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.

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.

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

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.

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, SLACK Incorporated.

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.

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.).

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.

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.

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.

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 more in less myopic than high myopic eyes.

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.

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.

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.

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.

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.

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 and generate pupil size independent refractions. PMID:24397356

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 annulus falls to zero, thus defining a circular near paraxial region of the pupil that determines refraction outcome. PMID:23683093

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 a higher spectacle independency for distance vision compared with bilateral control IOL implantation. No significant differences were identified in contrast sensitivity, higher-order aberrations, or refractive error-related quality of life following both treatments. clinicaltrials.gov Identifier: NCT01075542.

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.

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.

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.

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

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.

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.

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.

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.

[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.

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

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.

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

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.

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

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.

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 myopic LASIK. [J Refract Surg. 2018;34(2):121-130.]. Copyright 2018, SLACK Incorporated.

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.

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 feasible for the wavefront-guided refractive surgery.

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.

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.

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.

Six-month clinical outcomes after hyperopic correction with the SCHWIND AMARIS Total-Tech laser

PubMed Central

Arbelaez, María Clara; Vidal, Camila; Arba Mosquera, Samuel

2011-01-01

Purpose To evaluate postoperative clinical outcomes, and corneal High Order Aberrations, among eyes with hyperopia up to +5 D of spherical equivalent, that have undergone LASIK treatments using the SCHWIND AMARIS laser system. Methods At six-month follow-up, 100 eyes with preoperative hyperopia or hyperopic astigmatism up to +5 D of spherical equivalent were retrospectively analysed. Standard examinations, pre- and postoperative wavefront analysis with a corneal-wavefront-analyzer (OPTIKON Scout) were performed. Aberration-Free aspheric treatments were planned with Custom Ablation Manager software and ablations performed using the SCHWIND AMARIS flying-spot excimer laser system (both SCHWIND eye-tech-solutions). LASIK flaps were created using a LDV femtosecond laser (Ziemer Group) in all cases. Clinical outcomes were evaluated in terms of predictability, refractive outcome, safety, and wavefront aberration. Results At six month, 90 % of eyes achieved ≥ 20/25 UCVA and 44 % achieved ≥ 20/16 UCVA. Seventy-four percent of eyes were within ± 0.25D of spherical equivalent and 89 % within ± 0.50D, with 94 % within 0.50D of astigmatism. Mean spherical equivalent was −0.12 ± 0.51D and 0.50 ± 0.51D for the astigmatism. Fifty-two percent of eyes improved BSCVA vs. only 19 % losing lines of BSCVA. Predictability slope for refraction was 1.03 and intercept +0.01 D. On average, negative corneal spherical aberrations were significantly increased by the treatments, no other aberration terms changed from pre- to postoperative values. Conclusions LASIK for hyperopia and hyperopic astigmatism with SCHWIND AMARIS yields very satisfactory visual outcomes. Preoperative refractions were postoperatively reduced to subclinical values with no clinically relevant induction of corneal HOA.

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.

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.

Surface plasmon resonance microscopy: achieving a quantitative optical response

PubMed Central

Peterson, Alexander W.; Halter, Michael; Plant, Anne L.; Elliott, John T.

2016-01-01

Surface plasmon resonance (SPR) imaging allows real-time label-free imaging based on index of refraction, and changes in index of refraction at an interface. Optical parameter analysis is achieved by application of the Fresnel model to SPR data typically taken by an instrument in a prism based configuration. We carry out SPR imaging on a microscope by launching light into a sample, and collecting reflected light through a high numerical aperture microscope objective. The SPR microscope enables spatial resolution that approaches the diffraction limit, and has a dynamic range that allows detection of subnanometer to submicrometer changes in thickness of biological material at a surface. However, unambiguous quantitative interpretation of SPR changes using the microscope system could not be achieved using the Fresnel model because of polarization dependent attenuation and optical aberration that occurs in the high numerical aperture objective. To overcome this problem, we demonstrate a model to correct for polarization diattenuation and optical aberrations in the SPR data, and develop a procedure to calibrate reflectivity to index of refraction values. The calibration and correction strategy for quantitative analysis was validated by comparing the known indices of refraction of bulk materials with corrected SPR data interpreted with the Fresnel model. Subsequently, we applied our SPR microscopy method to evaluate the index of refraction for a series of polymer microspheres in aqueous media and validated the quality of the measurement with quantitative phase microscopy. PMID:27782542

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.

Comparing aspheric ablation profile with standard corneal ablation for correction of myopia and myopic astigmatism, a contralateral eye study.

PubMed

Ghoreishi, Mohammad; Naderi Beni, Afsaneh; Naderi Beni, Zahra; Zandi, Alireza; Kianersi, Farzan

2017-12-01

The purpose of this study is to compare visual outcomes of myopic refractive surgery, using tissue saving (TS), a standard ablation profile by a Technolas 217z100, and aberration smart ablation (ASA), an aspheric algorithm by a MEL 80 excimer laser in two eyes of one patient. In this prospective interventional paired-eye controlled study, a total of 100 eyes of 50 participants with myopia with or without astigmatism underwent thin-flap Femto-LASIK, using a Femto LDV femtosecond laser (Ziemer Ophthalmic Systems AG, Port, Switzerland). For each patient, one eye was randomly treated with tissue-saving algorithm (TS group) by the Technolas 217z100 excimer laser and the other eye was treated with optimized smart ablation profile (ASA group) by the MEL 80 excimer laser. Outcome measures were uncorrected distance visual acuities (UDVAs), corrected distance visual acuities (CDVAs), manifest refraction, higher-order aberrations (HOAs), contrast sensitivity, and patient satisfaction 12 months after surgery. At 12 months postoperative, "45 subjects returned with mean" UDVA was - 0.02 ± 0.08 Logarithm of mean angle of resolution (LogMAR) for TS group and - 0.02 ± 0.09 LogMAR for ASA group (P = 0.91). Of the TS eyes, 42/45 (93.3%) and 32/45 (71.1%) were within ± 0.5 D and ± 0.25 D of target refraction, respectively, and of the ASA eyes, 41/45 (91.1%) and 30/45 (66.6%) were within ± 0.5 D and ± 0.25 D of target refraction, respectively. No statistically significant differences were observed between groups in HOAs changes and contrast sensitivity function. Aspheric and non-aspheric LASIKs using the two different excimer lasers provide similar results in myopic and myopic astigmatism patients.

Small incision lenticule extraction (SMILE) versus laser in-situ keratomileusis (LASIK): study protocol for a randomized, non-inferiority trial.

PubMed

Ang, Marcus; Tan, Donald; Mehta, Jodhbir S

2012-05-31

Small incision lenticule extraction or SMILE is a novel form of 'flapless' corneal refractive surgery that was adapted from refractive lenticule extraction (ReLEx). SMILE uses only one femtosecond laser to complete the refractive surgery, potentially reducing surgical time, side effects, and cost. If successful, SMILE could potentially replace the current, widely practiced laser in-situ keratomileusis or LASIK. The aim of this study is to evaluate whether SMILE is non-inferior to LASIK in terms of refractive outcomes at 3 months post-operatively. Single tertiary center, parallel group, single-masked, paired-eye design, non-inferiority, randomized controlled trial. Participants who are eligible for LASIK will be enrolled for study after informed consent. Each participant will be randomized to receive SMILE and LASIK in each eye. Our primary hypothesis (stated as null) in this non-inferiority trial would be that SMILE differs from LASIK in adults (>21 years old) with myopia (> -3.00 diopter (D)) at a tertiary eye center in terms of refractive predictability at 3 months post-operatively. Our secondary hypothesis (stated as null) in this non-inferiority trial would be that SMILE differs from LASIK in adults (>21 years old) with myopia (> -3.00 D) at a tertiary eye center in terms of other refractive outcomes (efficacy, safety, higher-order aberrations) at 3 months post-operatively. Our primary outcome is refractive predictability, which is one of several standard refractive outcomes, defined as the proportion of eyes achieving a postoperative spherical equivalent (SE) within ±0.50 D of the intended target. Randomization will be performed using random allocation sequence generated by a computer with no blocks or restrictions, and implemented by concealing the number-coded surgery within sealed envelopes until just before the procedure. In this single-masked trial, subjects and their caregivers will be masked to the assigned treatment in each eye. This novel trial will provide information on whether SMILE has comparable, if not superior, refractive outcomes compared to the established LASIK for myopia, thus providing evidence for translation into clinical practice. Clinicaltrials.gov NCT01216475.

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.

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.

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.

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

Outcomes of photorefractive keratectomy following laser in situ keratomileusis: a cohort study.

PubMed

Iovieno, Alfonso; Teichman, Joshua C; Low, Stephanie; Yeung, Sonia N; Eve Lègarè, Marie; Lichtinger, Alejandro D; Slomovic, Allan R; Rootman, David S

2016-12-01

To analyze the outcomes of photorefractive keratectomy (PRK) on residual myopia and hyperopia post-laser in situ keratomileusis (LASIK) and to compare these results with PRK on eyes without previous laser refractive surgery. Retrospective comparative cohort study. Patients undergoing PRK between 2006 and 2010 were reviewed. Patients were divided into 4 groups, myopic or hyperopic PRK post-LASIK (mPRK-PL and hPRK-PL, respectively) and myopic or hyperopic PRK on corneas without previous laser refractive surgery (mPRK and hPRK, respectively). Uncorrected and corrected distance visual acuity, mean refractive spherical equivalent (MRSE), and mean keratometry and aberrations (total, higher order [HOA], coma, trefoil, and spherical aberration) were recorded at months 3 and 6 postoperatively, as were complications and attempted versus achieved MRSE. Thirty-three eyes of 25 patients who underwent PRK post-LASIK (21 eyes of 14 patients for hPRK-PL and 12 eyes of 11 patients for mPRK-PL) and 35 eyes of 21 patients who underwent PRK on virgin eyes (11 eyes of 8 patients for hPRK and 24 eyes of 13 patients for mPRK) were included in the study. The only significant differences in outcomes were found to be HOA at 3 months for hPRK-PL as compared with both hPRK and mPRK. Achieved MRSE was significantly different from expected MRSE for hPRK-PL at 3 months postoperatively. No haze- or flap-related complications were observed. Outcomes of PRK were not different in myopic and hyperopic corrections post-LASIK by 6 months or when compared with PRK in virgin eyes. HOA may render hPRK-PL results less predictable early in the postoperative period. Copyright © 2016 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Understanding the surface chemical and mechanical properties of hydrogel materials for contact lens applications

NASA Astrophysics Data System (ADS)

Huang, Fu-Chung

Vision problems such as near-sightedness, far-sightedness, as well as others, are due to optical aberrations in the human eye. These conditions are prevalent, and the population is growing rapidly. Correcting optical aberrations is traditionally done optically using eyeglasses, contact lenses, or refractive surgeries; these are sometime not convenient or not always available to everyone. Furthermore, higher order aberrations are not correctable with eyeglasses. In this work, we introduce a new computation based aberration-correcting light field display: by incorporating the persons own optical aberration into the computation, we alter the content shown on the display, such that he or she will be able to see it in sharp focus without wearing eyewear. We analyze the image formation models; through the retinal light field projection, we find it is possible to compensate for the optical blurring on the target image by prefiltering with the inverse blur. Using off-the-shelf components, we built a light field display prototype that supports our desired inverse light field prefiltering. The results show a significant contrast improvement and resolution enhancement over prior approaches. Finally, we also demonstrate the capability to correct for higher order aberrations.

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 aberrations induced by static and dynamic shifts in pupil center location is to reference the aberration measurement and treatment with respect to fixed features on the eye. Several other sources of aberration induction in LASIK, such as the efficiency of laser pulses striking the cornea perpendicularly versus obliquely, must still be investigated to optimize postoperative optical quality after LASIK.

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.

Three-year results of small incision lenticule extraction and wavefront-guided femtosecond laser-assisted laser in situ keratomileusis for correction of high myopia and myopic astigmatism

PubMed Central

Xia, Li-Kun; Ma, Jing; Liu, He-Nan; Shi, Ce; Huang, Qing

2018-01-01

AIM To compare and calculate the 3-year refractive results, higher-order aberrations (HOAs), contrast sensitivity (CS) and dry eye parameters after small incision lenticule extraction (SMILE) and wavefront-guided femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) for correction of high myopia and myopic astigmatism. METHODS In this prospective, non-randomized comparative study, 78 eyes with spherical equivalent (SE) of -8.11±1.09 diopters (D) received a SMILE surgery, and 65 eyes with SE of -8.05±1.12 D received a wavefront-guided FS-LASIK surgery with the VisuMax femtosecond laser (Carl Zeiss Meditec, Jena, Germany) for flap cutting. Visual acuity, manifest refraction, CS, HOAs, ocular surface disease index (OSDI) and tear break-up time (TBUT) were evaluated during a 3-year follow-up. RESULTS The difference of uncorrected distance visual acuity (UDVA) postoperatively was achieved at 1mo and at 3mo, whereas the difference of the mean UDVA between two groups at 3y were not statistically significant (t=-1.59, P=0.13). The postoperative change of SE was 0.89 D in the FS-LASIK group (t=5.76, P=0.00), and 0.14 D in the SMILE group (t=0.54, P=0.59) from 1mo to 3y after surgery. At 3-year postoperatively, both HOAs and spherical aberrations in the SMILE group were obviously less than those in the FS-LASIK group (P=0.00), but the coma root mean square (RMS) was higher in the SMILE group (0.59±0.26) than in the FS-LASIK group (0.29±0.14, P=0.00). The mesopic CS values between two groups were not statistically significant at 3y postoperatively. Compared with the FS-LASIK group, lower OSDI scores and longer TBUT values were found in the SMILE group at 1mo and 3mo postoperatively. With regard to safety, no eye lost any line of CDVA in both groups at 3y after surgery. CONCLUSION Both SMILE and wavefront-guided FS-LASIK procedures provide good visual outcomes. Both procedures are effective and safe, but SMILE surgery achieve more stable long-term refractive outcome and better control of early postoperative dry eye as compared to FS-LASIK. PMID:29600182

Three-year results of small incision lenticule extraction and wavefront-guided femtosecond laser-assisted laser in situ keratomileusis for correction of high myopia and myopic astigmatism.

PubMed

Xia, Li-Kun; Ma, Jing; Liu, He-Nan; Shi, Ce; Huang, Qing

2018-01-01

To compare and calculate the 3-year refractive results, higher-order aberrations (HOAs), contrast sensitivity (CS) and dry eye parameters after small incision lenticule extraction (SMILE) and wavefront-guided femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) for correction of high myopia and myopic astigmatism. In this prospective, non-randomized comparative study, 78 eyes with spherical equivalent (SE) of -8.11±1.09 diopters (D) received a SMILE surgery, and 65 eyes with SE of -8.05±1.12 D received a wavefront-guided FS-LASIK surgery with the VisuMax femtosecond laser (Carl Zeiss Meditec, Jena, Germany) for flap cutting. Visual acuity, manifest refraction, CS, HOAs, ocular surface disease index (OSDI) and tear break-up time (TBUT) were evaluated during a 3-year follow-up. The difference of uncorrected distance visual acuity (UDVA) postoperatively was achieved at 1mo and at 3mo, whereas the difference of the mean UDVA between two groups at 3y were not statistically significant ( t =-1.59, P =0.13). The postoperative change of SE was 0.89 D in the FS-LASIK group ( t =5.76, P =0.00), and 0.14 D in the SMILE group ( t =0.54, P =0.59) from 1mo to 3y after surgery. At 3-year postoperatively, both HOAs and spherical aberrations in the SMILE group were obviously less than those in the FS-LASIK group ( P =0.00), but the coma root mean square (RMS) was higher in the SMILE group (0.59±0.26) than in the FS-LASIK group (0.29±0.14, P =0.00). The mesopic CS values between two groups were not statistically significant at 3y postoperatively. Compared with the FS-LASIK group, lower OSDI scores and longer TBUT values were found in the SMILE group at 1mo and 3mo postoperatively. With regard to safety, no eye lost any line of CDVA in both groups at 3y after surgery. Both SMILE and wavefront-guided FS-LASIK procedures provide good visual outcomes. Both procedures are effective and safe, but SMILE surgery achieve more stable long-term refractive outcome and better control of early postoperative dry eye as compared to FS-LASIK.

Adaptive optics for peripheral vision

NASA Astrophysics Data System (ADS)

Rosén, R.; Lundström, L.; Unsbo, P.

2012-07-01

Understanding peripheral optical errors and their impact on vision is important for various applications, e.g. research on myopia development and optical correction of patients with central visual field loss. In this study, we investigated whether correction of higher order aberrations with adaptive optics (AO) improve resolution beyond what is achieved with best peripheral refractive correction. A laboratory AO system was constructed for correcting peripheral aberrations. The peripheral low contrast grating resolution acuity in the 20° nasal visual field of the right eye was evaluated for 12 subjects using three types of correction: refractive correction of sphere and cylinder, static closed loop AO correction and continuous closed loop AO correction. Running AO in continuous closed loop improved acuity compared to refractive correction for most subjects (maximum benefit 0.15 logMAR). The visual improvement from aberration correction was highly correlated with the subject's initial amount of higher order aberrations (p = 0.001, R 2 = 0.72). There was, however, no acuity improvement from static AO correction. In conclusion, correction of peripheral higher order aberrations can improve low contrast resolution, provided refractive errors are corrected and the system runs in continuous closed loop.

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

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.

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

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.

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, and was typically preferred over subjective refraction. Subjective refraction was preferred by habitually undercorrected hyperopic eyes. PMID:28370389

Comparison of the femtosecond laser and mechanical microkeratome for flap cutting in LASIK.

PubMed

Xia, Li-Kun; Yu, Jie; Chai, Guang-Rui; Wang, Dang; Li, Yang

2015-01-01

To compare refractive results, higher-order aberrations (HOAs), contrast sensitivity and dry eye after laser in situ keratomileusis (LASIK) performed with a femtosecond laser versus a mechanical microkeratome for myopia and astigmatism. In this prospective, non-randomized study, 120 eyes with myopia received a LASIK surgery with the VisuMax femtosecond laser for flap cutting, and 120 eyes received a conventional LASIK surgery with a mechanical microkeratome. Flap thickness, visual acuity, manifest refraction, contrast sensitivity function (CSF) curves, HOAs and dry-eye were measured at 1wk; 1, 3, 6mo after surgery. At 6mo postoperatively, the mean central flap thickness in femtosecond laser procedure was 113.05±5.89 µm (attempted thickness 110 µm), and 148.36±21.24 µm (attempted thickness 140 µm) in mechanical microkeratome procedure. An uncorrected distance visual acuity (UDVA) of 4.9 or better was obtained in more than 98% of eyes treated by both methods, a gain in logMAR lines of corrected distance visual acuity (CDVA) occurred in more than 70% of eyes treated by both methods, and no eye lost ≥1 lines of CDVA in both groups. The difference of the mean UDVA and CDVA between two groups at any time post-surgery were not statistically significant (P>0.05). The postoperative changes of spherical equivalent occurred markedly during the first month in both groups. The total root mean square values of HOAs and spherical aberrations in the femtosecond treated eyes were markedly less than those in the microkeratome treated eyes during 6mo visit after surgery (P<0.01). The CSF values of the femtosecond treated eyes were also higher than those of the microkeratome treated eyes at all space frequency (P<0.01). The mean ocular surface disease index scores in both groups were increased at 1wk, and recovered to preoperative level at 1mo after surgery. The mean tear breakup time (TBUT) of the femtosecond treated eyes were markedly longer than those of the microkeratome treated eyes at postoperative 1, 3mo (P<0.01). Both the femtosecond laser and the mechanical microkeratome for LASIK flap cutting are safe and effective to correct myopia, with no statistically significant difference in the UDVA, CDVA during 6mo follow-up. Refractive results remained stable after 1mo post-operation for both groups. The femtosecond laser may have advantages over the microkeratome in the flap thickness predictability, fewer induced HOAs, better CSF, and longer TBUT.

Comparison of the femtosecond laser and mechanical microkeratome for flap cutting in LASIK

PubMed Central

Xia, Li-Kun; Yu, Jie; Chai, Guang-Rui; Wang, Dang; Li, Yang

2015-01-01

AIM To compare refractive results, higher-order aberrations (HOAs), contrast sensitivity and dry eye after laser in situ keratomileusis (LASIK) performed with a femtosecond laser versus a mechanical microkeratome for myopia and astigmatism. METHODS In this prospective, non-randomized study, 120 eyes with myopia received a LASIK surgery with the VisuMax femtosecond laser for flap cutting, and 120 eyes received a conventional LASIK surgery with a mechanical microkeratome. Flap thickness, visual acuity, manifest refraction, contrast sensitivity function (CSF) curves, HOAs and dry-eye were measured at 1wk; 1, 3, 6mo after surgery. RESULTS At 6mo postoperatively, the mean central flap thickness in femtosecond laser procedure was 113.05±5.89 µm (attempted thickness 110 µm), and 148.36±21.24 µm (attempted thickness 140 µm) in mechanical microkeratome procedure. An uncorrected distance visual acuity (UDVA) of 4.9 or better was obtained in more than 98% of eyes treated by both methods, a gain in logMAR lines of corrected distance visual acuity (CDVA) occurred in more than 70% of eyes treated by both methods, and no eye lost ≥1 lines of CDVA in both groups. The difference of the mean UDVA and CDVA between two groups at any time post-surgery were not statistically significant (P>0.05). The postoperative changes of spherical equivalent occurred markedly during the first month in both groups. The total root mean square values of HOAs and spherical aberrations in the femtosecond treated eyes were markedly less than those in the microkeratome treated eyes during 6mo visit after surgery (P<0.01). The CSF values of the femtosecond treated eyes were also higher than those of the microkeratome treated eyes at all space frequency (P<0.01). The mean ocular surface disease index scores in both groups were increased at 1wk, and recovered to preoperative level at 1mo after surgery. The mean tear breakup time (TBUT) of the femtosecond treated eyes were markedly longer than those of the microkeratome treated eyes at postoperative 1, 3mo (P<0.01). CONCLUSION Both the femtosecond laser and the mechanical microkeratome for LASIK flap cutting are safe and effective to correct myopia, with no statistically significant difference in the UDVA, CDVA during 6mo follow-up. Refractive results remained stable after 1mo post-operation for both groups. The femtosecond laser may have advantages over the microkeratome in the flap thickness predictability, fewer induced HOAs, better CSF, and longer TBUT. PMID:26309880

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,

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.

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.

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.

Small incision lenticule extraction (SMILE) versus laser in-situ keratomileusis (LASIK): study protocol for a randomized, non-inferiority trial

PubMed Central

2012-01-01

Background Small incision lenticule extraction or SMILE is a novel form of ‘flapless’ corneal refractive surgery that was adapted from refractive lenticule extraction (ReLEx). SMILE uses only one femtosecond laser to complete the refractive surgery, potentially reducing surgical time, side effects, and cost. If successful, SMILE could potentially replace the current, widely practiced laser in-situ keratomileusis or LASIK. The aim of this study is to evaluate whether SMILE is non-inferior to LASIK in terms of refractive outcomes at 3 months post-operatively. Methods/Design Single tertiary center, parallel group, single-masked, paired-eye design, non-inferiority, randomized controlled trial. Participants who are eligible for LASIK will be enrolled for study after informed consent. Each participant will be randomized to receive SMILE and LASIK in each eye. Our primary hypothesis (stated as null) in this non-inferiority trial would be that SMILE differs from LASIK in adults (>21 years old) with myopia (> −3.00 diopter (D)) at a tertiary eye center in terms of refractive predictability at 3 months post-operatively. Our secondary hypothesis (stated as null) in this non-inferiority trial would be that SMILE differs from LASIK in adults (>21 years old) with myopia (> −3.00 D) at a tertiary eye center in terms of other refractive outcomes (efficacy, safety, higher-order aberrations) at 3 months post-operatively. Our primary outcome is refractive predictability, which is one of several standard refractive outcomes, defined as the proportion of eyes achieving a postoperative spherical equivalent (SE) within ±0.50 D of the intended target. Randomization will be performed using random allocation sequence generated by a computer with no blocks or restrictions, and implemented by concealing the number-coded surgery within sealed envelopes until just before the procedure. In this single-masked trial, subjects and their caregivers will be masked to the assigned treatment in each eye. Discussion This novel trial will provide information on whether SMILE has comparable, if not superior, refractive outcomes compared to the established LASIK for myopia, thus providing evidence for translation into clinical practice. Trial registration Clinicaltrials.gov NCT01216475. PMID:22647480

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

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.

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.

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.

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 of corneal astigmatism (P<0.05). The distribution of astigmatic CF differed among refraction groups. There were significant correlations between internal power and spherical aberration (P<0.05) and internal cylinder under the 5-mm zone and HOAs (P<0.001). There is a remarkable tilt in internal refraction in hyperopes. Although there is a tendency of undercompensation of the corneal astigmatism by internal astigmatism in the entire group of eyes, the compensation differs among refraction groups.

Combined laser-ray tracing and OCT system for biometry of the crystalline lens (Conference Presentation)

NASA Astrophysics Data System (ADS)

Ruggeri, Marco; Maceo Heilman, Bianca M.; Yao, Yue; Chang, Yu-Cherng; Gonzalez, Alex; Rowaan, Cornelis; Mohamed, Ashik; Williams, Siobhan; Durkee, Heather A.; Silgado, Juan; Bernal, Andres; Arrieta-Quintero, Esdras; Ho, Arthur; Parel, Jean-Marie A.; Manns, Fabrice

2017-02-01

Age-related changes in the crystalline lens shape and refractive index gradient produce changes in dioptric power and high-order aberrations that influence the optics of the whole eye and contribute to a decrease in overall visual quality. Despite their key role, the changes in lens shape and refractive index gradient with age and accommodation and their effects on high-order aberrations are still not well understood. The goal of this project was to develop a combined laser ray tracing (LRT) and optical coherence tomography (OCT) system to measure high-order aberrations, shape and refractive index gradient in non-human primate and human lenses. A miniature motorized lens stretching system was built to enable imaging and aberrometry of the lens during simulated accommodation. A positioning system was also built to enable on- and off-axis OCT imaging and aberrometry for characterization of the peripheral defocus of the lens. We demonstrated the capability of the LRT-OCT system to produce OCT images and aberration measurements of crystalline lens with age and accommodation in vitro. In future work, the information acquired with the LRT-OCT system will be used to develop an accurate age-dependent lens model to predict the role of the lens in the development of refractive error and aberrations of the whole eye.

Optical and Biometric Characteristics of Anisomyopia in Human Adults

PubMed Central

Tian, Yibin; Tarrant, Janice; Wildsoet, Christine F.

2011-01-01

Purpose To investigate the role of higher order optical aberrations and thus retinal image degradation in the development of myopia, through the characterization of anisomyopia in human adults in terms of their optical and biometric characteristics. Methods The following data were collected from both eyes of fifteen young adult anisometropic myopes and sixteen isometropic myopes: subjective and objective refractive errors, corneal power and shape, monochromatic optical aberrations, anterior chamber depth, lens thickness, vitreous chamber depth, and best corrected visual acuity. Monochromatic aberrations were analyzed in terms of their higher order components, and further analyzed in terms of 31 optical quality metrics. Interocular differences for the two groups (anisomyopes vs. isomyopes) were compared and the relationship between measured ocular parameters and refractive errors also analyzed across all eyes. Results As expected, anisomyopes and isomyopes differed significantly in terms of interocular differences in vitreous chamber depth, axial length and refractive error. However, interocular differences in other optical properties showed no significant intergroup differences. Overall, higher myopia was associated with deeper anterior and vitreous chambers, higher astigmatism, more prolate corneas, and more positive spherical aberration. Other measured optical and biometric parameters were not significantly correlated with spherical refractive error, although some optical quality metrics and corneal astigmatism were significantly correlated with refractive astigmatism. Conclusions An optical cause for anisomyopia related to increased higher order aberrations is not supported by our data. Corneal shape changes and increased astigmatism in more myopic eyes may be a by-product of the increased anterior chamber growth in these eyes; likewise, the increased positive spherical aberration in more myopic eyes may be a product of myopic eye growth. PMID:21797915

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

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 the aberrations in a mammal lens. Copyright © 2013 Elsevier Ltd. All rights reserved.

Clinical outcomes of small incision lenticule extraction versus femtosecond laser-assisted LASIK for myopia: a Meta-analysis

PubMed Central

Yan, Huan; Gong, Li-Yan; Huang, Wei; Peng, Yan-Li

2017-01-01

AIM To evaluate the possible differences in visual quality between small incision lenticule extraction (SMILE) and femtosecond laser in situ keratomileusis (FS-LASIK) for myopia. METHODS A Meta-analysis was performed. Patients were from previously reported comparative studies treated with SMILE versus FS-LASIK. The PubMed, EMBASE, Cochrane, Web of Science and Chinese databases (i.e. WANFANG and CNKI) were searched in Nov. of 2016 using RevMan 5.1 version software. The differences in visual acuity, aberration and biomechanical effects within six months postoperatively were showed. Twenty-seven studies including 4223 eyes were included. RESULTS No significant differences were observed between SMILE and FS-LASIK in terms of the proportion of eyes that lost one or more lines of corrected distance visual acuity after surgery (P=0.14), the proportion of eyes achieving an uncorrected distance visual acuity of 20/20 or better (P=0.43), the final refractive spherical equivalent (P=0.89), the refractive spherical equivalent within ±1.00 diopter of the target values (P=0.80), vertical coma (P=0.45) and horizontal coma (P=0.06). Compared with the FS-LASIK group, total higher-order aberration (P<0.001) and spherical aberration (P<0.001) were higher and the decrease in corneal hysteresis (P=0.0005) and corneal resistance factor (P=0.02) were lower in the SMILE group. CONCLUSION SMILE and FS-LASIK are comparable in efficacy, safety and predictability for correcting myopia. However, the aberration in the SMILE group is superior to that in the FS-LASIK group, and the loss of biomechanical effects may occur less frequently after SMILE than after FS-LASIK. PMID:28944205

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 over subjective refraction. Subjective refraction was preferred by habitually undercorrected hyperopic eyes. © 2017 The Authors Ophthalmic & Physiological Optics © 2017 The College of Optometrists.

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.

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

Reflective type objective based spectral-domain phase-sensitive optical coherence tomography for high-sensitive structural and functional imaging of cochlear microstructures through intact bone of an excised guinea pig cochlea

NASA Astrophysics Data System (ADS)

Subhash, Hrebesh M.; Wang, Ruikang K.; Chen, Fangyi; Nuttall, Alfred L.

2013-03-01

Most of the optical coherence tomographic (OCT) systems for high resolution imaging of biological specimens are based on refractive type microscope objectives, which are optimized for specific wave length of the optical source. In this study, we present the feasibility of using commercially available reflective type objective for high sensitive and high resolution structural and functional imaging of cochlear microstructures of an excised guinea pig through intact temporal bone. Unlike conventional refractive type microscopic objective, reflective objective are free from chromatic aberrations due to their all-reflecting nature and can support a broadband of spectrum with very high light collection efficiency.

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.

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.

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.

The use of WaveLight® Contoura to create a uniform cornea: the LYRA Protocol. Part 3: the results of 50 treated eyes.

PubMed

Motwani, Manoj

2017-01-01

To demonstrate how using the Wavelight Contoura measured astigmatism and axis eliminates corneal astigmatism and creates uniformly shaped corneas. A retrospective analysis was conducted of the first 50 eyes to have bilateral full WaveLight ® Contoura LASIK correction of measured astigmatism and axis (vs conventional manifest refraction), using the Layer Yolked Reduction of Astigmatism Protocol in all cases. All patients had astigmatism corrected, and had at least 1 week of follow-up. Accuracy to desired refractive goal was assessed by postoperative refraction, aberration reduction via calculation of polynomials, and postoperative visions were analyzed as a secondary goal. The average difference of astigmatic power from manifest to measured was 0.5462D (with a range of 0-1.69D), and the average difference of axis was 14.94° (with a range of 0°-89°). Forty-seven of 50 eyes had a goal of plano, 3 had a monovision goal. Astigmatism was fully eliminated from all but 2 eyes, and 1 eye had regression with astigmatism. Of the eyes with plano as the goal, 80.85% were 20/15 or better, and 100% were 20/20 or better. Polynomial analysis postoperatively showed that at 6.5 mm, the average C3 was reduced by 86.5% and the average C5 by 85.14%. Using WaveLight ® Contoura measured astigmatism and axis removes higher order aberrations and allows for the creation of a more uniform cornea with accurate removal of astigmatism, and reduction of aberration polynomials. WaveLight ® Contoura successfully links the refractive correction layer and aberration repair layer using the Layer Yolked Reduction of Astigmatism Protocol to demonstrate how aberration removal can affect refractive correction.

Aspheric photorefractive keratectomy for myopia and myopic astigmatism with the SCHWIND AMARIS laser: 2 years postoperative outcomes

PubMed Central

Aslanides, Ioannis M.; Padroni, Sara; Arba-Mosquera, Samuel

2012-01-01

Purpose To evaluate mid-term refractive outcomes and higher order aberrations of aspheric PRK for low, moderate and high myopia and myopic astigmatism with the AMARIS excimer laser system (SCHWIND eye-tech-solutions GmbH, Kleinostheim, Germany). Methods This prospective longitudinal study evaluated 80 eyes of 40 subjects who underwent aspheric PRK. Manifest refractive spherical equivalent (MRSE) of up to −10.00 diopters (D) at the spectacle plane with cylinder up to 3.25 was treated. Refractive outcomes and corneal wavefront data (6 mm pupil to the 7th Zernike order) were evaluated out to 2 years postoperatively. Statistical significance was indicated by P < 0.05. Results The mean manifest spherical equivalent refraction (MRSE) was −4.77 ± 2.45 (range, −10.00 D to −0.75 D) preoperatively and −0.12 ± 0.35 D (range, −1.87 D to +0.75 D) postoperatively (P < 0.0001). Postoperatively, 91% (73/80) of eyes had an MRSE within ±0.50 D of the attempted. No eyes lost one or more lines of corrected distance visual acuity (CDVA) and CDVA increased by one or more lines in 26% (21/80) of eyes. Corneal trefoil and corneal higher order aberration root mean square did not statistically change postoperatively compared to preoperatively (P > 0.05, both cases). There was a statistical increase in postoperative coma (+0.12 μm) and spherical aberration (+0.14 μm) compared to preoperatively (P < 0.001, both cases). Conclusion Aspheric PRK provides excellent visual and refractive outcomes with induction in individual corneal aberrations but not overall corneal aberrations.

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.

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.

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.

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

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

Aspherics in spectacle lenses

NASA Astrophysics Data System (ADS)

Dürsteler, Juan Carlos

2016-12-01

A review of the use of aspherics in the last decades, understood in a broad sense as encompassing single-vision lenses with conicoid surfaces and free-form and progressive addition lenses (PALs) as well, is provided. The appearance of conicoid surfaces to correct aphakia and later to provide thinner and more aesthetically appealing plus lenses and the introduction of PALs and free-form surfaces have shaped the advances in spectacle lenses in the last three decades. This document basically considers the main target optical aberrations, the idiosyncrasy of single lenses for correction of refractive errors and the restrictions and particularities of PAL design and their links to science vision and perception.

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

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.

Corneal power, thickness, and stiffness: results of a prospective randomized controlled trial of PRK and LASIK for myopia.

PubMed

Hjortdal, Jesper Ø; Møller-Pedersen, Torben; Ivarsen, Anders; Ehlers, Niels

2005-01-01

To compare the short-, medium-, and long-term changes in corneal optical power and corneal aberrations, central corneal thickness, and corneal "stiffness" assessed by pneumotonometry readings in patients having laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) for myopia. Department of Ophthalmology, Arhus University Hospital, Arhus, Denmark. One eye of each of 45 patients with myopia ranging from -6.00 to -8.00 diopters (D) (spherical equivalent spectacle refraction [SER]) was randomized to LASIK (n=25; mean SER -7.12 D +/- 0.57 [SD]) or PRK (n=20; mean SER -6.91 +/- 0.57 D). Data were collected prospectively before and 1, 3, 6, 12, and 36 months after surgery. Measurements included corneal topography (TMS-1, Tomey), corneal thickness (ultrasound pachymetry), and apparent intraocular pressure (IOP) (pneumotonometry). Retreatments were not performed during the first year, and retreated eyes were excluded from the 3-year follow-up. Changes in corneal power and aberrations, thickness, and apparent IOP were calculated in a pair-wise manner for 3 time periods: short term (preoperative to 1 month after surgery), medium term (1 to 12 months after surgery), and long term (1 to 3 years after surgery). In the short term, corneal power decreased equally in LASIK and PRK eyes. Spherical aberrations and coma-like aberrations increased equally, while corneal thickness decreased significantly less in LASIK eyes than in PRK eyes. The apparent IOP decreased more in LASIK eyes than in PRK eyes. In the medium term, corneal power increased significantly in both groups. Spherical aberrations decreased significantly in PRK eyes but not in LASIK eyes. From 1 to 12 months, corneal thickness increased more in PRK eyes than in LASIK eyes. During this period, the apparent IOP increased significantly in LASIK eyes. In the long term, corneal power and corneal aberrations did not change significantly in either group. Corneal thickness increased slightly but significantly in both groups. The apparent IOP increased significantly more in PRK eyes. Differences between LASIK and PRK related to time-dependent events affecting corneal shape and structural integrity were present. Peripheral changes in flap hydration in LASIK eyes and epithelial and/or stromal thickening in PRK eyes appeared to be the most important factors in optical power changes in the first year after treatment. The changes in apparent IOP suggest that some interlamellar healing occurred during the first year after LASIK. After LASIK and PRK, corneal bending stiffness seemed permanently decreased, although some restiffening may occur in PRK eyes in the long term.

Optical transfer function in corneal topography for clinical contrast sensitivity analysis

NASA Astrophysics Data System (ADS)

Bende, Thomas; Jean, Benedikt J.; Oltrup, Theo

2000-06-01

Customized ablation aiming to optimize visual acuity in refractive surgery requires objective data on corneal surface, like the contrast sensitivity. Fast ray tracing, using the high resolution 3-D elevation data in conjunction with Snell's law describe the diffraction of the incident rays and the resulting image on a 'virtual retina.' A retroprojection leads to a 'surface quality map.' For objective contrast sensitivity measurement a sinus (or cos) wave of different frequencies is used for a calculated projection in analogy to the clinical contrast sensitivity charts. The projection on the individual cornea surface is analyzed for the Modular Transfer Function (MTF) and the Phase Shift Function (PSF) as a function of frequencies. PSF, not yet clinically used, is a parameter to determine even minimal corneal tilt. The resulting corneal aberration map (CAM) as described here and applied to a 4.5 D PRK (OZD equals 6.5 mm) reveals that the area of minimal aberration measures only 4.2 mm. The CAM can likewise be used to describe the 'quality' of a laser system's ablation pattern based upon the area of minimal optical aberrations. The CAM only describes surface aberration with high resolution, an advantage over wave front sensing which measures all accumulated optical aberrations including the changing ones of the lens during accommodation and the transient ones due to lens aging and early cataract formation.

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.

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.

The development of an instrument to measure quality of vision: the Quality of Vision (QoV) questionnaire.

PubMed

McAlinden, Colm; Pesudovs, Konrad; Moore, Jonathan E

2010-11-01

To develop an instrument to measure subjective quality of vision: the Quality of Vision (QoV) questionnaire. A 30-item instrument was designed with 10 symptoms rated in each of three scales (frequency, severity, and bothersome). The QoV was completed by 900 subjects in groups of spectacle wearers, contact lens wearers, and those having had laser refractive surgery, intraocular refractive surgery, or eye disease and investigated with Rasch analysis and traditional statistics. Validity and reliability were assessed by Rasch fit statistics, principal components analysis (PCA), person separation, differential item functioning (DIF), item targeting, construct validity (correlation with visual acuity, contrast sensitivity, total root mean square [RMS] higher order aberrations [HOA]), and test-retest reliability (two-way random intraclass correlation coefficients [ICC] and 95% repeatability coefficients [R(c)]). Rasch analysis demonstrated good precision, reliability, and internal consistency for all three scales (mean square infit and outfit within 0.81-1.27; PCA >60% variance explained by the principal component; person separation 2.08, 2.10, and 2.01 respectively; and minimal DIF). Construct validity was indicated by strong correlations with visual acuity, contrast sensitivity and RMS HOA. Test-retest reliability was evidenced by a minimum ICC of 0.867 and a minimum 95% R(c) of 1.55 units. The QoV Questionnaire consists of a Rasch-tested, linear-scaled, 30-item instrument on three scales providing a QoV score in terms of symptom frequency, severity, and bothersome. It is suitable for measuring QoV in patients with all types of refractive correction, eye surgery, and eye disease that cause QoV problems.

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

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

Opto-mechanical design of a dispersive artificial eye.

PubMed

Coughlan, Mark F; Mihashi, Toshifumi; Goncharov, Alexander V

2017-05-20

We present an opto-mechanical artificial eye that can be used for examining multi-wavelength ophthalmic instruments. Standard off-the-shelf lenses and a refractive-index-matching fluid were used in the creation of the artificial eye. In addition to dispersive properties, the artificial eye can be used to simulate refractive error. To analyze the artificial eye, a multi-wavelength Hartmann-Shack aberrometer was used to measure the longitudinal chromatic aberration and the possibility of inducing refractive error. Off-axis chromatic aberrations were also analyzed by imaging through the artificial eye at two discrete wavelengths. Possible extensions to the dispersive artificial eye are also discussed.

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.

Presentation Annotated

NASA Technical Reports Server (NTRS)

Ditto, Thomas

2017-01-01

This Report is not the latest word on an old idea but the first word on a new one. The new idea reverses the old one, the axiom that the best primary objective for an astronomical telescope exhibits the least chromatic aberration. That axiomatic distinction goes back to a young Isaac Newton who knew from experiments with prisms and mirrors in the 1660's that magnification with a reflection primary was completely free of the dispersion he saw with refraction. The superiority of reflection primary objectives for eyeball or photographic viewing is now considered obvious. It was this piece of wisdom on achromatic primary objectives that led to the dominance of the parabolic mirror as the means to collect star light. Newton was aware of the problem when he introduced his telescope to the scientific world in 1670.This Report is not the latest word on an old idea but the first word on a new one. The new idea reverses the old one, the axiom that the best primary objective for an astronomical telescope exhibits the least chromatic aberration. That axiomatic distinction goes back to a young Isaac Newton who knew from experiments with prisms and mirrors in the 1660's that magnification with a reflection primary was completely free of the dispersion he saw with refraction. The superiority of reflection primary objectives for eyeball or photographic viewing is now considered obvious. Actually, Newton's design innovation was in a secondary mirror, a plane mirror far more easily fabricated than Gregory's embodiment of 1663 which required two curved mirrors.

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 Acri.Lisa design provided better distance and near visual outcomes and intraocular optical performance parameters. Copyright © 2012 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

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.

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.

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.

Zyoptix wavefront-guided versus standard photorefractive keratectomy (PRK) in low and moderate myopia: randomized controlled 6-month study.

PubMed

Mastropasqua, L; Toto, L; Zuppardi, E; Nubile, M; Carpineto, P; Di Nicola, M; Ballone, E

2006-01-01

To evaluate the refractive and aberrometric outcome of wavefront-guided photorefractive keratectomy (PRK) compared to standard PRK in myopic patients. Fifty-six eyes of 56 patients were included in the study and were randomly divided into two groups. The study group consisted of 28 eyes with a mean spherical equivalent (SE) of -2.25+/-0.76 diopters (D) (range: -1.5 to -3.5 D) treated with wavefront-guided PRK using the Zywave ablation profile and the Bausch & Lomb Technolas 217z excimer laser (Zyoptix system) and the control group included 28 eyes with a SE of -2.35+/-1.01 D (range: -1.5 to -3.5 D) treated with standard PRK (PlanoScan ablation) using the same laser. A Zywave aberrometer was used to analyze and calculate the root-mean-square (RMS) of total high order aberrations (HOA) and Zernike coefficients of third and fourth order before and after (over a 6-month follow-up period) surgery in both groups. Preoperative and postoperative SE, un-corrected visual acuity (UCVA), and best-corrected visual acuity (BCVA) were evaluated in all cases. There was a high correlation between achieved and intended correction. The differences between the two treatment groups were not statistically significant for UCVA, BCVA, or SE cycloplegic refraction . Postoperatively the RMS value of high order aberrations was raised in both groups. At 6-month control, on average it increased by a factor of 1.17 in the Zyoptix PRK group and 1.54 in the PlanoScan PRK group (p=0.22). In the Zyoptix group there was a decrease of coma aberration, while in the PlanoScan group this third order aberration increased. The difference between postoperative and preoperative values between the two groups was statistically significant for coma aberration (p=0.013). No statistically significant difference was observed for spherical-like aberration between the two groups. In the study group eyes with a low amount of preoperative aberrations (HOA RMS lower than the median value; <0.28 microm) showed an increase of HOA RMS while eyes with RMS higher than 0.28 microm showed a decrease (p<0.05). Zyoptix wavefront-guided PRK is as safe and efficacious for the correction of myopia and myopic astigmatism as PlanoScan PRK. Moreover this technique induces a smaller increase of third order coma aberration compared to standard PRK. The use of Zyoptix wavefront-guided PRK is particularly indicated in eyes with higher preoperative RMS values.

The use of WaveLight® Contoura to create a uniform cornea: the LYRA Protocol. Part 3: the results of 50 treated eyes

PubMed Central

Motwani, Manoj

2017-01-01

Purpose To demonstrate how using the Wavelight Contoura measured astigmatism and axis eliminates corneal astigmatism and creates uniformly shaped corneas. Patients and methods A retrospective analysis was conducted of the first 50 eyes to have bilateral full WaveLight® Contoura LASIK correction of measured astigmatism and axis (vs conventional manifest refraction), using the Layer Yolked Reduction of Astigmatism Protocol in all cases. All patients had astigmatism corrected, and had at least 1 week of follow-up. Accuracy to desired refractive goal was assessed by postoperative refraction, aberration reduction via calculation of polynomials, and postoperative visions were analyzed as a secondary goal. Results The average difference of astigmatic power from manifest to measured was 0.5462D (with a range of 0–1.69D), and the average difference of axis was 14.94° (with a range of 0°–89°). Forty-seven of 50 eyes had a goal of plano, 3 had a monovision goal. Astigmatism was fully eliminated from all but 2 eyes, and 1 eye had regression with astigmatism. Of the eyes with plano as the goal, 80.85% were 20/15 or better, and 100% were 20/20 or better. Polynomial analysis postoperatively showed that at 6.5 mm, the average C3 was reduced by 86.5% and the average C5 by 85.14%. Conclusions Using WaveLight® Contoura measured astigmatism and axis removes higher order aberrations and allows for the creation of a more uniform cornea with accurate removal of astigmatism, and reduction of aberration polynomials. WaveLight® Contoura successfully links the refractive correction layer and aberration repair layer using the Layer Yolked Reduction of Astigmatism Protocol to demonstrate how aberration removal can affect refractive correction. PMID:28553071

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

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.

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.

[Clinical results of the aspheric intraocular lens FY-60AD (Hoya) with particular respect to decentration and tilt].

PubMed

Mester, U; Heinen, S; Kaymak, H

2010-09-01

Aspheric intraocular lenses (IOLs) aim to improve visual function and particularly contrast vision by neutralizing spherical aberration. One drawback of such IOLs is the enhanced sensitivity to decentration and tilt, which can deteriorate image quality. A total of 30 patients who received bilateral phacoemulsification before implantation of the aspheric lens FY-60AD (Hoya) were included in a prospective study. In 25 of the patients (50 eyes) the following parameters could be assessed 3 months after surgery: visual acuity, refraction, contrast sensitivity, pupil size, wavefront errors and decentration and tilt using a newly developed device. The functional results were very satisfying and comparable to results gained with other aspheric IOLs. The mean refraction was sph + 0.1 D (±0.7 D) and cyl 0.6 D (±0.8 D). The spherical equivalent was −0.2 D (±0.6 D). Wavefront measurements revealed a good compensation of the corneal spherical aberration but vertical and horizontal coma also showed opposing values in the cornea and IOL. The assessment of the lens position using the Purkinje meter demonstrated uncritical amounts of decentration and tilt. The mean amount of decentration was 0.2 mm±0.2 mm in the horizontal and vertical directions. The mean amount of tilt was 4.0±2.1° in horizontal and 3.0±2.5° in vertical directions. In a normal dioptric power range the aspheric IOL FY-60AD compensates the corneal spherical aberration very well with only minimal decentration. The slight tilt is symmetrical in both eyes and corresponds to the position of the crystalline lens in young eyes. This may contribute to our findings of compensated corneal coma.

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.

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.

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.

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.

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.

Miniature hybrid optical imaging lens

DOEpatents

Sitter, Jr., David N.; Simpson, Marc L.

1997-01-01

A miniature lens system that corrects for imaging and chromatic aberrations, the lens system being fabricated from primarily commercially-available components. A first element at the input to a lens housing is an aperture stop. A second optical element is a refractive element with a diffractive element closely coupled to, or formed a part of, the rear surface of the refractive element. Spaced closely to the diffractive element is a baffle to limit the area of the image, and this is closely followed by a second refractive lens element to provide the final correction. The image, corrected for aberrations exits the last lens element to impinge upon a detector plane were is positioned any desired detector array. The diffractive element is fabricated according to an equation that includes, as variables, the design wavelength, the index of refraction and the radius from an optical axis of the lens system components.

Miniature hybrid optical imaging lens

DOEpatents

Sitter, D.N. Jr.; Simpson, M.L.

1997-10-21

A miniature lens system that corrects for imaging and chromatic aberrations is disclosed, the lens system being fabricated from primarily commercially-available components. A first element at the input to a lens housing is an aperture stop. A second optical element is a refractive element with a diffractive element closely coupled to, or formed a part of, the rear surface of the refractive element. Spaced closely to the diffractive element is a baffle to limit the area of the image, and this is closely followed by a second refractive lens element to provide the final correction. The image, corrected for aberrations exits the last lens element to impinge upon a detector plane were is positioned any desired detector array. The diffractive element is fabricated according to an equation that includes, as variables, the design wavelength, the index of refraction and the radius from an optical axis of the lens system components. 2 figs.

Visual outcomes after balanced salt solution infiltration during lenticule separation in small-incision lenticule extraction for myopic astigmatism.

PubMed

Liu, Ting; Zhu, Xiaomin; Chen, Kaijian; Bai, Ji

2017-07-01

To evaluate the refractive outcomes of balanced salt solution infiltration during small-incision lenticule extraction (SMILE).This randomized prospective study enrolled 52 patients (104 eyes) with myopic astigmatism. Patients underwent SMILE to correct the myopic astigmatism in Daping Hospital of the Third Military Medical University between January and July 2013. One eye of each patient received traditional SMILE (control group) and the other received a modified SMILE procedure (liquid infiltration group). The corrected distance visual acuity (CDVA), postoperative uncorrected distance visual acuity (UDVA), refraction, wavefront aberration, intraocular pressure (IOP), modulation transfer function (MTF) cut-off frequency, and objective scattering index (OSI) were evaluated.UDVA in the liquid infiltration group was significantly higher than that in the control group at 1 day postoperatively, but not at 1 month after surgery. Moreover, OSI and MTF cut-off frequency in the liquid infiltration group were higher than those in the control group at early follow-up. However, no significant intergroup difference was observed in the OSI and MTF cut-off frequency at 3 months after surgery. In addition, the predictability was better in the liquid infiltration group than in the control group. The changes of horizontal coma in the liquid infiltration group were lesser than those in the control group. However, no intergroup difference was observed in the reduction of IOP at 1 month after surgery.The modified SMILE procedure results in better visual outcomes than did the traditional SMILE procedure when used for treating myopic astigmatism.

Wavefront propagation from one plane to another with the use of Zernike polynomials and Taylor monomials.

PubMed

Dai, Guang-ming; Campbell, Charles E; Chen, Li; Zhao, Huawei; Chernyak, Dimitri

2009-01-20

In wavefront-driven vision correction, ocular aberrations are often measured on the pupil plane and the correction is applied on a different plane. The problem with this practice is that any changes undergone by the wavefront as it propagates between planes are not currently included in devising customized vision correction. With some valid approximations, we have developed an analytical foundation based on geometric optics in which Zernike polynomials are used to characterize the propagation of the wavefront from one plane to another. Both the boundary and the magnitude of the wavefront change after the propagation. Taylor monomials were used to realize the propagation because of their simple form for this purpose. The method we developed to identify changes in low-order aberrations was verified with the classical vertex correction formula. The method we developed to identify changes in high-order aberrations was verified with ZEMAX ray-tracing software. Although the method may not be valid for highly irregular wavefronts and it was only proven for wavefronts with low-order or high-order aberrations, our analysis showed that changes in the propagating wavefront are significant and should, therefore, be included in calculating vision correction. This new approach could be of major significance in calculating wavefront-driven vision correction whether by refractive surgery, contact lenses, intraocular lenses, or spectacles.

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.

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

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.

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.

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.

[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) .

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.

Journal of Special Operations Medicine Volume 1, Edition 2

DTIC Science & Technology

2001-01-01

news.... New Group Surgeons at ONE: LCDR Kevin Walters and CDR Scott Flin; at TWO: LT Jose Henao�, at DEVGRU: CDR Fenton , and at BUD/s: LT Ware. Look...be eligible for this surgery. A common belief is that refractive surgery is a � cosmetic � surgical procedure only designed to free one from wearing...corrective glasses, and that the mili- tary should not be in the � cosmetic � business. How- ever, this is a technique for enhancement of soldier readi

Full Modeling of High-Intensity Focused Ultrasound and Thermal Heating in the Kidney Using Realistic Patient Models.

PubMed

Suomi, Visa; Jaros, Jiri; Treeby, Bradley; Cleveland, Robin O

2018-05-01

High-intensity focused ultrasound (HIFU) therapy can be used for noninvasive treatment of kidney (renal) cancer, but the clinical outcomes have been variable. In this study, the efficacy of renal HIFU therapy was studied using nonlinear acoustic and thermal simulations in three patients. The acoustic simulations were conducted with and without refraction in order to investigate its effect on the shape, size, and pressure distribution at the focus. The values for the attenuation, sound speed, perfusion, and thermal conductivity of the kidney were varied over the reported ranges to determine the effect of variability on heating. Furthermore, the phase aberration was studied in order to quantify the underlying phase shifts using a second-order polynomial function. The ultrasound field intensity was found to drop on average 11.1 dB with refraction and 6.4 dB without refraction. Reflection at tissue interfaces was found to result in a loss less than 0.1 dB. Focal point splitting due to refraction significantly reduced the heating efficacy. Of all the tissue parameters, perfusion was found to affect the heating the most. Small changes in temperature were seen with varying attenuation and thermal conductivity, but no visible changes were present with sound speed variations. The aberration study revealed an underlying trend in the spatial distribution of the phase shifts. The results show that the efficacy of HIFU therapy in the kidney could be improved with aberration correction. A method is proposed by which patient specific pretreatment calculations could be used to overcome the aberration and therefore make ultrasound treatment possible.

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.

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.

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.

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.

Effects of chalazia on corneal astigmatism : Large-sized chalazia in middle upper eyelids compress the cornea and induce the corneal astigmatism.

PubMed

Jin, Ki Won; Shin, Young Joo; Hyon, Joon Young

2017-03-31

A chalazion is a common eyelid disease that causes eye morbidity due to inflammation and cosmetic disfigurement. Corneal topographic changes are important factors in corneal refractive surgery, intraocular lens power calculations for cataract surgery, and visual acuity assessments. However, the effects of chalazia on corneal astigmatism have not been thoroughly investigated. The changes in corneal astigmatism according to chalazion size and location is necessary for better outcome of ocular surgery. The aim of this study is to evaluate changes in corneal astigmatism according to chalazion size and location. In this cross-sectional study, a total of 44 eyes from 33 patients were included in the chalazion group and 70 eyes from 46 patients comprised the control group. Chalazia were classified according to location and size. An autokeratorefractometer (KR8100, Topcon; Japan) and a Galilei™ dual-Scheimpflug analyzer (Ziemer Group; Port, Switzerland) were utilized to evaluate corneal changes. Oblique astigmatism was greater in the chalazion group compared with the control group (p < 0.05). Astigmatism by simulated keratometry (simK), steep K by simK, total root mean square, second order aberration, oblique astigmatism, and vertical astigmatism were significantly greater in the upper eyelid group (p < 0.05). Astigmatism by simK, second order aberration, oblique astigmatism, and vertical astigmatism were significantly greater in the large-sized chalazion group (p < 0.05). Corneal wavefront aberration was the greatest in the upper eyelid chalazion group, whole area group, and large-sized chalazion group (p < 0.05). Large-sized chalazia in the whole upper eyelid should be treated in the early phase because they induced the greatest change in corneal topography. Chalazion should be treated before corneal topography is performed preoperatively and before the diagnosis of corneal diseases.

Sensitivity of corneal biomechanical and optical behavior to material parameters using design of experiments method.

PubMed

Xu, Mengchen; Lerner, Amy L; Funkenbusch, Paul D; Richhariya, Ashutosh; Yoon, Geunyoung

2018-02-01

The optical performance of the human cornea under intraocular pressure (IOP) is the result of complex material properties and their interactions. The measurement of the numerous material parameters that define this material behavior may be key in the refinement of patient-specific models. The goal of this study was to investigate the relative contribution of these parameters to the biomechanical and optical responses of human cornea predicted by a widely accepted anisotropic hyperelastic finite element model, with regional variations in the alignment of fibers. Design of experiments methods were used to quantify the relative importance of material properties including matrix stiffness, fiber stiffness, fiber nonlinearity and fiber dispersion under physiological IOP. Our sensitivity results showed that corneal apical displacement was influenced nearly evenly by matrix stiffness, fiber stiffness and nonlinearity. However, the variations in corneal optical aberrations (refractive power and spherical aberration) were primarily dependent on the value of the matrix stiffness. The optical aberrations predicted by variations in this material parameter were sufficiently large to predict clinically important changes in retinal image quality. Therefore, well-characterized individual variations in matrix stiffness could be critical in cornea modeling in order to reliably predict optical behavior under different IOPs or after corneal surgery.

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.

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.

Laser in situ keratomileusis for high hyperopia with corneal vertex centration and asymmetric offset.

PubMed

de Ortueta, Diego; Arba-Mosquera, Sam

2017-03-10

To investigate refractive outcomes and induction of corneal higher order aberrations (HOA) in eyes that underwent laser-assisted in situ keratomileusis (LASIK) for high hyperopia correction using an aberration neutral profile with corneal vertex centration and asymmetric offset. A total of 24 consecutive patients (38 eyes) who underwent LASIK by one surgeon using AMARIS 750S excimer laser and a Carriazo-Pendular microkeratome for flap creation were retrospectively analyzed. Eyes targeted for plano and with correction in the maximum hyperopic meridian strictly higher than +4D were included in the retrospective analysis. Patients were reviewed at 1, 3, and 6 months postoperatively. Postoperative monocular corrected distance visual acuity (CDVA) and uncorrected distance visual acuity (UDVA), manifest refraction, and corneal wavefront aberrations were compared with respective preoperative metrics. Mean preoperative spherical equivalent and refractive astigmatism was +4.07 ± 0.90 D and 1.37 ± 1.26 D, respectively, reducing to +0.28 ± 0.58D (p<0.0001) and 0.49 ± 0.47 D (p = 0.0001) at the last postoperative visit. Six months postoperatively, 78% of eyes achieved a UDVA of 20/25 or better. No eye lost more than 2 Snellen lines of CDVA at any follow-up. There was a statistically significant induction of vertical trefoil (+0.104 ± 0.299 µm, p<0.05), vertical coma (-0.181 ± 0.463 µm, p<0.01), horizontal coma (+0.198 ± 0.663 µm, p<0.05), spherical aberration (-0.324 ± 0.281 µm, p<0.0001), secondary vertical trefoil (+0.018 ± 0.044 µm, p<0.01), and secondary horizontal coma (+0.026 ± 0.083 µm, p<0.05). Laser-assisted in situ keratomileusis for high hyperopia using corneal vertex centration with asymmetric offset results in significant improvement in refraction and visual acuity although affected by significant induction of some higher order aberrations.

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 . ...

Large-field-of-view wide-spectrum artificial reflecting superposition compound eyes

NASA Astrophysics Data System (ADS)

Huang, Chi-Chieh

The study of the imaging principles of natural compound eyes has become an active area of research and has fueled the advancement of modern optics with many attractive design features beyond those available with conventional technologies. Most prominent among all compound eyes is the reflecting superposition compound eyes (RSCEs) found in some decapods. They are extraordinary imaging systems with numerous optical features such as minimum chromatic aberration, wide-angle field of view (FOV), high sensitivity to light and superb acuity to motion. Inspired by their remarkable visual system, we were able to implement the unique lens-free, reflection-based imaging mechanisms into a miniaturized, large-FOV optical imaging device operating at the wide visible spectrum to minimize chromatic aberration without any additional post-image processing. First, two micro-transfer printing methods, a multiple and a shear-assisted transfer printing technique, were studied and discussed to realize life-sized artificial RSCEs. The processes exploited the differential adhesive tendencies of the microstructures formed between a donor and a transfer substrate to accomplish an efficient release and transfer process. These techniques enabled conformal wrapping of three-dimensional (3-D) microstructures, initially fabricated in two-dimensional (2-D) layouts with standard fabrication technology onto a wide range of surfaces with complex and curvilinear shapes. Final part of this dissertation was focused on implementing the key operational features of the natural RSCEs into large-FOV, wide-spectrum artificial RSCEs as an optical imaging device suitable for the wide visible spectrum. Our devices can form real, clear images based on reflection rather than refraction, hence avoiding chromatic aberration due to dispersion by the optical materials. Compared to the performance of conventional refractive lenses of comparable size, our devices demonstrated minimum chromatic aberration, exceptional FOV up to 165o without distortion, modest spherical aberrations and comparable imaging quality without any post-image processing. Together with an augmenting cruciform pattern surrounding each focused image, our devices possessed enhanced, dynamic motion-tracking capability ideal for diverse applications in military, security, search and rescue, night navigation, medical imaging and astronomy. In the future, due to its reflection-based operating principles, it can be further extended into mid- and far-infrared for more demanding applications.

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

A case report of central toxic keratopathy in a patient post TransPRK (followed by corneal collagen cross-linking).

PubMed

Davey, Nicholas; Aslanides, Ioannis M; Selimis, Vasilis

2017-01-01

The purpose of this article is to report a case of central toxic keratopathy in a patient post transepithelial photorefractive keratectomy (TransPRK), followed immediately by corneal collagen cross-linking. This article describes the case of a 26-year-old male after bilateral aberration-free, TransPRK laser (Schwind Amaris 750S). The procedure was performed for compound myopic astigmatism in November 2015, followed immediately by accelerated corneal collagen cross-linking for early keratoconus. From day 3 post-op, tear film debris underneath both contact lenses with corneal haze and early, progressive central anterior stromal opacity formation only in the left eye were noted. At 2 weeks post-op, the left eye was noted to have a significant hyperopic shift with central corneal thinning in the anterior stroma. A central anterior stromal dense opacity had formed in the left eye with the surrounding superficial stromal haze. As of month 2, the opacity gradually started to improve in size and density. The hyperopic shift peaked at 2 months and continued to improve, largely due to epithelial compensation with a gradual recovery of stromal thickness. The question remains as to what provokes the typical central corneal necrosis/thinning in central toxic keratopathy. We hypothesize that the space between the contact lens and the corneal surface post TransPRK is prone to a "pseudo-interface pathology" that could mimic diffuse lamellar keratitis-like pathology. Suboptimal lid hygiene, resulting in tear film combinations of bacteria, inflammatory cells, matrix metalloproteinases and other proteolytic enzymes, contributes to the degradation of vulnerable, exposed collagen stromal tissue post TransPRK or any surface corneal ablation. Refractive surgeons should maintain a healthy lid margin and tear film, especially in contact lens wearers, to prevent potential complications in refractive surgery procedures.

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

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

Laser-assisted in situ keratomileusis with optimized, fast-repetition, and cyclotorsion control excimer laser to treat hyperopic astigmatism with high cylinder.

PubMed

Alió Del Barrio, Jorge L; Tiveron, Mauro; Plaza-Puche, Ana B; Amesty, María A; Casanova, Laura; García, María J; Alió, Jorge L

2017-10-18

To evaluate the visual outcomes after femtosecond laser-assisted laser in situ keratomileusis (LASIK) surgery to correct primary compound hyperopic astigmatism with high cylinder using a fast repetition rate excimer laser platform with optimized aspheric profiles and cyclotorsion control. Eyes with primary simple or compound hyperopic astigmatism and a cylinder power ≥3.00 D had uneventful femtosecond laser-assisted LASIK with a fast repetition rate excimer laser ablation, aspheric profiles, and cyclotorsion control. Visual, refractive, and aberrometric results were evaluated at the 3- and 6-month follow-up. The astigmatic outcome was evaluated using the Alpins method and ASSORT software. This study enrolled 80 eyes at 3 months and 50 eyes at 6 months. The significant reduction in refractive sphere and cylinder 3 and 6 months postoperatively (p<0.01) was associated with an improved uncorrected distance visual acuity (p<0.01). A total of 23.75% required retreatment 3 months after surgery. Efficacy and safety indices at 6 months were 0.90 and 1.00, respectively. At 6 months, 80% of eyes had an SE within ±0.50 D and 96% within ±1.00 D. No significant differences were detected between the third and the sixth postoperative months in refractive parameters. A significant increase in the spherical aberration was detected, but not in coma. The correction index was 0.94 at 3 months. Laser in situ keratomileusis for primary compound hyperopic astigmatism with high cylinder (>3.00 D) using the latest excimer platforms with cyclotorsion control, fast repetition rate, and optimized aspheric profiles is safe, moderately effective, and predictable.

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.

A prospective, contralateral comparison of photorefractive keratectomy (PRK) versus thin-flap LASIK: assessment of visual function.

PubMed

Hatch, Bryndon B; Moshirfar, Majid; Ollerton, Andrew J; Sikder, Shameema; Mifflin, Mark D

2011-01-01

To compare differences in visual acuity, contrast sensitivity, complications, and higher-order ocular aberrations (HOAs) in eyes with stable myopia undergoing either photo-refractive keratectomy (PRK) or thin-flap laser in situ keratomileusis (LASIK) (intended flap thickness of 90 μm) using the VISX Star S4 CustomVue excimer laser and the IntraLase FS60 femtosecond laser at 1, 3, and 6 months postoperatively. In this prospective, masked, and randomized pilot study, refractive surgery was performed contralaterally on 52 eyes: 26 with PRK and 26 with thin-flap LASIK. Primary outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), contrast sensitivity, and complications. At 6 months, mean values for UDVA (logMAR) were -0.043 ± 0.668 and -0.061 ± 0.099 in the PRK and thin-flap LASIK groups, respectively (n = 25, P = 0.466). UDVA of 20/20 or better was achieved in 96% of eyes undergoing PRK and 92% of eyes undergoing thin-flap LASIK, whereas 20/15 vision or better was achieved in 73% of eyes undergoing PRK and 72% of eyes undergoing thin-flap LASIK (P > 0.600). Significant differences were not found between treatment groups in contrast sensitivity (P ≥ 0.156) or CDVA (P = 0.800) at postoperative 6 months. Types of complications differed between groups, notably 35% of eyes in the thin-flap LASIK group experiencing complications, including microstriae and 2 flap tears. Under well-controlled surgical conditions, PRK and thin-flap LASIK refractive surgeries achieve similar results in visual acuity, contrast sensitivity, and induction of HOAs, with differences in experienced complications.

A prospective, contralateral comparison of photorefractive keratectomy (PRK) versus thin-flap LASIK: assessment of visual function

PubMed Central

Hatch, Bryndon B; Moshirfar, Majid; Ollerton, Andrew J; Sikder, Shameema; Mifflin, Mark D

2011-01-01

Purpose: To compare differences in visual acuity, contrast sensitivity, complications, and higher-order ocular aberrations (HOAs) in eyes with stable myopia undergoing either photo-refractive keratectomy (PRK) or thin-flap laser in situ keratomileusis (LASIK) (intended flap thickness of 90 μm) using the VISX Star S4 CustomVue excimer laser and the IntraLase FS60 femtosecond laser at 1, 3, and 6 months postoperatively. Methods: In this prospective, masked, and randomized pilot study, refractive surgery was performed contralaterally on 52 eyes: 26 with PRK and 26 with thin-flap LASIK. Primary outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), contrast sensitivity, and complications. Results: At 6 months, mean values for UDVA (logMAR) were −0.043 ± 0.668 and −0.061 ± 0.099 in the PRK and thin-flap LASIK groups, respectively (n = 25, P = 0.466). UDVA of 20/20 or better was achieved in 96% of eyes undergoing PRK and 92% of eyes undergoing thin-flap LASIK, whereas 20/15 vision or better was achieved in 73% of eyes undergoing PRK and 72% of eyes undergoing thin-flap LASIK (P > 0.600). Significant differences were not found between treatment groups in contrast sensitivity (P ≥ 0.156) or CDVA (P = 0.800) at postoperative 6 months. Types of complications differed between groups, notably 35% of eyes in the thin-flap LASIK group experiencing complications, including microstriae and 2 flap tears. Conclusion: Under well-controlled surgical conditions, PRK and thin-flap LASIK refractive surgeries achieve similar results in visual acuity, contrast sensitivity, and induction of HOAs, with differences in experienced complications. PMID:21573091

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.

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.

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 ...

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...

Outcomes of topography-guided versus wavefront-optimized laser in situ keratomileusis for myopia in virgin eyes.

PubMed

Jain, Arun Kumar; Malhotra, Chintan; Pasari, Anand; Kumar, Pawan; Moshirfar, Majid

2016-09-01

To compare the outcomes of topography-guided and wavefront-optimized treatment in patients having laser in situ keratomileusis (LASIK) for myopia. Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India. Prospective contralateral-eye case study. Patients had topography-guided LASIK in 1 eye and wavefront-optimized LASIK in the contralateral eye using the Customized Refractive Surgery Master software and Mel 80 excimer laser. Refractive (residual manifest refraction spherical equivalent [MRSE], higher-order aberrations [HOAs]), and visual (uncorrected distance visual acuity [UDVA] and photopic and mesopic contrast sensitivity) outcomes were prospectively analyzed 6 months postoperatively. The study comprised 35 patients. The UDVA was 0.0 logMAR or better and the postoperative residual MRSE was ±0.50 diopter in 94.29% of eyes in the topography-guided group and 85.71% of eyes in the wavefront-optimized group (P = .09). More eyes in the topography-guided group than in the wavefront-optimized group had a UDVA of -0.1 logMAR or better (P = .04). Topography-guided LASIK was associated with less deterioration of mesopic contrast sensitivity at higher spatial frequencies (12 cycles per degree [cpd] and 18 cpd) and lower amounts of induced coma (P = .04) and spherical aberration (P = .04). Less stromal tissue was ablated in the topography-guided group (mean 61.57 μm ± 16.23 [SD]) than in the wavefront-optimized group (mean 79.71 ± 14.81 μm) (P < .001). Although topography-guided LASIK and wavefront-optimized LASIK gave excellent results, topography-guided LASIK was associated with better contrast sensitivity, lower induction of HOAs, and a smaller amount of tissue ablation. 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.

Wavefront Measurement in Ophthalmology

NASA Astrophysics Data System (ADS)

Molebny, Vasyl

Wavefront sensing or aberration measurement in the eye is a key problem in refractive surgery and vision correction with laser. The accuracy of these measurements is critical for the outcome of the surgery. Practically all clinical methods use laser as a source of light. To better understand the background, we analyze the pre-laser techniques developed over centuries. They allowed new discoveries of the nature of the optical system of the eye, and many served as prototypes for laser-based wavefront sensing technologies. Hartmann's test was strengthened by Platt's lenslet matrix and the CCD two-dimensional photodetector acquired a new life as a Hartmann-Shack sensor in Heidelberg. Tscherning's aberroscope, invented in France, was transformed into a laser device known as a Dresden aberrometer, having seen its reincarnation in Germany with Seiler's help. The clinical ray tracing technique was brought to life by Molebny in Ukraine, and skiascopy was created by Fujieda in Japan. With the maturation of these technologies, new demands now arise for their wider implementation in optometry and vision correction with customized contact and intraocular lenses.

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.

[Hyperopic Laser-in-situ-Keratomileusis after trifocal intraocular lens implantation : Aberration-free femto-Laser-in-situ-Keratomileusis treatment after implantation of a diffractive, multifocal, toric intraocular lens-case analysis].

PubMed

Hemkeppler, E; Böhm, M; Kohnen, T

2018-05-29

A 52-year-old highly myopic female patient was implanted with a multifocal, diffractive, toric intraocular lens because of the wish to be independent of eyeglasses. Despite high-quality, extensive preoperative examinations, a hyperopic refractive error remained postoperatively, which led to the patient's dissatisfaction. This error was treated with Laser-in-situ-Keratomileusis (LASIK). After corneal LASIK treatment and implantation of a diffractive toric multifocal intraocular lens the patient showed a good postoperative visual result without optical phenomena.

Diplopia after laser in situ keratomileusis (LASIK) in a patient with a history of strabismus.

PubMed

Heinmiller, Laura J; Wasserman, Barry N

2013-02-01

In patients with a history of strabismus, refractive surgery can result in decompensation of ocular alignment, with subsequent diplopia. Refractive surgery in the management of strabismus has been described, although it remains controversial. We present a young adult with past history of strabismus surgery and new-onset diplopia after refractive surgery. Binocular diplopia was treated surgically with laser in situ keratomileusis. Copyright © 2013 American Association for Pediatric Ophthalmology and Strabismus. Published by Mosby, Inc. All rights reserved.

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

Optical design of a novel instrument that uses the Hartmann-Shack sensor and Zernike polynomials to measure and simulate customized refraction correction surgery outcomes and patient satisfaction

NASA Astrophysics Data System (ADS)

Yasuoka, Fatima M. M.; Matos, Luciana; Cremasco, Antonio; Numajiri, Mirian; Marcato, Rafael; Oliveira, Otavio G.; Sabino, Luis G.; Castro N., Jarbas C.; Bagnato, Vanderlei S.; Carvalho, Luis A. V.

2016-03-01

An optical system that conjugates the patient's pupil to the plane of a Hartmann-Shack (HS) wavefront sensor has been simulated using optical design software. And an optical bench prototype is mounted using mechanical eye device, beam splitter, illumination system, lenses, mirrors, mirrored prism, movable mirror, wavefront sensor and camera CCD. The mechanical eye device is used to simulate aberrations of the eye. From this device the rays are emitted and travelled by the beam splitter to the optical system. Some rays fall on the camera CCD and others pass in the optical system and finally reach the sensor. The eye models based on typical in vivo eye aberrations is constructed using the optical design software Zemax. The computer-aided outcomes of each HS images for each case are acquired, and these images are processed using customized techniques. The simulated and real images for low order aberrations are compared using centroid coordinates to assure that the optical system is constructed precisely in order to match the simulated system. Afterwards a simulated version of retinal images is constructed to show how these typical eyes would perceive an optotype positioned 20 ft away. Certain personalized corrections are allowed by eye doctors based on different Zernike polynomial values and the optical images are rendered to the new parameters. Optical images of how that eye would see with or without corrections of certain aberrations are generated in order to allow which aberrations can be corrected and in which degree. The patient can then "personalize" the correction to their own satisfaction. This new approach to wavefront sensing is a promising change in paradigm towards the betterment of the patient-physician relationship.

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…

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.

Stability of therapeutic retreatment of corneal wavefront customized ablation with the SCHWIND CAM: 4-year data.

PubMed

Aslanides, Ioannis M; Kolli, Sai; Padroni, Sara; Padron, Sara; Arba Mosquera, Samuel

2012-05-01

To evaluate the long-term outcomes of aspheric corneal wavefront ablation profiles for excimer laser retreatment. Eighteen eyes that had previously undergone LASIK or photorefractive keratectomy (PRK) were retreated with LASIK using the corneal wavefront ablation profile. Custom Ablation Manager (SCHWIND eye-tech-solutions, Kleinostheim, Germany) software and the ESIRIS flying spot excimer laser system (SCHWIND) were used to perform the ablations. Refractive outcomes and wavefront data are reported up to 4 years after retreatment. Pre- and postoperative data were compared with Student t tests and (multivariate) correlation tests. P<.05 was considered statistically significant. A bilinear correlation of various postoperative wavefront aberrations versus planned correction and preoperative aberration was performed. Mean manifest refraction spherical equivalent (MRSE) before retreatment was -0.38±1.85 diopters (D) and -0.09±0.22 D at 6 months and -0.10±0.38 D at 4 years postoperatively. The reduction in MRSE was statistically significant at both postoperative time points (P<.005). Postoperative aberrations were statistically lower (spherical aberration P<.05; coma P<.005; root-mean-square higher order aberration P<.0001) at 4 years postoperatively. Distribution of the postoperative uncorrected distance visual acuity (P<.0001) and corrected distance visual acuity (P<.01) were statistically better than preoperative values. Aspheric corneal wavefront customization with the ESIRIS yields visual, optical, and refractive results comparable to those of other wavefront-guided customized techniques for the correction of myopia and myopic astigmatism. The corneal wavefront customized approach shows its strength in cases where abnormal optical systems are expected. Systematic wavefront customized corneal ablation appears safe and efficacious for retreatment cases. Copyright 2012, SLACK Incorporated.

Accommodation and age-dependent eye model based on in vivo measurements.

PubMed

Zapata-Díaz, Juan F; Radhakrishnan, Hema; Charman, W Neil; López-Gil, Norberto

2018-03-21

To develop a flexible model of the average eye that incorporates changes with age and accommodation in all optical parameters, including entrance pupil diameter, under photopic, natural, environmental conditions. We collated retrospective in vivo measurements of all optical parameters, including entrance pupil diameter. Ray-tracing was used to calculate the wavefront aberrations of the eye model as a function of age, stimulus vergence and pupil diameter. These aberrations were used to calculate objective refraction using paraxial curvature matching. This was also done for several stimulus positions to calculate the accommodation response/stimulus curve. The model predicts a hyperopic change in distance refraction as the eye ages (+0.22D every 10 years) between 20 and 65 years. The slope of the accommodation response/stimulus curve was 0.72 for a 25 years-old subject, with little change between 20 and 45 years. A trend to a more negative value of primary spherical aberration as the eye accommodates is predicted for all ages (20-50 years). When accommodation is relaxed, a slight increase in primary spherical aberration (0.008μm every 10 years) between 20 and 65 years is predicted, for an age-dependent entrance pupil diameter ranging between 3.58mm (20 years) and 3.05mm (65 years). Results match reasonably well with studies performed in real eyes, except that spherical aberration is systematically slightly negative as compared with the practical data. The proposed eye model is able to predict changes in objective refraction and accommodation response. It has the potential to be a useful design and testing tool for devices (e.g. intraocular lenses or contact lenses) designed to correct the eye's optical errors. Copyright © 2018 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

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.

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.

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.

Retrospective Analysis of the Post-Operative Changes in Higher Order Aberrations: A Comparison of the WaveLight (registered trademark) EX500 to the Allegretto and Visx (registered trademark) S4 Laser in Refractive Surgery

DTIC Science & Technology

2017-06-16

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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

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.

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.

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

Optical correction and quality of vision of the French soldiers stationed in the Republic of Djibouti in 2009.

PubMed

Vignal, Rodolphe; Ollivier, Lénaïck

2011-03-01

To ensure vision readiness on the battlefield, the French military has been providing its soldiers with eyewear since World War I. A military refractive surgery program was initiated in 2008. A prospective questionnaire-based investigation on optical correction and quality of vision among active duty members with visual deficiencies stationed in Djibouti, Africa, was conducted in 2009. It revealed that 59.3% of the soldiers were wearing spectacles, 21.2% were wearing contact lenses--despite official recommendations--and 8.5% had undergone refractive surgery. Satisfaction rates were high with refractive surgery and contact lenses; 33.6% of eyeglass wearers were planning to have surgery. Eye dryness and night vision disturbances were the most reported symptoms following surgery. Military optical devices were under-prescribed before deployment. This suggests that additional and more effective studies on the use of military optical devices should be performed and policy supporting refractive surgery in military populations should be strengthened.

Two-dimensional simulation of eccentric photorefraction images for ametropes: factors influencing the measurement.

PubMed

Wu, Yifei; Thibos, Larry N; Candy, T Rowan

2018-05-07

Eccentric photorefraction and Purkinje image tracking are used to estimate refractive state and eye position simultaneously. Beyond vision screening, they provide insight into typical and atypical visual development. Systematic analysis of the effect of refractive error and spectacles on photorefraction data is needed to gauge the accuracy and precision of the technique. Simulation of two-dimensional, double-pass eccentric photorefraction was performed (Zemax). The inward pass included appropriate light sources, lenses and a single surface pupil plane eye model to create an extended retinal image that served as the source for the outward pass. Refractive state, as computed from the luminance gradient in the image of the pupil captured by the model's camera, was evaluated for a range of refractive errors (-15D to +15D), pupil sizes (3 mm to 7 mm) and two sets of higher-order monochromatic aberrations. Instrument calibration was simulated using -8D to +8D trial lenses at the spectacle plane for: (1) vertex distances from 3 mm to 23 mm, (2) uncorrected and corrected hyperopic refractive errors of +4D and +7D, and (3) uncorrected and corrected astigmatism of 4D at four different axes. Empirical calibration of a commercial photorefractor was also compared with a wavefront aberrometer for human eyes. The pupil luminance gradient varied linearly with refractive state for defocus less than approximately 4D (5 mm pupil). For larger errors, the gradient magnitude saturated and then reduced, leading to under-estimation of refractive state. Additional inaccuracy (up to 1D for 8D of defocus) resulted from spectacle magnification in the pupil image, which would reduce precision in situations where vertex distance is variable. The empirical calibration revealed a constant offset between the two clinical instruments. Computational modelling demonstrates the principles and limitations of photorefraction to help users avoid potential measurement errors. Factors that could cause clinically significant errors in photorefraction estimates include high refractive error, vertex distance and magnification effects of a spectacle lens, increased higher-order monochromatic aberrations, and changes in primary spherical aberration with accommodation. The impact of these errors increases with increasing defocus. © 2018 The Authors Ophthalmic & Physiological Optics © 2018 The College of Optometrists.

[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).

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

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.

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.

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.

Lenticular accommodation in relation to ametropia: the chick model.

PubMed

Choh, Vivian; Sivak, Jacob G

2005-03-04

Our goal was to determine whether experimentally induced ametropias have an effect on lenticular accommodation and spherical aberration. Form-deprivation myopia and hyperopia were induced in one eye of hatchling chicks by application of a translucent goggle and +15 D lens, respectively. After 7 days, eyes were enucleated and lenses were optically scanned prior to accommodation, during accommodation, and after accommodation. Accommodation was induced by electrical stimulation of the ciliary nerve. Lenticular focal lengths for form-deprived eyes were significantly shorter than for their controls and accommodation-associated changes in focal length were significantly smaller in myopic eyes compared to their controls. For eyes imposed with +15 D blur, focal lengths were longer than those for their controls and accommodative changes were greater. Spherical aberration of the lens increased with accommodation in both form-deprived and lens-treated birds, but induction of ametropia had no effect on lenticular spherical aberration in general. Nonmonotonicity from lenticular spherical aberration increased during accommodation but effects of refractive error were equivocal. The crystalline lens contributes to refractive error changes of the eye both in the case of myopia and hyperopia. These changes are likely attributable to global changes in the size and shape of the eye.

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.

Notes and Discussion

ERIC Educational Resources Information Center

American Journal of Physics, 1978

1978-01-01

Describes experiments demonstrating the Josephson effect, single-file diffusion in biological membranes, refractive index of beer, lines of magnetic fields, indexing diffraction patterns, Maxwell's equations, and spherical aberration. (SL)

[Evaluation of Postoperative Astigmatism Correction and Postoperative Rotational Stability of Two Toric Intraocular Lenses].

PubMed

Grohlich, M; Miháltz, K; Lasta, M; Weingessel, B; Vécsei-Marlovits, V

2017-06-01

Background The aim of this retrospective study was to evaluate the rotational stability and the refractive outcome of two different toric IOLs. Methods This study included 41 eyes with corneal astigmatism greater than 1.5 diopters (D). All patients underwent surgery in the Department of Ophthalmology at Hietzing Hospital between 2010 and 2013. The study lenses were the Alcon AcrySof IQ Toric IOL and the Abbott Tecnis Toric Aspheric IOL. Measurements of corneal topography and aberrations were performed with the HOYA iTrace™. Determination of visual acuity was performed with ETDRS charts. Optical aberrations were represented by Zernike coefficients, and optical quality was assessed with the Strehl ratio. Results Mean rotation was 4.92° (standard deviation: ± 4.10°) in the Alcon group and 4.31° (± 4.59°) in the Abbott group. No significant difference was observed between the two toric intraocular lenses. Rotational stability was comparable to results from other studies. Astigmatism correction was visualised with a power-vector analysis, which demonstrated similar results in both lenses and a clear success of astigmatism correction. No statistically significant differences were found in residual refractive astigmatism, which was 0.85 ± 0.48 D in the Alcon group and 1.09 ± 0.66 in the Tecnis group. No significant difference between the two groups was found in the Strehl ratio. Conclusion Implantation of toric intraocular lenses (Alcon + Abbott) in patients with regular astigmatism is an effective and safe method, which should be offered to patients. Both the Tecnis and the AcrySof toric IOLs similarly reduced ocular astigmatism. Georg Thieme Verlag KG Stuttgart · New York.

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 = 0.05). The proportions of types of procedure changed, with an increase in the proportion of PRK between 2007 and 2009 (p = 0.02). The mean age of patients did not change [42.4 ± 14.4 (standard deviation) years in 2007 vs. 39.6 ± 14.5 years in 2009; p = 0.4]. Astigmatism-correcting IOL and presbyopia-correcting IOL volumes increased 15-fold and three-fold, respectively, between 2007 and 2009. Volume of excimer laser refractive surgery decreased by at least 30% between 2007 and 2009. No significant change in mean age or in the distribution of refractive error was seen, although the proportion of high myopes decreased between summer quarters of 2007 and 2009. PRK gained as a proportion of total cases. Premium IOL volume increased, but still comprised a very small proportion of total IOL volume.

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, however, decreased (p = 0.05). The proportions of types of procedure changed, with an increase in the proportion of PRK between 2007 and 2009 (p = 0.02). The mean age of patients did not change [42.4 ± 14.4 (standard deviation) years in 2007 vs. 39.6 ± 14.5 years in 2009; p = 0.4]. Astigmatism-correcting IOL and presbyopia-correcting IOL volumes increased 15-fold and three-fold, respectively, between 2007 and 2009. Conclusions Volume of excimer laser refractive surgery decreased by at least 30% between 2007 and 2009. No significant change in mean age or in the distribution of refractive error was seen, although the proportion of high myopes decreased between summer quarters of 2007 and 2009. PRK gained as a proportion of total cases. Premium IOL volume increased, but still comprised a very small proportion of total IOL volume. PMID:21569564

Orbital-angular-momentum photons for optical communication in non-Kolmogorov atmospheric turbulence

NASA Astrophysics Data System (ADS)

Wei, Mei-Song; Wang, Jicheng; Zhang, Yixin; Hu, Zheng-Da

2018-06-01

We investigate the effects of non-Kolmogorov atmospheric turbulence on the transmission of orbital-angular-momentum single photons for different turbulence aberrations in optical communication, via the channel capacity. For non-Kolmogorov model, the characteristics of atmosphere turbulence may be determined by different cases, including the increasing altitude, the mutative index-of-refraction structure constant and the power-law exponent of non-Kolmogorov spectrum. It is found that the influences of low-order aberrations, including Z-tilt, defocus, astigmatism, and coma aberrations, are different and the turbulence Z-tilt aberration plays a more important role in the decay of the signal.

Nanosurgery with near-infrared 12-femtosecond and picosecond laser pulses

NASA Astrophysics Data System (ADS)

Uchugonova, Aisada; Zhang, Huijing; Lemke, Cornelius; König, Karsten

2011-03-01

Laser-assisted surgery based on multiphoton absorption of NIR laser light has great potential for high precision surgery at various depths within the cells and tissues. Clinical applications include refractive surgery (fs-LASIK). The non-contact laser method also supports contamination-free cell nanosurgery. Here we apply femtosecond laser scanning microscopes for sub-100 nm surgery of human cells and metaphase chromosomes. A mode-locked 85 MHz Ti:Sapphire laser with an M-shaped ultrabroad band spectrum (maxima: 770 nm/830 nm) with an in situ pulse duration at the target ranging from 12 femtoseconds up to 3 picoseconds was employed. The effects of laser nanoprocessing in cells and chromosomes have been quantified by atomic force microscopy (AFM) and electron microscopy. These studies demonstrate the potential of extreme ultrashort femtosecond laser pulses at low mean milliwatt powers for sub-100 nm surgery.

Nanosurgery of cells and chromosomes using near-infrared twelve-femtosecond laser pulses

NASA Astrophysics Data System (ADS)

Uchugonova, Aisada; Lessel, Matthias; Nietzsche, Sander; Zeitz, Christian; Jacobs, Karin; Lemke, Cornelius; König, Karsten

2012-10-01

Laser-assisted surgery based on multiphoton absorption of near-infrared laser light has great potential for high precision surgery at various depths within the cells and tissues. Clinical applications include refractive surgery (fs-LASIK). The non-contact laser method also supports contamination-free cell nanosurgery. In this paper we describe usage of an ultrashort femtosecond laser scanning microscope for sub-100 nm surgery of human cells and metaphase chromosomes. A mode-locked 85 MHz Ti:Sapphire laser with an M-shaped ultrabroad band spectrum (maxima: 770 nm/830 nm) and an in situ pulse duration at the target ranging from 12 fs up to 3 ps was employed. The effects of laser nanoprocessing in cells and chromosomes have been quantified by atomic force microscopy. These studies demonstrate the potential of extreme ultrashort femtosecond laser pulses at low mean milliwatt powers for sub-100 nm surgery of cells and cellular organelles.

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

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.

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

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

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.

The Charles F. Prentice Award Lecture 2005: optics of the human eye: progress and problems.

PubMed

Charman, W Neil

2006-06-01

The history of measurements of ocular aberration is briefly reviewed and recent work using much-improved aberrometers and large samples of eyes is summarized. When on-axis, higher-order, monochromatic aberrations are averaged, undercorrected, positive, fourth-order spherical aberration dominates; other Zernike wavefront aberration coefficients have average values near zero. Individually, however, many eyes show substantial amounts of third-order and other fourth-order aberrations; the value of these varies idiosyncratically about zero. Most normal eyes show only small amounts of axial monochromatic aberration for photopic pupils up to around 3 mm; the limits to retinal image quality are then usually set by diffraction, uncorrected or imperfectly corrected spherocylindrical refractive error, accommodation error, and chromatic aberration. Longitudinal chromatic aberration varies very little across the population. With larger mesopic and scotopic pupils, monochromatic aberration plays a more important optical role, but overall visual performance is increasingly dominated by neural factors. Some remaining problems in measuring and modeling the eye's optical performance are discussed.

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.

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.

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.

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.

Removal and Repositioning of Intracorneal Ring Segments: Improving Corneal Topography and Clinical Outcomes in Keratoconus and Ectasia.

PubMed

Chan, Kahei; Hersh, Peter S

2017-02-01

To evaluate the efficacy of removal and relocation of intracorneal ring segments for improving outcomes in treatment of keratoconus and corneal ectasia. This is a retrospective case series conducted at a cornea and refractive surgery subspecialty practice setting. Patients with previous insertion of 2 intracorneal ring segments underwent surgical removal and repositioning of segments because of unsatisfactory visual and topographic outcomes. The principal outcomes included uncorrected and corrected visual acuities, manifest refraction, topography-derived maximum keratometry (Kmax), inferior-superior topography power difference (I - S), and higher-order aberration profile derived from wavefront analysis. Three patients are presented in this case series. Uncorrected visual acuity improved in all eyes by an average of 2.75 lines. Corrected visual acuity improved in 2 eyes and remained unchanged in 1 eye. Refractive astigmatism decreased in all patients by an average of 2.50 D. Kmax decreased by an average of 1.43 D. All patients had improvement in the I - S value with a mean decrease of 5.13 D. Topography-guided repositioning and/or replacement of corneal ring segments can result in improved topographic, optical, and visual outcomes in patients in whom the initial result is suboptimal. In these cases, a single segment repositioned beneath the cone resulted in an improved outcome. Analysis of corneal topography can guide the surgeon in treatment planning and can suggest patients in whom such an effort will be rewarded with better results.

Light-adjustable lens.

PubMed Central

Schwartz, Daniel M

2003-01-01

PURPOSE: First, to determine whether a silicone light-adjustable intraocular lens (IOL) can be fabricated and adjusted precisely with a light delivery device (LDD). Second, to determine the biocompatibility of an adjustable IOL and whether the lens can be adjusted precisely in vivo. METHODS: After fabrication of a light-adjustable silicone formulation, IOLs were made and tested in vitro for cytotoxicity, leaching, precision of adjustment, optical quality after adjustment, and mechanical properties. Light-adjustable IOLs were then tested in vivo for biocompatibility and precision of adjustment in a rabbit model. In collaboration with Zeiss-Meditec, a digital LDD was developed and tested to correct for higher-order aberrations in light-adjustable IOLs. RESULTS: The results establish that a biocompatible silicone IOL can be fabricated and adjusted using safe levels of light. There was no evidence of cytotoxicity or leaching. Testing of mechanical properties revealed no significant differences from commercial controls. Implantation of light-adjustable lenses in rabbits demonstrated- excellent biocompatibility after 6 months, comparable to a commercially available IOL. In vivo spherical (hyperopic and myopic) adjustment in rabbits was achieved using an analog light delivery system. The digital light delivery system was tested and achieved correction of higher-order aberrations. CONCLUSION: A silicone light-adjustable IOL and LDD have been developed to enable postoperative, noninvasive adjustment of lens power. The ability to correct higher-order aberrations in these materials has broad potential applicability for optimization of vision in patients undergoing cataract and refractive surgery. PMID:14971588

Variant myopia: A new presentation?

PubMed Central

Hussaindeen, Jameel Rizwana; Anand, Mithra; Sivaraman, Viswanathan; Ramani, Krishna Kumar; Allen, Peter M

2018-01-01

Purpose: Variant myopia (VM) presents as a discrepancy of >1 diopter (D) between subjective and objective refraction, without the presence of any accommodative dysfunction. The purpose of this study is to create a clinical profile of VM. Methods: Fourteen eyes of 12 VM patients who had a discrepancy of >1D between retinoscopy and subjective acceptance under both cycloplegic and noncycloplegic conditions were included in the study. Fourteen eyes of 14 age- and refractive error-matched participants served as controls. Potential participants underwent a comprehensive orthoptic examination followed by retinoscopy (Ret), closed-field autorefractor (CA), subjective acceptance (SA), choroidal and retinal thickness, ocular biometry, and higher order spherical aberrations measurements. Results: In the VM eyes, a statistically and clinically significant difference was noted between the Ret and CA and Ret and SA under both cycloplegic and noncycloplegic conditions (multivariate repeated measures analysis of variance, P < 0.0001). A statistically significant difference was observed between the VM eyes, non-VM eyes, and controls for choroidal thickness in all the quadrants (Univariate ANOVA P < 0.05). The VM eyes had thinner choroids (197.21 ± 13.04 μ) compared to the non-VM eyes (249.25 ± 53.70 μ) and refractive error-matched controls (264.62 ± 12.53 μ). No statistically significant differences between groups in root mean square of total higher order aberrations and spherical aberration were observed. Conclusion: Accommodative etiology does not play a role in the refractive discrepancy seen in individuals with the variant myopic presentation. These individuals have thinner choroids in the eye with variant myopic presentation compared to the fellow eyes and controls. Hypotheses and clinical implications of variant myopia are discussed. PMID:29785987

Wavefront-guided versus wavefront-optimized laser in situ keratomileusis: contralateral comparative study.

PubMed

Padmanabhan, Prema; Mrochen, Michael; Basuthkar, Subam; Viswanathan, Deepa; Joseph, Roy

2008-03-01

To compare the outcomes of wavefront-guided and wavefront-optimized treatment in fellow eyes of patients having laser in situ keratomileusis (LASIK) for myopia. Medical and Vision Research Foundation, Tamil Nadu, India. This prospective comparative study comprised 27 patients who had wavefront-guided LASIK in 1 eye and wavefront-optimized LASIK in the fellow eye. The Hansatome (Bausch & Lomb) was used to create a superior-hinged flap and the Allegretto laser (WaveLight Laser Technologie AG), for photoablation. The Allegretto wave analyzer was used to measure ocular wavefront aberrations and the Functional Acuity Contrast Test chart, to measure contrast sensitivity before and 1 month after LASIK. The refractive and visual outcomes and the changes in aberrations and contrast sensitivity were compared between the 2 treatment modalities. One month postoperatively, 92% of eyes in the wavefront-guided group and 85% in the wavefront-optimized group had uncorrected visual acuity of 20/20 or better; 93% and 89%, respectively, had a postoperative spherical equivalent refraction of +/-0.50 diopter. The differences between groups were not statistically significant. Wavefront-guided LASIK induced less change in 18 of 22 higher-order Zernike terms than wavefront-optimized LASIK, with the change in positive spherical aberration the only statistically significant one (P= .01). Contrast sensitivity improved at the low and middle spatial frequencies (not statistically significant) and worsened significantly at high spatial frequencies after wavefront-guided LASIK; there was a statistically significant worsening at all spatial frequencies after wavefront-optimized LASIK. Although both wavefront-guided and wavefront-optimized LASIK gave excellent refractive correction results, the former induced less higher-order aberrations and was associated with better contrast sensitivity.

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

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.

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

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 relatively inexpensive because their surface figures are characterized by errors as large as about 10 waves. Figure 1 schematically depicts the apparatus used in an experiment to demonstrate such an application on a reduced scale involving a 30-cm-diameter aperture.

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...

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.

A case report of central toxic keratopathy in a patient post TransPRK (followed by corneal collagen cross-linking)

PubMed Central

Davey, Nicholas; Aslanides, Ioannis M; Selimis, Vasilis

2017-01-01

Purpose The purpose of this article is to report a case of central toxic keratopathy in a patient post transepithelial photorefractive keratectomy (TransPRK), followed immediately by corneal collagen cross-linking. Methods This article describes the case of a 26-year-old male after bilateral aberration-free, TransPRK laser (Schwind Amaris 750S). The procedure was performed for compound myopic astigmatism in November 2015, followed immediately by accelerated corneal collagen cross-linking for early keratoconus. Results From day 3 post-op, tear film debris underneath both contact lenses with corneal haze and early, progressive central anterior stromal opacity formation only in the left eye were noted. At 2 weeks post-op, the left eye was noted to have a significant hyperopic shift with central corneal thinning in the anterior stroma. A central anterior stromal dense opacity had formed in the left eye with the surrounding superficial stromal haze. As of month 2, the opacity gradually started to improve in size and density. The hyperopic shift peaked at 2 months and continued to improve, largely due to epithelial compensation with a gradual recovery of stromal thickness. Conclusion The question remains as to what provokes the typical central corneal necrosis/thinning in central toxic keratopathy. We hypothesize that the space between the contact lens and the corneal surface post TransPRK is prone to a “pseudo-interface pathology” that could mimic diffuse lamellar keratitis-like pathology. Suboptimal lid hygiene, resulting in tear film combinations of bacteria, inflammatory cells, matrix metalloproteinases and other proteolytic enzymes, contributes to the degradation of vulnerable, exposed collagen stromal tissue post TransPRK or any surface corneal ablation. Refractive surgeons should maintain a healthy lid margin and tear film, especially in contact lens wearers, to prevent potential complications in refractive surgery procedures. PMID:28450791

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.

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.

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.

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-cycloplegic EM measurements were found to be more pronounced for peripheral field angles than central measures, for both M and J180 components. PMID:26190684

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 pronounced for peripheral field angles than central measures, for both M and J180 components. Copyright © 2015 Spanish General Council of Optometry. Published by Elsevier Espana. All rights reserved.

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.

OPTICS OF CONDUCTIVE KERATOPLASTY: IMPLICATIONS FOR PRESBYOPIA MANAGEMENT

PubMed Central

Hersh, Peter S

2005-01-01

Purpose To define the corneal optics of conductive keratoplasty (CK) and assess the clinical implications for hyperopia and presbyopia management. Methods Four analyses were done. (1) Multifocal effects: In a prospective study of CK, uncorrected visual acuity (UCVA) for a given refractive error in 72 postoperative eyes was compared to control eyes. (2) Surgically induced astigmatism (SIA): 203 eyes were analyzed for magnitude and axis of SIA. (3) Higher-order optical aberrations: Corneal higher-order optical aberrations were assessed for 36 eyes after CK and a similar patient population after hyperopic laser in situ keratomileusis (LASIK). (4) Presbyopia clinical trial: Visual acuity, refractive result, and patient questionnaires were analyzed for 150 subjects in a prospective, multicenter clinical trial of presbyopia management with CK. Results (1) 63% and 82% of eyes after CK had better UCVA at distance and near, respectively, than controls. (2) The mean SIA was 0.23 diopter (D) steepening at 175° (P < .001); mean magnitude was 0.66 D (SD, 0.43 D). (3) After CK, composite fourth- and sixth-order spherical aberration increased; change in (Z12) spherical aberration alone was not statistically significant. When compared to hyperopic LASIK, there was a statistically significant increase in composite fourth- and sixth-order spherical aberration (P < .01) and spherical aberration (Z12) alone (P < .02); spherical aberration change was more prolate after CK. (4) After the CK monovision procedure, 80% of patients had J3 or better binocular UCVA at near; 84% of patients were satisfied. Satisfaction was associated with near UCVA of J3 or better in the monovision eye (P = .001) and subjectively good postoperative depth perception (P = .038). Conclusions CK seems to produce functional corneal multifocality with definable introduction of SIA and higher-order optical aberrations, and development of a more prolate corneal contour. These optical factors may militate toward improved near vision function. PMID:17057812

Small-incision lenticule extraction (SMILE): outcomes of 722 eyes treated for myopia and myopic astigmatism.

PubMed

Hansen, Rasmus Søgaard; Lyhne, Niels; Grauslund, Jakob; Vestergaard, Anders Højslet

2016-02-01

To study the outcomes of small-incision lenticule extraction (SMILE) for treatment of myopia and myopic astigmatism. Retrospective study of patients treated for myopia or myopic astigmatism with SMILE, using a VisuMax(®) femtosecond laser (Carl Zeiss Meditec, Jena, Germany), at the Department of Ophthalmology, Odense University Hospital, Odense, Denmark. Inclusion criteria were corrected distance visual acuity (CDVA) of 20/25 or better before surgery and no ocular conditions other than myopia up to -10.00 diopters (D) with astigmatism up to 3.00 D. Of the 729 treatments, 722 were included. The spherical equivalent (SE) refraction averaged -6.82 ± 1.66 diopters (D) before surgery. After 3 months, 88 % of eyes were within ±0.50 D of the intended refraction, whilst 98 % were within ±1.00 D. The mean difference between attempted and achieved SE refraction at 3 months after surgery was -0.06 ± 0.01 D (range: -1.25 to 1.25 D). In eyes with emmetropia as target refraction (n = 362), 63 % had uncorrected distance visual acuity (UDVA) of 20/25 or better 1 day after surgery, rising to 83 % at 3 months after surgery. The average gain in CDVA from before surgery to 3 months after surgery was 0.07 ± 0.03 (logMAR). However, 12 eyes (1.6 %) lost 2 or more lines of CDVA from before surgery to 3 months postoperatively. Simultaneous treatment of up to 3.00 D of astigmatism was not associated with less predictable refractive outcomes. In the short term, SMILE seemed predictable, efficient, and safe for treatment of myopia and myopic astigmatism.

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.

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

Improving vision by pupil masking

PubMed Central

Bonaque-González, Sergio; Ríos-Rodríguez, Susana; López-Gil, Norberto

2016-01-01

We propose an alternative solution to improve visual quality by spatially modulating the amplitude of light passing into the eye (related to the eye's transmittance), in contrast to traditional correction of the wavefront phase (related to the local refractive power). Numerical simulations show that masking the aberrated areas at the pupil plane should enhance visual function, especially in highly aberrated eyes. This correction could be implemented in practice using customized contact or intraocular lenses. PMID:27446688

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.

Three-dimensional reconstruction of the crystalline lens gradient index distribution from OCT imaging.

PubMed

de Castro, Alberto; Ortiz, Sergio; Gambra, Enrique; Siedlecki, Damian; Marcos, Susana

2010-10-11

We present an optimization method to retrieve the gradient index (GRIN) distribution of the in-vitro crystalline lens from optical path difference data extracted from OCT images. Three-dimensional OCT images of the crystalline lens are obtained in two orientations (with the anterior surface up and posterior surface up), allowing to obtain the lens geometry. The GRIN reconstruction method is based on a genetic algorithm that searches for the parameters of a 4-variable GRIN model that best fits the distorted posterior surface of the lens. Computer simulations showed that, for noise of 5 μm in the surface elevations, the GRIN is recovered with an accuracy of 0.003 and 0.010 in the refractive indices of the nucleus and surface of the lens, respectively. The method was applied to retrieve three-dimensionally the GRIN of a porcine crystalline lens in vitro. We found a refractive index ranging from 1.362 in the surface to 1.443 in the nucleus of the lens, an axial exponential decay of the GRIN profile of 2.62 and a meridional exponential decay ranging from 3.56 to 5.18. The effect of GRIN on the aberrations of the lens also studied. The estimated spherical aberration of the measured porcine lens was 2.87 μm assuming a homogenous equivalent refractive index, and the presence of GRIN shifted the spherical aberration toward negative values (-0.97 μm), for a 6-mm pupil.

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.

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

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

Seiboth, Frank; Wittwer, Felix; Scholz, Maria

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

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.

Aircrew Performance Cutting-Edge Technology: Emerging Human Performance Enhancement Technology Vision in Support of Operational Military Aviation Strategy

DTIC Science & Technology

2003-09-01

Refractive Surgery Origin and History, (RK, PRK , LASIK ) Refractive surgery was first considered as early as 1898 by a Dutch professor and was...34 This ejection demonstrated one extreme facet of the safety of PRK . Laser-Assisted In Situ Keratomileusis ( LASIK ) LASIK offers the greatest...refractive shift of clinical significance.35 Therefore LASIK and PRK , recipients had no significant vision changes at altitude, unlike recipients of RK

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.

Nanosurgery of cells and chromosomes using near-infrared twelve-femtosecond laser pulses.

PubMed

Uchugonova, Aisada; Lessel, Matthias; Nietzsche, Sander; Zeitz, Christian; Jacobs, Karin; Lemke, Cornelius; König, Karsten

2012-10-01

ABSTRACT. Laser-assisted surgery based on multiphoton absorption of near-infrared laser light has great potential for high precision surgery at various depths within the cells and tissues. Clinical applications include refractive surgery (fs-LASIK). The non-contact laser method also supports contamination-free cell nanosurgery. In this paper we describe usage of an ultrashort femtosecond laser scanning microscope for sub-100 nm surgery of human cells and metaphase chromosomes. A mode-locked 85 MHz Ti:Sapphire laser with an M-shaped ultrabroad band spectrum (maxima: 770  nm/830  nm) and an in situ pulse duration at the target ranging from 12 fs up to 3 ps was employed. The effects of laser nanoprocessing in cells and chromosomes have been quantified by atomic force microscopy. These studies demonstrate the potential of extreme ultrashort femtosecond laser pulses at low mean milliwatt powers for sub-100 nm surgery of cells and cellular organelles.

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 currently available clinical devices. By offering accurate corneal refractive power measurements in normal and surgically modified subjects, OCT offers a compelling alternative to current clinical devices for determining corneal refractive power. PMID:25487424

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.

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.

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

Iris registration in wavefront-guided LASIK to correct mixed astigmatism.

PubMed

Khalifa, Mounir; El-Kateb, Mohamed; Shaheen, Mohamed Shafik

2009-03-01

To investigate the predictability, safety, and efficiency of wavefront-guided laser in situ keratomileusis (LASIK) with iris-registration technology to correct mixed astigmatism. Vision correction center, Alexandria, Egypt. This retrospective double-blind study included randomly selected patients with mixed astigmatism who sought laser refractive surgery. Patients were divided equally into 3 groups and treated with conventional LASIK and manual marking, wavefront-guided LASIK and manual marking, or wavefront-guided LASIK with iris registration (LASIK+IR group). Eyes were analyzed preoperatively and up to 3 months postoperatively. The LASIK+IR group had better postoperative uncorrected visual acuity (100% 20/30 or better; 90% 20/20 or better; 20% 20/16 or better) than the other groups and did not lose preoperative best spectacle-corrected visual acuity, unlike the other groups. This group also had the highest percentage of eyes that gained lines of acuity (20% 1 line; 10% 2 lines). The LASIK+IR group had the highest predictability of spherical refraction (80% within +/-0.50 diopter [D]; 100% within +/-1.00 D [P<.05] and the highest predictability of cylinder refraction. The LASIK+IR eyes had a significantly smaller increase postoperatively in coma, trefoil, and secondary astigmatism. There was no significant difference between groups in spherical aberration or quadrafoil. The LASIK-IR group had the most improvement in scotopic contrast sensitivity (P<.05). Wavefront-guided LASIK with iris registration was more predictable, safe, and efficient than conventional or wavefront-guided LASIK with manual marking in correcting mixed astigmatism. Further studies are needed to confirm these results.

Subjective Visual Performance and Objective Optical Quality With Intraocular Lens Glistening and Surface Light Scattering.

PubMed

Luo, Furong; Bao, Xuan; Qin, Yingyan; Hou, Min; Wu, Mingxing

2018-06-01

To evaluate the long-term effect of glistenings and surface light scattering of intraocular lenses (IOLs) on visual and optical performance after cataract surgery. Pseudophakic eyes that underwent standard phacoemulsification and two types of hydrophobic acrylic spherical IOL implantation without complications for at least 5 years were included in this retrospective study. Participants were divided into the glistenings, surface light scattering, and control groups according to the current condition of the IOLs. Then participants received a follow-up examination including uncorrected and corrected distance visual acuity (UDVA and CDVA), contrast sensitivity, straylight, and intraocular higher order aberrations, as well as point spread function (PSF) and modulation transfer function (MTF). A total of 140 eyes were included in the study. UDVA, CDVA, and glare sensitivity were not significantly different among the three groups (P > .05). However, compared with the control group, the IOLs of the glistenings and surface light scattering groups were associated with significantly lower contrast sensitivity under no glare conditions. Furthermore, eye with glistenings exhibited the highest straylight value (P < .05), whereas no difference was found between the surface light scattering and control groups. In contrast to the control group, the spherical aberration increased and the mean values of PSF and MTF decreased in the glistenings and surface light scattering groups. Both glistenings and surface light scattering tend to impair subjective visual performance, such as contrast sensitivity, and potentially affect objective optical quality, including straylight, spherical aberration, PSF, and MTF. [J Refract Surg. 2018;34(6):372-378.]. Copyright 2018, SLACK Incorporated.

Correlation of major components of ocular astigmatism in myopic patients.

PubMed

Mohammadpour, Mehrdad; Heidari, Zahra; Khabazkhoob, Mehdi; Amouzegar, Afsaneh; Hashemi, Hassan

2016-02-01

To investigate the correlation of major components of ocular astigmatism in myopic patients in an academic hospital. This cross-sectional study was conducted on 376 eyes of 188 patients who were referred to Farabi Eye Hospital for refractive surgery. Preoperative examinations including refraction and corneal topography were performed for all candidates to measure refractive and corneal astigmatism. Ocular residual astigmatism was calculated using vector analysis. Pearson's correlation and ANOVA analysis were used to evaluate the strength of the association between different types of astigmatism. Both eyes were defined as cluster and the Generalized Estimating Equations (GEE) analysis were performed. Mean age of 119 women (63.3%) and 69 men (36.7%) was 27.8 ± 5.7 years. Mean refractive error based on spherical equivalent was -3.59 ± 1.95D (range, -0.54 to -10.22D). Mean refractive and corneal astigmatism was 1.97 ± 1.3D and 1.85 ± 1.01D, respectively. Mean amount of ORA was 0.65 ± 0.36D.There was a significant correlation between ORA and refractive astigmatism(r=0.23, p<0.001), corneal and refractive astigmatism (r=0.91, p<0.001) and a weak correlation between ORA and corneal astigmatism (r=0.13, p=0.014). There was a significant correlation between J0 and J45 values of ORA and corneal astigmatism (p<0.001). There is a significant correlation between ORA and refractive astigmatism, refractive and corneal astigmatism and a weak correlation between ORA and corneal astigmatism in refractive surgery candidates. Identifying the type of astigmatism and preoperative measurement of ocular residual astigmatism is highly recommended prior to any refractive surgery, especially in cases with significant astigmatism. Copyright © 2015 Elsevier Ltd. All rights reserved.

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.

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.

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.

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.

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.

Study of 3D printing method for GRIN micro-optics devices

NASA Astrophysics Data System (ADS)

Wang, P. J.; Yeh, J. A.; Hsu, W. Y.; Cheng, Y. C.; Lee, W.; Wu, N. H.; Wu, C. Y.

2016-03-01

Conventional optical elements are based on either refractive or reflective optics theory to fulfill the design specifications via optics performance data. In refractive optical lenses, the refractive index of materials and radius of curvature of element surfaces determine the optical power and wavefront aberrations so that optical performance can be further optimized iteratively. Although gradient index (GRIN) phenomenon in optical materials is well studied for more than a half century, the optics theory in lens design via GRIN materials is still yet to be comprehensively investigated before realistic GRIN lenses are manufactured. In this paper, 3D printing method for manufacture of micro-optics devices with special features has been studied based on methods reported in the literatures. Due to the additive nature of the method, GRIN lenses in micro-optics devices seem to be readily achievable if a design methodology is available. First, derivation of ray-tracing formulae is introduced for all possible structures in GRIN lenses. Optics simulation program is employed for characterization of GRIN lenses with performance data given by aberration coefficients in Zernike polynomial. Finally, a proposed structure of 3D printing machine is described with conceptual illustration.

Transient Ocular Wavefront Data in Type 1 Diabetes Mellitus.

PubMed

Blendowske, Ralf; Kalb, Max

2016-07-01

We report transient ocular wavefront and blood glucose data for one patient with acute type 1 diabetes mellitus after the treatment with insulin has been initiated. The wavefront data for both eyes of a 34-year-old male patient were examined by a Hartmann-Shack wavefront sensor. Refraction data and higher-order aberrations were recorded during 130 days for eyes in natural conditions, without cycloplegia. At the beginning, we sampled data every 3 to 4 days and enlarged the intervals, when values settled. In total, we report 20 measurements and 1 baseline entry. Blood glucose levels were recorded at least six times a day during the complete period. For the equivalent sphere, we recorded a bilateral hyperopic shift of 5 D from -2.75 DS to +2.25 DS, followed by a reverse myopic shift of the same amount. The equivalent sphere peaked about 15 to 18 days after the treatment with insulin had begun. Cylinder values kept remarkably stable. Higher-order aberrations are dominated by the spherical aberration. The Zernike coefficient c12 for both eyes changed substantially from OD 0.036 μm and OS 0.062 μm to OD 0.24 μm and OS 0.22 μm (5 mm pupil diameter) following the time pattern of the equivalent sphere. About 60 days after they had reached their peak, all refraction values and higher-order aberrations stabilized at their baseline levels. The baseline was defined by records taken 4 years before the treatment with insulin was commenced. Wavefront aberrometry gives quantitative insights in the transient alteration and recovering of the eye's optics whilst the therapy of acute type 1 diabetes mellitus is being initiated. The data of this case support the assumption that variations in the crystalline lens, most probably the modification of its refractive gradient index, as a cause for the transient behavior. An explanation is still missing.

Vision-Enhancing Interventions in Nursing Home Residents and Their Short-Term Impact on Physical and Cognitive Function

PubMed Central

Elliott, Amanda F.; McGwin, Gerald; Owsley, Cynthia

2009-01-01

OBJECTIVE To evaluate the effect of vision-enhancing interventions (i.e., cataract surgery or refractive error correction) on physical function and cognitive status in nursing home residents. DESIGN Longitudinal cohort study. SETTING Seventeen nursing homes in Birmingham, AL. PARTICIPANTS A total of 187 English-speaking older adults (>55 years of age). INTERVENTION Participants took part in one of two vision-enhancing interventions: cataract surgery or refractive error correction. Each group was compared against a control group (persons eligible for but who declined cataract surgery, or who received delayed correction of refractive error). MEASUREMENTS Physical function (i.e., ability to perform activities of daily living and mobility) was assessed with a series of self-report and certified nursing assistant ratings at baseline and at 2 months for the refractive error correction group, and at 4 months for the cataract surgery group. The Mini Mental State Exam was also administered. RESULTS No significant differences existed within or between groups from baseline to follow-up on any of the measures of physical function. Mental status scores significantly declined from baseline to follow-up for both the immediate (p= 0.05) and delayed (p< 0.02) refractive error correction groups and for the cataract surgery control group (p= 0.05). CONCLUSION Vision-enhancing interventions did not lead to short-term improvements in physical functioning or cognitive status in this sample of elderly nursing home residents. PMID:19170783

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.

LASIK and PRK in hyperopic astigmatic eyes: is early retreatment advisable?

PubMed

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

2016-01-01

To analyze the refractive and keratometric stability in hyperopic astigmatic laser in situ keratomileusis (LASIK) or photorefractive keratectomy (PRK) during the first 6 months after surgery. This retrospective cross-sectional study included 97 hyperopic eyes; 55 were treated with LASIK and 42 with PRK. Excimer ablation for all eyes was performed using the ALLEGRETTO excimer laser platform using a mitomycin C for PRK and a mechanical microkeratome for LASIK. Keratometric and refractive data were analyzed during three consecutive follow-up intervals (6 weeks, 3 months, and 6 months). The corneal topography was obtained using Scheimpflug topography, and subjective refractions were acquired by expert optometrists according to a standardized protocol. After 3 months, mean keratometry and spherical equivalent were stable after LASIK, whereas PRK-treated eyes presented statistically significant (P<0.001) regression of hyperopia. In eleven cases, hyperopic regression of >1 D occurred. The optical zone diameter did not correlate with the development of regression. After corneal laser refractive surgery, keratometric changes are followed by refractive changes and they occur up to 6 months after LASIK and for at least 6 months after PRK, and therefore, caution should be applied when retreatment is planned during the 1st year after surgery because hyperopic refractive regression can lead to suboptimal visual outcome. Keratometric and refractive stability is earlier achieved after LASIK, and therefore, retreatment may be independent of late regression.

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.

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.

Toric Intraocular Lens for Astigmatism Correction in Cataract Patients.

PubMed

Razmjoo, Hassan; Ghoreishi, Mohammad; Milasi, Azadeh Mohammadi; Peyman, Alireza; Jafarzadeh, Zahra; Mohammadinia, Mohadeseh; Kobra, Nasrollahi

2017-01-01

To assess the clinical consequences of AcrySof toric intraocular lens (IOL) and Hoya toric IOL implantation to correct preexisting corneal astigmatism in patients undergoing cataract surgery. In this study, we examined 55 eyes of 45 patients with at least 1.00 D corneal astigmatism who were scheduled for cataract surgery. After phacoemulsification, toric IOL was inserted and axis was aligned. We observed the patients, uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), keratometry, manifest refraction, and IOL axis alignment 6 months after surgery. After 6 months, the UDVA was 0.17 ± 0.17 logMAR in the AcrySof group and 0.17 ± 0.18 logMar in the Hoya group. More than 78% of eyes in the AcrySof group and 80% of eyes in the Hoya toric IOL achieved a UDVA of 20/40 or better. In the AcrySof group, the mean preoperative corneal astigmatism was 2.73 ± 0.92 D. The mean postoperative refractive astigmatism was 0.84 ± 0.63 D. In the Hoya group, the preoperative corneal astigmatism was 2.58 ± 0.76 D and the postoperative refractive astigmatism was 0.87 ± 0.66 D ( P < 0.05). The mean AcrySof IOL axis rotation was 1.88° ± 3.05°. In the Hoya group, the mean axis rotation was 1.53° ± 3.66°. All changes in visual and refractive data before and after surgery were statistically significant ( P < 0.05). There was no significant difference between the two groups regarding refractive and visual outcome after surgery ( P > 0.05 for all). Implantation of AcrySof toric IOL and Hoya toric IOL was an effective way to correct preexisting corneal astigmatism in cataract surgery.

[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.

[Advantages and disadvantages of femtosecond laser assisted LASIK and SMILE].

PubMed

Zhang, F J; Sun, M S

2018-01-11

With the development of excimer laser and femtosecond laser equipment, application of diversified and customized surgical decision in modern corneal refractive surgery has been an inevitable trend. However, how to make a personalized decision with an accurate surgical design to achieve better visual quality becomes the main focus in clinical applications. Small-incision lenticule extraction (SMILE) and femtosecond assisted laser in situ keratomileusis (FS-LASIK) have been commonly acknowledged as the mainstream of corneal refractive surgery for ametropia correction nowadays. Both methods have been verified by clinical practice for many years. This article compares and elaborates the different characteristics with advantages and disadvantages of the two methods so as to provide some reasonable treatment options for refractive surgery. (Chin J Ophthalmol, 2018, 54: 7-10) .

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.

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

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 ...

Comparison of the visual results after SMILE and femtosecond laser-assisted LASIK for myopia.

PubMed

Lin, Fangyu; Xu, Yesheng; Yang, Yabo

2014-04-01

To perform a comparative clinical analysis of the safety, efficacy, and predictability of two surgical procedures (ie, small incision lenticule extraction [SMILE] and femtosecond laser-assisted LASIK [FS-LASIK]) to correct myopia. Sixty eyes of 31 patients with a mean spherical equivalent of -5.13 ± 1.75 diopters underwent myopia correction with the SMILE procedure. Fifty-one eyes of 27 patients with a mean spherical equivalent of -5.58 ± 2.41 diopters were treated with the FS-LASIK procedure. Postoperative uncorrected and corrected distance visual acuity, manifest refraction, and higher-order aberrations were analyzed statistically at 1 and 3 months postoperatively. No statistically significant differences were found at 1 and 3 months in parameters that included the percentage of eyes with an uncorrected distance visual acuity of 20/20 or better (P = .556, .920) and mean spherical equivalent refraction (P = .055, .335). At 1 month, 4 SMILE-treated eyes and 1 FS-LASIK-treated eye lost one or more line of visual acuity (P = .214, chi-square test). At 3 months, 2 SMILE-treated eyes lost one or more line of visual acuity, whereas all FS-LASIK-treated eyes had an unchanged or corrected distance visual acuity. Higher-order aberrations and spherical aberration were significantly lower in the SMILE group than the FS-LASIK group at 1 (P = .007, .000) and 3 (P = .006, .000) months of follow-up. SMILE and FS-LASIK are safe, effective, and predictable surgical procedures to treat myopia. SMILE has a lower induction rate of higher-order aberrations and spherical aberration than the FS-LASIK procedure. Copyright 2014, SLACK Incorporated.

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.

[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.

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.

Review of Efforts to Develop a Low-Luminance-Level Disability Glare Tester

DTIC Science & Technology

2009-09-01

figures 1. LASIK and PRK refractive surgery. .......................................................................................... 6  2...inadequate at this time, particularly for post refractive surgery patients. Early LASIK and PRK produced a very high incidence of night vision...1999). They found that before PRK or LASER in-situ keratomileusis ( LASIK ), simulated pupil dilation from 3 to 7 mm caused a 5-6 fold increase in

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.

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.

Bilateral symmetry in vision and influence of ocular surgical procedures on binocular vision: A topical review.

PubMed

Arba Mosquera, Samuel; Verma, Shwetabh

2016-01-01

We analyze the role of bilateral symmetry in enhancing binocular visual ability in human eyes, and further explore how efficiently bilateral symmetry is preserved in different ocular surgical procedures. The inclusion criterion for this review was strict relevance to the clinical questions under research. Enantiomorphism has been reported in lower order aberrations, higher order aberrations and cone directionality. When contrast differs in the two eyes, binocular acuity is better than monocular acuity of the eye that receives higher contrast. Anisometropia has an uncommon occurrence in large populations. Anisometropia seen in infancy and childhood is transitory and of little consequence for the visual acuity. Binocular summation of contrast signals declines with age, independent of inter-ocular differences. The symmetric associations between the right and left eye could be explained by the symmetry in pupil offset and visual axis which is always nasal in both eyes. Binocular summation mitigates poor visual performance under low luminance conditions and strong inter-ocular disparity detrimentally affects binocular summation. Considerable symmetry of response exists in fellow eyes of patients undergoing myopic PRK and LASIK, however the method to determine whether or not symmetry is maintained consist of comparing individual terms in a variety of ad hoc ways both before and after the refractive surgery, ignoring the fact that retinal image quality for any individual is based on the sum of all terms. The analysis of bilateral symmetry should be related to the patients' binocular vision status. The role of aberrations in monocular and binocular vision needs further investigation. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

Holographic telescope

NASA Astrophysics Data System (ADS)

Odhner, Jefferson E.

2016-07-01

Holographic optical elements (HOEs) work on the principal of diffraction and can in some cases replace conventional optical elements that work on the principal of refraction. An HOE can be thinner, lighter, can have more functionality, and can be lower cost than conventional optics. An HOE can serve as a beam splitter, spectral filter, mirror, and lens all at the same time. For a single wavelength system, an HOE can be an ideal solution but they have not been widely accepted for multispectral systems because they suffer from severe chromatic aberration. A refractive optical system also suffers from chromatic aberration but it is generally not as severe. To color correct a conventional refractive optical system, a flint glass and a crown glass are placed together such that the color dispersion of the flint and the crown cancel each other out making an achromatic lens (achromat) and the wavelengths all focus to the same point. The color dispersion of refractive lenses and holographic lenses are opposite from each other. In a diffractive optical system, long wavelengths focus closer (remember for HOEs: RBM "red bends more") than nominal focus while shorter wavelengths focus further out. In a refractive optical system, it is just the opposite. For this reason, diffractives can be incorporated into a refractive system to do the color correction and often cut down on the number of optical elements used [1.]. Color correction can also be achieved with an all-diffractive system by combining a holographic optical element with its conjugate. In this way the color dispersion of the first holographic optical element can be cancelled by the color dispersion of the second holographic optic. It is this technique that will be exploited in this paper to design a telescope made entirely of holographic optical elements. This telescope could be more portable (for field operations) the same technique could be used to make optics light enough for incorporation into a UAV.

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

Pinhole Glasses

ERIC Educational Resources Information Center

Colicchia, Giuseppe; Hopf, Martin; Wiesner, Hartmut; Zollman, Dean

2008-01-01

Eye aberrations are commonly corrected by lenses that restore vision by altering rays before they pass through the cornea. Some modern promoters claim that pinhole glasses are better than conventional lenses in correcting all kinds of refractive defects such as myopia (nearsighted), hyperopia (farsighted), astigmatisms, and presbyopia. Do pinhole…

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, although there was a tendency toward more terms or orders changing statistically significantly in the Tecnis group, which had slightly higher amounts of induced aberrations. Cataract surgery with a small superior incision induced consistent and significant changes in several corneal Zernike terms (vertical astigmatism, trefoil, and tetrafoil), resulting in a significantly increased overall corneal RMS wavefront error. These results can be used to improve predictions of optical performance with new IOL designs using computer eye models and identify the potentially different impact of incision strategies on cataract surgery.

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-sparing vitrectomy for RRD and ERM, a progressive myopic shift in refraction owing to nuclear sclerosis was observed. Core vitrectomy itself would cause a myopic shift of refraction. The only risk factor associated with cataract progression following lens-sparing vitrectomy is age for both types of patients.

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 = 0.022). Following lens-sparing vitrectomy for RRD and ERM, a progressive myopic shift in refraction owing to nuclear sclerosis was observed. Core vitrectomy itself would cause a myopic shift of refraction. The only risk factor associated with cataract progression following lens-sparing vitrectomy is age for both types of patients. PMID:27512843

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.

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.

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.

[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.

Wide-Angle, Flat-Field Telescope

NASA Technical Reports Server (NTRS)

Hallam, K. L.; Howell, B. J.; Wilson, M. E.

1987-01-01

All-reflective system unvignetted. Wide-angle telescope uses unobstructed reflecting elements to produce flat image. No refracting elements, no chromatic aberration, and telescope operates over spectral range from infrared to far ultraviolet. Telescope used with such image detectors as photographic firm, vidicons, and solid-state image arrays.

Night firing range performance following photorefractive keratectomy and laser in situ keratomileusis.

PubMed

Bower, Kraig S; Burka, Jenna M; Subramanian, Prem S; Stutzman, Richard D; Mines, Michael J; Rabin, Jeff C

2006-06-01

To investigate the effect of laser refractive surgery on night weapons firing. Firing range performance was measured at baseline and postoperatively following photorefractive keratectomy and laser in situ keratomileusis. Subjects fired the M-16A2 rifle with night vision goggles (NVG) at starlight, and with iron sight (simulated dusk). Scores, before and after surgery, were compared for both conditions. No subject was able to acquire the target using iron sight without correction before surgery. After surgery, the scores without correction (95.9 +/- 4.7) matched the preoperative scores with correction (94.3 +/- 4.0; p = 0.324). Uncorrected NVG scores after surgery (96.4 +/- 3.1) exceeded the corrected scores before surgery (91.4 +/- 10.2), but this trend was not statistically significant (p = 0.063). Night weapon firing with both the iron sight and the NVG sight improved after surgery. This study supports the operational benefits of refractive surgery in the military.

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.

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.

Spatial beam shaping for lowering the threshold energy for femtosecond laser pulse photodisruption

NASA Astrophysics Data System (ADS)

Hansen, Anja; Ripken, Tammo; Heisterkamp, Alexander

2011-10-01

High precision femtosecond laser surgery is achieved by focusing femtosecond (fs) laser pulses in transparent tissues to create an optical breakdown leading to tissue dissection through photodisruption. For moving applications in ophthalmology from corneal or lental applications in the anterior eye to vitreal or retinal surgery in the posterior eye the applied pulse energy needs to be minimized in order to avoid harm to the retina. However, the aberrations of the anterior eye elements cause a distortion of the wave front and consequently an increase in size of the irradiated area and a decrease in photon density in the focal volume. Therefore, higher pulse energy is required to still surpass the threshold irradiance. In this work, aberrations in an eye model consisting of a plano-convex lens for focusing and 2-hydroxyethylmethacrylate (HEMA) in a water cuvette as eye tissue were corrected with a deformable mirror in combination with a Hartmann-Shack-sensor. The influence of an adaptive optics aberration correction on the pulse energy required for photodisruption was investigated. A reduction of the threshold energy was shown in the aberration-corrected case and the spatial confinement raised the irradiance at constant pulse energy. As less energy is required for photodisruption when correcting for wave front aberrations the potential risk of peripheral damage is reduced, especially for the retina during laser surgery in the posterior eye segment. This offers new possibilities for high precision fs-laser surgery in the treatment of several vitreal and retinal pathologies.

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.

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.

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.

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

Can the accuracy of multifocal intraocular lens power calculation be improved to make patients spectacle free?

PubMed

Ramji, Hasnain; Moore, Johnny; Moore, C B Tara; Shah, Sunil

2016-04-01

To optimise intraocular lens (IOL) power calculation techniques for a segmental multifocal IOL, LENTIS™ MPlus(®) (Oculentis GmbH, Berlin, Germany) and assess outcomes. A retrospective consecutive non-randomised case series of patients receiving the MPlus(®) IOL following cataract surgery or clear lens extraction was performed at a privately owned ophthalmic hospital, Midland Eye, Solihull, UK. Analysis was undertaken of 116 eyes, with uncomplicated lens replacement surgery using the LENTIS™ MPlus(®) lenses. Pre-operative biometry data were stratified into short (<22.00 mm) and long axial lengths (ALs) (≥22.00 mm). IOL power predictions were calculated with SRK/T, Holladay I, Hoffer Q, Holladay II and Haigis formulae and compared to the final manifest refraction. These were compared with the OKULIX ray tracing method and the stratification technique suggested by the Royal College of Ophthalmologists (RCOphth). Using SRK/T for long eyes and Hoffer Q for short eyes, 64% achieved postoperative subjective refractions of ≤±0.25 D, 83%≤±0.50 D and 93%≤±0.75 D, with a maximum predictive error of 1.25D. No specific calculation method performed best across all ALs; however for ALs under 22 mm Hoffer Q and Holliday I methods performed best. Excellent but equivalent overall refractive results were found between all biometry methods used in this multifocal IOL study. For eyes with ALs under 22 mm Hoffer Q and Holliday I performed best. Current techniques mean that patients are still likely to need top up glasses for certain situations. Copyright © 2015 Elsevier Ltd. All rights reserved.

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.

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.

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

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.

Sensorless adaptive optics for isoSTED nanoscopy

NASA Astrophysics Data System (ADS)

Antonello, Jacopo; Hao, Xiang; Allgeyer, Edward S.; Bewersdorf, Joerg; Rittscher, Jens; Booth, Martin J.

2018-02-01

The presence of aberrations is a major concern when using fluorescence microscopy to image deep inside tissue. Aberrations due to refractive index mismatch and heterogeneity of the specimen under investigation cause severe reduction in the amount of fluorescence emission that is collected by the microscope. Furthermore, aberrations adversely affect the resolution, leading to loss of fine detail in the acquired images. These phenomena are particularly troublesome for super-resolution microscopy techniques such as isotropic stimulated-emission-depletion microscopy (isoSTED), which relies on accurate control of the shape and co-alignment of multiple excitation and depletion foci to operate as expected and to achieve the super-resolution effect. Aberrations can be suppressed by implementing sensorless adaptive optics techniques, whereby aberration correction is achieved by maximising a certain image quality metric. In confocal microscopy for example, one can employ the total image brightness as an image quality metric. Aberration correction is subsequently achieved by iteratively changing the settings of a wavefront corrector device until the metric is maximised. This simplistic approach has limited applicability to isoSTED microscopy where, due to the complex interplay between the excitation and depletion foci, maximising the total image brightness can lead to introducing aberrations in the depletion foci. In this work we first consider the effects that different aberration modes have on isoSTED microscopes. We then propose an iterative, wavelet-based aberration correction algorithm and evaluate its benefits.

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

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.

Thomas Young's investigations in gradient-index optics.

PubMed

Atchison, David A; Charman, W Neil

2011-05-01

James Clerk Maxwell is usually recognized as being the first, in 1854, to consider using inhomogeneous media in optical systems. However, some 50 years earlier, Thomas Young, stimulated by his interest in the optics of the eye and accommodation, had already modeled some applications of gradient-index optics. These applications included using an axial gradient to provide spherical aberration-free optics and a spherical gradient to describe the optics of the atmosphere and the eye lens. We evaluated Young's contributions. We attempted to derive Young's equations for axial and spherical refractive index gradients. Raytracing was used to confirm accuracy of formula. We did not confirm Young's equation for the axial gradient to provide aberration-free optics but derived a slightly different equation. We confirmed the correctness of his equations for deviation of rays in a spherical gradient index and for the focal length of a lens with a nucleus of fixed index surrounded by a cortex of reducing index toward the edge. Young claimed that the equation for focal length applied to a lens with part of the constant index nucleus of the sphere removed, such that the loss of focal length was a quarter of the thickness removed, but this is not strictly correct. Young's theoretical work in gradient-index optics received no acknowledgment from either his contemporaries or later authors. Although his model of the eye lens is not an accurate physiological description of the human lens, with the index reducing least quickly at the edge, it represented a bold attempt to approximate the characteristics of the lens. Thomas Young's work deserves wider recognition.

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 refractive error are low methodological quality. Following widely accepted guidance, such as Cochrane or Institute of Medicine standards for conducting systematic reviews, would contribute to improved patient care and inform future research.

Use of the Femtosecond Lasers in Ophthalmology

NASA Astrophysics Data System (ADS)

Roszkowska, Anna M.; Urso, Mario; Signorino, Alberto; Aragona, Pasquale

2018-01-01

Femtosecond laser (FSL) is an infrared laser with a wavelength of 1053 nm. FS laser works producing photodisruption or photoionization of the optically transparent tissue such as cornea. Currently FS lasers have a wide range of applications in ophthalmic surgery. They are used above all in corneal surgery in refractive procedures and keratoplasty, and recently in cataract surgery. The use of the FSL in corneal refractive surgery includes LASIK flap creation, astigmatic keratotomy, Femtosecond Lenticule Extraction (FLEx), Small Incision Lenticule Extraction (SMILE) and channels creation for implantation of the intrastromal corneal rings. As to the corneal grafting, the FS lasers are used in laser-assisted anterior and posterior lamellar keratoplasty and customized trephination in the penetrating keratoplasty. FS Laser Assisted Cataract Surgery (FLACS) includes capsulorrhexis and nuclear fragmentation that enhance safety and efficacy of the procedure.

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.

Molecular Solutions to Low Vision Resulting from Battlefield Injuries. Addendum

DTIC Science & Technology

2009-05-01

determining how to minimize dry eye after LASIK refractive surgery by developing new tests to predict pre-disposition to refractive surgery induced dry eye...enrolled a total of 132 subjects. Three withdrew without treatment leaving 129 enrolled - 128 have been treated (70 PRK and 58 LASIK ) and 1 is scheduled...granulomatous anterior uveitis OS 2 weeks following uncomplicated LASIK . The subject was treated with Prednisolone Acetate 1.0% ophthalmic suspension

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 ...

Live imaging using adaptive optics with fluorescent protein guide-stars

PubMed Central

Tao, Xiaodong; Crest, Justin; Kotadia, Shaila; Azucena, Oscar; Chen, Diana C.; Sullivan, William; Kubby, Joel

2012-01-01

Spatially and temporally dependent optical aberrations induced by the inhomogeneous refractive index of live samples limit the resolution of live dynamic imaging. We introduce an adaptive optical microscope with a direct wavefront sensing method using a Shack-Hartmann wavefront sensor and fluorescent protein guide-stars for live imaging. The results of imaging Drosophila embryos demonstrate its ability to correct aberrations and achieve near diffraction limited images of medial sections of large Drosophila embryos. GFP-polo labeled centrosomes can be observed clearly after correction but cannot be observed before correction. Four dimensional time lapse images are achieved with the correction of dynamic aberrations. These studies also demonstrate that the GFP-tagged centrosome proteins, Polo and Cnn, serve as excellent biological guide-stars for adaptive optics based microscopy. PMID:22772285

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.

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.

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

Nonimaging achromatic shaped Fresnel lenses for ultrahigh solar concentration.

PubMed

Languy, Fabian; Habraken, Serge

2013-05-15

The maximum concentration ratio achievable with a solar concentrator made of a single refractive primary optics is much more limited by the chromatic aberration than by any other aberration. Therefore achromatic doublets made with poly(methyl methacrylate) and polycarbonate are of great interest to enhance the concentration ratio and to achieve a spectrally uniform flux on the receiver. In this Letter, shaped achromatic Fresnel lenses are investigated. One lossless design is of high interest since it provides spectrally and spatially uniform flux without being affected by soiling problems. With this design an optical concentration ratio of about 8500× can be achieved.

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.

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.

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

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.

Comparison of surgically induced astigmatism in patients with horizontal rectus muscle recession

PubMed Central

Çakmak, Harun; Kocatürk, Tolga; Dündar, Sema Oruç

2014-01-01

AIM To compare surgically induced astigmatism (SIA) following horizontal rectus muscle recession surgery between suspension recession with both the “hang-back” technique and conventional recession technique. METHODS Totally, 48 eyes of 24 patients who had undergone horizontal rectus muscle recession surgery were reviewed retrospectively. The patients were divided into two groups. Twelve patients were operated on by the hang-back technique (Group 1), and 12 by the conventional recession technique (Group 2). SIA was calculated on the 1st wk, 1st and in the 3rd mo after surgery using the SIA calculator. RESULTS SIA was statistically higher in the Group 1 all postoperative follow-up. SIA was the highest in the 1st wk, and decreased gradually in both groups. CONCLUSION The suspension recession technique induced much more SIA than the conventional recession technique. This difference also continued in the following visits. Therefore, the refractive power should be checked postoperatively in order to avoid refractive amblyopia. Conventional recession surgery should be the preferred method so as to minimize the postoperative refractive changes in patients with amblyopia. PMID:25161948

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 heterogeneous tissues. Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.

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 easily. Using a Liquid Crystal Spatial Light Modulator to induce aberrations in an imaging system is not limited to simulating atmospheric turbulence. Any turbulence model can be used either statically or dynamically for multiple applications.

Femtosecond-Assisted LASIK Versus PRK: Comparison of 6-Month Visual Acuity and Quality Outcome for High Myopia.

PubMed

Hashemi, Hassan; Miraftab, Mohammad; Ghaffari, Reza; Asgari, Soheila

2016-11-01

To compare the results of femtosecond-assisted laser in situ keratomileusis (femto-LASIK) and photorefractive keratectomy with mitomycin C (PRK-MMC) for the correction of myopia more than 7.0 diopters (D). In this comparative nonrandomized trial, 60 eyes (30 eyes in each group) were enrolled. Patients were tested for uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent, ocular and corneal aberrations, and contrast sensitivity (CS) before surgery and at 3 and 6 months postoperatively. Mean preoperative myopia was -8.65±1.51 and -8.04±1.70 D in the femto-LASIK and PRK-MMC groups, respectively (P=0.149). Intergroup differences in baseline indices were not statistically significant. At 6 months after surgery, UDVA showed an improving trend, but it was better in the femto-LASIK group (P=0.026). CDVA in the two groups remained similarly unchanged (P=0.170). For the femto-LASIK and PRK-MMC groups, the safety indices were 1.01±0.05 and 1.01±0.14 (P=0.949), respectively, and the efficacy indices were 0.99±0.07 and 0.93±0.22 (P=0.192), respectively. Comparing CS, only CS18 showed a significantly greater decrease in the femto-LASIK group compared with the PRK-MMC group (P=0.016). Intergroup differences were not statistically significant in other spatial frequencies. Changes in the ocular and corneal higher order aberrations were not statistically different between the two groups except ocular coma, which increased in the femto-LASIK group (P=0.041). Femto-LASIK improves UDVA better than PRK-MMC in high myopia. However, because of increased coma, the quality of vision is reduced. In other words, visual acuity outcome is better with femto-LASIK and visual quality outcome is better with PRK-MMC.

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.

Calculation of Ophthalmic Viscoelastic Device–Induced Focus Shift During Femtosecond Laser–Assisted Cataract Surgery

PubMed Central

de Freitas, Carolina P.; Cabot, Florence; Manns, Fabrice; Culbertson, William; Yoo, Sonia H.; Parel, Jean-Marie

2015-01-01

Purpose. To assess if a change in refractive index of the anterior chamber during femtosecond laser-assisted cataract surgery can affect the laser beam focus position. Methods. The index of refraction and chromatic dispersion of six ophthalmic viscoelastic devices (OVDs) was measured with an Abbe refractometer. Using the Gullstrand eye model, the index values were used to predict the error in the depth of a femtosecond laser cut when the anterior chamber is filled with OVD. Two sources of error produced by the change in refractive index were evaluated: the error in anterior capsule position measured with optical coherence tomography biometry and the shift in femtosecond laser beam focus depth. Results. The refractive indices of the OVDs measured ranged from 1.335 to 1.341 in the visible light (at 587 nm). The error in depth measurement of the refilled anterior chamber ranged from −5 to +7 μm. The OVD produced a shift of the femtosecond laser focus ranging from −1 to +6 μm. Replacement of the aqueous humor with OVDs with the densest compound produced a predicted error in cut depth of 13 μm anterior to the expected cut. Conclusions. Our calculations show that the change in refractive index due to anterior chamber refilling does not sufficiently shift the laser beam focus position to cause the incomplete capsulotomies reported during femtosecond laser–assisted cataract surgery. PMID:25626971

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=0.039, unpaired t-test). The latter observation makes it unlikely that the difference resulted just from a shift in the resting tonus of accommodation. (1) Imposed chromatic defocus produces a shift in accommodation tonus in both humans and chickens which is, in the case of the chicken, followed by a shift in cycloplegic refractive state into the same direction, (2) the difference to the previous study by Rohrer, Schaeffel and Zrenner [Journal of Physiology 449 (1992) 363] can be explained from the fact that shorter wavelengths were used than in the present study, at which emmetropization was no longer functional and, (3) the small amplitude and the variability of the shifts in refraction do not allow clear statements about the role of the "lag of accommodation" in refractive development but they show that several cone types contribute to emmetropization.

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.

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.

Accelerated versus conventional corneal collagen cross-linking in patients with keratoconus: an intrapatient comparative study.

PubMed

Sadoughi, Mohammad Mehdi; Einollahi, Bahram; Baradaran-Rafii, Alireza; Roshandel, Danial; Hasani, Hamidreza; Nazeri, Mehrdad

2018-02-01

To compare the outcomes of the conventional and accelerated corneal collagen cross-linking (CXL) in patients with bilateral progressive keratoconus (KC). Fifteen consecutive patients with bilateral progressive KC were enrolled. In each patient, the fellow eyes were randomly assigned to the conventional CXL (3 mW/cm 2 for 30 min) or accelerated CXL (ACXL) (9 mW/cm 2 for 10 min) groups. Manifest refraction; uncorrected and corrected distant visual acuity; maximum and mean keratometry; corneal hysteresis and corneal resistance factor; endothelial cell density and morphology; central corneal thickness; and wavefront aberrations were measured before and 12 months after the CXL. Manifest refraction spherical equivalent and refractive cylinder improved significantly only in conventional group. Uncorrected and corrected distant visual acuity did not change significantly in either group. Also there was no significant change in the maximum and mean keratometry after 12 months. There was significant decrease in central corneal thickness in both groups which was more prominent in conventional group. Endothelial cell density reduced only in the conventional group which was not statistically significant (P = 0.147). CH, CRF, and wavefront aberrations did not change significantly in either group. We did not observe any significant difference in the changes of the variables between the two groups. Accelerated CXL with 9 mW/cm 2 irradiation for 10 min had similar refractive, visual, keratometric, and aberrometric results and less adverse effects on the corneal thickness and endothelial cells as compared with the conventional method after 12 months follow-up. However, randomized clinical trials with longer follow-ups and larger sample sizes are needed.

TOPOGRAPHICALLY GUIDED LASIK FOR MYOPIA USING THE NIDEK CXII CUSTOMIZED ASPHERIC TREATMENT ZONE (CATZ)

PubMed Central

Waring, George; Dougherty, Paul J.; Chayet, Arturo; Fischer, Jeffery; Fant, Barbara; Stevens, Gary; Bains, Harkaran S.

2007-01-01

Purpose To assess the efficacy, predictability, and safety of topography-guided laser in situ keratomileusis (LASIK) for the surgical correction of low to moderate myopia with astigmatism using the Nidek CXIII excimer laser equipped with the customized aspheric treatment zone (CATz) algorithm. Methods In a multicenter US Food and Drug Administration study of topography-guided LASIK, 4 centers enrolled 135 eyes with manifest refraction sphere that ranged from −0.50 to −7.00 D (mean, −3.57 ± 1.45) with up to −4.00 D of astigmatism (mean, −1.02 ± 0.64 D). The intended outcome was plano in all eyes. Refractive outcomes and higher-order aberrations were analyzed preoperatively and postoperatively. Patient satisfaction was assessed using both the validated Refractive Status and Vision Profile (RSVP) questionnaire and a questionnaire designed for this study. Six-month postoperative outcomes are reported here. Results By 6 months postoperatively, the manifest refraction spherical equivalent (MRSE) for all eyes was −0.09 ± 0.31 D. Six months postoperatively, 116 of 131 eyes (88.55%) had an uncorrected visual acuity of 20/20 or better, and 122 of 131 eyes (93.13%) had a MRSE within ±0.50 D. Distance best spectacle-corrected visual acuity (BSCVA) increased by 2 or more lines in 21 of 131 eyes (19.01%), and no eyes lost 2 lines or more of BSCVA. The total ocular higher-order aberrations root-mean-square increased by 0.04 μm postoperatively. Patients reported significantly fewer night driving and glare and halo symptoms postoperatively than preoperatively. Conclusions Nidek CXIII CATz treatment of myopia with astigmatism is safe, efficacious, and predictable, and it reduces patient symptoms associated with night driving and glare and halo symptoms. PMID:18427614

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.

Ultrahigh resolution retinal imaging by visible light OCT with longitudinal achromatization

PubMed Central

Chong, Shau Poh; Zhang, Tingwei; Kho, Aaron; Bernucci, Marcel T.; Dubra, Alfredo; Srinivasan, Vivek J.

2018-01-01

Chromatic aberrations are an important design consideration in high resolution, high bandwidth, refractive imaging systems that use visible light. Here, we present a fiber-based spectral/Fourier domain, visible light OCT ophthalmoscope corrected for the average longitudinal chromatic aberration (LCA) of the human eye. Analysis of complex speckles from in vivo retinal images showed that achromatization resulted in a speckle autocorrelation function that was ~20% narrower in the axial direction, but unchanged in the transverse direction. In images from the improved, achromatized system, the separation between Bruch’s membrane (BM), the retinal pigment epithelium (RPE), and the outer segment tips clearly emerged across the entire 6.5 mm field-of-view, enabling segmentation and morphometry of BM and the RPE in a human subject. Finally, cross-sectional images depicted distinct inner retinal layers with high resolution. Thus, with chromatic aberration compensation, visible light OCT can achieve volume resolutions and retinal image quality that matches or exceeds ultrahigh resolution near-infrared OCT systems with no monochromatic aberration compensation. PMID:29675296

Temporal multiplexing to simulate multifocal intraocular lenses: theoretical considerations

PubMed Central

Akondi, Vyas; Dorronsoro, Carlos; Gambra, Enrique; Marcos, Susana

2017-01-01

Fast tunable lenses allow an effective design of a portable simultaneous vision simulator (SimVis) of multifocal corrections. A novel method of evaluating the temporal profile of a tunable lens in simulating different multifocal intraocular lenses (M-IOLs) is presented. The proposed method involves the characteristic fitting of the through-focus (TF) optical quality of the multifocal component of a given M-IOL to a linear combination of TF optical quality of monofocal lenses viable with a tunable lens. Three different types of M-IOL designs are tested, namely: segmented refractive, diffractive and refractive extended depth of focus. The metric used for the optical evaluation of the temporal profile is the visual Strehl (VS) ratio. It is shown that the time profiles generated with the VS ratio as a metric in SimVis resulted in TF VS ratio and TF simulated images that closely matched the TF VS ratio and TF simulated images predicted with the M-IOL. The effects of temporal sampling, varying pupil size, monochromatic aberrations, longitudinal chromatic aberrations and temporal dynamics on SimVis are discussed. PMID:28717577

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.

Analysis of age-dependence of the anterior and posterior cornea with scheimpflug imaging.

PubMed

Nemeth, Gabor; Hassan, Ziad; Szalai, Eszter; Berta, Andras; Modis, Laszlo

2013-05-01

To assess keratometric and higher-order aberrations of the anterior and posterior cornea and their age-related changes. This study investigated one healthy eye of 227 patients (mean age: 55.15 ± 21.2 years; range: 16 to 90 years; 135 right eyes, 92 left eyes). Images were captured from each eye with Pentacam HR (Oculus Optikgeräte GmbH, Wetzlar, Germany) using automatic mode. Keratometric, astigmatism data, and corneal higher-order aberrations were analyzed. With respect to laterality, no deviance was found in any of the parameters (P > .05). Mean refractive error was 0.52 ± 0.23 diopters. The level of astigmatism decreased significantly with advancing age for both the anterior and posterior corneal surfaces (P < .05). The overall root mean square of the higher-order aberration increased continuously with age (r = 0.517; P < .01), which can be explained by the combined effect of the increased in both the anterior and posterior corneal root mean square higher-order aberrations. Of the higher-order aberrations, the constant increase of the primary and secondary spherical aberration with aging (P < .01) is caused by the spherical aberration growth of the anterior surface. Apart from these, only the vertical coma aberration of the posterior surface and the vertical trefoil aberrations of both the anterior and posterior surfaces showed a significantly positive correlation with aging (P < .05). Corneal astigmatism showed a significant decrease with aging. Of the higher-order aberrations, primary and secondary spherical aberrations, vertical coma, and vertical trefoil significantly increase with age, whereas other higher-order aberrations show no correlation with aging. Copyright 2013, SLACK Incorporated.

A prospective, contralateral eye study comparing thin-flap LASIK (sub-Bowman keratomileusis) with photorefractive keratectomy.

PubMed

Slade, Stephen G; Durrie, Daniel S; Binder, Perry S

2009-06-01

To determine the differences in the visual results, pain response, biomechanical effect, quality of vision, and higher-order aberrations, among other parameters, in eyes undergoing either photorefractive keratectomy (PRK) or thin-flap LASIK/sub-Bowman keratomileusis (SBK; intended flap thickness of +/-100 microm and 8.5-mm diameter) at 1, 3, and 6 months after surgery. A contralateral eye pilot study. Fifty patients (100 eyes) were enrolled at 2 sites. The mean preoperative spherical refraction was -3.66 diopters (D) and the mean cylinder was -0.66 D for all eyes. Eyes in the PRK group underwent 8.5-mm ethanol-assisted PRK, whereas in eyes in the SBK group, an 8.5-mm, (intended) 100-microm flap was created with a 60-kHz IntraLase femtosecond laser (Advanced Medical Optics, Santa Ana, CA). All eyes underwent a customized laser ablation using an Alcon LADARVision 4000 CustomCornea excimer laser (Alcon Laboratories, Fort Worth, TX). Preoperative and postoperative tests included best spectacle-corrected visual acuity, uncorrected visual acuity (UCVA), corneal topography, wavefront aberrometry, retinal image quality, and contrast sensitivity. Patients completed subjective questionnaires at each visit. One- and 3-month UCVA results showed a statistically significant difference: SBK, 88% 20/20 or better vs. 48% 20/20 or better for PRK. At 6 months, UCVA was 94% 20/20 or better for PRK and 92% for SBK. At 1 and 3 months, the SBK group had lower higher-order aberrations (coma and spherical aberration; P

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 region except in cases of keratoconus, where there can be a dominant upwards displacement. Pupil diameters are between 2.7 and 5.6 mm. The corneal higher order root mean square wavefront error for a 6 mm pupil ranges between 0.3 (normal eye) and 5.3 [mu]m (keratoconus).

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.

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.

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.

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.

[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.

Modeling the influence of LASIK surgery on optical properties of the human eye

NASA Astrophysics Data System (ADS)

Szul-Pietrzak, Elżbieta; Hachoł, Andrzej; Cieślak, Krzysztof; Drożdż, Ryszard; Podbielska, Halina

2011-11-01

The aim was to model the influence of LASIK surgery on the optical parameters of the human eye and to ascertain which factors besides the central corneal radius of curvature and central thickness play the major role in postsurgical refractive change. Ten patients were included in the study. Pre- and postsurgical measurements included standard refraction, anterior corneal curvature and pachymetry. The optical model used in the analysis was based on the Le Grand and El Hage schematic eye, modified by the measured individual parameters of corneal geometry. A substantial difference between eye refractive error measured after LASIK and estimated from the eye model was observed. In three patients, full correction of the refractive error was achieved. However, analysis of the visual quality in terms of spot diagrams and optical transfer functions of the eye optical system revealed some differences in these measurements. This suggests that other factors besides corneal geometry may play a major role in postsurgical refraction. In this paper we investigated whether the biomechanical properties of the eyeball and changes in intraocular pressure could account for the observed discrepancies.

Applied optics. Multiwavelength achromatic metasurfaces by dispersive phase compensation.

PubMed

Aieta, Francesco; Kats, Mikhail A; Genevet, Patrice; Capasso, Federico

2015-03-20

The replacement of bulk refractive optical elements with diffractive planar components enables the miniaturization of optical systems. However, diffractive optics suffers from large chromatic aberrations due to the dispersion of the phase accumulated by light during propagation. We show that this limitation can be overcome with an engineered wavelength-dependent phase shift imparted by a metasurface, and we demonstrate a design that deflects three wavelengths by the same angle. A planar lens without chromatic aberrations at three wavelengths is also presented. Our designs are based on low-loss dielectric resonators, which introduce a dense spectrum of optical modes to enable dispersive phase compensation. The suppression of chromatic aberrations in metasurface-based planar photonics will find applications in lightweight collimators for displays, as well as chromatically corrected imaging systems. Copyright © 2015, American Association for the Advancement of Science.

Influence of local inhomogeneities induced in corneal ablation on the evolution of contrast sensitivity

NASA Astrophysics Data System (ADS)

Ortiz, Dolores; Saiz, Jose M.; González, Francisco

2004-04-01

The presence of local inhomogeneities in corneal tissue after refractive surgery has an influence on visual performance. Here we focus on the corneal ablation associated with Lasik surgery and its effect on the modulation transfer function (MTF) that we obtained by modifying a personalized Kooijman model. Inhomogeneities induced by the ablation occur in the form of Gaussian-distributed refractive-index variations of a given correlation length. We show how variation of refractive-index deviation and correlation length (size) of the inhomogeneities allows us to obtain pairs of values that are able to achieve a MTF evolution similar to that observed for contrast sensitivity in the same patients. An estimate of the characteristics of the local effects is obtained.

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...

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...

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.

Flat dielectric metasurface lens array for three dimensional integral imaging

NASA Astrophysics Data System (ADS)

Zhang, Jianlei; Wang, Xiaorui; Yang, Yi; Yuan, Ying; Wu, Xiongxiong

2018-05-01

In conventional integral imaging, the singlet refractive lens array limits the imaging performance due to its prominent aberrations. Different from the refractive lens array relying on phase modulation via phase change accumulated along the optical paths, metasurfaces composed of nano-scatters can produce phase abrupt over the scale of wavelength. In this letter, we propose a novel lens array consisting of two neighboring flat dielectric metasurfaces for integral imaging system. The aspherical phase profiles of the metasurfaces are optimized to improve imaging performance. The simulation results show that our designed 5 × 5 metasurface-based lens array exhibits high image quality at designed wavelength 865 nm.

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.

[Multifocal intraocular lenses. A review].

PubMed

Auffarth, G U; Dick, H B

2001-02-01

Modern cataract surgery has developed tremendously during the past 10-15 years. Improved surgical techniques, as well as improved implant materials and designs, have enlarged patient profiles and indications for cataract surgery. This also created much higher expectations from the patients' site. The loss of accommodation is loss of quality of life for presbyopic and especially young pseudophakic patients. Therefore cataract surgery with multifocal IOL implantation is not only of academic interest, but reflects demands and expectations of our patients. Multifocal IOLs have been implanted since 1986, starting with 2-3 zone refractive and diffractive designs. Due to surgical techniques of that time MIOL decentration and surgically induced astigmatism were possible complications. In addition reduced contrast sensitivity and increased glare were common problems of MIOL because of their optical principles. New developments in this field in recent years such as the multizonal, progressive refractive MIOL in combination with improved surgical techniques have overcome those initial problems. Therefore, modern multifocal IOLs can be considered not only for correction of aphakia but also for refractive purposes.

Free-form reflective optics for mid-infrared camera and spectrometer on board SPICA

NASA Astrophysics Data System (ADS)

Fujishiro, Naofumi; Kataza, Hirokazu; Wada, Takehiko; Ikeda, Yuji; Sakon, Itsuki; Oyabu, Shinki

2017-11-01

SPICA (Space Infrared Telescope for Cosmology and Astrophysics) is an astronomical mission optimized for mid-and far-infrared astronomy with a cryogenically cooled 3-m class telescope, envisioned for launch in early 2020s. Mid-infrared Camera and Spectrometer (MCS) is a focal plane instrument for SPICA with imaging and spectroscopic observing capabilities in the mid-infrared wavelength range of 5-38μm. MCS consists of two relay optical modules and following four scientific optical modules of WFC (Wide Field Camera; 5'x 5' field of view, f/11.7 and f/4.2 cameras), LRS (Low Resolution Spectrometer; 2'.5 long slits, prism dispersers, f/5.0 and f/1.7 cameras, spectral resolving power R ∼ 50-100), MRS (Mid Resolution Spectrometer; echelles, integral field units by image slicer, f/3.3 and f/1.9 cameras, R ∼ 1100-3000) and HRS (High Resolution Spectrometer; immersed echelles, f/6.0 and f/3.6 cameras, R ∼ 20000-30000). Here, we present optical design and expected optical performance of MCS. Most parts of MCS optics adopt off-axis reflective system for covering the wide wavelength range of 5-38μm without chromatic aberration and minimizing problems due to changes in shapes and refractive indices of materials from room temperature to cryogenic temperature. In order to achieve the high specification requirements of wide field of view, small F-number and large spectral resolving power with compact size, we employed the paraxial and aberration analysis of off-axial optical systems (Araki 2005 [1]) which is a design method using free-form surfaces for compact reflective optics such as head mount displays. As a result, we have successfully designed compact reflective optics for MCS with as-built performance of diffraction-limited image resolution.

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 ...

Evaluation of image quality metrics for the prediction of subjective best focus.

PubMed

Kilintari, Marina; Pallikaris, Aristophanis; Tsiklis, Nikolaos; Ginis, Harilaos S

2010-03-01

Seven existing and three new image quality metrics were evaluated in terms of their effectiveness in predicting subjective cycloplegic refraction. Monochromatic wavefront aberrations (WA) were measured in 70 eyes using a Shack-Hartmann based device (Complete Ophthalmic Analysis System; Wavefront Sciences). Subjective cycloplegic spherocylindrical correction was obtained using a standard manifest refraction procedure. The dioptric amount required to optimize each metric was calculated and compared with the subjective refraction result. Metrics included monochromatic and polychromatic variants, as well as variants taking into consideration the Stiles and Crawford effect (SCE). WA measurements were performed using infrared light and converted to visible before all calculations. The mean difference between subjective cycloplegic and WA-derived spherical refraction ranged from 0.17 to 0.36 diopters (D), while paraxial curvature resulted in a difference of 0.68 D. Monochromatic metrics exhibited smaller mean differences between subjective cycloplegic and objective refraction. Consideration of the SCE reduced the standard deviation (SD) of the difference between subjective and objective refraction. All metrics exhibited similar performance in terms of accuracy and precision. We hypothesize that errors pertaining to the conversion between infrared and visible wavelengths rather than calculation method may be the limiting factor in determining objective best focus from near infrared WA measurements.

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.

Femtosecond Laser-assisted Arcuate Keratotomy Versus Toric IOL Implantation for Correcting Astigmatism.

PubMed

Yoo, Aeri; Yun, Samyoung; Kim, Jae Yong; Kim, Myoung Joon; Tchah, Hungwon

2015-09-01

To evaluate the clinical efficacy and safety of femtosecond laser-assisted arcuate keratotomy (FS-AK) versus toric intraocular lens (IOL) implantation for correcting astigmatism in patients with cataract. A retrospective chart review was performed. All patients had senile cataracts with corneal astigmatism (range: +1.00 to +3.00 diopters [D]) before cataract surgery. Twenty-five patients agreed to undergo toric IOL implantation (the toric IOL group). Twenty-three patients did not agree to undergo toric IOL implantation despite astigmatism; however, these patients were not satisfied with their remaining astigmatism following cataract surgery and requested astigmatism correction using FS-AK (the FS-AK group). Visual acuity and intraocular pressure were evaluated, and automated refraction, keratometry, and slit-lamp examinations were performed at 1 day, 1 week, 1 month, and 5 months after surgery. Refractive astigmatism decreased in both groups. The mean preoperative and postoperative refractive cylinders were 1.71 ± 1.15 and 0.78 ± 1.06 D, respectively, in the FS-AK group (P < .001) and 1.67 ± 0.13 and 0.83 ± 0.097 D, respectively, in the toric IOL group (P < .001). There were no statistically significant differences between groups at any time during the follow-up period. FS-AK is a fast, customizable, adjustable, precise, and safe procedure for reducing refractive errors in patients with residual astigmatism after cataract surgery. The results of this procedure are comparable to the toric IOL. Copyright 2015, SLACK Incorporated.

[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.

Close Up of Monochromatic Aberrations Using Snell's Law: An Undergraduate Computational Experiment

ERIC Educational Resources Information Center

Levesque, L.

2009-01-01

Images formed from light rays refracting a spherical surface are often introduced in textbooks using the paraxial approximation. Incoming rays propagating from the object meeting the surface of a transparent medium at a given point for which the angle is larger than 15 degrees with respect to the normal are not described accurately from the…

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.

LASIK for myopia and astigmatism using the SCHWIND AMARIS excimer laser: an international multicenter trial.

PubMed

Arbelaez, Maria Clara; Aslanides, Ioannis M; Barraquer, Carmen; Carones, Francesco; Feuermannova, Alena; Neuhann, Tobias; Rozsival, Pavel

2010-02-01

To assess the efficacy, predictability, and safety of LASIK for the surgical correction of low to moderate myopia with astigmatism using the SCHWIND AMARIS excimer laser. Six international study sites enrolled 358 eyes with a manifest refraction spherical equivalent (MRSE) from -0.50 to -7.38 diopters (D) (mean sphere: -3.13+/-1.58 D) with up to -5.00 D of astigmatism (mean: -0.69+/-0.67 D). All eyes underwent treatment with the nonwavefront-guided aspheric algorithm of the SCHWIND AMARIS excimer laser. All eyes were targeted for emmetropia. Refractive outcomes and corneal higher order aberrations were analyzed pre- and postoperatively. Visual quality was assessed using photopic and mesopic contrast sensitivity. Six-month postoperative outcomes are reported. At 6 months postoperative, the MRSE for all eyes was -0.21+/-0.20 D, and 96% (343/358) of eyes had MRSE within +/-0.50 D. Uncorrected visual acuity was 20/20 or better in 98% (351/358) of eyes, and no eyes lost 2 or more lines of best spectacle-corrected visual acuity. The total corneal higher order aberrations root-mean-square increased by 0.09 microm, spherical aberration increased by 0.08 microm, and coma increased by 0.04 microm postoperatively. Photopic and mesopic contrast sensitivity did not change 6 months postoperatively. Treatment of myopia with astigmatism using the SCHWIND AMARIS excimer laser is safe, efficacious, predictable, and maintains visual quality.

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.

New trends in intraocular lens imaging

NASA Astrophysics Data System (ADS)

Millán, María S.; Alba-Bueno, Francisco; Vega, Fidel

2011-08-01

As a result of modern technological advances, cataract surgery can be seen as not only a rehabilitative operation, but a customized procedure to compensate for important sources of image degradation in the visual system of a patient, such as defocus and some aberrations. With the development of new materials, instruments and surgical techniques in ophthalmology, great progress has been achieved in the imaging capability of a pseudophakic eye implanted with an intraocular lens (IOL). From the very beginning, optical design has played an essential role in this progress. New IOL designs need, on the one hand, theoretical eye models able to predict optical imaging performance and on the other hand, testing methods, verification through in vitro and in vivo measurements, and clinical validation. The implant of an IOL requires a precise biometry of the eye, a prior calculation from physiological data, and an accurate position inside the eye. Otherwise, the effects of IOL calculation errors or misplacements degrade the image very quickly. The incorporation of wavefront aberrometry into clinical ophthalmology practice has motivated new designs of IOLs to compensate for high order aberrations in some extent. Thus, for instance, IOLs with an aspheric design have the potential to improve optical performance and contrast sensitivity by reducing the positive spherical aberration of human cornea. Monofocal IOLs cause a complete loss of accommodation that requires further correction for either distance or near vision. Multifocal IOLs address this limitation using the principle of simultaneous vision. Some multifocal IOLs include a diffractive zone that covers the aperture in part or totally. Reduced image contrast and undesired visual phenomena, such as halos and glare, have been associated to the performance of multifocal IOLs. Based on a different principle, accommodating IOLs rely on the effort of the ciliary body to increase the effective power of the optical system of the eye in near vision. Finally, we present a theoretical approach that considers the modification of less conventional ocular parameters to compensate for possible refractive errors after the IOL implant.

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.

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.

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.

Excimer Laser Versus Phakic Intraocular Lenses for Myopia and Astigmatism: A Meta-Analysis of Randomized Controlled Trials.

PubMed

Chen, Haiting; Liu, Yu; Niu, Guangzeng; Ma, Jingxue

2018-05-01

Meta-analysis of randomized controlled trials (RCTs) which compared excimer laser refractive surgery and phakic intraocular lenses (PIOLs) for the treatment of myopia and astigmatism. An electronic literature search was performed using the PubMed, EBSCO, CNKI, and Cochrane Library database to identify prospective RCTs which compared excimer laser refractive surgery and PIOL with a follow-up time of at least 12 months. Efficacy, accuracy, safety outcomes, and complications were analyzed by standardized mean difference, risk ratio, and the pooled estimates according to a fixed effect model or random effect model. This review included 5 RCTs with a sum of 405 eyes. The range of myopia was 6.0 to 20.0 D with up to 4.0 D of astigmatism. The PIOL group was more likely to achieve a spherical equivalence within±1.0 D of target refraction at 12 months postoperatively (P=0.009), and was less likely to lose one or more lines of best spectacle corrected visual acuity than the LASER group (P=0.002). On the whole, there is no significant difference in efficacy and complications between the two kinds of surgeries. This meta-analysis indicated that PIOLs were safer and more accurate within 12 months of follow-up compared with excimer laser surgical for refractive errors.

[Internal astigmatism with other ocular lesions].

PubMed

Limaiem, R; Baba, A; Bouraoui, R; Mghaieth, F; El Matri, L

2012-04-01

Astigmatism is a refractive defect whose origin is not always purely corneal, and is sometimes the result of corneal, crystalline lens or mixte contributions. The aim of our study is to report, through two cases, ocular lesions associated with a lenticular astigmatism and their evolution after treatment. In the first observation, it is a 25-year-old patient with a unilateral extra corneal astigmatism within the framework of the "tilted disc syndrome" associated with bilateral myopia. This patient has received treatment by Lasik. The postoperative course was good with a decline of 5 ans. The second observation is that of a patient aged 35 years without having a general history with a posterior lenticonus associated with keratoconus responsible for a major mixed astigmatism. She received combined surgery: penetrating keratoplasty with lens extraction and implantation of an artificial lens. The evolution was good with good visual recovery. The balance of internal astigmatism must include the systematic achievement of a subjective and objective refraction under cycloplegia and corneal topography. The search for etiology is critical to screen for eye or general disease and guide the therapeutic strategy. Knowledge of the refractive power of the cornea and crystalline lens of astigmatism separately would be important for surgery refractive and crystalline lens surgery. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

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.

Thick lens chromatic effective focal length variation versus bending

NASA Astrophysics Data System (ADS)

Sparrold, Scott

2017-11-01

Longitudinal chromatic aberration (LCA) can limit the optical performance in refractive optical systems. Understanding a singlet's chromatic change of effective focal leads to insights and methods to control LCA. Long established, first order theory, shows the chromatic change in focal length for a zero thickness lens is proportional to it's focal length divided by the lens V number or inverse dispersion. This work presents the derivation of an equation for a thick singlet's chromatic change in effective focal length as a function of center thickness, t, dispersion, V, index of refraction, n, and the Coddington shape factor, K. A plot of bending versus chromatic focal length variation is presented. Lens thickness does not influence chromatic variation of effective focal length for a convex plano or plano convex lens. A lens's center thickness'influence on chromatic focal length variation is more pronounced for lower indices of refraction.

Analysis and design of optical systems by use of sensitivity analysis of skew ray tracing

NASA Astrophysics Data System (ADS)

Lin, Psang Dain; Lu, Chia-Hung

2004-02-01

Optical systems are conventionally evaluated by ray-tracing techniques that extract performance quantities such as aberration and spot size. Current optical analysis software does not provide satisfactory analytical evaluation functions for the sensitivity of an optical system. Furthermore, when functions oscillate strongly, the results are of low accuracy. Thus this work extends our earlier research on an advanced treatment of reflected or refracted rays, referred to as sensitivity analysis, in which differential changes of reflected or refracted rays are expressed in terms of differential changes of incident rays. The proposed sensitivity analysis methodology for skew ray tracing of reflected or refracted rays that cross spherical or flat boundaries is demonstrated and validated by the application of a cat's eye retroreflector to the design and by the image orientation of a system with noncoplanar optical axes. The proposed sensitivity analysis is projected as the nucleus of other geometrical optical computations.

Analysis and Design of Optical Systems by Use of Sensitivity Analysis of Skew Ray Tracing

NASA Astrophysics Data System (ADS)

Dain Lin, Psang; Lu, Chia-Hung

2004-02-01

Optical systems are conventionally evaluated by ray-tracing techniques that extract performance quantities such as aberration and spot size. Current optical analysis software does not provide satisfactory analytical evaluation functions for the sensitivity of an optical system. Furthermore, when functions oscillate strongly, the results are of low accuracy. Thus this work extends our earlier research on an advanced treatment of reflected or refracted rays, referred to as sensitivity analysis, in which differential changes of reflected or refracted rays are expressed in terms of differential changes of incident rays. The proposed sensitivity analysis methodology for skew ray tracing of reflected or refracted rays that cross spherical or flat boundaries is demonstrated and validated by the application of a cat ?s eye retroreflector to the design and by the image orientation of a system with noncoplanar optical axes. The proposed sensitivity analysis is projected as the nucleus of other geometrical optical computations.

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.

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

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.

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

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.

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

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

Factors Affecting Long-term Myopic Regression after Laser In Situ Keratomileusis and Laser-assisted Subepithelial Keratectomy for Moderate Myopia.

PubMed

Lim, Sung A; Park, Yooyeon; Cheong, Yu Jin; Na, Kyung Sun; Joo, Choun-Ki

2016-04-01

High myopia is known to be a risk factor for long-term regression after laser refractive surgery. There have been few studies about the correction of moderate myopias that did not need retreatment after long-term follow-up. We evaluated 10 years of change in visual acuity and refractive power in eyes with moderate myopia after laser refractive surgery. We included patients that had undergone laser in situ keratomileusis (LASIK) or laser-assisted subepithelial keratectomy (LASEK) to correct their myopia and that had at least 10 years of follow-up. We evaluated the stability of visual acuity in terms of safety, efficacy, and refractive changes at examinations 6 months and 1, 2, 5, 7, and 10 years after surgery. The study evaluated 62 eyes (36 eyes in LASIK patients and 26 eyes in LASEK patients). In both groups, the efficacy index tended to decrease, and it was consistently higher in the LASEK group compared to the LASIK group over the 10 years of follow-up. The safety index improved over 10 years and was always higher than 0.9 in both groups. The difference between the spherical equivalent at 6 months postoperatively and later periods was statistically significant after 5, 7, and 10 years in both groups (LASIK, p = 0.036, p = 0.003, and p < 0.001, respectively; LASEK, p = 0.006, p = 0.002, and p = 0.001, respectively). Ten years after surgery,26 eyes (66.7%) in the LASIK group and 19 eyes (73.1%) in the LASEK group had myopia greater than 1 diopter. In comparison with the thickness at 6 months postoperatively, central corneal thickness was significantly increased after 5, 7, and 10 years in both LASIK and LASEK groups (LASIK, p < 0.001, p < 0.001, and p < 0.001, respectively; LASEK, p = 0.01, p < 0.001, and p < 0.001, respectively). Moderately myopic eyes showed progressive myopic shifting and corneal thickening after LASIK and LASEK during 10 years of follow-up. We also found that early refractive regression may indicate the long-term refractive outcome.

Factors Affecting Long-term Myopic Regression after Laser In Situ Keratomileusis and Laser-assisted Subepithelial Keratectomy for Moderate Myopia

PubMed Central

Lim, Sung A; Park, Yooyeon; Cheong, Yu Jin; Na, Kyung Sun

2016-01-01

Purpose High myopia is known to be a risk factor for long-term regression after laser refractive surgery. There have been few studies about the correction of moderate myopias that did not need retreatment after long-term follow-up. We evaluated 10 years of change in visual acuity and refractive power in eyes with moderate myopia after laser refractive surgery. Methods We included patients that had undergone laser in situ keratomileusis (LASIK) or laser-assisted subepithelial keratectomy (LASEK) to correct their myopia and that had at least 10 years of follow-up. We evaluated the stability of visual acuity in terms of safety, efficacy, and refractive changes at examinations 6 months and 1, 2, 5, 7, and 10 years after surgery. Results The study evaluated 62 eyes (36 eyes in LASIK patients and 26 eyes in LASEK patients). In both groups, the efficacy index tended to decrease, and it was consistently higher in the LASEK group compared to the LASIK group over the 10 years of follow-up. The safety index improved over 10 years and was always higher than 0.9 in both groups. The difference between the spherical equivalent at 6 months postoperatively and later periods was statistically significant after 5, 7, and 10 years in both groups (LASIK, p = 0.036, p = 0.003, and p < 0.001, respectively; LASEK, p = 0.006, p = 0.002, and p = 0.001, respectively). Ten years after surgery,26 eyes (66.7%) in the LASIK group and 19 eyes (73.1%) in the LASEK group had myopia greater than 1 diopter. In comparison with the thickness at 6 months postoperatively, central corneal thickness was significantly increased after 5, 7, and 10 years in both LASIK and LASEK groups (LASIK, p < 0.001, p < 0.001, and p < 0.001, respectively; LASEK, p = 0.01, p < 0.001, and p < 0.001, respectively). Conclusions Moderately myopic eyes showed progressive myopic shifting and corneal thickening after LASIK and LASEK during 10 years of follow-up. We also found that early refractive regression may indicate the long-term refractive outcome. PMID:27051256

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, sex, race, and study site, higher education level, being employed, and being taller were associated with a higher prevalence of myopia. In contrast, lower educational level and being shorter were associated with a higher prevalence of hyperopia. CONCLUSIONS Myopia and astigmatism were most prevalent in the Chinese population, with Chinese subjects having 3 times the prevalence of myopia as Hispanic subjects. Hyperopia was most common in Hispanic subjects. These findings provide further insights into variations in refractive errors among different racial groups and have important implications for the eye care services in the United States. PMID:23453694

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 education level, being employed, and being taller were associated with a higher prevalence of myopia. In contrast, lower educational level and being shorter were associated with a higher prevalence of hyperopia. Myopia and astigmatism were most prevalent in the Chinese population, with Chinese subjects having 3 times the prevalence of myopia as Hispanic subjects. Hyperopia was most common in Hispanic subjects. These findings provide further insights into variations in refractive errors among different racial groups and have important implications for the eye care services in the United States. Copyright © 2013 Elsevier Inc. All rights reserved.

What Are the Risks and How Can I Find the Right Doctor for Me? (Refractive Surgery)

MedlinePlus

... glasses after surgery. Some patients may develop severe dry eye syndrome. As a result of surgery, your eye may not be able to produce enough tears to keep the eye moist and comfortable. Dry eye not only causes discomfort, but can reduce ...

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.

Fractal propagation method enables realistic optical microscopy simulations in biological tissues

PubMed Central

Glaser, Adam K.; Chen, Ye; Liu, Jonathan T.C.

2017-01-01

Current simulation methods for light transport in biological media have limited efficiency and realism when applied to three-dimensional microscopic light transport in biological tissues with refractive heterogeneities. We describe here a technique which combines a beam propagation method valid for modeling light transport in media with weak variations in refractive index, with a fractal model of refractive index turbulence. In contrast to standard simulation methods, this fractal propagation method (FPM) is able to accurately and efficiently simulate the diffraction effects of focused beams, as well as the microscopic heterogeneities present in tissue that result in scattering, refractive beam steering, and the aberration of beam foci. We validate the technique and the relationship between the FPM model parameters and conventional optical parameters used to describe tissues, and also demonstrate the method’s flexibility and robustness by examining the steering and distortion of Gaussian and Bessel beams in tissue with comparison to experimental data. We show that the FPM has utility for the accurate investigation and optimization of optical microscopy methods such as light-sheet, confocal, and nonlinear microscopy. PMID:28983499

Crystalline lens paradoxes revisited: significance of age-related restructuring of the GRIN.

PubMed

Sheil, Conor J; Goncharov, Alexander V

2017-09-01

The accommodating volume-constant age-dependent optical (AVOCADO) model of the crystalline lens is used to explore the age-related changes in ocular power and spherical aberration. The additional parameter m in the GRIN lens model allows decoupling of the axial and radial GRIN profiles, and is used to stabilise the age-related change in ocular power. Data for age-related changes in ocular geometry and lens parameter P in the axial GRIN profile were taken from published experimental data. In our age-dependent eye model, the ocular refractive power shows behaviour similar to the previously unexplained "lens paradox". Furthermore, ocular spherical aberration agrees with the data average, in contrast to the proposed "spherical aberration paradox". The additional flexibility afforded by parameter m , which controls the ratio of the axial and radial GRIN profile exponents, has allowed us to study the restructuring of the lens GRIN medium with age, resulting in a new interpretation of the origin of the power and spherical aberration paradoxes. Our findings also contradict the conceptual idea that the ageing eye is similar to the accommodating eye.

First in vivo animal studies on intraocular nanosurgery and multiphoton tomography with low-energy 80-MHz near-infrared femtosecond laser pulses

NASA Astrophysics Data System (ADS)

Konig, Karsten; Wang, Bagui; Krauss, Oliver; Riemann, Iris; Schubert, Harald; Kirste, Sigrun; Fischer, Peter

2004-07-01

We report on a method for refractive laser surgery based on low-energy femtosecond laser pulses provided by ultracompact turn-key non-amplified laser systems. An additional excimer laser is not required for ablation of the stroma. The novel method has the potential to be used for (i) optical flap creation as well as stroma ablation and (ii) for non-invasive flap-free intrastromal ablation. In addition, 3D multiphoton imaging of the cornea can be performed. In particular, we used sub-nanojoule near infrared 80 MHz femtosecond laser pulses for multiphoton imaging of corneal structures with ultrahigh resolution (< 1μm) as well as for highly precise intraocular refractive surgery. Imaging based on two-photon excited cellular autofluorescence and SHG formation in collagen structures was performed at GW/cm2 intensities, whereas destructive optical breakdown for nanoprocessing occurred at TW/cm2 light intensities. These high intensities were realized with sub-nJ pulses within a subfemtoliter intrastromal volume by diffraction-limited focussing with high NA objectives and beam scanning 50 to 140 μm below the epithelial surface. Multiphoton tomography of the cornea was used to determine the target of interest and to visualize intraocular post-laser effects. Histological examination with light- and electron microscopes of laser-exposed porcine and rabbit eyes reveal a minimum intratissue cut size below 1 μm without destructive effects to surrounding collagen structures. LASIK flaps and intracorneal cavities could be realized with high precision using 200 fs, 80 MHz, sub-nanojoule pulses at 800 nm. First studies on 80 MHz femtosecond laser surgery on living rabbits have been performed.

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

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.

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

Reconstruction of the optical system of personalized eye models by using magnetic resonance imaging.

PubMed

Sun, Han-Yin; Lee, Chi-Hung; Chuang, Chun-Chao

2016-11-10

This study presents a practical method for reconstructing the optical system of personalized eye models by using magnetic resonance imaging (MRI). Monocular images were obtained from a young (20-year-old) healthy subject viewing at a near point (10 cm). Each magnetic resonance image was first analyzed using several commercial software to capture the profile of each optical element of the human eye except for the anterior lens surface, which could not be determined because it overlapped the ciliary muscle. The missing profile was substituted with a modified profile from a generic eye model. After the data-including the refractive indices from a generic model-were input in ZEMAX, we obtained a reasonable initial layout. By further considering the resolution of the MRI, the model was optimized to match the optical performance of a healthy eye. The main benefit of having a personalized eye model is the ability to quantitatively identify wide-angle ocular aberrations, which were corrected by the designed free-form spectacle lens.

Full 3-D OCT-based pseudophakic custom computer eye model

PubMed Central

Sun, M.; Pérez-Merino, P.; Martinez-Enriquez, E.; Velasco-Ocana, M.; Marcos, S.

2016-01-01

We compared measured wave aberrations in pseudophakic eyes implanted with aspheric intraocular lenses (IOLs) with simulated aberrations from numerical ray tracing on customized computer eye models, built using quantitative 3-D OCT-based patient-specific ocular geometry. Experimental and simulated aberrations show high correlation (R = 0.93; p<0.0001) and similarity (RMS for high order aberrations discrepancies within 23.58%). This study shows that full OCT-based pseudophakic custom computer eye models allow understanding the relative contribution of optical geometrical and surgically-related factors to image quality, and are an excellent tool for characterizing and improving cataract surgery. PMID:27231608

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.

Mandibular reconstruction using fibula free flap harvested using a customised cutting guide: how we do it.

PubMed

Tarsitano, A; Ciocca, L; Cipriani, R; Scotti, R; Marchetti, C

2015-06-01

Free fibula flap is routinely used for mandibular reconstructions. For contouring the flap, multiple osteotomies should be shaped to reproduce the native mandibular contour. The bone segments should be fixed using a reconstructive plate. This plate is usually manually bent by the surgeon during surgery. This method is efficient, but during reconstruction it is complicated to reproduce the complex 3D conformation of the mandible and recreate a normal morphology with a mandibular profile as similar as possible to the original; any aberration in its structural alignment may lead to aesthetic and function alterations due to malocclusion or temporomandibular disorders. In order to achieve better morphological and functional outcomes, we have performed a customised flap harvest using cutting guides. This study demonstrates how we have performed customised mandibular reconstruction using CAD-CAM fibular cutting guides in 20 patients undergoing oncological segmental resection.

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.

Positional and rotational stability of the toric phakic intraocular lens under high +Gz environments.

PubMed

Tan, Marcus C L; Nah, Gerard K M

2012-02-01

Phakic intraocular lens (PIOL) implantation is a surgical option for correction of refractive errors. PIOLs can be use to correct myopia, hyperopia, and astigmatism. It is a surgical option available to patients in addition to methods such as laser cornea refractive surgery, e.g., laser assisted in-situ keratomileusis (LASIK) and photo-refractive keratectomy (PRK). Visian implantable collamer lens (ICL) are posterior chamber lenses which are surgically positioned in a phakic eye in the sulcus between the iris diaphragm and the natural crystalline lens. This case report describes the stability of Visian toric ICL in a candidate with bilateral implants under high +Gz force exposure in a human centrifuge trainer. The subject was sequentially exposed to three incremental +Gz profiles of +5 Gz, +7 Gz, and +9 Gz. Pre- and post-+Gz exposure, ophthalmic examination revealed no ICL displacement, implant touch or induced cataract, or change in refractive error. The rotational stability of the toric implants was also demonstrated by identical subjective refractions in both eyes taken pre- and post-+Gz, exposure. A search of the literature did not reveal any published articles on intraocular stability of ICL in the +Gz environment. This case report suggests that ICL may be considered an alternative to laser refractive surgery for patients subjected to a high +G, environment such as military aviators.

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.

[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) .

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.

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

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 ± 0.19 μm (P = 0.004), 0.21 ± 0.09 μm (P < 0.0001) and 0.77 ± 0.27 μm (P < 0.0001), six months postoperatively. The change in spherical aberration after the procedure increased with an increase in the degree of preoperative myopia. Wavefront-guided IntraLASIK offers a safe and effective option for vision and visual function improvement in astigmatism. Although, reduction of HOA is possible in a few eyes, spherical-like aberrations are increased in majority of the treated eyes.

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.

Visual performance after conventional LASIK and wavefront-guided LASIK with iris-registration: results at 1 year

PubMed Central

Zhang, Jing; Zhou, Yue-Hua; Li, Rui; Tian, Lei

2013-01-01

AIM To compare visual performance of wavefront-guided laser in situ keratomileusis (LASIK) with iris-registration (Wg-LASIK group) and conventional LASIK (LASIK group) one year after surgery and analyze the correlation between wavefront aberrations and visual performance. METHODS Eight hundred and fifty-two myopic eyes of 430 patients were enrolled in this prospective study and divided into two groups: Wg-LASIK group (436 eyes) and LASIK group (416 eyes). A Wavescan Wavefront aberrometer was used to analyze Zernike coefficients and the root-mean-square (RMS) of higher order aberrations, and Optec 6500 visual function instrument was used to measure contrast sensitivity (CS) before and 3, 6, 12 months after surgery. RESULTS The mean spherical equivalent (SE) in Wg-LASIK group was significantly better than those in LASIK group one year after surgery (P=0.024). Wg-LASIK eyes showed better CS values than LASIK eyes at all spatial frequencies with and without glare after surgery (P all<0.01). Moreover, the increase of higher RMS (RMSh), coma, RMS3, RMS4, RMS5 in Wg-LASIK group were significantly lower than those in LASIK group 1 year after surgery (P all<0.05). The increase of coma, spherical aberration (SA), RMS3 and RMS4 in Wg-LASIK and coma and RMS3 in LASIK group were negatively correlated with reduction of contrast sensitivity 1 year after surgery. CONCLUSION A significant better visual performance is got in Wg-LASIK group compared with LASIK group 1 year after surgery, and the Wg-LASIK is particularly suitable for eyes with high-magnitude RMSh. PMID:23991386

Non-Invasive Evaluation of Corneal Abnormalities Using Static and Dynamic Light Scattering

NASA Technical Reports Server (NTRS)

Ansari, Rafat R.; Misra, Anup K.; Leung, Alfred B.; King, James F.; Datiles, Manuel B., III

2002-01-01

A preliminary study of corneal abnormalities in intact bovine eyes is presented. Twenty-one eyes were treated with chemicals, cotton swabs, and radial and photo-refractive surgeries. Dynamic and static light scattering was performed as a function of the penetration depth into the corneal tissue. Topographical maps of corneal refractive power from untreated and treated corneas were also obtained using videokeratoscopy and results compared. The ultimate aim is to develop the technique of dynamic light scattering (DLS) for clinical applications in early evaluation of corneal complications after laser-assisted in situ keratomileusis (LASIK) surgeries and other corneal abnormalities.

Noninvasive evaluation of corneal abnormalities using static and dynamic light scattering

NASA Astrophysics Data System (ADS)

Ansari, Rafat R.; Misra, Anup K.; Leung, Alfred B.; King, James F.; Datiles, Manuel B., III

2002-06-01

A preliminary study of corneal abnormalities in intact bovine eyes is presented. Twenty-one eyes were treated with chemicals, cotton swabs, and radial and photo-refractive surgeries. Dynamic and static light scattering was performed as a function of the penetration depth into the corneal tissue. Topographical maps of corneal refractive power from untreated and treated corneas were also obtained using videokeratoscopy and results compared. The ultimate aim is to develop the technique of dynamic light scattering (DLS) for clinical applications in early evaluation of corneal complications after laser-assisted in situ keratomileusis (LASIK) surgeries and other corneal abnormalities.

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.

Target-in-the-loop beam control: basic considerations for analysis and wave-front sensing

NASA Astrophysics Data System (ADS)

Vorontsov, Mikhail A.; Kolosov, Valeriy

2005-01-01

Target-in-the-loop (TIL) wave propagation geometry represents perhaps the most challenging case for adaptive optics applications that are related to maximization of irradiance power density on extended remotely located surfaces in the presence of dynamically changing refractive-index inhomogeneities in the propagation medium. We introduce a TIL propagation model that uses a combination of the parabolic equation describing coherent outgoing-wave propagation, and the equation describing evolution of the mutual correlation function (MCF) for the backscattered wave (return wave). The resulting evolution equation for the MCF is further simplified by use of the smooth-refractive-index approximation. This approximation permits derivation of the transport equation for the return-wave brightness function, analyzed here by the method of characteristics (brightness function trajectories). The equations for the brightness function trajectories (ray equations) can be efficiently integrated numerically. We also consider wave-front sensors that perform sensing of speckle-averaged characteristics of the wave-front phase (TIL sensors). Analysis of the wave-front phase reconstructed from Shack-Hartmann TIL sensor measurements shows that an extended target introduces a phase modulation (target-induced phase) that cannot be easily separated from the atmospheric-turbulence-related phase aberrations. We also show that wave-front sensing results depend on the extended target shape, surface roughness, and outgoing-beam intensity distribution on the target surface. For targets with smooth surfaces and nonflat shapes, the target-induced phase can contain aberrations. The presence of target-induced aberrations in the conjugated phase may result in a deterioration of adaptive system performance.

Target-in-the-loop beam control: basic considerations for analysis and wave-front sensing.

PubMed

Vorontsov, Mikhail A; Kolosov, Valeriy

2005-01-01

Target-in-the-loop (TIL) wave propagation geometry represents perhaps the most challenging case for adaptive optics applications that are related to maximization of irradiance power density on extended remotely located surfaces in the presence of dynamically changing refractive-index inhomogeneities in the propagation medium. We introduce a TIL propagation model that uses a combination of the parabolic equation describing coherent outgoing-wave propagation, and the equation describing evolution of the mutual correlation function (MCF) for the backscattered wave (return wave). The resulting evolution equation for the MCF is further simplified by use of the smooth-refractive-index approximation. This approximation permits derivation of the transport equation for the return-wave brightness function, analyzed here by the method of characteristics (brightness function trajectories). The equations for the brightness function trajectories (ray equations) can be efficiently integrated numerically. We also consider wave-front sensors that perform sensing of speckle-averaged characteristics of the wave-front phase (TIL sensors). Analysis of the wave-front phase reconstructed from Shack-Hartmann TIL sensor measurements shows that an extended target introduces a phase modulation (target-induced phase) that cannot be easily separated from the atmospheric-turbulence-related phase aberrations. We also show that wave-front sensing results depend on the extended target shape, surface roughness, and outgoing-beam intensity distribution on the target surface. For targets with smooth surfaces and nonflat shapes, the target-induced phase can contain aberrations. The presence of target-induced aberrations in the conjugated phase may result in a deterioration of adaptive system performance.

Analysis of Macular and Retinal Nerve Fiber Layer Thickness in Children with Refractory Amblyopia after Femtosecond Laser-assisted Laser In situ Keratomileusis: A Retrospective Study.

PubMed

Zhao, Peng-Fei; Zhou, Yue-Hua; Zhang, Jing; Wei, Wen-Bin

2017-09-20

Localized macular edema and retinal nerve fiber layer (RNFL) thinning have been reported shortly after laser in situ keratomileusis (LASIK) in adults. However, it is still unclear how LASIK affects the retina of children. This study aimed to investigate the macular retina and RNFL thickness in children with refractive amblyopia who underwent femtosecond laser-assisted LASIK (FS-LASIK). In this study, we included 56 eyes of 32 patients with refractive amblyopia who underwent FS-LASIK in our hospital from January 2012 to December 2016. Foveal (foveal center retinal, parafoveal retinal, and perifoveal), macular inner retinal (superior and inferior), and peripapillary RNFL thicknesses (superior, inferior, temporal, and nasal) were measured using Fourier-domain optical coherence tomography before surgery and 1 day, 3 days, and 1 week after surgery. We divided these patients into three groups based on their refractive error: High myopic group with 22 eyes (equivalent sphere, >6.00 D), mild myopic group with 19 eyes (equivalent sphere, 0-6.00 D), and hyperopic group with 15 eyes (equivalent sphere, >+0.50 D). We compared the macular retina and RNFL thickness before and after LASIK. A paired simple t-test was used for data analysis. One week after surgery, the visual acuity for all 56 eyes of the 32 patients reached their preoperative best-corrected vision. Visual acuity improved two lines or better for 31% of the patients. The residual refractive errors in 89% of the patients were within ±0.5 D. In the high myopic group, the foveal center retinal and parafoveal retinal thicknesses were thicker 1 day and 3 days after surgery than before surgery (t = 2.689, P = 0.012; t = 2.383, P = 0.018, respectively); no significant difference was found 1 week after surgery (P > 0.05). The foveal center retinal and parafoveal retinal thicknesses were greater 1 day after surgery than they were before surgery (P = 0.000 and P = 0.005, respectively) in the mild myopic and hyperopic groups. No significant difference was found 3 days or 1 week after surgery (P > 0.05). In all three groups, no significant difference was found in the macular inner retinal or peripapillary RNFL thickness 1 day, 3 days, or 1 week after surgery (P > 0.05). The foveal center retinal edema after FS-LASIK is mild and reversible in children, that mostly occurred in the high myopic group with no effect on the visual acuity, and is always relieved within 1 week.

[Design and analysis of a novel light visible spectrum imaging spectrograph optical system].

PubMed

Shen, Man-de; Li, Fei; Zhou, Li-bing; Li, Cheng; Ren, Huan-huan; Jiang, Qing-xiu

2015-02-01

A novel visible spectrum imaging spectrograph optical system was proposed based on the negative dispersion, the arbitrary phase modulation characteristics of diffractive optical element and the aberration correction characteristics of freeform optical element. The double agglutination lens was substituted by a hybrid refractive/diffractive lens based on the negative dispersion of diffractive optical element. Two freeform optical elements were used in order to correct some aberration based on the aberration correction characteristics of freeform optical element. An example and frondose design process were presented. When the design parameters were uniform, compared with the traditional system, the novel visible spectrum imaging spectrograph optical system's weight was reduced by 22.9%, the total length was reduced by 26.6%, the maximal diameter was reduced by 30.6%, and the modulation transfer function (MTF) in 1.0 field-of-view was improved by 0.35 with field-of-view improved maximally. The maximal distortion was reduced by 1.6%, the maximal longitudinal aberration was reduced by 56.4%, and the lateral color aberration was reduced by 59. 3%. From these data, we know that the performance of the novel system was advanced quickly and it could be used to put forward a new idea for modern visible spectrum imaging spectrograph optical system design.

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 Commercialization, Ithaca, New York. No other 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.

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 underwater hologrammetry. The results of experimental trials which demonstrate the correction of astigmatism and field curvature are presented. Exact expressions are obtained for the aberrations in wavelength compensated holograms and are employed to determine the conditions for optimum compensation and the degree of residual aberration. (Abstract shortened by UMI.).

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

NASA Astrophysics Data System (ADS)

Tian, Yibin

2007-12-01

Retinal image quality is important for normal eye growth. Optical aberrations are of interest for two reasons: first, they degrade retinal images; second, they might provide some cues to defocus. Higher than normal ocular aberrations have been previously associated with human myopia. However, these studies were cross-sectional in design, and only reported aberrations in terms of root mean square (RMS) errors of Zernike coefficients, a poor metric of optical quality. This dissertation presents results from investigations of ocular optical aberrations, retinal image quality and eye growth in chicks and humans. A number of techniques were utilized, including Shack-Hartmann aberrometry, high-frequency A-scan ultrasonography, ciliary nerve section (CNX), photorefractive keratectomy (PRK) as well as computer simulations and modeling. A technique to extract light scatter information from Shack-Hartmann images was also developed. The main findings of the dissertation are summarized below. In young chicks, most ocular aberrations decreased with growth in both normal and CNX eyes, and there were diurnal fluctuations in some aberrations. Modeling suggested active reduction in higher order aberrations (HOAs) during early development. Although CNX eyes manifested greater than normal HOAs, they showed near normal growth. Retinal image degradation varied greatly among individual eyes post-PRK in young chicks. Including light scatter information into analyses of retinal image quality better estimated the latter. Albino eyes showed more severe retinal image degradation than normal eyes, due to increased optical aberrations and light scatter, but their growth was similar to those of normal eyes, implying that they are relatively insensitive to retina image quality. Although the above results questioned the influence of optical aberrations on early ocular growth, some optical quality metrics, derived from optical aberrations data, could predict how much the eyes of young chicks 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.

Ultrasonic biomicroscopy in ophthalmology and eye banking

NASA Astrophysics Data System (ADS)

Rosenwasser, George O. D.

1999-06-01

Echography has become a valuable diagnostic tool in ophthalmology. Ultrasonic biomicroscopy (UBM) in particular may be applied to the evaluation of small lesions of the anterior segment of the eye. Disease processes such as conjunctival and iris melanoma, other forms of neoplasia, intraocular cysts, narrow angle glaucoma, and intraocular foreign bodies can be diagnostically evaluated and followed longitudinally by UBM. Combining UBM with spectroscopy may become useful in determining cell type origins of a variety of tumors. Eye banking also has an increased need for UBM in corneal tissue banking. The recent development of the Laser In Situ Keratomileusis procedure has allowed corneal surgeries to create a partial thickness flap of tissue in the cornea, remove tissue from the base of the cornea with excimer laser ablation, and replace the hinged flap. This causes a substantial change in refractive error while thinning the cornea and leaving an interface within the corneal stroma. The ability to detect this type of surgery is essential in eye banking. Ultrasonic pachymetry to determine central thickness and biomicroscopy to detect the presence of an interface are essential in avoiding the use of these corneas for transplantation purposes. Determining the topography of the preserved corneas is another potential application for ultrasonography. Using this information to reduce optical aberration after transplant is crucial in improving visual performance post transplantation. A review of the anatomy of the eye, pathology of ocular diseases relevant to UBM, and principles of eye banking will be presented.

[Comparative clinical study of wavefront-guided laser in situ keratomileusis with versus without iris recognition for myopia or myopic astigmatism].

PubMed

Wang, Wei-qun; Zhang, Jin-song; Zhao, Xiao-jin

2011-10-01

To explore the postoperative visual acuity results of wavefront-guided LASIK with iris recognition for myopia or myopic astigmatism and the changes of higher-order aberrations and contrast sensitivity function (CSF). Series of prospective case studies, 158 eyes (85 cases) of myopia or myopic astigmatism were divided into two groups: one group underwent wavefront-guided LASIK with iris recognition (iris recognition group); another group underwent wavefront-guided LASIK treatment without iris recognition through the limbus maring point (non-iris recognition group). To comparative analyze the postoperative visual acuity, residual refraction, the RMS of higher-order aberrations and CSF of two groups. There was no statistical significance difference between two groups of the average uncorrected visual acuity (t = 0.039, 0.058, 0.898; P = 0.844, 0.810, 0.343), best corrected visual acuity (t = 0.320, 0.440, 1.515; P = 0.572, 0.507, 0.218), and residual refraction [spherical equivalent (t = 0.027, 0.215, 0.238; P = 0.869, 0.643, 0.626), spherical (t = 0.145, 0.117, 0.038; P = 0.704, 0.732, 0.845) and cylinder (t = 1.676, 1.936, 0.334; P = 0.195, 0.164, 0.563)] at postoperative 10 days, 1 month and 3 month. The security index of iris recognition group at postoperative 3 month was 1.06 and non-iris recognition group was 1.03; the efficacy index of iris recognition group is 1.01 and non-iris recognition group was 1.00. Postoperative 3 month iris recognition group 93.83% eyes and non-iris recognition group of 90.91% eyes spherical equivalent within ± 0.50 D (χ(2) = 0.479, P = 0.489), iris recognition group of 98.77% eyes and non-iris recognition group of 97.40% eyes spherical equivalent within ± 1.00 D (Fisher test, P = 0.613). There was no significance difference between the two groups of security, efficacy and predictability. Non-iris recognition group postoperative 1 month and postoperative 3 months 3-order order aberrations root mean square value (RMS) higher than the iris recognition group increased (t = 3.414, -2.870; P = 0.027, 0.045), in particular of coma; the general higher-order aberrations (t = 0.386, 1.132; P = 0.719, 0.321), 4-order aberrations (t = 0.808, 2.720; P = 0.464, 0.063), and 5-order aberrations (t = 0.148, -1.717; P = 0.890, 0.161) show no statistically significant difference. Three months after surgery, two groups have recovered at all spatial frequencies of CSF, iris recognition group at 3.0 c/d (t = 3.209, P = 0.002) and 6.0 c/d (t = 2.997, P = 0.004) spatial frequencies of CSF under mesopic condition was better than non-iris recognition group, glare contrast sensitivity function (GCSF) for 3.0 c/d (t = 3.423, P = 0.001) and 6.0 c/d (t = 6.986, P = 0.000) spatial frequencies under mesopic condition and 1.5 c/d (t = 9.839, P = 0.000) and 3.0 c/d (t = 7.367, P = 0.000) spatial frequencies under photopic condition in iris recognition group were better than non-iris recognition group, there were no significant difference between two groups at the other spatial frequencies. Wavefront-guided LASIK with or without iris recognition both acquired better postoperative visual acuity, but in comparison with without iris recognition, wavefront-guided LASIK with iris recognition is efficient to reduce coma and enhance contrast sensitivity of postoperative.

Infrared zone-scanning system.

PubMed

Belousov, Aleksandr; Popov, Gennady

2006-03-20

Challenges encountered in designing an infrared viewing optical system that uses a small linear detector array based on a zone-scanning approach are discussed. Scanning is performed by a rotating refractive polygon prism with tilted facets, which, along with high-speed line scanning, makes the scanning gear as simple as possible. A method of calculation of a practical optical system to compensate for aberrations during prism rotation is described.

Ocular residual astigmatism's effect on high myopic astigmatism LASIK surgery

PubMed Central

Teus, M A; Arruabarrena, C; Hernández-Verdejo, J L; Cañones, R; Mikropoulos, D G

2014-01-01

Purpose To analyze the effect of ocular residual astigmatism (ORA) on the effectiveness of LASIK for treating high myopic astigmatism. Methods This is an observational, cross-sectional study. We studied 116 consecutive myopic eyes with −3 diopters (D) or more of astigmatism that underwent LASIK surgery. The magnitude of uncorrected residual refractive astigmatism 3 months postoperatively was measured. Results The mean preoperative cylinder was −4.0±0.83 D (range, −7.5 to −3 D) and the mean preoperative ORA was 0.82±0.5 D. The mean residual refractive cylinder 3 months postoperatively was −0.78±0.83 D (range, −3 to 0 D). No correlation was found between ORA and the refractive cylinder 3 months postoperatively (P=0.6). Conclusion In eyes with high myopic astigmatism undergoing LASIK, ORA was not correlated with the residual postoperative cylinder. PMID:24971989

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.

An investigation of ultramarathon-associated visual impairment.

PubMed

Høeg, Tracy B; Corrigan, Genevieve K; Hoffman, Martin D

2015-06-01

The purpose of this study was to investigate the characteristics under which ultramarathon-associated visual impairment occurs and to seek to identify its physiological basis and risk factors. Through an online questionnaire, distributed worldwide, we obtained information from 173 self-identified ultramarathon runners who had experienced visual impairment during an ultramarathon. We attempted to characterize this vision impairment-its symptoms, duration, and the conditions under which it occurs. Select characteristics were compared with a reference group of 412 registrants of the 161-km Western States Endurance Run. Ultramarathon-associated visual impairment was typically characterized as painless clouding of vision that resolved either during (13.5%) or after racing within a median of 3.5 hours (range 0 to 48 hours) upon cessation of running. The mean (±SD) distance at which vision impairment occurred was 73±40 km, and the 161-km distance was the most frequent race distance (46.8%) in which visual impairment occurred. Visual impairment was often recurrent, with respondents reporting having it develop during a median of 2 races. Respondents with a history of refractive surgery had more episodes than those without such history (median 3.5 vs 2 episodes, P=.010). Compared with the reference group, runners with visual impairment were nearly twice as likely (23.7% vs 12.1%, P<.001) to have had refractive surgery. Ultramarathon-associated visual impairment typically presents as a painless clouding of vision that is self-limited but tends to recur in certain runners. Risk appears higher among those with a history of refractive surgery, which is relevant for ultramarathon runners who are considering, or who have a history of, refractive surgery. Published by Elsevier Inc.

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.

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.

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.

[Visual outcomes 5 years after small incision lenticule extraction (SMILE), surgery on spherocylindrical myopia eyes, from 616 eyes].

PubMed

Burazovitch, J; Ferguene, H; Naguszewski, D

2018-05-15

Determine if the visual criteria of the technique of surgery refractive by Femtosecond Laser-assisted duckweed Extraction - Small Lenticule Extraction (FLEx-Smile ® ), realized in the laser femtosecond VisuMax ® (Carl Zeiss Meditec, Jena, Germany), are stable, secure, effective and predictable in the long term, to the nearsighted and astigmatic. Retrospective study, monocentric with data collected between March 2012 and March 2017. The study included 616 eyes of 309 nearsighted and astigmatic patients (spherical equivalent from 1 to 11 D). They were followed in postoperative immediate (D+1), in 3 months, in 1 year and in 5 years. The taken measures include the refraction, the uncorrected visual acuteness (UVAC) and the best visual corrected acuteness (BVAC). The criteria of evaluation were based on the BVAC, the refractive stability, the index of security (IS: MAVC to preoperative D+1/BVAC before operation) and the predictability (percentage of eyes in±1 D of SE target). UVAC was better 5th year than after the intervention (P=0.001) and 88% of the operated eyes had an UVAC in 8/10 (logMAR=0.1). For the stability refractive, the patients became nearsighted between the intervention and 5th year (P=0.001), with a regression of 0.240 D. The indication of safety was better 5th year than the day after the intervention (P=0.001), 92% of eyes operated in 5 years were 0.5 D of SE target and 77% of eyes had lost no line. SMILE is a good technique of surgery refractive stable, secure, effective and predictable on the long term. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

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.

Beam shaping to provide round and square-shaped beams in optical systems of high-power lasers

NASA Astrophysics Data System (ADS)

Laskin, Alexander; Laskin, Vadim

2016-05-01

Optical systems of modern high-power lasers require control of irradiance distribution: round or square-shaped flat-top or super-Gaussian irradiance profiles are optimum for amplification in MOPA lasers and for thermal load management while pumping of crystals of solid-state ultra-short pulse lasers to control heat and minimize its impact on the laser power and beam quality while maximizing overall laser efficiency, variable profiles are also important in irradiating of photocathode of Free Electron lasers (FEL). It is suggested to solve the task of irradiance re-distribution using field mapping refractive beam shapers like piShaper. The operational principle of these devices presumes transformation of laser beam intensity from Gaussian to flat-top one with high flatness of output wavefront, saving of beam consistency, providing collimated output beam of low divergence, high transmittance, extended depth of field, negligible residual wave aberration, and achromatic design provides capability to work with ultra-short pulse lasers having broad spectrum. Using the same piShaper device it is possible to realize beams with flat-top, inverse Gauss or super Gauss irradiance distribution by simple variation of input beam diameter, and the beam shape can be round or square with soft edges. This paper will describe some design basics of refractive beam shapers of the field mapping type and optical layouts of their applying in optical systems of high-power lasers. Examples of real implementations and experimental results will be presented as well.

Matched optical quality comparison of 3-year results of PRK-MMC and phakic IOL implantation in the correction of high myopia.

PubMed

Miraftab, M; Hashemi, H; Asgari, S

2015-07-01

To compare 3-year results of PRK-MMC and phakic intraocular lens (PIOL) implantation in patients with >8.0 diopters (D) of myopia. This study was conducted as a non-randomized clinical trial on 23 eyes treated with PIOL (Artiflex; group A) and 23 eyes treated with PRK-MMC (group B). This report compares 3-year treatment results in these two groups. At 3 years after surgery, uncorrected visual acuity was 0.02±0.06 LogMAR in group A and 0.04±0.07 LogMAR in group B (P=0.639). Mean best corrected visual acuity in group A (0.004±0.02) was better than group B (0.03±0.07 LogMAR) (P=0.035). Mean manifest refraction spherical equivalent was -0.16±0.21 and -0.09±0.20D (P=0.190), respectively. Mesopic contrast sensitivity (CS) in the spatial frequency of three cycle/degree (CS3) significantly decreased in both groups, but the reduction was significantly higher in group B (P=0.024). CS6 decreased significantly only in group B (P=0.019). Changes in CS12 and CS18 showed no significant inter-group difference. In group A, the increase in C6 trefoil (0.16±0.18 μm, P=0.003) and reduction in spherical aberration (SA; 0.16±0.08 μm, P<0.001) were statistically significant. In group B, the reduction in vertical coma (P=0.052), and increases in horizontal coma (P=0.044), coma (P<0.001), SA (P<0.001), and total higher order aberrations (P<0.001) were significant after surgery. Based on 3-year results, PIOL implantation is a better choice than PRK-MMC for treating patients with >8.0D myopia. However, for patients with an inadequate aqueous depth, PRK-MMC can be an acceptable treatment option with a potential for decreased quality of vision.

Matched optical quality comparison of 3-year results of PRK–MMC and phakic IOL implantation in the correction of high myopia

PubMed Central

Miraftab, M; Hashemi, H; Asgari, S

2015-01-01

Aims To compare 3-year results of PRK–MMC and phakic intraocular lens (PIOL) implantation in patients with >8.0 diopters (D) of myopia. Methods This study was conducted as a non-randomized clinical trial on 23 eyes treated with PIOL (Artiflex; group A) and 23 eyes treated with PRK–MMC (group B). This report compares 3-year treatment results in these two groups. Results At 3 years after surgery, uncorrected visual acuity was 0.02±0.06 LogMAR in group A and 0.04±0.07 LogMAR in group B (P=0.639). Mean best corrected visual acuity in group A (0.004±0.02) was better than group B (0.03±0.07 LogMAR) (P=0.035). Mean manifest refraction spherical equivalent was −0.16±0.21 and −0.09±0.20D (P=0.190), respectively. Mesopic contrast sensitivity (CS) in the spatial frequency of three cycle/degree (CS3) significantly decreased in both groups, but the reduction was significantly higher in group B (P=0.024). CS6 decreased significantly only in group B (P=0.019). Changes in CS12 and CS18 showed no significant inter-group difference. In group A, the increase in C6 trefoil (0.16±0.18 μm, P=0.003) and reduction in spherical aberration (SA; 0.16±0.08 μm, P<0.001) were statistically significant. In group B, the reduction in vertical coma (P=0.052), and increases in horizontal coma (P=0.044), coma (P<0.001), SA (P<0.001), and total higher order aberrations (P<0.001) were significant after surgery. Conclusion Based on 3-year results, PIOL implantation is a better choice than PRK–MMC for treating patients with >8.0D myopia. However, for patients with an inadequate aqueous depth, PRK–MMC can be an acceptable treatment option with a potential for decreased quality of vision. PMID:25976638

Design and fabrication of a high-precision cylinder beam expander

NASA Astrophysics Data System (ADS)

Zhang, Yong-hong; Yan, Hong; Xie, Bing; Li, Jian-ming; Luo, Zhong-xiang

2018-03-01

In order to compress the beam divergence angle and reduce the energy density, beam expansion system is widely used to expand the beam in laser system. Cylinder beam expander belongs to one-dimension expander, which expands the laser beam in only one direction (X direction or Y direction), a refraction cylinder expander whose beam diameter is 180mm×120mm and magnitude ratio is 12 is designed in this paper, the working wavelength is 1058nm. To solve the problem of inequality of the working wavelength and the testing wavelength, compensation method of using parallel plate to test the system aberration is proposed. By rough grinding (precision grinding) polish and the system grinding, the final system aberration is 0.24λ(peak-valley value)

Performance comparison of four kinds of flat nonimaging Fresnel lenses made of polycarbonates and polymethyl methacrylate for concentrated photovoltaics.

PubMed

Languy, Fabian; Habraken, Serge

2011-07-15

Solar concentrators made of a single refractive primary optics are limited to a concentration ratio of about 1000× [Opt. Express 19, A280 (2011)], due only to longitudinal chromatic aberration, while mirrors are limited to ∼46,000× by the angular size of the Sun. To reduce the chromatic aberration while keeping cost-effective systems for concentrated photovoltaics, a study of four different kinds of flat Fresnel doublets made of polycarbonates and polymethyl methacrylate is presented. It reveals that Fresnel doublets may have fewer optical losses than non-Fresnel doublets, with a lower lateral chromatic split allowing for even higher concentration ratio. © 2011 Optical Society of America

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.

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

[Visual outcomes four years after small incision lenticule extraction (SMILE) surgery on highly myopic eyes [French version

PubMed

Burazovitch, J; Naguzeswski, D; Beuste, T; Guillard, M

2017-09-01

To determine whether the visual outcomes of the refractive surgery technique, small incision lenticule extraction (SMILE), are stable, effective, and predictable for high myopia over a four-year period. This is a retrospective study. The data were collected between March 2012 and July 2016. Two hundred and forty-eight patients participated in the study; that is, 496 eyes: 140 eyes of 70 patients (52 women/18 men) were classified in the highly myopic group (refraction measured in spherical equivalent [RMSE]>-6D), and 356 eyes of 178 patients (98 women/80 men) in the control group (RMSE≤-6D). Follow-up tests were conducted immediately post-operatively (D+1), after three months, after one year, and after four years. Refraction, uncorrected visual acuity (UCVA), and best visual corrected acuity (BCVA) were measured. The highly myopic group (HMG) contained more women, and astigmatism was higher for this group than for the control group (CG). These are BCVA, refractive stability, the index of safety (SI: BCVA preoperatively D+1/BCVA postoperatively), and predictability (the percentage of eyes within±0.5 D of the target). In both groups, UCVA was better after the fourth year than it was immediately after the procedure (HMG: P=0.001; CG: P=0.001). Although it differed at one year (P=0.01), the groups' refractive stability tended to converge over four years (P=0.138). Both groups' SI was identical in the four follow-up tests (P=0.734 at D+1; P=0.07 at M+1; P=0.160 at M3 and Y1; and P=0.274 at Y4). For the HMG, SI stability was attained after three months (1.00±0.1); whereas it was attained after one month (0.91±0.11) for the CG. Four years after the surgery, we observed that 87 % of the operated eyes in the HMG were within 0.5 D of the target. SMILE is a good refractive surgery technique for treating high myopia. It yields stable, safe, effective, and predictable results over four years. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

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

An optical wavefront sensor based on a double layer microlens array.

PubMed

Lin, Vinna; Wei, Hsiang-Chun; Hsieh, Hsin-Ta; Su, Guo-Dung John

2011-01-01

In order to determine light aberrations, Shack-Hartmann optical wavefront sensors make use of microlens arrays (MLA) to divide the incident light into small parts and focus them onto image planes. In this paper, we present the design and fabrication of long focal length MLA with various shapes and arrangements based on a double layer structure for optical wavefront sensing applications. A longer focal length MLA could provide high sensitivity in determining the average slope across each microlens under a given wavefront, and spatial resolution of a wavefront sensor is increased by numbers of microlenses across a detector. In order to extend focal length, we used polydimethysiloxane (PDMS) above MLA on a glass substrate. Because of small refractive index difference between PDMS and MLA interface (UV-resin), the incident light is less refracted and focused in further distance. Other specific focal lengths could also be realized by modifying the refractive index difference without changing the MLA size. Thus, the wavefront sensor could be improved with better sensitivity and higher spatial resolution.

Phase conjugate Twyman-Green interferometer for testing spherical surfaces and lenses and for measuring refractive indices of liquids or solid transparent materials

NASA Technical Reports Server (NTRS)

Shukla, R. P.; Dokhanian, Mostafa; Venkateswarlu, Putcha; George, M. C.

1990-01-01

The present paper describes an application of a phase conjugate Twyman-Green interferometer using barium titanate as a self-pumping mirror for testing optical components like concave and convex spherical mirrors and lenses. The aberrations introduced by the beam splitter while testing concave or convex spherical mirrors of large aperture are automatically eliminated due to self-focussing property of the phase conjugate mirror. There is no necessity for a good spherical surface as a reference surface unlike in classical Twyman-Green interferometer or Williams interferometer. The phase conjugate Twyman Green interferometer with a divergent illumination can be used as a test plate for checking spherical surfaces. A nondestructive technique for measuring the refractive indices of a Fabry Perot etalon by using a phase conjugate interferometer is also suggested. The interferometer is found to be useful for measuring the refractive indices of liquids and solid transparent materials with an accuracy of the order of + or - 0.0004.

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.

Geometrical theory to predict eccentric photorefraction intensity profiles in the human eye

NASA Astrophysics Data System (ADS)

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

1995-08-01

In eccentric photorefraction, light returning from the retina of the eye is photographed by a camera focused on the eye's pupil. We use a geometrical model of eccentric photorefraction to generate intensity profiles across the pupil image. The intensity profiles for three different monochromatic aberration functions induced in a single eye are predicted and show good agreement with the measured eccentric photorefraction intensity profiles. A directional reflection from the retina is incorporated into the calculation. Intensity profiles for symmetric and asymmetric aberrations are generated and measured. The latter profile shows a dependency on the source position and the meridian. The magnitude of the effect of thresholding on measured pattern extents is predicted. Monochromatic aberrations in human eyes will cause deviations in the eccentric photorefraction measurements from traditional crescents caused by defocus and may cause misdiagnoses of ametropia or anisometropia. Our results suggest that measuring refraction along the vertical meridian is preferred for screening studies with the eccentric photorefractor.

Subjective method of refractometry and depth of focus

PubMed Central

Sergienko, Nikolai M.; Gromova, Anastasia; Sergienko, Nikolai

2012-01-01

Purpose To study the impact of the depth of focus on subjective refraction and distribution of myopic and hyperopic refractions. Methods A total of 450 eyes of 305 subjects in the age range of 23–34 years were recruited for the study. A distribution of refractions was examined using a traditional method of the subjective refractometry on the basis of point-like posterior focus notion. Correction of the results was made on the assumption that the emmetropic eye retains high visual acuity when applying convex lenses with values which are fewer or equal to the depth of focus values. The following values of the depth of focus were used: ±0.55 D, ±0.35 D and ±0.2 D for visual acuity 1.0, 1.5 and 2.0, respectively. Results Application of the traditional method of refractometry produced the following occurrence of refractions: hypermetropia 59.3%, myopia 22% and emmetropia 18.7%. After correction of the initial results of values of the depth of focus the distribution of refractions was as follows: hypermetropia 12.7%, myopia 22% and emmetropia 65.3%. Conclusion The traditional method of subjective refractometry with application of trial lenses was developed on the basis of data of large optical aberrations and significant depth of focus which values should be taken into account during interpretation of results of subjective refractometry. Our data regarding to prevalence of emmetropic refraction falls in line with basic science provisions in respect of the physiology of the eye.

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.

Adaptive optics in spinning disk microscopy: improved contrast and brightness by a simple and fast method.

PubMed

Fraisier, V; Clouvel, G; Jasaitis, A; Dimitrov, A; Piolot, T; Salamero, J

2015-09-01

Multiconfocal microscopy gives a good compromise between fast imaging and reasonable resolution. However, the low intensity of live fluorescent emitters is a major limitation to this technique. Aberrations induced by the optical setup, especially the mismatch of the refractive index and the biological sample itself, distort the point spread function and further reduce the amount of detected photons. Altogether, this leads to impaired image quality, preventing accurate analysis of molecular processes in biological samples and imaging deep in the sample. The amount of detected fluorescence can be improved with adaptive optics. Here, we used a compact adaptive optics module (adaptive optics box for sectioning optical microscopy), which was specifically designed for spinning disk confocal microscopy. The module overcomes undesired anomalies by correcting for most of the aberrations in confocal imaging. Existing aberration detection methods require prior illumination, which bleaches the sample. To avoid multiple exposures of the sample, we established an experimental model describing the depth dependence of major aberrations. This model allows us to correct for those aberrations when performing a z-stack, gradually increasing the amplitude of the correction with depth. It does not require illumination of the sample for aberration detection, thus minimizing photobleaching and phototoxicity. With this model, we improved both signal-to-background ratio and image contrast. Here, we present comparative studies on a variety of biological samples. © 2015 The Authors Journal of Microscopy © 2015 Royal Microscopical Society.

[Understanding the advantages and disadvantages of femtosecond laser comprehensive applications in ophthalmology].

PubMed

Xie, Li-xin; Gao, Hua

2013-04-01

The femtosecond (FS) laser is a novel laser technology, and is approved clinical application by FDA in 2000. FS laser initially mainly used in corneal refractive surgery to replace the mechanical microkeratome. Since the accuracy and controllability of the FS laser is very high, it shows superiority in the field of corneal refractive surgery. And with the development of the relative hard and software, FS laser is began to used in other fields of ophthalmology, such as corneal transplants, cataract surgery, as well as assisted diagnosis et al., although still have some limitations, the preliminary clinical results have been shown a very good prospects in the ophthalmology fields. Therefore, we reviewed the alternative applications, challenges and limitations, research direction in the future of FS laser, so that provide a reference and revelations for the peers.

Triple ectopic thyroid: A rare entity

PubMed Central

Nilegaonkar, Sujit; Naik, Chetna; Sonar, Sameer; Hirawe, Deepti

2011-01-01

Ectopic thyroid tissue is an uncommon congenital aberration. It is extremely rare to have three ectopic foci at three different sites. The thyroid scan has been used successfully to diagnose ectopic thyroid tissue. We report a case of ectopic thyroid tissue at base of tongue, another at the level of hyoid and third one as aberrant tissue at suprahyoid location in a 16 year old female who presented with swelling in front of neck. This patient was clinically diagnosed as thyroglossal cyst and was being planned for surgery. Preoperative thyroid scan helped in establishing diagnosis of ectopic thyroid which was the only functioning thyroid tissue. Thus, it prevented unnecessary surgery. Therefore it is suggested that thyroid scan and USG/CT scan must be done as routine work up in neck swellings pre operatively to avoid unnecessary surgeries. PMID:23559716

Laser in situ keratomileusis using optimized aspheric profiles and cyclotorsion control to treat compound myopic astigmatism with high cylinder.

PubMed

Alió, Jorge L; Plaza-Puche, Ana B; Martinez, Lorena M; Torky, Magda; Brenner, Luis F

2013-01-01

To evaluate the visual outcomes after laser in situ keratomileusis (LASIK) surgery to correct primary compound myopic astigmatism with high cylinder performed using a fast-repetition-rate excimer laser platform with optimized aspheric profiles and cyclotorsion control. Vissum Corporation and Division of Ophthalmology, Universidad Miguel Hernández, Alicante, Spain. Retrospective consecutive observational nonrandomized noncomparative case series. Eyes with primary compound myopic astigmatism and a cylinder power over 3.00 diopters (D) had uneventful LASIK with femtosecond flap creation and fast-repetition-rate excimer laser ablation with aspheric profiles and cyclotorsion control. Visual, refractive, and aberrometric outcomes were evaluated at the 6-month follow-up. The astigmatic correction was evaluated using the Alpins method and Assort software. The study enrolled 37 eyes (29 patients; age range 19 to 55 years). The significant reduction in refractive sphere and cylinder 3 months and 6 months postoperatively (P<.01) was associated with improved uncorrected distance visual acuity (P<.01). Eighty-seven percent of eyes had a spherical equivalent within ±0.50 D; 7.5% of eyes were retreated. There was no significant induction of higher-order aberrations (HOAs). The targeted and surgically induced astigmatism magnitudes were 3.23 D and 2.96 D, respectively, and the correction index was 0.91. The safety and efficacy indices were 1.05 and 0.95, respectively. Laser in situ keratomileusis for primary compound myopic astigmatism with high cylinder (>3.00 D) performed using a fast-repetition-rate excimer laser with optimized aspheric profiles and cyclotorsion control was safe, effective, and predictable and did not cause significant induction of HOAs. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

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.

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.

[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.

Comparison of Newer IOL Power Calculation Methods for Eyes With Previous Radial Keratotomy

PubMed Central

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

2016-01-01

Purpose To evaluate the accuracy of the optical coherence tomography–based (OCT formula) and Barrett True K (True K) intraocular lens (IOL) calculation formulas in eyes with previous radial keratotomy (RK). Methods In 95 eyes of 65 patients, using the actual refraction following cataract surgery as target refraction, the predicted IOL power for each method was calculated. The IOL prediction error (PE) was obtained by subtracting the predicted IOL power from the implanted IOL power. The arithmetic IOL PE and median refractive PE were calculated and compared. Results All formulas except the True K produced hyperopic IOL PEs at 1 month, which decreased at ≥4 months (all P < 0.05). For the double-K Holladay 1, OCT formula, True K, and average of these three formulas (Average), the median absolute refractive PEs were, respectively, 0.78 diopters (D), 0.74 D, 0.60 D, and 0.59 D at 1 month; 0.69 D, 0.77 D, 0.77 D, and 0.61 D at 2 to 3 months; and 0.34 D, 0.65 D, 0.69 D, and 0.46 D at ≥4 months. The Average produced significantly smaller refractive PE than did the double-K Holladay 1 at 1 month (P < 0.05). There were no significant differences in refractive PEs among formulas at 4 months. Conclusions The OCT formula and True K were comparable to the double-K Holladay 1 method on the ASCRS (American Society of Cataract and Refractive Surgery) calculator. The Average IOL power on the ASCRS calculator may be considered when selecting the IOL power. Further improvements in the accuracy of IOL power calculation in RK eyes are desirable. PMID:27409468

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.

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

Treatment of gingival recession using free gingival graft with fibrin fibronectin sealing system: A novel approach

PubMed Central

Srinivas, B. V. V.; Rupa, N.; Halini Kumari, K. V.; Rajender, A.; Reddy, M. Narendra

2015-01-01

Periodontal plastic surgery is the branch of periodontology that is focused mainly on the correction or elimination of mucogingival problems associated with lack of attached gingiva, a shallow vestibule and aberrant frenum. Various mucogingival surgical procedures are used to halt the progression of the gingival recession and to correct poor esthetic appearance. Free gingival autograft is one of the most common techniques used for a gingival recession in areas of inadequate attached gingiva in the mandibular anterior region. Fibrin sealants are human plasma derivatives that mimic the final stages of blood coagulation, forming a fibrin clot. Fibrin Sealants enhances the overall outcome of surgical intervention because of their hemostatic, adhesive, and healing properties. These properties of fibrin sealants may reduce operating time, prevent complications, and enhance the overall outcome of many surgical interventions. Hence, this case report aims to investigate the clinical effectiveness of free gingival graft along with the commercially available fibrin-fibronectin sealing system (Tissucol®) in the treatment of Miller's class II gingival recession. PMID:26538956

Concept for image-guided vitreo-retinal fs-laser surgery: adaptive optics and optical coherence tomography for laser beam shaping and positioning

NASA Astrophysics Data System (ADS)

Matthias, Ben; Brockmann, Dorothee; Hansen, Anja; Horke, Konstanze; Knoop, Gesche; Gewohn, Timo; Zabic, Miroslav; Krüger, Alexander; Ripken, Tammo

2015-03-01

Fs-lasers are well established in ophthalmic surgery as high precision tools for corneal flap cutting during laser in situ keratomileusis (LASIK) and increasingly utilized for cutting the crystalline lens, e.g. in assisting cataract surgery. For addressing eye structures beyond the cornea, an intraoperative depth resolved imaging is crucial to the safety and success of the surgical procedure due to interindividual anatomical disparities. Extending the field of application even deeper to the posterior eye segment, individual eye aberrations cannot be neglected anymore and surgery with fs-laser is impaired by focus degradation. Our demonstrated concept for image-guided vitreo-retinal fs-laser surgery combines adaptive optics (AO) for spatial beam shaping and optical coherence tomography (OCT) for focus positioning guidance. The laboratory setup comprises an adaptive optics assisted 800 nm fs-laser system and is extended by a Fourier domain optical coherence tomography system. Phantom structures are targeted, which mimic tractional epiretinal membranes in front of excised porcine retina within an eye model. AO and OCT are set up to share the same scanning and focusing optics. A Hartmann-Shack sensor is employed for aberration measurement and a deformable mirror for aberration correction. By means of adaptive optics the threshold energy for laser induced optical breakdown is lowered and cutting precision is increased. 3D OCT imaging of typical ocular tissue structures is achieved with sufficient resolution and the images can be used for orientation of the fs-laser beam. We present targeted dissection of the phantom structures and its evaluation regarding retinal damage.

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.

Visual Outcomes After LASIK Using Topography-Guided vs Wavefront-Guided Customized Ablation Systems.

PubMed

Toda, Ikuko; Ide, Takeshi; Fukumoto, Teruki; Tsubota, Kazuo

2016-11-01

To evaluate the visual performance of two customized ablation systems (wavefront-guided ablation and topography-guided ablation) in LASIK. In this prospective, randomized clinical study, 68 eyes of 35 patients undergoing LASIK were enrolled. Patients were randomly assigned to wavefront-guided ablation using the iDesign aberrometer and STAR S4 IR Excimer Laser system (Abbott Medical Optics, Inc., Santa Ana, CA) (wavefront-guided group; 32 eyes of 16 patients; age: 29.0 ± 7.3 years) or topography-guided ablation using the OPD-Scan aberrometer and EC-5000 CXII excimer laser system (NIDEK, Tokyo, Japan) (topography-guided group; 36 eyes of 19 patients; age: 36.1 ± 9.6 years). Preoperative manifest refraction was -4.92 ± 1.95 diopters (D) in the wavefront-guided group and -4.44 ± 1.98 D in the topography-guided group. Visual function and subjective symptoms were compared between groups before and 1 and 3 months after LASIK. Of seven subjective symptoms evaluated, four were significantly milder in the wavefront-guided group at 3 months. Contrast sensitivity with glare off at low spatial frequencies (6.3° and 4°) was significantly higher in the wavefront-guided group. Uncorrected and corrected distance visual acuity, manifest refraction, and higher order aberrations measured by OPD-Scan and iDesign were not significantly different between the two groups at 1 and 3 months after LASIK. Both customized ablation systems used in LASIK achieved excellent results in predictability and visual function. The wavefront-guided ablation system may have some advantages in the quality of vision. It may be important to select the appropriate system depending on eye conditions such as the pattern of total and corneal higher order aberrations. [J Refract Surg. 2016;32(11):727-732.]. Copyright 2016, SLACK Incorporated.

Quality of image of grating target placed in model of human eye with corneal aberrations as observed through multifocal intraocular lenses.

PubMed

Inoue, Makoto; Noda, Toru; Mihashi, Toshifumi; Ohnuma, Kazuhiko; Bissen-Miyajima, Hiroko; Hirakata, Akito

2011-04-01

To evaluate the quality of the image of a grating target placed in a model eye viewed through multifocal intraocular lenses (IOLs). Laboratory investigation. Refractive (NXG1 or PY60MV) or diffractive (ZM900 or SA60D3) multifocal IOLs were placed in a fluid-filled model eye with human corneal aberrations. A United States Air Force resolution target was placed on the posterior surface of the model eye. A flat contact lens or a wide-field contact lens was placed on the cornea. The contrasts of the gratings were evaluated under endoillumination and compared to those obtained through a monofocal IOL. The grating images were clear when viewed through the flat contact lens and through the central far-vision zone of the NXG1 and PY60MV, although those through the near-vision zone were blurred and doubled. The images observed through the central area of the ZM900 with flat contact lens were slightly defocused but the images in the periphery were very blurred. The contrast decreased significantly in low frequencies (P<.001). The images observed through the central diffractive zone of the SA60D3 were slightly blurred, although the images in the periphery were clearer than that of the ZM900. The images were less blurred in all of the refractive and diffractive IOLs with the wide-field contact lens. Refractive and diffractive multifocal IOLs blur the grating target but less with the wide-angle viewing system. The peripheral multifocal optical zone may be more influential on the quality of the images with contact lens system. Copyright © 2011 Elsevier Inc. All rights reserved.

Axial ultrasound B-scans of the entire eye with a 20-MHz linear array: correction of crystalline lens phase aberration by applying Fermat's principle.

PubMed

Mateo, Tony; Chang, Alexandre; Mofid, Yassine; Pisella, Pierre-Jean; Ossant, Frederic

2014-11-01

In ophthalmic ultrasonography the crystalline lens is known to be the main source of phase aberration, causing a significant decrease in resolution and distortion effects on axial B-scans. This paper proposes a computationally efficient method to correct the phase aberration arising from the crystalline lens, including refraction effects using a bending ray tracing approach based on Fermat's principle. This method is used as a basis to perform eye-adapted beamforming (BF), with appropriate focusing delays for a 128-element 20-MHz linear array in both emission and reception. Implementation was achieved on an in-house developed experimental ultrasound scanning device, the ECODERM. The proposed BF was tested in vitro by imaging a wire phantom through an eye phantom consisting of a synthetic gelatin lens anatomically set up in an appropriate liquid (turpentine) to approach the in vivo velocity ratio. Both extremes of accommodation shapes of the human crystalline lens were investigated. The performance of the developed BF was evaluated in relation to that in homogeneous medium and compared to a conventional delay-and-sum (DAS) BF and a second adapted BF which was simplified to ignore the lens refraction. Global expectations provided by our method with the transducer array are reviewed by an analysis quantifying both image quality and spatial fidelity, as well as the detrimental effects of a crystalline lens in conventional reconstruction. Compared to conventional array imaging, the results indicated a two-fold improvement in the lateral resolution, greater sensitivity and a considerable reduction of spatial distortions that were sufficient to envisage reliable biometry directly in B-mode, especially phakometry.

Analysis of Macular and Retinal Nerve Fiber Layer Thickness in Children with Refractory Amblyopia after Femtosecond Laser-assisted Laser In situ Keratomileusis: A Retrospective Study

PubMed Central

Zhao, Peng-Fei; Zhou, Yue-Hua; Zhang, Jing; Wei, Wen-Bin

2017-01-01

Background: Localized macular edema and retinal nerve fiber layer (RNFL) thinning have been reported shortly after laser in situ keratomileusis (LASIK) in adults. However, it is still unclear how LASIK affects the retina of children. This study aimed to investigate the macular retina and RNFL thickness in children with refractive amblyopia who underwent femtosecond laser-assisted LASIK (FS-LASIK). Methods: In this study, we included 56 eyes of 32 patients with refractive amblyopia who underwent FS-LASIK in our hospital from January 2012 to December 2016. Foveal (foveal center retinal, parafoveal retinal, and perifoveal), macular inner retinal (superior and inferior), and peripapillary RNFL thicknesses (superior, inferior, temporal, and nasal) were measured using Fourier-domain optical coherence tomography before surgery and 1 day, 3 days, and 1 week after surgery. We divided these patients into three groups based on their refractive error: High myopic group with 22 eyes (equivalent sphere, >6.00 D), mild myopic group with 19 eyes (equivalent sphere, 0–6.00 D), and hyperopic group with 15 eyes (equivalent sphere, >+0.50 D). We compared the macular retina and RNFL thickness before and after LASIK. A paired simple t-test was used for data analysis. Results: One week after surgery, the visual acuity for all 56 eyes of the 32 patients reached their preoperative best-corrected vision. Visual acuity improved two lines or better for 31% of the patients. The residual refractive errors in 89% of the patients were within ±0.5 D. In the high myopic group, the foveal center retinal and parafoveal retinal thicknesses were thicker 1 day and 3 days after surgery than before surgery (t = 2.689, P = 0.012; t = 2.383, P = 0.018, respectively); no significant difference was found 1 week after surgery (P > 0.05). The foveal center retinal and parafoveal retinal thicknesses were greater 1 day after surgery than they were before surgery (P = 0.000 and P = 0.005, respectively) in the mild myopic and hyperopic groups. No significant difference was found 3 days or 1 week after surgery (P > 0.05). In all three groups, no significant difference was found in the macular inner retinal or peripapillary RNFL thickness 1 day, 3 days, or 1 week after surgery (P > 0.05). Conclusions: The foveal center retinal edema after FS-LASIK is mild and reversible in children, that mostly occurred in the high myopic group with no effect on the visual acuity, and is always relieved within 1 week. PMID:28875960

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

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

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

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.

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.

[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 < 0,05). There were no complications after surgery.Refractive surgery in children, multizonal LASEK and pIOL Verisyse implantation, are effective and safe methods for correction of high myopic anisometropia, and has an important role in the treatment of amblyopia in children when contact lens intolerance. Visual acuity and binocular vision outcomes were better in children who received permanent surgical correction of anisometropia, than in children conventionally treated by contact lenses. myopic anisometropia, amblyopia, children, laser subepithelial keratomileusis (LASEK), anterior chamber phakic intraocular lenses (AC pIOL), binocular vision.

The art of nomograms.

PubMed

Arba Mosquera, Samuel; de Ortueta, Diego; Verma, Shwetabh

2018-01-01

To retrospectively analyse strategies for adjusting refractive surgery plans with reference to the preoperative manifest refraction. We constructed seven nomograms based on the refractive outcomes (sphere, cylinder, axis [SCA]) of 150 consecutive eyes treated with laser in situ keratomileusis for myopic astigmatism. We limited the initial data to the SCA of the manifest refraction. All nomograms were based on the strategy: if for x diopters (D) of attempted metric, y D is achieved; we can reverse this sentence and state for achieving y D of change in the metric, x D will be planned. The effects of the use of plus or minus astigmatism notation, spherical equivalent, sphere, principal meridians notation, cardinal and oblique astigmatism, and astigmatic axis were incorporated. All nomograms detected subtle differences in the spherical component ( p  < 0.0001). Nomograms 5 and 7 (using power vectors) and 6 (considering axis shifts) detected significant astigmatic differences (nomogram 5, p  < 0.001; nomogram 6, p  < 0.05; nomogram 7, p  < 0.005 for cardinal astigmatism, p  = 0.1 for oblique astigmatism). We observed mild clinically relevant differences (~ 0.5 D) in sphere or astigmatism among the nomograms; differences of ~ 0.25 D in the proposals for sphere or cylinder were not uncommon. All nomograms suggested minor improvements versus actual observed outcomes, with no clinically relevant differences among them. All nomograms anticipated minor improvements versus actual observed outcomes without clinically relevant differences among them. The minimal uncertainties in determining the manifest refraction (~ 0.6 D) are the major limitation to improving the accuracy of refractive surgery nomograms.

Outcomes of Cataract Surgery in Urban and Rural Population in the South Indian State of Andhra Pradesh: Rapid Assessment of Visual Impairment (RAVI) Project.

PubMed

Marmamula, Srinivas; Khanna, Rohit C; Shekhar, Konegari; Rao, Gullapalli N

2016-01-01

To assess the visual outcomes after cataract surgery among urban and rural population aged ≥40 years in the South India state of Andhra Pradesh. A population based cross-sectional study was conducted in which 7800 subjects were sampled from two rural and one urban location. Visual Acuity was assessed and eye examination were performed by trained personnel. A questionnaire was used to collect personal and demographic information, and history of cataract surgery. Blindness and moderate Visual Impairment (MVI) was defined as presenting VA <6/60 and <6/18 to 6/60 in the better eye respectively. In total, 7378 (94.6%) were examined. Of these, 1228 eyes of 870 individuals were operated for cataract. The mean age of operated subjects was 63.7 years (SD: 10.7 years). Overall, 56.3% of those operated were women, 76% were illiterate and 42% of them were using spectacles after cataract surgery. Even after surgery, 12.2% of the operated eyes had MVI and blindness was seen in 14.7% of the eyes. A significantly higher proportion of subjects in urban area had good outcome as compared to those in the rural area (p = 0.01). Uncorrected refractive error (58.7%) was the leading cause of MVI, and posterior segment disease (34.3%) was the leading cause of blindness. On applying multiple logistic regression, risk factors for poor outcomes were age ≥ 70 years (OR: 1.9, 95% CI: 1.3-2.8), rural residence (OR: 1.3, 95% CI:1.0-1.8) and presence of aphakia (OR: 8.9, 95% CI: 5.7-13.8). Post cataract surgery, refractive errors remain an important correctable cause of MVI, in the south Indian state of Andhra Pradesh. The correction of refractive errors is required to provide good visual recovery and achieve the benefit of cataract surgery.

Comparison of visual results and higher-order aberrations after small incision lenticule extraction (SMILE): high myopia vs. mild to moderate myopia.

PubMed

Jin, Hong-Ying; Wan, Ting; Wu, Fang; Yao, Ke

2017-07-06

To compare the refractive results and higher-order aberrations (HOAs) after small incision lenticule extraction (SMILE) in high myopia and mild to moderate myopia patients. This prospective study included 165 eyes (86 patients) undergoing SMILE. According to the preoperative spherical equivalent (SE), treated eyes were divided into two groups: the high myopia group (more than -6.0 D, group-H) and the mild to moderate group (less than -6.0 D, group-M). Follow-up intervals were at 1 day, 10 days, 1 month and 3 months postoperatively. We obtained the following parameters: uncorrected (UDVA) and corrected distance visual acuity (CDVA), SE, efficacy and safety index, and HOAs. Preoperative SE was -7.16 ± 0.93 D in group-H and -4.34 ± 0.97 D in group-M. At 3 months postoperatively, the SE in group-H and group-M was -0.20 ± 0.37 D and 0.01 ± 0.19 D (t = - 4.11, P<0.05), respectively. It was found that 77% and 98% had an UDVA of 20/20, 98% and 99% had a CDVA of 20/20 in group-H and group-M, respectively, while 87% and 95% had a SE within ±0.5 D and ±1.0 D in group-H, and 98% and 100% in group-M. The efficacy indexes were 0.98 ± 0.18 in group-H and 1.05 ± 0.10 in group-M (t = - 3.084, p < 0.05). The safety indexes were 1.06 ± 0.09 and 1.06 ± 0.09 (t = 0.153, p > 0.05), respectively. There were significant increases in total HOAs, 3 rd -order coma, and 4 th -order spherical aberrations. SMILE is an effective and safe surgery for correcting myopia. But the target correction amount in high myopia patients should be adjusted to avoid undercorrection and acquired more satisfaction. SMILE induced increases of HOAs. ChiTrial registration number: ChiCTR-OON-16009164 . Retrospectively registered: 06.September.2016.

The evolution of lenses.

PubMed

Land, Michael F

2012-11-01

Structures which bend light and so form images are present in all the major phyla. Lenses with a graded refractive index, and hence reduced spherical aberration, evolved in the vertebrates, arthropods, annelid worms, and several times in the molluscs. Even cubozoan jellyfish have lens eyes. In some vertebrate eyes, multiple focal lengths allow some correction for chromatic aberration. In land vertebrates the cornea took over the main ray-bending task, leaving accommodation as the main function of the lens. The spiders are the only other group to make use of a single cornea as the optical system in their main eyes, and some of these - the salticids - have evolved a remarkable system based on image scanning. Similar scanning arrangements are found in some crustaceans, sea-snails and insect larvae. © 2012 The College of Optometrists.

Optofluidic lens with tunable focal length and asphericity

PubMed Central

Mishra, Kartikeya; Murade, Chandrashekhar; Carreel, Bruno; Roghair, Ivo; Oh, Jung Min; Manukyan, Gor; van den Ende, Dirk; Mugele, Frieder

2014-01-01

Adaptive micro-lenses enable the design of very compact optical systems with tunable imaging properties. Conventional adaptive micro-lenses suffer from substantial spherical aberration that compromises the optical performance of the system. Here, we introduce a novel concept of liquid micro-lenses with superior imaging performance that allows for simultaneous and independent tuning of both focal length and asphericity. This is achieved by varying both hydrostatic pressures and electric fields to control the shape of the refracting interface between an electrically conductive lens fluid and a non-conductive ambient fluid. Continuous variation from spherical interfaces at zero electric field to hyperbolic ones with variable ellipticity for finite fields gives access to lenses with positive, zero, and negative spherical aberration (while the focal length can be tuned via the hydrostatic pressure). PMID:25224851

Whole-angle spherical retroreflector using concentric layers of homogeneous optical media.

PubMed

Oakley, John P

2007-03-01

Spherical retroreflectors have a much greater acceptance angle than conventional retroreflectors such as corner cubes. However, the optical performance of known spherical reflectors is limited by spherical aberration. It is shown that third-order spherical aberration may be corrected by using two or more layers of homogeneous optical media of different refractive indices. The performance of the retroreflector is characterized by the scattering (or radar) cross section, which is calculated by using optical design software. A practical spherical reflector is described that offers a significant increase in optical performance over existing devices. No gradient index components are required, and the device is constructed by using conventional optical materials and fabrication techniques. The experimental results confirm that the device operates correctly at the design wavelength of 690 nm.

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.

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.

Models for joint ophthalmology-optometry patient management.

PubMed

Kim, John J; Kim, Christine M

2011-07-01

American Academy of Ophthalmology (AAO) and American Society of Cataract and Refractive Surgery (ASCRS) presented a joint position paper in February 2000 declaring that they do not support routine comanagement of patients with the optometrists. American Optometric Association and American Academy of Optometry quickly responded in support of AAO and ASCRS. All four entities did not preclude legitimate and proper comanagement arrangements. Since that time, the pattern of practice has changed, requiring us to rethink our positions. This paper is written to provide a possible model for the ophthalmology-optometry practice management in ophthalmic surgeries including refractive surgery. Since the publication of the Joint Position Paper, the concept of comanagement has faded and a new model of integrated management has evolved. This has occurred as the changes in the employment pattern of the ophthalmic practice have incorporated optometrists into its fold. This evolution allowed ophthalmic and optometric community to co-exist and thrive to provide better patient care.

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.

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

Measuring ocular characteristics after gel injection adjustable keratoplasty (GIAK) in the rabbit

NASA Astrophysics Data System (ADS)

Comander, Jason I.; Parel, Jean-Marie A.; Simon, Gabriel; Takesue, Yoshiko; Villain, Franck L.

1995-05-01

Gel Injection Adjustable Keratoplasty (GIAK) is a refractive surgery procedure which uses an ocular ring implant made of a polyethylene oxide hydrogel to cause a refractive change in the cornea. Unlike laser photo refractive keratectomy, GIAK does not interfere with the central cornea because the ring lies around the optical axis. Thus, vision can be assessed immediately after surgery. Our in vivo study was designed to quantify GIAK's effects on tissues, the biocompatibility of the polymer and in the process investigate which ocular changes in the rabbit model can be monitored with precision using current technology. Thirty-two young rabbits underwent a delamination in one eye, 22 of which were injected with a new polymeric gel. Corneal topography, keratometry, pachymetry, and tonometry were performed on both eyes for up to 105 days. All corneas flattened with growth. In GIAK animals, we found an average flattening of 6.51 +/- 1.23 diopters (p < 0.0001) relative to the fellow eye. No statistically significant regression over the 102 days was observed. Intraocular pressure dropped slightly by 0.69 +/- 1.21 mmHg (p equals 0.025), a clinically insignificant value, while no significant change was detected in corneal thickness. Keratometry can be tracked in rabbits after GIAK surgery from POD 1. Measuring unoperated fellow eyes allows for the effects of surgery to be assessed without bias from growth. Using this protocol, GIAK was shown to be stable. It was more difficult to draw conclusions from pachymetry, tonometry, and topography data.

Ronchi test for characterization of nanofocusing optics at a hard x-ray free-electron laser.

PubMed

Nilsson, Daniel; Uhlén, Fredrik; Holmberg, Anders; Hertz, Hans M; Schropp, Andreas; Patommel, Jens; Hoppe, Robert; Seiboth, Frank; Meier, Vivienne; Schroer, Christian G; Galtier, Eric; Nagler, Bob; Lee, Hae Ja; Vogt, Ulrich

2012-12-15

We demonstrate the use of the classical Ronchi test to characterize aberrations in focusing optics at a hard x-ray free-electron laser. A grating is placed close to the focus and the interference between the different orders after the grating is observed in the far field. Any aberrations in the beam or the optics will distort the interference fringes. The method is simple to implement and can provide single-shot information about the focusing quality. We used the Ronchi test to measure the aberrations in a nanofocusing Fresnel zone plate at the Linac Coherent Light Source at 8.194 keV.

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

Predictability of SMILE over four years in high myopes.

PubMed

Burazovitch, J; Naguzeswski, D; Beuste, T; Guillard, M

2017-06-01

To determine whether the visual outcomes of the refractive surgery technique small incision lenticule extraction (SMILE), are stable, effective, and predictable for high myopia over a four-year period. This is a retrospective study. The data were collected between March 2012 and July 2016. Two hundred and forty-eight patients participated in the study; that is, 496 eyes: 140 eyes of 70 patients (52 women/18 men) were classified into the highly myopic group (refraction measured in spherical equivalent (RMSE)>-6 D), and 356 eyes of 178 patients (98 women/80 men) into the control group (RMSE<-6 D). Follow-up tests were conducted immediately following the procedure (D+1), after three months, after one year, and after four years. Refraction, uncorrected visual acuity (UCVA), and best visual corrected acuity (BCVA) were measured. The highly myopic group (HMG) contained more women, and astigmatism was higher for this group than for the control group (CG). These were BCVA, refractive stability, the index of safety (SI: BCVA preoperatively D+1/BCVA postoperatively), and predictability (the percentage of eyes within±0.5 D of the target). In both groups, UCVA was better after the fourth year than it was immediately after the procedure (HMG: P=0.001; CG: P=0.001). Although it differed at one year (P=0.01), the groups' refractive stability tended to converge over four years (P=0.138). The groups' SI was found to be identical in the four follow-up tests (P=0.734 at D+1; P=0.07 at M+1; P=0.160 at M3 and Y1; and P=0.274 at Y4). For the HMG, SI stability was attained after three months (1.00±0.1); whereas it was attained after one month (0.91±0.11) for the CG. Four years after the surgery, we observed that 87% of the operated-upon eyes in the HMG were within 0.5 D of the target. SMILE is a good refractive surgery technique for treating high myopia. It yields stable, safe, effective, and predictable results over four years. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

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.

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).

Medical malpractice predictors and risk factors for ophthalmologists performing LASIK and PRK surgery.

PubMed Central

Abbott, Richard L

2003-01-01

PURPOSE: To identify physician predictors in laser-assisted in-situ keratomileusis (LASIK) and photorefractive keratectomy (PRK) surgery that correlate with a higher risk for malpractice liability claims and lawsuits. METHODOLOGY: A retrospective, longitudinal, cohort study comparing physician characteristics of 100 consecutive Ophthalmic Mutual Insurance Company (OMIC) LASIK and PRK claims and suits to demographic and practice pattern data for all active refractive surgeons insured by OMIC between 1996 and 2002. Background information and data were obtained from OMIC underwriting applications, a physician practice pattern survey, and claims file records. Using an outcome of whether or not a physician had a prior history of a claim or suit, logistic regression analyses were used separately for each predictor as well as controlling for refractive surgery volume. RESULTS: Logistic regression analysis demonstrated that the most important predictor of filing a claim was surgical volume, with those performing more surgery having a greater risk of incurring a claim (odds ratio [OR], 31.4 for >1,000/year versus 0 to 20/year; 95% confidence interval [CI], 7.9 - 125; P = .0001). Having one or more prior claims was the only other predictor examined that remained statistically significant after controlling for patient volume (OR, 6.4; 95% CI 2.5 - 16.4; P = .0001). Physician gender, advertising, preoperative time spent with patient, and comanagement appeared to be strong predictors in multivariate analyses when surgical volume was greater than 100 cases per year. CONCLUSION: The chances of incurring a malpractice claim or suit for PRK or LASIK correlates significantly with higher surgical volume and a history of a prior claim or suit. Additional risk factors that increase in importance with higher surgical volume include gender, advertising, preoperative time spent with patient, and comanagement with optometrists. These findings may be used in the future to help improve the quality of care for patients undergoing refractive surgery and provide data for underwriting criteria and risk management protocols to proactively manage and reduce the risk of claims and lawsuits against refractive surgeons. PMID:14971582

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 specificity of 91% and a sensitivity of 96% in this series. A quantitative method can be used to identify eyes at risk for developing ectasia after LASIK that, if validated, represents a significant improvement over current screening strategies.

Pseudolentogenic astigmatic effect of multifocal intraocular lenses: non-corneal ocular residual astigmatism (N-CORA) as a new parameter in astigmatic change analysis.

PubMed

Frings, Andreas; Steinberg, Johannes; Druchkiv, Vasyl; Linke, Stephan J; Katz, Toam

2017-08-01

This study was initiated to introduce the term non-corneal ocular residual astigmatism (N-CORA) as a new parameter in astigmatic change analysis after implantation of two different types of non-toric, multifocal intraocular lenses (MIOL). Seventy-two eyes from 72 consecutive patients after MIOL surgery were studied in terms of a retrospective, cross-sectional data analysis. Two types of spherical MIOL were used. Surgical technique in all patients was a 2.4-mm incision phacoemulsification, performed by one surgeon. To investigate the magnitude and axis of astigmatic changes, the true corneal astigmatism and Alpins vector method were applied. There were no statistically significant between-group differences related to the preoperative refraction or ocular residual astigmatism (ORA). After surgery, the mean refractive surgically induced astigmatism (RSIA) and the topographic SIA (TSIA) did not differ significantly between the lenses. The magnitude and orientation of ORA and N-CORA changed after surgery. There are no statistically significant differences in postoperative ORA in magnitude or axis when implanting different types of MIOL. The similarity of N-CORA between both MIOL types shows that both diffractive and refractive asymmetric MIOLs with plate haptics have the same pseudolentogenic astigmatic effect which could be presented in terms of the newly introduced parameter N-CORA.

[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.

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

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.

Cataracts

MedlinePlus

... Oncology Oculoplastics/Orbit Refractive Management/Intervention Retina/Vitreous Uveitis Focus On Pediatric Ophthalmology ... Are Cataracts? Pediatric Cataracts Cataract Diagnosis and Treatment Cataract Surgery IOL Implants: Lens Replacement After Cataracts ...

[Multifocal phakic intraocular lens implant to correct presbyopia].

PubMed

Baikoff, G; Matach, G; Fontaine, A; Ferraz, C; Spera, C

2005-03-01

Presbyopic surgery is considered as the new frontier in refractive surgery. Different solutions are proposed: myopization of one eye, insertion of an accommodative crystalline lens, scleral surgery, the effects of which are still unknown, and finally multifocal phakic implants. We therefore decided to undertake a prospective study under the Huriet law to determine its efficacy and specify the conditions required for an anterior chamber multifocal phakic implant. Fifty-five eyes of 33 patients received an anterior chamber foldable multifocal phakic implant. Twenty-one females and 12 males underwent surgery. Initial refraction was between -5D and +5D. The implant's single addition was +2.50. Recuperating a distant uncorrected visual acuity of 0.6 or better and near uncorrected vision of Parinaud 3 or better can be considered a very good postoperative result. Average follow-up was 42.6+/-18 weeks. Mean postoperative refraction was -0.12+/-0.51 D. Mean postoperative uncorrected visual acuity was 0.78+/-0.20. Postoperative uncorrected visual acuity was Parinaud 2.3+/-0.6. Eighty-four percent of eyes operated on recuperated 0.6 or better without correction and Parinaud 3 or better without correction. Lenses in four eyes were explanted for different reasons, essentially optical, and no severe anatomical complications were observed. Placing an anterior chamber multifocal phakic implant to correct presbyopia is an effective technique with good predictability and has the advantage of being reversible in case of intolerance, optical parasite effects or undesired complications. Considering the particularity of this surgery, it is imperative to respect very strict inclusion criteria: anterior chamber depth equal to or above 3.1 mm, open angle, endothelial cell count equal to or above 2000 cells/mm2, absence of an incipient cataract or the slightest evidence of macular alteration.

Changes in astigmatism and corneal higher-order aberrations after phacoemulsification with toric intraocular lens implantation for mild keratoconus with cataract.

PubMed

Kamiya, Kazutaka; Shimizu, Kimiya; Miyake, Toshiyuki

2016-07-01

To assess the changes in astigmatism and higher-order aberrations (HOAs) after toric intraocular lens (IOL) implantation for mild non-progressive keratoconus with cataract. We prospectively examined 19 eyes of 19 consecutive keratoconic patients (mean age ± standard deviation, 63.1 ± 9.1 years) who underwent phacoemulsification with toric IOL implantation. We determined uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), refractive astigmatism, corneal astigmatism, corneal HOAs and astigmatic axis rotation both preoperatively and 3 months postoperatively. Logarithm of the minimal angle of resolution (logMAR) UDVA was significantly improved from 1.14 ± 0.50 preoperatively to 0.46 ± 0.33 postoperatively (Wilcoxon signed-rank test, p < 0.001). LogMAR CDVA was also significantly improved from 0.27 ± 0.45 preoperatively to -0.01 ± 0.09 postoperatively (p < 0.001). In 5 of 6 eyes in which the target refraction was emmetropia, postoperative UDVA was better than 20/32. The achieved spherical equivalent correction was within ±0.5 diopters (D) of the targeted correction in 13 (68 %) eyes and 1.0 in 18 (95 %) eyes. The refractive astigmatism was significantly decreased from -1.92 ± 1.73 D preoperatively to -0.70 ± 0.60 D postoperatively (p = 0.006). The corneal astigmatism changed from 2.89 ± 1.30 D preoperatively to 2.98 ± 1.09 D postoperatively (p = 0.492), which was not statistically significant. The corneal HOAs for a 4-mm pupil was changed from 0.47 ± 0.23 µm preoperatively to 0.52 ± 0.26 µm postoperatively (p = 0.211), which was not statistically significant. According to our experience, toric IOL implantation for mild keratoconic patients having rigid gas-permeable lens intolerance appears to be effective for reducing refractive astigmatism without a significant induction of corneal HOAs.

Molecular Solutions to Low Injuries Resulting from Battlefield Injuries

DTIC Science & Technology

2007-05-01

nerve regeneration; (5) dry eye bydetermining how to minimize dry eye after LASIK refractive surgery by developing new tests to predict pre-disposition...Conjunctiva after Corneal Wounding Mimicking Nerve Loss in LASIK Surgery, Invest. Ophthalmol. Vis. Sci. 2006 47: E-Abstract 4600. CONCLUSIONS We...Mimicking Nerve Loss in LASIK Surgery, Invest. Ophthalmol. Vis. Sci. 2006 47: E-Abstract 4600. Table 1. Alterations in phosphoprotein levels in non-wounded

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.

Personalized pseudophakic model

NASA Astrophysics Data System (ADS)

Ribeiro, F.; Castanheira-Dinis, A.; Dias, J. M.

2014-08-01

With the aim of taking into account all optical aberrations, a personalized pseudophakic optical model was designed for refractive evaluation using ray tracing software. Starting with a generic model, all clinically measurable data were replaced by personalized measurements. Data from corneal anterior and posterior surfaces were imported from a grid of elevation data obtained by topography, and a formula for the calculation of the intraocular lens (IOL) position was developed based on the lens equator. For the assessment of refractive error, a merit function minimized by the approximation of the Modulation Transfer Function values to diffraction limit values on the frequencies corresponding up to the discrimination limits of the human eye, weighted depending on the human contrast sensitivity function, was built. The model was tested on the refractive evaluation of 50 pseudophakic eyes. The developed model shows good correlation with subjective evaluation of a pseudophakic population, having the added advantage of being independent of corrective factors, allowing it to be immediately adaptable to new technological developments. In conclusion, this personalized model, which uses individual biometric values, allows for a precise refractive assessment and is a valuable tool for an accurate IOL power calculation, including in conditions to which population averages and the commonly used regression correction factors do not apply, thus achieving the goal of being both personalized and universally applicable.

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.