, 0.13 to 7.28; P=0.99) and ±0.50 D (OR, 1.62; 95% CI, 0.62 to 4.28; P=0.33) of target postoperatively. Thirdly, for higher-order aberrations, we found no differences in the total higher-order aberrations (WMD, -0.04; 95% CI, -0.09 to 0.01; P=0.14), coma (WMD, -0.04; 95% CI, -0.09 to 0.01; P=0.11), spherical (WMD, 0.01; 95% CI, -0.02 to 0.03; P=0.60) and trefoil (WMD, -0.00; 95% CI, -0.04 to 0.03; P=0.76). Furthermore, for corneal biomechanical parameters, we also found no differences (WMD, 0.08; 95% CI, -0.17 to 0.33; P=0.54) after SMILE versus FLEx. There are no statistically differences in efficacy, safety, predictability, higher-order aberrations and corneal biomechnical parameters postoperative between SMILE and FLEx.

  17. Peripheral refraction in normal infant rhesus monkeys

    PubMed Central

    Hung, Li-Fang; Ramamirtham, Ramkumar; Huang, Juan; Qiao-Grider, Ying; Smith, Earl L.

    2008-01-01

    Purpose To characterize peripheral refractions in infant monkeys. Methods Cross-sectional data for horizontal refractions were obtained from 58 normal rhesus monkeys at 3 weeks of age. Longitudinal data were obtained for both the vertical and horizontal meridians from 17 monkeys. Refractive errors were measured by retinoscopy along the pupillary axis and at eccentricities of 15, 30, and 45 degrees. Axial dimensions and corneal power were measured by ultrasonography and keratometry, respectively. Results In infant monkeys, the degree of radial astigmatism increased symmetrically with eccentricity in all meridians. There were, however, initial nasal-temporal and superior-inferior asymmetries in the spherical-equivalent refractive errors. Specifically, the refractions in the temporal and superior fields were similar to the central ametropia, but the refractions in the nasal and inferior fields were more myopic than the central ametropia and the relative nasal field myopia increased with the degree of central hyperopia. With age, the degree of radial astigmatism decreased in all meridians and the refractions became more symmetrical along both the horizontal and vertical meridians; small degrees of relative myopia were evident in all fields. Conclusions As in adult humans, refractive error varied as a function of eccentricity in infant monkeys and the pattern of peripheral refraction varied with the central refractive error. With age, emmetropization occurred for both central and peripheral refractive errors resulting in similar refractions across the central 45 degrees of the visual field, which may reflect the actions of vision-dependent, growth-control mechanisms operating over a wide area of the posterior globe. PMID:18487366

  18. Submillisecond Optical Knife-Edge Testing

    NASA Technical Reports Server (NTRS)

    Thurlow, P.

    1983-01-01

    Fast computer-controlled sampling of optical knife-edge response (KER) signal increases accuracy of optical system aberration measurement. Submicrosecond-response detectors in optical focal plane convert optical signals to electrical signals converted to digital data, sampled and feed into computer for storage and subsequent analysis. Optical data are virtually free of effects of index-of-refraction gradients.

  19. Refraction in Exoplanet Transit Observations

    NASA Astrophysics Data System (ADS)

    Dalba, Paul

    2018-01-01

    Before an exoplanet transit, atmospheric refraction bends light into the line of sight of an observer. The refracted light forms a stellar mirage---a distorted secondary image of the host star---that causes flux increases before transit ingress and after transit egress. The extent of this flux increase provides clues as to the composition and structure of the exoplanetary atmosphere. Here, I model the stellar mirages produced by a comprehensive set of stellar, orbital, planetary, and atmospheric parameters. Refracted light offers unprecedented atmospheric characterization opportunities for cold, long-period gas giant exoplanets. At visible wavelengths, opacity from Rayleigh scattering presents a substantial challenge to detecting stellar mirages for most exoplanets with orbital distances less than 6 AU. Based on physical parameters, I derive a criterion that determines if refracted light will significantly influence observations of a specific exoplanetary system with application to the high-precision Kepler data set. I also investigate the potential for refracted light to identify non-transiting exoplanets and serve as a novel means of out-of-transit atmospheric characterization. The atmospheric lensing events produced by non-transiting exoplanets are more detectable than the corresponding flux increases for transiting exoplanets. Compared to visible light observations, those at red to near-infrared wavelengths are more likely to detect refracted light in an exoplanet atmosphere. With upcoming exoplanet discovery and characterization missions in mind, I consider science cases that are uniquely enabled by photometric and spectroscopic observations of refracted light in exoplanetary systems.

  20. Single-step transepithelial photorefractive keratectomy in myopia and astigmatism: 18-month follow-up.

    PubMed

    Adib-Moghaddam, Soheil; Soleyman-Jahi, Saeed; Salmanian, Bahram; Omidvari, Amir-Houshang; Adili-Aghdam, Fatemeh; Noorizadeh, Farsad; Eslani, Medi

    2016-11-01

    To evaluate the long-term quantitative and qualitative optical outcomes of 1-step transepithelial photorefractive keratectomy (PRK) to correct myopia and astigmatism. Bina Eye Hospital, Tehran, Iran. Prospective interventional case series. Eyes with myopia with or without astigmatism were evaluated. One-step transepithelial PRK was performed with an aberration-free aspheric optimized profile and the Amaris 500 laser. Eighteen-month follow-up results for refraction, visual acuities, vector analysis, higher-order aberrations, contrast sensitivity, postoperative pain, and haze grade were assessed. The study enrolled 146 eyes (74 patients). At the end of follow-up, 93.84% of eyes had an uncorrected distance visual acuity of 20/20 or better and 97.94% of eyes were within ±0.5 diopter of the targeted spherical refraction. On vector analysis, the mean correction index value was close to 1 and the mean index of success and magnitude of error values were close to 0. The achieved correction vector was on an axis counterclockwise to the axis of the intended correction. Photopic and mesopic contrast sensitivities and ocular and corneal spherical, cylindrical, and corneal coma aberrations significantly improved (all P < .001). A slight amount of trefoil aberration was induced (P < .001, ocular aberration; P < .01, corneal aberration). No eye lost more than 1 line of corrected distance visual acuity. No eye had a haze grade of 2+ degrees or higher throughout the follow-up. Eighteen-month results indicate the efficacy and safety of transepithelial PRK to correct myopia and astigmatism. It improved refraction and quality of vision. None of the authors has a financial or proprietary interest in any material or method mentioned. Copyright © 2016 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.