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.

The Unevenness and Non-orthogonal State of Distribution of Corneal Thickness and the Influence on Correction of Myopic Astigmatism by LASEK.

PubMed

Wang, Shulin; Wang, Xin; Liu, Mingna; Wang, Haiying; Li, Jing; Shi, Weiyun

2015-09-01

To observe and calculate the unevenness and the non-orthogonal state of distribution of corneal thickness and the relationship between them using Pentacam and to investigate the influence of unevenness and the non-orthogonal state on correction of myopic astigmatism by laser subepithelial keratomileusis (LASEK). 230 eyes with myopic astigmatism treated with LASEK were divided into two groups: 114 eyes as the low astigmatism group (-0.25 to -0.75 DC) and 116 eyes as the midrange-high astigmatism group (-1.00 to -4.50 DC). With the help of the diagram of keratoconus evaluation program of the Pentacam, the D 3.0 and D 6.5 were calculated for the index of distribution of unevenness of the corneal thickness, and the absolute value of the angle between the maximum and minimum progression-index orientation (M 90) for the index of non-orthogonal states. The correction of myopic astigmatism by LASEK was based on standard vector analysis and power vector analysis. The follow-up period was for 3 months. The preoperative M 90 was 22.14° ± 20.87°, D 6.5 was 58.66 ± 21.32 μm, and D 3.0 was 16.11 ± 4.28 μm for the 230 eyes that were tested. The D 6.5 of low astigmatism group (55.62 ± 20.81) μm was significantly lower than that of midrange-high astigmatism group (61.65 ± 21.48) μm (P < 0.05). Of the 230 eyes, the M 90 was positively correlated with D 6.5 (r = 0.37, P < 0.001), and D 6.5 was positively correlated with D 3.0 (r = 0.56, P < 0.001). 3 months postoperatively, the absolute error vector (|EV|) of low astigmatism group (0.46 ± 0.34) was significantly lower than that of midrange-high astigmatism group (0.53 ± 0.29) (P < 0.01). The error of magnitude of low astigmatism group (-0.10 ± 0.31) was significantly lower than that of midrange-high astigmatism group (0.08 ± 0.41) (P < 0.001). The absolute error of angle (|EA|) of low astigmatism group (26.10 ± 27.24) was significantly higher than that of midrange-high

Effect of iris registration on outcomes of FEMTOLASIK for myopia and myopic astigmatism.

PubMed

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

2017-09-05

To compare the visual and refractive outcomes after FEMTOLASIK with and without iris registration. In this randomized, prospective, comparative, contralateral eye study, 118 eyes of 59 patients with myopia and myopic astigmatism underwent LASIK using the Femto LDV femtosecond laser (160 µm) and the MEL80 with or without iris registration. For each patient, iris registration FEMTOLASIK was performed on one eye and non-iris registration FEMTOLASIK was performed on the other eye, assigned at random. Patients were evaluated before and 12 months. Uncorrected visual acuity, best-corrected visual acuity, manifest refraction, contrast sensitivity, and higher-order aberrations (HOAs) were evaluated. At 12 months, the mean UDVA was 0.002 ± 0.07 logMAR (20/19) in iris registration eyes and 0.00 ± 0.06 logMAR (20/24) in non-iris registration eyes (P = 0.9). 61% of iris registration eyes and 71.2% of non-iris registration eyes achieved a UDVA of 20/20 or better (P = 0.31); 98.3% of eyes with the iris registration FEMTOLASIK and 94.9% with the non-iris registration FEMTOLASIK were within ±0.50 D from emmetropia (P = 0.71). No statistically significant difference was found in postoperative contrast sensitivity between groups at 3, 6, 12, or 18 cycles/degree (P > 0.05). There was significant increase in total HOA root mean square in two groups. The mean error magnitude of surgically induced astigmatism 12 months postoperatively was -0.33 in iris registration eyes and -0.24 in the non-iris registration eyes (P = 0.36). FEMTOLASIK with and without iris registration provides similar results in myopic and myopic astigmatism patients.

Manual limbal markings versus iris-registration software for correction of myopic astigmatism by laser in situ keratomileusis.

PubMed

Shen, Elizabeth P; Chen, Wei-Li; Hu, Fung-Rong

2010-03-01

To compare the efficacy and safety of manual limbal markings and wavefront-guided treatment with iris-registration software in laser in situ keratomileusis (LASIK) for myopic astigmatism. National Taiwan University Hospital, Taipei, Taiwan. Eyes with myopic astigmatism had LASIK with a Technolas 217z laser. Eyes in the limbal-marking group had conventional LASIK (PlanoScan or Zyoptix tissue-saving algorithm) with manual cyclotorsional-error adjustments according to 2 limbal marks. Eyes in the iris-registration group had wavefront-guided ablation (Zyoptix) in which cyclotorsional errors were automatically detected and adjusted. Refraction, corneal topography, and visual acuity data were compared between groups. Vector analysis was by the Alpins method. The mean preoperative spherical equivalent (SE) was -6.64 diopters (D) +/- 1.99 (SD) in the limbal-marking group and -6.72 +/- 1.86 D in the iris-registration group (P = .92). At 6 months, the mean SE was -0.42 +/- 0.63 D and -0.47 +/- 0.62 D, respectively (P = .08). There was no statistically significant difference between groups in the astigmatism correction, success, or flattening index values using 6-month postoperative refractive data. The angle of error was within +/-10 degrees in 73% of eyes in the limbal-marking group and 75% of eyes in the iris-registration group. Manual limbal markings and iris-registration software were equally effective and safe in LASIK for myopic astigmatism, showing that checking cyclotorsion by manual limbal markings is a safe alternative when automated systems are not available. Copyright 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Comparison of femtosecond laser small-incision lenticule extraction and laser-assisted subepithelial keratectomy to correct myopic astigmatism.

PubMed

Qian, Yishan; Huang, Jia; Zhou, Xingtao; Wang, Yutung

2015-11-01

To compare the efficacy of correcting myopic astigmatism with femtosecond laser small-incision lenticule extraction (SMILE, Carl Zeiss Meditec AG) versus laser-assisted subepithelial keratectomy (LASEK). The study was conducted at the Ophthalmology Department, Eye and ENT Hospital, Shanghai, China. A retrospective, cross-sectional study. This study included patients who underwent small-incision lenticule extraction or LASEK for the correction of myopia and myopic astigmatism. Preoperative and 6-month postoperative astigmatism values were analyzed. The efficacies of the 2 surgeries to correct astigmatism were compared. A total of 180 right eyes of 180 patients (small-incision lenticule extraction: n = 113, LASEK: n = 67) were included. No significant difference was found between the 2 groups in the preoperative astigmatism (small-incision lenticule extraction: 1.16 ± 0.85D, LASEK: 1.16 ± 0.83D, P > .05) or the postoperative astigmatism (small-incision lenticule extraction: 0.35 ± 0.37D; LASEK: 0.31 ± 0.42D, P > .05), determined by manifest refraction. No significant difference was found between the 2 groups in surgically induced astigmatism vector (small-incision lenticule extraction: 1.13 ± 0.83D, LASEK: 1.01 ± 0.65D, P > .05). The correction index was higher for the small-incision lenticule extraction group (1.05 ± 0.53) than for the LASEK group (0.95 ± 0.21, P = .045). The postoperative astigmatism was significantly higher for the small-incision lenticule extraction group when the preoperative astigmatism was 1.0 D or less (small-incision lenticule extraction: 0.26 ± 0.30D, LASEK: 0.12 ± 0.20D, P = .007) and lower for the small-incision lenticule extraction group when the preoperative astigmatism was more than 2.0 D (small-incision lenticule extraction: 0.48 ± 0.37D, LASEK: 0.89 ± 0.46D, P = .002). An adjustment of nomograms for correcting low astigmatism (≤1.0 D) by small-incision lenticule extraction is suggested due to the tendency toward

Comparison of two techniques of marking the horizontal axis during excimer laser keratorefractive surgery for myopic astigmatism.

PubMed

Burka, Jenna M; Bower, Kraig S; Cute, David L; Stutzman, Richard D; Subramanian, Prem S; Rabin, Jeff C

2005-04-01

To compare two methods of limbal marking used during laser refractive surgery for myopic astigmatism. Retrospective chart review. Forty-two eyes of 42 patients who underwent photorefractive keratectomy (PRK) or laser-assisted in-situ keratomileusis (LASIK) for myopic astigmatism were marked preoperatively to identify the horizontal axis. In 18 eyes, marks were placed at the slit lamp (SL) with the slit beam set at 180 degrees as a reference. In 24 eyes, marks were placed in the laser room (LR) immediately before reclining under the laser. All treatments were performed with the Alcon LADARVision excimer laser system. Vector analysis of postoperative cylinder and reduction in cylinder and uncorrected and best-corrected visual acuity were evaluated for both groups. The mean postoperative magnitude of error was -0.19 +/- 0.44 diopters for the LR group and -0.09 +/- 0.42 diopters for the SL group (P = .439, NS). Both groups had a mean angle of error indicating an overall counterclockwise rotation of axis with an angle of error of 6.3 +/- 8.7 degrees for the LR group and 8.0 +/- 10.2 degrees for the SL group (P = .562, NS). We found no significant difference in outcomes with an overall trend toward undercorrection of cylinder in both groups, leaving room for improvement after refractive surgery for myopic astigmatism.

Comparison of Wavelight Allegretto Eye-Q and Schwind Amaris 750S excimer laser in treatment of high astigmatism.

PubMed

Bohac, Maja; Biscevic, Alma; Koncarevic, Mateja; Anticic, Marija; Gabric, Nikica; Patel, Sudi

2014-10-01

To compare functional outcomes of Wavelight Allegretto Eye-Q 400Hz and Schwind Amaris 750S excimer laser for astigmatism between 2 and 7 diopters(D). Prospective comparative non-randomized case series of 480 eyes assigned in two laser groups and further divided into myopic and mixed astigmatism subgroups. All treatments were centered on corneal vertex. One-year results were compared between the groups. Statistical analysis was performed using z-test. Both Allegretto and Amaris postoperative uncorrected distance visual acuity (UDVA) improved in comparison to preoperative corrected distance visual acuity (CDVA). The difference was significant in the Allegretto group for myopic astigmatism (p = 0.017). There was no difference in postoperative UDVA between lasers. Average sphere decreased in all groups for both lasers (p < 0.001) without difference in effectiveness of spherical correction between lasers for both groups. In Allegretto, average cylinder decreased from -3.30D to -0.55D in myopic astigmatism (p < 0.001) and from -3.84D to -0.85D in mixed astigmatism (p < 0.001). In Amaris average cylinder decreased from -3.21D to -0.43D in myopic astigmatism (p < 0.001) and from -3.66D to -0.58D in mixed astigmatism (p < 0.001). Amaris group had less residual astigmatism (myopic astigmatism p = 0.023, mixed astigmatism p < 0.001). Mean spherical aberration shifted from positive to negative in mixed astigmatism for both lasers. Both lasers are effective in terms of UDVA, CDVA, spherical correction, and preservation of high-order aberrations. However, Amaris was more effective in cylinder correction.

Comparative analysis of the efficacy of astigmatic correction after wavefront-guided and wavefront-optimized LASIK in low and moderate myopic eyes

PubMed Central

Khalifa, Mounir A.; Alsahn, Mahmoud F.; Shaheen, Mohamed Shafik; Pinero, David P.

2017-01-01

AIM To evaluate and compare the efficacy of the astigmatic correction achieved with laser in situ keratomileusis (LASIK) in eyes with myopic astigmatism using wavefront-guided (WFG) and wavefront-optimized (WFO) ablation profiles. METHODS Prospective study included 221 eyes undergoing LASIK: 99 and 122 eyes with low and moderate myopic astigmatism (low and moderate myopia groups). Two subgroups were differentiated in each group according to the ablation profile: WFG subgroup, 109 eyes (45/64, low/moderate myopia groups) treated using the Advanced CustomVue platform (Abbott Medical Optics Inc.), and WFO subgroup, 112 eyes (54/58, low/moderate myopia groups) treated using the EX-500 platform (Alcon). Clinical outcomes were evaluated during a 6-month follow-up, including a vector analysis of astigmatic changes. RESULTS Significantly better postoperative uncorrected visual acuity and efficacy index was found in the WFG subgroups of each group (P≤0.041). Postoperative spherical equivalent and cylinder were significantly higher in WFO subgroups (P≤0.003). In moderate myopia group, a higher percentage of eyes with a postoperative cylinder ≤0.25 D was found in the WFG subgroup (90.6% vs 65.5%, P=0.002). In low and moderate myopia groups, the difference vector was significantly higher in the WFO subgroup compared to WFG (P<0.001). In moderate myopia group, the magnitude (P=0.008) and angle of error (P<0.001) were also significantly higher in the WFO subgroup. Significantly less induction of high order aberrations were found with WFG treatments in both low and moderate myopia groups (P≤0.006). CONCLUSION A more efficacious correction of myopic astigmatism providing a better visual outcome is achieved with WFG LASIK compared to WFO LASIK. PMID:28251090

Matched population comparison of visual outcomes and patient satisfaction between 3 modalities for the correction of low to moderate myopic astigmatism

PubMed Central

Ganesh, Sri; Brar, Sheetal; Pawar, Archana

2017-01-01

Purpose To compare toric implantable collamer lens (T-ICL), femto-LASIK, and ReLEx SMILE for the treatment of low to moderate myopic astigmatism in terms of long-term visual and refractive outcomes and predictability of astigmatic correction. Materials and methods The study included 30 eyes from 30 patients between the age groups of 21 and 40 years, undergoing bilateral surgery with any of the three procedures – T-ICL, femto-LASIK, or ReLEx SMILE – for correction of myopic astigmatism within the range of −3 to −8 D spherical equivalent (SE), with a minimum astigmatism of −0.75 D. Patients were followed up at day 1, 1 month, 6 months, and 1 year. Results At 1 year, the mean cylinder reduced to −0.21±0.28, −0.17±0.36, and −0.22±0.28 D in the T-ICL, femto-LASIK, and ReLEx SMILE group, respectively. The predictability of astigmatism correction was comparable, with no statistically significant difference between the 3 groups (P>0.05). A total of 97% of eyes in ReLEx SMILE achieved a uncorrected distance visual acuity of 20/20 or better, compared to T-ICL (93%) and FS-LASIK (90%). However, gain in lines of corrected distant visual acuity (CDVA) was maximum in T-ICL group (60%). Four eyes in the femto-LASIK group had loss of CDVA by one line. Three eyes required exchange due to high vault and rotation of the T-ICL, which did not affect the final outcome. Conclusion All 3 modalities were effective for myopic astigmatism at the end of 1 year. Quality of vision and patient satisfaction with T-ICL and ReLEx SMILE were similar and better than FS-LASIK. However, slight chances of postoperative rotation and exchange exist with T-ICL, which warrant thorough preoperative planning. PMID:28740361

Effect of Iris registration on visual outcome in wavefront-guided LASEK for myopic astigmatism.

PubMed

Lee, Jong Joo; Kim, Mee Kum; Wee, Won Ryang

2018-04-01

This study aimed to investigate the effect of iris registration (IR) on visual outcomes in wavefront-guided LASEK for myopic astigmatism. The retrospective chart review was performed for wavefront-guided LASEK using VISX Star S4 in patients with myopic astigmatism (cylinder ≥ 1.00 diopter[D]). Eyes were divided into IR group (LASEK with IR at the time of surgery) and Non-IR group (LASEK without IR system + failed-IR engagement during LASEK). Visual acuity (VA), astigmatism, higher-order aberration (HOA), and contrast sensitivity were assessed preoperatively and 3 months postoperatively. The IR and Non-IR groups were subcategorized depending on the spherical equivalent (lower myopia ≤-5.00 D vs. higher myopia >-5.00 D) for the comparison of HOA changes. Postoperative uncorrected VAs showed no differences between IR (n = 30) and Non-IR (n = 46). In astigmatic vector analyses, no differences were noted in the mean magnitude of error and the mean angle of error between two groups. There were no differences in postoperative total HOA, spherical aberration (SA), coma, and trefoil between the groups, either. The total HOA and SA increased in both groups, while coma increased only in Non-IR. In higher myopia, ΔRMS of coma was smaller in IR. Preoperative and postoperative total HOA were linearly correlated in Non-IR, but not for IR. Contrast sensitivity of 12 cycles per degree improved in both groups. IR had similar outcomes to conventional trackers in wavefront-guided LASEK, with less tendency of inducing coma, especially in higher myopia.

Functional outcome and patient satisfaction after laser in situ keratomileusis for correction of myopia and myopic astigmatism.

PubMed

Bamashmus, Mahfouth A; Hubaish, Khammash; Alawad, Mohammed; Alakhlee, Hisham

2015-01-01

The purpose was to evaluate subjective quality of vision and patient satisfaction after laser in situ keratomileusis (LASIK) for myopia and myopic astigmatism. A self-administered patient questionnaire consisting 29 items was prospectively administered to LASIK patients at the Yemen Magrabi Hospital. Seven scales covering specific aspects of the quality of vision were formulated including; global satisfaction; quality of uncorrected and corrected vision; quality of night vision; glare; daytime driving and; night driving. Main outcome measures were responses to individual questions and scale scores and correlations with clinical parameters. The scoring scale ranged from 1 (dissatisfied) to 3 (very satisfied) and was stratified in the following manner: 1-1.65 = dissatisfied; 1.66-2.33 = satisfied and; 2.33-3 = very satisfied. Data at 6 months postoperatively are reported. This study sample was comprised of 200 patients (122 females: 78 males) ranging in age from 18 to 46 years old. The preoperative myopic sphere was - 3.50 ± 1.70 D and myopic astigmatism was 0.90 ± 0.82 D. There were 96% of eyes within ± 1.00 D of the targeted correction. Postoperatively, the uncorrected visual acuity was 20/40 or better in 99% of eyes. The mean score for the overall satisfaction was 2.64 ± 0.8. A total of 98.5% of patients was satisfied or very satisfied with their surgery, 98.5% considered their main goal for surgery was achieved. Satisfaction with uncorrected vision was 2.5 ± 0.50. The main score for glare was 1.98 ± 0.7 at night. Night driving was rated more difficult preoperatively by 6.2%, whereas 79% had less difficulty driving at night. Patient satisfaction with uncorrected vision after LASIK for myopia and myopic astigmatism appears to be excellent and is related to the residual refractive error postoperatively.

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.

Evaluation of iris recognition system for wavefront-guided laser in situ keratomileusis for myopic astigmatism.

PubMed

Ghosh, Sudipta; Couper, Terry A; Lamoureux, Ecosse; Jhanji, Vishal; Taylor, Hugh R; Vajpayee, Rasik B

2008-02-01

To evaluate the visual and refractive outcomes of wavefront-guided laser in situ keratomileusis (LASIK) using an iris recognition system for the correction of myopic astigmatism. Centre for Eye Research Australia, Melbourne Excimer Laser Research Group, and Royal Victorian Eye and Ear Hospital, East Melbourne, Victoria, Australia. A comparative analysis of wavefront-guided LASIK was performed with an iris recognition system (iris recognition group) and without iris recognition (control group). The main parameters were uncorrected visual acuity (UCVA), best spectacle-corrected visual acuity, amount of residual cylinder, manifest spherical equivalent (SE), and the index of success using the Alpins method of astigmatism analysis 1 and 3 months postoperatively. A P value less than 0.05 was considered statistically significant. Preoperatively, the mean SE was -4.32 diopters (D) +/- 1.59 (SD) in the iris recognition group (100 eyes) and -4.55 +/- 1.87 D in the control group (98 eyes) (P = .84). At 3 months, the mean SE was -0.05 +/- 0.21 D and -0.20 +/- 0.40 D, respectively (P = .001), and an SE within +/-0.50 D of emmetropia was achieved in 92.0% and 85.7% of eyes, respectively (P = .07). At 3 months, the UCVA was 20/20 or better in 90.0% and 76.5% of eyes, respectively. A statistically significant difference in the amount of astigmatic correction was seen between the 2 groups (P = .00 and P = .01 at 1 and 3 months, respectively). The index of success was 98.0% in the iris recognition group and 81.6% in the control group (P = .03). Iris recognition software may achieve better visual and refractive outcomes in wavefront-guided LASIK for myopic astigmatism.

LASIK for spherical refractive myopia: effect of topographic astigmatism (ocular residual astigmatism, ORA) on refractive outcome.

PubMed

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

2015-01-01

In eyes with a preoperative plano refractive cylinder, it would appear that there is no rationale for astigmatic treatment. The aim of this retrospective, cross-sectional data analysis was to determine the amount of topographic astigmatism in refractive plano eyes that results in reduced efficacy after myopic laser in situ keratomileusis (LASIK). This study included 267 eyes from 267 consecutive myopic patients with a refractive plano cylinder. Receiver operating characteristic analysis was used to find the cut-off values of preoperative ocular residual astigmatism (= topographic astigmatism) that can best discriminate between groups of efficacy and safety indices in preoperative plano refractive cylinder eyes. Preoperative ocular residual astigmatism (ORA) (or topographic astigmatism) of ≤0.9 diopters (D) resulted in an efficacy index of at least 0.8 statistically significantly more frequently than eyes with a preoperative ORA of >0.9 D. Eyes with a high ORA preoperatively also had a high ORA postoperatively. Regression analysis showed that each diopter of preoperative ORA reduced efficacy by 0.07. A preoperative corneal astigmatism of ≥0.9 D could (partially) be taken into account in the LASIK design, even if the subjective refractive astigmatism is neutral.

Astigmatism in Chinese primary school children: prevalence, change, and effect on myopic shift.

PubMed

Chan, Shao-En; Kuo, Hsi-Kung; Tsai, Chia-Ling; Wu, Pei-Chang

2018-05-01

To study the prevalence, type, and progression of astigmatism in primary school children, and its effect on myopic shift. A prospective study carried out in a primary school in southern Taiwan. The study was performed on a subset of children, one year after initial examination. Refractive error measured by cycloplegic autorefraction was the main study outcome. Astigmatism was recorded as negative cylinder form, and we defined clinical significant astigmatism (CSA) as cylinder refraction -1.0 D or greater. Myopia was defined as a spherical equivalent refraction (SER) of -0.50 D or greater. Three hundred sixty-two children, mean age was 8.97 y/o (SD 1.41; range 7 to 11 y/o) participated in the study. One hundred nineteen (32.9 %) subjects had CSA at the initial screening. The mean cylinder refraction was -0.80 + 0.84 diopters (D) (-5.25 D to 0.00 D), with predominant with rule astigmatism (69.7%). In the 183 children studied longitudinally, the mean cylinder refraction was reduced from -0.74 D to -0.58 D (p< 0.05). The cylinder refraction in the initial CSA group was not associated with SER change (p=0.99) or axial length change (p=0.55). Compared to the initial non-CSA group, the initial CSA group had no significant difference in axial length elongation (p=0.20). The prevalence of astigmatism was not low in the Chinese primary school children and with-the-rule astigmatism was predominant. The astigmatism decreased during the 1 year follow-up. The CSA was not associated with myopia progression (p=0.99).

Functional Outcome and Patient Satisfaction after Laser In Situ Keratomileusis for Correction of Myopia and Myopic Astigmatism

PubMed Central

Bamashmus, Mahfouth A.; Hubaish, Khammash; Alawad, Mohammed; Alakhlee, Hisham

2015-01-01

Purpose: The purpose was to evaluate subjective quality of vision and patient satisfaction after laser in situ keratomileusis (LASIK) for myopia and myopic astigmatism. Patients and Methods: A self-administered patient questionnaire consisting 29 items was prospectively administered to LASIK patients at the Yemen Magrabi Hospital. Seven scales covering specific aspects of the quality of vision were formulated including; global satisfaction; quality of uncorrected and corrected vision; quality of night vision; glare; daytime driving and; night driving. Main outcome measures were responses to individual questions and scale scores and correlations with clinical parameters. The scoring scale ranged from 1 (dissatisfied) to 3 (very satisfied) and was stratified in the following manner: 1-1.65 = dissatisfied; 1.66-2.33 = satisfied and; 2.33-3 = very satisfied. Data at 6 months postoperatively are reported. Results: This study sample was comprised of 200 patients (122 females: 78 males) ranging in age from 18 to 46 years old. The preoperative myopic sphere was − 3.50 ± 1.70 D and myopic astigmatism was 0.90 ± 0.82 D. There were 96% of eyes within ± 1.00 D of the targeted correction. Postoperatively, the uncorrected visual acuity was 20/40 or better in 99% of eyes. The mean score for the overall satisfaction was 2.64 ± 0.8. A total of 98.5% of patients was satisfied or very satisfied with their surgery, 98.5% considered their main goal for surgery was achieved. Satisfaction with uncorrected vision was 2.5 ± 0.50. The main score for glare was 1.98 ± 0.7 at night. Night driving was rated more difficult preoperatively by 6.2%, whereas 79% had less difficulty driving at night. Conclusion: Patient satisfaction with uncorrected vision after LASIK for myopia and myopic astigmatism appears to be excellent and is related to the residual refractive error postoperatively. PMID:25624684

Vector analysis of astigmatic correction after small-incision lenticule extraction and femtosecond-assisted LASIK for low to moderate myopic astigmatism.

PubMed

Chan, Tommy C Y; Ng, Alex L K; Cheng, George P M; Wang, Zheng; Ye, Cong; Woo, Victor C P; Tham, Clement C Y; Jhanji, Vishal

2016-04-01

To compare astigmatic correction between femtosecond-assisted laser in situ keratomileusis (LASIK) and small-incision lenticule extraction (SMILE). A total of 111 patients were included in this prospective study. Fifty-seven eyes were treated with LASIK and 54 eyes were treated with SMILE for myopia with low to moderate (-0.25 to -4.0 D) astigmatism. Uncorrected distance visual acuity (UDVA), corrected distance visual acuity and manifest refraction were measured preoperatively and at 1 and 3 months postoperatively. Visual and refractive outcomes were reported. Changes in refractive astigmatism were evaluated using vector analysis. Preoperative characteristics were similar between both groups. The UDVA at 1 and 3 months was better in the LASIK group compared with the SMILE group (p<0.009). Postoperative cylinder was higher in the SMILE group (p<0.001). Fewer eyes attained the attempted cylindrical correction in the SMILE group (p<0.029). Vector analysis showed no significant difference in target-induced astigmatism (p=0.091) and angle of error (p>0.596) between the two groups. Surgically induced astigmatism was significantly lower in the SMILE group (p<0.023), while the difference vector (p<0.001) and absolute angle of error (p<0.016) were significantly higher in the SMILE group. No significant difference was found in these parameters between 1 and 3 months in both groups (p>0.122). Our results showed that SMILE offered a less favourable astigmatic correction comparable to femtosecond-assisted LASIK in eyes with low to moderate myopic astigmatism. The alignment of treatment was more variable in SMILE, leading to a lower efficacy compared with LASIK by 3 months postoperatively. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

LASIK for Spherical Refractive Myopia: Effect of Topographic Astigmatism (Ocular Residual Astigmatism, ORA) on Refractive Outcome

PubMed Central

Frings, Andreas; Richard, Gisbert; Steinberg, Johannes; Skevas, Christos; Druchkiv, Vasyl; Katz, Toam; Linke, Stephan J.

2015-01-01

Purpose In eyes with a preoperative plano refractive cylinder, it would appear that there is no rationale for astigmatic treatment. The aim of this retrospective, cross-sectional data analysis was to determine the amount of topographic astigmatism in refractive plano eyes that results in reduced efficacy after myopic laser in situ keratomileusis (LASIK). Methods This study included 267 eyes from 267 consecutive myopic patients with a refractive plano cylinder. Receiver operating characteristic analysis was used to find the cut-off values of preoperative ocular residual astigmatism (= topographic astigmatism) that can best discriminate between groups of efficacy and safety indices in preoperative plano refractive cylinder eyes. Results Preoperative ocular residual astigmatism (ORA) (or topographic astigmatism) of ≤0.9 diopters (D) resulted in an efficacy index of at least 0.8 statistically significantly more frequently than eyes with a preoperative ORA of >0.9 D. Eyes with a high ORA preoperatively also had a high ORA postoperatively. Regression analysis showed that each diopter of preoperative ORA reduced efficacy by 0.07. Conclusion A preoperative corneal astigmatism of ≥0.9 D could (partially) be taken into account in the LASIK design, even if the subjective refractive astigmatism is neutral. PMID:25875476

Clinical outcomes of Transepithelial photorefractive keratectomy to treat low to moderate myopic astigmatism.

PubMed

Xi, Lei; Zhang, Chen; He, Yanling

2018-05-09

To evaluate the refractive and visual outcomes of Transepithelial photorefractive keratectomy (TransPRK) in the treatment of low to moderate myopic astigmatism. This retrospective study enrolled a total of 47 eyes that had undergone Transepithelial photorefractive keratectomy. Preoperative cylinder diopters ranged from - 0.75D to - 2.25D (mean - 1.11 ± 0.40D), and the sphere was between - 1.50D to - 5.75D. Visual outcomes and vector analysis of astigmatism that included error ratio (ER), correction ratio (CR), error of magnitude (EM) and error of angle (EA) were evaluated. At 6 months after TransPRK, all eyes had an uncorrected distance visual acuity of 20/20 or better, no eyes lost ≥2 lines of corrected distant visual acuity (CDVA), and 93.6% had residual refractive cylinder within ±0.50D of intended correction. On vector analysis, the mean correction ratio for refractive cylinder was 1.03 ± 0.30. The mean error magnitude was - 0.04 ± 0.36. The mean error of angle was 0.44° ± 7.42°and 80.9% of eyes had axis shift within ±10°. The absolute astigmatic error of magnitude was statistically significantly correlated with the intended cylinder correction (r = 0.48, P < 0.01). TransPRK showed safe, effective and predictable results in the correction of low to moderate astigmatism and myopia.

Vector analysis of astigmatism before and after LASIK: a comparison of two different platforms for treatment of high astigmatism.

PubMed

Biscevic, Alma; Bohac, Maja; Koncarevic, Mateja; Anticic, Marija; Dekaris, Iva; Patel, Sudi

2015-12-01

To compare the outcomes of astigmatic laser in-situ keratomileusis (LASIK) procedures between two different platforms using J0 and J45 vector analysis. Patients were divided into four groups, depending on the type of astigmatism and laser platform on which they were treated. Astigmatism was between 2 and 7 diopters (D). One hundred and thirty-five patients with myopic astigmatism (246 eyes) and 102 patients with mixed astigmatism (172 eyes) underwent unremarkable LASIK correction on Wavelight Allegretto Eye-Q 400Hz and Schwind Amaris 750S laser platform. The preoperative and postoperative sphere, negative cylinder [C] and axis (ø) of manifest refractions were subjected to vector analysis by calculations of the standard J0 (cos [4π(ø-90)/360]xC/2) and J45 (sin[4π(ø-90)/360]xC/2). Reporting the key results, we found J0 significantly reduced after LASIK in both groups (p < 0.001) but not J45. There was no significant association between individual pairs of pre and postoperative J0 & J45 values. There was no significant difference between the outcomes of the two platforms. Wavelight Allegretto 400Hz and Schwind Amaris 750S showed excellent results for treating patients with astigmatism, regardless whether it is mixed or myopic astigmatism. The J45 did not reduce significantly possibly because of the low number of eyes with oblique astigmatism. There was no genuine difference post-operatively between groups treated on two different laser platforms according to the vector analyses.

Astigmatism among myopics and its changes from childhood to adult age: a 23-year follow-up study.

PubMed

Pärssinen, Olavi; Kauppinen, Markku; Viljanen, Anne

2015-05-01

To study the prevalence of and changes in astigmatism from the onset of myopia at school age. Two hundred and forty myopic schoolchildren (mean age 10.9 years), with no previous spectacles, were recruited during 1983-1984 to a randomized 3-year clinical trial of bifocal treatment of myopia. Three annual examinations with subjective cycloplegic refraction were performed for 237-238 subjects. Subsequent examinations were performed at the mean ages of 23.2 and 33.9 years for 178 and 163 subjects, and the last examination, including data from prescriptions of different ophthalmologists, for 32 subjects. Corneal topography was studied at baseline, at the 3-year follow-up and at the two adulthood follow-ups. Prevalence and changes in refractive astigmatism (RA), in its polar values J0 and J45, and corneal astigmatism (CA) were studied. Mean RA of the right eye increased during follow-up from 0.26 D (SD) ± 0.30 to 0.79 D ± 0.74. Mean CA was 1.07 D ± 0.74 at study end. The prevalence of RA ≥0.25 or ≥1.00 D increased from 54.9 and 3.8% to 83.4 and 34.4%, respectively. The main direction of the axis of RA and its polar value J0 and CA changed mainly through sphericity, from against the rule (ATR) to with the rule during the follow-up. There was a negative correlation between RA and spherical refraction in the ATR group at end of follow-up. Changes in RA were associated with increase in myopia and with changes in CA. The prevalence and mean amount of RA associated with CA increased, and the axis of astigmatism changed among myopics during the 23-year follow-up. © 2014 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Polar Value Analysis of Low to Moderate Astigmatism with Wavefront-Guided Sub-Bowman Keratomileusis

PubMed Central

Zhang, Yu

2017-01-01

Purpose To evaluate the astigmatic outcomes of wavefront-guided sub-Bowman keratomileusis (WFG-SBK) for low to moderate myopic astigmatism. Methods This study enrolled 100 right eyes from 100 patients who underwent WFG-SBK for the correction of myopia and astigmatism. The polar value method was performed with anterior and posterior corneal astigmatism measured with Scheimpflug camera combined with Placido corneal topography (Sirius, CSO) and refractive astigmatism preoperatively and 1 month, 3 months, and 6 months postoperatively. Results Similar results for surgically induced astigmatism (SIA) and error of the procedure in both anterior corneal astigmatism (ACA) and total ocular astigmatism (TOA). There was a minor undercorrection of the cylinder in both ACA and TOA. Posterior corneal astigmatism (PCA) showed no significant change. Conclusions Wavefront-guided SBK could provide good astigmatic outcomes for the correction of low to moderate myopic astigmatism. The surgical effects were largely attributed to the astigmatic correction of the anterior corneal surface. Posterior corneal astigmatism remained unchanged even after WFG-SBK for myopic astigmatism. Polar value analysis can be used to guide adjustments to the treatment cylinder alongside a nomogram designed to optimize postoperative astigmatic outcomes in myopic WFG-SBK. PMID:28831306

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

PubMed

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

2017-01-01

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

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

PubMed Central

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

2017-01-01

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

Single-Step Transepithelial PRK vs Alcohol-Assisted PRK in Myopia and Compound Myopic Astigmatism Correction.

PubMed

Kaluzny, Bartlomiej J; Cieslinska, Iwona; Mosquera, Samuel A; Verma, Shwetabh

2016-02-01

Transepithelial photorefractive keratectomy (tPRK), where both the epithelium and stroma are removed in a single-step, is a relatively new procedure of laser refractive error correction. This study compares the 3-month results of myopia and compound myopic astigmatism correction by tPRK or conventional alcohol-assisted PRK (aaPRK).This prospective, nonrandomized, case-control study recruited 148 consecutive patients; 93 underwent tPRK (173 eyes) and 55 aaPRK (103 eyes). Refractive results, predictability, safety, and efficacy were evaluated during the 3-month follow-up. The main outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and mean refractive spherical equivalent (MRSE).Mean preoperative MRSE was -4.30 ± 1.72 D and -4.33 ± 1.96 D, respectively (P = 0.87). The 3-month follow-up rate was 82.1% in the tPRK group (n = 145) and 86.4% in aaPRK group (n = 90), P = 0.81. Postoperative UDVA was 20/20 or better in 97% and 94% of eyes, respectively (P = 0.45). In the tPRK and aaPRK groups, respectively, 13% and 21% of eyes lost 1 line of CDVA, and 30% and 31% gained 1 or 2 lines (P = 0.48). Mean postoperative MRSE was -0.14 ± 0.26 D in the tPRK group and -0.12 ± 0.20 D in the aaPRK group (P = 0.9). The correlation between attempted versus achieved MRSE was equally high in both groups.Single-step transepithelial PRK and conventional PRK provide very similar results 3 months postoperatively. These procedures are predictable, effective, and safe for correction of myopia and compound myopic astigmatism.

Results of Intraoperative Manual Cyclotorsion Compensation for Myopic Astigmatism in Patients Undergoing Small Incision Lenticule Extraction (SMILE).

PubMed

Ganesh, Sri; Brar, Sheetal; Pawar, Archana

2017-08-01

To study the safety, efficacy, and outcomes of manual cyclotorsion compensation in small incision lenticule extraction (SMILE) for myopic astigmatism. Eligible patients with myopia from -1.00 to -10.00 diopters (D) spherical equivalent with a minimum astigmatism of 0.75 D undergoing SMILE were included. Intraoperative cyclotorsion compensation was performed by gently rotating the cone and aligning the 0° to 180° limbal marks with the horizontal axis of the reticule of the right eye piece of the microscope of the femtosecond laser after activating the suction. In this study, 81 left eyes from 81 patients were analyzed for vector analysis of astigmatism. The mean cyclotorsion was 5.64° ± 2.55° (range: 2° to 12°). No significant differences were found for surgically induced astigmatism, difference vector, angle of error (AE), correction index, magnitude of error, index of success (IOS), and flattening index between 2 weeks and 3 months postoperatively (P > .05). The eyes were categorized into low (≤ 1.50 D, n = 37) and high (> 1.50 D, n = 44) cylinder groups. At 3 months, intergroup analysis showed a comparable correction index of 0.97 for the low and 0.93 for the high cylinder groups, suggesting a slight undercorrection of 3% and 7%, respectively (P = .14). However, the AE and IOS were significantly lower in the high compared to the low cylinder group (P = .032 and .024 for AE and IOS, respectively), suggesting better alignment of the treatment in the high cylinder group. However, the mean uncorrected distance visual acuity of both groups was comparable (P = .21), suggesting good visual outcomes in the low cylinder group despite a less favorable IOS. Manual compensation may be a safe, feasible, and effective approach to refine the results of astigmatism with SMILE, especially in higher degrees of cylinders. [J Refract Surg. 2017;33(8):506-512.]. Copyright 2017, SLACK Incorporated.

Multiple regression analysis in nomogram development for myopic wavefront laser in situ keratomileusis: Improving astigmatic outcomes.

PubMed

Allan, Bruce D; Hassan, Hala; Ieong, Alvin

2015-05-01

To describe and evaluate a new multiple regression-derived nomogram for myopic wavefront laser in situ keratomileusis (LASIK). Moorfields Eye Hospital, London, United Kingdom. Prospective comparative case series. Multiple regression modeling was used to derive a simplified formula for adjusting attempted spherical correction in myopic LASIK. An adaptation of Thibos' power vector method was then applied to derive adjustments to attempted cylindrical correction in eyes with 1.0 diopter (D) or more of preoperative cylinder. These elements were combined in a new nomogram (nomogram II). The 3-month refractive results for myopic wavefront LASIK (spherical equivalent ≤11.0 D; cylinder ≤4.5 D) were compared between 299 consecutive eyes treated using the earlier nomogram (nomogram I) in 2009 and 2010 and 414 eyes treated using nomogram II in 2011 and 2012. There was no significant difference in treatment accuracy (variance in the postoperative manifest refraction spherical equivalent error) between nomogram I and nomogram II (P = .73, Bartlett test). Fewer patients treated with nomogram II had more than 0.5 D of residual postoperative astigmatism (P = .0001, Fisher exact test). There was no significant coupling between adjustments to the attempted cylinder and the achieved sphere (P = .18, t test). Discarding marginal influences from a multiple regression-derived nomogram for myopic wavefront LASIK had no clinically significant effect on treatment accuracy. Thibos' power vector method can be used to guide adjustments to the treatment cylinder alongside nomograms designed to optimize postoperative spherical equivalent results in myopic LASIK. mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Vector analysis of high (≥3 diopters) astigmatism correction using small-incision lenticule extraction and laser in situ keratomileusis.

PubMed

Chan, Tommy C Y; Wang, Yan; Ng, Alex L K; Zhang, Jiamei; Yu, Marco C Y; Jhanji, Vishal; Cheng, George P M

2018-06-13

To compare the astigmatic correction in high myopic astigmatism between small-incision lenticule extraction and laser in situ keratomileusis (LASIK) using vector analysis. Hong Kong Laser Eye Center, Hong Kong. Retrospective case series. Patients who had correction of myopic astigmatism of 3.0 diopters (D) or more and had either small-incision lenticule extraction or femtosecond laser-assisted LASIK were included. Only the left eye was included for analysis. Visual and refractive results were presented and compared between groups. The study comprised 105 patients (40 eyes in the small-incision lenticule extraction group and 65 eyes in the femtosecond laser-assisted LASIK group.) The mean preoperative manifest cylinder was -3.42 D ± 0.55 (SD) in the small-incision lenticule extraction group and -3.47 ± 0.49 D in the LASIK group (P = .655). At 3 months, there was no significant between-group difference in uncorrected distance visual acuity (P = .915) and manifest spherical equivalent (P = .145). Ninety percent and 95.4% of eyes were within ± 0.5 D of the attempted cylindrical correction for the small-incision lenticule extraction and LASIK group, respectively (P = .423). Vector analysis showed comparable target-induced astigmatism (P = .709), surgically induced astigmatism vector (P = .449), difference vector (P = .335), and magnitude of error (P = .413) between groups. The absolute angle of error was 1.88 ± 2.25 degrees in the small-incision lenticule extraction group and 1.37 ± 1.58 degrees in the LASIK group (P = .217). Small-incision lenticule extraction offered astigmatic correction comparable to LASIK in eyes with high myopic astigmatism. Copyright © 2018 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Rapidly progressive idiopathic lenticular astigmatism.

PubMed

Tint, Naing L; Jayaswal, Rakesh; Masood, Imran; Maharajan, V Senthil

2007-02-01

A myopic 43-year-old woman with early nuclear sclerotic cataract developed more than 11.0 diopters (D) of astigmatism over a 6-month period. This was found to be lenticular in origin. Phacoemulsification with intraocular lens implantation was performed, resulting in residual astigmatism of 0.75 D. To our knowledge, this is the first case of rapidly progressive lenticular astigmatism in an otherwise healthy eye with early nuclear sclerotic cataract.

Refractive Lenticule Transplantation for Correction of Iatrogenic Hyperopia and High Astigmatism After LASIK.

PubMed

Lazaridis, Apostolos; Reinstein, Dan Z; Archer, Timothy J; Schulze, Stephan; Sekundo, Walter

2016-11-01

To design a technique for intrastromal transplantation of stromal lenticules with specific refractive power for correction of post-LASIK induced hyperopia and astigmatism. A 28-year-old patient was referred for consultation after complicated LASIK for moderate myopia and astigmatism. The refractive error of the right eye was severely overcorrected due to data entry error. Post-LASIK refraction showed high astigmatism (right eye: +6.50 -9.00 @ 84°) and corrected distance visual acuity (CDVA) of 20/32. The corneal thickness was 282 µm. A refractive lenticule transplantation was performed due to contact lens intolerance, poor visual acuity, and severe anisometropia. A toric and myopic lenticule, obtained from a donor using the femtosecond lenticule extraction technique, was implanted under the flap to reduce the refractive error, bring the refraction of the eye to the level correctable by phakic intraocular lens, and restore corneal volume. Six weeks postoperatively, the donor lenticule was spread smoothly in the interface with a minor temporal decentration in relation to pupil center. The refraction showed a reduction of astigmatism but a stronger myopization compared to preoperative calculations (right eye: -6.50 -4.00 @ 70°). At 3 months, the CDVA returned to the preoperative value of 20/32. One year postoperatively, corneal tomography showed no signs of ectasia and biomicroscopy revealed no signs of rejection. After implanting a toric myopic implantable collamer lens, the patient regained uncorrected distance visual acuity of 20/40 and full stereopsis. The refractive lenticule transplantation technique offers a solution for rare cases of post-LASIK hyperopia and high astigmatism while restoring the volume of thin corneas. Moreover, it is a reversible procedure with low probability of rejection. [J Refract Surg. 2016;32(11):780-786.]. Copyright 2016, SLACK Incorporated.

Early visual outcomes and optical quality after femtosecond laser small-incision lenticule extraction for myopia and myopic astigmatism correction of over -10 dioptres.

PubMed

Qin, Bing; Li, Meiyan; Chen, Xun; Sekundo, Walter; Zhou, Xingtao

2018-05-01

To investigate early visual and refractive outcomes, corneal stability and optical quality after femtosecond laser small-incision lenticule extraction (SMILE) for treating myopia and myopic astigmatism over -10 D. Thirty eyes (30 patients) with myopia and myopic astigmatism of over -10 D were treated with VisuMax ® femtosecond laser (version 3.0; Carl Zeiss Meditec AG, Jena, Germany). Six months postoperative safety, efficacy and predictability were evaluated. Corneal Scheimpflug topography was measured preoperatively, 1 day, 3 months and 6 months postoperatively. Wavefront aberrations were measured preoperatively, 3 months and 6 months postoperatively. Six months postoperatively, LogMAR uncorrected and corrected distance visual acuity (CDVA) were -0.013 ± 0.086 and -0.073 ± 0.069, respectively. 73% (97%) of eyes were within 0.5 (1) D of target refraction. No eyes lost CDVA, 43% (13 eyes) gained one line and 7% (two eyes) gained two lines. Mean corneal back curvature (KMB) and posterior central elevation (PCE) did not change significantly comparing preoperative and 6 months postoperative data (p = 0.91 and 0.77, respectively). Comparing 1 day with 6 months postoperative data, central corneal thickness (CCT), mean corneal front curvature (KMF), KMB and PCE did not change significantly (p = 0.27, 0.07, 0.52, 0.71, respectively). Total higher-order aberration (HOA), spherical aberration and coma increased significantly (p < 0.01) but trefoil remained stable (p = 0.49). Our results indicate that SMILE can correct myopia and myopic astigmatism of over -10 D predictably. No early ectasia was observed. Long-term changes in visual quality and corneal stability require further investigation. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Safety, efficacy, and predictability of laser in situ keratomileusis to correct myopia or myopic astigmatism with a 750 Hz scanning-spot laser system.

PubMed

Tomita, Minoru; Watabe, Miyuki; Yukawa, Satoshi; Nakamura, Nobuo; Nakamura, Tadayuki; Magnago, Thomas

2014-02-01

To evaluate the clinical outcomes of laser in situ keratomileusis (LASIK) to correct myopia or myopic astigmatism using the Amaris 750S 750 Hz excimer laser. Private LASIK center, Tokyo, Japan. Case series. Patients with myopia or myopic astigmatism (spherical equivalent -0.50 to -11.63 diopters [D]), a corrected distance visual acuity (CDVA) of 20/20 or better, and an estimated residual bed thickness of 300 μm or more had LASIK using the aspheric aberration-free ablation profile of the 750 Hz scanning-spot laser and the Femto LDV Crystal Line femtosecond laser for flap creation. Study parameters included uncorrected distance visual acuity (UDVA), CDVA, manifest refraction, astigmatism, and higher-order aberrations (HOAs). The study included 1280 eyes (685 patients). At 3 months, 96.6% of eyes had a UDVA of 20/20 or better and 99.1% had 20/32 or better; 94.1% of eyes were within ± 0.50 D of the intended correction and 98.9% were within ± 1.00 D; 89.7% of eyes had no residual cylinder and 96.0% had a postoperative astigmatism of less than 0.50 D. All eyes had a postoperative CDVA of 20/20 or better. The HOAs increased postoperatively (P<.001), with mean total postoperative corneal and ocular HOAs of 0.66 μm ± 0.20 (SD) and 0.56 ± 0.23 μm, respectively. The efficacy index and safety index were 1.02 and 1.06, respectively. Laser in situ keratomileusis with the 750 Hz scanning-spot laser was safe, effective, and predictable. No specific clinical side effects that might be associated with a high repetition rate occurred. Mr. Magnago is an employee of Schwind eye-tech-solutions GmbH. No other author has a financial or proprietary interest in any material or method mentioned. Copyright © 2013 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

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.

Mild Myopic Astigmatism Corrected by Accidental Flap Complication: A Case Report

PubMed Central

Fahed, Daoud C; Fahed, Charbel D

2009-01-01

A 35-year-old female presented for laser in-situ keratomileusis (LASIK). Her preoperative eye exam was normal, with a preop refraction of OD −2.50 D Sph +1.25 D Cyl ×175 and OS −2.75 D Sph +1.50 D Cyl ×165 (cycloplegic and manifest), with 20/20 BCVA OU. The central pachymetry reading was 553 μm in the right eye. Preoperative topography was normal. At the start of the pendular microkeratome path, some resistance was felt, but the microkeratome continued along its path. Upon inspection of the flap, there was a central rectangle of intact epithelium with two mirror-image flaps on both sides. The flap was repositioned and LASIK was discontinued. The cornea healed with two faint thin linear vertical parallel scars at the edge of the pupil. Postoperative inspection of the blade revealed central blunting. One month postoperatively, the uncorrected visual acuity (UCVA) was 20/20. Manifest and cycloplegic refractions were plano. This is an interesting case of accidental flap complication resulting in the correction of mild myopic astigmatism. PMID:20404996

Combining primary and piggyback intraocular lenses to treat extreme myopic astigmatism in stable keratoconus following cataract surgery.

PubMed

Goh, Yi Wei; Misra, Stuti; Patel, Dipika V; McGhee, Charles N J

2013-03-01

The majority of those with keratoconus can maximise visual acuity with spectacle or contact lens correction as they age; however, as subjects enter their sixties, cataracts may supervene and contact lens tolerance diminishes with consequent reduction in visual acuity. Following cataract extraction, the complex refractive error associated with keratoconus may not be readily corrected by an intraocular lens alone. This report highlights the planned implantation of a primary posterior chamber toric intraocular lens with a secondary piggyback, sulcus-based, intraocular lens in advanced but stable keratoconus with extreme myopic astigmatism and cataract. © 2013 The Authors. Clinical and Experimental Optometry © 2013 Optometrists Association Australia.

Influence of different types of astigmatism on visual acuity.

PubMed

Remón, Laura; Monsoriu, Juan A; Furlan, Walter D

To investigate the change in visual acuity (VA) produced by different types of astigmatism (on the basis of the refractive power and position of the principal meridians) on normal accommodating eyes. The lens induced method was employed to simulate a set of 28 astigmatic blur conditions on different healthy emmetropic eyes. Additionally, 24 values of spherical defocus were also simulated on the same eyes for comparison. VA was measured in each case and the results, expressed in logMAR units, were represented against of the modulus of the dioptric power vector (blur strength). LogMAR VA varies in a linear fashion with increasing astigmatic blur, being the slope of the line dependent on the accommodative demand in each type of astigmatism. However, in each case, we found no statistically significant differences between the three axes investigated (0°, 45°, 90°). Non-statistically significant differences were found either for the VA achieved with spherical myopic defocus (MD) and mixed astigmatism (MA). VA with simple hyperopic astigmatism (SHA) was higher than with simple myopic astigmatism (SMA), however, in this case non conclusive results were obtained in terms of statistical significance. The VA achieved with imposed compound hyperopic astigmatism (CHA) was highly influenced by the eye's accommodative response. VA is correlated with the blur strength in a different way for each type of astigmatism, depending on the accommodative demand. VA is better when one of the focal lines lie on the retina irrespective of the axis orientation; accommodation favors this situation. Copyright © 2016 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

Efficacy and safety of cross-cylinder photorefractive keratectomy versus single method in medium-high astigmatism: a randomized clinical trial.

PubMed

Sedghipour, Mohammad R; Lotfi, Afshin; Sadeghilar, Ayaz; Banan, Saeeid

2012-09-07

BACKGROUND: To compare efficacy and safety of photorefractive keratectomy (PRK) by cross-cylinder with single methods in medium-high astigmatism. DESIGN: Randomized clinical trial study PARTICIPANTS: Fifty patients with medium-high compound myopic astigmatism were enrolled between September 2007 and September 2008. METHODS: PRK was performed on 100 eyes of 50 patients with compound myopic astigmatism. Each patient underwent PRK by cross-cylinder approach in one eye and single method on the contralateral eye. Vector analysis was used to assess astigmatic results. MAIN OUTCOME MEASURES: Improvement of visual acuity (snelen chart), refraction, aberrometry. RESULTS: Uncorrected visual acuity (UCCA) equal to 20/40 or better after six months, was achieved in 98% of eyes in the cross-cylinder method versus 96% in single method.. Mean preoperative spherical equivalent(SE) was -5.2 ±2.1 D in the cross-cylinder method versus -5.1 ±0.5 D in the single method. At six months, the mean SE was - 0.5±0.4 D and -0.6±0.3 D, respectively. Mean IOS was 0.4±0.3 in the cross-cylinder group and 0.4±0.4 in the single group. Mean postoperative absolute change in total root-mean-square higher order aberrations in the cross-cylinder group and single group were 0.16 pm and 0.17 pm, respectively. Any of the mentioned differences didn't appear to be statistically significant. CONCLUSIONS: Both PRK methods appeared to be safe and effective in correcting medium-high astigmatism. © 2012 The Author. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.

[Astigmatism correction with Excimer laser].

PubMed

Gauthier, L

2012-03-01

Excimer laser is the best and the more used technique for Astigmatism correction. Lasik is generally preferred to PRK and must be the choice for hyperopic and mix astigmatisms. Myopic astigmatisms are the easier cases to treat: the length of the photoablation is placed on the flat meridian. Hyperopic and mix astigmatisms are more difficult to correct because they are more technically demanding and because the optical zone of the photoablation must be large. Flying spots lasers are the best for these cases. The most important point is to trace the photoablation very precisely on the astigmatism axis. The use of eye trackers with iris recognition or a preoperative marking of the reference axis avoid cyclotorsion or a wrong position of the head. Irregular astigmatism are better corrected with topoguided or wavefront guided photoablations. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

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.

Night driving simulation in a randomized prospective comparison of Visian toric implantable collamer lens and conventional PRK for moderate to high myopic astigmatism.

PubMed

Schallhorn, Steven; Tanzer, David; Sanders, Donald R; Sanders, Monica; Brown, Mitch; Kaupp, Sandor E

2010-05-01

To compare changes in simulated night driving performance after Visian Toric Implantable Collamer Lens (TICL; STAAR Surgical) implantation and photorefractive keratectomy (PRK) for the correction of moderate to high myopic astigmatism. This prospective, randomized study consisted of 43 eyes implanted with the TICL (20 bilateral cases) and 45 eyes receiving conventional PRK (VISX Star S3 excimer laser) with mitomycin C (22 bilateral cases) for moderate to high myopia (-6.00 to -20.00 diopters[D] sphere) measured at the spectacle plane and 1.00 to 4.00 D of astigmatism. As a substudy, 27 eyes of 14 TICL patients and 41 eyes of 21 PRK patients underwent a simulated night driving test. The detection and identification distances of road signs and hazards with the Night Driving Simulator (Vision Sciences Research Corp) were measured with and without a glare source before and 6 months after each procedure. No significant difference was noted in the pre- to postoperative Night Driving Simulator in detection distances with and without the glare source between the TICL and PRK groups. The differences in identification distances without glare were significantly better for business and traffic road signs and pedestrian hazards in the TICL group relative to the PRK group whereas with glare, only the pedestrian hazards were significantly better. A clinically relevant change of Night Driving Simulator performance (>0.5 seconds change in ability to identify tasks postoperatively) was significantly better in the TICL group (with and without glare) for all identification tasks. The TICL performed better than conventional PRK in the pre- to postoperative Night Driving Simulator testing with and without a glare source present. Copyright 2010, SLACK Incorporated.

Bilateral phacomorphic angle-closure glaucoma in a highly myopic patient secondary to isolated spherophakia.

PubMed

Sowka, Joseph; Girgis, Nadine

2010-09-01

Angle closure most commonly occurs in older hyperopic patients as a result of primary relative pupil block. Less frequently, angle closure occurs in highly myopic patients with conditions other than primary relative pupil block. This report presents the diagnosis, pathophysiologic mechanism, and management of a patient with both high myopia and bilateral advanced phacomorphic angle-closure glaucoma caused by isolated spherophakia. A 40-year-old asymptomatic man with very high myopic astigmatism presented with chronic angle closure and an intraocular pressure of 42 mmHg in both eyes. Additionally there was a nonmyopic fundus and 24-mm axial length, with a clear crystalline lens protruding through the pupillary plane in each eye, confirmed by B-scan ultrasonography. Gonioscopy and A-scan and B-scan ultrasonography identified the pathogenesis of intraocular pressure elevation, angle closure, and high myopia to be lenticular in origin. Initial medical therapy and subsequent laser iridotomy relieved the pupil block angle closure and successfully lowered intraocular pressure. Angle closure can occur in highly myopic eyes. Careful gonioscopy and ultrasonography can lead to the correct diagnosis and tailored management for these eyes. Phacomorphic angle-closure glaucoma from spherophakia is associated with Weill-Marchesani syndrome as well as a few other uncommon syndromes. Isolated pseudophakia is a rarely reported cause of phacomorphic angle closure. Copyright 2010 American Optometric Association. Published by Elsevier Inc. All rights reserved.

Outcomes of LASIK for Myopia or Myopic Astigmatism Correction with the FS200 Femtosecond Laser and EX500 Excimer Laser Platform

PubMed Central

Niparugs, Muanploy; Tananuvat, Napaporn; Chaidaroon, Winai; Tangmonkongvoragul, Chulaluck; Ausayakhun, Somsanguan

2018-01-01

Purpose: To evaluate the efficacy, predictability, stability and safety of laser in situ keratomileusis (LASIK) using the FS200 femtosecond laser and EX500 excimer laser platform. Methods: The outcomes of 254 eyes of 129 consecutive patients with myopia or myopic astigmatism who underwent full correction femtosecond laser-assisted LASIK at CMU LASIK Center were assessed. Pre-operative and post-operative parameters including manifest refraction, Uncorrected Distance Visual Acuity (UDVA), Best Corrected Distance Visual Acuity (BDVA), corneal topography and tomography were analyzed. The results between low to moderate myopia and high myopia were compared up to 12 months. Results: Mean pre-operative Spherical Equivalent (SE) was -5.15±2.41 Diopters (D) (range -0.50 to -11.50 D) and -0.13±0.28 D, -0.13±0.27 D, -0.13±0.28 D and -0.14±0.30 D at 1, 3, 6, and 12 months, post-operatively. At 12 months, the propor¬tion of eyes achieving UDVA ≥ 20/20 was 90.0% and ≥20/40 was 98.8%. The proportion of eyes achieving post-operative mean SE ±0.5 D, and ±1 D was 91.3%, and 98.5%. No eyes lost more than two lines of BDVA. The low to moderate myopic group had a statistically significant better UDVA at one (p=0.017) and three months (p=0.014) but no difference at six (p=0.061) and 12 months (p=0.091). The mean post-operative SE was better in low to moderate myopic group at every follow-up visit (p=0.001, 0.007, <0.001 and <0.001). Conclusion: One-year clinical results of LASIK with the FS200 femtosecond laser and EX500 excimer laser showed high efficacy, predictability, stability and safety. PMID:29872485

Evaluation of the toric implantable collamer lens for simultaneous treatment of myopia and astigmatism.

PubMed

Price, Marianne O; Price, Francis W

2015-01-01

Myopic astigmatism is a prevalent condition that can be treated with spectacles, contact lenses, or laser refractive surgery. However, these treatment options have functional limitations at higher levels of refractive error. The toric implantable collamer lens is designed to treat a broad range of refractive error, generally up to -18 diopters with +1 to +6 diopters of astigmatism. Approval for a more limited treatment range of up to 15 diopters of myopia with +1 to +4 diopters of astigmatism is being sought in the US, where this device has not yet received marketing approval. Surgical correction of high-myopic astigmatism can be life-altering and allow people to participate in activities that were not previously feasible because of visual limitations. The toric implantable collamer lens is implanted behind the iris and in front of the natural crystalline lens. With earlier lens designs, it was necessary to create an iridectomy or iridotomy to prevent pupillary block. The newest toric implantable collamer lens model has a small central hole that is not visually noticeable. This eliminates the need to create a hole in the iris, thereby enhancing the safety of the procedure.

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.

Combined Special Capsular Tension Ring and Toric IOL Implantation for Management of Astigmatism and High Axial Myopia with Cataracts.

PubMed

Zhao, Yang; Li, Jiaxin; Yang, Ke; Li, Xiao; Zhu, Siquan

2018-01-01

This study aimed to compare the effects of toric intraocular lens (IOL) implantation with a capsular tension ring and toric IOL implantation only in patients with axial myopic astigmatism who had undergone cataract surgery. Of 34 patients with axial myopia, 16 patients who had received IOL and capsular tension ring (CTR) implantation were included in the combined group and 18 patients who received toric IOL implantation only were included in the simple group. Uncorrected visual acuity (UCVA) and best-corrected visual acuity (BCVA) were evaluated by measuring subjective refraction, residual astigmatism, and the toric IOL axis six months post-surgery. At six months postoperatively, the UCVA for the combined and simple groups was 4.6 ± 0.1 and 4.5 ± 0.2, respectively, a statistically significant difference (t = 3.531, P<0.05). The toric IOL in all of the cases was located in the capsular sac, but there were more cases with IOL rotation (12 eyes) in the simple group than in the combined group (4 eyes). The rotation angles were 20°~30° (one eye), 10°~20° (four eyes), and <10° (seven eyes) compared with 2°~5° (four eyes). The residual astigmatism was -0.50 ± 0.25 D in the combined group, not a significant difference from the predicted residual astigmatism (-0.35 ± 0.13 D). There was a significant difference in the simple group (-1.25 ± 0.33 D) when the predicted residual astigmatism was compared (-0.37 ± 0.11 D) (t = -9.511, P < 0.01). In patients with axial myopic astigmatism, CTR can effectively increase the rotational stability of a toric IOL, achieving improvement in corneal astigmatism and visual acuity.

Variation of axial and oblique astigmatism with accommodation across the visual field

PubMed Central

Liu, Tao; Thibos, Larry N.

2017-01-01

In this study we investigated the impact of accommodation on axial and oblique astigmatism along 12 meridians of the central 30° of visual field and explored the compensation of corneal first-surface astigmatism by the remainder of the eye's optical system. Our experimental evidence revealed no systematic effect of accommodation on either axial or oblique astigmatism for two adult populations (myopic and emmetropic eyes). Although a few subjects exhibited systematic changes in axial astigmatism during accommodation, the dioptric value of these changes was much smaller than the amount of accommodation. For most subjects, axial and oblique astigmatism of the whole eye are both less than for the cornea alone, which indicates a compensatory role for internal optics at all accommodative states in both central and peripheral vision. A new method for determining the eye's optical axis based on visual field maps of oblique astigmatism revealed that, on average, the optical axis is 4.8° temporal and 0.39° superior to the foveal line-of-sight in object space, which agrees with previous results obtained by different methodologies and implies that foveal astigmatism includes a small amount of oblique astigmatism (0.06 D on average). Customized optical models of each eye revealed that oblique astigmatism of the corneal first surface is negligible along the pupillary axis for emmetropic and myopic eyes. Individual variation in the eye's optical axis is due in part to misalignment of the corneal and internal components that is consistent with tilting of the crystalline lens relative to the pupillary axis. PMID:28362902

Clinical outcomes of laser in situ keratomileusis with an aberration-neutral profile centered on the corneal vertex comparing vector planning with manifest refraction planning for the treatment of myopic astigmatism.

PubMed

Arbelaez, Maria Clara; Alpins, Noel; Verma, Shwetabh; Stamatelatos, George; Arbelaez, Juan Guillermo; Arba-Mosquera, Samuel

2017-12-01

To evaluate clinical outcomes of laser in situ keratomileusis (LASIK) with an aberration-neutral profile centered on the estimated visual axis (considering 70% of the pupil offset toward the corneal vertex) comparing vector planning with manifest refraction planning for the treatment of myopic astigmatism. Muscat Eye Laser Center, Muscat, Sultanate of Oman, Muscat, Oman. Retrospective case series. The outcomes were evaluated at a 6-month follow-up in eyes showing ocular residual astigmatism (ORA) over 0.75 diopters (D) preoperatively. Eighty-five treatments were based on manifest astigmatism (preoperative sphere -2.11 D ± 1.3 [SD], cylinder -0.90 ± 1.0 D), and 79 treatments were based on vector planning (preoperative sphere -2.46 ± 1.5 D, cylinder -0.78 ± 0.79 D). At a 6-month follow-up, 128 patients (164 eyes) were evaluated and no significant differences were observed between the 2 groups in terms of difference between corrected distance visual acuity and uncorrected distance visual acuity (UDVA) (P = .1, t test and Fisher exact test Snellen lines 1 or better, P = .4) and postoperative UDVA (P = .05, t test and Fisher exact test for UDVA 20/16 or better, P = .3). Significant differences were observed between the 2 groups in terms of achieved spherical equivalent (P = .04), corneal toricity, and ORA (P < .001, t test and Fisher exact test for ORA ≤0.75 D, P < .001). Performing LASIK for myopic astigmatism with the vector planning approach resulted in comparable visual outcomes to manifest refraction planning. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Corneal coupling of astigmatism applied to incisional and ablative surgery.

PubMed

Alpins, Noel; Ong, James K Y; Stamatelatos, George

2014-11-01

To redefine measures of corneal coupling for use with incisional and ablation procedures for astigmatism. Private clinics, Melbourne, Victoria, Australia. Retrospective nonrandomized study. The measures known as the coupling ratio (CR) and coupling constant (CC) were redefined to ensure validity in most cases of incisional procedures and laser vision correction procedures. In addition, a new measure--the coupling adjustment (CAdj)--was developed to quantify the amount of spherical adjustment that must be applied to compensate for coupling that occurs as a result of astigmatism treatment. These quantitative measures of coupling were applied to retrospective data to show their applicability. Pure myopic, compound myopic, and compound hyperopic astigmatism excimer laser treatments showed a CR close to zero, a CC close to 0.5, and a CAdj close to zero. Incision LRIs showed a CR close to 1.0 and a CC close to zero. In all cases, the coupling measures were consistent for treatments with a larger astigmatic component (>1.0 diopter) but variable when the astigmatic component of the treatment was smaller. The revised definitions of CR and CC can be used with incisional and ablative surgery. Incorporating the CAdj into the planning of spherocylindrical treatments allows one to factor in the effect of the astigmatic treatment on the spherical component and thus to more accurately target the desired spherical equivalent. Dr. Alpins and Mr. Stamatelatos have a financial interest in the Assort software program. Dr. Ong is an employee of Assort. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

[Static and dynamic contrast sensitivity of myopic eyes before and after laser in situ keratomileusis].

PubMed

Liu, Xiao-wei; Pang, Guo-xiang; Liu, Xi-pu; Jiang, Ru-xin; Jin, Yu-mei; Sun, Yu-min; Wang, Zhong-hai

2003-10-01

To evaluate the static and dynamic contrast sensitivity changes in myopic patients before and after laser in situ keratomileusis (LASIK). Seventy-three eyes in 37 patients with myopia (with or without astigmatism) who received LASIK were tested for static and dynamic contrast sensitivities using the METRO VISION MON ELEC I system at 0.7, 1.4, 2.7, 5.5, 11, and 22 cpd and cps prior to LASIK, and at one-, three-, and six-month intervals after LASIK. All eyes gained naked visual acuity of more than 0.5 after LASIK. The contrast sensitivity was depressed at all frequencies 1 month after LASIK, as compared to one week prior to LASIK. The depression at 2.7, 5.5, 11 (P < 0.01) and 22 cpd (P < 0.05) was statistically significant for static contrast sensitivity, and also at 5.5 (P < 0.01) and 11 cps (P < 0.05) for dynamic contrast sensitivity. Myopic eyes between 6.25 D and 14.0 D, and astigmatic eyes 2 DC and more, suffered more static and dynamic contrast sensitivity depression than the myopic eyes between 1.25 D and 6.00 D and astigmatic eyes less than 2 DC. Contrast sensitivities were improved and exceeded preoperative levels 3 months after LASIK, and improved even more 6 months after LASIK. All sequences were statistically significant for static contrast sensitivity (P < 0.01), while only 2.7, 5.5, and 11 cps were statistically significant for dynamic contrast sensitivity (P < 0.01). The astigmatic eyes 2 DC and more showed less improvement, even below the preoperative level at 1.4 cps of dynamic contrast sensitivity. While temporary depression of contrast sensitivity for myopic eyes after LASIK was seen, contrast sensitivity soon returned to exceed preoperative levels at 3 months after LASIK, while improving even more 6 months after LASIK.

Myopic Maculopathy and Optic Disc Changes in Highly Myopic Young Asian Eyes and Impact on Visual Acuity.

PubMed

Koh, Victor; Tan, Colin; Tan, Pei Ting; Tan, Marcus; Balla, Vinay; Nah, Gerard; Cheng, Ching-Yu; Ohno-Matsui, Kyoko; Tan, Mellisa M H; Yang, Adeline; Zhao, Paul; Wong, Tien Yin; Saw, Seang-Mei

2016-04-01

To determine the prevalence and risk factors of myopic maculopathy and specific optic disc and macular changes in highly myopic eyes of young Asian adults and their impact on visual acuity. Prospective cross-sectional study. In total, 593 highly myopic (spherical equivalent refraction [SER] less than -6.00 diopters [D]) and 156 emmetropic (SER between -1.00 and +1.00 D) male participants from a population-based survey were included. All participants underwent standardized medical interviews, ophthalmic examination, and color fundus photographs. These photographs were graded systematically to determine the presence of optic disc and macular lesions. Myopic maculopathy was classified based on the International Classification of Myopic Maculopathy. The mean age was 21.1 ± 1.2 years. The mean SER for the highly myopic and emmetropic group was -8.87 ± 2.11 D and 0.40 ± 0.39 D, respectively (P < .001). Compared to emmetropic eyes, highly myopic eyes were significantly more likely to have optic disc tilt, peripapillary atrophy (PPA), posterior staphyloma, chorioretinal atrophy, and myopic maculopathy (all P < .001). The main findings included PPA (98.3%), disc tilt (22.0%), posterior staphyloma (32.0%), and chorioretinal atrophy (8.3%). Myopic maculopathy was present in 8.3% of highly myopic eyes and was associated with older age (odds ratio [OR] 1.66; 95% CI: 1.22, 2.26), reduced choroidal thickness (OR 0.99; 95% CI: 0.98, 0.99), and increased axial length (AL) (OR 1.52; 95% CI: 1.06, 2.19). The presence of disc tilt, posterior staphyloma, and chorioretinal atrophy were associated with reduced visual acuity. Our study showed that myopia-related changes of the optic disc and macula were common in highly myopic eyes even at a young age. The risk factors for myopic maculopathy include increased age, longer AL, and reduced choroidal thickness. Some of these changes were associated with reduced central visual function. Copyright © 2016 Elsevier Inc. All rights

Toric phakic implantable collamer lens for correction of astigmatism: 1-year outcomes

PubMed Central

Mertens, Erik L

2011-01-01

Purpose: The purpose of this study was to assess predictability, efficacy, safety and stability in patients who received a toric implantable collamer lens to correct moderate to high myopic astigmatism. Methods: Forty-three eyes of 23 patients underwent implantation of a toric implantable collamer lens (STAAR Surgical Inc) for astigmatism correction. Mean spherical refraction was −4. 98 ± 3.49 diopters (D) (range: 0 to −13 D), and mean cylinder was −2.62 ± 0.97 D (range: −1.00 to −5.00 D). Main outcomes measures evaluated during a 12-month follow-up included uncorrected visual acuity (UCVA), refraction, best-corrected visual acuity (BCVA), vault, and adverse events. Results: At 12 months the mean Snellen decimal UCVA was 0.87 ± 0.27 and mean BCVA was 0.94 ± 0.21, with an efficacy index of 1.05. More than 60% of the eyes gained ≥1 line of BCVA (17 eyes, safety index of 1.14). The treatment was highly predictable for spherical equivalent (r2 = 0.99) and astigmatic components: J0 (r2 = 0.99) and J45 (r2 = 0.90). The mean spherical equivalent dropped from −7.29 ± 3.4 D to −0.17 ± 0.40 D at 12 months. Of the attempted spherical equivalent, 76.7% of the eyes were within ±0.50 D and 97.7% eyes were within ±1.00 D, respectively. For J0 and J45, 97.7% and 83.7% were within ±0.50 D, respectively. Conclusion: The results of the present study support the safety, efficacy, and predictability of toric implantable collamer lens implantation to treat moderate to high myopic astigmatism. PMID:21468348

Comparison of glaucoma diagnostic accuracy of macular ganglion cell complex thickness based on nonhighly myopic and highly myopic normative database

PubMed Central

Chen, Henry Shen-Lih; Liu, Chun-Hsiu; Lu, Da-Wen

2016-01-01

Background/Purpose: To evaluate and compare the diagnostic discriminative ability for detecting glaucoma in highly myopic eyes from a normative database of macular ganglion cell complex (mGCC) thickness based on nonhighly myopic and highly myopic normal eyes. Methods: Forty-nine eyes of 49 participants with high myopia (axial length ≥ 26.0 mm) were enrolled. Spectral-domain optical coherence tomography scans were done using RS-3000, and the mGCC thickness/significance maps within a 9-mm diameter circle were generated using built-in software. We compared the difference of sensitivity, specificity, and diagnostic accuracy between the nonhighly myopic database and the highly myopic database for differentiating the early glaucomatous eyes from the nonglaucomatous eyes. Results: This study enrolled 15 normal eyes and 34 eyes with glaucoma. The mean mGCC thickness of the glaucoma group was significantly less than that of the normal group (p < 0.001). Sensitivity was 96.3%, and the specificity was 50.0% when using the nonhighly myopic normative database. When the highly myopic normative database was used, the sensitivity was 88.9%, and the specificity was 90.0%. The false positive rate was significantly lower when using the highly myopic normative database (p < 0.05). Conclusion: The evaluations of glaucoma in eyes with high myopia using a nonhighly myopic normative database may lead to a frequent misdiagnosis. When evaluating glaucoma in high myopic eyes, the mGCC thickness determined by the long axial length high myopic normative database should be applied. PMID:29018704

Combined astigmatic keratotomy and conductive keratoplasty to correct high corneal astigmatism.

PubMed

Sy, Mary Ellen; Kovoor, Timmy A; Tannan, Anjali; Choi, Daniel; Deng, Sophie X; Danesh, Jennifer; Hamilton, D Rex

2015-05-01

To determine the safety, efficacy, and predictability of combined astigmatic keratotomy (AK) and conductive keratoplasty (CK) for treating high corneal astigmatism. University of California-Los Angeles, Los Angeles, California, USA. Retrospective case series. From January 1, 2004, to December 31, 2009, AK and CK were performed in eyes with corneal astigmatism of 5.0 diopters (D) or more after keratoplasty or trauma. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities, spherical equivalent (SE), defocus equivalent, mean astigmatism, efficacy index, and complications were evaluated. In 11 eyes of 11 patients, the mean UDVA improved from 1.54 logMAR ± 0.50 (SD) preoperatively to 0.69 ± 0.62 logMAR 3 months postoperatively (P < .001) and the mean CDVA from 0.55 ± 0.62 logMAR to 0.12 ± 0.11 logMAR (P = .028). The mean SE and mean defocus equivalent decreased from -1.25 ± 5.06 D to 3.13 ± 3.06 D (P = .15) and from 7.98 ± 4.41 D to 6.97 ± 3.73 D (P = .45), respectively; these changes were not statistically significant. The mean absolute astigmatism decreased from 10.25 ± 4.71 D to 4.31 ± 2.34 D (P < .001). The mean absolute orthogonal and mean oblique astigmatism showed a statistically significant decrease. The efficacy index was 0.82. One case of wound gape after AK required suturing. No infectious keratitis, corneal perforation, or graft rejection occurred. Results indicate that combined AK and CK is safe and effective for correcting high corneal astigmatism after surgery or trauma. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Planning for Coupling Effects in Bitoric Mixed Astigmatism Ablative Treatments.

PubMed

Alpins, Noel; Ong, James K Y; Stamatelatos, George

2017-08-01

To demonstrate how to determine the historical coupling adjustments of bitoric mixed astigmatism ablative treatments and how to use these historical coupling adjustments to adjust future bitoric treatments. The individual coupling adjustments of the myopic and hyperopic cylindrical components of a bitoric treatment were derived empirically from a retrospective study where the theoretical combined treatment effect on spherical equivalent was compared to the actual change in refractive spherical equivalent. The coupling adjustments that provided the best fit in both mean and standard deviation were determined to be the historical coupling adjustments. Theoretical treatments that incorporated the historical coupling adjustments were then calculated. The actual distribution of postoperative spherical equivalent errors was compared to the theoretically adjusted distribution. The study group comprised 242 eyes and included 118 virgin right eyes and 124 virgin left eyes of 155 individuals. For the laser used, the myopic coupling adjustment was -0.02 and the hyperopic coupling adjustment was 0.30, as derived by global nonlinear optimization. This implies that almost no adjustment of the myopic component of the bitoric treatment is necessary, but that the hyperopic component of the bitoric treatment generates a large amount of unintended spherical shift. The theoretically adjusted treatments targeted zero mean spherical equivalent error, as intended, and the distribution of the theoretical spherical equivalent errors had the same spread as the distribution of actual postoperative spherical equivalent errors. Bitoric mixed astigmatism ablative treatments may display non-trivial coupling effects. Historical coupling adjustments should be taken into consideration when planning mixed astigmatism treatments to improve surgical outcomes. [J Refract Surg. 2017;33(8):545-551.]. Copyright 2017, SLACK Incorporated.

Biometric Risk Factors for Corneal Neovascularization Associated with Hydrogel Soft Contact Lens Wear in Korean Myopic Patients

PubMed Central

Lee, Dae Seung; Wee, Won Ryang

2014-01-01

Purpose To investigate the biometric risk factors for corneal surface complications associated with hydrogel soft contact lens (SCL) fitting in myopic patients in Korea. Methods This is a retrospective case-control study. The records of 124 subjects (124 eyes) who wore SCLs on a daily basis were reviewed. Thirty-one patients (31 eyes) who were diagnosed with corneal neovascularization (NV) while wearing SCLs were included in the complication group. Ninety-three age- and sex-matched patients (93 eyes) who wore SCLs, who did not have corneal NV and who visited our clinic for correction of refractive errors were included in the control group. The degree of spherical equivalent, astigmatism and corneal base curve radius (BCR) were compared in both groups. Results Patients with NV exhibited poorer best corrected visual acuity and more myopia than controls (p = 0.008 and 0.006, respectively). In univariate analysis, highly myopic patients (-9 diopters [D] or higher) were more likely to experience NV (odds ratio [OR], 2.232; 95% confidence interval [CI], 1.602 to 3.105). High astigmatism (≥2 D) increased the risk of complications (OR, 2.717; 95% CI, 1.141 to 6.451). Steep cornea, in which BCR was <7.5 mm, also raised the risk of complications (OR, 4.000; 95% CI, 1.661 to 9.804). Flat cornea was not a risk factor for the development of NV. Conclusions High myopia, high astigmatism, and steep cornea seemed to be risk factors in the development of corneal NV in SCL wearers. PMID:25120337

Biometric risk factors for corneal neovascularization associated with hydrogel soft contact lens wear in Korean myopic patients.

PubMed

Lee, Dae Seung; Kim, Mee Kum; Wee, Won Ryang

2014-08-01

To investigate the biometric risk factors for corneal surface complications associated with hydrogel soft contact lens (SCL) fitting in myopic patients in Korea. This is a retrospective case-control study. The records of 124 subjects (124 eyes) who wore SCLs on a daily basis were reviewed. Thirty-one patients (31 eyes) who were diagnosed with corneal neovascularization (NV) while wearing SCLs were included in the complication group. Ninety-three age- and sex-matched patients (93 eyes) who wore SCLs, who did not have corneal NV and who visited our clinic for correction of refractive errors were included in the control group. The degree of spherical equivalent, astigmatism and corneal base curve radius (BCR) were compared in both groups. Patients with NV exhibited poorer best corrected visual acuity and more myopia than controls (p = 0.008 and 0.006, respectively). In univariate analysis, highly myopic patients (-9 diopters [D] or higher) were more likely to experience NV (odds ratio [OR], 2.232; 95% confidence interval [CI], 1.602 to 3.105). High astigmatism (≥2 D) increased the risk of complications (OR, 2.717; 95% CI, 1.141 to 6.451). Steep cornea, in which BCR was <7.5 mm, also raised the risk of complications (OR, 4.000; 95% CI, 1.661 to 9.804). Flat cornea was not a risk factor for the development of NV. High myopia, high astigmatism, and steep cornea seemed to be risk factors in the development of corneal NV in SCL wearers.

Safety and efficacy of wavefront-guided myopic laser in situ keratomileusis using a new wavefront sensor technology: first 100 cases.

PubMed

Smadja, David; Santhiago, Marcony R; Tellouck, Joy; De Castro, Tania; Lecomte, Fanny; Mello, Glauco R; Touboul, David

2015-08-01

To evaluate the safety and efficacy of wavefront-guided laser in situ keratomileusis (LASIK) for the correction of low to high myopia and myopic astigmatism using data derived from a new-generation Hartmann-Shack aberrometer. Refractive Surgery Unit, Bordeaux Hospital University, France. Retrospective case series. This retrospective study analyzed the initial group of eyes treated with wavefront-guided LASIK for myopia and myopic astigmatism using the Visx S4IR excimer laser and wavefront data derived from a new Hartmann-Shack aberrometer (iDesign Advanced Wavescan aberrometer). Refractive (refraction and refractive accuracy) and visual outcomes (uncorrected [UDVA] and corrected [CDVA] distance visual acuities) were recorded 3 months postoperatively. The study included 100 eyes of 50 consecutively treated patients. The mean decimal UDVA improved from 0.1 ± 0.1 (SD) preoperatively to 1.1 ± 0.15 postoperatively (P < .01). A monocular UDVA of 20/16, 20/20, and 20/25 were achieved in 76.6%, 94.4%, and 96.6% of eyes, respectively. The postoperative manifest spherical equivalent was within ±0.5 diopter in all eyes. No eye lost 2 or more lines of CDVA, and 29.2% of the eyes gained 1 or more lines of CDVA. Wavefront-guided LASIK performed using data derived from the new Hartmann-Shack aberrometer was safe, effective, and predictable for treating myopia and myopic astigmatism. 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.

Reduced vision in highly myopic eyes without ocular pathology: the ZOC-BHVI high myopia study.

PubMed

Jong, Monica; Sankaridurg, Padmaja; Li, Wayne; Resnikoff, Serge; Naidoo, Kovin; He, Mingguang

2018-01-01

The aim was to investigate the relationship of the magnitude of myopia with visual acuity in highly myopic eyes without ocular pathology. Twelve hundred and ninety-two highly myopic eyes (up to -6.00 DS both eyes, no astigmatic cut-off) with no ocular pathology from the ZOC-BHVI high myopia study in China, had cycloplegic refraction, followed by subjective refraction and visual acuities and axial length measurement. Two logistic regression models were undertaken to test the association of age, gender, refractive error, axial length and parental myopia with reduced vision. Mean group age was 19.0 ± 8.6 years; subjective spherical equivalent refractive error was -9.03 ± 2.73 D; objective spherical equivalent refractive error was -8.90 ± 2.60 D and axial length was 27.0 ± 1.3 mm. Using visual acuity, 82.4 per cent had normal vision, 16.0 per cent had mildly reduced vision, 1.2 per cent had moderately reduced vision, 0.3 per cent had severely reduced vision and no subjects were blind. The percentage with reduced vision increased with spherical equivalent to 74.5 per cent from -15.00 to -39.99 D, axial length to 67.7 per cent of eyes from 30.01 to 32.00 mm and age to 22.9 per cent of those 41 years and over. Spherical equivalent and axial length were significantly associated with reduced vision (p < 0.0001). Age and parental myopia were not significantly associated with reduced vision. Gender was significant for one model (p = 0.04). Mildly reduced vision is common in high myopia without ocular pathology and is strongly correlated with greater magnitudes of refractive error and axial length. Better understanding is required to minimise reduced vision in high myopes. © 2017 Optometry Australia.

[Astigmatic keratotomy with the femtosecond laser: correction of high astigmatisms after keratoplasty].

PubMed

Kook, D; Bühren, J; Klaproth, O K; Bauch, A S; Derhartunian, V; Kohnen, T

2011-02-01

The purpose of this study was to evaluate a novel technique for the correction of postoperative astigmatism after penetrating keratoplasty with the use of the femtosecond laser creating astigmatic keratotomies (femto-AK) in the scope of a retrospective case series. Clinical data of ten eyes of nine patients with high residual astigmatism after penetrating keratoplasty undergoing paired femto-AK using a 60-kHz femtosecond laser (IntraLase™, AMO) were analyzed. A new software algorithm was used to create paired arcuate cuts deep into the donor corneal button with different cut angles. Target values were refraction, uncorrected visual acuity, best corrected visual acuity, topographic data (Orbscan®, Bausch & Lomb, Rochester, NY, USA), and corneal wavefront analysis using Visual Optics Lab (VOL)-Pro 7.14 Software (Sarver and Associates). Vector analysis was performed using the Holladay, Cravy and Koch formula. Statistical analysis was performed to detect significances between visits using Student's t test. All procedures were performed without any major complications. The mean follow-up was 13 months. The mean patient age was 48.7 years. The preoperative mean uncorrected visual acuity (logMAR) was 1.27, best corrected visual acuity 0.55, mean subjective cylinder -7.4 D, and mean topometric astigmatism 9.3 D. The postoperative mean uncorrected visual acuity (logMAR) was 1.12, best corrected visual acuity 0.47, mean subjective cylinder -4.1 D, and mean topometric astigmatism 6.5 D. Differences between corneal higher order aberrations showed a high standard deviation and were therefore not statistically significant. Astigmatic keratotomy using the femtosecond laser seems to be a safe and effective tool for the correction of higher corneal astigmatisms. Due to the biomechanical properties of the cornea and missing empirical data for the novel femto-AK technology, higher numbers of patients are necessary to develop optimal treatment nomograms.

Lenticular astigmatism in tilted disc syndrome.

PubMed

Gündüz, Abuzer; Evereklioglu, Cem; Er, Hamdi; Hepşen, Ibrahim F

2002-10-01

To evaluate whether an abnormal optic disc shape in patients with tilted disc syndrome (TDS) is associated with an abnormal configuration of the crystalline lens measured as lenticular astigmatism. Department of Ophthalmology, Inönü University Medical Faculty, Turgut Ozal Medical Center, Malatya, Turkey. This cross-sectional masked case-control study comprised 32 eyes of 32 patients with established TDS (13 men, 19 women; mean age 21.31 years +/- 7.05 [SD]) and 20 age- and sex-matched healthy control subjects (8 men, 12 women; mean age 22.65 +/- 7.11 years) with a comparable amount of myopic astigmatism (spherical equivalent) without TDS. The optic disc was morphometrically analyzed by planimetric evaluation of optic disc photographs. The total refractive and keratometric corneal astigmatism was obtained, and lenticular astigmatism was calculated by vector analysis. The Mann-Whitney U test was used for statistical analysis; 1 eye of each patient was evaluated in both groups. A P value less than 0.05 was considered statistically significant. The mean spherical equivalent refraction was comparable in TDS patients (-4.73 +/- 1.12 diopters [D]) and controls (-4.28 +/- 1.29 D) (P =.210). The mean total astigmatism was higher in TDS patients (-2.96 +/- 1.04 D) than in the controls (-2.51 +/- 1.09 D), but the difference was not significant (P =.151). The mean corneal astigmatism was comparable in TDS patients (-2.07 +/- 0.83 D) and controls (-2.28 +/- 0.87 D) (P =.454), but the calculated mean lenticular astigmatism was significantly higher in TDS patients (-1.31 +/- 0.98 D and -0.20 +/- 0.35 D, respectively) (P <.001). Twenty-nine of 32 TDS patients (90.6%) had lenticular astigmatism; in 16 (50%), it was greater than -1.00 D. Lenticular astigmatism was present in 7 controls (35%); in 2 (10%), it was greater than -1.00 D. The mean keratometry was significantly higher in TDS patients (43.84 +/- 1.06 D) than in the controls (42.75 +/- 1.45 D) (P =.011). Clinically

Internal Astigmatism in Myopes and Non-myopes: Compensation or Constant?

PubMed Central

Manny, Ruth E.; Deng, Li; Gwiazda, Jane; Hyman, Leslie; Weissberg, Erik; Scheiman, Mitchell; Fern, Karen D.

2016-01-01

Purpose To examine internal astigmatism (IA) in myopes and non-myopes using a new method to assess compensation of corneal astigmatism (CA) by IA, to look for predictors of high IA in young adult myopes and determine if as CA changes IA changes to reduce refractive astigmatism (RA) in an active compensatory process in myopes. Methods Right eye keratometry and cycloplegic autorefraction were measured annually over 14 years in 367 myopes and once in 204 non-myopes age- (mean 21.91 years ± 1.47), gender-, and ethnicity-matched to myopes at year 12. CA and RA at the corneal plane were expressed as J0, J45. IA = RA - CA. Inverse power transformation provided cylinder power and axis of IA for the compensation factor (IA/CA). Analyses included: 1) paired and unpaired t-tests (refractive data), 2) chi-square tests (distributions of compensation factor), 3) logistic regression analysis (predictors of high IA), and 4) linear mixed models (time effect on RA, CA and IA). Results The magnitude of IAJ0 varied by refractive error (myopes −0.25 ±0.24 vs non-myopes −0.32 ± 0.21, p<0.001). Compensation of CA by IA was poorer in myopes than non-myopes (χ2 p<0.001). When matched by CA, compensation remained poorer in myopes than non-myopes (χ2 all p≤ 0.04). Within each refractive group compensation was better when CA was low than high (χ2 p<0.001). When CA was low in myopes, high IA (≥1.00D) was less likely (p=0.01). Longitudinal follow-up of myopes found no evidence for an active compensatory role for IA as CA increased over time. There were differences in IAJ0 by ethnicity over time (p<0.0001). Conclusions In myopic and non-myopic eyes with low amounts of CA, IA may reduce CA’s contribution to RA, but IA is not a constant. However, there is no evidence for an active compensatory role for IA reducing CA in myopes. PMID:27564515

A Critical Evaluation of Refractive Outcomes Following LASIK for Moderate to High Astigmatism Using Two Excimer Laser Platforms.

PubMed

Patel, Sudi; Bohac, Maja; Biscevic, Alma; Koncarevic, Mateja; Anticic, Marija; Gabric, Nikica

2017-02-01

To calculate the surgically induced astigmatism (SIA) following LASIK and identify any association between SIA and the target induced astigmatism (TIA) at 1 year postoperatively. The SIA was calculated using the TIA and residual astigmatism values for [A] myopic astigmatism and [B] mixed astigmatism treated with either the [I] WaveLight Allegretto EyeQ 400-Hz (Alcon Laboratories, Inc. Fort Worth, TX) or [II] Schwind Amaris 750S (Schwind eye-tech-solutions, Kleinostheim, Germany) platforms. The TIA and corresponding SIA results were analyzed using various techniques. Key findings were the negative SIA power (y 1 ) was significantly correlated with negative TIA power (x 1 ) and sine of the TIA axis (x 2 ) as follows: [A] I, y 1 = 0.829x 1 -0.403x 2 -0.325 (F = 87.76, r = 0.804, P < .001, n = 127); II, y 1 = 0.891x 1 -0.037x 2 -0.192 (F = 240.06, r = 0.901, P < .001, n = 119) and [B] I, y 1 = 1.063x 1 +0.233x 2 +0.411 (F = 990.99, r = 0.881, P < .001, n = 61); II, y 1 = 1.029x 1 -0.115x 2 +0.322 (F = 270.12, r = 0.908, P < 0.001, n = 111). The sine of negative SIA axis (y 2 ) was significantly correlated with negative TIA power (x 1 ) and TIA axis (x 2 ) as follows: [A] I, y 2 = 0.951x 2 -0.007x 1 +0.008 (F = 446.58, r = 0.950, P < .001, n = 127); II, y 2 = 0.856x 2 +0.007x 1 +0.105 (F = 277.18, r = 0.912, P< .001, n = 119) and [B] I, y 2 = 0.953x 2 +0.009x 1 +0.075 (F = 362.6, r = 0.963, P < .001, n = 61); II, y 2 = 0.977x 2 -0.004x 1 +0.002 (F = 2910.9, r = 0.990, P < .001, n = 111). The predicted SIA power was up to 12% less than expected in cases of -6.00 diopters cylinder treated for myopic astigmatism using the Allegretto platform. The mean predicted angle of error (the angle between the SIA and TIA axes) was less than 4°, increasing to 12° for against-the-rule astigmatism. The Allegretto platform tended toward a clockwise axis rotational error, whereas the Amaris platform tended toward the opposite. [J Refract Surg. 2017;33(2):104-109.]. Copyright 2017, SLACK

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

Corneal Irregular Astigmatism and Curvature Changes After Small Incision Lenticule Extraction: Three-Year Follow-Up.

PubMed

Sideroudi, Haris; Lazaridis, Apostolos; Messerschmidt-Roth, Anke; Labiris, Georgios; Kozobolis, Vassilios; Sekundo, Walter

2018-04-27

To evaluate the long-term changes in anterior and posterior corneal irregular astigmatism and curvatures after small incision lenticule extraction (SMILE). Fifty eyes of 28 patients underwent SMILE for myopic astigmatism. All procedures were performed using the VisuMax® femtosecond laser. A Scheimpflug camera was used for preoperative and 3-year postoperative tomography. Anterior and posterior corneal Fourier parameters (spherical component, regular astigmatism, asymmetry, and irregularity) and curvature data were evaluated and compared within 2 subgroups according to the magnitude of the refractive correction (low myopia group: spherical equivalent (SEQ) ≥ -6 D; high myopia group: (SEQ) < -6 D). Associations between all studied parameters were examined. Three years postoperatively, an increase in anterior corneal curvatures and Fourier parameters was detected and the results were strongly correlated with the preoperative SEQ, lenticule thickness, and volume. At the posterior cornea, the flattest radius, corneal astigmatism, spherical component, regular astigmatism, and irregularity decreased only in the high myopia group. A correlation was found between changes in posterior astigmatism and changes in anterior radii (R = 0.349, P = 0.014), SEQ (R = 0.396, P = 0.0049), and lenticule thickness (R = -0.414, P = 0.0031). Moreover, changes in posterior corneal irregularity correlated with the changes in anterior and posterior radii (R = -0.3, P = 0.034, and R = 0.449, P = 0.0012, respectively), changes in preoperative SEQ (R = 0.284, P = 0.0477), and lenticule thickness (R = -0.311, P = 0.0298). Three years after SMILE, there was a reduction of posterior astigmatism in high refractive corrections. This could result in undercorrection in high refractive treatments. Total irregularities increased despite the compensatory effect of the posterior corneal surface.

Comparison of the predictability of refractive cylinder correction by laser in situ keratomileusis in eyes with low or high ocular residual astigmatism.

PubMed

Archer, Timothy J; Reinstein, Dan Z; Piñero, David P; Gobbe, Marine; Carp, Glenn I

2015-07-01

To compare the manifest refractive cylinder (MRC) predictability of myopic astigmatism laser in situ keratomileusis (LASIK) between eyes with low and high ocular residual astigmatism (ORA). London Vision Clinic, London, United Kingdom. Retrospective case study. The ORA was considered the vector difference between the MRC and the corneal astigmatism. The index of success (IoS), difference vector ÷ MRC, was analyzed for different groups as follows: stage 1, low ORA (ORA ÷ MRC <1), high ORA (ORA ÷ MRC ≥1); stage 2, low ORA group reduced to match the high ORA group for MRC; stage 3, grouped by ORA magnitude with low ORA (<0.50 diopters [D]), mid ORA (0.50 to 1.24 D), and high ORA (≥1.25 D); stage 4, high ORA group subdivided into low (<0.75 D) and high (≥0.75 D) corneal astigmatism. For stage 1, the mean preoperative MRC and mean IoS were -1.32 D ± 0.65 (SD) (range -0.55 to -3.77 D) and 0.27, respectively, for low ORA and -0.79 ± 0.20 D (range -0.56 to -2.05 D) and 0.37, respectively, for high ORA. For stage 2, the mean IoS increased to 0.32 for low ORA. For stage 3, the mean IoS was 0.28, 0.29, and 0.31 for low ORA, mid ORA, and high ORA, respectively. For stage 4, the mean IoS was 0.20 for high ORA/low corneal astigmatism and 0.35 for high ORA/high corneal astigmatism. The MRC predictability was slightly worse in eyes with high ORA when grouped by the ORA ÷ MRC. Matching for the MRC and grouping by ORA magnitude resulted in similar predictability; however, eyes with high ORA and high corneal astigmatism were less predictable. Dr. Reinstein is a consultant to Carl Zeiss Meditec AG, has a proprietary interest in the Artemis technology (Arcscan, Inc.), and is an author of patents related to very-high-frequency digital ultrasound administered by the Center for Technology Licensing at Cornell University, Ithaca, New York, USA. No other author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS

Sensitivity and specificity for detecting early glaucoma in eyes with high myopia from normative database of macular ganglion cell complex thickness obtained from normal non-myopic or highly myopic Asian eyes.

PubMed

Nakanishi, Hideo; Akagi, Tadamichi; Hangai, Masanori; Kimura, Yugo; Suda, Kenji; Kumagai, Kyoko Kawashima; Morooka, Satoshi; Ikeda, Hanako Ohashi; Yoshimura, Nagahisa

2015-07-01

We aimed to determine the sensitivity and specificity of the normative database of non-myopic and highly myopic eyes of the macular ganglion cell complex (mGCC) thickness embedded in the NIDEK RS-3000 spectral-domain optical coherence tomography (SD-OCT) for detecting early glaucoma in highly myopic eyes. Forty-seven highly myopic eyes (axial length ≥26.0 mm) of 47 subjects were studied. The SD-OCT images were used to determine the mGCC thickness within a 9-mm diameter circle centered on the fovea. The sensitivity and specificity of the non-myopic database were compared to that of the highly myopic database for distinguishing the early glaucomatous eyes from the non-glaucomatous eyes. The mGCC scans were classified as abnormal if at least one of the eight sectors of the significance map was < 1 % of the normative thickness. Twenty-one eyes were diagnosed to be non-glaucomatous and 26 eyes to have early glaucoma. . The average mGCC thickness was significantly thinner (80.9 ± 8.5 μm) in the early glaucoma group than in the non-glaucomatous group (91.2 ± 7.5 μm; p <1 × 10(-4)). The sensitivity was 96.2 % and specificity was 47.6 % when the non-myopic database was used, and the sensitivity was 92.3 % and the specificity was 90.5 % when the highly myopic database was used. The difference in the specificity was significant (p < 0.01). The significantly higher specificity of the myopic normative database for detecting early glaucoma in highly myopic eyes will lead to fewer false positive diagnoses. The database obtained from highly myopic eyes should be used when evaluating the mGCC thickness of highly myopic eyes.

Topography-modified refraction (TMR): adjustment of treated cylinder amount and axis to the topography versus standard clinical refraction in myopic topography-guided LASIK.

PubMed

Kanellopoulos, Anastasios John

2016-01-01

To evaluate the safety, efficacy, and contralateral eye comparison of topography-guided myopic LASIK with two different refraction treatment strategies. Private clinical ophthalmology practice. A total of 100 eyes (50 patients) in consecutive cases of myopic topography-guided LASIK procedures with the same refractive platform (FS200 femtosecond and EX500 excimer lasers) were randomized for treatment as follows: one eye with the standard clinical refraction (group A) and the contralateral eye with the topographic astigmatic power and axis (topography-modified treatment refraction; group B). All cases were evaluated pre- and post-operatively for the following parameters: refractive error, best corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), topography (Placido-disk based) and tomography (Scheimpflug-image based), wavefront analysis, pupillometry, and contrast sensitivity. Follow-up visits were conducted for at least 12 months. Mean refractive error was -5.5 D of myopia and -1.75 D of astigmatism. In group A versus group B, respectively, the average UDVA improved from 20/200 to 20/20 versus 20/16; post-operative CDVA was 20/20 and 20/13.5; 1 line of vision gained was 27.8% and 55.6%; and 2 lines of vision gained was 5.6% and 11.1%. In group A, 27.8% of eyes had over -0.50 diopters of residual refractive astigmatism, in comparison to 11.7% in group B ( P <0.01). The residual percentages in both groups were measured with refractive astigmatism of more than -0.5 diopters. Topography-modified refraction (TMR): topographic adjustment of the amount and axis of astigmatism treated, when different from the clinical refraction, may offer superior outcomes in topography-guided myopic LASIK. These findings may change the current clinical paradigm of the optimal subjective refraction utilized in laser vision correction.

Topography-modified refraction (TMR): adjustment of treated cylinder amount and axis to the topography versus standard clinical refraction in myopic topography-guided LASIK

PubMed Central

Kanellopoulos, Anastasios John

2016-01-01

Purpose To evaluate the safety, efficacy, and contralateral eye comparison of topography-guided myopic LASIK with two different refraction treatment strategies. Setting Private clinical ophthalmology practice. Patients and methods A total of 100 eyes (50 patients) in consecutive cases of myopic topography-guided LASIK procedures with the same refractive platform (FS200 femtosecond and EX500 excimer lasers) were randomized for treatment as follows: one eye with the standard clinical refraction (group A) and the contralateral eye with the topographic astigmatic power and axis (topography-modified treatment refraction; group B). All cases were evaluated pre- and post-operatively for the following parameters: refractive error, best corrected distance visual acuity (CDVA), uncorrected distance visual acuity (UDVA), topography (Placido-disk based) and tomography (Scheimpflug-image based), wavefront analysis, pupillometry, and contrast sensitivity. Follow-up visits were conducted for at least 12 months. Results Mean refractive error was −5.5 D of myopia and −1.75 D of astigmatism. In group A versus group B, respectively, the average UDVA improved from 20/200 to 20/20 versus 20/16; post-operative CDVA was 20/20 and 20/13.5; 1 line of vision gained was 27.8% and 55.6%; and 2 lines of vision gained was 5.6% and 11.1%. In group A, 27.8% of eyes had over −0.50 diopters of residual refractive astigmatism, in comparison to 11.7% in group B (P<0.01). The residual percentages in both groups were measured with refractive astigmatism of more than −0.5 diopters. Conclusion Topography-modified refraction (TMR): topographic adjustment of the amount and axis of astigmatism treated, when different from the clinical refraction, may offer superior outcomes in topography-guided myopic LASIK. These findings may change the current clinical paradigm of the optimal subjective refraction utilized in laser vision correction. PMID:27843292

Correcting lenticular astigmatism by reinstating the correct neuromuscular message.

PubMed

Yee, John William

2013-07-01

The spasm of the oblique muscles can contribute to lenticular astigmatism. The visual cortex interprets the tension of the oblique muscles as an eye that is in near focus mode. It overrides the response to the information generated by depth perception to bring a distant image into focus. Any excessive effort to bring it into focus will not be successful and continuing to make that effort can cause a misalignment in the tension of the rectus muscles. This in turn can directly induce corneal astigmatism and indirectly induce lenticular astigmatism. The astigmatic eye can still bring a near image into focus, but a distant image remains aberrant. The design of a special contact lens to treat lenticular astigmatism is similar to the design of a contact lens to treat corneal astigmatism by means of orthoculogy (or ortho C) as outlined in the paper Correcting Corneal Astigmatism by Reinstating the Correct Neuromuscular Message. The ortho C lens is worn for about two minutes to attend to the blur and distorted aspects of "simple myopic astigmatism". Both of these refractive errors are corrected simultaneously. Once the oblique muscles become "loose" due to a "contact lens draw", it triggers the visual cortex to reinstate the proper neuromotor message to stimulate the ciliary muscle (the muscle that controls the shape of the crystalline lens) to relax along a certain meridian-which in turn "flattens" the crystalline lens along that meridian to bring a blur and distorted image in the distance into focus. The correction only takes a few minutes because the ciliary muscle of an astigmatic eye was not compromised. The correction is not strictly due to an ortho C lens. Its design is the same for corneal astigmatism or lenticular astigmatism. The purpose of the design is to "loosen" the oblique muscles in a certain manner depending on the degree of astigmatism instead of a specific type of astigmatism. The visual cortex can discriminate whether to correct for corneal astigmatism

Risk factors for astigmatism in the Vision in Preschoolers Study.

PubMed

Huang, Jiayan; Maguire, Maureen G; Ciner, Elise; Kulp, Marjean Taylor; Cyert, Lynn A; Quinn, Graham E; Orel-Bixler, Deborah; Moore, Bruce; Ying, Gui-Shuang

2014-05-01

To determine demographic and refractive risk factors for astigmatism in the Vision in Preschoolers Study. Three- to 5-year-old Head Start preschoolers (N = 4040) from five clinical centers underwent comprehensive eye examinations by study-certified optometrists and ophthalmologists, including monocular visual acuity testing, cover testing, and cycloplegic retinoscopy. Astigmatism was defined as the presence of greater than or equal to +1.5 diopters (D) cylinder in either eye, measured with cycloplegic refraction. The associations of risk factors with astigmatism were evaluated using the odds ratio (OR) and its 95% confidence interval (CI) from logistic regression models. Among 4040 Vision in Preschoolers Study participants overrepresenting children with vision disorders, 687 (17%) had astigmatism, and most (83.8%) had with-the-rule astigmatism. In multivariate analyses, African American (OR, 1.65; 95% CI, 1.22 to 2.24), Hispanic (OR, 2.25; 95% CI, 1.62 to 3.12), and Asian (OR, 1.76; 95% CI, 1.06 to 2.93) children were more likely to have astigmatism than non-Hispanic white children, whereas American Indian children were less likely to have astigmatism than Hispanic, African American, and Asian children (p < 0.0001). Refractive error was associated with astigmatism in a nonlinear manner, with an OR of 4.50 (95% CI, 3.00 to 6.76) for myopia (≤-1.0 D in spherical equivalent) and 1.55 (95% CI, 1.29 to 1.86) for hyperopia (≥+2.0 D) when compared with children without refractive error (>-1.0 D, <+2.0 D). There was a trend of an increasing percentage of astigmatism among older children (linear trend p = 0.06). The analysis for risk factors of with-the-rule astigmatism provided similar results. Among Head Start preschoolers, Hispanic, African American, and Asian race as well as myopic and hyperopic refractive error were associated with an increased risk of astigmatism, consistent with findings from the population-based Multi-ethnic Pediatric Eye Disease Study and the

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.

Neuronal adaptation to simulated and optically-induced astigmatic defocus.

PubMed

Ohlendorf, Arne; Tabernero, Juan; Schaeffel, Frank

2011-03-25

It is well established that spatial adaptation can improve visual acuity over time in the presence of spherical defocus. It is less well known how far adaptation to astigmatic defocus can enhance visual acuity. We adapted subjects to "simulated" and optically-induced "real" astigmatic defocus, and studied how much they adapt and how selective adaptation was for the axis of astigmatism. Ten subjects with a mean age of 26.7±2.4years (range 23-30) were enrolled in the study, three of them myopic (average spherical equivalent (SE)±SD: -3.08±1.42D) and seven emmetropic (average SE±SD: -0.11±0.18D). All had a corrected minimum visual acuity (VA) of logVA 0.0. For adaptation, subjects watched a movie at 4m distance for 10min that was convolved frame-by-frame with an astigmatic point spread function, equivalent to +3D defocus, or they watched an unfiltered movie but with spectacle frames with a 0/+3D astigmatic trial lenses. Subsequently, visual acuity was determined at the same distance, using high contrast letter acuity charts. Four experiments were performed. In experiment (1), simulated astigmatic defocus was presented both for adaptation and testing, in experiment (2) optically-induced astigmatic defocus was presented both for adaptation and testing of visual acuity. In all these cases, the +3D power meridian was at 0°. In experiments (3) and (4), the +3D power meridian was at 0° during adaptation but rotated to 90° during testing. Astigmatic defocus was simulated in experiment (3) but optically-induced in experiment (4). Experiments 1 and 2: adaptation to either simulated or real astigmatic defocus increased visual acuity in both test paradigms, simulated (change in VA 0.086±0.069 log units; p<0.01) and lens-induced astigmatic defocus (change in VA 0.068±0.031 log units; p<0.001). Experiments 3 and 4: when the axis was rotated, the improvement in visual acuity failed to reach significance, both for simulated (change in VA 0.042±0.079 log units; p=0.13) and

Full-Thickness Astigmatic Keratotomy Combined With Small-Incision Lenticule Extraction to Treat High-Level and Mixed Astigmatism.

PubMed

Kim, Bu Ki; Mun, Su Joung; Lee, Dae Gyu; Kim, Jae Ryun; Kim, Hyun Seung; Chung, Young Taek

2015-12-01

To explore the clinical effects of combined full-thickness astigmatic keratotomy and small-incision lenticule extraction (SMILE) in patients who are inoperable using SMILE alone. We included 13 eyes of 9 patients with high-level or mixed astigmatism who underwent full-thickness astigmatic keratotomy followed by SMILE (secondarily) to correct the residual refractive error. Six months after SMILE, the spherical equivalent was reduced from -4.83 ± 3.26 D to -0.17 ± 0.38 D (P < 0.001), and the astigmatism was reduced from 5.12 ± 0.96 D to 0.21 ± 0.22 D (P < 0.001). The uncorrected and corrected (CDVA) distance visual acuities improved from 1.07 ± 0.62 to 0.02 ± 0.13 (P < 0.001) and from 0.08 ± 0.14 to -0.01 ± 0.14 (P = 0.002), respectively. The CDVA improved by 1 or 2 Snellen lines in 8 cases (61.5%), and there was no loss in CDVA. All procedures were completed without intraoperative or postoperative complications. This combined procedure was effective and safe for the treatment of high-level or mixed astigmatism.

Astigmatism and defocus wavefront correction via Zernike modes produced with fluidic lenses

PubMed Central

Marks, Randall; Mathine, David L.; Schwiegerling, Jim; Peyman, Gholam; Peyghambarian, Nasser

2010-01-01

Fluidic lenses have been developed for ophthalmic applications with continuously varying optical powers for second order Zernike modes. Continuously varying corrections for both myopic and hyperopic defocus have been demonstrated over a range of three diopters using a fluidic lens with a circular retaining aperture. Likewise, a six diopter range of astigmatism has been continuously corrected using fluidic lenses with rectangular apertures. Imaging results have been characterized using a model eye. PMID:19571912

Biometric measurements in highly myopic eyes.

PubMed

Shen, Peiyang; Zheng, Yingfeng; Ding, Xiaohu; Liu, Bin; Congdon, Nathan; Morgan, Ian; He, Mingguang

2013-02-01

To assess the repeatability and accuracy of optical biometry (Lenstar LS900 optical low-coherence reflectometry [OLCR] and IOLMaster partial coherence interferometry [PCI]) and applanation ultrasound biometry in highly myopic eyes. Division of Preventive Ophthalmology, Zhongshan Ophthalmic Center, Guangzhou, China. Comparative evaluation of diagnostic technology. Biometric measurements were taken in highly myopic subjects with a spherical equivalent (SE) of -6.00 diopters (D) or higher and an axial length (AL) longer than 25.0 mm. Measurements of AL and anterior chamber depth (ACD) obtained by OLCR were compared with those obtained by PCI and applanation A-scan ultrasound. Right eyes were analyzed. Repeatability was evaluated using the coefficient of variation (CoV) and agreement, using Bland-Altman analyses. The mean SE was -11.20 D ± 4.65 (SD). The CoVs for repeated AL measurements using OLCR, PCI, and applanation ultrasound were 0.06%, 0.07%, and 0.20%, respectively. The limits of agreement (LoA) for AL were 0.11 mm between OLCR and PCI, 1.01 mm between OLCR and applanation ultrasound, and 1.03 mm between PCI and ultrasound. The ACD values were 0.29 mm, 0.53 mm, and 0.51 mm, respectively. These repeatability and agreement results were comparable in eyes with extreme myopia (AL ≥ 27.0 mm) or posterior staphyloma. The mean radius of corneal curvature was similar between OLCR and PCI (7.66 ± 0.24 mm versus 7.64 ± 0.25 mm), with an LoA of 0.12 mm. Optical biometry provided more repeatable and precise measurements of biometric parameters, including AL and ACD, than applanation ultrasound biometry in highly myopic eyes. 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.

The effect of fractal contact lenses on peripheral refraction in myopic model eyes.

PubMed

Rodriguez-Vallejo, Manuel; Benlloch, Josefa; Pons, Amparo; Monsoriu, Juan A; Furlan, Walter D

2014-12-01

To test multizone contact lenses in model eyes: Fractal Contact Lenses (FCLs), designed to induce myopic peripheral refractive error (PRE). Zemax ray-tracing software was employed to simulate myopic and accommodation-dependent model eyes fitted with FCLs. PRE, defined in terms of mean sphere M and 90°-180° astigmatism J180, was computed at different peripheral positions, ranging from 0 to 35° in steps of 5°, and for different pupil diameters (PDs). Simulated visual performance and changes in the PRE were also analyzed for contact lens decentration and model eye accommodation. For comparison purposes, the same simulations were performed with another commercially available contact lens designed for the same intended use: the Dual Focus (DF). PRE was greater with FCL than with DF when both designs were tested for a 3.5 mm PD, and with and without decentration of the lenses. However, PRE depended on PD with both multizone lenses, with a remarkable reduction of the myopic relative effect for a PD of 5.5 mm. The myopic PRE with contact lenses decreased as the myopic refractive error increased, but this could be compensated by increasing the power of treatment zones. A peripheral myopic shift was also induced by the FCLs in the accommodated model eye. In regard to visual performance, a myopia under-correction with reference to the circle of least confusion was obtained in all cases for a 5.5 mm PD. The ghost images, generated by treatment zones of FCL, were dimmer than the ones produced with DF lens of the same power. FCLs produce a peripheral myopic defocus without compromising central vision in photopic conditions. FCLs have several design parameters that can be varied to obtain optimum results: lens diameter, number of zones, addition and asphericity; resulting in a very promising customized lens for the treatment of myopia progression.

Glaucoma-induced optic disc morphometric changes and glaucoma diagnostic ability of Heidelberg Retina Tomograph II in highly myopic eyes.

PubMed

Mayama, Chihiro; Tsutsumi, Tae; Saito, Hitomi; Asaoka, Ryo; Tomidokoro, Atsuo; Iwase, Aiko; Otani, Shinichiro; Miyata, Kazunori; Araie, Makoto

2014-01-01

This study was performed to first investigate the morphological differences in the optic nerve head between highly myopic non-glaucomatous controls and highly myopic glaucomatous eyes in comparison with the differences between emmetropic non-glaucomatous controls and emmetropic glaucomatous eyes using confocal scanning laser ophthalmoscopy. Further, the ability of the apparatus in glaucoma diagnosis in highly myopic eyes was compared with that in emmetropic eyes. Healthy subjects and age-matched patients with early-stage open-angle glaucoma were divided into two groups: emmetropic eyes (-1.0 to +1.0 diopters) and highly myopic eyes (-12.0 to -5.0 diopters).The participants were comprised of 65 emmetropic normal eyes, 59 emmetropic glaucomatous eyes, 62 highly myopic normal eyes, and 68 highly myopic glaucomatous eyes and eyes with pathologic myopia were carefully excluded. Confocal scanning laser tomographic parameters were compared among all subjects after adjustment for age and disc area. The ROC curves and sensitivity and specificity for glaucoma detection using several clinical methods were then compared between the emmetropic and highly myopic eyes. Rim area, cup/disc area ratio, mean cup depth, and cup shape measure of glaucoma eyes are significantly different from those of normal eyes in both highly myopic eyes and emmetropic eyes. Methodological overestimation of retinal nerve fiber layer cross sectional area due to optic disc tilting was suggested in the highly myopic eyes. The diagnostic performance of glaucoma using several discriminant methods significantly deteriorated in the highly myopic eyes. In the highly myopic glaucomatous eyes, confocal scanning laser tomographic parameters were significantly different from that of non-glaucomatous highly myopic eyes but diagnostic performance of glaucoma was deteriorated than that in emmetropic eyes. These findings demonstrate the utility and limitations of the apparatus in diagnosing glaucoma in highly myopic

Correction of high amounts of astigmatism through orthokeratology. A case report

PubMed Central

Baertschi, Michael; Wyss, Michael

2011-01-01

The purpose of this case report is to introduce a method for a successful treatment of high astigmatism with a new orthokeratology design, called FOKX (Falco Kontaktlinsen, Switzerland). This novel toric orthokeratology contact lens design, the fitting approach and the performance of FOKX lenses will be illustrated in the form of a case report. Correcting astigmatism with orthokeratology offers a new perspective for all patients suffering astigmatism.

Beveled Femtosecond Laser Astigmatic Keratotomy for the Treatment of High Astigmatism Post–Penetrating Keratoplasty

PubMed Central

Cleary, Catherine; Tang, Maolong; Ahmed, Habeeb; Fox, Martin; Huang, David

2013-01-01

Purpose To use beveled femtosecond laser astigmatic keratotomy (FLAK) incisions to treat high astigmatism after penetrating keratoplasty. Methods Paired FLAK incisions at a bevel angle of 135 degrees, 65% to 75% depth, and arc lengths of 60 to 90 degrees were performed using a femtosecond laser. One case of perpendicular FLAK was presented for comparison. Vector analysis was used to calculate the changes in astigmatism. Fourier domain optical coherence tomography was used to examine incision morphology. Results Wound gaping requiring suturing was observed in the case of perpendicular FLAK. Six consecutive cases of beveled FLAK were analyzed. Fourier domain optical coherence tomography showed that beveled FLAK caused a mean forward shift of Bowman layer anterior to the incisions of 126 ± 38 μm, with no wound gaping. The mean magnitude of preoperative keratometric astigmatism was 9.8 ± 2.9 diopters (D), and postoperatively it was 4.5 ± 3.2 D (P < 0.05). Uncorrected visual acuity improved from 1.24 ± 0.13 logarithm of the minimum angle of resolution preoperatively to 0.76 ± 0.38 postoperatively (P < 0.05). Best spectacle–corrected visual acuity improved from 0.43 ± 0.33 logarithm of the minimum angle of resolution preoperatively to 0.27 ± 0.24 postoperatively (P = 0.22). Visual results were reduced in 2 patients by cataract progression. Between 1 and 3 months after beveled FLAK, the keratometric cylinder was stable (<1 D change) in 5 of 6 patients, and regressed in 1 patient. No complications occurred. Conclusions Beveled FLAK incisions at varied depth are effective in the management of postkeratoplasty astigmatism. Early postoperative changes stabilized within 1 month in most patients. Further studies are needed to assess long-term outcomes. PMID:22968362

[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

Management of pseudophakic myopic anisometropic amblyopia with piggyback Visian® implantable collamer lens.

PubMed

Eissa, Sherif A

2017-03-01

To assess the outcomes of sulcus implantation of the Visian ® implantable collamer lens (ICL) to correct pseudophakic myopic anisometropic amblyopia with myopic shift and/or primary refractive overcorrection. Prospective case series enrolled 14 pseudophakic eyes of 14 patients, 5-9 years old, with history of cataract surgery and primary in the bag-intraocular lenses (IOL) implantation, followed by myopic shift and/or refractive overcorrection and anisometropic amblyopia of variable degrees. All cases had implantation of a piggyback ICL/toric ICL, to correct the myopia/myopic astigmatism. Preoperatively, we evaluated the uncorrected distance visual acuity (UCVA), corrected distance visual acuity (CDVA), manifest refraction spherical equivalent (MRSE), intraocular pressure (IOP) and endothelial cell density (ECD). We assessed the position and vaulting of the ICLs on slit lamp examination and confirmed by Scheimpflug tomography. Postoperative follow-up was at 1st week and 1, 3, 6, 9, 12, 18 and 24 months. Uncorrected distance visual acuity improved in all cases, and CDVA improved in 11 amblyopic eyes (2-4 lines). There was no evidence of interlenticular opacification (ILO) throughout the 2-year follow-up. Two cases were complicated with early postoperative acute elevation of IOP and were controlled with topical beta-blockers. Postoperative acute anterior uveitis occurred in six eyes and controlled by topical steroids. Implantable collamer lens (ICL) vault was measured using Pentacam, with mean value of 470 ± 238 μm. Sulcus implantation of the secondary piggyback ICL to correct unilateral pseudophakic myopic refractive error in children was safe, efficient, predictable and well tolerated in management of anisometropic amblyopia in all eyes. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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

Optimal refraction with monofocal intraocular lenses: no beneficial effect of astigmatism.

PubMed

Naeser, Kristian; Hjortdal, Jesper

2011-03-01

This study aimed to determine the optimal spherocylindrical refraction in the monofocal, pseudophakic eye using power vectors in dioptric space. For parallel incident light the defocus of a spherocylinder may be described in dioptric space as: Defocus equivalent for distance fixation = D((SEP,M,x=∞)) = √SEP(2)+(1/2M)(2), where SEP = spherical equivalent power in dioptres (D) and M = astigmatic magnitude in D. In the pseudophakic eye the defocus for any fixation distance x is: Defocus equivalent for the fixation distance x = D((SEP,M,x)) = √(SEP-1/x)(2)+ (1/2M)(2). The cumulative defocus over a fixation interval is the integral of D((SEP,M,x)) . A minimal value for cumulative defocus will indicate a maximal unaided visual acuity (VA) over the chosen fixation interval. We calculated the summated defocus for various spherocylinders for fixation distances ranging from 0.5 m to 6.0 m. Minimal cumulative defocus was present for pure spheres of -0.25 D to -0.5 D. No beneficial effect of the presence of astigmatism was detected. In monofocal pseudophakia the highest possible VAs over the most extended fixation ranges may be achieved with slight myopic refractions without astigmatic components. © 2009 The Authors. Journal compilation © 2009 Acta Ophthalmol.

Effectiveness and confounding factors of penetrating astigmatic keratotomy in clinical practice

PubMed Central

Yen, Chu-Yu; Tseng, Gow-Lieng

2018-01-01

. 1.1 ± 0.69, P = .214). Higher PCA were associated with higher net correction in both group A (P = .002) and group B (P = .019). Compound myopic astigmatism caused less net correction than others only in group A (P = 0.031). Lessons: Penetrating AK is an accessible, affordable, and effective way to correct corneal astigmatism. The results of this procedure are comparable to modern methods in patients with low to moderate corneal astigmatism. PMID:29369200

Comparison of Visian toric collamer lens and toric acrylic intraocular lens implantation for the treatment of myopia with astigmatism

PubMed Central

Ammar, Hatem; Anbar, Mohamed; Abdellah, Marwa M

2017-01-01

Purpose To compare the efficacy and outcome of phakic toric implantable collamer lens (TICL) and refractive clear lens extraction with AcrySof Toric intraocular lens (TIOL) implantation for the treatment of myopic astigmatism. Patients and methods This study assessed eyes with myopic astigmatism >−1 D and ≤−4 D with a spherical equivalent >10 D or <10 D if the patients were unsuitable for corneal refractive surgery. These eyes were divided into group A, in which Visian Toric ICL™ Phakic TICL was implanted, and group B, which involved clear lens extraction with implantation of an AcrySof IQ toric SN60T3-9™ IOL. The outcome and complications were evaluated. Results This study enrolled 63 eyes of 38 patients with a follow-up period of at least 6 months. The mean postoperative spherical equivalent was −0.19±0.31 D in group A and −0.21±0.28 D in group B (P=0.69). The mean postoperative cylinder value was −0.46±0.53 D in group A and −0.32±0.41 D in group B (P=0.35). Postoperative cylinder was <1 D in 76.47% and 79.31% of eyes in groups A and B, respectively. The mean endothelial cell count was reduced by 4.32% in group A and by 5.32% in group B (P=0.003). The mean postoperative intraocular pressure increased insignificantly in group A (P=0.22) and reduced significantly in group B (P=0.004). The complication rate was 11.76% in group A and 6.90% in group B. Conclusion Both procedures showed predictable results and good visual results. However, the loss of accommodation and risk of retinal complications in the TIOL group suggest that the use of TICL for myopic astigmatism is a better choice in younger patients. PMID:28096654

Long-term follow-up of astigmatic keratotomy for corneal astigmatism after penetrating keratoplasty.

PubMed

Böhringer, Daniel; Dineva, Nina; Maier, Philip; Birnbaum, Florian; Kirschkamp, Thomas; Reinhard, Thomas; Eberwein, Philipp

2016-11-01

To report the long-term stability of paired arcuate corneal keratotomies (AKs) in patients with high regular postpenetrating keratoplasty astigmatism. Retrospective chart review of best-corrected visual acuity, refraction and keratometric values of 41 eyes with AK between 2003 and 2012. Magnitude of median target induced astigmatism vector was 9.2 dioptres (Dpt). We reached a median magnitude of surgically induced astigmatism vector of 9.81 Dpt and a median magnitude of difference vector of 5.5 Dpt. In keratometry, we achieved a net median astigmatism reduction by 3.3 Dpt. The average correction index was 1.14, showing a slight overcorrection. Irregularity of keratometric astigmatism increased by 0.6 Dpt, and spherical equivalent changed by 1.75 Dpt. Monocular best spectacle corrected visual acuity increased from preoperatively 20/63 (0.5 logMAR) to 20/40 (0.3 logMAR) postoperatively. Median gain on the ETDRS chart was two lines. Long-term follow-up showed a median keratometric astigmatic increase by 0.3 Dpt per year. Arcuate corneal keratotomies is a safe and effective method to reduce high regular corneal astigmatism following penetrating keratoplasty but has limited predictability. The long-term follow-up shows an increase of keratometric astigmatism by 0.3 Dpt/year, equalizing the surgical effect after 10 years. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Reading Fluency in School-Age Children with Bilateral Astigmatism

PubMed Central

Harvey, Erin M.; Miller, Joseph M.; Twelker, J. Daniel; Davis, Amy L.

2015-01-01

Purpose To compare oral reading fluency (ORF) in students with no/low astigmatism and moderate/high astigmatism and to assess the impact of spectacle correction on ORF in moderate and high astigmats. Methods Subjects were 3rd–8th grade students from a highly astigmatic population. Refractive error was determined through subjectively refined cycloplegic autorefraction. Data from students with ocular abnormalities, anisometropia, symptomatic binocular vision disorders, or refractive error that did not meet study criteria (no/low (cyl < 1.00 both eyes, no significant myopia/hyperopia), moderate (cyl ≥ 1.00 D both eyes, mean ≥ 1.00 D and < 3.00 D), or high astigmatism group (cyl ≥ 1.00 D both eyes, mean ≥ 3.00 D)) were excluded. ORF was tested with a modified version of the DIBELS Next test of ORF. No/low astigmats were tested without spectacles; astigmats were tested with and without spectacles. Mean ORF was compared in no/low astigmats and astigmats (with and without correction). Improvement in ORF with spectacles was compared for moderate and high astigmats. Results The sample included 130 no/low, 67 moderate, and 76 high astigmats. ORF was lower in uncorrected astigmats than in no/low astigmats (p=0.011). ORF did not significantly differ in no/low astigmats and corrected astigmats (p=0.10). ORF significantly improved with spectacle correction in high astigmats (p=0.001, mean improvement 6.55 words per minute (WPM)), but not in moderate astigmats (p=0.193, mean improvement 1.87 WPM). Effects of spectacle wear were observed in students who read smaller text stimuli (older grades). Conclusions ORF is significantly reduced in students with bilateral astigmatism (≥ 1.00D) when uncorrected, but not when best-corrected, compared to their non-astigmatic peers. Improvement in ORF with spectacle correction is seen in high astigmats, but not in moderate astigmats. These data support the recommendation for full-time spectacle wear in astigmatic students

Reading Fluency in School-Aged Children with Bilateral Astigmatism.

PubMed

Harvey, Erin M; Miller, Joseph M; Twelker, J Daniel; Davis, Amy L

2016-02-01

To compare oral reading fluency (ORF) in students with no/low astigmatism and moderate/high astigmatism and to assess the impact of spectacle correction on ORF in moderate and high astigmats. Subjects were third- to eighth-grade students from a highly astigmatic population. Refractive error was determined through subjectively refined cycloplegic autorefraction. Data from students with ocular abnormalities, anisometropia, symptomatic binocular vision disorders, or refractive error that did not meet study criteria (no/low [cylinder < 1.00 both eyes, no significant myopia/hyperopia], moderate [cylinder ≥ 1.00 D both eyes, mean ≥ 1.00 D and < 3.00 D], or high astigmatism group [cylinder ≥ 1.00 D both eyes, mean ≥ 3.00 D]) were excluded. Oral reading fluency was tested with a modified version of the Dynamic Indicators of Basic Early Literacy Skills (DIBELS) Next test of ORF. No/low astigmats were tested without spectacles; astigmats were tested with and without spectacles. Mean ORF was compared in no/low astigmats and astigmats (with and without correction). Improvement in ORF with spectacles was compared between moderate and high astigmats. The sample included 130 no/low, 67 moderate, and 76 high astigmats. ORF was lower in uncorrected astigmats than in no/low astigmats (p = 0.011). ORF did not significantly differ in no/low astigmats and corrected astigmats (p = 0.10). ORF significantly improved with spectacle correction in high astigmats (p = 0.001; mean improvement, 6.55 words per minute) but not in moderate astigmats (p = 0.193; mean improvement, 1.87 words per minute). Effects of spectacle wear were observed in students who read smaller text stimuli (older grades). ORF is significantly reduced in students with bilateral astigmatism (≥1.00D) when uncorrected but not when best-corrected compared with their nonastigmatic peers. Improvement in ORF with spectacle correction is seen in high astigmats but not in moderate astigmats. These data support the

Comparison of Astigmatism Induced by Combined Inferior Oblique Anterior Transposition Procedure and Lateral Rectus Recession Alone.

PubMed

Eum, Sun Jung; Chun, Bo Young

2016-12-01

The purpose of this study is to compare the magnitude and axis of astigmatism induced by a combined inferior oblique (IO) anterior transposition procedure with lateral rectus (LR) recession versus LR recession alone. Forty-six patients were retrospectively analyzed. The subjects were divided into two groups: those having concurrent inferior oblique muscle overaction (IOOA) and intermittent exotropia (group 1, 20 patients) and those having only intermittent exotropia as a control (group 2, 26 patients). Group 1 underwent combined anterior transposition of IO with LR recession and group 2 underwent LR recession alone. Induced astigmatism was defined as the difference between preoperative and postoperative astigmatism using double-angle vector analysis. Cylinder power, axis of induced astigmatism, and spherical equivalent were analyzed at 1 week, 1 month, and 3 months after surgery. Larger changes in the axis of induced astigmatism were observed in group 1, with 4.5° incyclotorsion, than in group 2 at 1 week after surgery (axis, 84.5° vs. 91°; p < 0.001). However, there was no statistically significant inter-group difference thereafter. Relaxation and rapid regression in the incyclotorsion of induced astigmatism were observed over-time. Spherical equivalent significantly decreased postoperatively at 1 month in both groups, indicating a myopic shift ( p = 0.011 for group 1 and p = 0.019 for group 2) but did not show significant differences at 3 months after surgery ( p = 0.107 for group 1 and p = 0.760 for group 2). Combined IO anterior transposition procedures caused an increased change in the axis of induced astigmatism, including temporary incyclotorsion, during the first week after surgery. However, this significant difference was not maintained thereafter. Thus, combined IO surgery with LR recession does not seem to produce a sustained astigmatic change, which can be a potential risk factor of postoperative amblyopia or diplopia compared with LR recession alone.

The early results of excimer laser photorefractive keratectomy for compound myopic astigmatism.

PubMed

Horgan, S E; Pearson, R V

1996-01-01

An excimer laser (VISX Twenty/Twenty Excimer Refractive System) was used to treat 51 eyes for myopia and astigmatism. Uncorrected pretreatment visual acuity was between 6/18 and 6/60 (log unit +0.45 to +1.0) in 59% and worse than 6/60 in 29%. The mean pretreatment spherical refractive error was -4.05 dioptre (range 1.25 to 13.25), and the mean pretreatment cylindrical error was -0.97 dioptre (range 0.25 to 4.00). Uncorrected visual acuity measured 6/6 or better (log unit 0.0 or less) in 80% at three months, and averaged 6/6 for all eyes at six months post-treatment, with 75% eyes obtaining 6/6 or better. The mean post-treatment spherical error decayed according to pre-treatment values, with a mean sphere of -0.20 dioptre for eyes initially less than -2.00 dioptre, -0.40 dioptre (for those between -2.25 and -3.00), -0.71 dioptre (for those between -4.25 and -5.00), and -1.15 dioptre for eyes initially above -6.25 dioptre. Vectored cylindrical correction exhibited response proportional to initial refraction, with a mean post-treatment cylinder of -1.83 dioptre for eyes formerly averaging -3.08 dioptre, -0.55 dioptre (eyes initially averaging -1.63 dioptre), and -0.51 dioptre (eyes initially averaging -0.67 dioptre). Vector analysis of post-treatment astigmatism showed 58% eyes exhibiting 51 or more degrees of axis shift, although 34% eyes remained within 20 degrees of their pretreatment axis. An effective reduction in spherocylindrical error was achieved with all eyes, although axis misalignment was a common event.

Anisometropia of spherical equivalent and astigmatism among myopes: a 23-year follow-up study of prevalence and changes from childhood to adulthood.

PubMed

Pärssinen, Olavi; Kauppinen, Markku

2017-08-01

To study anisometropia of spherical equivalent and astigmatism from the onset of myopia at school age to adulthood. A total of 240 myopic schoolchildren (mean age 10.9 years), with no previous spectacles, were recruited during 1983-1984 to a randomized 3-year clinical trial of bifocal treatment of myopia. Examinations with subjective cyclopedic refraction were repeated 3 years later (follow-up 1) for 238 subjects and thereafter at the mean ages of 23.2 (follow-up 2) and 33.9 years (follow-up 3) for 178 and 134 subjects. After exclusions, the 102 subjects who attended all three follow-ups were included in the analyses. Corneal refractive power and astigmatism and anterior chamber depth was measured with Pentacam topography and axial length with IOL master at study end. Prevalence and changes in anisometropia of spherical equivalent (AnisoSE) and astigmatism (AnisoAST) and their relationships with refractive and axial measures were studied. Mean (±SD) of spherical equivalent (SE), AnisoSE and AnisoAST increased from baseline to follow-up end from -1.44 ± 0.57 D to -5.11 ± 2.23 D, from 0.28 ± 0.30 D to 0.68 ± 0.69 D and from 0.14 ± 0.18 D to 0.37 ± 0.36 D, respectively. Prevalence of AnioSE, ≥1 D, increased from 5% to 22.6% throughout follow-up. Higher AnisoSE was associated with SE in the less myopic eye at baseline and at follow-up 1, and with SE in the more myopic eye in follow-ups 2 and 3 in adulthood. At study end, AnisoSE was associated with the interocular difference in axial length (AL) (r = 0.612, p < 0.001) but not with the interocular difference in corneal refraction (CR) (r = -0.122, p = 0.266). In cases of low AnisoSE(≤1.00 D), the negative correlation between the real interocular differences (value of right eye minus value of left eye) in CR and AL (r = -0.427, p < 0.001) decreased the influence of the interocular difference in AL on AnisoSE, causing emmetropization in AnisoSE. The interocular difference in corneal

Age-Related Changes in Corneal Astigmatism.

PubMed

Shao, Xu; Zhou, Kai-Jing; Pan, An-Peng; Cheng, Xue-Ying; Cai, He-Xie; Huang, Jin-Hai; Yu, A-Yong

2017-10-01

To analyze the changes in corneal astigmatism as a function of age and develop a novel model to estimate corneal astigmatic change according to age. This was a cross-sectional study of right eyes of 3,769 individuals. Total corneal astigmatism, keratometric astigmatism, anterior corneal astigmatism, and posterior corneal astigmatism were measured by a Scheimpflug tomographer. Smoothing fitting curves of polar values of corneal astigmatism as a function of age were drawn and average changes in corneal astigmatism at different ages were calculated. Two turning points of age on total corneal astigmatism were 36 and 69 years. The average change of total corneal astigmatism toward against-the-rule astigmatism was 0.13 diopters (D)/10 years from 18 to 35 years, 0.45 D/10 years from 36 to 68 years, and decreased after 69 years, mainly caused by anterior corneal astigmatism. The mean magnitude of posterior corneal astigmatism was -0.33 D and exceeded 0.50 D in 14.27% of eyes. The vectorial difference between total corneal astigmatism and keratometric astigmatism was correlated with posterior corneal astigmatism, polar value of anterior corneal astigmatism, age, and corneal higher order aberrations (r = 0.636; standard partial regression coefficients were 0.479, -0.466, 0.282, and 0.196, respectively; all P < .001). Based on the non-linear model to estimate corneal astigmatic change with age, a formula was developed to calculate recommended correction of astigmatism according to age and astigmatic type. The rate of change of total corneal astigmatism showed a non-linear trend toward against-the-rule astigmatism, which was low at young and old age, high at middle age, and should be taken into account when performing surgery to correct astigmatism. [J Refract Surg. 2017;33(10):696-703.]. Copyright 2017, SLACK Incorporated.

[Predictability of residual astigmatism after implantation of posterior chamber toric lenses].

PubMed

Mies, D; Klink, T; Eisenbarth, W; Meyer, L M

2018-01-01

The objective of the study was to examine the predictability of residual astigmatism after cataract surgery and implantation of the posterior chamber aspheric toric lens TECNIS® ZCT, Abott Medical Optic (Ettlingen, Deutschland). The retrospective study included a total of 88 patient eyes undergoing a cataract operation with a toric lens implantation between March 2014 and October 2015. The inclusion criteria were a regular astigmatism of at least 0.75 dpt. Posterior chamber toric lenses (model Tecnis ZCT) were exclusively implanted. Post-surgery check-ups were performed after 1 day, 1 month and 2 months. Main study outcome was best-corrected visual acuity (BCVA), spherical and astigmatic aberration and the difference between expected and actual residual astigmatism after cataract surgery. The median reduction of corneal astigmatism was from -2.50 dpt (±1.06 dpt) to -0.75 dpt (±0.51 dpt) (p ≤ 0.05). The median BCVA increased from 0.37 logMAR (±0.25 logMAR) before surgery to 0.09 logMAR (±0.10 logMAR) after surgery. The spherical equivalent was reduced from +3.50 dpt (±1.11 dpt) (presurgery) to -0.56 dpt (±0.51 dpt) (postsurgery) in hyperopic patients and from -2.44 dpt (±3.03 dpt) to -0.69 dpt (±0.81 dpt) in myopic patients. By using the power vector analysis no significant deviation from the expected target values was observed; however, the median discrepancy between the expected and actual residual astigmatism was -0.50 dpt despite a surgical orientation of the intraocular lens (IOL) within 5° of the desired axis. The IOL showed a median rotation of 3.00° (±4.46°). Implantation of the aspheric toric intraocular lens Tecnis ZCT is a predictable, effective and reproducible tool in cataract surgery to account for regular corneal astigmatis; however, despite an optimal surgical orientation of the toric IOL, a small and rarely a large discrepancy might occur between expected and actual residual astigmatism.

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

The relationship between scleral staphyloma and choroidal thinning in highly myopic eyes: The Beijing Eye Study.

PubMed

Zhou, Ling Xiao; Shao, Lei; Xu, Liang; Wei, Wen Bin; Wang, Ya Xing; You, Qi Sheng

2017-08-29

Based on the Beijing Eye Study 2011, a detailed ophthalmic examination was performed including spectral-domain optical coherence tomography (SD-OCT) with enhanced depth imaging for measurement of subfoveal choroidal thickness (SFCT) and relative height of posterior scleral staphyloma. OCT images were obtained in 103 highly myopic eyes (≤-6.00 diopters) and 227 normal eyes. The mean SFCT in highly myopic eyes was 110.6 ± 85.2 μm (range, 3 to 395 μm). The SFCT of high myopia without posterior scleral staphyloma(55 eyes) was 157.79 ± 85.18 μm, which was significantly greater than that (54.94 ± 49.96 μm) of high myopia with posterior scleral staphyloma (48 eyes) (P < 0.001). In multivariate analysis, posterior scleral staphyloma was the most important factor of choroidal thinning in high myopia (F = 22.63; P < 0.001), then age (F = 19.14; P < 0.001), axial length (F = 17.37; P < 0.001) and gender (F = 17.31; P < 0.001). The SFCT in highly myopic eyes is very thin and undergoes further thinning with increasing age and axial length (refractive error). Posterior staphyloma formation was a key factor in choroidal thinning in highly myopic eyes and to be a good indicator for risk management of choroidal thinning. Abnormalities of the choroid may play a role in the pathogenesis of myopic degeneration.

Corneal and lenticular components of total astigmatism in a preschool sample.

PubMed

Shankar, Sunita; Bobier, William R

2004-07-01

To examine the contribution of corneal and lenticular components to total astigmatism in preschool low and high astigmats to determine whether there was any compensation for high astigmatism by the lenticular component. Cycloplegic refractive and keratometric measures using the Retinomax K-Plus (Nikon Inc., Melville, NY) were conducted on 129 children (mean age, 51.1 +/- 8.4 mo) in Oxford County, Canada. We divided the sample into high astigmats (total cylinder > or =1 D; mean, 1.38 +/- 0.43 D; n = 29) and normal astigmats (total cylinder < or =0.75 D; mean, 0.22 +/- 0.20 D; n = 100). Measures of total and corneal cylinder were transposed into J0 and J45 components, where positive and negative J0 values quantified with-the-rule (WTR) and against-the-rule astigmatisms, respectively, and J45 quantified oblique astigmatism. WTR astigmatism was dominant in both the high and normal astigmatic group. J0 and J45 components of corneal astigmatism were highly correlated with total astigmatism in high astigmats, whereas only J0 was significantly correlated with total astigmatism in normal astigmats. Although the magnitude of total and corneal cylinder was significantly greater in high astigmats, overall lenticular cylinder was similar in both groups. However, the Fourier transforms showed high astigmats to have significantly lower lenticular J0 and higher lenticular J45 than the normal astigmats. Astigmatism in 3- to 5-year-old children is primarily corneal. In preschool children, the lens does not vary in response to high amounts of corneal WTR astigmatism, and in fact, it increases the oblique astigmatism component when the corneal component is high. In high astigmats, lenticular astigmatism contributes to both J0 and J45 components, whereas the corneal contribution is primarily J0.

Astigmatism following retinal detachment surgery.

PubMed Central

Goel, R; Crewdson, J; Chignell, A H

1983-01-01

Eighty-three patients on whom successful retinal detachment had been performed were studied to note astigmatic changes following surgery. In the majority of cases the errors following such surgery are of no great clinical importance. However, in some situations a high degree of astigmatism may be produced. This study showed that these sequelae are particularly likely after radial buckling procedures, and surgeons favouring these techniques should be aware that astigmatic errors can be induced. The astigmatic errors may persist for several years after surgery. PMID:6838807

[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.

Accommodation in Astigmatic Children During Visual Task Performance

PubMed Central

Harvey, Erin M.; Miller, Joseph M.; Apple, Howard P.; Parashar, Pavan; Twelker, J. Daniel; Crescioni, Mabel; Davis, Amy L.; Leonard-Green, Tina K.; Campus, Irene; Sherrill, Duane L.

2014-01-01

Purpose. To determine the accuracy and stability of accommodation in uncorrected children during visual task performance. Methods. Subjects were second- to seventh-grade children from a highly astigmatic population. Measurements of noncycloplegic right eye spherical equivalent (Mnc) were obtained while uncorrected subjects performed three visual tasks at near (40 cm) and distance (2 m). Tasks included reading sentences with stimulus letter size near acuity threshold and an age-appropriate letter size (high task demands) and viewing a video (low task demand). Repeated measures ANOVA assessed the influence of astigmatism, task demand, and accommodative demand on accuracy (mean Mnc) and variability (mean SD of Mnc) of accommodation. Results. For near and distance analyses, respectively, sample size was 321 and 247, mean age was 10.37 (SD 1.77) and 10.30 (SD 1.74) years, mean cycloplegic M was 0.48 (SD 1.10) and 0.79 diopters (D) (SD 1.00), and mean astigmatism was 0.99 (SD 1.15) and 0.75 D (SD 0.96). Poor accommodative accuracy was associated with high astigmatism, low task demand (video viewing), and high accommodative demand. The negative effect of accommodative demand on accuracy increased with increasing astigmatism, with the poorest accommodative accuracy observed in high astigmats (≥3.00 D) with high accommodative demand/high hyperopia (1.53 D and 2.05 D of underaccommodation for near and distant stimuli, respectively). Accommodative variability was greatest in high astigmats and was uniformly high across task condition. No/low and moderate astigmats showed higher variability for the video task than the reading tasks. Conclusions. Accuracy of accommodation is reduced in uncorrected children with high astigmatism and high accommodative demand/high hyperopia, but improves with increased visual task demand (reading). High astigmats showed the greatest variability in accommodation. PMID:25103265

Astigmatism

MedlinePlus

... change the shape of the cornea surface to eliminate astigmatism, along with nearsightedness or farsightedness. ... contact lenses. Laser vision correction can most often eliminate, or greatly reduce astigmatism.

Comparison of Astigmatism Induced by Combined Inferior Oblique Anterior Transposition Procedure and Lateral Rectus Recession Alone

PubMed Central

Eum, Sun Jung

2016-01-01

Purpose The purpose of this study is to compare the magnitude and axis of astigmatism induced by a combined inferior oblique (IO) anterior transposition procedure with lateral rectus (LR) recession versus LR recession alone. Methods Forty-six patients were retrospectively analyzed. The subjects were divided into two groups: those having concurrent inferior oblique muscle overaction (IOOA) and intermittent exotropia (group 1, 20 patients) and those having only intermittent exotropia as a control (group 2, 26 patients). Group 1 underwent combined anterior transposition of IO with LR recession and group 2 underwent LR recession alone. Induced astigmatism was defined as the difference between preoperative and postoperative astigmatism using double-angle vector analysis. Cylinder power, axis of induced astigmatism, and spherical equivalent were analyzed at 1 week, 1 month, and 3 months after surgery. Results Larger changes in the axis of induced astigmatism were observed in group 1, with 4.5° incyclotorsion, than in group 2 at 1 week after surgery (axis, 84.5° vs. 91°; p < 0.001). However, there was no statistically significant inter-group difference thereafter. Relaxation and rapid regression in the incyclotorsion of induced astigmatism were observed over-time. Spherical equivalent significantly decreased postoperatively at 1 month in both groups, indicating a myopic shift (p = 0.011 for group 1 and p = 0.019 for group 2) but did not show significant differences at 3 months after surgery (p = 0.107 for group 1 and p = 0.760 for group 2). Conclusions Combined IO anterior transposition procedures caused an increased change in the axis of induced astigmatism, including temporary incyclotorsion, during the first week after surgery. However, this significant difference was not maintained thereafter. Thus, combined IO surgery with LR recession does not seem to produce a sustained astigmatic change, which can be a potential risk factor of postoperative amblyopia or

Ocular residual and corneal astigmatism in a clinical population of high school students.

PubMed

Chen, Zhao; Liu, Luoru; Pan, Chenglin; Li, Xiaoning; Pan, Lun; Lan, Weizhong; Yang, Zhikuan

2018-01-01

Total refractive astigmatism is usually the first consideration that guides the selection of contact lens type (e.g., spherical or toric), while the ocular source of the astigmatism is a second, but more important consideration, for the final clinical decision. This study was conducted to provide detailed data on this topic by evaluating astigmatic components in Chinese adolescents. Participants were recruited from healthy high school students undergoing an annual ocular examination at a local hospital. Total astigmatism (TA), corneal astigmatism (CA), and ocular residual astigmatism (ORA) were determined by a Hartmann-Shack wavefront analyzer system (KR-1W, Topcon) with the natural pupil. The axis relationship between CA and ORA was placed into three categories: on-axis, defined as an axis with a difference of 0 ± 10°; opposite-axis, a difference of 90 ± 10°; and the rest defined as oblique-axis. The study consisted of 1,466 students (57.84% girls, age: 16.49 ± 1.05 years). ORA was present in 83.97%, 66.64%, and 45.23% of participants, according to the various criteria for astigmatism (≥ 0.50 D, ≥ 0.75 D, and ≥ 1.00 D, respectively). While with-the-rule was the most common axis orientation for both TA (76.28%) and CA (89.94%), against-the-rule predominated in ORA (93.82%; χ2 = 1688.544, p < 0.001). Opposite-axis was the major type of axis difference (90.96%) of clinical significance (i.e., ≥ 1.00 D) between CA and ORA, which also prevailed in all levels of TA (range: 56.25-82.26%). ORA is common in high school students and usually demonstrates a compensation relationship with CA, which should be taken into consideration when determining the design of contact lenses to correct refractive error.

Ocular residual and corneal astigmatism in a clinical population of high school students

PubMed Central

Liu, Luoru; Pan, Chenglin; Li, Xiaoning; Pan, Lun; Yang, Zhikuan

2018-01-01

Purpose Total refractive astigmatism is usually the first consideration that guides the selection of contact lens type (e.g., spherical or toric), while the ocular source of the astigmatism is a second, but more important consideration, for the final clinical decision. This study was conducted to provide detailed data on this topic by evaluating astigmatic components in Chinese adolescents. Methods Participants were recruited from healthy high school students undergoing an annual ocular examination at a local hospital. Total astigmatism (TA), corneal astigmatism (CA), and ocular residual astigmatism (ORA) were determined by a Hartmann-Shack wavefront analyzer system (KR-1W, Topcon) with the natural pupil. The axis relationship between CA and ORA was placed into three categories: on-axis, defined as an axis with a difference of 0 ± 10°; opposite-axis, a difference of 90 ± 10°; and the rest defined as oblique-axis. Results The study consisted of 1,466 students (57.84% girls, age: 16.49 ± 1.05 years). ORA was present in 83.97%, 66.64%, and 45.23% of participants, according to the various criteria for astigmatism (≥ 0.50 D, ≥ 0.75 D, and ≥ 1.00 D, respectively). While with-the-rule was the most common axis orientation for both TA (76.28%) and CA (89.94%), against-the-rule predominated in ORA (93.82%; χ2 = 1688.544, p < 0.001). Opposite-axis was the major type of axis difference (90.96%) of clinical significance (i.e., ≥ 1.00 D) between CA and ORA, which also prevailed in all levels of TA (range: 56.25–82.26%). Conclusions ORA is common in high school students and usually demonstrates a compensation relationship with CA, which should be taken into consideration when determining the design of contact lenses to correct refractive error. PMID:29630629

[High myopic patients: A survey of their history, feelings, beliefs and needs].

PubMed

Gaucher, D; Chartier, C; Cohen, S-Y; Malecaze, F; Souied, E H; Weber, M; Leveziel, N

2016-01-01

High myopia (HM), which affects 0.9 to 3.1% of the population, is a major cause of vision loss. The purpose of this investigation was to study and evaluate the impact of their high myopia on the daily lives of patients and to better understand their expectations in order to better meet their needs. The survey was conducted between February 19 and March 21, 2014. To be eligible, patients had to have myopia of at least -8 diopters and be over 40 years of age, with or without myopic complications. Patients' degree of myopia was defined as the optical prescription of their worse eye. The 123 patients included were interviewed by phone using a questionnaire developed and validated by a scientific committee composed of experts and members of the patients' Association against myopic maculopathy (AMAM). The phone interview, semi-structured, lasted 20 minutes. On average, myopia was -11.7 diopters. Women accounted for 71% of the population, 89% of patients were under 65 years and were mostly professionals (65%). Over half of the subjects reported myopic complications; 5% of patients had choroidal neovascularization (CNV). Only 29% had been informed of the risk of CNV or maculopathy. HM was a handicap in sports for 64% of patients, in leisure activities for 51%, and in professional activities for more than a quarter (28%). Only 56% of HM patients reported living perfectly well with their condition. This survey is the first study on the daily life of people with HM aiming to analyze their social and emotional environment. It shows that HM has a profound impact on the daily lives of patients and may affect social life and professional activity. Most myopic patients possess incomplete or unclear information about the nature and risk of myopic complications. They expressed the desire to be better informed about their condition earlier, before the onset of complications. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Amblyopia in Astigmatic Children: Patterns of Deficits

PubMed Central

Harvey, Erin M.; Dobson, Velma; Miller, Joseph M.; Clifford-Donaldson, Candice E.

2007-01-01

Neural changes that result from disruption of normal visual experience during development are termed amblyopia. To characterize visual deficits specific to astigmatism-related amblyopia, we compared best-corrected visual performance in 330 astigmatic and 475 non-astigmatic kindergarten through 6th grade children. Astigmatism was associated with deficits in letter, grating and vernier acuity, high and middle spatial frequency contrast sensitivity, and stereoacuity. Although grating acuity, vernier acuity, and contrast sensitivity were reduced across stimulus orientation, astigmats demonstrated orientation-dependent deficits (meridional amblyopia) only for grating acuity. Astigmatic children are at risk for deficits across a range of visual functions. PMID:17184807

Lenticular astigmatism after penetrating eye injury.

PubMed

Rumelt, S; Jager, G; Rehany, U

1996-09-01

Lenticular astigmatism of 5.00 diopters developed after penetrating injury in the eye of a 16-year-old boy. Full visual acuity, refraction, and crystalline lens clarity remained stable for more than 2 years. The high astigmatism, in conjunction with a spherical cornea and posterior lens capsule striae, indicates the lenticular origin of the astigmatism.

Assessment of Optical Coherence Tomography Color Probability Codes in Myopic Glaucoma Eyes After Applying a Myopic Normative Database.

PubMed

Seol, Bo Ram; Kim, Dong Myung; Park, Ki Ho; Jeoung, Jin Wook

2017-11-01

To evaluate the optical coherence tomography (OCT) color probability codes based on a myopic normative database and to investigate whether the implementation of the myopic normative database can improve the OCT diagnostic ability in myopic glaucoma. Comparative validity study. In this study, 305 eyes (154 myopic healthy eyes and 151 myopic glaucoma eyes) were included. A myopic normative database was obtained based on myopic healthy eyes. We evaluated the agreement between OCT color probability codes after applying the built-in and myopic normative databases, respectively. Another 120 eyes (60 myopic healthy eyes and 60 myopic glaucoma eyes) were included and the diagnostic performance of OCT color codes using a myopic normative database was investigated. The mean weighted kappa (Kw) coefficients for quadrant retinal nerve fiber layer (RNFL) thickness, clock-hour RNFL thickness, and ganglion cell-inner plexiform layer (GCIPL) thickness were 0.636, 0.627, and 0.564, respectively. The myopic normative database showed a higher specificity than did the built-in normative database in quadrant RNFL thickness, clock-hour RNFL thickness, and GCIPL thickness (P < .001, P < .001, and P < .001, respectively). The receiver operating characteristic curve values increased when using the myopic normative database in quadrant RNFL thickness, clock-hour RNFL thickness, and GCIPL thickness (P = .011, P = .004, P < .001, respectively). The diagnostic ability of OCT color codes for detection of myopic glaucoma significantly improved after application of the myopic normative database. The implementation of a myopic normative database is needed to allow more precise interpretation of OCT color probability codes when used in myopic eyes. Copyright © 2017 Elsevier Inc. All rights reserved.

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

Microkeratome-Assisted Anterior Lamellar Keratoplasty for the Correction of High-Degree Postkeratoplasty Astigmatism.

PubMed

Gutfreund, Shay; Leon, Pia; Busin, Massimo

2017-07-01

To describe the surgical technique and report the outcomes of patients treated with microkeratome-assisted anterior lamellar keratoplasty (MALK) for the correction of high-degree postkeratoplasty astigmatism. Four eyes of 2 patients with extremely high (>10 D) and irregular [surface asymmetry index >1.0 D] post-penetrating keratoplasty astigmatism occurring after complete suture removal underwent MALK and were followed for at least 3 years after the procedure. In all cases, 250-µm lamellar keratectomy was performed, followed by 2 full-thickness incisions through the penetrating keratoplasty scar and the placement of an appropriately sized donor graft, which was secured with a double-running 10-0 nylon suture. All sutures were removed in all eyes within 1 year from surgery. Corrected distance visual acuity, refraction, corneal topography, and endothelial cell density were noted at each examination. At the last follow-up examination (3 years or longer after MALK), corrected distance visual acuity had improved to 20/20, refractive astigmatism had decreased to an average of 2.1 D (in all cases within 4.5 D), and the average surface asymmetry index had reduced from 2.27 to 0.56. MALK is an effective and safe technique for the correction of high-degree postkeratoplasty astigmatism.

Comparison of Moderate- to High-Astigmatism Corrections Using WaveFront-Guided Laser In Situ Keratomileusis and Small-Incision Lenticule Extraction.

PubMed

Zhang, Jiamei; Wang, Yan; Chen, Xiaoqin

2016-04-01

To evaluate and compare refractive outcomes of moderate- and high-astigmatism correction after wavefront-guided laser in situ keratomileusis (LASIK) and small-incision lenticule extraction (SMILE). This comparative study enrolled a total of 64 eyes that had undergone SMILE (42 eyes) and wavefront-guided LASIK (22 eyes). Preoperative cylindrical diopters were ≤-2.25 D in moderate- and >-2.25 D in high-astigmatism subgroups. The refractive results were analyzed based on the Alpins vector method that included target-induced astigmatism, surgically induced astigmatism, difference vector, correction index, index of success, magnitude of error, angle of error, and flattening index. All subjects completed the 3-month follow-up. No significant differences were found in the target-induced astigmatism, surgically induced astigmatism, and difference vector between SMILE and wavefront-guided LASIK. However, the average angle of error value was -1.00 ± 3.16 after wavefront-guided LASIK and 1.22 ± 3.85 after SMILE with statistical significance (P < 0.05). The absolute angle of error value was statistically correlated with difference vector and index of success after both procedures. In the moderate-astigmatism group, correction index was 1.04 ± 0.15 after wavefront-guided LASIK and 0.88 ± 0.15 after SMILE (P < 0.05). However, in the high-astigmatism group, correction index was 0.87 ± 0.13 after wavefront-guided LASIK and 0.88 ± 0.12 after SMILE (P = 0.889). Both procedures showed preferable outcomes in the correction of moderate and high astigmatism. However, high astigmatism was undercorrected after both procedures. Axial error of astigmatic correction may be one of the potential factors for the undercorrection.

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.

One-year visual outcome of small incision lenticule extraction (SMILE) surgery in high myopic eyes: retrospective cohort study

PubMed Central

Wu, Wenjing; Wang, Yan; Zhang, Hui; Zhang, Jiamei; Li, Hua; Dou, Rui

2016-01-01

Objective To determine whether the long-term visual outcome of small incision lenticule extraction (SMILE) surgery is consistent with the short-term results in high myopic eyes. Design Retrospective cohort study; data collected from 8 August 2011 to 31 August 2015. Setting Single refractive surgery centre. Participants A total of 156 eyes were studied: 65 eyes of 39 subjects (22 female/17 male) in the high myopic group (manifest refraction spherical equivalent (MRSE) ≥−6.0 D), and 91 eyes of 54 subjects (29 female/25 male) in the control group (MRSE <−6.0 D). The inclusion criteria were subjects who had follow-ups after 1 day, 1 week, 1 month, 3, 6 months and 1 year with the manifest refraction, uncorrected and corrected distance visual acuity (UDVA/CDVA). There were no statistically significant differences between the two groups in the subjects' gender, age, or cylindrical dioptre, preoperatively (p=0.835, p=0.055, p=0.341, respectively). Primary and secondary outcome measures UDVA, refractive stability, safety index (postoperative CDVA/preoperative CDVA), and predictability (the percentage of eyes within ±0.50 D). Results In both groups, the 1-year UDVA and safety index were significantly better than results at 1 day (high myopic group: p=0.035, p<0.001; control group: p<0.016, p<0.001); the 1-year predictability showed no significant difference with the short-term results (p=1.00 in both groups). In the high myopic eyes, the 1-year MRSE was significantly worse than the short-term result (p=0.048). To correct it, the added magnitude (D) for the high myopic eyes may equal 0.13×Attempted SE (D)−0.66 D. However, the postoperative MRSE showed no differences from 1 day to 1 year (p=0.612) in the control group. Conclusions The 1-year visual outcomes were better than the short-term results after the SMILE surgery on the visual acuity and safety. However, the high myopic eyes suffered a significant regression at 1 year, which may be

Tubular astigmatism-tunable fluidic lens.

PubMed

Kopp, Daniel; Zappe, Hans

2016-06-15

We demonstrate a new means to fabricate three-dimensional liquid lenses which may be tuned in focal length and astigmatism. Using actuation by electrowetting-on-dielectrics, astigmatism in arbitrary directions may be tuned independently, with almost no cross talk between orthogonal orientations. The lens is based on electrodes structured on planar polyimide foils and subsequently rolled, enabling high-resolution patterning of complex electrodes along the azimuthal and radial directions of the lens. Based on a design established through fluidic and optical simulations, the astigmatism tuning is experimentally verified by a change of the corresponding Zernike coefficients measured using a Shack-Hartmann wavefront sensor. It was seen that the back focal length can be tuned by 5 mm and 0° and 45° astigmatism by 3 μm through application of voltages in the range of 50  V_rms. It was observed that the cross talk with other aberrations is very low, suggesting a novel means for astigmatism control in imaging systems.

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.

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.

Exploration of peripapillary vessel density in highly myopic eyes with peripapillary intrachoroidal cavitation and its relationship with ocular parameters using optical coherence tomography angiography.

PubMed

Chen, Qiuying; He, Jiangnan; Hua, Yihong; Fan, Ying

2017-12-01

Identifying changes of peripapillary vessel density in highly myopic eyes with peripapillary intrachoroidal cavitation by optical coherence tomography angiography. To investigate peripapillary vessel density and its relationship with other ocular parameters in highly myopic eyes with peripapillary intrachoroidal cavitation. Hospital-based, cross-sectional study. Thirty-five highly myopic eyes with peripapillary intrachoroidal cavitation, 46 highly myopic eyes without peripapillary intrachoroidal cavitation and 36 normal eyes were included in this study. All participants underwent optical coherence tomography angiography to image the retinal vasculature in the peripapillary areas, including the radial peripapillary capillaries and optic nerve head layer. Correlations between vessel density and ocular metrics were analysed. Peripapillary vessel density. In highly myopic eyes, vessel density was significantly lower in eyes with peripapillary intrachoroidal cavitation than in those without in peripapillary (P = 0.014, P = 0.037), inferotemporal (P < 0.001, P < 0.001) and superotemporal (P = 0.014, P = 0.009) areas. In the radial peripapillary capillaries layer, vessel density was negatively correlated with peripapillary atrophy area (P = 0.012) and myopic maculopathy (P = 0.002), and in the optic nerve head layer, it was negatively associated with a diagnosis of peripapillary intrachoroidal cavitation (P = 0.012) and myopic maculopathy (P < 0.001). In addition, it was positively correlated with retinal nerve fibre layer thickness in both layers (P < 0.001). Highly myopic eyes with peripapillary intrachoroidal cavitation had lower peripapillary vessel densities, especially in the temporal area, than those without. © 2017 Royal Australian and New Zealand College of Ophthalmologists.

[Astigmatism after keratoplasty: influence of orthotopic transplantation].

PubMed

Feuerstacke, J; Hellwinkel, O; Naydis, I; Linke, S; Klemm, M

2014-09-01

Patients undergoing corneal transplantation often suffer from postoperative reduced vision due to high astigmatism. This retrospective study analyzed the influence of heterotopic or orthotopic transplantation on astigmatism and visual outcome. In this study 373 eyes of 334 patients were analyzed. Group 1 (OT) contained 186 eyes, which underwent orthotopic transplantation (side of recipient and donor corresponded), whereas group 2 (HT) included 187 heterotopic keratoplasties (donor cornea placed in the recipient's contralateral side). After 1, 3, 6, 12 and 24 months the median of keratometric astigmatism, objective astigmatism, topographic astigmatism and best corrected visual acuity (BCVA) were assessed and compared between groups. The long-term results showed no statistically significant differences regarding keratometric and objective astigmatism, whereas topographic astigmatism differed significantly (p = 0.04) after 3 months. We observed a lower astigmatism of 5.7 dpt (range 3.08-7.78 dpt) in group OT than in the group HT with 7.1 dpt (range 3.9-10.7 dpt). No differences were found at the other time points. The BCVA showed a significantly better effect after 1 month (p = 0.01) in the OT group of 0.2 (0.1-0.3) than in HT group of 0.1 (0.05/0.25). In the postoperative course no additional significant dissimilarities were documented. Heterotopic and orthotopic keratoplasty show no significant long-term differences in astigmatism and visual outcom.

Natural course and surgical management of high myopic foveoschisis.

PubMed

Rey, Amanda; Jürgens, Ignasi; Maseras, Xavier; Carbajal, Miriam

2014-01-01

To describe the spectral-domain optical coherence tomographic characteristics, natural course and surgical management for eyes with myopic foveoschisis. The medical records of 39 consecutive patients (56 eyes) with myopic foveoschisis were retrospectively reviewed. Pars plana vitrectomy with internal limiting membrane peeling and Brilliant Blue G staining was performed on 16 symptomatic eyes (14 patients). Optical coherence tomography at baseline showed an isolated foveoschisis in 62.5%, foveal detachment in 21.4%, and a lamellar hole in 16.1% of the eyes. After a mean follow-up period of 15.7 months, 1.8% of the eyes developed a full-thickness macular hole and 28.5% of the eyes required surgery. The mean preoperative visual acuity (VA) was 20/63 and the mean central retinal thickness (CRT) was 507.6 µm. The mean postoperative VA was 20/40 and the mean CRT 282.9 µm. Anatomical success was achieved in 75% of the eyes at a mean of 3.3 months after surgery, and 81.2% of the eyes had an improvement of 2 lines of VA. Myopic foveoschisis remained stable in most eyes; however, 28.5% of the eyes had decreases in VA secondary to progression of the foveoschisis and required surgery. © 2013 S. Karger AG, Basel.

Effectiveness of Toric Orthokeratology in the Treatment of Patients with Combined Myopia and Astigmatism.

PubMed

Lyu, Byul; Hwang, Kyu Yeon; Kim, Sun Young; Kim, Su Young; Na, Kyung Sun

2016-12-01

The purpose of this multi-institute, single-group clinical trial was to evaluate the effectiveness and safety of toric orthokeratology lenses for the treatment of patients with combined myopia and astigmatism. A total of 44 patients were included in this clinical trial. The patients ranged in age from 7 to 49 years, with myopia of -0.75 to -6.0 diopters (D) and astigmatism of 1.25 to 4.0 D. After excluding 21 subjects, 23 subjects (39 eyes) were analyzed after toric orthokeratology lens use. The subjects underwent ophthalmologic examination after 1 day and 1, 2, 3, and 4 weeks of wearing overnight toric orthokeratology lenses. A total of 19 subjects (31 eyes) completed the trial after five subjects (eight eyes) dropped out. In the patients who completed the study by wearing lenses for 4 weeks, the myopic refractive error decreased significantly by 2.60 ± 2.21 D ( p < 0.001), from -3.65 ± 1.62 to -1.05 ± 1.64 D. The astigmatic refractive error were also significantly decreased by 0.63 ± 0.98 D ( p = 0.001), from 2.07 ± 0.83 to 1.44 ± 0.99 D. The mean uncorrected and corrected visual acuities before wearing the lenses were 2.14 ± 0.80 logarithm of the logMAR (logMAR) and 0.05 ± 0.13 logMAR, respectively, which changed to 0.12 ± 0.30 logarithm of the logMAR ( p < 0.001) and 0.01 ± 0.04 logMAR ( p = 0.156) after 4 weeks. No serious adverse reactions were reported during the clinical trial. Our results suggest that toric orthokeratology is an effective and safe treatment for correcting visual acuity in patients with combined myopia and astigmatism.

Effectiveness of Toric Orthokeratology in the Treatment of Patients with Combined Myopia and Astigmatism

PubMed Central

Lyu, Byul; Hwang, Kyu Yeon; Kim, Sun Young; Kim, Su Young

2016-01-01

Purpose The purpose of this multi-institute, single-group clinical trial was to evaluate the effectiveness and safety of toric orthokeratology lenses for the treatment of patients with combined myopia and astigmatism. Methods A total of 44 patients were included in this clinical trial. The patients ranged in age from 7 to 49 years, with myopia of -0.75 to -6.0 diopters (D) and astigmatism of 1.25 to 4.0 D. After excluding 21 subjects, 23 subjects (39 eyes) were analyzed after toric orthokeratology lens use. The subjects underwent ophthalmologic examination after 1 day and 1, 2, 3, and 4 weeks of wearing overnight toric orthokeratology lenses. Results A total of 19 subjects (31 eyes) completed the trial after five subjects (eight eyes) dropped out. In the patients who completed the study by wearing lenses for 4 weeks, the myopic refractive error decreased significantly by 2.60 ± 2.21 D (p < 0.001), from -3.65 ± 1.62 to -1.05 ± 1.64 D. The astigmatic refractive error were also significantly decreased by 0.63 ± 0.98 D (p = 0.001), from 2.07 ± 0.83 to 1.44 ± 0.99 D. The mean uncorrected and corrected visual acuities before wearing the lenses were 2.14 ± 0.80 logarithm of the logMAR (logMAR) and 0.05 ± 0.13 logMAR, respectively, which changed to 0.12 ± 0.30 logarithm of the logMAR (p < 0.001) and 0.01 ± 0.04 logMAR (p = 0.156) after 4 weeks. No serious adverse reactions were reported during the clinical trial. Conclusions Our results suggest that toric orthokeratology is an effective and safe treatment for correcting visual acuity in patients with combined myopia and astigmatism. PMID:27980362

Longitudinal Change and Stability of Refractive, Keratometric, and Internal Astigmatism in Childhood

PubMed Central

Harvey, Erin M.; Miller, Joseph M.; Twelker, J. Daniel; Sherrill, Duane L.

2015-01-01

Purpose. To assess longitudinal change in refractive, keratometric, and internal astigmatism in a sample of students from a population with a high prevalence of with-the-rule (WTR) astigmatism and to determine the optical origins of changes in refractive astigmatism. Methods. A retrospective analysis of longitudinal measurements of right eye refractive and keratometric astigmatism in Tohono O'odham Native American children was conducted. Changes in refractive and keratometric astigmatism per year were compared in a younger cohort (n = 1594, 3 to <11 years old) and an older cohort (n = 648, 11 to <19 years old). Data were analyzed in clinical notation (Cyl) and vector notation (J0, J45). Results. On average, refractive astigmatism (means: 1.19 diopters [D] Cyl, +0.54 J0, +0.03 J45) resulted primarily from WTR corneal astigmatism (means: +0.85 J0, −0.02 J45) and against-the-rule (ATR) internal astigmatism (means: −0.31 J0, +0.05 J45). Mean longitudinal changes in astigmatism were statistically significant (younger cohort −0.02 D/y Cyl; older cohort +0.06 D/y Cyl). In the younger cohort, astigmatism decreased with age in low and moderate astigmats (<3.00 D) and increased with age in high astigmats (≥3.00 D). In the older cohort, astigmatism increased with age across all levels of astigmatism. Longitudinal changes in keratometric and internal astigmatism were negatively correlated in both cohorts. Conclusions. Cross-sectional data suggest the presence of a constant ATR contribution from internal astigmatism (0.60 D Cyl) that is close to the 0.50 D ATR constant reported by Javal and others. Highly astigmatic 3- to <11-year-old children and children older than age 11 years show a small (not clinically significant) increase in astigmatism with age. A negative correlation between changes in keratometric astigmatism and internal astigmatism suggests an active compensation that may contribute to the stability of astigmatism in Tohono O'odham children. PMID:25515577

Surgical technique for management of isolated lenticular coloboma with high corneal astigmatism.

PubMed

Singh, Simar Rajan; Yangzes, Sonam; Gupta, Rohit; Ram, Jagat

2018-04-01

We describe a surgical technique for the correction of isolated congenital lenticular coloboma associated with high corneal astigmatism. Transscleral fixation of the capsular bag with a single eyelet Cionni capsular tension ring was followed by in-the-bag implantation of a toric intraocular lens (IOL). This lead to complete correction of the lenticular defect and perfect alignment of the toric lens. In this case, the child attained an unaided distance visual acuity of 20/30 following amblyopia therapy and a well-aligned toric IOL at 12 months of follow-up. This technique can be used in cases with concomitant lenticular coloboma and significant corneal astigmatism.

Surgical technique for management of isolated lenticular coloboma with high corneal astigmatism

PubMed Central

Singh, Simar Rajan; Yangzes, Sonam; Gupta, Rohit; Ram, Jagat

2018-01-01

We describe a surgical technique for the correction of isolated congenital lenticular coloboma associated with high corneal astigmatism. Transscleral fixation of the capsular bag with a single eyelet Cionni capsular tension ring was followed by in-the-bag implantation of a toric intraocular lens (IOL). This lead to complete correction of the lenticular defect and perfect alignment of the toric lens. In this case, the child attained an unaided distance visual acuity of 20/30 following amblyopia therapy and a well-aligned toric IOL at 12 months of follow-up. This technique can be used in cases with concomitant lenticular coloboma and significant corneal astigmatism. PMID:29582820

Analysis of components of total astigmatism in infants and young children.

PubMed

Sayed, Khulood Muhammad

2017-02-01

The aim of this study is to examine and analyze the contribution of corneal and lenticular components of total astigmatism (TA) in infants and young children and to determine whether there is any compensation for astigmatism by the lenticular component or not. The study was conducted on 614 eyes of 307 infants and young children. Cycloplegic refraction and keratometric measures using the Hand-held Autokeratometer (Nidek Co. Ltd., Hiroishi, Japan) were done for the study group under general anesthesia in Paediatric Ophthalmology Center, Sohag City, Egypt. We divided the sample into high astigmats (total cylinder ≥ 1.00 D; mean, 1.99 ± 0.89 D; n = 431 eyes; 70 %) and normal astigmats (total cylinder ≤ 0.75 D; mean, 0.55 ± 0.22 D; n = 183; 30 %). The prevalence of corneal astigmatism (CA) ≥ 1.00 D was (73 %), any degree of lenticular astigmatism (LA) was (85 %), (LA > 0.25 D = 72 %) TA was predominantly with the rule (n = 499 eyes, 81 %). Eyes with against the rule astigmatism were (n = 33 eyes, 5.3 %) and eyes with oblique astigmatism were (n = 82 eyes; 13.3 %). Gender or age differences in TA, CA, LA, or type of astigmatism were not significant. The prevalence of astigmatism found in this population of newlyborn infants and young children was relatively high, primarily corneal, and WTR astigmatism with high prevalence of oblique astigmatism. LA was much less than previous reports (mean = -0.0044 D), associated with more hyperopic eyes and eyes with high TA. The data suggest that a compensatory process exists between CA and LA to decrease the amount of TA.

Analysis of Fundus Shape in Highly Myopic Eyes by Using Curvature Maps Constructed from Optical Coherence Tomography

PubMed Central

Miyake, Masahiro; Yamashiro, Kenji; Akagi-Kurashige, Yumiko; Oishi, Akio; Tsujikawa, Akitaka; Hangai, Masanori; Yoshimura, Nagahisa

2014-01-01

Purpose To evaluate fundus shape in highly myopic eyes using color maps created through optical coherence tomography (OCT) image analysis. Methods We retrospectively evaluated 182 highly myopic eyes from 113 patients. After obtaining 12 lines of 9-mm radial OCT scans with the fovea at the center, the Bruch’s membrane line was plotted and its curvature was measured at 1-µm intervals in each image, which was reflected as a color topography map. For the quantitative analysis of the eye shape, mean absolute curvature and variance of curvature were calculated. Results The color maps allowed staphyloma visualization as a ring of green color at the edge and as that of orange-red color at the bottom. Analyses of mean and variance of curvature revealed that eyes with myopic choroidal neovascularization tended to have relatively flat posterior poles with smooth surfaces, while eyes with chorioretinal atrophy exhibited a steep, curved shape with an undulated surface (P<0.001). Furthermore, eyes with staphylomas and those without clearly differed in terms of mean curvature and the variance of curvature: 98.4% of eyes with staphylomas had mean curvature ≥7.8×10−5 [1/µm] and variance of curvature ≥0.26×10−8 [1/µm]. Conclusions We established a novel method to analyze posterior pole shape by using OCT images to construct curvature maps. Our quantitative analysis revealed that fundus shape is associated with myopic complications. These values were also effective in distinguishing eyes with staphylomas from those without. This tool for the quantitative evaluation of eye shape should facilitate future research of myopic complications. PMID:25259853

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.

Influence of Posterior Corneal Astigmatism on Total Corneal Astigmatism in Eyes With Keratoconus.

PubMed

Savini, Giacomo; Næser, Kristian; Schiano-Lomoriello, Domenico; Mularoni, Alessandro

2016-11-01

To measure posterior corneal astigmatism (PCA) and investigate its influence on total corneal astigmatism (TCA) in eyes with keratoconus. Keratometric astigmatism (KA), PCA, and TCA were investigated by means of a dual Scheimpflug analyzer in patients with keratoconus. Vector analysis was carried out with the Næser polar value method. We enrolled 119 eyes. PCA magnitude averaged 0.77 ± 0.43 diopters (D) and exceeded 0.50, 1.00, and 2.00 D in 73.9%, 21.8%, and 16.8% of eyes, respectively. PCA averaged 0.95 ± 0.48, 0.55 ± 0.28, and 0.70 ± 0.35 D in eyes with with-the-rule (WTR), against-the-rule (ATR), and oblique astigmatism. The steepest posterior meridian was oriented vertically (between 61 and 119 degrees) in 55.5% of eyes, thus generating ATR astigmatism. The difference between the location of the steepest meridian of KA and that of TCA was >10 degrees in 8.4% of eyes. On average, KA overestimated TCA in eyes with WTR astigmatism by 0.16 D and underestimated TCA in eyes with ATR astigmatism by 0.22 D. The PCA power oriented along the steeper anterior corneal meridian averaged -0.83 ± 0.40, -0.40 ± 0.37, and -0.53 ± 0.43 D for WTR, ATR, and obliquely astigmatic eyes, respectively. Linear regression disclosed a statistically significant correlation (P < 0.0001, r = 0.16) between the meridional powers of TCA and PCA. In eyes with keratoconus, PCA displays large, variable values and is correlated to TCA. The influence of PCA on TCA cannot be disregarded when planning astigmatism correction by toric intraocular lenses.

Outcome of corneal and laser astigmatic axis alignment in photoastigmatic refractive keratectomy.

PubMed

Farah, S G; Olafsson, E; Gwynn, D G; Azar, D T; Brightbill, F S

2000-12-01

To compare the refractive results of laser astigmatic treatment in eyes in which the astigmatic axes of the eye and laser are aligned by limbal marking at the 6 o'clock position and in eyes that are not marked. University Hospital and Clinics, Madison, Wisconsin, USA. This retrospective study comprised 143 eyes that had photoastigmatic refractive keratectomy with the VISX Star excimer laser. The eyes were divided into marked (G1) and unmarked (G2) groups. Based on the preoperative astigmatism, each group was subdivided into low astigmatism (high astigmatism (>/=1.25 D). Early postoperative manifest refractions (1.0 to 2.5 months) were analyzed. The Alpins vector analysis method was used to calculate the target induced astigmatism, surgically induced astigmatism, difference vector (DV), magnitude of error (ME), angle of error (AE), and index of success (IS). There was no significant difference between the groups in DV, ME, and IS. When the subgroups were analyzed, the DV and ME were comparable; the IS in the G1 high astigmatism subgroup was significantly better than that in the G2 high astigmatism subgroup (0.22 +/- 0.08 and 0.29 +/- 0.04, respectively; P <.0001). There was comparable scatter of AE values; 30% and 36% in G1 and G2, respectively, had an AE of 0. Similar scatter was observed in the subgroups. Of the eyes that had an AE of 0, 90% and 43% in the high astigmatism subgroups of G1 and G2, respectively (P <.05), had full correction of astigmatism. Limbal marking and subsequent eye and laser astigmatic axis alignment improved the refractive outcome of laser astigmatic treatment of >/=1.25 D. A preliminary report of an ongoing prospective randomized study of eyes that had laser in situ keratomileusis is included.

Refractive eye surgery in treating functional amblyopia in children.

PubMed

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

2006-01-01

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

Effects of Induced Astigmatism.

ERIC Educational Resources Information Center

Schubert, Delwyn G.; Walton, Howard N.

1968-01-01

The relationship of astigmatism to reading and the possible detrimental effects it might have on reading were investigated. The greatest incidence of astigmatism was for the with-the-rule type ranging from .50 to 1.00 diopter. This type of astigmatism was induced in 35 seniors from the Los Angeles College of Optometry by placing cylindrical lenses…

Role of Hemidivisional Corneal Topographic Astigmatisms (CorTs) in the Regularization and Reduction of Irregular Astigmatism.

PubMed

Alpins, Noel; Ong, James K Y; Stamatelatos, George

2018-03-01

To demonstrate how the concept of hemidivisional corneal topographic astigmatism (hemiCorT) enables the planning of hemidivisional corneal treatments to reduce irregularity and overall astigmatism. Whole-of-cornea corneal topographic astigmatism (CorT) is calculated from topography data derived from a corneal topographer or tomographer. The cornea is conceptually divided into 2 hemidivisions along the flat meridian of the CorT. For each hemidivision, hemiCorTs are calculated. The regularization treatment for each hemidivision is the treatment required to target the whole-of-cornea CorT, which is a symmetrical orthogonal corneal astigmatism. The regularization is then combined with astigmatism reduction treatment, which could be a conventional refractive treatment or a vector-planned treatment. For each hemidivision, the combined astigmatic effect of the regularization treatment and reduction treatment can be determined through double-angle vector summation. The 2 hemidivisional treatments together regularize and reduce corneal astigmatism. A theoretical pair of hemidivisional treatments is derived from an actual example of a cornea displaying idiopathic asymmetric nonorthogonal astigmatism. HemiCorTs allow for the design of hemidivisional corneal treatments of asymmetric nonorthogonal astigmatism. Such treatments should be suitable in the routine treatment of commonly occurring irregular astigmatism, while also allowing the spherical refractive error to be treated concurrently.

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.

Improved astigmatic focus error detection method

NASA Technical Reports Server (NTRS)

Bernacki, Bruce E.

1992-01-01

All easy-to-implement focus- and track-error detection methods presently used in magneto-optical (MO) disk drives using pre-grooved media suffer from a side effect known as feedthrough. Feedthrough is the unwanted focus error signal (FES) produced when the optical head is seeking a new track, and light refracted from the pre-grooved disk produces an erroneous FES. Some focus and track-error detection methods are more resistant to feedthrough, but tend to be complicated and/or difficult to keep in alignment as a result of environmental insults. The astigmatic focus/push-pull tracking method is an elegant, easy-to-align focus- and track-error detection method. Unfortunately, it is also highly susceptible to feedthrough when astigmatism is present, with the worst effects caused by astigmatism oriented such that the tangential and sagittal foci are at 45 deg to the track direction. This disclosure outlines a method to nearly completely eliminate the worst-case form of feedthrough due to astigmatism oriented 45 deg to the track direction. Feedthrough due to other primary aberrations is not improved, but performance is identical to the unimproved astigmatic method.

Scleral Shape and Its Correlations With Corneal Astigmatism.

PubMed

Consejo, Alejandra; Rozema, Jos J

2018-03-06

To assess the correlation between the scleral shape and corneal astigmatism. Twenty-two participants (11 nonastigmatic and 11 astigmatic) aged from 19 to 36 years and with no previous ocular surgeries were included in this study. Three-dimensional (3D) corneoscleral maps from both eyes (44 eyes) were acquired using a corneoscleral topographer (Eye Surface Profiler). Each 3D map was split into 13 concentric annuli, each 0.5-mm wide, starting at 1.0-mm radius from the corneal apex to the scleral periphery at 7.5 mm from the apex. Each ring was fitted to a quadratic function of the radial distance to the apex, to calculate the elevation difference between the raw data and the fitting surface ring. For each ring, the resulting elevation difference between the original and fit data profile was fit to a sum of sine function. Decentration and astigmatic terms obtained from the sinusoidal fit were analyzed and compared between nonastigmatic and astigmatic groups. In astigmatic eyes, corneal and scleral asymmetry are highly correlated, but both appear independent of each other in nonastigmatic eyes. No significant difference between astigmatic and nonastigmatic eyes was found for the decentration term [P > 0.05/N (Bonferroni)], whereas for the astigmatic component, the differences were statistically significant [P < 0.05/N (Bonferroni)]. Corneal and scleral shapes are correlated in astigmatic eyes, which suggests that astigmatism is not restricted to the cornea but should rather be considered a property of the entire eye globe.

[Implantation of a sulcus-fixated toric additive intraocular lens in a case of high astigmatism after a triple procedure].

PubMed

Linz, K; Auffarth, G U; Kretz, F T A

2014-08-01

Residual refractive errors, especially high-grade astigmatism after penetrating keratoplasty, often lead to a significant loss of vision. If high anismetropia could not be corrected with glasses or contact lenses, different kinds of surgical procedures are available for visual rehabilitation (intraocular lens exchange, astigmatic keratotomy, Excimer laser treatment, intrastromal corneal ring segment implantation and additive intraocular lens implantation). Toric add-on IOLs are especially designed for sulcus implantation and correcting high astigmatism in pseudophakic eyes. All toric IOLs are individually manufactured according to subjective refraction and biometry. Depending on the underlying manufacturer high-grade astigmatism can be corrected with a cylindrical power up to + 30.0 D. A 74-year-old patient presented with endothelial decompensation and an uncorrected distance visual acuity (UDVA) of 1.0 logMAR for penetrating keratoplasty on the right eye due to a Fuchs endothelial dystrophy. Postoperatively, the uncorrected distance visual acuity improved to 0.8 logMAR, with pinhole correction to 0.5 logMAR. After removing the sutures a high and irregular corneal astigmatism of 21.0 D was found. The corrected distance visual acuity (CDVA) with a refraction of + 5.5 D sph, - 21.0 D cyl 90° was 0.24 logMAR. Therefore an individually manufactured toric additive intraocular lens of + 25.0 D cylindrical and - 18.0 D spherical power for sulcus implantation was chosen and implanted uneventfully. Eight months after surgery refractive astigmatism was reduced significantly to - 0.75 D with an UDVA of 0.08 logMAR and a CDVA of 0.02 logMAR. During the 8-months follow-up period the additive IOL remained centered and no IOL rotation could be observed. Toric add-on IOLs are a safe and successful method for reducing high astigmatism and anisometropia after penetrating keratoplasty. One of the main advantages is the reversibility of the procedure by an explantation of

Status of astigmatism-corrected Czerny-Turner spectrometers

NASA Astrophysics Data System (ADS)

Li, Xinhang; Dong, Keyan; An, Yan; Wang, Zhenye

2016-10-01

In order to analysis and design the Czerny-Turner structure spectrometer with the high resolution and high energy reception, various astigmatism methods of the Czerny-Turner structure are reported. According to the location of plane grating, the astigmatism correction methods are divided into two categories, one is the plane grating in divergent illumination, another is the plane grating in parallel illumination. Basing on the different methods, the anastigmatic principle and methods are analyzed, the merits and demerits of the above methods are summarized and evaluated. The theoretical foundation for design of broadband eliminating astigmatism Czerny-Turner spectrometer and the reference value for the further design work are laid by the summary and analyzing in this paper.

Comparability and repeatability of different methods of corneal astigmatism assessment.

PubMed

Ferreira, Tiago B; Ribeiro, Filomena J

2018-01-01

To assess the comparability and repeatability of keratometric and astigmatism values measured by four techniques: Orbscan IIz ® (Bausch and Lomb), Lenstar LS 900 ® (Haag-Streit), Cassini ® (i-Optics), and Total Cassini (anterior + posterior surface), in healthy volunteers. Fifteen healthy volunteers (30 eyes) were assessed by the four techniques. In each eye, three consecutive measures were performed by the same operator. Keratometric and astigmatism values were recorded. The intraclass correlation coefficient (ICC) was used to assess comparability and repeatability. Agreement between measurement techniques was evaluated with Bland-Altman plots. Comparability was high between all measurement techniques for minimum keratometry (K1), maximum keratometry (K2), astigmatism magnitude, and astigmatism axis, with ICC >0.900, except for astigmatism magnitude measured by Cassini compared to Lenstar (ICC =0.798) and Orbscan compared to Lenstar (ICC =0.810). However, there were some differences in the median values of K1 and K2 between measurement techniques, and the Bland-Altman plots showed a wide data spread for all variables, except for astigmatism magnitude measured by Cassini and Total Cassini. For J0 and J45, comparability was only high for J0 between Cassini and Orbscan. Repeatability was also high for all measurement techniques except for K2 (ICC =0.814) and J45 (ICC =0.621) measured by Cassini. All measurement techniques showed high comparability regarding K1, K2, and astigmatism axis. Although posterior corneal surface is known to influence these measurements, comparability was high between Cassini and Total Cassini regarding astigmatism magnitude and axis. However, the wide data spread suggests that none of these devices should be used interchangeably.

The visual and functional impacts of astigmatism and its clinical management.

PubMed

Read, Scott A; Vincent, Stephen J; Collins, Michael J

2014-05-01

To provide a comprehensive overview of research examining the impact of astigmatism on clinical and functional measures of vision, the short and longer term adaptations to astigmatism that occur in the visual system, and the currently available clinical options for the management of patients with astigmatism. The presence of astigmatism can lead to substantial reductions in visual performance in a variety of clinical vision measures and functional visual tasks. Recent evidence demonstrates that astigmatic blur results in short-term adaptations in the visual system that appear to reduce the perceived impact of astigmatism on vision. In the longer term, uncorrected astigmatism in childhood can also significantly impact on visual development, resulting in amblyopia. Astigmatism is also associated with the development of spherical refractive errors. Although the clinical correction of small magnitudes of astigmatism is relatively straightforward, the precise, reliable correction of astigmatism (particularly high astigmatism) can be challenging. A wide variety of refractive corrections are now available for the patient with astigmatism, including spectacle, contact lens and surgical options. Astigmatism is one of the most common refractive errors managed in clinical ophthalmic practice. The significant visual and functional impacts of astigmatism emphasise the importance of its reliable clinical management. With continued improvements in ocular measurement techniques and developments in a range of different refractive correction technologies, the future promises the potential for more precise and comprehensive correction options for astigmatic patients. © 2014 The Authors Ophthalmic & Physiological Optics © 2014 The College of Optometrists.

The Results of Toric Intraocular Lens Implantation in Patients With Cataract and High Astigmatism After Penetrating Keratoplasty.

PubMed

Müftüoğlu, İlkay Klç; Akova, Yonca Aydn; Egrilmez, Sait; Yilmaz, Suzan Guven

2016-03-01

To evaluate the results of toric intraocular lens (IOL) implantation in patients with cataract and postpenetrating keratoplasty astigmatism. Seven eyes of 7 patients with cataract and more than 3.5 diopters (D) astigmatism following penetrating keratoplasty were included in this retrospective case series study. All of the eyes underwent phacoemulsification and Acrysof toric IOL (t5-t9) implantation at least 6 months later than the complete suture removal. Corrected visual acuity (CVA), manifest astigmatism, the keratometry measurements, and complications were assessed. The mean preoperative CVA significantly increased (0.7±0.3 [range: 0.3-1.3] logMAR to 0.1±0.04 [range: 0.05-0.15] logMAR; P<0.05) at mean 8.71±4.11 months after the surgery. The mean preoperative corneal astigmatism and the average manifest refractive astigmatism at the last visit were 5.4±0.9 D (range: 4.25-7 D) and 1.6±0.6 D (range: 0.5-2.5 D), respectively. The mean attempted cylinder correction at spectacle plane was 4.3±0.9 D (range: 2.4-4.7 D) whereas the mean cylinder correction was 4.6±0.5 D (range: 3.9-5.9 D), showing a slightly tendency for overcorrection. All eyes (100%) were within 1 D of predicted residual astigmatism. No complication occurred during the follow-up. Toric IOL implantation seems to be an effective, predictable, and safe procedure in patients with cataract formation and high astigmatism after penetrating keratoplasty.

Astigmatism induced by conventional spherical ablation after PRK and LASIK in myopia with astigmatism < 1.00 D.

PubMed

Christiansen, Steven M; Mifflin, Mark D; Edmonds, Jason N; Simpson, Rachel G; Moshirfar, Majid

2012-01-01

The purpose of this study was to evaluate surgically-induced astigmatism after spherical ablation in photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) for myopia with astigmatism < 1.00 D. The charts of patients undergoing spherical PRK or LASIK for the correction of myopia with minimal astigmatism of <1.00 D from 2002 to 2012 at the John A Moran Eye Center in Salt Lake City, UT, were retrospectively reviewed. Astigmatism was measured by manifest refraction. The final astigmatic refractive outcome at 6 months postoperatively was compared with the initial refraction by Alpins vector analysis. For PRK, average cylinder increased from 0.39 ± 0.25 (0.00-0.75) preoperatively to 0.55 ± 0.48 (0.00-1.75) postoperatively (P = 0.014), compared with an increase in LASIK eyes from 0.40 ± 0.27 (0.00-0.75) preoperatively to 0.52 ± 0.45 (0.00-2.00) postoperatively (P = 0.041). PRK eyes experienced an absolute value change in cylinder of 0.41 ± 0.32 (0.00-1.50) and LASIK eyes experienced a change of 0.41 ± 0.31 (0.00-1.50, P = 0.955). Mean surgically-induced astigmatism was 0.59 ± 0.35 (0.00-1.70) in PRK eyes, with an increase in surgically-induced astigmatism of 0.44 D for each additional 1.00 D of preoperative cylinder; in LASIK eyes, mean surgically-induced astigmatism was 0.55 ± 0.32 (0.00-1.80, P = 0.482), with an increase in surgically-induced astigmatism of 0.29 D for each 1.00 D of preoperative cylinder. Spherical ablation can induce substantial astigmatism even in eyes with less than one diopter of preoperative astigmatism in both PRK and LASIK. No significant difference in the magnitude of surgically-induced astigmatism was found between eyes treated with PRK and LASIK, although surgically-induced astigmatism was found to increase with greater levels of preoperative astigmatism in both PRK and LASIK.

Multi-modality imaging findings of huge intrachoroidal cavitation and myopic peripapillary sinkhole.

PubMed

Chen, Yutong; Ma, Xiaoli; Hua, Rui

2018-02-02

Peripapillary intrachoroidal cavitation was described as the presence of an asymptomatic, well-circumscribed, yellow-orange, peripapillary lesion at the inferior border of the myopic conus in eyes with high myopia. A 66-year-old myopic Chinese man was enrolled and his multi-color imaging examination showed a well-circumscribed, caesious, peripapillary lesion coalesced with the optic nerve head vertically rotated and obliquely tilted, together with an inferotemporal sinkhole in the myopic conus. The optical coherence tomography images showed an intrachoroidal hyporeflective space, schisis, an intracavitary septum located below the retinal pigment epithelium and inserted beneath the optic nerve head, as well as a sinkhole between the peripapillary intrachoroidal cavitation and the vitreous space. Both myopic colobomas and sinkhole in myopic conus may contribute the coalescence of intrachoroidal cavitation with optic nerve head. These qualitative and quantitative new findings will be beneficial for understanding its pathomorphological mechanism, and the impact on optic nerve tissue of myopic patients.

[The relations of corneal, lenticular and total astigmatism].

PubMed

Liang, D; Guan, Z; Lin, J

1995-06-01

To determine the relations of corneal, lenticular and total astigmatism and the changes of the astigmatism with age. Out-patients with refractive errors were refracted with retinoscope after using cycloplegic drops and measured the radii of anterior corneal curvature. One hundred and ninety-four cases (382 eyes) with refractive errors were studied. Of the eyes 67.9% had regular corneal astigmatism, 68.1% irregular lenticular astigmatism and 60.7% regular total astigmatism, 88.5% of the corneal astigmatism has the same quality as the total astigmatism. The total astigmatism in 46% of the eyes included the summation of corneal and lenticular astigmatism, but in 41.3% of the eyes irregular lenticular astigmatism corrected the regular corneal astigmatism. The astigmatism of cornea, lens and total astigmatism changed from regular to irregular with the increase of age. The linear correlation analysis showed a positive correlation between the power of horizontal corneal refraction and age, and a negative corrlation between the power of vertical corneal refraction and age. The shape of cornea was the major cause of total astigmatism. The influence of lens on the total astigmatism was different. The reasons for the change of the total astigmatism from regular to irregular with the increase of age were the changes of the power of corneal refraction, particularly the increase of the power of horizontal corneal refraction and lenticular irregular astigmatism.

Combined intrastromal astigmatic keratotomy and laser in situ keratomileusis flap followed by photoablation to correct post-penetrating keratoplasty ametropia and high astigmatism: One-year follow-up.

PubMed

Shalash, Riad B; Elshazly, Malak I; Salama, Marwa M

2015-10-01

To evaluate a new technique combining intrastromal astigmatic keratotomy (AK) with a laser in situ keratomileusis (LASIK) flap followed by excimer laser photoablation to correct post-penetrating keratoplasty (PKP) high astigmatism and ametropia. Kasr El Aini Hospital, Cairo University, Cairo, Egypt. Prospective interventional uncontrolled case series. Patients with post-PKP high astigmatism and ametropia had paired intrastromal AK with LASIK flap using the M2 microkeratome followed 2 to 3 months later by excimer laser photoablation. The main outcome measures were uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), mean refractive spherical equivalent (SE), and mean cylinder after each step and at the 1-year follow-up. The study comprised 20 eyes (20 patients). All parameters were significantly improved in all patients by the last follow-up visit. The mean UDVA improved from 1.07 logMAR ± 0.2 (SD) preoperatively to 0.23 ± 0.18 logMAR (P < .001), the mean CDVA improved from 0.79 ± 0.18 logMAR to 0.12 ± 0.12 logMAR (P < .001), the mean refractive SE improved from -5.04 ± 2.62 diopters (D) to -1.47 ± 1.32 D (P = .001), and the mean cylinder reduced from -5.39 ± 0.98 D to -1.05 ± 0.71 D (P < .001). The mean correction index was 0.84 ± 0.10, and the mean flattening index was 0.83 ± 0.10. Thirty-five percent of cases developed microperforations, and 15% developed epithelial ingrowth. This combined approach allowed for the correction of high astigmatism and ametropia following PKP; however, epithelial ingrowth requiring intervention is a complication to be considered. 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.

Astigmatism induced by conventional spherical ablation after PRK and LASIK in myopia with astigmatism < 1.00 D

PubMed Central

Christiansen, Steven M; Mifflin, Mark D; Edmonds, Jason N; Simpson, Rachel G; Moshirfar, Majid

2012-01-01

Background The purpose of this study was to evaluate surgically-induced astigmatism after spherical ablation in photorefractive keratectomy (PRK) and laser-assisted in situ keratomileusis (LASIK) for myopia with astigmatism < 1.00 D. Methods The charts of patients undergoing spherical PRK or LASIK for the correction of myopia with minimal astigmatism of <1.00 D from 2002 to 2012 at the John A Moran Eye Center in Salt Lake City, UT, were retrospectively reviewed. Astigmatism was measured by manifest refraction. The final astigmatic refractive outcome at 6 months postoperatively was compared with the initial refraction by Alpins vector analysis. Results For PRK, average cylinder increased from 0.39 ± 0.25 (0.00–0.75) preoperatively to 0.55 ± 0.48 (0.00–1.75) postoperatively (P = 0.014), compared with an increase in LASIK eyes from 0.40 ± 0.27 (0.00–0.75) preoperatively to 0.52 ± 0.45 (0.00–2.00) postoperatively (P = 0.041). PRK eyes experienced an absolute value change in cylinder of 0.41 ± 0.32 (0.00–1.50) and LASIK eyes experienced a change of 0.41 ± 0.31 (0.00–1.50, P = 0.955). Mean surgically-induced astigmatism was 0.59 ± 0.35 (0.00–1.70) in PRK eyes, with an increase in surgically-induced astigmatism of 0.44 D for each additional 1.00 D of preoperative cylinder; in LASIK eyes, mean surgically-induced astigmatism was 0.55 ± 0.32 (0.00–1.80, P = 0.482), with an increase in surgically-induced astigmatism of 0.29 D for each 1.00 D of preoperative cylinder. Conclusion Spherical ablation can induce substantial astigmatism even in eyes with less than one diopter of preoperative astigmatism in both PRK and LASIK. No significant difference in the magnitude of surgically-induced astigmatism was found between eyes treated with PRK and LASIK, although surgically-induced astigmatism was found to increase with greater levels of preoperative astigmatism in both PRK and LASIK. PMID:23277735

The effect of corneal anterior surface eccentricity on astigmatism after cataract surgery.

PubMed

Park, Choul Yong; Chuck, Roy S; Channa, Prabjot; Lim, Chi-Yeon; Ahn, Byung-Jin

2011-01-01

To evaluate the effect of cornea eccentricity on induced astigmatism after cataract surgery. The study included 125 eyes of 87 patients. Preoperative corneal astigmatism, pachymetry, and eccentricity were measured. During cataract surgery, the location of the main incision (2.8-mm clear corneal) was selected to be either superior, superior-nasal, superior-temporal, nasal, or temporal to decrease the preexisting corneal astigmatism. Aspheric intraocular lenses were implanted. Keratometry and manifest refraction were recorded 6 months after surgery. Astigmatism was calculated using vector subtraction software. Three parameters significantly affected postoperative astigmatism: preoperative amount of corneal astigmatism, eccentricity of anterior cornea, and location of the main incision. The mean surgically induced astigmatism (SIA) was calculated to be: superior = 0.82 diopters (D), superior-nasal = 0.50 D, superior-temporal = 0.63 D, temporal = 0.45 D, and nasal = 0.55 D. Superior incision induced the greatest SIA and temporal incision induced the smallest SIA. The eccentricity of anterior cornea showed significantly positive correlation with the amount of SIA (P < .001). The preoperative corneal cylinder power showed significantly positive correlation with the amount of SIA (P < .001). Postoperative astigmatism was affected by various factors in cataract surgery. The greatest postoperative astigmatism is expected in corneas with high anterior eccentricity, high preoperative corneal astigmatism, and superior location of the main incision. Copyright 2011, SLACK Incorporated.

Astigmatism-corrected echelle spectrometer using an off-the-shelf cylindrical lens.

PubMed

Fu, Xiao; Duan, Fajie; Jiang, Jiajia; Huang, Tingting; Ma, Ling; Lv, Changrong

2017-10-01

As a special kind of spectrometer with the Czerny-Turner structure, the echelle spectrometer features two-dimensional dispersion, which leads to a complex astigmatic condition. In this work, we propose an optical design of astigmatism-corrected echelle spectrometer using an off-the-shelf cylindrical lens. The mathematical model considering astigmatism introduced by the off-axis mirrors, the echelle grating, and the prism is established. Our solution features simplified calculation and low-cost construction, which is capable of overall compensation of the astigmatism in a wide spectral range (200-600 nm). An optical simulation utilizing ZEMAX software, astigmatism assessment based on Zernike polynomials, and an instrument experiment is implemented to validate the effect of astigmatism correction. The results demonstrated that astigmatism of the echelle spectrometer was corrected to a large extent, and high spectral resolution better than 0.1 nm was achieved.

Predictors of femtosecond laser intrastromal astigmatic keratotomy efficacy for astigmatism management in cataract surgery.

PubMed

Day, Alexander C; Stevens, Julian D

2016-02-01

To evaluate the factors associated with the efficacy of femtosecond laser intrastromal astigmatic keratotomy (AK). Moorfields Eye Hospital, London, United Kingdom. Prospective case series. Eyes having intrastromal AK for corneal cylinder correction were analyzed. Preoperative biometric parameters included axial length, anterior chamber depth, central corneal thickness, and Ocular Response Analyzer corneal hysteresis (CH) and corneal resistance factor (CRF). Preoperative and 1-month postoperative corneal keratometry was measured using the Topcon KR8100PA topographer-autorefractor. Astigmatic analyses were performed using the Alpins method. The study analyzed 319 eyes of 213 patients with a mean target induced astigmatism of 1.24 diopters (D) ± 0.44 (SD), mean surgically induced astigmatism (SIA) of 0.71 ± 0.43 D, and mean difference vector of 0.79 ± 0.41 D. Two multiple regression models were constructed for SIA prediction. Model 1, based on previous manual limbal relaxing incision parameters, confirmed age and astigmatism meridian (with/against the rule and oblique) to be associated with SIA in addition to AK arc length, AK start depth, and preoperative corneal cylinder magnitude. Model 2, additionally considering other parameters, found only lower CH (-0.06 DC per unit CH), a higher CRF (0.04 D per unit CRF), and the astigmatism meridian to be independent predictors of greater SIA (after adjusting for intrastromal AK arc length, start depth, and preoperative corneal cylinder). With-the-rule astigmatism was associated with a 0.13 D higher SIA than against-the-rule astigmatism, holding all other variables constant. Corneal biomechanical parameters and astigmatism meridian were independent predictors of femtosecond laser intrastromal AK efficacy even after adjusting for AK arc length, AK start depth, and preoperative corneal cylinder. Dr. Stevens is a previous consultant to Optimedica, Inc. which is now part of Abbott Medical Optics, Inc. Drs. Stevens and Day have

Evaluation of pigment epithelium-derived factor and complement factor I polymorphisms as a cause of choroidal neovascularization in highly myopic eyes.

PubMed

Miyake, Masahiro; Yamashiro, Kenji; Nakanishi, Hideo; Nakata, Isao; Akagi-Kurashige, Yumiko; Kumagai, Kyoko; Oishi, Maho; Tsujikawa, Akitaka; Moriyama, Muka; Ohno-Matsui, Kyoko; Mochizuki, Manabu; Yoshimura, Nagahisa

2013-06-19

A case-control study in a relatively large cohort of highly myopic patients was conducted to explore the genetic background of the occurrence of choroidal neovascularization (CNV) secondary to high myopia. We evaluated three single nucleotide polymorphisms (SNPS) from two candidate genes: pigment epithelium-derived factor (PEDF) and complement factor I (CFI). The SNPs were selected based on previous reports. A total of 1082 unrelated highly myopic (i.e., axial length ≥ 26 mm in at least one eye) Japanese individuals with CNV (n = 478) and without CNV (n = 557) who were 50 years of age and older were genotyped by using an SNP assay. Multivariable logistic regression was conducted to adjust for age, sex, and axial length. compared with individuals without CNV, subjects with CNV were significantly older (P 0.01) and more likely to be female (P 0.01), but they did not have a significantly different axial length (P = 0.50). We did not find an association between the three SNPS and the occurrence of CNV. However, a subanalysis using extremely myopic patients (case: control = 284:317) revealed a marginal association of rs12603825 in the PEDF gene (P = 0.045). The contribution of rs1136287 in CFI was not found in any analysis. We demonstrated a marginal association of the PEDF SNP, rs12603825, with myopic CNV in extremely myopic patients. A further study using a larger cohort might elucidate a significant association; rs1136287 in CFI is less likely to be associated in Japanese individuals.

Corneo-scleral contact lenses in an uncommon case of keratoconus with high hyperopia and astigmatism.

PubMed

Porcar, Esteban; Montalt, Juan Carlos; España-Gregori, Enrique; Peris-Martínez, Cristina

2017-10-01

To analyse the visual quality achieved by fitting corneo-scleral contact lenses (CScL) in an uncommon case of bilateral keratoconus, high hyperopia and astigmatism. A 45-year-old man presented for eye examination due to the unsatisfactory quality of his vision wearing soft toric contact lenses. He presented high hyperopia and astigmatism with bilateral keratoconus. He was fitted with CScL to correct his irregular astigmatism and ocular aberrations. A diagnostic trial set was used in the fitting process and he was assessed according to standardised fitting methodology. Visual acuity, corneal topography, biometry and ocular aberrations were evaluated. The follow-up period was 1year. The best spectacle-corrected visual acuity was 20/32 with +8.00/-4.50×30° for the right eye (RE) and 20/25 with +7.75/-2.25×120° for the left eye (LE). After CScL fitting, visual acuity was improved to 20/20 and 20/16 for the RE and LE, respectively. The patient wore these contact lenses an average of 13h a day. The total high order aberrations decreased by approximately 79% in the RE (2.37-0.50μm) and 47% in the LE (1.04-0.55μm) after CScL fitting. Visual quality and wearing time were maintained after 1year wearing CScL. In addition, no adverse ocular effects were found during this period. The present case report describes how the patient had CScL fitted successfully for management of keratoconus with high hyperopia and astigmatism. They provided optimal visual quality, along with prolonged use times and no adverse effects to the cornea. Copyright © 2017 British Contact Lens Association. Published by Elsevier Ltd. All rights reserved.

Relationship between preoperative axis of astigmatism and postoperative astigmatic change after superior scleral incision phacoemulsification.

PubMed

Lyhne, N; Hansen, T E; Corydon, L

1998-07-01

To evaluate the effect of the preoperative axis of astigmatism on the outcome of corneal astigmatism after sutured 5.2 to 5.7 mm superior incision phacoemulsification. Departments of Opthalmology, Odense and Vejle Hospitals, Denmark. Seventy-three consecutive patients with preoperative corneal astigmatism of 2.0 diopters (D) or less, axial length between 20.0 and 25.5 mm, and no eye disease except cataract were grouped according to preoperative with-the-rule (WTR) or against-the-rule (ATR) astigmatism. The keratometric cylinder, induced keratometric cylinder (subtraction), and induced cylinder (Jaffe) were measured and calculated 10 to 12 months postoperatively. The postoperative keratometric cylinder and induced keratometric cylinder were significantly higher in the ATR group (P < .00001; mean difference [95% confidence limits]: 0.76 D [0.54; 0.98] and 0.69 D [0.46; 0.92], respectively). There was no significant difference between groups in induced cylinder (Jaffe). The estimated differences were significantly in favor of patients with preoperative WTR astigmatism. The findings support using temporal incision in cases with a preoperative ATR axis of astigmatism.

Astigmatism Progression in the Early Treatment for Retinopathy of Prematurity Study to 6 years of age

PubMed Central

Davitt, Bradley V.; Quinn, Graham E.; Wallace, David K.; Dobson, Velma; Hardy, Robert J.; Tung, Betty; Lai, Dejian; Good, William V.

2011-01-01

Purpose To examine the prevalence of astigmatism (≥1.00 diopter (D)) and high astigmatism (≥2.00 D) from 6 months post term due date to 6 years postnatal, in preterm children with birth weight ≤ 1251g who developed high-risk prethreshold retinopathy of prematurity (ROP) and participated in the Early Treatment for ROP (ETROP) Study. Design Observational Cohort Study Participants 401 infants who developed high-risk prethreshold ROP in one or both eyes and were randomized to early treatment (ET) versus conventional management (CM). Refractive error was measured by cycloplegic retinoscopy. Eyes were excluded if they received additional retinal, glaucoma, or cataract surgery. Intervention Eyes were randomized to receive laser photocoagulation at high-risk prethreshold ROP or to receive treatment only if threshold ROP developed. Main Outcome Measures Astigmatism and high astigmatism at each study visit. Results For both ET and CM eyes, there was a consistent increase in prevalence of astigmatism over time, increasing from 42% at 4 years to 52% by 6 years for the group of ET eyes and from 47% to 54% in the CM eyes. There was no statistically significant difference between the slopes (rate of change per month) of the ET and CM eyes for both astigmatism and high astigmatism. (P=0.75) Conclusions By 6 years of age, over 50% of eyes with high-risk prethreshold ROP developed astigmatism ≥ 1.00 D, and nearly 25% of such eyes had high astigmatism (≥ 2.00 D). Presence of astigmatism was not influenced by timing of treatment, zone of acute-phase ROP, or presence of plus disease. However, there was a trend toward higher prevalence of astigmatism and high astigmatism in eyes with ROP residua. Most astigmatism was with-the-rule (75º –105º). More eyes with Type 2 than Type 1 had astigmatism by 6 years. These findings reinforce the need for follow-up eye examinations through early grade school years in infants with high risk prethreshold ROP. PMID:21872933

Progressive lenticular astigmatism in the clear lens.

PubMed

Tatham, Andrew; Prydal, Jeremy

2008-03-01

We describe a case of progressive lenticular astigmatism in a 53-year-old man with a clear lens. The patient acquired 5 diopters of lenticular astigmatism in his right eye over an 18-month period. The visual acuity was reduced to 6/60. Following phacoemulsification and intraocular lens implantation, the uncorrected visual acuity was 6/5. Progressive astigmatism is usually corneal in origin and in an otherwise healthy eye, significant lenticular astigmatism is rare. When lenticular astigmatism occurs, it is usually associated with a cortical cataract; however, astigmatism may precede the development of a clinically visible cataract.

Defocus and magnification dependent variation of TEM image astigmatism.

PubMed

Yan, Rui; Li, Kunpeng; Jiang, Wen

2018-01-10

Daily alignment of the microscope is a prerequisite to reaching optimal lens conditions for high resolution imaging in cryo-EM. In this study, we have investigated how image astigmatism varies with the imaging conditions (e.g. defocus, magnification). We have found that the large change of defocus/magnification between visual correction of astigmatism and subsequent data collection tasks, or during data collection, will inevitably result in undesirable astigmatism in the final images. The dependence of astigmatism on the imaging conditions varies significantly from time to time, so that it cannot be reliably compensated by pre-calibration of the microscope. Based on these findings, we recommend that the same magnification and the median defocus of the intended defocus range for final data collection are used in the objective lens astigmatism correction task during microscope alignment and in the focus mode of the iterative low-dose imaging. It is also desirable to develop a fast, accurate method that can perform dynamic correction of the astigmatism for different intended defocuses during automated imaging. Our findings also suggest that the slope of astigmatism changes caused by varying defocuses can be used as a convenient measurement of objective lens rotation symmetry and potentially an acceptance test of new electron microscopes.

Astigmatism in reflector antennas.

NASA Technical Reports Server (NTRS)

Cogdell, J. R.; Davis, J. H.

1973-01-01

Astigmatic phase error in large parabolic reflector antennas is discussed. A procedure for focusing an antenna and diagnosing the presence and degree of astigmatism is described. Theoretical analysis is conducted to determine the nature of this error in such antennas.

Comparing surgically induced astigmatism calculated by means of simulated keratometry versus total corneal refractive power.

PubMed

Garzón, Nuria; Rodríguez-Vallejo, Manuel; Carmona, David; Calvo-Sanz, Jorge A; Poyales, Francisco; Palomino, Carlos; Zato-Gómez de Liaño, Miguel Á; Fernández, Joaquín

2018-03-01

To evaluate surgically induced astigmatism as computed by means of either simulated keratometry (K SIM ) or total corneal refractive power (TCRP) after temporal incisions. Prospective observational study including 36 right eyes undergoing cataract surgery. Astigmatism was measured preoperatively during the 3-month follow-up period using Pentacam. Surgically induced astigmatism was computed considering anterior corneal surface astigmatism at 3 mm with K SIM and considering both corneal surfaces with TCRP from 1 to 8 mm (TCRP 3 for 3 mm). The eyes under study were divided into two balanced groups: LOW with K SIM astigmatism <0.90 D and HIGH with K SIM astigmatism ≥0.90 D. Resulting surgically induced astigmatism values were compared across groups and measuring techniques by means of flattening, steepening, and torque analysis. Mean surgically induced astigmatism was higher in the HIGH group (0.31 D @ 102°) than in the LOW group (0.04 D @ 16°). The temporal incision resulted in a steepening in the HIGH group of 0.15 D @ 90°, as estimated with K SIM , versus 0.28 D @ 90° with TCRP 3 , but no significant differences were found for the steepening in the LOW group or for the torque in either group. Differences between K SIM - and TCRP 3 -based surgically induced astigmatism values were negligible in LOW group. Surgically induced astigmatism was considerably higher in the high-astigmatism group and its value was underestimated with the K SIM approach. Eyes having low astigmatism should not be included for computing the surgically induced astigmatism because steepening would be underestimated.

Small incision corneal refractive surgery using the small incision lenticule extraction (SMILE) procedure for the correction of myopia and myopic astigmatism: results of a 6 month prospective study.

PubMed

Sekundo, Walter; Kunert, Kathleen S; Blum, Marcus

2011-03-01

This 6 month prospective multi-centre study evaluated the feasibility of performing myopic femtosecond lenticule extraction (FLEx) through a small incision using the small incision lenticule extraction (SMILE) procedure. Prospective, non-randomised clinical trial. PARTICIPANTS; Ninety-one eyes of 48 patients with myopia with and without astigmatism completed the final 6 month follow-up. The patients' mean age was 35.3 years. Their preoperative mean spherical equivalent (SE) was −4.75±1.56 D. A refractive lenticule of intrastromal corneal tissue was cut utilising a prototype of the Carl Zeiss Meditec AG VisuMax femtosecond laser system. Simultaneously two opposite small ‘pocket’ incisions were created by the laser system. Thereafter, the lenticule was manually dissected with a spatula and removed through one of incisions using modified McPherson forceps. Uncorrected visual acuity (UCVA) and best spectacle corrected visual acuity (BSCVA) after 6 months, objective and manifest refraction as well as slit-lamp examination, side effects and a questionnaire. Six months postoperatively the mean SE was −0.01 D±0.49 D. Most treated eyes (95.6%) were within ±1.0 D, and 80.2% were within ±0.5 D of intended correction. Of the eyes treated, 83.5% had an UCVA of 1.0 (20/20) or better, 53% remained unchanged, 32.3% gained one line, 3.3% gained two lines of BSCVA, 8.8% lost one line and 1.1% lost ≥2 lines of BSCVA. When answering a standardised questionnaire, 93.3% of patients were satisfied with the results obtained and would undergo the procedure again. SMILE is a promising new flapless minimally invasive refractive procedure to correct myopia.

Optical devices in highly myopic eyes with low vision: a prospective study.

PubMed

Scassa, C; Cupo, G; Bruno, M; Iervolino, R; Capozzi, S; Tempesta, C; Giusti, C

2012-01-01

To compare, in relation to the cause of visual impairment, the possibility of rehabilitation, the corrective systems already in use and the finally prescribed optical devices in highly myopic patients with low vision. Some considerations about the rehabilitation of these subjects, especially in relation to their different pathologies, have also been made. 25 highly myopic subjects were enrolled. We evaluated both visual acuity and retinal sensitivity by Scanning Laser Ophthalmoscope (SLO) microperimetry. 20 patients (80%) were rehabilitated by means of monocular optical devices while five patients (20%) were rehabilitated binocularly. We found a good correlation between visual acuity and retinal sensitivity only when the macular pathology did not induce large areas of chorioretinal atrophy that cause lack of stabilization of the preferential retinal locus. In fact, the best results in reading and performing daily visual tasks were obtained by maximizing the residual vision in patients with retinal sensitivity greater than 10 dB. A well circumscribed area of absolute scotoma with a defined new retinal fixation locus could be considered as a positive predictive factor for the final rehabilitation process. A more careful evaluation of visual acuity, retinal sensitivity and preferential fixation locus is necessary in order to prescribe the best optical devices to patients with low vision, thus reducing the impact of the disability on their daily life.

Refractive and corneal astigmatism in white school children in northern ireland.

PubMed

O'Donoghue, Lisa; Rudnicka, Alicja R; McClelland, Julie F; Logan, Nicola S; Owen, Christopher G; Saunders, Kathryn J

2011-06-08

To study the prevalence of and relation between refractive and corneal astigmatism in white school children in Northern Ireland and to describe the association between refractive astigmatism and refractive error. Stratified random clustering was used to recruit 1053 white children, 392 aged 6-7 years and 661 aged 12-13 years. Eye examinations included cycloplegic autorefraction and ocular biometric measures of axial length and corneal curvature. The prevalence of refractive astigmatism (≥ 1 DC) did not differ significantly between 6- to 7-year-old children (24%; 95% confidence interval [CI], 19-30) and 12- to 13-year-old children (20%; 95% CI, 14-25). The prevalence of corneal astigmatism (≥ 1 DC) also did not differ significantly between 6- to 7-year-old children (29%; 95% CI, 24-34) and 12- to 13-year-old children (25%; 95% CI, 21-28). While levels of refractive astigmatism and corneal astigmatism were similar, refractive astigmatism was predominantly oblique (76%; 95% CI, 67-85, of 6- to 7-year-olds; 59%; 95% CI, 48-70, of 12- to 13-year-olds), but corneal astigmatism was predominantly with-the-rule (80%; 95% CI, 72-87, of 6- to 7-year-olds; 82%; 95% CI, 74-90, of 12- to 13-year-olds). The prevalence of refractive astigmatism was associated with increasing myopia and hyperopia. This study is the first to provide robust population-based data on the prevalence of astigmatism in white school children in the United Kingdom. The prevalence of refractive astigmatism and corneal astigmatism is stable between 6 and 7 years and 12 and 13 years, although this finding would need to be confirmed by prospective studies. There is a high prevalence of refractive and corneal astigmatism which is associated with ametropia.

Astigmatism-free Czerny-Turner compact spectrometer with cylindrical mirrors.

PubMed

Xia, Guo; Wu, Su; Wang, Guodong; Hu, Mingyong; Xing, Jinyu

2017-11-10

A modified optical design for a broadband, high resolution, astigmatism-free Czerny-Turner spectrometer is proposed. Astigmatism is corrected by using cylindrical mirrors over a broad spectral range. The theory and method for astigmatism correction are thoroughly analyzed. The comparison between the modified Czerny-Turner spectrometer and the traditional Czerny-Turner spectrometer is also described in detail. The ray-tracing results show that the RMS spot radius has decreased to 4.2 μm at the central wavelength and 17 μm at the wedge wavelength.

Developmental compensation of imposed astigmatism is not initiated by astigmatic accommodation in chickens.

PubMed

Thomas, S; Schaeffel, F

2000-01-01

It is not clear whether emmetropization is confined to spherical refractive errors, or whether astiqmatic errors are also corrected via visual feedback. Experimental results from the animal model of the chicken are equivocal since compensation of imposed astimatic defocus was found in some but not all studies. Astigmatism could only be compensated by changes in the geometry of the cornea or lens. One has tested whether astigmatic spectacle lenses induce astigmatic accommodation as a possible first step of long-lasting compensation. Thirty-five chickens were treated with cylinder lenses (+3/0D or -3/0D) for 5 h. Refractions were determined at 1.38 m distance without cycloplegia in hand-held chicks before attaching the lenses, with the lenses on (0 h), and after 3 and 5 h, and after removal of the lenses. Spheres (S), cylinders (C) and axes (A) were determined using infrared photoretinocopy in three axes (the 'PowerRefractor', equipped with a 135 mm lens). (1) The performance of the 'PowerRefractor' was tested in the chickens with trial lenses and gave correct refractions. (2) Astigmatic trial lenses induced refractive errors as expected from their powers in the case of +3/0D lenses: (S) +3.26 +/- 0.93D, (C) -3.45 +/- 0.87D). In the case of -3/0D lenses, slightly more hyperopic spheres were induced (refractions (S) +4.5 +/- 0.48D) but the cylinders were still as expected (-3.25 +/- 0.49D). The axes of astigmatism were correctly reproduced, since rotating the lenses changed the axes of the induced cylinders as expected. (3) Neither after 3 nor after 5 h of lens wear were there significant changes in the axes or the magnitude of astigmatism. Directly after removal of the lens, the refractions did not differ from their start-up values (with +3/0D lenses: (S) +3.31 +/- 1.05D vs. +3.22 +/- 0.76D, (C) -1.19 +/- 1.77D vs. -0.65 +/- 0.94D, (A) 96 +/- 49 vs. 113 +/- 45 deg; with -3/0D lenses: (S) 2.63 +/- 1.12D vs. 2.97 +/- 0.94D, (C) -1.11 +/- 1.15D vs. -0.53 +/- 0.56D, (A

Astigmatism in the Early Treatment for Retinopathy of Prematurity Study: findings to 3 years of age

PubMed Central

Davitt, Bradley V.; Dobson, Velma; Quinn, Graham E.; Hardy, Robert J.; Tung, Betty; Good, William V.

2009-01-01

Purpose To examine the prevalence of astigmatism (≥ 1.00 diopter (D)) and high astigmatism (≥ 2.00 D) at 6 and 9 months post-term and 2 and 3 years postnatal, in preterm children with birth weight < 1251g who developed high-risk prethreshold retinopathy of prematurity (ROP) and participated in the Early Treatment for ROP (ETROP) Study. Design Randomized controlled clinical trial Participants 401 infants who developed prethreshold ROP in one or both eyes and were randomized after they were determined to have a high risk (≥ 15%) of poor structural outcome without treatment, using the RM-ROP2 risk management program. Refractive error was measured by cycloplegic retinoscopy. Eyes with additional retinal, glaucoma, or cataract surgery were excluded. Intervention Eyes were randomized to receive laser photocoagulation at high-risk prethreshold ROP (early treated (ET)) or to be conventionally managed (CM), receiving treatment only if threshold ROP developed. Main Outcome Measures Astigmatism and high astigmatism at each visit. Astigmatism was classified as “with-the rule” (75° – 105° (WTR)), “against-the-rule” (0° – 15° and 165° – 180° (ATR), or “oblique” (16° – 74° and 106° – 164° (OBL)). Results The prevalence of astigmatism in ET and CM eyes was similar at each test age. For both groups, there was an increase in prevalence of astigmatism from approximately 32% at 6 months to approximately 42% by 3 years, mostly occurring between 6 and 9 months. Among eyes that could be refracted, astigmatism was not influenced by zone of acute-phase ROP, presence of plus disease, or retinal residua of ROP. Eyes with astigmatism and high astigmatism most often had WTR astigmatism. Conclusions By age 3 years, nearly 43% of eyes treated at high-risk prethreshold ROP developed astigmatism ≥ 1.00 D and nearly 20% had astigmatism ≥ 2.00 D. Presence of astigmatism was not influenced by timing of treatment of acute-phase ROP, characteristics of acute

Photorefractive keratectomy (PRK) at 193 nm using an erodible mask: new developments and clinical progress

NASA Astrophysics Data System (ADS)

Gordon, Michael; Seiler, Theo; Carey, Joseph P.; Friedman, Marc D.; Johnsson, N. M. F.; King, Michael C.; Muller, David F.

1993-06-01

This paper reports on our progress using an erodible mask to perform photorefractive keratectomy (PRK) for the correction of myopic astigmatism. We describe modifications to the mask, the mask eye cup and the surgical microscope aimed at simplifying the procedure and improving the ergonomics of the hardware. We report the clinical results of the post-op exam for 20 patients who have undergone PRK for myopic astigmatism under a Phase IIA study. The results compare favorably with an earlier Phase IIA study for performing PRK with a computer-controlled iris. Most important, the clinical data show the absence of any significant corneal haze and no significant decrease in spectacle corrected visual acuity. Although more long term follow-up is needed, the preliminary results support the safety and effectiveness of using an erodible mask to perform PRK for myopic astigmatism.

Astigmatism evaluation prior to cataract surgery.

PubMed

Gupta, Pankaj C; Caty, Jane T

2018-01-01

To evaluate and summarize literature from the past 18 months reporting advancements and issues in astigmatism assessment prior to cataract surgery. New and updated toric calculators and regression formulas offer the opportunity for more accurate lens selection for our patients. Concurrently, improvements in topographic evaluation of corneal keratometry have allowed for a decrease in unplanned residual corneal astigmatism. Measuring posterior corneal astigmatism is especially valuable in eyes with keratoconus when planning to implant toric intraocular lens (IOL) and now allows access to this patient population. Improved accuracy of astigmatism evaluation now occurs with point reflections on the corneal surface along with the latest generation toric lens formulas which integrated posterior corneal astigmatism, predicted lens position, and intended spherical power of the IOL. These improvements can allow for incorporation of toric lenses in keratoconus patients.

Development of a nomogram for femtosecond laser astigmatic keratotomy for astigmatism after keratoplasty.

PubMed

St Clair, Ryan M; Sharma, Anushree; Huang, David; Yu, Fei; Goldich, Yakov; Rootman, David; Yoo, Sonia; Cabot, Florence; Jun, Jason; Zhang, Lijun; Aldave, Anthony J

2016-04-01

To develop a nomogram for femtosecond laser astigmatic keratotomy (AK) to treat post-keratoplasty astigmatism. Three academic medical centers. Retrospective interventional case series. A review of post-keratoplasty femtosecond laser AK was performed. Uncorrected (UDVA) and corrected (CDVA) distance visual acuities, manifest refraction, and keratometry were recorded preoperatively and 1, 3, 6, and 12 months postoperatively. The location, length, depth, and diameter of the AK incisions were recorded, and the surgically induced astigmatic correction was related to these variables using regression analysis. One hundred forty femtosecond laser AK procedures were performed after penetrating keratoplasty (PKP) (n = 129) or deep anterior lamellar keratoplasty (DALK) (n =11), with 89 procedures (80 PKP, 9 DALK) included in the analysis. The mean CDVA improved from 20/59 (0.47 logMAR ± 0.38 [SD]) preoperatively to 20/45 (0.35 ± 0.31 logMAR) postoperatively (P = .013) (n = 46). The mean keratometric astigmatism decreased from 8.26 ± 2.90 diopters (D) preoperatively to 3.62 ± 2.59 D postoperatively (P < .0001) (n = 89). The mean refractive cylinder decreased from 6.77 ± 2.80 D preoperatively to 2.85 ± 2.57 D postoperatively (P < .0001) (n = 69). A nomogram for femtosecond laser AK to treat post-keratoplasty astigmatism was generated using regression analysis. Femtosecond laser AK significantly improved UDVA and CDVA and significantly reduced keratometric astigmatism and refractive cylinder after keratoplasty. The nomogram generated should improve the accuracy of post-keratoplasty femtosecond laser AK. 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.

Age-related changes in with-the-rule and oblique corneal astigmatism.

PubMed

Naeser, Kristian; Savini, Giacomo; Bregnhøj, Jesper Flethøj

2018-01-25

To describe the age-related changes in with-the-rule (WTR) and oblique keratometric astigmatism (KA), posterior corneal astigmatism (PCA) and total corneal astigmatism (TCA). We used a Pentacam HR (high-resolution) rotating Scheimpflug camera to determine the KA, PCA and TCA in the right eyes of 710 patients, aged from 20 to 88 years. The age-related changes along the vertical, horizontal and oblique meridians were analyzed with Naeser's polar value method in a cross-sectional study. In the whole group, all meridional astigmatic powers and polar values were stable in the age groups from 20 to 49 years, followed by a 1.0 dioptre (D) against-the-rule (ATR) change in KA and TCA, and a 0.12 D reduction in against-the-rule PCA. A nasal rotation of the steep meridian in KA and TCA was noted in the 70-88 years old. The PCA averaged approximately 0.25 D ATR in all age groups. Females displayed the same early astigmatic stability as in the whole group, while male eyes demonstrated a linear decay from 1.5 D WTR at 20 years to 0.5 D ATR astigmatism for the oldest patients. Corneal astigmatism is stable until the age of 50 years; thereafter both keratometric and total corneal astigmatism show a 0.25 D ATR change per 10 years. The average 0.25 D ATR PCA compensates the predominant keratometric WTR astigmatism in the younger patients and increases the TCA in the elderly with keratometric ATR astigmatism. The gender-based differences in age-related astigmatism require further studies. © 2018 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Compensation of Corneal Oblique Astigmatism by Internal Optics: a Theoretical Analysis

PubMed Central

Liu, Tao; Thibos, Larry N.

2017-01-01

internal lens. Conclusions Partial compensation of corneal astigmatism by internal optics is due mainly to the highly converging nature of wavefronts incident upon the lens resulting from corneal refraction. The degree of compensation is quadratically dependent on eccentricity but is expected to diminish as the eye accommodates. Neutralising the cornea by index-matching defeats internal compensation, revealing classical, radially-oriented oblique astigmatism in the isolated lens. PMID:28281302

Compensation of corneal oblique astigmatism by internal optics: a theoretical analysis.

PubMed

Liu, Tao; Thibos, Larry N

2017-05-01

compensation of corneal astigmatism by internal optics is due mainly to the highly converging nature of wavefronts incident upon the lens resulting from corneal refraction. The degree of compensation is quadratically dependent on eccentricity but is expected to diminish as the eye accommodates. Neutralising the cornea by index-matching defeats internal compensation, revealing classical, radially-oriented oblique astigmatism in the isolated lens. © 2017 The Authors Ophthalmic & Physiological Optics © 2017 The College of Optometrists.

Astigmatism

MedlinePlus

... retina, at the back of your eye. A refractive error If either your cornea or lens is egg ... too close to the television or squinting. Other refractive errors Astigmatism may occur in combination with other refractive ...

Assessment of corneal biomechanical properties and intraocular pressure in myopic spanish healthy population.

PubMed

Del Buey, María A; Lavilla, Laura; Ascaso, Francisco J; Lanchares, Elena; Huerva, Valentín; Cristóbal, José A

2014-01-01

Purpose. To examine biomechanical parameters of the cornea in myopic eyes and their relationship with the degree of myopia in a western healthy population. Methods. Corneal hysteresis (CH), corneal resistance factor (CRF), Goldmann correlated intraocular pressure (IOP), and corneal compensated IOP (IOPcc) were measured using the ocular response analyzer (ORA) in 312 eyes of 177 Spanish subjects aged between 20 and 56 years. Refraction was expressed as spherical equivalent (SE), which ranged from 0 to -16.50 diopters (D) (mean: -3.88 ± 2.90 D). Subjects were divided into four groups according to their refractive status: group 1 or control group: emmetropia (-0.50 ≤ SE < 0.50); group 2: low myopia (-0.75 ≤ SE < 3.00 D); group 3: moderate myopia (-3.00 ≤ SE ≤ -6.00 D); and group 3: high myopia (SE greater than -6.00 D). We analyzed the relationship between corneal biomechanics measured with ORA and SE. Results. CH in the emmetropia, low myopia, moderate myopia, and high myopia groups was 11.13 ± 0.98, 11.49 ± 1.25, 10.52 ± 1.54, and 10.35 ± 1.33 mmHg, respectively. CH in the highly myopic group was significantly lower than that in the emmetropic group (P = 0.07) and low myopic group (P = 0.035); however, there were no differences with the moderate myopic group (P = 0.872). There were no statistically significant differences regarding IOP among the four groups (P > 0.05); nevertheless, IOPcc was significantly higher in the moderately myopic (15.47 ± 2.47 mmHg) and highly myopic (16.14 ± 2.59 mmHg) groups than in the emmetropia (15.15 ± 2.06 mmHg) and low myopia groups (14.53 ± 2.37 mmHg). No correlation between age and the measured parameters was found. CH and IOPcc were weakly but significantly correlated with SE (r = 0.171, P = 0.002 and r = -0.131, P = 0.021, resp.). Conclusions. Present study showed only a very weak, but significant, correlation between CH and refractive error, with CH being lower in both moderately and highly

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.

Are high lags of accommodation in myopic children due to motor deficits?

PubMed

Labhishetty, Vivek; Bobier, William R

2017-01-01

Children with a progressing myopia exhibit an abnormal pattern of high accommodative lags coupled with high accommodative convergence (AC/A) and high accommodative adaptation. This is not predicted by the current models of accommodation and vergence. Reduced accommodative plant gain and reduced sensitivity to blur have been suggested as potential causes for this abnormal behavior. These etiologies were tested by altering parameters (sensory, controller and plant gains) in the Simulink model of accommodation. Predictions were then compared to the static and dynamic blur accommodation (BA) measures taken using a Badal optical system on 12 children (6 emmetropes and 6 myopes, 8-13years) and 6 adults (20-35years). Other critical parameters such as CA/C, AC/A, and accommodative adaptation were also measured. Usable BA responses were classified as either typical or atypical. Typical accommodation data confirmed the abnormal pattern of myopia along with an unchanged CA/C. Main sequence relationship remained invariant between myopic and nonmyopic children. An overall reduction was noted in the response dynamics such as peak velocity and acceleration with age. Neither a reduced plant gain nor reduced blur sensitivity could predict the abnormal accommodative behavior. A model adjustment reflecting a reduced accommodative sensory gain (ASG) coupled with an increased AC cross-link gain and reduced vergence adaptive gain does predict the empirical findings. Empirical measures also showed a greater frequency of errors in accommodative response generation (atypical responses) in both myopic and control children compared to adults. Copyright © 2016 Elsevier Ltd. All rights reserved.

Delayed visual attention caused by high myopic refractive error.

PubMed

Winges, Kimberly M; Zarpellon, Ursula; Hou, Chuan; Good, William V

2005-06-01

Delayed visual maturation (DVM) is usually a retrospective diagnosis given to infants who are born with no or poor visually-directed behavior, despite normal acuity on objective testing, but who recover months later. This condition can be organized into several types based on associated neurodevelopmental or ocular findings, but the etiology of DVM is probably complex and involves multiple possible origins. Here we report two infants who presented with delayed visual maturation (attention). They were visually unresponsive at birth but were later found to have high myopic errors. Patient 1 had -4 D right eye, -5 D left eye. Patient 2 had -9 D o.u. Upon spectacle correction at 5 and 4 months, respectively, both infants immediately displayed visually-directed behavior, suggesting that a high refractive error was the cause of inattention in these patients. These findings could add to knowledge surrounding DVM and the diagnosis of apparently blind infants. Findings presented here also indicate the importance of prompt refractive error measurement in such cases.

Measurement of Posterior Corneal Astigmatism by the IOLMaster 700.

PubMed

LaHood, Benjamin R; Goggin, Michael

2018-05-01

To provide the first description of posterior corneal astigmatism as measured by the IOLMaster 700 (Carl Zeiss Meditec, Jena, Germany) and assess how its characteristics compare to previous measurements from other devices. A total of 1,098 routine IOLMaster 700 biometric measurements were analyzed to provide magnitudes and orientation of steep and flat axes of anterior and posterior corneal astigmatism. Subgroup analysis was conducted to assess correlation of posterior corneal astigmatism characteristics to anterior corneal astigmatism and describe the distribution of posterior corneal astigmatism with age. Mean posterior corneal astigmatism was 0.24 ± 0.15 diopters (D). The steep axis of posterior corneal astigmatism was vertically oriented in 73.32% of measurements. Correlation between the magnitude of anterior and posterior corneal astigmatism was greatest when the steep axis of the anterior corneal astigmatism was oriented vertically (r = 0.68, P < .0001). Vertical orientation of the steep axis of anterior corneal astigmatism became less common as age increased, whereas for posterior corneal astigmatism it remained by far the most common orientation. This first description of posterior corneal astigmatism measurement by the IOLMaster 700 found the average magnitude of posterior corneal astigmatism and proportion of vertical orientation of steep axis was lower than previous estimates. The IOLMaster 700 appears capable of providing enhanced biometric measurement for individualized surgical planning. [J Refract Surg. 2018;34(5):331-336.]. Copyright 2018, SLACK Incorporated.

Off-axis astigmatism in the isolated chicken crystalline lens.

PubMed

Maier, Felix; Wahl, Siegfried; Schaeffel, Frank

2016-12-01

The chicken eye was previously found to have little off-axis astigmatism which is not explained by its special corneal shape but rather by the optical properties of the crystalline lens. To learn more about lens design, we studied off-axis astigmatism in the chicken lens in situ and compared it to a glass lens of similar power but with homogenous refractive index. After euthanasia, enucleated eye balls were cut in the equatorial plane right behind the scleral ossicles. The anterior segment was placed in a water-filled chamber. Several thin laser beams were projected in two perpendicular meridians through the lens under various eccentricities and the focal lengths were determined. Off-axis astigmatism across the horizontal visual field was determined as the differences in power in the two meridians. The same procedure was used for the glass lens. On-axis, the chicken crystalline lens had slightly more power in the vertical than in the horizontal meridian (-2.8±0.7D (SEM)). Astigmatism flipped sign and increased with eccentricity to reach +6.1±2.1D (SEM) at 33.5deg off-axis, as expected from off-axis astigmatism. Even though this value appears high, it was still 2.5 times lower than in the glass lens. A ZEMAX model of a lens with a homogeneous index and with surface profiles taken of the natural chicken lens revealed even higher levels of off-axis astigmatism. Obviously, the natural chicken lens displays much less off-axis astigmatism than a glass lens with similar power. Since its shape does not explain the low off-axis astigmatism, it must be due to a refined internal refractive index structure. Copyright © 2016 Elsevier Ltd. All rights reserved.

Can current models of accommodation and vergence predict accommodative behavior in myopic children?

PubMed

Sreenivasan, Vidhyapriya; Irving, Elizabeth L; Bobier, William R

2014-08-01

Investigations into the progression of myopia in children have long considered the role of accommodation as a cause and solution. Myopic children show high levels of accommodative adaptation, coupled with accommodative lag and high response AC/A (accommodative convergence per diopter of accommodation). This pattern differs from that predicted by current models of interaction between accommodation and vergence, where weakened reflex responses and a high AC/A would be associated with a low not high levels of accommodative adaptation. However, studies of young myopes were limited to only part of the accommodative vergence synkinesis and the reciprocal components of vergence adaptation and convergence accommodation were not studied in tandem. Accordingly, we test the hypothesis that the accommodative behavior of myopic children is not predicted by current models and whether that departure is explained by differences in the accommodative plant of the myopic child. Responses to incongruent stimuli (-2D, +2D adds, 10 prism diopter base-out prism) were investigated in 28 myopic and 25 non-myopic children aged 7-15 years. Subjects were divided into phoria groups - exo, ortho and eso based upon their near phoria. The school aged myopes showed high levels of accommodative adaptation but with reduced accommodation and high AC/A. This pattern is not explained by current adult models and could reflect a sluggish gain of the accommodative plant (ciliary muscle and lens), changes in near triad innervation or both. Further, vergence adaptation showed a predictable reciprocal relationship with the high accommodative adaptation, suggesting that departures from adult models were limited to accommodation not vergence behavior. Copyright © 2014 Elsevier Ltd. All rights reserved.

Perioperative Modulating Factors on Astigmatism in Sutured Cataract Surgery

PubMed Central

Cho, Yang Kyeung

2009-01-01

Purpose To evaluate the factors that affect postoperative astigmatism and post-suture removal astigmatism, and to evaluate the risk factors associated with astigmatism axis shift. Methods We performed a retrospective chart review of 130 eyes that had undergone uneventful phacoemulsification cataract surgery. Preoperative astigmatism was divided into four groups (Groups I, II, III, and IV) according to the differences between the axis of preoperative astigmatism (flattest axis) and the incision axis (105 degrees). We analyzed the magnitude and axis of the induced astigmatism after the operation and after suture removal in each group. We also analyzed the factors which affected the postoperative astigmatism and post-suture removal astigmatism in each sub-group of Groups I, II, III, and IV, excluding postoperative or post-suture removal axis shift (specifically, Group IWAS, IIWAS, IIIWAS, and IVWAS). We identified the variables associated with the prevalence of postoperative astigmatism axis shift and those associated with the prevalence of post-suture removal axis shift. Results An increase in the magnitude of postoperative astigmatism was associated with an increase in the preoperative magnitude of astigmatism in Groups IWAS, IIWAS, and IIIWAS (p<0.05), and with an increase in the corneal tunnel length in Group IWAS. A decrease in the magnitude of postoperative astigmatism was associated with an increase in the corneal tunnel length in Groups IIIWAS and IVWAS (p<0.05). An increase in the magnitude of post-suture removal astigmatism was associated with an increase in the magnitude of postoperative astigmatism in Groups IWAS and IVWAS (p<0.05), and with late suture removal in Group IVWAS (p<0.05). A decrease in the magnitude of post-suture removal astigmatism was associated with late suture removal in Groups IWAS and IIWAS. A logistic regression analysis showed that the prevalence of post-suture removal astigmatism axis shift was associated with increased corneal

Toric intraocular lens implantation versus astigmatic keratotomy to correct astigmatism during phacoemulsification.

PubMed

Titiyal, Jeewan S; Khatik, Mukesh; Sharma, Namrata; Sehra, Sri Vatsa; Maharana, Parfulla K; Ghatak, Urmimala; Agarwal, Tushar; Khokhar, Sudarshan; Chawla, Bhavana

2014-05-01

To compare toric intraocular lens (IOL) implantation and astigmatic keratotomy (AK) in correction of astigmatism during phacoemulsification. Tertiary care hospital. Prospective randomized trial. Consecutive patients with visually significant cataract and moderate astigmatism (1.25 to 3.00 diopters [D]) were randomized into 2 groups. Temporal clear corneal 2.75 mm phacoemulsification with toric IOL implantation was performed in the toric IOL group and with 30-degree coupled AK at the 7.0 mm optic zone in the keratotomy group. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities, refraction, keratometry, topography, central corneal thickness, and endothelial cell density were evaluated preoperatively and 1 day, 1 week, and 1 and 3 months postoperatively. The study enrolled 34 eyes (34 patients), 17 in each group. There was no difference in UDVA or CDVA between the 2 groups at any follow-up visit. The mean preoperative and postoperative refractive cylinder was 2.00 D ± 0.49 (SD) and 0.33 ± 0.17 D, respectively, in the toric IOL group and 1.95 ± 0.47 D and 0.57 ± 0.41 D, respectively, in the keratotomy group (P=.10). The mean residual astigmatism at 3 months was 0.44 ± 1.89 @ 160 in the toric IOL group and 0.77 ± 1.92 @ 174 in the keratotomy group (P=.61). All eyes in the toric IOL group and 14 eyes (84%) in the keratotomy group achieved a residual refractive cylinder of 1.00 D or less (P=.17). Toric IOL implantation was comparable to AK in eyes with moderate astigmatism having phacoemulsification. Copyright © 2014 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Glaucoma-Diagnostic Ability of Ganglion Cell-Inner Plexiform Layer Thickness Difference Across Temporal Raphe in Highly Myopic Eyes.

PubMed

Kim, Young Kook; Yoo, Byeong Wook; Jeoung, Jin Wook; Kim, Hee Chan; Kim, Hae Jin; Park, Ki Ho

2016-11-01

To evaluate the glaucoma-diagnostic ability of the ganglion cell-inner plexiform layer (GCIPL) thickness difference across the temporal raphe in highly myopic eyes. We consecutively enrolled a total of 195 highly myopic eyes (axial length [AL] >26.5 mm) of 195 subjects: 93 glaucoma patients along with and 102 nonglaucomatous subjects. Cirrus high-definition optical coherence tomography (OCT) was employed to scan all of the subjects' macular and optic discs. Using a MATLAB-based customized program (the GCIPL hemifield test), a positive test result was automatically declared if the following two conditions were met: (1) the horizontal line is detected for longer than one-half of the distance from the temporal inner elliptical annulus to the outer elliptical annulus, and (2) the average GCIPL thickness difference within 10 pixels of the reference line, both above and below, is 5 μm or more. The glaucoma-diagnostic ability was computed using the area under the receiver operating characteristic curve (AUC). Among the glaucomatous eyes, GCIPL hemifield test positivity was shown in 92.5% (86 of 93), significantly higher than that for the nonglaucomatous eyes (4.90%, 5 of 102; P <0.001). The value of AUC for the GCIPL hemifield test was excellent (0.938; sensitivity 92.50%, specificity 95.10%) and was the best compared with those for any of OCT parameters. In highly myopic eyes, determination of the presence or absence of GCIPL thickness difference across the temporal raphe via OCT macula scan can be a useful means of distinguishing the glaucomatous damage.

[Analyzing and tracking preoperative and intraoperative astigmatism].

PubMed

Perez, M

2012-03-01

Precise evaluation of preoperative astigmatism is the first step optimizing outcomes. This begins with office-based evaluation of astigmatism; corneal astigmatism is evaluated by keratometry, traditionally by Javal keratometry, but now including topography, whether Placido- or elevation-based, which allows for detailed analysis of even irregular astigmatism, including the corneal periphery, which is invaluable. Aberrometers, essentially "super-auto refractors", allow the incorporation of additional data into the qualitative analysis of astigmatism. The correlation between these multiple preoperative data helps to differentiate between corneal and total astigmatism, to infer the lenticular astigmatism, and to integrate all of these data into the clinical decision-making process. Immediately preoperatively, the 0 and 180° axes are marked; then, with the aid of a special marker, the axis of alignment for the toric IOL is also marked. Once the cataract is removed, the toric IOL is injected and pre-aligned; the viscoelastic is carefully removed, particularly from between the IOL and posterior capsule, with the toric IOL being definitively aligned at this point. These alignment techniques represent a major advance, soon to be indispensible for toric IOL surgery, which will certainly continue to grow in the future. Copyright © 2011 Elsevier Masson SAS. All rights reserved.

Simulated astigmatism impairs academic-related performance in children.

PubMed

Narayanasamy, Sumithira; Vincent, Stephen J; Sampson, Geoff P; Wood, Joanne M

2015-01-01

Astigmatism is an important refractive condition in children. However, the functional impact of uncorrected astigmatism in this population is not well established, particularly with regard to academic performance. This study investigated the impact of simulated bilateral astigmatism on academic-related tasks before and after sustained near work in children. Twenty visually normal children (mean age: 10.8 ± 0.7 years; six males and 14 females) completed a range of standardised academic-related tests with and without 1.50 D of simulated bilateral astigmatism (with both academic-related tests and the visual condition administered in a randomised order). The simulated astigmatism was induced using a positive cylindrical lens while maintaining a plano spherical equivalent. Performance was assessed before and after 20 min of sustained near work, during two separate testing sessions. Academic-related measures included a standardised reading test (the Neale Analysis of Reading Ability), visual information processing tests (Coding and Symbol Search subtests from the Wechsler Intelligence Scale for Children) and a reading-related eye movement test (the Developmental Eye Movement test). Each participant was systematically assigned either with-the-rule (WTR, axis 180°) or against-the-rule (ATR, axis 90°) simulated astigmatism to evaluate the influence of axis orientation on any decrements in performance. Reading, visual information processing and reading-related eye movement performance were all significantly impaired by both simulated bilateral astigmatism (p < 0.001) and sustained near work (p < 0.001), however, there was no significant interaction between these factors (p > 0.05). Simulated astigmatism led to a reduction of between 5% and 12% in performance across the academic-related outcome measures, but there was no significant effect of the axis (WTR or ATR) of astigmatism (p > 0.05). Simulated bilateral astigmatism impaired children's performance on a

Development of a program for toric intraocular lens calculation considering posterior corneal astigmatism, incision-induced posterior corneal astigmatism, and effective lens position.

PubMed

Eom, Youngsub; Ryu, Dongok; Kim, Dae Wook; Yang, Seul Ki; Song, Jong Suk; Kim, Sug-Whan; Kim, Hyo Myung

2016-10-01

To evaluate the toric intraocular lens (IOL) calculation considering posterior corneal astigmatism, incision-induced posterior corneal astigmatism, and effective lens position (ELP). Two thousand samples of corneal parameters with keratometric astigmatism ≥ 1.0 D were obtained using bootstrap methods. The probability distributions for incision-induced keratometric and posterior corneal astigmatisms, as well as ELP were estimated from the literature review. The predicted residual astigmatism error using method D with an IOL add power calculator (IAPC) was compared with those derived using methods A, B, and C through Monte-Carlo simulation. Method A considered the keratometric astigmatism and incision-induced keratometric astigmatism, method B considered posterior corneal astigmatism in addition to the A method, method C considered incision-induced posterior corneal astigmatism in addition to the B method, and method D considered ELP in addition to the C method. To verify the IAPC used in this study, the predicted toric IOL cylinder power and its axis using the IAPC were compared with ray-tracing simulation results. The median magnitude of the predicted residual astigmatism error using method D (0.25 diopters [D]) was smaller than that derived using methods A (0.42 D), B (0.38 D), and C (0.28 D) respectively. Linear regression analysis indicated that the predicted toric IOL cylinder power and its axis had excellent goodness-of-fit between the IAPC and ray-tracing simulation. The IAPC is a simple but accurate method for predicting the toric IOL cylinder power and its axis considering posterior corneal astigmatism, incision-induced posterior corneal astigmatism, and ELP.

Myopic (HD-PTP, PTPN23) selectively regulates synaptic neuropeptide release.

PubMed

Bulgari, Dinara; Jha, Anupma; Deitcher, David L; Levitan, Edwin S

2018-02-13

Neurotransmission is mediated by synaptic exocytosis of neuropeptide-containing dense-core vesicles (DCVs) and small-molecule transmitter-containing small synaptic vesicles (SSVs). Exocytosis of both vesicle types depends on Ca 2+ and shared secretory proteins. Here, we show that increasing or decreasing expression of Myopic (mop, HD-PTP, PTPN23), a Bro1 domain-containing pseudophosphatase implicated in neuronal development and neuropeptide gene expression, increases synaptic neuropeptide stores at the Drosophila neuromuscular junction (NMJ). This occurs without altering DCV content or transport, but synaptic DCV number and age are increased. The effect on synaptic neuropeptide stores is accounted for by inhibition of activity-induced Ca 2+ -dependent neuropeptide release. cAMP-evoked Ca 2+ -independent synaptic neuropeptide release also requires optimal Myopic expression, showing that Myopic affects the DCV secretory machinery shared by cAMP and Ca 2+ pathways. Presynaptic Myopic is abundant at early endosomes, but interaction with the endosomal sorting complex required for transport III (ESCRT III) protein (CHMP4/Shrub) that mediates Myopic's effect on neuron pruning is not required for control of neuropeptide release. Remarkably, in contrast to the effect on DCVs, Myopic does not affect release from SSVs. Therefore, Myopic selectively regulates synaptic DCV exocytosis that mediates peptidergic transmission at the NMJ.

[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.

Lack of oblique astigmatism in the chicken eye.

PubMed

Maier, Felix M; Howland, Howard C; Ohlendorf, Arne; Wahl, Siegfried; Schaeffel, Frank

2015-04-01

Primate eyes display considerable oblique off-axis astigmatism which could provide information on the sign of defocus that is needed for emmetropization. The pattern of peripheral astigmatism is not known in the chicken eye, a common model of myopia. Peripheral astigmatism was mapped out over the horizontal visual field in three chickens, 43 days old, and in three near emmetropic human subjects, average age 34.7years, using infrared photoretinoscopy. There were no differences in astigmatism between humans and chickens in the central visual field (chicks -0.35D, humans -0.65D, n.s.) but large differences in the periphery (i.e. astigmatism at 40° in the temporal visual field: humans -4.21D, chicks -0.63D, p<0.001, unpaired t-test). The lack of peripheral astigmatism in chicks was not due to differences in corneal shape. Perhaps related to their superior peripheral optics, we found that chickens had excellent visual performance also in the far periphery. Using an automated optokinetic nystagmus paradigm, no difference was observed in spatial visual performance with vision restricted to either the central 67° of the visual field or to the periphery beyond 67°. Accommodation was elicited by stimuli presented far out in the visual field. Transscleral images of single infrared LEDs showed no sign of peripheral astigmatism. The chick may be the first terrestrial vertebrate described to lack oblique astigmatism. Since corneal shape cannot account for the difference in astigmatism in humans and chicks, it must trace back to the design of the crystalline lens. The lack of peripheral astigmatism in chicks also excludes a role in emmetropization. Copyright © 2015 Elsevier Ltd. All rights reserved.

Astigmatism in Monkeys with Experimentally Induced Myopia or Hyperopia

PubMed Central

KEE, CHEA-SU; HUNG, LI-FANG; QIAO-GRIDER, YING; RAMAMIRTHAM, RAMKUMAR; SMITH, EARL L.

2006-01-01

Purpose Astigmatism is the most common ametropia found in humans and is often associated with large spherical ametropias. However, little is known about the etiology of astigmatism or the reason(s) for the association between spherical and astigmatic refractive errors. This study examines the frequency and characteristics of astigmatism in infant monkeys that developed axial ametropias as a result of altered early visual experience. Methods Data were obtained from 112 rhesus monkeys that experienced a variety of lens-rearing regimens that were intended to alter the normal course of emmetropization. These visual manipulations included form deprivation (n = 13); optically imposed defocus (n = 48); and continuous ambient lighting with (n = 6) or without optically imposed defocus (n = 6). In addition, data from 19 control monkeys and 39 infants reared with an optically imposed astigmatism were used for comparison purposes. The lens-rearing period started at approximately 3 weeks of age and ended by 4 to 5 months of age. Refractive development for all monkeys was assessed periodically throughout the treatment and subsequent recovery periods by retinoscopy, keratometry, and A-scan ultrasonography. Results In contrast to control monkeys, the monkeys that had experimentally induced axial ametropias frequently developed significant amounts of astigmatism (mean refractive astigmatism = 0.37 ± 0.33 D [control] vs. 1.24 ± 0.81 D [treated]; two-sample t-test, p < 0.0001), especially when their eyes exhibited relative hyperopic shifts in refractive error. The astigmatism was corneal in origin (Pearson’s r; p < 0.001 for total astigmatism and the JO and J45 components), and the axes of the astigmatism were typically oblique and bilaterally mirror symmetric. Interestingly, the astigmatism was not permanent; the majority of the monkeys exhibited substantial reductions in the amount of astigmatism at or near the end of the lens-rearing procedures. Conclusions In infant monkeys

Pattern of refractive errors among patients at a tertiary hospital in Kathmandu.

PubMed

Rizyal, A; Ghising, R; Shrestha, R K; Kansakar, I

2011-09-01

A hospital based cross sectional study was carried out to determine the pattern of refractive errors among patients attending the out patient department, Department of Ophthalmology, Nepal Medical College Teaching Hospital. A total of 1100 patients were evaluated, (male 43.67%; female 56.33%). Simple myopic astigmatism was the most prevalent type of refractive error accounting for 27.18% followed by simple myopia (21.66%) and compound myopic astigmatism (19.48%). Simple hypermetropia (15.03%) and mixed astigmatism (4.3%) were also noted. Simple myopia was prevalent among the younger age group in the first to third decades, whereas hypermetropia was seen in the older patients in the third to fifth decades.

A design of PAL with astigmatism

NASA Astrophysics Data System (ADS)

Wei, Yefei; Xiang, Huazhong; Zhu, Tianfeng; Chen, Jiabi

2015-08-01

Progressive addition lens (PAL) is designed for those who suffer from myopia and presbyopia to have a clear vision from a far distance to a nearby distance. Additionally there are many people that also suffer from astigmatism and need to be corrected. The cylinder power can't be simply added to the diopter of the PAL directly, because the diopter of the PAL needs to be changed smoothly. A methods has been proposed in this article to solve the problem, the freeform surface height of a PAL without astigmatism and the cylindrical lens surface height for the correction of astigmatism are calculated separately. The both two surface heights were added together, then the final surface is produced and shown with the both properties of PALs and cylindrical lenses used to correct the astigmatism.

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

[Toric add-on intraocular lenses for correction of high astigmatism after pseudophakic keratoplasty].

PubMed

Hassenstein, A; Niemeck, F; Giannakakis, K; Klemm, M

2017-06-01

Perforating keratoplasty shows good morphological results with a clear cornea; however, a limiting factor is often the resulting astigmatism, which cannot be corrected with either glasses or contact lenses (CL) in up to 20% of the patients. We retrospectively investigated 15 patients after pseudophakic perforating keratoplasty, who received implantation of toric add-on intraocular lenses (IOL) to correct astigmatism. The mean preoperative astigmatism of 6.5 diopter (dpt) could be reduced to a mean postoperative value of 1.0 dpt. The mean visual acuity could be improved from a preoperative value of sc <0.05 (cc 0.6) to a postoperative value of sc 0.4 (cc 0.63). There were no complications except for one case of a lens extension tear. Based on our good experiences we now provide toric add-on IOL to all patients with pseudophakic perforating keratoplasty when this cannot be corrected or only insufficiently corrected by conservative methods.

Spherical aberrations of human astigmatic corneas.

PubMed

Zhao, Huawei; Dai, Guang-Ming; Chen, Li; Weeber, Henk A; Piers, Patricia A

2011-11-01

To evaluate whether the average spherical aberration of human astigmatic corneas is statistically equivalent to human nonastigmatic corneas. Spherical aberrations of 445 astigmatic corneas prior to laser vision correction were retrospectively investigated to determine Zernike coefficients for central corneal areas 6 mm in diameter using CTView (Sarver and Associates). Data were divided into groups according to cylinder power (0.01 to 0.25 diopters [D], 0.26 to 0.75 D, 0.76 to 1.06 D, 1.07 to 1.53 D, 1.54 to 2.00 D, and >2.00 D) and according to age by decade. Spherical aberrations were correlated with age and astigmatic power among groups and the entire population. Statistical analyses were conducted, and P<.05 was considered statistically significant. Mean patient age was 42.6±11 years. Astigmatic corneas had an average astigmatic power of 0.78±0.58 D and mean spherical aberration was 0.25±0.13 μm for the entire population and approximately the same (0.27 μm) for individual groups, ranging from 0.23 to 0.29 μm (P>.05 for all tested groups). Mean spherical aberration of astigmatic corneas was not correlated significantly with cylinder power or age (P>.05). Spherical aberrations are similar to those of nonastigmatic corneas, permitting the use of these additional data in the design of aspheric toric intra-ocular lenses. Copyright 2011, SLACK Incorporated.

The effect of static cyclotorsion compensation on refractive and visual outcomes using the Schwind Amaris laser platform for the correction of high astigmatism.

PubMed

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

2011-06-01

To compare the refractive and visual outcomes using the Schwind Amaris excimer laser in patients with high astigmatism (>1D) with and without the static cyclotorsion compensation (SCC) algorithm available with this new laser platform. 70 consecutive eyes with ≥1D astigmatism were randomized to treatment with compensation of static cyclotorsion (SCC group- 35 eyes) or not (control group- 35 eyes). A previously validated optimized aspheric ablation algorithm profile was used in every case. All patients underwent LASIK with a microkeratome cut flap. The SCC and control group did not differ preoperatively, in terms of refractive error, magnitude of astigmatism or in terms of cardinal or oblique astigmatism. Following treatment, average deviation from target was SEq +0.16D, SD±0.52 D, range -0.98 D to +1.71 D in the SCC group compared to +0.46 D, SD±0.61 D, range -0.25 D to +2.35 D in the control group, which was statistically significant (p<0.05). Following treatment, average astigmatism was 0.24 D (SD±0.28 D, range -1.01 D to 0.00 D) in the SCC group compared to 0.46 D (SD±0.42 D, range -1.80 D to 0.00 D) in the control group, which was highly statistically significant (p<0.005). There was no statistical difference in the postoperative uncorrected vision when the aspheric algorithm was used although there was a trend to increased number of lines gained in the SCC group. This study shows that static cyclotorsion is accurately compensated for by the Schwind Amaris laser platform. The compensation of static cyclotorsion in patients with moderate astigmatism produces a significant improvement in refractive and astigmatic outcomes than when not compensated. Copyright © 2011 British Contact Lens Association. Published by Elsevier Ltd. 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.

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.

Postoperative Corneal Asphericity in Low, Moderate, and High Myopic Eyes After Transepithelial PRK Using a New Pulse Allocation.

PubMed

Lin, David T C; Holland, Simon P; Verma, Shwetabh; Hogden, John; Arba-Mosquera, Samuel

2017-12-01

To evaluate the postoperative asphericity in low, moderate, and high myopic eyes after combined transepithelial photorefractive keratectomy and SmartSurf ACE treatment (SCHWIND eye-tech-solutions GmbH, Kleinostheim, Germany). In this retrospective case series, the outcomes of myopic SmartSurf ACE were evaluated at 3 months postoperatively in 106 eyes and divided into low (less than -4.125 diopters [D]), moderate (-4.125 to -6.25 D), and high (more than -6.25 D) myopia groups. In all cases, standard examinations and preoperative and postoperative corneal topography (SCHWIND Sirius) were performed. The analysis comprised evaluating the change in asphericity versus planned correction, comparing expected and achieved postoperative asphericity for all eyes, and comparison of the three groups in terms of the preoperative and postoperatively expected and achieved asphericity. RESULTS At 3 months postoperatively, the low myopia group (n = 33) improved average negative asphericity (Q = -0.04 ± 0.17 preoperative vs -0.19 ± 0.20 postoperative, P < .05). The moderate myopia group (n = 35) maintained or slightly improved average negative asphericity (Q = -0.07 ± 0.14 preoperative vs -0.05 ± 0.24 postoperative, P = .35). For the high myopia group (n = 38), the eyes became more oblate compared to the preoperative status (Q = -0.09 ± 0.15 preoperative vs 0.62 ± 0.70 postoperative, P < .05). In terms of asphericity, the difference between the three groups was not statistically significant preoperatively (P > .10), but showed significant differences postoperatively (P < .007). The cohort's average preoperative corrected distance visual acuity was 0.01 ± 0.04 logMAR (range: 0.0 to 0.18 logMAR) and uncorrected distance visual acuity was 0.03 ± 0.08 logMAR (range: -0.12 to 0.40 logMAR) 3 months postoperatively. SmartSurf ACE maintained or slightly improved preoperative corneal asphericity for low to moderate myopic corrections (up to -6.00 D). This may provide advantages in the

Does blunt ocular trauma induce corneal astigmatism?

PubMed

Akinci, Arsen; Ileri, Dilek; Polat, Sibel; Can, Cigdem; Zilelioglu, Orhan

2007-06-01

To determine the effect of blunt ocular trauma on refractive astigmatism. Eighty-six eyes of 86 patients with known previous refractive status exposed to blunt ocular trauma were included in the study. Trauma-induced astigmatism (TIA) was calculated using vector analysis. In eyes with TIA, central corneal thickness was assessed by ultrasound pachymetry, and corneal topographies were obtained. Anterior-chamber angles were examined by Goldmann 3-mirror lens to find microhemorrhages, scarring, or recession. Patients were followed up between 8 and 12 months (average, 9.2 months). In 18 eyes (21%), TIA was detected. Six (7%) of these eyes had lenticular astigmatism caused by traumatic lens subluxation. In the remaining 12 eyes (14%), corneal topography showed regular astigmatic patterns, which were symmetrical in 3 eyes and asymmetric in the remaining 9. The etiologic factor was a game marble in 6 eyes and a stone in the remaining 6. The mean central corneal thickness was 535.75 microm (range, 498-570 microm) in these 12 eyes. In 9 of these 12 eyes, recession or scarring in the anterior-chamber angle was detected at 1 edge of the steepest axis. Blunt trauma can induce astigmatism. Hard and small objects are more likely to induce astigmatism.

Identification of a Candidate Gene for Astigmatism

PubMed Central

Lopes, Margarida C.; Hysi, Pirro G.; Verhoeven, Virginie J. M.; Macgregor, Stuart; Hewitt, Alex W.; Montgomery, Grant W.; Cumberland, Phillippa; Vingerling, Johannes R.; Young, Terri L.; van Duijn, Cornelia M.; Oostra, Ben; Uitterlinden, Andre G.; Rahi, Jugnoo S.; Mackey, David A.; Klaver, Caroline C. W.; Andrew, Toby; Hammond, Christopher J.

2013-01-01

Purpose. Astigmatism is a common refractive error that reduces vision, where the curvature and refractive power of the cornea in one meridian are less than those of the perpendicular axis. It is a complex trait likely to be influenced by both genetic and environmental factors. Twin studies of astigmatism have found approximately 60% of phenotypic variance is explained by genetic factors. This study aimed to identify susceptibility loci for astigmatism. Methods. We performed a meta-analysis of seven genome-wide association studies that included 22,100 individuals of European descent, where astigmatism was defined as the number of diopters of cylinder prescription, using fixed effect inverse variance-weighted methods. Results. A susceptibility locus was identified with lead single nucleotide polymorphism rs3771395 on chromosome 2p13.3 (meta-analysis, P = 1.97 × 10−7) in the VAX2 gene. VAX2 plays an important role in the development of the dorsoventral axis of the eye. Animal studies have shown a gradient in astigmatism along the vertical plane, with corresponding changes in refraction, particularly in the ventral field. Conclusions. This finding advances the understanding of refractive error, and provides new potential pathways to be evaluated with regard to the development of astigmatism. PMID:23322567

Astigmatism transfer phenomena in the optical parametric amplification process

NASA Astrophysics Data System (ADS)

Li, Wenkai; Chen, Yun; Li, Yanyan; Xu, Yi; Guo, Xiaoyang; Lu, Jun; Leng, Yuxin

2017-01-01

We numerically and experimentally investigate the astigmatism transfer phenomena in femtosecond optical parametric amplification (OPA). We model the OPA process based on the coupled second-order three-wave nonlinear propagation equations. The numerical and experimental results support that the input pump pulse astigmatism can be transferred into the idler pulse but not the signal pulse, and the idler pulse astigmatism originating from spatial walk-off is less than the idler pulse astigmatism received from the pump. Thus, we can provide a clear understanding of astigmatism transfer mechanisms in the OPA process, and make better use of broadband tunable OPA sources.

Age of onset of myopia predicts risk of high myopia in later childhood in myopic Singapore children.

PubMed

Chua, Sharon Y L; Sabanayagam, Charumathi; Cheung, Yin-Bun; Chia, Audrey; Valenzuela, Robert K; Tan, Donald; Wong, Tien-Yin; Cheng, Ching-Yu; Saw, Seang-Mei

2016-07-01

To investigate the effect of age of myopia onset on the severity of myopia later in life among myopic children. In this prospective study, school children aged 7-9 years from the Singapore Cohort Of the Risk factors for Myopia (SCORM) were followed up till 11 years (n = 928). Age of myopia onset was defined either through questionnaire at baseline (age 7-9 years) or subsequent annual follow-up visits. Age of onset of myopia was a surrogate indicator of duration of myopia progression till age 11 years. Cycloplegic refraction and axial length were measured at every annual eye examination. High myopia was defined as spherical equivalent of ≤-5.0 D. A questionnaire determined the other risk factors. In multivariable regression models, younger age of myopia onset (per year decrease) or longer duration of myopia progression was associated with high myopia (odds ratio (OR) = 2.86; 95% CI: 2.39 to 3.43), more myopic spherical equivalent (regression coefficient (β) = -0.86 D; 95% CI: -0.93 to -0.80) and longer axial length (β = 0.28 mm; 95% CI: 0.24 to 0.32) at aged 11 years, after adjusting for gender, race, school, books per week and parental myopia. In Receiver Operating Curve (ROC) analyses, age of myopia onset alone predicted high myopia by 85% (area under the curve = 0.85), while the addition of other factors including gender, race, school, books per week and parental myopia only marginally improved this prediction (area under the curve = 0.87). Age of myopia onset or duration of myopia progression was the most important predictor of high myopia in later childhood in myopic children. Future trials to retard the progression of myopia to high myopia could focus on children with younger age of myopia onset or with longer duration of myopia progression. © 2016 The Authors Ophthalmic & Physiological Optics © 2016 The College of Optometrists.

Efficacy of vitrectomy with triamcinolone assistance versus internal limiting membrane peeling for highly myopic macular hole retinal detachment.

PubMed

Wei, Yong; Wang, Ningli; Zu, Zhongqiao; Bi, Chuncao; Wang, Huaizhou; Chen, Fenghua; Yang, Xingguang

2013-06-01

To compare the outcomes of pars plana vitrectomy (PPV) with or without the adjuvant surgical procedures: triamcinolone acetonide (TA) assistance and/or internal limiting membrane (ILM) peeling for the treatment of highly myopic macular hole retinal detachment (MHRD). Case-control study. Pars plana vitrectomy combined with 2 kinds of adjuvant surgical procedures were used on 96 highly myopic eyes with MHRD. These eyes were assigned to 4 groups randomly: Group 1, non-TA-assisted PPV and without ILM peeling; Group 2, non-TA-assisted PPV with ILM peeling; Group 3, TA-assisted PPV and without ILM peeling; Group 4, TA-assisted PPV with ILM peeling. Anatomical reattachment of the retina, macular hole closure, and best-corrected visual acuity were measured. The rates of both retinal reattachment and macular hole closure were higher in Group 2 (84.0 and 44.0%) and Group 3 (80.8 and 46.2%) than Group 1 (73.9 and 17.4%); however, there were no differences between Group 2 and Group 3 (P > 0.05). The rates of macular hole closure were extremely low in Group 1 and also in eyes with extreme long axial lengths (≥29.0 mm), "severe" chorioretinal atrophy, and posterior staphyloma. Pars plana vitrectomy with either TA assistance or ILM peeling was effective for the treatment of highly myopic MHRD. If you peel the ILM, adding TA does not affect closure rates; and if TA is used to visualize the vitreous, ILM peeling may not be necessary in MHRD. There was a lower anatomical success rate in MHRD with extreme long axial lengths, severe chorioretinal atrophy, and posterior staphyloma.

Astigmatism and early academic readiness in preschool children.

PubMed

Orlansky, Gale; Wilmer, Jeremy; Taub, Marc B; Rutner, Daniella; Ciner, Elise; Gryczynski, Jan

2015-03-01

This study investigated the relationship between uncorrected astigmatism and early academic readiness in at-risk preschool-aged children. A vision screening and academic records review were performed on 122 three- to five-year-old children enrolled in the Philadelphia Head Start program. Vision screening results were related to two measures of early academic readiness, the teacher-reported Work Sampling System (WSS) and the parent-reported Ages and Stages Questionnaire (ASQ). Both measures assess multiple developmental and skill domains thought to be related to academic readiness. Children with astigmatism (defined as >|-0.25| in either eye) were compared with children who had no astigmatism. Associations between astigmatism and specific subscales of the WSS and ASQ were examined using parametric and nonparametric bivariate statistics and regression analyses controlling for age and spherical refractive error. Presence of astigmatism was negatively associated with multiple domains of academic readiness. Children with astigmatism had significantly lower mean scores on Personal and Social Development, Language and Literacy, and Physical Development domains of the WSS, and on Personal/Social, Communication, and Fine Motor domains of the ASQ. These differences between children with astigmatism and children with no astigmatism persisted after statistically adjusting for age and magnitude of spherical refractive error. Nonparametric tests corroborated these findings for the Language and Literacy and Physical Health and Development domains of the WSS and the Communication domain of the ASQ. The presence of astigmatism detected in a screening setting was associated with a pattern of reduced academic readiness in multiple developmental and educational domains among at-risk preschool-aged children. This study may help to establish the role of early vision screenings, comprehensive vision examinations, and the need for refractive correction to improve academic success in

Posterior corneal astigmatism in refractive lens exchange surgery.

PubMed

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

2016-05-01

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

Higher Order Aberration and Astigmatism in Children with Hyperopic Amblyopia.

PubMed

Choi, Seung Kwon; Chang, Ji Woong

2016-02-01

To investigate the changes in corneal higher-order aberration (HOA) during amblyopia treatment and the correlation between HOA and astigmatism in hyperopic amblyopia children. In this retrospective study, a total of 72 eyes from 72 patients ranging in age from 38 to 161 months were included. Patients were divided into two groups based on the degree of astigmatism. Corneal HOA was measured using a KR-1W aberrometer at the initial visit and at 3-, 6-, and 12-month follow-ups. Correlation analysis was performed to assess the association between HOA and astigmatism. A total of 72 patients were enrolled in this study, 37 of which were classified as belonging to the higher astigmatism group, while 35 were assigned to the lower astigmatism group. There was a statistically significant difference in success rate between the higher and lower astigmatism groups. In both groups, all corneal HOAs were significantly reduced during amblyopia treatment. When comparing the two groups, a significant difference in coma HOA at the 12-month follow-up was detected (p = 0.043). In the Pearson correlation test, coma HOA at the 12-month follow-up demonstrated a statistically significant correlation with astigmatism and a stronger correlation with astigmatism in the higher astigmatism group than in the lower astigmatism group (coefficient values, 0.383 and 0.284 as well as p = 0.021 and p = 0.038, respectively). HOA, particularly coma HOA, correlated with astigmatism and could exert effects in cases involving hyperopic amblyopia.

Mean Posterior Corneal Power and Astigmatism in Normal Versus Keratoconic Eyes.

PubMed

Feizi, Sepehr; Delfazayebaher, Siamak; Javadi, Mohammad Ali; Karimian, Farid; Ownagh, Vahid; Sadeghpour, Fatemeh

2018-01-01

To compare mean posterior corneal power and astigmatism in normal versus keratoconus affected eyes and determine the optimal cut-off points to maximize sensitivity and specificity in discriminating keratoconus from normal corneas. A total of 204 normal eyes and 142 keratoconus affected eyes were enrolled in this prospective comparative study. Mean posterior corneal power and astigmatism were measured using a dual Scheimpflug camera. Correlation coefficients were calculated to assess the relationship between the magnitudes of keratometric and posterior corneal astigmatism in the study groups. Receiver operating characteristic curves were used to compare the sensitivity and specificity of the measured parameters and to identify the optimal cut-off points for discriminating keratoconus from normal corneas. The mean posterior corneal power was -6.29 ± 0.20 D in the normal group and -7.77 ± 0.87 D in the keratoconus group ( P < 0.001). The mean magnitudes of the posterior corneal astigmatisms were -0.32 ± 0.15 D and -0.94 ± 0.39 D in the normal and keratoconus groups, respectively ( P < 0.001). Significant correlations were found between the magnitudes of keratometric and posterior corneal astigmatism in the normal (r=-0.76, P < 0.001) and keratoconus (r=-0.72, P < 0.001) groups. The mean posterior corneal power and astigmatism were highly reliable characteristics that distinguished keratoconus from normal corneas (area under the curve, 0.99 and 0.95, respectively). The optimal cut-off points of mean posterior corneal power and astigmatism were -6.70 D and -0.54 D, respectively. Mean posterior corneal power and astigmatism measured using a Galilei analyzer camera might have potential in diagnosing keratoconus. The cut-off points provided can be used for keratoconus screening.

Higher Order Aberration and Astigmatism in Children with Hyperopic Amblyopia

PubMed Central

Choi, Seung Kwon

2016-01-01

Purpose To investigate the changes in corneal higher-order aberration (HOA) during amblyopia treatment and the correlation between HOA and astigmatism in hyperopic amblyopia children. Methods In this retrospective study, a total of 72 eyes from 72 patients ranging in age from 38 to 161 months were included. Patients were divided into two groups based on the degree of astigmatism. Corneal HOA was measured using a KR-1W aberrometer at the initial visit and at 3-, 6-, and 12-month follow-ups. Correlation analysis was performed to assess the association between HOA and astigmatism. Results A total of 72 patients were enrolled in this study, 37 of which were classified as belonging to the higher astigmatism group, while 35 were assigned to the lower astigmatism group. There was a statistically significant difference in success rate between the higher and lower astigmatism groups. In both groups, all corneal HOAs were significantly reduced during amblyopia treatment. When comparing the two groups, a significant difference in coma HOA at the 12-month follow-up was detected (p = 0.043). In the Pearson correlation test, coma HOA at the 12-month follow-up demonstrated a statistically significant correlation with astigmatism and a stronger correlation with astigmatism in the higher astigmatism group than in the lower astigmatism group (coefficient values, 0.383 and 0.284 as well as p = 0.021 and p = 0.038, respectively). Conclusions HOA, particularly coma HOA, correlated with astigmatism and could exert effects in cases involving hyperopic amblyopia. PMID:26865804

A New Approach for the Calculation of Total Corneal Astigmatism Considering the Magnitude and Orientation of Posterior Corneal Astigmatism and Thickness.

PubMed

Piñero, David P; Caballero, María T; Nicolás-Albujer, Juan M; de Fez, Dolores; Camps, Vicent J

2018-06-01

To evaluate a new method of calculation of total corneal astigmatism based on Gaussian optics and the power design of a spherocylindrical lens (C) in the healthy eye and to compare it with keratometric (K) and power vector (PV) methods. A total of 92 healthy eyes of 92 patients (age, 17-65 years) were enrolled. Corneal astigmatism was calculated in all cases using K, PV, and our new approach C that considers the contribution of corneal thickness. An evaluation of the interchangeability of our new approach with the other 2 methods was performed using Bland-Altman analysis. Statistically significant differences between methods were found in the magnitude of astigmatism (P < 0.001), with the highest values provided by K. These differences in the magnitude of astigmatism were clinically relevant when K and C were compared [limits of agreement (LoA), -0.40 to 0.62 D), but not for the comparison between PV and C (LoA, -0.03 to 0.01 D). Differences in the axis of astigmatism between methods did not reach statistical significance (P = 0.408). However, they were clinically relevant when comparing K and C (LoA, -5.48 to 15.68 degrees) but not for the comparison between PV and C (LoA, -1.68 to 1.42 degrees). The use of our new approach for the calculation of total corneal astigmatism provides astigmatic results comparable to the PV method, which suggests that the effect of pachymetry on total corneal astigmatism is minimal in healthy eyes.

Combined laser in situ keratomileusis and prophylactic high-fluence corneal collagen crosslinking for high myopia: two-year safety and efficacy.

PubMed

Kanellopoulos, Anastasios John; Asimellis, George

2015-07-01

To evaluate the safety, efficacy, and refractive and keratometric stability of myopic femtosecond laser in situ keratomileusis (LASIK) with concurrent prophylactic high-fluence corneal collagen crosslinking (CXL) compared with the outcomes of standard femtosecond LASIK. Private clinical practice, Athens, Greece. Consecutive randomized prospective comparative study. Eyes that had myopic LASIK or myopic LASIK with concurrent high-fluence CXL were evaluated preoperatively and up to 2 years postoperatively for manifest refraction spherical equivalent (MRSE), refractive astigmatism, visual acuity, corneal keratometry (K), and endothelial cell count. One hundred forty consecutive eyes had myopic LASIK; 65 of the eyes were treated additionally with CXL. In the LASIK-CXL eyes, the mean postoperative MRSE was -0.18 diopter (D) ± 17.0 (SD) from -6.67 ± 2.14 D preoperatively. The postoperative flat K was 37.67 D from 43.92 D, and the steep K was 38.38 D from 45.15 D. The correlation coefficient of SE correction predictability was 0.975. In the LASIK-only eyes, the mean postoperative MRSE was -0.32 ± 0.24 D from -5.49 ± 1.99 D preoperatively. The flat K was 38.04 D from 43.15 D, and the steep K was 38.69 D from 44.03 D. The correlation coefficient of SE correction predictability was 0.968. The differences between the 2 groups at the 20/20 and 20/25 levels were statistically significant (P = .045 and P = .039, respectively). Two-year results indicate that the application of prophylactic CXL concurrently with high-myopic LASIK appears to improve refractive and keratometric stability, presumably by affecting corneal biomechanical properties. Dr. Kanellopoulos is a consultant to Alcon Surgical, Inc., Wavelight Laser Technologie AG, Allergan, Inc., Avedro, Inc., and i-Optics Corp. Dr. Asimellis has no financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

[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) .

Comparison of Whole Eye vs. First-Surface Astigmatism in Down Syndrome

PubMed Central

Knowlton, Rachel; Marsack, Jason D.; Leach, Norman E.; Herring, Ralph J.; Anderson, Heather A.

2016-01-01

Purpose Individuals with Down syndrome (DS) have structural differences in the cornea and lens, as compared to the general population. This study investigates objectively measured refractive and corneal astigmatism, as well as calculated internal astigmatism in subjects with and without DS. Methods Refractive (Grand Seiko autorefraction) and anterior corneal astigmatism (difference between steep and flat keratometry obtained with Zeiss Atlas corneal topography) were measured in 128 subjects with DS (mean age = 24.8±8.7 yrs) and 137 controls without DS (mean age = 24.9±9.9 yrs), with 1 eye randomly selected for analysis per subject. Refractive astigmatism and corneal astigmatism were converted to vector notation (J0, J45) to calculate internal astigmatism (Refractive – Corneal) and then converted back to minus cylinder form. Results Mean refractive astigmatism was significantly greater in subjects with DS than controls (−1.94±1.30DC vs −0.66±0.60DC, t=−10.16, p<0.001), as was mean corneal astigmatism (1.70±1.04DC vs 1.02±0.63DC, t=6.38, p<0.001) and mean internal astigmatism (−1.07±0.68DC vs −0.77±0.41DC, t=−4.21, p<0.001). A positive linear correlation between corneal and refractive astigmatism was observed for both study populations for both the J0 and J45 vectors (p<0.001 for all comparisons, R2 range = 0.31 to 0.74). The distributions of astigmatism orientation differed significantly between the two study populations when compared across all three types of astigmatism (Chi-Square, p<0.001). Conclusions This study demonstrates that corneal astigmatism is predictive of overall refractive astigmatism in individuals with DS, as it is in the general population. The greater magnitudes of astigmatism and wider variation of astigmatism orientation in individuals with DS for refractive, corneal, and calculated internal astigmatism is likely attributable to previously reported differences in the structure of the cornea and internal optical components

Progression of Myopic Maculopathy during 18-Year Follow-up.

PubMed

Fang, Yuxin; Yokoi, Tae; Nagaoka, Natsuko; Shinohara, Kosei; Onishi, Yuka; Ishida, Tomoka; Yoshida, Takeshi; Xu, Xian; Jonas, Jost B; Ohno-Matsui, Kyoko

2018-06-01

To examine the progression pattern of myopic maculopathy. Retrospective, observational case series. Highly myopic patients who had been followed up for 10 years or more. Using fundus photographs, myopic features were differentiated according to Meta-analysis of Pathologic Myopia (META-PM) Study Group recommendations. Progression pattern of maculopathy. The study included 810 eyes of 432 patients (mean age, 42.3±16.8 years; mean axial length, 28.8±1.9 mm; mean follow-up, 18.7±7.1 years). The progression rate of myopic maculopathy was 47.0 per 1000 eye-years. Within the pathologic myopia (PM) group (n = 521 eyes), progression of myopic maculopathy was associated with female gender (odds ratio [OR], 2.21; P = 0.001), older age (OR, 1.03; P = 0.002), longer axial length (OR, 1.20; P = 0.007), greater axial elongation (OR, 1.45; P = 0.005), and development of parapapillary atrophy (PPA; OR, 3.14; P < 0.001). Diffuse atrophy, found in 217 eyes without choroidal neovascularization (CNV) or lacquer cracks (LCs) at baseline, progressed in 111 (51%) eyes, leading to macular diffuse atrophy (n = 64; 64/111 or 58%), patchy atrophy (n = 59; 53%), myopic CNV (n = 18; 16%), LCs (n = 9; 5%), and patchy-related macular atrophy (n = 3; 3%). Patchy atrophy, detected in 63 eyes without CNV or LCs at baseline, showed progression in 60 eyes (95%), leading to enlargement of original patchy atrophy (n = 59; 59/60 or 98%), new patchy atrophy (n = 29; 48%), CNV-related macular atrophy (n = 13; 22%), and patchy-related macular atrophy (n = 5; 8%). Of 66 eyes with LCs, 43 eyes (65%) showed progression with development of new patchy atrophy (n = 38; 38/43 or 88%) and new LCs (n = 7; 16%). Reduction in best-corrected visual acuity (BCVA) was associated mainly (all P < 0.001) with the development of CNV or CNV-related macular atrophy and enlargement of macular atrophy. The most frequent progression patterns were an extension of peripapillary diffuse atrophy to macular diffuse

Topographical analysis of corneal astigmatism in patients with tilted-disc syndrome.

PubMed

Bozkurt, Banu; Irkec, Murat; Gedik, Sansal; Orhan, Mehmet; Erdener, Uğur

2002-07-01

To evaluate the corneal topography in patients with tilted-disc syndrome to determine the relationship between optic disc dysversion and corneal astigmatism and the pattern of astigmatism in these patients. The study included 23 eyes of the 13 tilted-disc syndrome patients with spheric refractive errors ranging between +1.00 D and -9.00 D (mean -4.00 +/- 3.4 D) and astigmatic errors ranging between -0.50 and -4.50 D (mean -1.95 +/- 0.93 D). Corneal topography was performed by computer-assisted videokeratoscope topographic modelling system 2 (TMS-2) and incidence of corneal astigmatism, corneal topographic patterns, and mean values of the topographic indices were determined. Corneal topographic analysis showed corneal astigmatism in 22 out of 23 patients with tilted discs. Corneal astigmatism was symmetric bow tie pattern in 10 eyes (45.45%), asymmetric bow tie pattern in 11 eyes (50%) and irregular in 1 eye (4.5%). Among the patients with bow tie pattern group (21 eyes), 14 eyes had with-the-rule astigmatism, 1 eye had against-the-rule astigmatism, and 6 eyes had oblique astigmatism. In 18 eyes, astigmatism was corneal, whereas combined corneal and lenticular in 4 eyes and lenticular in 1 eye. In the majority of tilted-disc cases, ocular astigmatism is mainly corneal. Morphogenetic factors in the development of the tilted disc might possibly influence the corneal development in such a way to result in corneal astigmatism.

Does correcting astigmatism with toric lenses improve driving performance?

PubMed

Cox, Daniel J; Banton, Thomas; Record, Steven; Grabman, Jesse H; Hawkins, Ronald J

2015-04-01

Driving is a vision-based activity of daily living that impacts safety. Because visual disruption can compromise driving safety, contact lens wearers with astigmatism may pose a driving safety risk if they experience residual blur from spherical lenses that do not correct their astigmatism or if they experience blur from toric lenses that rotate excessively. Given that toric lens stabilization systems are continually improving, this preliminary study tested the hypothesis that astigmats wearing toric contact lenses, compared with spherical lenses, would exhibit better overall driving performance and driving-specific visual abilities. A within-subject, single-blind, crossover, randomized design was used to evaluate driving performance in 11 young adults with astigmatism (-0.75 to -1.75 diopters cylinder). Each participant drove a highly immersive, virtual reality driving simulator (210 degrees field of view) with (1) no correction, (2) spherical contact lens correction (ACUVUE MOIST), and (3) toric contact lens correction (ACUVUE MOIST for Astigmatism). Tactical driving skills such as steering, speed management, and braking, as well as operational driving abilities such as visual acuity, contrast sensitivity, and foot and arm reaction time, were quantified. There was a main effect for type of correction on driving performance (p = 0.05). Correction with toric lenses resulted in significantly safer tactical driving performance than no correction (p < 0.05), whereas correction with spherical lenses did not differ in driving safety from no correction (p = 0.118). Operational tests differentiated corrected from uncorrected performance for both spherical (p = 0.008) and toric (p = 0.011) lenses, but they were not sensitive enough to differentiate toric from spherical lens conditions. Given previous research showing that deficits in these tactical skills are predictive of future real-world collisions, these preliminary data suggest that correcting low to moderate

Implantation of a customized toric intraocular lens for correction of post-keratoplasty astigmatism

PubMed Central

Srinivasan, S; Ting, D S J; Lyall, D A M

2013-01-01

Purpose To report visual and refractive outcomes, and endothelial cell loss following primary and secondary ‘piggyback' toric intraocular lens (IOL) implantation in patients with high post-penetrating keratoplasty (PK) astigmatism. Methods Prospective case series. Nine eyes of nine patients with post-PK astigmatism were consecutively recruited for implantation of a customized toric IOL. Six underwent simultaneous phacoemulsification (PE) and three pseudophakic eyes had a secondary ‘piggyback' toric IOL implanted in the ciliary sulcus. Mean follow-up time was 17.2±7.7 months. Pre- and post-operative uncorrected (UDVA) and best-corrected (BDVA) distance visual acuities and refractive errors were collected for comparison. Cartesian astigmatic vectors were calculated to identify a change in the magnitude of astigmatism pre- compared to postoperatively. Pre- and post-operative endothelial cell counts were also collected for analysis. Results UDVA (logMAR) improved from 1.13±0.51 preoperatively to 0.48±0.24 postoperatively (P-value=0.003). There was no significant change in BDVA (P-value=0.905) from 0.31±0.27 to 0.26±0.19. Corneal astigmatism preoperatively was 6.57±4.40 diopters (D). Post-operative refractive cylinder was 0.83±1.09 D compared to 3.89±4.01 D preoperatively (P=0.039). Analysis of astigmatic Cartesian x and y coordinates found a significant reduction postoperatively compared to preoperatively (P=0.005 and P=0.002), respectively. Mean endothelial cell loss was 9.9%. Conclusion: Implantation of a customized primary or secondary ‘piggyback' toric IOL serves as an effective modality in treating patients with high post-PK astigmatism. PMID:23348728

Relationship between central and peripheral corneal astigmatism in elderly patients

NASA Astrophysics Data System (ADS)

Kawamorita, Takushi; Shimizu, Kimiya; Hoshikawa, Rie; Kamiya, Kazutaka; Shoji, Nobuyuki

2018-03-01

Abstract Purpose We investigated the relationship between central and peripheral corneal astigmatism in elderly patients. Methods Seventy-six eyes of 76 elderly subjects (mean age = 72.6 ± 3.0 years) were included in the study. Corneal shape was evaluated using the Pentacam HR (Oculus, Wetzlark, Germany), which is comprised of a rotating Scheimpflug camera and a short-wavelength slit light. The power distribution map was selected and corneal astigmatism was calculated using front K-Readings in zones centered on the pupil. Analyzed zones were 2.0-6.0 mm in diameter. Results Corneal astigmatism decreased as diameter increased, similar to what was observed in eyes with with-the-rule astigmatism and against-the-rule astigmatism (ANOVA, p < 0.01). This effect was more pronounced in eyes with a large central corneal astigmatism (Spearman's rank-correlation coefficient test, r = 0.51, p < 0.01). There was no change as to axis of corneal astigmatism (ANOVA, p = 0.98). Conclusion These results suggest that the relationship between central and peripheral corneal astigmatism should be taken into consideration to optimize vision when astigmatic correction is needed.

Visual acuity with simulated and real astigmatic defocus.

PubMed

Ohlendorf, Arne; Tabernero, Juan; Schaeffel, Frank

2011-05-01

To compare the effects of "simulated" and "real" spherical and astigmatic defocus on visual acuity (VA). VA was determined with letter charts that were blurred by calculated spherical or astigmatic defocus (simulated defocus) or were seen through spherical or astigmatic trial lenses (real defocus). Defocus was simulated using ZEMAX and the Liou-Brennan eye model. Nine subjects participated [mean age, 27.2 ± 1.8 years; logarithm of the minimum angle of resolution (logMAR), -0.1]. Three different experiments were conducted in which VA was reduced by 20% (logMAR 0.0), 50% (logMAR 0.2), or 75% (logMAR 0.5) by either (1) imposing positive spherical defocus, (2) imposing positive and negative astigmatic defocus in three axes (0, 45, and 90°), and (3) imposing cross-cylinder defocus in the same three axes as in (2). Experiment (1): there were only minor differences in VA with simulated and real positive spherical defocus. Experiment (2): simulated astigmatic defocus reduced VA twice as much as real astigmatic defocus in all tested axes (p < 0.01 in all cases). Experiment (3): simulated cross-cylinder defocus reduced VA much more than real cross-cylinder defocus (p < 0.01 in all cases), similarly for all three tested axes. The visual system appears more tolerant against "real" spherical, astigmatic, and cross-cylinder defocus than against "simulated" blur. Possible reasons could be (1) limitations in the modeling procedures to simulate defocus, (2) higher ocular aberrations, and (3) fluctuations of accommodation. However, the two optical explanations (2) and (3) cannot account for the magnitude of the effect, and (1) was carefully analyzed. It is proposed that something may be special about the visual processing of real astigmatic and cross-cylinder defocus-because they have less effect on VA than simulations predict.

Optimized keratometry and total corneal astigmatism for toric intraocular lens calculation.

PubMed

Savini, Giacomo; Næser, Kristian; Schiano-Lomoriello, Domenico; Ducoli, Pietro

2017-09-01

To compare keratometric astigmatism (KA) and different modalities of measuring total corneal astigmatism (TCA) for toric intraocular lens (IOL) calculation and optimize corneal measurements to eliminate the residual refractive astigmatism. G.B. Bietti Foundation IRCCS, Rome, Italy. Prospective case series. Patients who had a toric IOL were enrolled. Preoperatively, a Scheimpflug camera (Pentacam HR) was used to measure TCA through ray tracing. Different combinations of measurements at a 3.0 mm diameter, centered on the pupil or the corneal vertex and performed along a ring or within it, were compared. Keratometric astigmatism was measured using the same Scheimpflug camera and a corneal topographer (Keratron). Astigmatism was analyzed with Næser's polar value method. The optimized preoperative corneal astigmatism was back-calculated from the postoperative refractive astigmatism. The study comprised 62 patients (64 eyes). With both devices, KA produced an overcorrection of with-the-rule (WTR) astigmatism by 0.6 diopter (D) and an undercorrection of against-the-rule (ATR) astigmatism by 0.3 D. The lowest meridional error in refractive astigmatism was achieved by the TCA pupil/zone measurement in WTR eyes (0.27 D overcorrection) and the TCA apex/zone measurement in ATR eyes (0.07 D undercorrection). In the whole sample, no measurement allowed more than 43.75% of eyes to yield an absolute error in astigmatism magnitude lower than 0.5 D. Optimized astigmatism values increased the percentage of eyes with this error up to 57.81%, with no difference compared with the Barrett calculator and the Abulafia-Koch calculator. Compared with KA, TCA improved calculations for toric IOLs; however, optimization of corneal astigmatism measurements led to more accurate results. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Accuracy of the Welch Allyn Suresight for measurement of magnitude of astigmatism in 3- to 7-year-old children

PubMed Central

Harvey, Erin M.; Dobson, Velma; Miller, Joseph M.; Clifford-Donaldson, Candice E.; Green, Tina K.; Messer, Dawn H.; Garvey, Katherine A.

2009-01-01

Purpose To evaluate the accuracy of the Welch Allyn SureSight in noncycloplegic measurements of astigmatism as compared to cycloplegic Retinomax K+ autorefractor measurements of astigmatism in children from a Native American population with a high prevalence of high astigmatism. Methods Data are reported for 825 3- to 7-year-old children with no ocular abnormalities. Each child had a Retinomax K+ cycloplegic measurement of right eye astigmatism with a confidence rating ≥8 and 3 attempts to obtain a SureSight measurement on the right eye. Results SureSight measurement success rates did not differ significantly across age or measurement confidence rating (<6 vs ≥6). Ninety-six percent of children had at least 1 measurement (any confidence), and 89% had at least 1 measurement with confidence at the manufacturer's recommended value (≥6). Overall, the SureSight tended to overestimate astigmatism. If the SureSight measurement had any dioptric value (0.00 D to 3.00 D), astigmatism of 2.00 D or less was likely to be present. If the SureSight showed astigmatism beyond the instrument's dioptric range (>3.00 D), Retinomax K+ measurements indicated that >2.00 D of astigmatism was present in 136 of 157 (86.6%). In cooperative children for whom the SureSight would not give a reading, 32 of 34 (94%) had >3.00 D of astigmatism. Conclusions The SureSight does not provide an accurate, quantitative measure of amount of astigmatism. However, it does allow accurate categorization of amount of astigmatism as ≤2.00 D, >2.00 D, or >3.00 D, and it has high measurement success rate in young children. PMID:19840726

Effects of Optically Imposed Astigmatism on Early Eye Growth in Chicks

PubMed Central

Chu, Chin Hung Geoffrey; Kee, Chea Su

2015-01-01

Purpose To determine the effects of optically imposed astigmatism on early eye growth in chicks. Methods 5-day-old (P5) White Leghorn chicks were randomly assigned to either wear, monocularly, a “high magnitude” (H: +4.00DS/-8.00DC) crossed-cylindrical lens oriented at one of four axes (45, 90, 135, and 180; n = 20 in each group), or were left untreated (controls; n = 8). Two additional groups wore a “low magnitude” (L: +2.00DS/−4.00DC) cylindrical lens orientated at either axis 90 or 180 (n = 20 and n = 18, respectively). Refractions were measured at P5 and after 7 days of treatment for all chicks (P12), whereas videokeratography and ex-vivo eyeshape analysis were performed at P12 for a subset of chicks in each group (n = 8). Results Compared to controls, chicks in the treatment groups developed significant amounts of refractive astigmatism (controls: 0.03±0.22DC; treatment groups: 1.34±0.22DC to 5.51±0.26DC, one-way ANOVAs, p≤0.05) with axes compensatory to those imposed by the cylindrical lenses. H cylindrical lenses induced more refractive astigmatism than L lenses (H90 vs. L90: 5.51±0.26D vs. 4.10±0.16D; H180 vs. L180: 2.84±0.44D vs. 1.34±0.22D, unpaired two-sample t-tests, both p≤0.01); and imposing with-the-rule (H90 and L90) and against-the-rule astigmatisms (H180 and L180) resulted in, respectively, steeper and flatter corneal shape. Both corneal and internal astigmatisms were moderately to strongly correlated with refractive astigmatisms (Pearson’s r: +0.61 to +0.94, all p≤0.001). In addition, the characteristics of astigmatism were significantly correlated with multiple eyeshape parameters at the posterior segments (Pearson’s r: -0.27 to +0.45, all p≤0.05). Conclusions Chicks showed compensatory ocular changes in response to the astigmatic magnitudes imposed in this study. The correlations of changes in refractive, corneal, and posterior eyeshape indicate the involvement of anterior and posterior ocular segments during the

Astigmatism corrected common path probe for optical coherence tomography.

PubMed

Singh, Kanwarpal; Yamada, Daisuke; Tearney, Guillermo

2017-03-01

Optical coherence tomography (OCT) catheters for intraluminal imaging are subject to various artifacts due to reference-sample arm dispersion imbalances and sample arm beam astigmatism. The goal of this work was to develop a probe that minimizes such artifacts. Our probe was fabricated using a single mode fiber at the tip of which a glass spacer and graded index objective lens were spliced to achieve the desired focal distance. The signal was reflected using a curved reflector to correct for astigmatism caused by the thin, protective, transparent sheath that surrounds the optics. The probe design was optimized using Zemax, a commercially available optical design software. Common path interferometric operation was achieved using Fresnel reflection from the tip of the focusing graded index objective lens. The performance of the probe was tested using a custom designed spectrometer-based OCT system. The probe achieved an axial resolution of 15.6 μm in air, a lateral resolution 33 μm, and a sensitivity of 103 dB. A scattering tissue phantom was imaged to test the performance of the probe for astigmatism correction. Images of the phantom confirmed that this common-path, astigmatism-corrected OCT imaging probe had minimal artifacts in the axial, and lateral dimensions. In this work, we developed an astigmatism-corrected, common path probe that minimizes artifacts associated with standard OCT probes. This design may be useful for OCT applications that require high axial and lateral resolutions. Lasers Surg. Med. 49:312-318, 2017. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

On multisoliton solutions of the constant astigmatism equation

NASA Astrophysics Data System (ADS)

Hlaváč, Adam

2015-09-01

We introduce an algebraic formula producing infinitely many exact solutions of the constant astigmatism equation {z}{yy}+{(1/z)}{xx}+2=0 from a given seed. A construction of corresponding surfaces of constant astigmatism is then a matter of routine. As a special case, we consider multisoliton solutions of the constant astigmatism equation defined as counterparts of famous multisoliton solutions of the sine-Gordon equation. A few particular examples are surveyed as well.

Evaluation of a Myopic Normative Database for Analysis of Retinal Nerve Fiber Layer Thickness.

PubMed

Biswas, Sayantan; Lin, Chen; Leung, Christopher K S

2016-09-01

Analysis of retinal nerve fiber layer (RNFL) abnormalities with optical coherence tomography in eyes with high myopia has been complicated by high rates of false-positive errors. An understanding of whether the application of a myopic normative database can improve the specificity for detection of RNFL abnormalities in eyes with high myopia is relevant. To evaluate the diagnostic performance of a myopic normative database for detection of RNFL abnormalities in eyes with high myopia (spherical equivalent, -6.0 diopters [D] or less). In this cross-sectional study, 180 eyes with high myopia (mean [SD] spherical equivalent, -8.0 [1.8] D) from 180 healthy individuals were included in the myopic normative database. Another 46 eyes with high myopia from healthy individuals (mean [SD] spherical equivalent, -8.1 [1.8] D) and 74 eyes from patients with high myopia and glaucoma (mean [SD] spherical equivalent, -8.3 [1.9] D) were included for evaluation of specificity and sensitivity. The 95th and 99th percentiles of the mean and clock-hour circumpapillary RNFL thicknesses and the individual superpixel thicknesses of the RNFL thickness map measured by spectral-domain optical coherence tomography were calculated from the 180 eyes with high myopia. Participants were recruited from January 2, 2013, to December 30, 2015. The following 6 criteria of RNFL abnormalities were examined: (1) mean circumpapillary RNFL thickness below the lower 95th or (2) the lower 99th percentile; (3) one clock-hour or more for RNFL thickness below the lower 95th or (4) the lower 99th percentile; and (5) twenty contiguous superpixels or more of RNFL thickness in the RNFL thickness map below the lower 95th or (6) the lower 99th percentile. Specificities and sensitivities for detection of RNFL abnormalities. Of the 46 healthy eyes and 74 eyes with glaucoma studied (from 39 men and 38 women), the myopic normative database showed a higher specificity (63.0%-100%) than did the built-in normative database of

Beam width evolution of astigmatic hollow Gaussian beams in highly nonlocal nonlinear media

NASA Astrophysics Data System (ADS)

Yang, Zhen-Feng; Jiang, Xue-Song; Yang, Zhen-Jun; Li, Jian-Xing; Zhang, Shu-Min

We investigate the beam width evolution of astigmatic hollow Gaussian beams propagating in highly nonlocal nonlinear media. The input-power-induced different evolutions of the beam width are illustrated: (i) the beam widths in two transverse directions are compressed or broadened at the same time; (ii) the beam width in one transverse direction keeps invariant, and the other is compressed or broadened; (iii) furthermore, the beam width in one transverse direction is compressed, whereas it in the other transverse direction is broadened.

Changes in Visual Function Following Optical Treatment of Astigmatism-Related Amblyopia

PubMed Central

Harvey, Erin M.; Dobson, Velma; Miller, Joseph M.; Donaldson, Candice E.

2009-01-01

Effects of optical correction on best-corrected grating acuity (vertical (V), horizontal (H), oblique (O)), vernier acuity (V, H, O), contrast sensitivity (1.5, 6.0, and 18.0 cy/deg spatial frequency, V and H), and stereoacuity were evaluated prospectively in 4- to 13-year-old astigmats and a non-astigmatic age-matched control group. Measurements made at baseline (eyeglasses dispensed for astigmats), 6 weeks, and 1 year showed greater improvement in astigmatic than non-astigmatic children for all measures. Treatment effects occurred by 6 weeks, and did not differ by cohort (< 8 vs. 8 years), but astigmatic children did not attain normal levels of visual function. PMID:18261760

Non-toric extended depth of focus contact lenses for astigmatism and presbyopia correction

NASA Astrophysics Data System (ADS)

Ben Yaish, Shai; Zlotnik, Alex; Yehezkel, Oren; Lahav-Yacouel, Karen; Belkin, Michael; Zalevsky, Zeev

2010-02-01

Purpose: Testing whether the extended depth of focus technology embedded on non-toric contact lenses is a suitable treatment for both astigmatism and presbyopia. Methods: The extended depth of focus pattern consisting of microndepth concentric grooves was engraved on a surface of a mono-focal soft contact lens. These grooves create an interference pattern extending the focus from a point to a length of about 1mm providing a 3.00D extension in the depth of focus. The extension in the depth of focus provides high quality focused imaging capabilities from near through intermediate and up to far ranges. Due to the angular symmetry of the engraved pattern the extension in the depth of focus can also resolve regular as well as irregular astigmatism aberrations. Results: The contact lens was tested on a group of 8 astigmatic and 13 subjects with presbyopia. Average correction of 0.70D for astigmatism and 1.50D for presbyopia was demonstrated. Conclusions: The extended depth of focus technology in a non-toric contact lens corrects simultaneously astigmatism and presbyopia. The proposed solution is based upon interference rather than diffraction effects and thus it is characterized by high energetic efficiency to the retina plane as well as reduced chromatic aberrations.

Global prevalence and economic and humanistic burden of astigmatism in cataract patients: a systematic literature review.

PubMed

Anderson, David F; Dhariwal, Mukesh; Bouchet, Christine; Keith, Michael S

2018-01-01

To systematically review the published evidence on the prevalence and economic and humanistic burden of astigmatism in cataract patients. For this systematic literature review, the Medline, PubMed, Embase, and Cochrane databases were searched from 1996 to September 2015 for available scientific literature that met the inclusion criteria. Studies published in the English language reporting prevalence and humanistic and economic burden in patients diagnosed with cataract and astigmatism were included. Of 3,649 papers reviewed, 31 studies from 32 publications met the inclusion criteria of this review. Preexisting astigmatism ≥1 D was present in up to 47% of cataract eyes. The cost burden of residual uncorrected astigmatism after cataract surgery was driven by the cost of spectacles, which was estimated to range from $2,151 to $3,440 in the US and $1,786 to $4,629 in Europe over a lifetime. In cataract patients, both preexisting and postoperative residual astigmatism were associated with poor vision-related patient satisfaction and quality of life, as well as higher spectacle burden. Astigmatism correction during cataract surgery appears to improve visual outcomes and results in overall lifetime cost savings compared to astigmatism correction with postoperative vision correction. There is a high prevalence of preexisting astigmatism in cataract patients. Although published data are limited, both preoperative astigmatism and postoperative residual astigmatism affect visual function and vision-related quality of life, resulting in increased humanistic burden. Suboptimal correction of astigmatism during cataract surgery drives the continuous need for vision correction with spectacles in the postoperative period. Patients must bear the out-of-pocket expenses, since payers often do not reimburse the cost of spectacles. Greater access to astigmatism correction during cataract surgery could improve visual outcomes and quality of life in patients. More research is required

Myopic refractive shift represents dense nuclear sclerosis and thin lens in lenticular myopia.

PubMed

Cho, Yang Kyung; Huang, Wei; Nishimura, Eiichi

2013-09-01

It is not rare to meet unilateral nuclear sclerotic cataracts with myopic refractive changes (lenticular myopia) compared with the fellow eye in the ophthalmic examination of patients with decreased visual acuity. To determine the relationship between the myopic refractive changes and interocular differences of parameters, we investigated the interocular differences of ocular parameters between a lenticular myopic eye and the fellow eye. This retrospective study included 68 eyes of 34 patients, who showed unilateral lenticular myopia. We compared the dimensions of ocular component, such as anterior chamber depth, anterior chamber volume, lens thickness, vitreous chamber depth, lens position, lens density of nuclear sclerosis, anterior lens curvature and myopic refractive changes (spherical equivalent refraction) between the lenticular myopic eye and the myopic refractive change were examined. Statistically significant differences were found between the lenticular myopic eye and the fellow eye for anterior chamber depth (p = 0.015) anterior chamber volume (p = 0.031), lens thickness (p < 0.001), lens density of the nuclear sclerosis (p < 0.001) and the spherical equivalent myopic refractive changes (p < 0.001). Based on univariate analysis, the interocular difference in spherical equivalent refraction was significantly correlated with interocular differences of the density of the nuclear sclerosis (r = 0.79, p < 0.001), lens thickness (r = -0.70, p < 0.001) and vitreous chamber depth (r = 0.43, p = 0.012). Based on multiple regression analysis, the interocular difference in spherical equivalent refraction was significantly correlated with interocular differences of density of nuclear sclerosis (p < 0.001) and lens thickness (p = 0.007). The difference in myopic spherical change reflects the differences in the severity of nuclear sclerosis and lens thickness between the lenticular myopic eye and the fellow eye. © 2013 The Authors. Clinical and Experimental Optometry

A simple method for astigmatic compensation of folded resonator without Brewster window.

PubMed

Qiao, Wen; Xiaojun, Zhang; Yonggang, Wang; Liqun, Sun; Hanben, Niu

2014-02-10

A folded resonator requires an oblique angle of incidence on the folded curved mirror, which introduces astigmatic distortions that limit the performance of the lasers. We present a simple method to compensate the astigmatism of folded resonator without Brewster windows for the first time to the best of our knowledge. Based on the theory of the propagation and transformation of Gaussian beams, the method is both effective and reliable. Theoretical results show that the folded resonator can be compensated astigmatism completely when the following two conditions are fulfilled. Firstly, when the Gaussian beam with a determined size beam waist is obliquely incident on an off-axis concave mirror, two new Gaussian beam respectively in the tangential and sagittal planes are formed. Another off-axis concave mirror is located at another intersection point of the two new Gaussian beams. Secondly, adjusting the incident angle of the second concave mirror or its focal length can make the above two Gaussian beam coincide in the image plane of the second concave mirror, which compensates the astigmatic aberration completely. A side-pumped continues-wave (CW) passively mode locked Nd:YAG laser was taken as an example of the astigmatically compensated folded resonators. The experimental results show good agreement with the theoretical predictions. This method can be used effectively to design astigmatically compensated cavities resonator of high-performance lasers.

Prevalence of Corneal Astigmatism in Tohono O'odham Native American Children 6 Months to 8 Years of Age

PubMed Central

Dobson, Velma; Miller, Joseph M.; Schwiegerling, Jim; Clifford-Donaldson, Candice E.; Green, Tina K.; Messer, Dawn H.

2011-01-01

Purpose. To describe the prevalence of corneal astigmatism in infants and young children who are members of a Native American tribe with a high prevalence of refractive astigmatism. Methods. The prevalence of corneal astigmatism was assessed by obtaining infant keratometer (IK4) measurements from 1235 Tohono O'odham children, aged 6 months to 8 years. Results. The prevalence of corneal astigmatism >2.00 D was lower in the 1- to <2-year-old age group when compared with all other age groups, except the 6- to <7-year-old group. The magnitude of mean corneal astigmatism was significantly lower in the 1- to <2-year age group than in the 5- to <6-, 6- to <7-, and 7- to <8-year age groups. Corneal astigmatism was with-the-rule (WTR) in 91.4% of astigmatic children (≥1.00 D). Conclusions. The prevalence and mean amount of corneal astigmatism were higher than reported in non–Native American populations. Mean astigmatism increased from 1.43 D in 1-year-olds to nearly 2.00 D by school age. PMID:21460261

[Eyeball structure changes in high myopic patients and their significance for forensic assessment].

PubMed

Liu, Yi-Chang; Xia, Wen-Tao; Zhou, Xing-Tao; Liu, Rui-Jue; Bian, Shi-Zhong; Ying, Chong-Liang; Zhu, Guang-You

2008-10-01

There are irreversible eyeball structural changes in high myopic patients. These changes include axial length, corneal radius, anterior chamber depth, fundus degeneration, macula thickness, etc. There is a close relationship between the damage degree of visual function and these changes. The incidence of complications, such as vitreous opacity, posterior vitreous detachment, cataract, glaucoma, posterior staphyloma and retina detachment, is also highly related to the myopia diopter. More and more researches have indicated that the myopia diopter and the level of visual function are affected by multiple factors. It is promising to detect all of these changes by different kinds of methods, and to assess visual function through these changes. By clarifying these changes, it is also useful to distinguish traumatic damage from disease to provide evidence for forensic assessment of eye injuries.

Refractive, corneal and ocular residual astigmatism: distribution in a German population and age-dependency - the Gutenberg health study.

PubMed

Schuster, Alexander Karl-Georg; Pfeiffer, Norbert; Schulz, Andreas; Hoehn, René; Ponto, Katharina A; Wild, Philipp S; Blettner, Maria; Beutel, Manfred E; Lackner, Karl J; Münzel, Thomas; Mirshahi, Alireza

2017-12-01

Worldwide, the most frequent cause of visual impairment is uncorrected refractive error. This analysis focused on the distribution and associations of refractive, corneal and ocular residual astigmatism. As part of the Gutenberg Health study, a population-based cross-sectional study was conducted in the general population of Germany. A comprehensive ophthalmological examination including refraction, tonometry, and Scheimpflug imaging of the anterior cornea (Pachycam) was performed. In addition to the magnitude and type (with-the-rule, against-the-rule, oblique) of the refractive or corneal astigmatism, we calculated the vector components (J 0 , J 45 ) of both astigmatisms and calculated the ocular residual astigmatism. We performed multiple quantile regression analysis to evaluate the factors associated with refractive, corneal and ocular residual astigmatisms. A total of 13,558 subjects (49% female) with a mean age of 54.0 years (range 35-74 years) were included in this study. The prevalence of refractive astigmatism (>1.0D) was 13.0% in right eyes and 12.0% in left eyes, and 85% of these subjects wore spectacles. The distribution of refractive astigmatism showed a two-peak distribution with high astigmatism for with-the-rule and against-the-rule astigmatism. The associated factors were corneal curvature, age and sex for the different astigmatisms (p < 0.001). We analyzed the prevalence of different astigmatisms within a European population. We confirmed a shift with aging from with-the-rule to against-the-rule astigmatism to refractive and corneal astigmatism. Astigmatism has a large impact on visual perception; more than 85% of people with astigmatism over one diopter wore glasses for distance vision.

Studies of intrastromal corneal ring segments for the correction of low to moderate myopic refractive errors.

PubMed Central

Schanzlin, D J

1999-01-01

PURPOSE: Intrastromal corneal ring segments (ICRS) were investigated for safety and reliability in the correction of low to moderate myopic refractive errors. METHODS: Initially, 74 patients with spherical equivalent refractive errors between -1.00 and -4.25 diopters (D) received the ICRS in 1 eye. After 6 months, 51 of these patients received the ICRS in the contralateral eye. The total number of eyes investigated was 125. The outcome measures were uncorrected and best-corrected visual acuity, predictability and stability of the refraction, refractive astigmatism, contrast sensitivity, and endothelial cell morphology. RESULTS: The 89 eyes with 12-month follow-up showed significant improvement with uncorrected visual acuities of 20/16 or better in 37%, 20/20 or better in 62%, and 20/40 or better in 97%. Cycloplegic refraction spherical equivalents showed that 68% of the eyes were within +/- 0.50 D and 90% within +/- 1.00 D of the intended correction. Refractive stability was present by 3 months after the surgery. Only 1 patients had a loss greater than 2 lines or 10 letters of best spectacle-corrected visual acuity, but the patient's acuity was 20/20. Refractive cylinder, contrast sensitivity, and endothelial cell morphology were not adversely affected. The ICRS was removed from the eyes of 6 patients. Three removals were prompted by glare and double images occurring at night; 3 were for nonmedical reasons. All patients returned to within +/- 1.00 D of their preoperative refractive spherical equivalent, and no patients lost more than 1 line of best corrected visual acuity by 3 months after ICRS removal. CONCLUSION: The ICRS safely and reliably corrects myopic refractive errors between -1.00 and -4.50 D. Images FIGURE 1 FIGURE 2 FIGURE 3 FIGURE 6 FIGURE 7 FIGURE 8 FIGURE 9 FIGURE 10 FIGURE 11 FIGURE 12 PMID:10703146

Convergence Insufficiency, Accommodative Insufficiency, Visual Symptoms, and Astigmatism in Tohono O'odham Students

PubMed Central

Twelker, J. Daniel; Miller, Joseph M.; Campus, Irene

2016-01-01

Purpose. To determine rate of convergence insufficiency (CI) and accommodative insufficiency (AI) and assess the relation between CI, AI, visual symptoms, and astigmatism in school-age children. Methods. 3rd–8th-grade students completed the Convergence Insufficiency Symptom Survey (CISS) and binocular vision testing with correction if prescribed. Students were categorized by astigmatism magnitude (no/low: <1.00 D, moderate: 1.00 D to <3.00 D, and high: ≥3.00 D), presence/absence of clinical signs of CI and AI, and presence of symptoms. Analyses determine rate of clinical CI and AI and symptomatic CI and AI and assessed the relation between CI, AI, visual symptoms, and astigmatism. Results. In the sample of 484 students (11.67 ± 1.81 years of age), rate of symptomatic CI was 6.2% and symptomatic AI 18.2%. AI was more common in students with CI than without CI. Students with AI only (p = 0.02) and with CI and AI (p = 0.001) had higher symptom scores than students with neither CI nor AI. Moderate and high astigmats were not at increased risk for CI or AI. Conclusions. With-the-rule astigmats are not at increased risk for CI or AI. High comorbidity rates of CI and AI and higher symptoms scores with AI suggest that research is needed to determine symptomatology specific to CI. PMID:27525112

Scintillation of astigmatic dark hollow beams in weak atmospheric turbulence.

PubMed

Cai, Yangjian; Eyyuboğlu, Halil T; Baykal, Yahya

2008-07-01

The scintillation properties of astigmatic dark hollow beams (DHBs) in weak atmospheric turbulence were investigated in detail. An explicit expression for the on-axis scintillation index of an astigmatic DHB propagating in weak atmospheric turbulence was derived. It was found that the scintillation index value of an astigmatic DHB with suitable astigmatism (i.e., ratio of the beam waist size in the x direction to that in the y direction), dark size, beam waist size, and wavelength can be smaller than that of a stigmatic DHB and that of stigmatic and astigmatic flat-topped, annular, and Gaussian beams in weak atmospheric turbulence particularly at long propagation ranges. Our results will be useful in long-distance free-space optical communications.

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

Agreement between total corneal astigmatism calculated by vector summation and total corneal astigmatism measured by ray tracing using Galilei double Scheimpflug analyzer.

PubMed

Feizi, Sepehr; Delfazayebaher, Siamak; Ownagh, Vahid; Sadeghpour, Fatemeh

To evaluate the agreement between total corneal astigmatism calculated by vector summation of anterior and posterior corneal astigmatism (TCA Vec ) and total corneal astigmatism measured by ray tracing (TCA Ray ). This study enrolled a total of 204 right eyes of 204 normal subjects. The eyes were measured using a Galilei double Scheimpflug analyzer. The measured parameters included simulated keratometric astigmatism using the keratometric index, anterior corneal astigmatism using the corneal refractive index, posterior corneal astigmatism, and TCA Ray . TCA Vec was derived by vector summation of the astigmatism on the anterior and posterior corneal surfaces. The magnitudes and axes of TCA Vec and TCA Ray were compared. The Pearson correlation coefficient and Bland-Altman plots were used to assess the relationship and agreement between TCA Vec and TCA Ray , respectively. The mean TCA Vec and TCA Ray magnitudes were 0.76±0.57D and 1.00±0.78D, respectively (P<0.001). The mean axis orientations were 85.12±30.26° and 89.67±36.76°, respectively (P=0.02). Strong correlations were found between the TCA Vec and TCA Ray magnitudes (r=0.96, P<0.001). Moderate associations were observed between the TCA Vec and TCA Ray axes (r=0.75, P<0.001). Bland-Altman plots produced the 95% limits of agreement for the TCA Vec and TCA Ray magnitudes from -0.33 to 0.82D. The 95% limits of agreement between the TCA Vec and TCA Ray axes was -43.0 to 52.1°. The magnitudes and axes of astigmatisms measured by the vector summation and ray tracing methods cannot be used interchangeably. There was a systematic error between the TCA Vec and TCA Ray magnitudes. Copyright © 2017 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

Patterned corneal collagen crosslinking for astigmatism: Computational modeling study

PubMed Central

Seven, Ibrahim; Roy, Abhijit Sinha; Dupps, William J.

2014-01-01

PURPOSE To test the hypothesis that spatially selective corneal stromal stiffening can alter corneal astigmatism and assess the effects of treatment orientation, pattern, and material model complexity in computational models using patient-specific geometries. SETTING Cornea and Refractive Surgery Service, Academic Eye Institute, Cleveland, Ohio, USA. DESIGN Computational modeling study. METHODS Three-dimensional corneal geometries from 10 patients with corneal astigmatism were exported from a clinical tomography system (Pentacam). Corneoscleral finite element models of each eye were generated. Four candidate treatment patterns were simulated, and the effects of treatment orientation and magnitude of stiffening on anterior curvature and aberrations were studied. The effect of material model complexity on simulated outcomes was also assessed. RESULTS Pretreatment anterior corneal astigmatism ranged from 1.22 to 3.92 diopters (D) in a series that included regular and irregular astigmatic patterns. All simulated treatment patterns oriented on the flat axis resulted in mean reductions in corneal astigmatism and depended on the pattern geometry. The linear bow-tie pattern produced a greater mean reduction in astigmatism (1.08 D ± 0.13 [SD]; range 0.74 to 1.23 D) than other patterns tested under an assumed 2-times increase in corneal stiffness, and it had a nonlinear relationship to the degree of stiffening. The mean astigmatic effect did not change significantly with a fiber- or depth-dependent model, but it did affect the coupling ratio. CONCLUSIONS In silico simulations based on patient-specific geometries suggest that clinically significant reductions in astigmatism are possible with patterned collagen crosslinking. Effect magnitude was dependent on patient-specific geometry, effective stiffening pattern, and treatment orientation. PMID:24767795

Safety and efficacy of femtosecond laser-assisted arcuate keratotomy to treat irregular astigmatism after penetrating keratoplasty.

PubMed

Fadlallah, Ali; Mehanna, Chadi; Saragoussi, Jean-Jacques; Chelala, Elias; Amari, Belkacem; Legeais, Jean-Marc

2015-06-01

To determine the refractive efficacy, predictability, stability, and complication rate of Intralase femtosecond laser-assisted astigmatic keratotomy (AK) for irregular astigmatism after penetrating keratoplasty (PKP). Ophthalmology Department, Hôtel-Dieu, Paris, France. Retrospective case series. Femtosecond laser-assisted AK was performed to treat high irregular astigmatism (>5.0 diopters [D]) after PKP. The uncorrected (UDVA) and corrected (CDVA) distance visual acuities, manifest refraction, vector analysis, and complications were evaluated. The study evaluated 62 eyes of 57 patients over a mean follow-up of 28 months ± 3.5 (SD). Preoperatively, the mean CDVA was 0.51 ± 0.26 logMAR and the mean UDVA was 0.98 ± 0.24 logMAR; 6 months postoperatively, the mean CDVA and UDVA improved to 0.40 ± 0.22 logMAR and 0.60 ± 0.2 logMAR, respectively (both P < .01). The mean preoperative absolute astigmatism was 7.1 ± 1.72 D; 6 months postoperatively, the mean refractive astigmatism was 2.6 ± 2.4 D (P < .001). The UDVA, CDVA, and astigmatism remained stable up to the end of follow-up. The efficacy index was 0.81 at 6 months and 0.67 at 2 years. There were 2 cases of microperforation, 3 cases of infectious keratitis, 3 graft rejection episodes, and 1 case of endophthalmitis. Overcorrection occurred in 12 eyes. Femtosecond laser-assisted AK was effective in reducing irregular astigmatism after PKP. Predictability of astigmatism correction is variable over time with a decrease in the efficacy index 2 years postoperatively. Refinement of the treatment nomogram for femtosecond laser-assisted AK for high astigmatism after PKP remains a major issue. 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.

Management of postkeratoplasty astigmatism by paired arcuate incisions with compression sutures.

PubMed

Fares, Usama; Mokashi, Aashish A; Al-Aqaba, Mouhamed Ali; Otri, Ahmad Muneer; Miri, Ammar; Dua, Harminder Singh

2013-04-01

To analyse the efficacy of paired arcuate incisions and compression sutures technique in the management of post penetrating keratoplasty (PK) astigmatism. A paired arcuate incision with compression sutures procedure was used to treat 26 eyes with post-PK astigmatism ranging from 6.00 to 16.50 dioptres (D). The incisions were placed at the 7.0 mm optical zone inside the graft-host junction at a depth of 80% of corneal thickness. A 45° paired arc length was planned for eyes with preoperative astigmatism between 6D and 9D, and a 60° paired arc length was planned for eyes with preoperative astigmatism of >9D. At 3 months, corneal topography and refraction was performed and suture(s) removed if indicated. Net and vector astigmatism changes were calculated to determine the efficacy of the procedure. The indications for PK included keratoconus, Fuch's endothelial dystrophy, pseudophakic bullous keratopathy and corneal scar. There was a statistically significant reduction in the mean magnitude of astigmatism from 9.66 ± 2.90D preoperatively to 4.37 ± 2.53D postoperatively in the whole group. The mean decrease in the astigmatism was 4.37 ± 2.05D (58.4%) and 6.23 ± 3.63D (52.6%) in patients with 6-9D and >9D, respectively. Vector power calculations also showed a significant astigmatism reduction in all groups. The safety and efficacy indices were 1.40 and 0.28, respectively. Manual astigmatic keratotomy is a viable technique with relatively good safety and efficacy outcomes. Based on the results we propose that increasing the arc length to a minimum of 60° for astigmatism of 6-9D, and to 75° for astigmatism >9D, is likely to have a greater beneficial effect.

The location of incision in cataract surgery and its impact on induced astigmatism.

PubMed

Hashemi, Hassan; Khabazkhoob, Mehdi; Soroush, Sara; Shariati, Reyhane; Miraftab, Mohammad; Yekta, Abbasali

2016-01-01

The purpose of the present study is a systematic review of previous studies on choosing the best incision site for the correction of astigmatism in cataract surgery and assessing the amount of surgically induced astigmatism (SIA) with each approach. Regardless of astigmatism axis, studies show that using an on-axis incision is associated with favorable results for 0.5-1.0 diopter (D) of astigmatism. In cases with more than 1.0 D astigmatism, paired on-axis incisions can be appreciably efficient in astigmatism correction and cause at least 1.5 D SIA. Considering the amount of SIA, a temporal incision is the best approach when the patient has minimal amounts of corneal astigmatism preoperatively. At higher levels of astigmatism, if no other astigmatism correction method is used simultaneously, the temporal incision is used less frequently; however, since it is associated with the least SIA, it is still the choice site when another correction method is used. The temporal incisions in cataract surgery are associated with little SIA and are appropriate choices for mild preoperative astigmatism. At higher levels of preoperative astigmatism, superior incisions are associated with better results when combined methods are not applied.

More exact solutions of the constant astigmatism equation

NASA Astrophysics Data System (ADS)

Hlaváč, Adam

2018-01-01

By using Bäcklund transformation for the sine-Gordon equation, new periodic exact solutions of the constant astigmatism equation zyy +(1 / z) xx + 2 = 0 are generated from a seed which corresponds to Lipschitz surfaces of constant astigmatism.

Global prevalence and economic and humanistic burden of astigmatism in cataract patients: a systematic literature review

PubMed Central

Anderson, David F; Dhariwal, Mukesh; Bouchet, Christine; Keith, Michael S

2018-01-01

Purpose To systematically review the published evidence on the prevalence and economic and humanistic burden of astigmatism in cataract patients. Materials and methods For this systematic literature review, the Medline, PubMed, Embase, and Cochrane databases were searched from 1996 to September 2015 for available scientific literature that met the inclusion criteria. Studies published in the English language reporting prevalence and humanistic and economic burden in patients diagnosed with cataract and astigmatism were included. Results Of 3,649 papers reviewed, 31 studies from 32 publications met the inclusion criteria of this review. Preexisting astigmatism ≥1 D was present in up to 47% of cataract eyes. The cost burden of residual uncorrected astigmatism after cataract surgery was driven by the cost of spectacles, which was estimated to range from $2,151 to $3,440 in the US and $1,786 to $4,629 in Europe over a lifetime. In cataract patients, both preexisting and postoperative residual astigmatism were associated with poor vision-related patient satisfaction and quality of life, as well as higher spectacle burden. Astigmatism correction during cataract surgery appears to improve visual outcomes and results in overall lifetime cost savings compared to astigmatism correction with postoperative vision correction. Conclusion There is a high prevalence of preexisting astigmatism in cataract patients. Although published data are limited, both preoperative astigmatism and postoperative residual astigmatism affect visual function and vision-related quality of life, resulting in increased humanistic burden. Suboptimal correction of astigmatism during cataract surgery drives the continuous need for vision correction with spectacles in the postoperative period. Patients must bear the out-of-pocket expenses, since payers often do not reimburse the cost of spectacles. Greater access to astigmatism correction during cataract surgery could improve visual outcomes and quality

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.

Astigmatism at nearpoint: adventitious, purposeful, and environmental influences.

PubMed

Nicholson, S B; Garzia, R P

1988-12-01

Previous studies indicate that a number of individuals display significant differences between astigmatism measured at farpoint and nearpoint. Adventitious effects, purposeful lenticular changes and adaptations in response to environmental forces are reviewed as possible sources of this astigmatic variability.

Vessel density, retinal thickness, and choriocapillaris vascular flow in myopic eyes on OCT angiography.

PubMed

Milani, Paolo; Montesano, Giovanni; Rossetti, Luca; Bergamini, Fulvio; Pece, Alfredo

2018-06-06

To investigate foveal avascular zone area, macular vascular density, choroidal thickness, and outer retina and choriocapillaris flow in myopic eyes by OCT angiography. Automated macular maps and flow calculations were retrospectively evaluated in 42 myopic and in 40 control eyes. Myopic eyes presented lower whole superficial vessel density (46.4 ± 4.9 vs. 51.6 ± 3.6%, P < 0.0001) and higher flow area in the outer retina (1.3 ± 0.2 vs. 1.1 ± 0.3 mm 2 , P = 0.0012). Between the myopic and non-myopic eyes, no significant differences could be detected in the choriocapillaris perfusion area (1.9 ± 0.07 vs. 1.9 ± 0.05 mm 2 , respectively; P = 0.55) and in the foveal avascular zone area (0.23 ± 0.1 vs. 0.26 ± 0.1 mm 2 , respectively; P = 0.12). The spherical correction positively correlated with superficial vessel density and negatively correlated with outer retina perfusion (P ≤ 0.0021). The superficial vessel density and the local retinal thickness positively correlated at all macular locations (P < 0.005), especially in the foveal region (P < 0.0001). Eyes with high myopia present reduced superficial vascular density and increased outer retina flow. Superficial vascular density and retinal thickness appear to be significantly correlated.

Astigmatism and biometric optic components of diode laser-treated threshold retinopathy of prematurity at 9 years of age

PubMed Central

Yang, C-S; Wang, A-G; Shih, Y-F; Hsu, W-M

2013-01-01

Purpose To assess the prevalence of astigmatism and its relationship with biometric optic components in preterm school children with diode laser-treated threshold retinopathy of prematurity (ROP). Methods A prospective, cross-sectional study in which cycloplegic keratometry, refraction, and ultrasound biometric measurement of optic components were performed on 24 consecutive preterm children with diode laser-treated threshold ROP at the age of 9 years. The study results were compared with data on 1021 age-matched full-term control children from a national survey. Results The laser-treated eyes had a mean astigmatism of 3.47 D, with a mean spherical equivalent of −4.49 D. Of the 46 eyes studied, 98% of eyes showed astigmatism ≥0.5 D and 50% had high astigmatism (>3.0 D). Most astigmatic eyes (97.7%) showed with-the-rule astigmatism, with the mean plus cylinder axis at 89.30o. Further correlation analysis showed the astigmatism in refraction was highly correlated with the corneal astigmatism (r=0.921, P<0.001) and the vertical corneal curvature (r=0.405, P=0.005). There was significantly steeper vertical corneal curvature (P=0.003) and flatter horizontal corneal curvature (P=0.031) in eyes with laser-treated ROP when compared with age-matched full-term controls. The eyes with laser-treated ROP also show significantly thicker lens (3.93 mm) and shallower anterior chamber depth (ACD; 2.92 mm) than full-term controls (P<0.001). Conclusions There is significantly higher prevalence and greater magnitude of astigmatism in eyes with laser-treated threshold ROP compared with full-term controls. The steeper vertical corneal curvature component contributes to the increased astigmatism in eyes with laser-treated ROP. PMID:23222565

Simulation of the impact of refractive surgery ablative laser pulses with a flying-spot laser beam on intrasurgery corneal temperature.

PubMed

Shraiki, Mario; Arba-Mosquera, Samuel

2011-06-01

To evaluate ablation algorithms and temperature changes in laser refractive surgery. The model (virtual laser system [VLS]) simulates different physical effects of an entire surgical process, simulating the shot-by-shot ablation process based on a modeled beam profile. The model is comprehensive and directly considers applied correction; corneal geometry, including astigmatism; laser beam characteristics; and ablative spot properties. Pulse lists collected from actual treatments were used to simulate the temperature increase during the ablation process. Ablation efficiency reduction in the periphery resulted in a lower peripheral temperature increase. Steep corneas had lesser temperature increases than flat ones. The maximum rise in temperature depends on the spatial density of the ablation pulses. For the same number of ablative pulses, myopic corrections showed the highest temperature increase, followed by myopic astigmatism, mixed astigmatism, phototherapeutic keratectomy (PTK), hyperopic astigmatism, and hyperopic treatments. The proposed model can be used, at relatively low cost, for calibration, verification, and validation of the laser systems used for ablation processes and would directly improve the quality of the results.

Primary angle closure glaucoma in a myopic kinship.

PubMed

Hagan, J C; Lederer, C M

1985-03-01

Three related myopic individuals with primary angle closure glaucoma are reported. They had true myopia and not pseudomyopia secondary to increased lenticular index of refraction. We believe one of these individuals (-8.62 spherical equivalent) to have the most myopic case of primary angle closure glaucoma reported in the literature. Although myopia is associated with anatomical factors that offer considerable protection from primary angle closure glaucoma, its presence does not eliminate the possibility of this disease. Laser iridectomy was effective in the treatment of these patients.

Astigmatism of the Ex Vivo Human Lens: Surface and Gradient Refractive Index Age-Dependent Contributions.

PubMed

Birkenfeld, Judith; de Castro, Alberto; Marcos, Susana

2015-08-01

We estimated the contribution of the gradient refractive index (GRIN) and lens surfaces to lens astigmatism and lens astigmatic angle as a function of age in human donor lenses. Human lenses were imaged, ex vivo, with 3D-spectral optical coherence tomography (OCT) and their back focal length was measured using laser ray tracing. The contribution of lens surfaces and GRIN to lens astigmatism were evaluated by computational ray tracing on the GRIN lens and a homogenous equivalent index lens. Astigmatism magnitude and relative astigmatic angle of and between lens surfaces, GRIN lens, and lens with homogeneous refractive index were evaluated, and all results were correlated with age. The magnitude of astigmatism in the anterior lens surface decreased with age (slope = -0.005 diopters [D]/y; r = 0.397, P = 0.018). Posterior surface astigmatism and lens astigmatism were not age-dependent. Presence of GRIN did not alter significantly the magnitude or axis of the lens astigmatism. The astigmatism of GRIN lens and lens with homogeneous refractive index correlated with anterior lens surface astigmatism (GRIN, P = 3.9E - 6, r = 0.693; equivalent refractive index lens, P = 4.1E - 4, r = 0.565). The astigmatic angle of posterior surface, GRIN lens, and homogeneous refractive index lens did not change significantly with age. The axis of lens astigmatism is close to the astigmatic axis of the anterior lens surface. Age-related changes in lens astigmatism appear to be related to changes in the anterior lens astigmatism. The influence of the GRIN on lens astigmatism and the astigmatic axis is minor.

Aspheric versus wavefront-guided aspheric photorefractive keratectomy in eyes with significant astigmatism.

PubMed

Faramarzi, Amir; Moshirfar, Majid; Karimian, Farid; Delfazayebaher, Siamak; Kheiri, Bahareh

2017-12-01

To compare the refractive and higher-order aberrations (HOAs) outcomes after photorefractive keratectomy (PRK) in patients with significant astigmatism using aspheric versus wavefront-guided aspheric profiles. Ophthalmic Research Center and Department of Ophthalmology, Shahid Beheshti University of Medical Sciences, Negah Eye Hospital, Tehran, Iran. Prospective randomized case series. One eye of each patient with a refractive astigmatism more than 2.00 diopters (D) randomly received aspheric PRK. In the other eye, wavefront-guided and aspheric treatment was performed using a personalized treatment advanced algorithm. Visual acuity, refractive errors, and HOAs were compared between the 2 groups preoperatively and 12 months postoperatively. The study comprised 32 patients (64 eyes). The mean preoperative refractive astigmatism was -4.07 D ± 1.64 (SD) and -4.02 ± 1.55 D in the aspheric group and wavefront-guided aspheric group, respectively (P = .2). The mean postoperative astigmatism was -0.46 ± 0.37 D and -0.82 ± 0.53 D in the aspheric group and wavefront-guided aspheric group, respectively (P = .02). Postoperatively, the root mean square of total HOAs was significantly increased in both groups. However, compared with wavefront-guided aspheric PRK, aspheric PRK induced fewer HOAs (P = .003). In eyes with high astigmatism, post-PRK residual astigmatism was lower in the aspheric group than in the wavefront-guided aspheric group. The increase in HOAs was significantly higher in the wavefront-guided aspheric group than in the aspheric group. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Serous retinal detachment accompanied by MEWDS in a myopic patient with dome-shaped macula.

PubMed

Shin, Min Kyu; Byon, Ik Soo; Park, Sung Who; Lee, Ji Eun

2014-01-01

Macular serous retinal detachment (MSRD) is a rare complication in highly myopic patients with an inferior staphyloma, tilted disc, or dome-shaped macula. Multiple evanescent white dot syndrome (MEWDS) presents with sudden visual loss and multiple yellowish dots that resolve spontaneously within several weeks. The authors report the development and spontaneous resolution of subretinal fluid accompanied by MEWDS in a myopic patient with a dome-shaped macula. Dysfunction of the retinal pigment epithelium due to MEWDS likely induced temporary MSRD in this patient. Copyright 2014, SLACK Incorporated.

The Limiting Effects of Astigmatism on Visual Performance through Periscopes

DTIC Science & Technology

1979-10-01

NAVAL SUBMARINE MEDICAL RESEARCH LABORATORY SUBMARINE BASE, GROTON, CONN. , ; REPORT NUMBER 905 THE LIMITING EFFECTS OF ASTIGMATISM ...distribution unlimited THE LIMITING EFFECTS OF ASTIGMATISM ON VISUAL PERFORMANCE THROUGH PERISCOPES by S. M. Luria, J. A. S. Kinney, C. L. Schlichting...release; distribution unlimited PROBLEM To determine if the new peri: Navy standards for astigmatic peris« FINDINGS copes make it possible to relax

Excimer laser correction of hyperopia, hyperopic and mixed astigmatism: past, present, and future.

PubMed

Lukenda, Adrian; Martinović, Zeljka Karaman; Kalauz, Miro

2012-06-01

The broad acceptance of "spot scanning" or "flying spot" excimer lasers in the last decade has enabled the domination of corneal ablative laser surgery over other refractive surgical procedures for the correction of hyperopia, hyperopic and mixed astigmatism. This review outlines the most important reasons why the ablative laser correction of hyperopia, hyperopic and mixed astigmatism for many years lagged behind that of myopia. Most of today's scanning laser systems, used in the LASIK and PRK procedures, can safely and effectively perform low, moderate and high hyperopic and hyperopic astigmatic corrections. The introduction of these laser platforms has also significantly improved the long term refractive stability of hyperopic treatments. In the future, further improvements in femtosecond and nanosecond technology, eye-tracker systems, and the development of new customized algorithms, such as the ray-tracing method, could additionally increase the upper limit for the safe and predictable corneal ablative laser correction ofhyperopia, hyperopic and mixed astigmatism.

Goos-Hänchen and Imbert-Fedorov shifts for astigmatic Gaussian beams

NASA Astrophysics Data System (ADS)

Ornigotti, Marco; Aiello, Andrea

2015-06-01

In this work we investigate the role of the beam astigmatism in the Goos-Hänchen and Imbert-Fedorov shift. As a case study, we consider a Gaussian beam focused by an astigmatic lens and we calculate explicitly the corrections to the standard formulas for beam shifts due to the astigmatism induced by the lens. Our results show that the different focusing in the longitudinal and transverse direction introduced by an astigmatic lens may enhance the angular part of the shift.

Refractive Error in a Sample of Black High School Children in South Africa.

PubMed

Wajuihian, Samuel Otabor; Hansraj, Rekha

2017-12-01

This study focused on a cohort that has not been studied and who currently have limited access to eye care services. The findings, while improving the understanding of the distribution of refractive errors, also enabled identification of children requiring intervention and provided a guide for future resource allocation. The aim of conducting the study was to determine the prevalence and distribution of refractive error and its association with gender, age, and school grade level. Using a multistage random cluster sampling, 1586 children, 632 males (40%) and 954 females (60%), were selected. Their ages ranged between 13 and 18 years with a mean of 15.81 ± 1.56 years. The visual functions evaluated included visual acuity using the logarithm of minimum angle of resolution chart and refractive error measured using the autorefractor and then refined subjectively. Axis astigmatism was presented in the vector method where positive values of J0 indicated with-the-rule astigmatism, negative values indicated against-the-rule astigmatism, whereas J45 represented oblique astigmatism. Overall, patients were myopic with a mean spherical power for right eye of -0.02 ± 0.47; mean astigmatic cylinder power was -0.09 ± 0.27 with mainly with-the-rule astigmatism (J0 = 0.01 ± 0.11). The prevalence estimates were as follows: myopia (at least -0.50) 7% (95% confidence interval [CI], 6 to 9%), hyperopia (at least 0.5) 5% (95% CI, 4 to 6%), astigmatism (at least -0.75 cylinder) 3% (95% CI, 2 to 4%), and anisometropia 3% (95% CI, 2 to 4%). There was no significant association between refractive error and any of the categories (gender, age, and grade levels). The prevalence of refractive error in the sample of high school children was relatively low. Myopia was the most prevalent, and findings on its association with age suggest that the prevalence of myopia may be stabilizing at late teenage years.

Association between mode of delivery and astigmatism in preschool children.

PubMed

Liu, Fengyang; Yang, Xubo; Tang, Angcang; Liu, Longqian

2018-03-01

To determine whether mode of delivery has any impact on astigmatism. This case-control study was performed in the Department of Ophthalmology in 2015. Exposure was mode of delivery [vaginal delivery (VD) or caesarean section (CS), which here included both elective and emergency CS]. Outcome was astigmatism (≥2.5 D), which was determined by cycloplegic refraction. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were computed to assess the associations between mode of delivery and astigmatism from logistic regression models. Of the 659 children studied here (341 boys; mean age, 4.37 years), 440 were born by CS and 219 by VD. The incidence of severe astigmatism (≥2.5 D) in the CS and VD groups was 22.06% and 13.24%, respectively. Children delivered by CS had a 77.9% higher risk of severe astigmatism compared with vaginally delivered children (OR = 1.779; 95% CI, 1.121 to 2.824). After dividing CS into elective CS and emergency CS, children delivered by elective CS had an 87.3% increased risk of severe astigmatism (OR = 1.873; 95% CI, 1.157 to 3.032), but children delivered by emergency CS did not differ from vaginally delivered children. In addition, the children whose mothers had histories of breastfeeding had a 44.6% lower risk of severe astigmatism than children whose mother did not breastfeed them (OR = 0.554, 95% CI, 0.335-0.914). Birth by CS, especially elective CS, increases the risk of severe astigmatism (≥2.50 D) in childhood. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Evaluation of biometry and corneal astigmatism in cataract surgery patients from Central China.

PubMed

Yu, Ji-Guo; Zhong, Jie; Mei, Zhong-Ming; Zhao, Fang; Tao, Na; Xiang, Yi

2017-04-26

To evaluate the distribution of biometric parameters and corneal astigmatism using the IOLMaster device before phacoemulsification in cataract patients in Central China. Consecutive cataract patients were recruited at the Central Hospital of Wuhan between January 2015 and June 2016. Ocular axial length (AL), keratometry values, anterior chamber depth (ACD) and horizontal corneal diameter (white to white [WTW]) of each cataract-affected eye were measured with the IOLMaster device. The study evaluated 3209 eyes of 2821 cataract patients. The mean AL, ACD, and WTW were 24.38 ± 2.47 mm, 3.15 ± 0.48 mm, and 11.63 ± 0.43 mm, respectively. Corneal astigmatism of 0.51-1.00 diopters (D) was the most common range of values (34.96%). A total of 10.56% patients exhibited a corneal astigmatism greater than 2.0 D. The flat and steep keratometry values gradually increased with age. The mean ACD and WTW showed increasing trends as the AL increased (P < 0.001). When the AL was shorter than 26.0 mm, the keratometry decreased as AL increased. The against-the-rule (ATR) astigmatism proportion increased with age and the with-the-rule (WTR) astigmatism proportion decreased with age. The profile of ocular biometric data and corneal astigmatism may help ophthalmologists improve their surgical procedures and make an appropriate IOL choice to gain a high quality of postoperative vision.

Effect of posterior corneal astigmatism on refractive outcomes after toric intraocular lens implantation.

PubMed

Zhang, Lijun; Sy, Mary Ellen; Mai, Harry; Yu, Fei; Hamilton, D Rex

2015-01-01

To compare the prediction error after toric intraocular lens (IOL) (Acrysof IQ) implantation using corneal astigmatism measurements obtained with an IOLMaster automated keratometer and a Galilei dual rotating camera Scheimpflug-Placido tomographer. Jules Stein Eye Institute, University of California Los Angeles, Los Angeles, California, USA. Retrospective case series. The predicted residual astigmatism after toric IOL implantation was calculated using preoperative astigmatism values from an automated keratometer and the total corneal power (TCP) determined by ray tracing through the measured anterior and posterior corneal surfaces using dual Scheimpflug-Placido tomography. The prediction error was calculated as the difference between the predicted astigmatism and the manifest astigmatism at least 1 month postoperatively. The calculations included vector analysis. The study evaluated 35 eyes (35 patients). The preoperative corneal posterior astigmatism mean magnitude was 0.33 diopter (D) ± 0.16 (SD) (vector mean 0.23 × 176). Twenty-six eyes (74.3%) had with-the-rule (WTR) posterior astigmatism. The postoperative manifest refractive astigmatism mean magnitude was 0.38 ± 0.18 D (vector mean 0.26 × 171). There was no statistically significant difference in the mean magnitude prediction error between the automated keratometer and TCP techniques. However, the automated keratometer method tended to overcorrect WTR astigmatism and undercorrect against-the-rule (ATR) astigmatism. The TCP technique lacked these biases. The automated keratometer and TCP methods for estimating the magnitude of corneal astigmatism gave similar results. However, the automated keratometer method tended to overcorrect WTR astigmatism and undercorrect ATR astigmatism. Dr. Hamilton has received honoraria for educational lectures from Ziemer Ophthalmic Systems. No other author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published

Retinal cell imaging in myopic chickens using adaptive optics multiphoton microscopy.

PubMed

Bueno, Juan M; Palacios, Raquel; Giakoumaki, Anastasia; Gualda, Emilio J; Schaeffel, Frank; Artal, Pablo

2014-03-01

Abnormal eye growth induced by visual deprivation can modify the structure and density of the retinal cells. We have used an adaptive optics multiphoton microscope to image photoreceptors (PRs) and ganglion cells (GCs) at different retinal locations in unstained retinas of chicken eyes with about 10D of myopia and their normal-sighted fellow eyes. In all samples, the local averaged inter-PR distance increased with eccentricity. No significant differences in PR density were found between control and myopic eyes. GC density declined in myopic eyes compared to control eyes and the inter-cell distance increased. In normal eyes, the size of the GC cell bodies increased approximately two-fold between the area centralis and the peripheral retina. In myopic eyes, this trend was preserved but the GC bodies were larger at each retinal location, compared to control eyes. Obviously, GC morphology is changing when the retinal area is enlarged in myopic eyes.

Retinal cell imaging in myopic chickens using adaptive optics multiphoton microscopy

PubMed Central

Bueno, Juan M.; Palacios, Raquel; Giakoumaki, Anastasia; Gualda, Emilio J.; Schaeffel, Frank; Artal, Pablo

2014-01-01

Abnormal eye growth induced by visual deprivation can modify the structure and density of the retinal cells. We have used an adaptive optics multiphoton microscope to image photoreceptors (PRs) and ganglion cells (GCs) at different retinal locations in unstained retinas of chicken eyes with about 10D of myopia and their normal-sighted fellow eyes. In all samples, the local averaged inter-PR distance increased with eccentricity. No significant differences in PR density were found between control and myopic eyes. GC density declined in myopic eyes compared to control eyes and the inter-cell distance increased. In normal eyes, the size of the GC cell bodies increased approximately two-fold between the area centralis and the peripheral retina. In myopic eyes, this trend was preserved but the GC bodies were larger at each retinal location, compared to control eyes. Obviously, GC morphology is changing when the retinal area is enlarged in myopic eyes. PMID:24688804

Longitudinal Outcomes of U.S. Air Force Pilot Applicants With Waivered Astigmatism.

PubMed

Andrus, David E; Haynes, Jared T; Wright, Steven T

2017-03-01

Current U.S. Air Force medical standards allow applicants to enter pilot training with up to 1.50 D of astigmatism. However, waivers are considered for individuals with up to 3.00 D of astigmatism. Although typically a benign finding, higher levels of astigmatism may be progressive and can be associated with corneal ectasia (e.g., keratoconus or pellucid marginal degeneration) leading to reduced visual acuity with spectacles and/or soft contact lenses. The goal of this study was to evaluate the long-term outcomes of pilot applicants waivered into training with astigmatism exceeding the aeromedical standard. Subjects were identified on the basis of their enrollment in the Excessive Astigmatism Management Group maintained by the Aeromedical Consultation Service, Ophthalmology branch at Wright-Patterson Air Force Base, Ohio. Metrics evaluated included refractive status, visual acuity, aeromedical waiver status, safety data, and the development of corneal ectasia. Seventy-six subjects were tracked for up to 10 years, with an average follow-up period of 5.5 years. Mean astigmatism at initial examination was 1.91 D, although mean astigmatism on the basis of the most recent examination was 2.19 D. Subjects with excessive astigmatism who were waivered into pilot training showed an average increase in astigmatism of slightly less than 0.05 D annually, which equates to a total increase in astigmatism of approximately 0.25 D for the duration of the study. No subjects developed ectasia or were disqualified from flying for vision or refractive reasons. No mishaps were identified with vision being a causative or contributing factor. This study supports continuation of current Air Force waiver policy, although a longer follow-up period is required to consider modifying the aeromedical standard for astigmatism. Reprint & Copyright © 2017 Association of Military Surgeons of the U.S.

The effect of astigmatism axis on visual acuity.

PubMed

Mimouni, Michael; Nemet, Achia; Pokroy, Russell; Sela, Tzahi; Munzer, Gur; Kaiserman, Igor

2017-05-11

To evaluate the effect of astigmatism axis on uncorrected distance visual acuity (UDVA) in emmetropic eyes that underwent laser refractive surgery. This retrospective study included patients who underwent laser in situ keratomileusis or photorefractive keratectomy between January 2000 and December 2015 at the Care-Vision Laser Centers, Tel Aviv, Israel. Eyes with a 3-month postoperative spherical equivalent between -0.5 D and 0.5 D were included in this study. Eyes with ocular comorbidities and planned ametropia were excluded. Study eyes were divided into 3 groups according to the steep astigmatic axis: with the rule (WTR) (60-120), oblique (31-59 or 121-149), and against the rule (ATR) (0-30 or 150-180). The UDVA of these 3 groups was compared. The oblique group was divided into oblique ATR and oblique WTR, which were compared with each other. A total of 17,416 consecutive eyes of 8,708 patients were studied. The WTR eyes (n = 10,651) had significantly better UDVA (logMAR 0.01 ± 0.08) than the oblique (n = 3,141, logMAR 0.02 ± 0.09) and ATR eyes (n = 3,624, logMAR 0.02 ± 0.10) (p<0.001). The oblique WTR group had significantly better UDVA than the oblique ATR group (p<0.001). The UDVA of the oblique and ATR groups was similar. Stepwise multiple regression analysis showed that the group accounted for 15% of the UDVA variance (p = 0.04). The astigmatic axis has a small but significant effect on UDVA in emmetropic eyes; WTR was better than oblique and ATR astigmatism. Therefore, when correcting astigmatism, it may be preferable to err towards WTR astigmatism.

Correction of irregular and induced regular corneal astigmatism with toric IOL after posterior segment surgery: a case series.

PubMed

Kolozsvári, Bence L; Losonczy, Gergely; Pásztor, Dorottya; Fodor, Mariann

2017-01-13

Toric intraocular lens (IOL) implantation can be an effective method for correcting corneal astigmatism in patients with vitreoretinal diseases and cataract. Our purpose is to report the outcome of toric IOL implantation in two cases - a patient with scleral-buckle-induced regular corneal astigmatism and a patient with keratoconus following pars plana vitrectomy. As far as we are aware, there are no reported cases of toric IOL implantation in a vitrectomized eye with keratoconus nor of toric IOL implantation in patients with scleral-buckle-induced regular corneal astigmatism. Two patients with myopia and high corneal astigmatism underwent cataract operation with toric IOL implantation after posterior segment surgery. Myopia and high astigmatism (>2.5 diopter) were caused by previous scleral buckling in one case and by keratoconus in the other case. Pre- and postoperative examinations during the follow-up of included uncorrected and spectacle corrected distance visual acuity (UCDVA/CDVA), automated kerato-refractometry (Topcon), Pentacam HR, IOL Master (Zeiss) axial length measurements and fundus optical coherence tomography (Zeiss). One year postoperatively, the UCDVA and CDVA were 20/25 and 20/20 in both cases, respectively. The absolute residual refractive astigmatism was 1.0 and 0.75 Diopters, respectively. The IOL rotation was within 3° in both eyes, therefore IOL repositioning was not necessary. Complications were not observed in our cases. These cases demonstrate that toric IOL implantation is a predictable and safe method for the correction of high corneal astigmatism in complicated cases with different origins. Irregular corneal astigmatism in keratoconus or scleral-buckle-induced regular astigmatisms can be equally well corrected with the use of toric IOL during cataract surgery. Previous scleral buckling or pars plana vitrectomy seem to have no impact on the success of the toric IOL implantation, even in keratoconus. IOL rotational stability and

Lens-induced astigmatism after perforating scleral injury.

PubMed

Ludwig, Klaus; Moradi, Said; Rudolph, Guenther; Boergen, Klaus Peter

2002-10-01

Within 6 weeks of a penetrating scleral injury that included vitreous prolapse, a 6-year-old boy developed lenticular astigmatism with a regular component of 5.5 diopters (D). Visible indentational folds in the posterior lens capsule, caused by anterior vitreous fibers and anterior hyaloid, were presumed to be the origin of the astigmatism. Because of decreased visual acuity and the suspicion of early amblyopia, a pars plana vitrectomy with removal of the anterior hyaloid and the critical anterior vitreous fibers was performed. Dense fibrotic tissue between the lens equator and the site of the original scleral perforation limited reduction of the preoperative astigmatism to 4.0 D. However, the striae-like lenticular deformation disappeared completely, and full visual acuity was restored. During the 12-month follow-up, the lens remained clear

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.

Analysis of corneal astigmatism before surgery in Chinese congenital ectopia lentis patients.

PubMed

Zhang, Yichi; Jin, Guangming; Young, Charlotte Aimee; Cao, Qianzhong; Lin, Junxiong; Lin, Jianqiang; Wang, Yiyao; Zheng, Danying

2018-04-26

Purpose This study aims to describe the characteristics of corneal astigmatism before surgery in congenital ectopia lentis (CEL) patients. Methods This retrospective study reviewed 306 CEL patients from 1st January 2006, to 31st December 2015. One eye was randomly selected from each patient when the patient had bilateral EL. The influence of sex, laterality, and Marfan syndrome on corneal astigmatism in different age subgroups was evaluated and compared. The correlation between age and corneal astigmatism was evaluated. Results Two hundred fifty-two eyes were included in this study. The mean corneal astigmatism of CEL patients was 2.00 ± 1.28 D. There was a statistical difference in corneal astigmatism between CEL eyes with and without Marfan syndrome. However, no statistical difference was found between male and female patients, or between the EL-affected eye and the unaffected eye in monocular EL patients. There was a positive correlation between age and corneal astigmatism in CEL eyes. Conclusions This study suggests that CEL patients' corneal astigmatism is higher in patients with Marfan syndrome, and corneal astigmatism of the CEL eye increases with age. Our results are useful for surgeons to make appropriate incision and intraocular lens (IOL) choices for patients, as well as a useful reference for designs of new IOLs.

Myopic aberrations: Simulation based comparison of curvature and Hartmann Shack wavefront sensors

NASA Astrophysics Data System (ADS)

Basavaraju, Roopashree M.; Akondi, Vyas; Weddell, Stephen J.; Budihal, Raghavendra Prasad

2014-02-01

In comparison with a Hartmann Shack wavefront sensor, the curvature wavefront sensor is known for its higher sensitivity and greater dynamic range. The aim of this study is to numerically investigate the merits of using a curvature wavefront sensor, in comparison with a Hartmann Shack (HS) wavefront sensor, to analyze aberrations of the myopic eye. Aberrations were statistically generated using Zernike coefficient data of 41 myopic subjects obtained from the literature. The curvature sensor is relatively simple to implement, and the processing of extra- and intra-focal images was linearly resolved using the Radon transform to provide Zernike modes corresponding to statistically generated aberrations. Simulations of the HS wavefront sensor involve the evaluation of the focal spot pattern from simulated aberrations. Optical wavefronts were reconstructed using the slope geometry of Southwell. Monte Carlo simulation was used to find critical parameters for accurate wavefront sensing and to investigate the performance of HS and curvature sensors. The performance of the HS sensor is highly dependent on the number of subapertures and the curvature sensor is largely dependent on the number of Zernike modes used to represent the aberration and the effective propagation distance. It is shown that in order to achieve high wavefront sensing accuracy while measuring aberrations of the myopic eye, a simpler and cost effective curvature wavefront sensor is a reliable alternative to a high resolution HS wavefront sensor with a large number of subapertures.

The effect of bifocal add on accommodative lag in myopic children with high accommodative lag.

PubMed

Berntsen, David A; Mutti, Donald O; Zadnik, Karla

2010-12-01

To determine the effect of a bifocal add and manifest correction on accommodative lag in myopic children with high accommodative lag, who have been reported to have the greatest reduction in myopia progression with progressive addition lenses (PALs). Monocular accommodative lag to a 4-D Badal stimulus was measured on two occasions 6 months apart in 83 children (mean ± SD age, 9.9 ± 1.3 years) with high lag randomized to wearing single-vision lenses (SVLs) or PALs. Accommodative lag was measured with the following corrections: habitual, manifest, manifest with +2.00-D add, and habitual with +2.00-D add (6-month visit only). At baseline, accommodative lag was higher (1.72 ± 0.37 D; mean ± SD) when measured with manifest correction than with habitual correction (1.51 ± 0.50; P < 0.05). This higher lag with manifest correction correlated with a larger amount of habitual undercorrection at baseline (r = -0.29, P = 0.009). A +2.00-D add over the manifest correction reduced lag by 0.45 ± 0.34 D at baseline and 0.33 ± 0.38 D at the 6-month visit. Lag results at 6 months were not different between PAL and SVL wearers (P = 0.92). A +2.00-D bifocal add did not eliminate accommodative lag and reduced lag by less than 25% of the bifocal power, indicating that children mainly responded to a bifocal by decreasing accommodation. If myopic progression is substantial, measuring lag with full correction can overestimate the hyperopic retinal blur that a child most recently experienced. (ClinicalTrials.gov number, NCT00335049.).

The Effect of Bifocal Add on Accommodative Lag in Myopic Children with High Accommodative Lag

PubMed Central

Mutti, Donald O.; Zadnik, Karla

2010-01-01

Purpose. To determine the effect of a bifocal add and manifest correction on accommodative lag in myopic children with high accommodative lag, who have been reported to have the greatest reduction in myopia progression with progressive addition lenses (PALs). Methods. Monocular accommodative lag to a 4-D Badal stimulus was measured on two occasions 6 months apart in 83 children (mean ± SD age, 9.9 ± 1.3 years) with high lag randomized to wearing single-vision lenses (SVLs) or PALs. Accommodative lag was measured with the following corrections: habitual, manifest, manifest with +2.00-D add, and habitual with +2.00-D add (6-month visit only). Results. At baseline, accommodative lag was higher (1.72 ± 0.37 D; mean ± SD) when measured with manifest correction than with habitual correction (1.51 ± 0.50; P < 0.05). This higher lag with manifest correction correlated with a larger amount of habitual undercorrection at baseline (r = −0.29, P = 0.009). A +2.00-D add over the manifest correction reduced lag by 0.45 ± 0.34 D at baseline and 0.33 ± 0.38 D at the 6-month visit. Lag results at 6 months were not different between PAL and SVL wearers (P = 0.92). Conclusions. A +2.00-D bifocal add did not eliminate accommodative lag and reduced lag by less than 25% of the bifocal power, indicating that children mainly responded to a bifocal by decreasing accommodation. If myopic progression is substantial, measuring lag with full correction can overestimate the hyperopic retinal blur that a child most recently experienced. (ClinicalTrials.gov number, NCT00335049.) PMID:20688729

A genome-wide association study of corneal astigmatism: The CREAM Consortium.

PubMed

Shah, Rupal L; Li, Qing; Zhao, Wanting; Tedja, Milly S; Tideman, J Willem L; Khawaja, Anthony P; Fan, Qiao; Yazar, Seyhan; Williams, Katie M; Verhoeven, Virginie J M; Xie, Jing; Wang, Ya Xing; Hess, Moritz; Nickels, Stefan; Lackner, Karl J; Pärssinen, Olavi; Wedenoja, Juho; Biino, Ginevra; Concas, Maria Pina; Uitterlinden, André; Rivadeneira, Fernando; Jaddoe, Vincent W V; Hysi, Pirro G; Sim, Xueling; Tan, Nicholas; Tham, Yih-Chung; Sensaki, Sonoko; Hofman, Albert; Vingerling, Johannes R; Jonas, Jost B; Mitchell, Paul; Hammond, Christopher J; Höhn, René; Baird, Paul N; Wong, Tien-Yin; Cheng, Chinfsg-Yu; Teo, Yik Ying; Mackey, David A; Williams, Cathy; Saw, Seang-Mei; Klaver, Caroline C W; Guggenheim, Jeremy A; Bailey-Wilson, Joan E

2018-01-01

To identify genes and genetic markers associated with corneal astigmatism. A meta-analysis of genome-wide association studies (GWASs) of corneal astigmatism undertaken for 14 European ancestry (n=22,250) and 8 Asian ancestry (n=9,120) cohorts was performed by the Consortium for Refractive Error and Myopia. Cases were defined as having >0.75 diopters of corneal astigmatism. Subsequent gene-based and gene-set analyses of the meta-analyzed results of European ancestry cohorts were performed using VEGAS2 and MAGMA software. Additionally, estimates of single nucleotide polymorphism (SNP)-based heritability for corneal and refractive astigmatism and the spherical equivalent were calculated for Europeans using LD score regression. The meta-analysis of all cohorts identified a genome-wide significant locus near the platelet-derived growth factor receptor alpha ( PDGFRA ) gene: top SNP: rs7673984, odds ratio=1.12 (95% CI:1.08-1.16), p=5.55×10 -9 . No other genome-wide significant loci were identified in the combined analysis or European/Asian ancestry-specific analyses. Gene-based analysis identified three novel candidate genes for corneal astigmatism in Europeans-claudin-7 ( CLDN7 ), acid phosphatase 2, lysosomal ( ACP2 ), and TNF alpha-induced protein 8 like 3 ( TNFAIP8L3 ). In addition to replicating a previously identified genome-wide significant locus for corneal astigmatism near the PDGFRA gene, gene-based analysis identified three novel candidate genes, CLDN7 , ACP2 , and TNFAIP8L3 , that warrant further investigation to understand their role in the pathogenesis of corneal astigmatism. The much lower number of genetic variants and genes demonstrating an association with corneal astigmatism compared to published spherical equivalent GWAS analyses suggest a greater influence of rare genetic variants, non-additive genetic effects, or environmental factors in the development of astigmatism.

A genome-wide association study of corneal astigmatism: The CREAM Consortium

PubMed Central

Shah, Rupal L.; Li, Qing; Zhao, Wanting; Tedja, Milly S.; Tideman, J. Willem L.; Khawaja, Anthony P.; Fan, Qiao; Yazar, Seyhan; Williams, Katie M.; Verhoeven, Virginie J.M.; Xie, Jing; Wang, Ya Xing; Hess, Moritz; Nickels, Stefan; Lackner, Karl J.; Pärssinen, Olavi; Wedenoja, Juho; Biino, Ginevra; Concas, Maria Pina; Uitterlinden, André; Rivadeneira, Fernando; Jaddoe, Vincent W.V.; Hysi, Pirro G.; Sim, Xueling; Tan, Nicholas; Tham, Yih-Chung; Sensaki, Sonoko; Hofman, Albert; Vingerling, Johannes R.; Jonas, Jost B.; Mitchell, Paul; Hammond, Christopher J.; Höhn, René; Baird, Paul N.; Wong, Tien-Yin; Cheng, Chinfsg-Yu; Teo, Yik Ying; Mackey, David A.; Williams, Cathy; Saw, Seang-Mei; Klaver, Caroline C.W.; Bailey-Wilson, Joan E.

2018-01-01

Purpose To identify genes and genetic markers associated with corneal astigmatism. Methods A meta-analysis of genome-wide association studies (GWASs) of corneal astigmatism undertaken for 14 European ancestry (n=22,250) and 8 Asian ancestry (n=9,120) cohorts was performed by the Consortium for Refractive Error and Myopia. Cases were defined as having >0.75 diopters of corneal astigmatism. Subsequent gene-based and gene-set analyses of the meta-analyzed results of European ancestry cohorts were performed using VEGAS2 and MAGMA software. Additionally, estimates of single nucleotide polymorphism (SNP)-based heritability for corneal and refractive astigmatism and the spherical equivalent were calculated for Europeans using LD score regression. Results The meta-analysis of all cohorts identified a genome-wide significant locus near the platelet-derived growth factor receptor alpha (PDGFRA) gene: top SNP: rs7673984, odds ratio=1.12 (95% CI:1.08–1.16), p=5.55×10−9. No other genome-wide significant loci were identified in the combined analysis or European/Asian ancestry-specific analyses. Gene-based analysis identified three novel candidate genes for corneal astigmatism in Europeans—claudin-7 (CLDN7), acid phosphatase 2, lysosomal (ACP2), and TNF alpha-induced protein 8 like 3 (TNFAIP8L3). Conclusions In addition to replicating a previously identified genome-wide significant locus for corneal astigmatism near the PDGFRA gene, gene-based analysis identified three novel candidate genes, CLDN7, ACP2, and TNFAIP8L3, that warrant further investigation to understand their role in the pathogenesis of corneal astigmatism. The much lower number of genetic variants and genes demonstrating an association with corneal astigmatism compared to published spherical equivalent GWAS analyses suggest a greater influence of rare genetic variants, non-additive genetic effects, or environmental factors in the development of astigmatism. PMID:29422769

Lenticular meridional astigmatism secondary to iris mesectodermal leiomyoma.

PubMed

Chalam, K V; Cutler Peck, Carolee M; Grover, Sandeep; Radhakrishnan, Ravi

2012-01-01

A 61-year-old African American man presented with decreased vision of 2 months duration. Examination revealed a significant lenticular astigmatism and sectoral cataract as a result of an amelanotic iris lesion. Slitlamp optical coherence tomography (OCT) revealed angle crowding. An excisional biopsy was performed along with phacoemulsification in the right eye, with intraocular lens implantation for meridional lenticular astigmatism. Histopathology and histoimmunochemistry confirmed a diagnosis of uveal mesectodermal leiomyoma. Lenticular astigmatism may be a subtle sign of an anterior segment tumor. Anterior segment slitlamp OCT is an effective tool in diagnosing as well as monitoring small interval changes in these types of tumors. Copyright © 2012 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

[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.

Pediatric cataract, myopic astigmatism, familial exudative vitreoretinopathy and primary open-angle glaucoma co-segregating in a family

PubMed Central

Hewitt, A.W.; Ruddle, J.B.; Vote, B.; Buttery, R.G.; Toomes, C.; Metlapally, R.; Li, Y.J.; Tran-Viet, K.N.; Malecaze, F.; Calvas, P.; Rosenberg, T.; Guggenheim, J.A.; Young, T.L.

2011-01-01

Purpose To describe an Australian pedigree of European descent with a variable autosomal dominant phenotype of: pediatric cortical cataract (CC), asymmetric myopia with astigmatism, familial exudative vitreoretinopathy (FEVR), and primary open-angle glaucoma (POAG). Methods Probands with CC, FEVR, and POAG were enrolled in three independent genetic eye studies in Tasmania. Genealogy confirmed these individuals were closely related and subsequent examination revealed 11 other family members with some or all of the associated disorders. Results Twelve individuals had CC thought to be of childhood onset, with one child demonstrating progressive lenticular opacification. One individual had severe retinal detachment while five others had dragged retinal vessels. Seven individuals had POAG. Seven individuals had myopia in at least one eye ≤-3 Diopters. DNA testing excluded mutations in myocilin, trabecular meshwork inducible glucocorticoid response (MYOC) and tetraspanin 12 (TSPAN12). Haplotype analysis excluded frizzled family receptor 4 (FZD4) and low density lipoprotein receptor-related protein 5 (LRP5), but only partly excluded EVR3. Multipoint linkage analysis revealed multiple chromosomal single-nucleotide polymorphisms (SNPs) of interest, but no statistically significant focal localization. Conclusions This unusual clustering of ophthalmic diseases suggests a possible single genetic cause for an apparently new cataract syndrome. This family’s clinical ocular features may reflect the interplay between retinal disease with lenticular changes and axial length in the development of myopia and glaucoma. PMID:21850187

Pediatric cataract, myopic astigmatism, familial exudative vitreoretinopathy and primary open-angle glaucoma co-segregating in a family.

PubMed

Mackey, D A; Hewitt, A W; Ruddle, J B; Vote, B; Buttery, R G; Toomes, C; Metlapally, R; Li, Y J; Tran-Viet, K N; Malecaze, F; Calvas, P; Rosenberg, T; Guggenheim, J A; Young, T L

2011-01-01

To describe an Australian pedigree of European descent with a variable autosomal dominant phenotype of: pediatric cortical cataract (CC), asymmetric myopia with astigmatism, familial exudative vitreoretinopathy (FEVR), and primary open-angle glaucoma (POAG). Probands with CC, FEVR, and POAG were enrolled in three independent genetic eye studies in Tasmania. Genealogy confirmed these individuals were closely related and subsequent examination revealed 11 other family members with some or all of the associated disorders. Twelve individuals had CC thought to be of childhood onset, with one child demonstrating progressive lenticular opacification. One individual had severe retinal detachment while five others had dragged retinal vessels. Seven individuals had POAG. Seven individuals had myopia in at least one eye ≤-3 Diopters. DNA testing excluded mutations in myocilin, trabecular meshwork inducible glucocorticoid response (MYOC) and tetraspanin 12 (TSPAN12). Haplotype analysis excluded frizzled family receptor 4 (FZD4) and low density lipoprotein receptor-related protein 5 (LRP5), but only partly excluded EVR3. Multipoint linkage analysis revealed multiple chromosomal single-nucleotide polymorphisms (SNPs) of interest, but no statistically significant focal localization. This unusual clustering of ophthalmic diseases suggests a possible single genetic cause for an apparently new cataract syndrome. This family's clinical ocular features may reflect the interplay between retinal disease with lenticular changes and axial length in the development of myopia and glaucoma.

MAGNETIC DEFLEXION OF ELECTRON BEAMS WITHOUT ASTIGMATISM

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

Archard, G.D.; Mulvey, T.

1958-09-01

An electron beam passing through a magnetic defiecting field is, in general, subject to astigmatism. For circular pole pieces, this takes the form of focusing in the plane of deflection; for square pole pieces, focusing perpendicular to the pinne of deflection. Deflection free from astigmatism can be achieved by means of circular pole-pieces from which semicircular portions have been removed. An application of this to reflection electron microsccpy is described. (auth)

The Changes in Corneal Astigmatism after Botulinum Toxin-A Injection in Patients with Blepharospasm

PubMed Central

Moon, Nam Ju; Lee, Hyeon Il

2006-01-01

To determine if the involuntary contractions of eyelids may have any effects on the development of corneal astigmatism, we performed this prospective study which includes 19 patients with either essential blepharospasm or hemifacial spasm. In hemifacial spasm, the degree of corneal astigmatism was evaluated between two eyes. Then the topographic changes were checked using vector analysis technique before and after passively opening the eyelids. They were also measured before and at 1 and 6 months after the injection of Botulinum toxin. Resultantly, 20 eyes had the with-the-rule (group1) and 9 eyes against-the-rule (group2) astigmatism. In hemifacial spasm, significantly more astigmatism was found at spastic eyes. The corneal topographic changes after passively opening the eyelids showed 10 eyes with the astigmatic shift to the with-the-rule, while the remaining 19 to the against-the-rule. At 1 month after injection of Botulinum toxin, group 1 showed reduced average corneal astigmatism, whereas group 2 showed increased astigmatism. The astigmatic change vector showed significantly more against-the-rule. In the contrary, 6 months after treatment, corneal astigmatism again increased in group 1 and decreased in group 2. So they took on the appearance of pretreatment astigmatic status eventually. Conclusively eyelids may play an important role in corneal curvature. PMID:16479079

Correction of low corneal astigmatism in cataract surgery.

PubMed

Leon, Pia; Pastore, Marco Rocco; Zanei, Andrea; Umari, Ingrid; Messai, Meriem; Negro, Corrado; Tognetto, Daniele

2015-01-01

To evaluate and compare aspheric toric intraocular lens (IOL) implantation and aspheric monofocal IOL implantation with limbal relaxing incisions (LRI) to manage low corneal astigmatism (1.0-2.0 D) in cataract surgery. A prospective randomized comparative clinical study was performed. There were randomly recruited 102 eyes (102 patients) with cataracts associated with corneal astigmatism and divided into two groups. The first group received toric IOL implantation and the second one monofocal IOL implantation with peripheral corneal relaxing incisions. Outcomes considered were: visual acuity, postoperative residual astigmatism, endothelial cell count, the need for spectacles, and patient satisfaction. To determine the postoperative toric axis, all patients who underwent the toric IOL implantation were further evaluated using an OPD Scan III (Nidek Co, Japan). Follow-up lasted 6mo. The mean uncorrected distance visual acuity (UCVA) and the best corrected visual acuity (BCVA) demonstrated statistically significant improvement after surgery in both groups. At the end of the follow-up the UCVA was statistically better in the patients with toric IOL implants compared to those patients who underwent implantation of monofocal IOL plus LRI. The mean residual refractive astigmatism was of 0.4 D for the toric IOL group and 1.1 D for the LRI group (P<0.01). No difference was observed in the postoperative endothelial cell count between the two groups. The two surgical procedures demonstrated a significant decrease in refractive astigmatism. Toric IOL implantation was more effective and predictable compared to the limbal relaxing incision.

Surgically induced astigmatism following trabeculectomy.

PubMed

Kim, Gyu Ah; Lee, Si Hyung; Lee, Sang Yeop; Kwon, Hee Jung; Bae, Hyoung Won; Seong, Gong Je; Kim, Chan Yun

2018-03-14

Surgically induced astigmatism (SIA) has attracted much interest in recent times because changes in corneal astigmatism can lead to decreased uncorrected visual acuity and patient discomfort. This study aimed to evaluate SIA and to identify factors correlated therewith after trabeculectomy. We retrospectively reviewed medical charts of patients who were treated with trabeculectomy at 120° meridian (superotemporal area on right eye and superonasal area on left eye) by the same surgeon. Preoperative keratometric data were compared with data collected from 2 months to 12 months postoperatively. SIA was evaluated using Naeser's polar value analysis. Using Naeser's method, ΔKP(120) was calculated as 0.7 ± 0.7 (0.82@104°), which indicates a with-the-rule change. After surgery, the combined mean polar values changed significantly (Hotelling T 2  = 22.47; p < 0.001). Multivariate analysis of variance indicated that postoperative intraocular pressure and location of surgery were independent factors that were significantly associated with SIA (p = 0.002 and 0.03, respectively). Trabeculectomy at the 120° meridian was not astigmatically neutral. In addition, the SIA after trabeculectomy appears to be greater in eyes with low postoperative intraocular pressure and a superonasal surgical wound rather than a superotemporal wound.

Community trust reduces myopic decisions of low-income individuals

PubMed Central

Jachimowicz, Jon M.; Chafik, Salah; Munrat, Sabeth; Prabhu, Jaideep C.; Weber, Elke U.

2017-01-01

Why do the poor make shortsighted choices in decisions that involve delayed payoffs? Foregoing immediate rewards for larger, later rewards requires that decision makers (i) believe future payoffs will occur and (ii) are not forced to take the immediate reward out of financial need. Low-income individuals may be both less likely to believe future payoffs will occur and less able to forego immediate rewards due to higher financial need; they may thus appear to discount the future more heavily. We propose that trust in one’s community—which, unlike generalized trust, we find does not covary with levels of income—can partially offset the effects of low income on myopic decisions. Specifically, we hypothesize that low-income individuals with higher community trust make less myopic intertemporal decisions because they believe their community will buffer, or cushion, against their financial need. In archival data and laboratory studies, we find that higher levels of community trust among low-income individuals lead to less myopic decisions. We also test our predictions with a 2-y community trust intervention in rural Bangladesh involving 121 union councils (the smallest rural administrative and local government unit) and find that residents in treated union councils show higher levels of community trust and make less myopic intertemporal choices than residents in control union councils. We discuss the implications of these results for the design of domestic and global policy interventions to help the poor make decisions that could alleviate poverty. PMID:28400516

A simplified focusing and astigmatism correction method for a scanning electron microscope

NASA Astrophysics Data System (ADS)

Lu, Yihua; Zhang, Xianmin; Li, Hai

2018-01-01

Defocus and astigmatism can lead to blurred images and poor resolution. This paper presents a simplified method for focusing and astigmatism correction of a scanning electron microscope (SEM). The method consists of two steps. In the first step, the fast Fourier transform (FFT) of the SEM image is performed and the FFT is subsequently processed with a threshold to achieve a suitable result. In the second step, the threshold FFT is used for ellipse fitting to determine the presence of defocus and astigmatism. The proposed method clearly provides the relationships between the defocus, the astigmatism and the direction of stretching of the FFT, and it can determine the astigmatism in a single image. Experimental studies are conducted to demonstrate the validity of the proposed method.

Calculation of the change in corneal astigmatism following cataract extraction.

PubMed

Cravy, T V

1979-01-01

Obtaining a minimal amount of postoperative astigmatism following cataract surgery is becoming increasingly important. One aspect of the patient's surgery which should not be overlooked is the preoperative keratometry which provides a basis for preoperative planning of surgical technique to be used and a point of reference for determining the amount of change in astigmatism produced by the surgery. Analysis of the surgically induced change in astigmatism using the calculations described in this paper will allow the surgeon to evaluate his own techniques and to maximize his potential for obtaining consistently good postoperative astigmatic results without the need for suture removal. The method presented is based upon concepts in common use in surgical ophthalmology and requires only simple mathematical procedures, familiar to all with a background in algebra and trigonometry.

Development of a real-time wave field reconstruction TEM system (II): correction of coma aberration and 3-fold astigmatism, and real-time correction of 2-fold astigmatism.

PubMed

Tamura, Takahiro; Kimura, Yoshihide; Takai, Yoshizo

2018-02-01

In this study, a function for the correction of coma aberration, 3-fold astigmatism and real-time correction of 2-fold astigmatism was newly incorporated into a recently developed real-time wave field reconstruction TEM system. The aberration correction function was developed by modifying the image-processing software previously designed for auto focus tracking, as described in the first article of this series. Using the newly developed system, the coma aberration and 3-fold astigmatism were corrected using the aberration coefficients obtained experimentally before the processing was carried out. In this study, these aberration coefficients were estimated from an apparent 2-fold astigmatism induced under tilted-illumination conditions. In contrast, 2-fold astigmatism could be measured and corrected in real time from the reconstructed wave field. Here, the measurement precision for 2-fold astigmatism was found to be ±0.4 nm and ±2°. All of these aberration corrections, as well as auto focus tracking, were performed at a video frame rate of 1/30 s. Thus, the proposed novel system is promising for quantitative and reliable in situ observations, particularly in environmental TEM applications.

Correction of low corneal astigmatism in cataract surgery

PubMed Central

Leon, Pia; Pastore, Marco Rocco; Zanei, Andrea; Umari, Ingrid; Messai, Meriem; Negro, Corrado; Tognetto, Daniele

2015-01-01

AIM To evaluate and compare aspheric toric intraocular lens (IOL) implantation and aspheric monofocal IOL implantation with limbal relaxing incisions (LRI) to manage low corneal astigmatism (1.0-2.0 D) in cataract surgery. METHODS A prospective randomized comparative clinical study was performed. There were randomly recruited 102 eyes (102 patients) with cataracts associated with corneal astigmatism and divided into two groups. The first group received toric IOL implantation and the second one monofocal IOL implantation with peripheral corneal relaxing incisions. Outcomes considered were: visual acuity, postoperative residual astigmatism, endothelial cell count, the need for spectacles, and patient satisfaction. To determine the postoperative toric axis, all patients who underwent the toric IOL implantation were further evaluated using an OPD Scan III (Nidek Co, Japan). Follow-up lasted 6mo. RESULTS The mean uncorrected distance visual acuity (UCVA) and the best corrected visual acuity (BCVA) demonstrated statistically significant improvement after surgery in both groups. At the end of the follow-up the UCVA was statistically better in the patients with toric IOL implants compared to those patients who underwent implantation of monofocal IOL plus LRI. The mean residual refractive astigmatism was of 0.4 D for the toric IOL group and 1.1 D for the LRI group (P<0.01). No difference was observed in the postoperative endothelial cell count between the two groups. CONCLUSION The two surgical procedures demonstrated a significant decrease in refractive astigmatism. Toric IOL implantation was more effective and predictable compared to the limbal relaxing incision. PMID:26309869

Astigmatism error modification for absolute shape reconstruction using Fourier transform method

NASA Astrophysics Data System (ADS)

He, Yuhang; Li, Qiang; Gao, Bo; Liu, Ang; Xu, Kaiyuan; Wei, Xiaohong; Chai, Liqun

2014-12-01

A method is proposed to modify astigmatism errors in absolute shape reconstruction of optical plane using Fourier transform method. If a transmission and reflection flat are used in an absolute test, two translation measurements lead to obtain the absolute shapes by making use of the characteristic relationship between the differential and original shapes in spatial frequency domain. However, because the translation device cannot guarantee the test and reference flats rigidly parallel to each other after the translations, a tilt error exists in the obtained differential data, which caused power and astigmatism errors in the reconstructed shapes. In order to modify the astigmatism errors, a rotation measurement is added. Based on the rotation invariability of the form of Zernike polynomial in circular domain, the astigmatism terms are calculated by solving polynomial coefficient equations related to the rotation differential data, and subsequently the astigmatism terms including error are modified. Computer simulation proves the validity of the proposed method.

Preoperative corneal astigmatism among adult patients with cataract in Northern Nigeria

PubMed Central

Isyaku, Mohammed; Ali, Syed A; Hassan, Sadiq

2014-01-01

The prevalence and nature of corneal astigmatism among patients with cataract has not been well-documented in the resident African population. This retrospective study was undertaken to investigate preexisting corneal astigmatism in adult patients with cataract. We analyzed keratometric readings acquired by manual Javal-Schiotz keratometry before surgery between January 1, 2011 and December 31, 2011. There were 3,169 patients (3286 eyes) aged between 16 and 110 years involved with a Male to female ratio of 1.4:1. Mean keratometry in diopters was K1 = 43.99 and K2 = 43.80. Mean corneal astigmatism was 1.16 diopter and a majority (45.92%) of eyes had astigmatism between 1.00 and 1.99 diopters. Two-thirds of the eyes (66.9%) in this study had preoperative corneal astigmatism equal to or above 1.00 diopter. Findings will help local cataract surgeons to estimate the potential demand for toric intraocular lenses. PMID:25494254

Non-Orthogonal Corneal Astigmatism among Normal and Keratoconic Brazilian and Chinese populations.

PubMed

Abass, Ahmed; Clamp, John; Bao, FangJun; Ambrósio, Renato; Elsheikh, Ahmed

2018-06-01

To investigate the prevalence of non-orthogonal astigmatism among normal and keratoconic Brazilian and Chinese populations. Topography data were obtained using the Pentacam High Resolution (HR) system ® from 458 Brazilian (aged 35.6 ± 15.8 years) and 505 Chinese (aged 31.6 ± 10.8 years) eyes with no history of keratoconus or refractive surgery, and 314 Brazilian (aged 24.2 ± 5.7 years) and 74 Chinese (aged 22.0 ± 5.5 years) keratoconic eyes. Orthogonal values of optical flat and steep powers were determined by finding the angular positions of two perpendicular meridians that gave the maximum difference in power. Additionally, the angular positions of the meridians with the minimum and maximum optical powers were located while being unrestricted by the usual orthogonality assumption. Eyes were determined to have non-orthogonal astigmatism if the angle between the two meridians with maximum and minimum optical power deviated by more than 5° from 90°. Evidence of non-orthogonal astigmatism was found in 39% of the Brazilian keratoconic eyes, 26% of the Chinese keratoconic eyes, 29% of the Brazilian normal eyes and 20% of the Chinese normal eyes. The large percentage of participants with non-orthogonal astigmatism in both normal and keratoconic eyes illustrates the need for the common orthogonality assumption to be reviewed when correcting for astigmatism. The prevalence of non-orthogonality should be considered by expanding the prescription system to consider the two power meridians and their independent positions.

Characteristics of Posterior Corneal Astigmatism in Different Stages of Keratoconus.

PubMed

Aslani, Fereshteh; Khorrami-Nejad, Masoud; Aghazadeh Amiri, Mohammad; Hashemian, Hesam; Askarizadeh, Farshad; Khosravi, Bahram

2018-01-01

To evaluate the magnitudes and axis orientation of anterior corneal astigmatism (ACA) and posterior corneal astigmatism (PCA), the ratio of ACA to PCA, and the correlation between ACA and PCA in the different stages of keratoconus (KCN). This retrospective case series comprised 161 eyes of 161 patients with KCN (104 men, 57 women; mean age, 22.35 ± 6.10 years). The participants were divided into four subgroups according to the Amsler-Krumeich classification. A Scheimpflug imaging system was used to measure the magnitude and axis orientation of ACA and PCA. The posterior-anterior corneal astigmatism ratio was also calculated. The results were compared among different subgroups. The average amounts of anterior, posterior, and total corneal astigmatism were 4.08 ± 2.21 diopters (D), 0.86 ± 0.46 D, and 3.50 ± 1.94 D, respectively. With-the-rule, against-the-rule, and oblique astigmatisms of the posterior surface of the cornea were found in 61 eyes (37.9%), 67 eyes (41.6%), and 33 eyes (20.5%), respectively; corresponding figures in the anterior corneal surface were 55 eyes (32.4%), 56 eyes (34.8%), and 50 eyes (31.1%), respectively. A strong correlation ( P ≤ 0.001, r = 0.839) was found between ACA and PCA in the different stages of KCN; the correlation was weaker in eyes with grade 3 ( P ≤ 0.001, r = 0.711) and grade 4 ( P ≤ 0.001, r = 0.717) KCN. The maximum posterior-anterior corneal astigmatism ratio (PCA/ACA, 0.246) was found in patients with stage 1 KCN. Corneal astigmatism in anterior surface was more affected than posterior surface by increasing in the KCN severity, although PCA was more affected than ACA in an early stage of KCN.

Effects of local myopic defocus on refractive development in monkeys.

PubMed

Smith, Earl L; Hung, Li-Fang; Huang, Juan; Arumugam, Baskar

2013-11-01

Visual signals that produce myopia are mediated by local, regionally selective mechanisms. However, little is known about spatial integration for signals that slow eye growth. The purpose of this study was to determine whether the effects of myopic defocus are integrated in a local manner in primates. Beginning at 24 ± 2 days of age, seven rhesus monkeys were reared with monocular spectacles that produced 3 diopters (D) of relative myopic defocus in the nasal visual field of the treated eye but allowed unrestricted vision in the temporal field (NF monkeys). Seven monkeys were reared with monocular +3 D lenses that produced relative myopic defocus across the entire field of view (FF monkeys). Comparison data from previous studies were available for 11 control monkeys, 8 monkeys that experienced 3 D of hyperopic defocus in the nasal field, and 6 monkeys exposed to 3 D of hyperopic defocus across the entire field. Refractive development, corneal power, and axial dimensions were assessed at 2- to 4-week intervals using retinoscopy, keratometry, and ultrasonography, respectively. Eye shape was assessed using magnetic resonance imaging. In response to full-field myopic defocus, the FF monkeys developed compensating hyperopic anisometropia, the degree of which was relatively constant across the horizontal meridian. In contrast, the NF monkeys exhibited compensating hyperopic changes in refractive error that were greatest in the nasal visual field. The changes in the pattern of peripheral refractions in the NF monkeys reflected interocular differences in vitreous chamber shape. As with form deprivation and hyperopic defocus, the effects of myopic defocus are mediated by mechanisms that integrate visual signals in a local, regionally selective manner in primates. These results are in agreement with the hypothesis that peripheral vision can influence eye shape and potentially central refractive error in a manner that is independent of central visual experience.

Post-keratoplasty astigmatism management by relaxing incisions: a systematic review.

PubMed

Ho Wang Yin, Gaëlle; Hoffart, Louis

2017-01-01

Postoperative visual acuity can be limited by post-keratoplasty astigmatism, even with a clear corneal graft. Astigmatism management can be performed by selective suture removal, adjustment of sutures, optical correction, photorefractive procedures, wedge resection, intra-ocular lens implantation, intracorneal ring segments, relaxing incisions with or without compression sutures and repeated keratoplasty. Relaxing incisions can be made in the graft, graft-host interface or host cornea. Despite the unpredictability of the method because the flat and steep meridians are usually not orthogonal after penetrating keratoplasty, with asymmetric power distribution, all the studies showed an overall reduction of refractive, keratometric or topographic astigmatism, ranging from 30% to 72% with manual or femtosecond-assisted techniques. Most patients with astigmatism higher than 6 diopters had residual cylinder less than or equal to 3 diopters, which can be treated by laser excimer ablation or secondary intraocular lens implantation.

Diagnostic Accuracy of Optical Coherence Tomography and Scanning Laser Tomography for Identifying Glaucoma in Myopic Eyes.

PubMed

Malik, Rizwan; Belliveau, Anne C; Sharpe, Glen P; Shuba, Lesya M; Chauhan, Balwantray C; Nicolela, Marcelo T

2016-06-01

Ruling out glaucoma in myopic eyes often poses a diagnostic challenge because of atypical optic disc morphology and visual field defects that can mimic glaucoma. We determined whether neuroretinal rim assessment based on Bruch's membrane opening (BMO), rather than conventional optic disc margin (DM)-based assessment or retinal nerve fiber layer (RNFL) thickness, yielded higher diagnostic accuracy in myopic patients with glaucoma. Case-control, cross-sectional study. Myopic patients with glaucoma (n = 56) and myopic normal controls (n = 74). Myopic subjects with refraction error greater than -2 diopters (D) (spherical equivalent) and typical myopic optic disc morphology, with and without glaucoma, were recruited from a glaucoma clinic and a local optometry practice. The final classification of myopic glaucoma or myopic control was based on consensus assessment by 3 clinicians of visual fields and optic disc photographs. Participants underwent imaging with confocal scanning laser tomography for measurement of DM rim area (DM-RA) and with spectral domain optical coherence tomography (SD OCT) for quantification of a BMO-based neuroretinal rim parameter, minimum rim width (BMO-MRW), and RNFL thickness. Sensitivity of DM-RA, BMO-MRW, and RNFL thickness at a fixed specificity of 90% and partial area under the curves (pAUCs) for global and sectoral parameters for specificities ≥90%. Sensitivities at 90% specificity were 30% for DM-RA and 71% for both BMO-MRW and RNFL thickness. The pAUC was higher for the BMO-MRW compared with DM-RA (P < 0.001), but similar to RNFL thickness (P > 0.5). Sectoral values of BMO-MRW tended to have a higher, but nonsignificant, pAUC across all sectors compared with RNFL thickness. Bruch's membrane opening MRW is more sensitive than DM-RA and similar to RNFL thickness for the identification of glaucoma in myopic eyes and offers a valuable diagnostic tool for patients with glaucoma with myopic optic discs. Copyright © 2016 American Academy

Ocular Biometrics of Myopic Eyes With Narrow Angles.

PubMed

Chong, Gabriel T; Wen, Joanne C; Su, Daniel Hsien-Wen; Stinnett, Sandra; Asrani, Sanjay

2016-02-01

The purpose of this study was to compare the ocular biometrics between myopic patients with and without narrow angles. Patients with a stable myopic refraction (myopia worse than -1.00 D spherical equivalent) were prospectively recruited. Angle status was assessed using gonioscopy and biometric measurements were performed using an anterior segment optical coherence tomography and an IOLMaster. A total of 29 patients (58 eyes) were enrolled with 13 patients (26 eyes) classified as having narrow angles and 16 patients (32 eyes) classified as having open angles. Baseline demographics of age, sex, and ethnicity did not differ significantly between the 2 groups. The patients with narrow angles were on average older than those with open angles but the difference did not reach statistical significance (P=0.12). The central anterior chamber depth was significantly less in the eyes with narrow angles (P=0.05). However, the average lens thickness, although greater in the eyes with narrow angles, did not reach statistical significance (P=0.10). Refractive error, axial lengths, and iris thicknesses did not differ significantly between the 2 groups (P=0.32, 0.47, 0.15). Narrow angles can occur in myopic eyes. Routine gonioscopy is therefore recommended for all patients regardless of refractive error.

Astigmatic Herriott cell for optical refrigeration

NASA Astrophysics Data System (ADS)

Gragossian, Aram; Meng, Junwei; Ghasemkhani, Mohammadreza; Albrecht, Alexander R.; Sheik-Bahae, Mansoor

2017-01-01

Cooling rare-earth-doped crystals to the lowest temperature possible requires enhanced resonant absorption and high-purity crystals. Since resonant absorption decreases as the crystal is cooled, the only path forward is to increase the number of roundtrips that the laser makes inside the crystal. To achieve even lower temperatures than previously reported, we have employed an astigmatic Herriott cell to improve laser absorption at low temperatures. Preliminary results indicate improvement over previous designs. This cavity potentially enables us to use unpolarized high-power fiber lasers, and to achieve much higher cooling power for practical applications.

Supra choroidal buckling in managing myopic vitreoretinal interface disorders: 1-year data.

PubMed

El Rayes, Ehab N

2014-01-01

To evaluate the efficacy of supra choroidal buckling procedure using a supra choroidal catheter, as a new approach in treating myopic vitreomacular interface disorders specially in difficult cases of myopic traction maculopathy with or without macular hole retinal detachment in posterior staphyloma depending on the concept of indenting the choroid only, from a 1-year data study. A newly developed supra choroidal catheter was used to deliver stabilized, cross-linked, long-acting hyaluronic acid as a filler in the supra choroidal space in the area of the staphyloma forming a choroidal indenting effect. Before the injection, pars plana vitrectomy was performed without internal limiting membrane peeling to avoid the risk of break of the roof of foveal detachment in case of foveoschisis. This indentation was used to treat 11 patients with myopic foveoschisis and 12 patients with myopic macular hole retinal detachment, 5 of whom had failed primary repair by vitrectomy before inclusion in this trial. Clinical and optical coherence tomographic evaluations of these patients were performed over 1-year follow-up. Retinal layer restoration was achieved in all 11 eyes with myopic foveoschisis. This was gradual over a period of 2 to 6 weeks postoperatively. No recurrence over the 12-month follow-up was observed. Visual acuity improved by 1 line or more in 9 eyes (81.8%). Of the 12 eyes, 10 with macular hole detachment (83%) showed closure of the holes in association with the resolution of the detachment; 2 eyes showed resolution of the detachment and flatting of the edge of the holes but with incomplete closure on optical coherence tomography. Eight eyes (66.6%) showed improvement in visual acuity by 1 or more lines with no recurrence of retinal detachment over the 12-month follow-up period. The indentation effect was sufficient over the 12-month follow-up period. The indentation effect achieved by supra choroidal approach can be used as a method of managing myopic foveoschisis

Beginnings of Astigmatism Understanding and Management in the 19th Century.

PubMed

Grzybowski, Andrzej; Kanclerz, Piotr

2017-11-14

Within the last 200 years, the perception of astigmatism has evolved from that of an infrequent and peculiar defect of the eye to a distortion almost as common as spherical refractive errors. Most of the significant findings on this condition were made in the 19th century, including the first description by Thomas Young (1773-1829) and the introduction of the treatment methods used today. The purpose of this study was to investigate the milestones in the understanding and management of astigmatism that occurred up to the year 1900. This fascinating history illustrates how knowledge evolves across time, geographical areas, and interdisciplinary boundaries. The first article looking at the use of a cylindrical lens to correct astigmatism was written by George Airy (1801-1892) in 1825. The term "astigmatism" was introduced in by William Whewell (1794-1866) in 1846. Methods for subjective and objective evaluation were subsequently established, including the introduction of a cross cylinder, keratoscope, astigmatic dial, and the development of retinoscopy and ophthalmoscopy. In the last two decades of the 19th century, the first attempt to alter the refraction in astigmatic patients by changing the shape of the cornea was made. It must be noted that diverse challenges were encountered in this field on the way to the development of a treatment, including the technical manufacture of a lens, the precise measurement of the refractive error, and understanding the optical properties of the eye. The importance of the 19th century was that interdisciplinary cooperation, such as that seen in this study, between physicists and astronomers, and mathematicians and physicians, led to the development of comprehensive knowledge on astigmatism.

An analysis of the factors influencing the residual refractive astigmatism after cataract surgery with toric intraocular lenses.

PubMed

Savini, Giacomo; Næser, Kristian

2015-01-13

To investigate the influence of posterior corneal astigmatism, surgically-induced corneal astigmatism (SICA), intraocular lens (IOL) orientation, and effective lens position on the refractive outcome of toric IOLs. Five models were prospectively investigated. Keratometric astigmatism and an intended SICA of 0.2 diopters (D) were entered into model 1. Total corneal astigmatism, measured by a rotating Scheimpflug camera, was used instead of keratometric astigmatism in model 2. The mean postoperative SICA, the actual postoperative IOL orientation, and the influence of the effective lens position were added, respectively, into models 3, 4, and 5. Astigmatic data were vectorially described by meridional and torsional powers. A set of equations was developed to describe the error in refractive astigmatism (ERA) as the difference between the postoperative refractive astigmatism and the target refractive astigmatism. We enrolled 40 consecutive eyes. In model 1, ERA calculations revealed significant cylinder overcorrection in with-the-rule (WTR) eyes (meridional power = -0.59 ± 0.34 D, P < 0.0001) and undercorrection in against-the-rule (ATR) eyes (0.32 ± 0.42 D, P = 0.01). When total corneal astigmatism was used instead of keratometric astigmatism (model 2), the ERA meridional power decreased in WTR (-0.13 ± 0.42 D) and ATR (0.07 ± 0.59 D) eyes, both values being not statistically significant. Models 3 to 5 did not lead to significant improvement. Posterior corneal astigmatism exerts the highest influence on the ERA after toric IOL implantation. Basing calculations on total corneal astigmatism rather than keratometric astigmatism improves the prediction of the residual refractive astigmatism. Copyright 2015 The Association for Research in Vision and Ophthalmology, Inc.

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.

A comparison between Goldmann applanation tonometry and dynamic contour tonometry after photorefractive keratectomy.

PubMed

Sadigh, Afshin Lotfi; Fouladi, Rohollah F; Hashemi, Hassan; Beheshtnejad, Amir Houshang

2013-02-01

The intraocular pressure (IOP) could be measured by both Goldmann applanation tonometry (GAT) and dynamic contour tonometry (DCT). Although these two methods have been discussed widely after laser-assisted sub-epithelial keratectomy (LASIK), there is little data in the cases undergoing photorefractive keratectomy (PRK). We aimed to compare the changes of IOP measurements obtained by GAT and DCT after PRK for myopia/myopic astigmatism. This prospective study enrolled 77 candidates (154 eyes) for PRK to correct myopia or myopic astigmatism and 30 matched patients (30 eyes) with myopia or myopic astigmatism who served as controls. Changes of the IOP measurements (ΔIOP) obtained by GAT and DCT before and at 6 months after PRK in the operated eyes, and at baseline and 6 months later in the controls, were documented. Changes of the central corneal thickness (ΔCCT) were determined in the same fashion. The mean IOP readings obtained by DCT were comparable before and at 6 months after procedure (18.34 ± 3.03 mmHg and 17.87 ± 2.61 mmHg respectively, p = 0.41); whereas the mean IOP reading obtained by GAT decreased significantly 6 months postoperatively (17.92 ± 3.63 mmHg and 16.25 ± 2.66 mmHg, p < 0.001). A significant correlation was present between the ΔIOP obtained by GAT and ΔCCT (r = 0.61, p < 0.001). Similar correlation was not significant between the DCT-obtained ΔIOP and the ΔCCT (r = 0.07, p = 0.44). The mean ΔIOP obtained by GAT was significantly higher in the operated eyes than in the controls (-1.54 ± 1.45 vs 0.07 ± 0.44 mmHg, p = 0.02). The mean DCT-obtained ΔIOP was just marginally insignificant between the operated and nonoperated eyes (-0.63 ± 0.59 vs 0.02 ± 0.38 mmHg respectively; p = 0.09). The authors recommend DCT after PRK in the cases with myopia or myopic astigmatism.

Distribution of the anterior, posterior, and total corneal astigmatism in healthy eyes.

PubMed

Feizi, Sepehr; Naderan, Mohammad; Ownagh, Vahid; Sadeghpour, Fatemeh

2018-04-01

To evaluate the magnitude and axis orientation of the anterior, posterior, and total corneal astigmatism in normal healthy eyes of an Iranian population. In a prospective cross-sectional study, ophthalmic and anterior segment parameters of 153 healthy eyes of 153 subjects were evaluated by Galilei dual Scheimpflug analyzer. The magnitude and axis orientation [with-the-rule (WTR), against-the-rule (ATR), and oblique] of the anterior, posterior, and total corneal astigmatism measurements (ACA, PCA, and TCA) were compared according to the age, sex, and other ophthalmic parameters. The mean ± SD age of the study population was 30 ± 5.9 years. The mean magnitude was 1.09 ± 0.76 diopters (D) for ACA, 0.30 ± 0.13 D for PCA, and 1.08 ± 0.77 D for TCA. Males had a significantly higher magnitude of PCA than females (p = 0.041). Most eyes had a WTR anterior astigmatism and an ATR posterior astigmatism. The WTR astigmatism had a higher mean magnitude compared to the ATR and oblique astigmatism in all the astigmatism groups, with a significant difference in the ACA and TCA groups (p < 0.05). PCA magnitude exceeded 0.50 D in only 7.8% of the subjects. ACA, PCA, and TCA were significantly correlated with each other and also had a significant correlation with the anterior and posterior maximum corneal elevation measurements (p < 0.001). The results of this study although are limited due to the small number of participants and confined to our demographics, provided information regarding a population that was not described before and may be helpful in obtaining optimum results in astigmatism correction in refractive surgery or designing new intraocular lenses.

Oregon Elks Children's Eye Clinic vision screening results for astigmatism.

PubMed

Vaughan, Joannah; Dale, Talitha; Herrera, Daniel; Karr, Daniel

2018-04-19

In the Elks Preschool Vision Screening program, which uses the plusoptiX S12 to screen children 36-60 months of age, the most common reason for over-referral, using the 1.50 D referral criterion, was found to be astigmatism. The goal of this study was to compare the accuracy of the 2.25 D referral criterion for astigmatism to the 1.50 D referral criterion using screening data from 2013-2014. Vision screenings were conducted on Head Start children 36-72 months of age by Head Start teachers and Elks Preschool Vision Screening staff using the plusoptiX S12. Data on 4,194 vision screenings in 2014 and 4,077 in 2013 were analyzed. Area under the curve (AUC) and receiver operating characteristic curve (ROC) analysis were performed to determine the optimal referral criteria. A t test and scatterplot analysis were performed to compare how many children required treatment using the different criteria. The medical records of 136 (2.25 D) and 117 children (1.50 D) who were referred by the plusoptiX screening for potential astigmatism and received dilated eye examinations from their local eye doctors were reviewed retrospectively. Mean subject age was 4 years. Treatment for astigmatism was prescribed to 116 of 136 using the 2.25 D setting compared to 60 of 117 using the 1.50 D setting. In 2013 the program used the 1.50 D setting for astigmatism. Changing the astigmatism setting to 2.25 D; , 85% of referrals required treatment, reducing false positives by 34%. Copyright © 2018. Published by Elsevier Inc.

Characteristics of astigmatism as a function of age in a Hong Kong clinical population.

PubMed

Leung, Tsz-Wing; Lam, Andrew Kwok-Cheung; Deng, Li; Kee, Chea-Su

2012-07-01

To characterize astigmatism as a function of age in a Hong Kong clinical population. All records from new clinical patients at a university optometry clinic in the year 2007 were used for the study. Only data from subjects with corrected visual acuity ≥6/9 in both eyes and with completed subjective refraction were analyzed. The subjects were divided into seven age groups by decade (i.e., 3 to 10 years, 11 to 20 years, …, >60 years). Refractive errors were decomposed into spherical-equivalent refractive error (M), J0, and J45 astigmatic components for analyses. Internal astigmatism was calculated by subtracting corneal astigmatism from refractive astigmatism (RA). Of the 2759 cases that fulfilled our selection criteria, 58.9% had myopia (M ≥-0.75 D) and 28.4% had RA (Cyl ≥ 1.00 D). The prevalence of RA increased from 17.8% in the 3 to 10 years age group to 38.1% in the 21 to 30 years age group. It then dipped to 25.8% in 41 to 50 years age group but increased again to 41.8% in the >60 years age group. Among the astigmats, almost all 3- to 10-year-old children (92.6%) had with-the-rule (WTR) astigmatism, but a majority of the elderly (>60 years) had against-the-rule (ATR) astigmatism (79.7%). For a subset of subjects who had both subjective refraction and keratometric readings (n = 883), RA was more strongly correlated with corneal (r = 0.35 to 0.74) than with internal astigmatism (r = 0.01 to 0.35). More importantly, the magnitudes of both refractive and corneal J0 were consistent with synchronized decrements (-0.15 and -0.14 D per 10 years, respectively) after the age of 30 years, indicating that the shift toward more ATR astigmatism was related to corneal change. In this Hong Kong Chinese clinical population, the prevalence rates of both myopia and astigmatism increased during the first three decades and shared a similar trend before the age of 50 years. The manifest astigmatism was mainly corneal in nature, bilaterally mirror symmetric in axis, and

What is the influence of parents' myopia on their children's myopic progression? A 22-year follow-up study.

PubMed

Pärssinen, Olavi; Kauppinen, Markku

2016-09-01

To study the connection between parental myopia and their children's myopia from school age to adulthood. Two hundred and forty myopic schoolchildren (119 boys, 121 girls, mean age 10.9 years) with no previous spectacles for myopia were recruited to a 3-year treatment trial with different use of spectacles. Follow-ups were performed at mean ages of 13.9, 23.7 and 33.2 years for 238, 176 and 170 subjects respectively. Subjective refraction was calibrated to the spherical equivalent at corneal level (SEcor). Corneal refractive power (CR) and axial length (AL) were measured. Parental myopia was assessed with a questionnaire and the children assigned accordingly to one of three hereditary groups: both parents myopic H++, one myopic parent = H+- and no myopic parents = H-. At baseline, no significant gender differences in age or SEcor were found in the different hereditary groups. Among girls, CR was significantly higher in hereditary group H++ (45.20 ± 1.08 D) than in group H+- (44.19 ± 1.28 D; p = 0.006) or H- (43.84 ± 1.18 D; p < 0.001). Among boys, the differences in CR between the hereditary groups were smaller and significant at follow-up 2 only. At follow-up end, among males, no significant differences between the hereditary groups were found in SEcor, CR, AL or myopic progression. Among females, myopic progression was 4.21 ± 1.81 D if one or both parents were myopic and -3.19 ± 1.36 D if neither parent was myopic (p = 0.035), but no significant difference was observed in AL. The main difference between the hereditary groups was higher CR and myopic progression among females with myopic parents than non-myopic parents, but with no significant difference in AL with respect to parental myopia at study end. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Inheritance of astigmatism: evidence for a major autosomal dominant locus.

PubMed Central

Clementi, M; Angi, M; Forabosco, P; Di Gianantonio, E; Tenconi, R

1998-01-01

Although astigmatism is a frequent refractive error, its mode of inheritance remains uncertain. Complex segregation analysis was performed, by the POINTER and COMDS programs, with data from a geographically well-defined sample of 125 nuclear families of individuals affected by astigmatism. POINTER could not distinguish between alternative genetic models, and only the hypothesis of no familial transmission could be rejected. After inclusion of the severity parameter, COMDS results defined a genetic model for corneal astigmatism and provided evidence for single-major-locus inheritance. These results suggest that genetic linkage studies could be implemented and that they should be limited to multiplex families with severely affected individuals. PMID:9718344

Transformation of the optical vortex dipole by an astigmatic lens

NASA Astrophysics Data System (ADS)

Yan, Hongwei; Lü, Baida

2009-06-01

The transformation of the optical vortex dipole (OVD) by an astigmatic lens is studied. The explicit propagation expression of the OVD nested in a Gaussian beam is derived and used to analytically determine the position of the OVD after the passage through the astigmatic lens. The transformation by an aberration-free lens is treated as a special case. It is shown that, depending on the propagation distance, waist width, off-axis distance and astigmatic coefficient, the motion, annihilation and revival of the OVD and the inversion of the topological charge may take place. Specifically, the creation of two OVDs may appear under certain conditions. The results are illustrated by numerical examples.

Laser in situ keratomileusis for astigmatism ≤ 0.75 Diopter combined with low myopia: a retrospective data analysis

PubMed Central

2014-01-01

Background This study examined the refractive and visual outcome of wavefront-optimized laser in situ keratomileusis (LASIK) in eyes with low myopia and compound myopic astigmatism ≤ 0.75 diopter (D). Methods 153 eyes from 153 consecutive myopic patients (74 male, 79 female; mean age at surgery 40.4 ± 10.4 years) who had a preoperative refractive cylinder ≤ 0.75 D and a manifest sphere between -0.25 D and -2.75 D, and who had completed 4-month follow-up. Three subgroups defined by the magnitude of preoperative manifest refractive cylinder (0.25, 0.50, and 0.75 D) were formed. Manifest refraction, uncorrected and corrected visual acuity were assessed pre- and postoperatively. The astigmatic changes achieved were determined using the Alpins vector analysis. Results After 4 months (120.0 ± 27.6 days) of follow-up, a mean uncorrected distant visual acuity of 0.07 ± 0.11 logMAR and a mean manifest refraction spherical equivalent of -0.06 ± 0.56 D were found. There was no statistically significant difference in efficacy and safety between the preoperative cylinder groups. Astigmatic overcorrection for preoperative cylinder of ≤ 0.50 D was suggested by the correction index, the magnitude of error, the index of success, and the flattening index. Conclusions Low myopic eyes with a preoperative cylinder of ≤ 0.50 D were significantly overcorrected with regard to cylinder correction when combined with low myopic LASIK. Accordingly, we are cautious in recommending full astigmatic correction for eyes with low myopia and manifest cylinder of ≤ 0.50 D. PMID:24393469

Vector Analysis of Corneal Astigmatism After Combined Femtosecond-Assisted Phacoemulsification and Arcuate Keratotomy.

PubMed

Chan, Tommy C Y; Cheng, George P M; Wang, Zheng; Tham, Clement C Y; Woo, Victor C P; Jhanji, Vishal

2015-08-01

To evaluate the outcomes of femtosecond-assisted arcuate keratotomy combined with cataract surgery in eyes with low to moderate corneal astigmatism. Retrospective, interventional case series. This study included patients who underwent combined femtosecond-assisted phacoemulsification and arcuate keratotomy between March 2013 and August 2013. Keratometric astigmatism was evaluated before and 2 months after the surgery. Vector analysis of the astigmatic changes was performed using the Alpins method. Overall, 54 eyes of 54 patients (18 male and 36 female; mean age, 68.8 ± 11.4 years) were included. The mean preoperative (target-induced astigmatism) and postoperative astigmatism was 1.33 ± 0.57 diopters (D) and 0.87 ± 0.56 D, respectively (P < .001). The magnitude of error (difference between surgically induced and target-induced astigmatism) (-0.13 ± 0.68 D), as well as the correction index (ratio of surgically induced and target-induced astigmatism) (0.86 ± 0.52), demonstrated slight undercorrection. The angle of error was very close to 0, indicating no significant systematic error of misaligned treatment. However, the absolute angle of error showed a less favorable range (17.5 ± 19.2 degrees), suggesting variable factors such as healing or alignment at an individual level. There were no intraoperative or postoperative complications. Combined phacoemulsification with arcuate keratotomy using femtosecond laser appears to be a relatively easy and safe means for management of low to moderate corneal astigmatism in cataract surgery candidates. Misalignment at an individual level can reduce its effectiveness. This issue remains to be elucidated in future studies. Copyright © 2015 Elsevier Inc. All rights reserved.

Myopic Macular Retinoschisis in Teenagers: Clinical Characteristics and Spectral Domain Optical Coherence Tomography Findings

PubMed Central

Sun, Chuan-bin; You, Yong-sheng; Liu, Zhe; Zheng, Lin-yan; Chen, Pei-qing; Yao, Ke; Xue, An-quan

2016-01-01

To investigate the morphological characteristics of myopic macular retinoschisis (MRS) in teenagers with high myopia, six male (9 eyes) and 3 female (4 eyes) teenagers with typical MRS identified from chart review were evaluated. All cases underwent complete ophthalmic examinations including best corrected visual acuity (BCVA), indirect ophthalmoscopy, colour fundus photography, B-type ultrasonography, axial length measurement, and spectral-domain optical coherence tomography (SD-OCT). The average age was 17.8 ± 1.5 years, average refractive error was −17.04 ± 3.04D, average BCVA was 0.43 ± 0.61, and average axial length was 30.42 ± 1.71 mm. Myopic macular degenerative changes (MDC) by colour fundus photographs revealed Ohno-Matsui Category 1 in 4 eyes, and Category 2 in 9 eyes. Posterior staphyloma was found in 9 eyes. SD-OCT showed outer MRS in all 13 eyes, internal limiting membrane detachment in 7 eyes, vascular microfolds in 2 eyes, and inner MRS in 1 eye. No premacular structures such as macular epiretinal membrane or partially detached posterior hyaloids were found. Our results showed that MRS rarely occurred in highly myopic teenagers, and was not accompanied by premacular structures, severe MDC, or even obvious posterior staphyloma. This finding indicates that posterior scleral expansion is probably the main cause of MRS. PMID:27294332

Refractive errors in children and adolescents in Bucaramanga (Colombia).

PubMed

Galvis, Virgilio; Tello, Alejandro; Otero, Johanna; Serrano, Andrés A; Gómez, Luz María; Castellanos, Yuly

2017-01-01

The aim of this study was to establish the frequency of refractive errors in children and adolescents aged between 8 and 17 years old, living in the metropolitan area of Bucaramanga (Colombia). This study was a secondary analysis of two descriptive cross-sectional studies that applied sociodemographic surveys and assessed visual acuity and refraction. Ametropias were classified as myopic errors, hyperopic errors, and mixed astigmatism. Eyes were considered emmetropic if none of these classifications were made. The data were collated using free software and analyzed with STATA/IC 11.2. One thousand two hundred twenty-eight individuals were included in this study. Girls showed a higher rate of ametropia than boys. Hyperopic refractive errors were present in 23.1% of the subjects, and myopic errors in 11.2%. Only 0.2% of the eyes had high myopia (≤-6.00 D). Mixed astigmatism and anisometropia were uncommon, and myopia frequency increased with age. There were statistically significant steeper keratometric readings in myopic compared to hyperopic eyes. The frequency of refractive errors that we found of 36.7% is moderate compared to the global data. The rates and parameters statistically differed by sex and age groups. Our findings are useful for establishing refractive error rate benchmarks in low-middle-income countries and as a baseline for following their variation by sociodemographic factors.

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

Can Opposite Clear Corneal Incisions Have a Role with Post-laser In Situ Keratomileusis Astigmatism?

PubMed Central

El-Awady, Hatem; Ghanem, Asaad A.

2012-01-01

Purpose: To evaluate the astigmatic correcting effect of paired opposite clear corneal incisions (OCCIs) on the steep axis in patients with residual astigmatism after laser in situ keratomileusis (LASIK) Materials and Methods: Thirty-one eyes of 24 patients with a mean age of 28.4 years ±2.46 (range, 19-36 years) were recruited for the study. Inclusion criteria included residual astigmatism of ≥1.5 diopter (D) after LASIK with inadequate residual stromal bed thickness that precluded ablation. The cohort was divided into two groups; group I (with astigmatism ranging from -1.5 D to -2.5 D) and group II (with astigmatism > -2.5 D). The steep axis was marked prior to surgery. Paired three-step self-sealing opposite clear corneal incisions were performed 1-mm anterior to the limbus on the steep axis with 3.2-mm keratome for group I and 4.1 mm for group II. Patients were examined 1 day, 1 week, 1 month, 3 months and 6 months, postoperatively. Visual acuity, refraction, keratometry, and corneal topography were evaluated preoperatively and postoperatively. Analysis of the difference between groups was performed with the Student t-test. P<0.05 was considered statistically significant. Results: The mean uncorrected visual acuity (UCVA) improved from 0.35±0.13 (range, 0.1-0.6) to 0.78±0.19 (range, 0.5-1) in group I and from 0.26±0.19 (range, 0.1-0.5) to 0.7±0.18 (range, 0.4-1) in group II. The increase in UCVA was statistically significant in both groups (P=0.001, both cases). The mean preoperative and postoperative keratometric astigmatism in group I was 2.0±0.48 D (range, 1.5-2.5 D) and 0.8±0.37 D (range, 0.1-1.4 D), respectively. The decrease in keratometric astigmatism was highly statistically significant in group II (P=0.001.). Mean surgically induced astigmatic reduction by vector analysis was 1.47±0.85 D and 2.21±0.97 D in groups I and II respectively. There were no incision-related complications. Conclusions: Paired OCCIs were predictable and effective in

Corneal Astigmatism Stability in Descemet Membrane Endothelial Keratoplasty for Fuchs Corneal Dystrophy.

PubMed

Yokogawa, Hideaki; Sanchez, P James; Mayko, Zachary M; Straiko, Michael D; Terry, Mark A

2016-07-01

To calculate the magnitude and angle of the shift in corneal astigmatism associated with Descemet membrane endothelial keratoplasty (DMEK) surgery to determine the feasibility of concurrent astigmatism correction at the time of DMEK triple procedures. Retrospective study. Forty-seven eyes that previously underwent the DMEK procedure for Fuchs endothelial corneal dystrophy and that had more than 1.0 diopter (D) of front corneal astigmatism preoperatively were identified. All DMEK surgeries used a clear corneal temporal incision of 3.2 mm. Surgically induced astigmatism (SIA) was evaluated 6 months postsurgery with vector analysis using Scheimpflug image reading. We did not find a difference between pre- and postoperative magnitude of front astigmatism (P = 0.88; paired t test). The magnitude of the SIA front surface was 0.77 ± 0.63 D (range, 0.10-3.14 D). The centroid vector of the SIA front surface was 0.14 at 89.3°. A hyperopic corneal power shift was noted in both the front surface by 0.26 ± 0.74 D (range, 0.45-3.05 D) (P = 0.018; paired t test) and back surface by 0.56 ± 0.55 D (range, 0.25-2.40 D) (P < 0.01; paired t test). DMEK surgery induces minimal amounts of corneal astigmatism that is a with-the-rule shift associated with a temporal clear corneal incision. The stability of these data from preop to postop supports the plausibility of incorporating astigmatism correction with the cautious use of toric intraocular lenses for patients with Fuchs corneal dystrophy and cataract.

Incidence and distribution of paravascular lamellar holes and their relationship with macular retinoschisis in highly myopic eyes using spectral-domain oct.

PubMed

Vela, José I; Sánchez, Fernando; Díaz-Cascajosa, Jesús; Mingorance, Ester; Andreu, David; Buil, José A

2016-04-01

The purpose of the study is to determine the incidence and distribution of paravascular lamellar holes (PLH) around retinal vessels in highly myopic eyes and their relationship with macular retinoschisis (MR). We examined 306 eyes of 178 patients with high myopia, performing multiple scans of the posterior pole within the retinal vascular arcades using spectral-domain OCT. Type of staphyloma was determined. PLH were divided into three groups: holes only (group 1), holes extending below vessels (group 2), and holes in an area of paravascular retinoschisis (group 3). OCT showed that 96/306 eyes (31.4 %) had PLH mainly along the infero-temporal arcade (39.9 %). Type V and IX staphylomas had a higher proportion of PLH in the infero-temporal arcade than other staphylomas. Group 3 eyes presented higher rates of myopia and staphyloma. MR was detected in 10/27 eyes (37 %) in Group 3, but only in 2/33 eyes (6.1 %) in Group 1. No MR was found in Group 2. PLH are relatively common in highly myopic eyes and mainly distributed in the inferior temporal arcade. Findings from this descriptive study suggest that distribution of PLH might be related to the type of staphyloma. Further studies are needed to evaluate the relevance of PLH in the pathogenesis of MR.

Detection of Myopic Choroidal Neovascularization Using Optical Coherence Tomography Angiography.

PubMed

Miyata, Manabu; Ooto, Sotaro; Hata, Masayuki; Yamashiro, Kenji; Tamura, Hiroshi; Akagi-Kurashige, Yumiko; Nakanishi, Hideo; Ueda-Arakawa, Naoko; Takahashi, Ayako; Kuroda, Yoshimasa; Wakazono, Tomotaka; Yoshikawa, Munemitsu; Yoshimura, Nagahisa

2016-05-01

To assess whether optical coherence tomography angiography (OCTA) can be used as an alternative to conventional fundus fluorescein angiography (FFA) for the detection of myopic choroidal neovascularization (CNV). Validity and reliability analysis. Twenty-eight eyes of 26 consecutive Japanese patients with exudative lesions associated with pathologic myopia were included in this institutional study. Myopic CNV was detected in 23 eyes of 22 patients; 5 eyes exhibited simple hemorrhage. The main outcome measure was CNV detection by OCTA and FFA. The CNV area was individually measured by FFA and OCTA. Intraclass correlation coefficients (ICCs) for the CNV area, independently measured by 2 investigators using OCTA and FFA, were determined. OCTA images with sufficient quality for CNV assessment were obtained for 17 eyes with CNV and 4 without. FFA alone detected CNV in all 17 eyes, while OCTA alone detected CNV in 16 (94.1%). The 1 eye for which CNV was not detected by OCTA exhibited a 0.01 mm(2) area on FFA. Both FFA and OCTA did not detect CNV in eyes with simple hemorrhage. The mean CNV areas on FFA and OCTA were 0.59 ± 0.56 mm(2) and 0.51 ± 0.55 mm(2), respectively; the 2 values were significantly correlated (P < .001, r = .86). The ICC (2, 1) values for FFA and OCTA were 0.944 and 0.997, respectively. Our results indicate that OCTA can detect most myopic CNVs if high-quality images are acquired and can preclude the requirement for FFA in these settings. Copyright © 2016 Elsevier Inc. All rights reserved.

Feedforward operation of a lens setup for large defocus and astigmatism correction

NASA Astrophysics Data System (ADS)

Verstraete, Hans R. G. W.; Almasian, MItra; Pozzi, Paolo; Bilderbeek, Rolf; Kalkman, Jeroen; Faber, Dirk J.; Verhaegen, Michel

2016-04-01

In this manuscript, we present a lens setup for large defocus and astigmatism correction. A deformable defocus lens and two rotational cylindrical lenses are used to control the defocus and astigmatism. The setup is calibrated using a simple model that allows the calculation of the lens inputs so that a desired defocus and astigmatism are actuated on the eye. The setup is tested by determining the feedforward prediction error, imaging a resolution target, and removing introduced aberrations.

Repair of Irregularly Irregular Astigmatism by Transepithelial Phototherapeutic Keratectomy.

PubMed

Guglielmetti, Stefano; Kirton, Amy; Reinstein, Dan Z; Carp, Glenn I; Archer, Timothy J

2017-10-01

To evaluate the outcome of transepithelial phototherapeutic keratectomy (PTK) in the management of irregularly irregular astigmatism. This was a case series of two patients who underwent transepithelial PTK for irregularly irregular astigmatism. In the first case, the patient complained of diplopia due to corneal scarring caused by a metallic foreign body injury. The topography demonstrated irregularly irregular astigmatism with significant asymmetry in the inferotemporal to superonasal axis. In the second case, the patient complained of blurred vision and ghosting caused by significant central epithelial ingrowth through a buttonhole LASIK flap, which was causing a localized irregularity on topography. Due to the localized nature of the irregularities, a transepithelial PTK treatment was preferred to custom ablation given the degree of epithelial masking present. Transepithelial PTK was performed in both cases using the Schwind Amaris 500E excimer laser (Schwind eye-tech-solutions, Kleinostheim, Germany) and an 8-mm optical zone. The ablation depth was planned to reach the depth of the epithelium using a stepwise protocol, reviewing the pattern of the remaining epithelium and regularity of the stromal surface between each ablation. A marked improvement in the regularity of the topography was achieved in both cases, with only regular astigmatism remaining. Both patients reported a subjective improvement in quality of vision and the corrected distance visual acuity improved by one and two lines, respectively. Transepithelial PTK was effective in treating these cases of localized irregularly irregular astigmatism, achieving both objective and subjective improvement in vision. Compensatory epithelial remodeling over the irregularities enabled the transepithelial PTK approach to target the stromal surface irregularities. [J Refract Surg. 2017;33(10):714-719.]. Copyright 2017, SLACK Incorporated.

Quasi-Bessel beams from asymmetric and astigmatic illumination sources.

PubMed

Müller, Angelina; Wapler, Matthias C; Schwarz, Ulrich T; Reisacher, Markus; Holc, Katarzyna; Ambacher, Oliver; Wallrabe, Ulrike

2016-07-25

We study the spatial intensity distribution and the self-reconstruction of quasi-Bessel beams produced from refractive axicon lenses with edge emitting laser diodes as asymmetric and astigmatic illumination sources. Comparing these to a symmetric mono-mode fiber source, we find that the asymmetry results in a transition of a quasi-Bessel beam into a bow-tie shaped pattern and eventually to a line shaped profile at a larger distance along the optical axis. Furthermore, we analytically estimate and discuss the effects of astigmatism, substrate modes and non-perfect axicons. We find a good agreement between experiment, simulation and analytic considerations. Results include the derivation of a maximal axicon angle related to astigmatism of the illuminating beam, impact of laser diode beam profile imperfections like substrate modes and a longitudinal oscillation of the core intensity and radius caused by a rounded axicon tip.

Comparison of exact pupil astigmatism conditions with Seidel approximations

NASA Astrophysics Data System (ADS)

Zhao, Chunyu; Burge, James H.

2002-12-01

The aberrations of axisymmetric imaging systems can be calculated to third order by use of the Seidel formulas. The Coddington equations give aberrations that have quadratic dependence on the pupil, for all field points. The pupil astigmatism conditions were recently developed to predict and control aberrations that have quadratic field dependence and arbitrary pupil dependence. We investigate the relationship between the exact pupil astigmatism conditions and the classical Seidel treatment of pupil aberrations.

Effect of astigmatism on visual acuity in eyes with a diffractive multifocal intraocular lens.

PubMed

Hayashi, Ken; Manabe, Shin-Ichi; Yoshida, Motoaki; Hayashi, Hideyuki

2010-08-01

To examine the effect of astigmatism on visual acuity at various distances in eyes with a diffractive multifocal intraocular lens (IOL). Hayashi Eye Hospital, Fukuoka, Japan. In this study, eyes had implantation of a diffractive multifocal IOL with a +3.00 diopter (D) addition (add) (AcrySof ReSTOR SN6AD1), a diffractive multifocal IOL with a +4.00 D add (AcrySof ReSTOR SN6AD3), or a monofocal IOL (AcrySof SN60WF). Astigmatism was simulated by adding cylindrical lenses of various diopters (0.00, 0.50, 1.00, 1.50, 2.00), after which distance-corrected acuity was measured at various distances. At most distances, the mean visual acuity in the multifocal IOL groups decreased in proportion to the added astigmatism. With astigmatism of 0.00 D and 0.50 D, distance-corrected near visual acuity (DCNVA) in the +4.00 D group and distance-corrected intermediate visual acuity (DCIVA) and DCNVA in the +3.00 D group were significantly better than in the monofocal group; the corrected distance visual acuity (CDVA) was similar. The DCNVA with astigmatism of 1.00 D was better in 2 multifocal groups; however, with astigmatism of 1.50 D and 2.00 D, the CDVA and DCIVA at 0.5m in the multifocal groups were significantly worse than in the monofocal group, although the DCNVA was similar. With astigmatism of 1.00 D or greater, the mean CDVA and DCNVA in the multifocal groups reached useful levels (20/40). The presence of astigmatism in eyes with a diffractive multifocal IOL compromised all distance visual acuities, suggesting the need to correct astigmatism of greater than 1.00 D. No author has a financial or proprietary interest in any material or method mentioned. Copyright 2010 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Cross-Sectional and Longitudinal Investigation of the Power Vector in Astigmatism: The Yamagata Study (Funagata).

PubMed

Namba, Hiroyuki; Kawasaki, Ryo; Sugano, Akira; Nishi, Katsuhiro; Murakami, Takanori; Nishitsuka, Koichi; Kato, Takeo; Kayama, Takamasa; Yamashita, Hidetoshi

2018-01-01

To investigate how age and other factors affect astigmatism in Japanese adults over a period of 5 years. We included 512 Japanese participants who had undergone systemic and ophthalmological examinations both in 2005-2007 and in 2010-2012 in Funagata town, Yamagata, Japan. Astigmatism was evaluated using power vector analyses, where J0 represents the power of orthogonal astigmatism. Positive values of J0 indicate with-the-rule astigmatism, whereas negative values indicate against-the-rule (ATR). In this cross-sectional investigation, J0 represented the power of orthogonal astigmatism, and multivariate regression revealed that both J0 and corneal J0 (cJ0) declined with increasing age (both P < 0.001). In a longitudinal investigation spanning 5 years, the mean amounts of change (Δ) in J0 and ΔcJ0 were -0.045 ± 0.308 and -0.072 ± 0.278, respectively. This confirmed an ATR shift with increasing age in most individuals. The age-divided distribution of the magnitude of differences indicated that older age was associated with a larger astigmatic change over a 5-year period in both the cornea and the entire eye. Using multivariate logistic regression, we observed that older age at baseline was a risk factor for low ΔJ0, indicating a large shift toward ATR astigmatism. We confirmed that a refractive and keratometric shift toward ATR astigmatism occurs with aging. Older age at baseline was also associated with a larger magnitude of astigmatic changes over the subsequent 5 years.

[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

Age Differences in Axial Length, Corneal Curvature, and Corneal Astigmatism in Marfan Syndrome with Ectopia Lentis

PubMed Central

Jing, Qinghe; Tang, Yating; Qian, Dongjin

2018-01-01

Purpose To investigate the differences in axial length, corneal curvature, and corneal astigmatism with age in patients with Marfan syndrome (MFS) and ectopia lentis. Methods A retrospective case series study was conducted. MFS patients with ectopia lentis were divided into groups according to age. Axial length, corneal curvature, and corneal astigmatism were measured. Results This study included 114 MFS patients (215 eyes) with a mean age of 19.0 ± 13.9 years. Axial length differed significantly across age groups in MFS patients (P < 0.001), whereas corneal curvature did not (P = 0.767). Corneal astigmatism was statistically significant throughout the MFS cohort (P = 0.009), but no significant difference was found in young MFS patients (P = 0.838). With increasing age, the orientation of the corneal astigmatism changed from with-the-rule astigmatism to against-the-rule or oblique astigmatism (P < 0.001). A linear correlation analysis showed weak correlations between age and axial length for both eyes and with corneal astigmatism for the left eye, but there was no correlation between age and corneal curvature. Conclusions In MFS, axial length varies with age, corneal curvature remains stable, and corneal astigmatism is higher in young patients and tends to shift toward against-the-rule or oblique astigmatism. Therefore, it is important to consider age when diagnosing MFS with ocular biometric data. PMID:29854424

Correlation between refraction level and retinal breaks in myopic eye.

PubMed

Alimanović-Halilović, Emina

2008-11-01

In this study we analyzed 180 myopic eyes in order to determine the refraction that is "critical" for the occurrence of retinal breaks as a main cause of retinal detachment. Detachment of retina involves separation of the neurosensory retina from the pigmented epithelium with the severe impairment of vision. After the focused ophthalmological assessment, determination of objective refraction, indirect binocular ophthalmoscopy, we compared the diagnosed retinal breaks according to the shape with the refraction. All the examined eyes were divided into six groups according to the axis length. Mean age of our patients was between 48,43 and 51,60 years with SD ranging from 13,88 to 18,45. The age differences among the groups were not statistically significant. This study included 102 (56,7%) male and 78 (43,3%) female patients and no statistically significant differences between genders was found regarding the occurrence of retinal breaks compared to refraction. The most dominant ruptures were the round ones (28,2%), followed by oval (25%), the category of multiple small holes (19,2%), horseshoe shaped (15,3%), and finally holes with operculum. In cases with myopic refraction ranging between 3,50 and 7,49 dsph, the frequency of retinal breaks statistically significantly differs from all other analyzed refractions. Also, there is positive correlation between the above mentioned myopic refraction and the frequency of retinal breaks. In order to prevent retinal detachment in a myopic eye, we suggest further thorough examinations of the eye fundus in patients with the above mentioned myopia. Diagnosing retinal breaks involves the application of adequate therapy: laser photocoagulation, cryotherapy, sclera buckling and pneumatic retinopexy.

New pinhole sulcus implant for the correction of irregular corneal astigmatism.

PubMed

Trindade, Claudio C; Trindade, Bruno C; Trindade, Fernando C; Werner, Liliana; Osher, Robert; Santhiago, Marcony R

2017-10-01

To evaluate the effect on visual acuity of the implantation of a new intraocular pinhole device (Xtrafocus) in cases of irregular corneal astigmatism with significant visual impairment. University of São Paulo, São Paulo, Brazil. Prospective case series. Pseudophakic eyes of patients with irregular corneal astigmatism were treated with the pinhole device. The causes of irregular corneal astigmatism were keratoconus, post radial keratotomy (RK), post-penetrating keratoplasty (PKP), and traumatic corneal laceration. The device was implanted in the ciliary sulcus in a piggyback configuration to minimize the effect of corneal aberrations. Preoperative and postoperative visual parameters were compared. The main outcome variables were manifest refraction, uncorrected and corrected distance and near visual acuities, subjective patient satisfaction, and intraoperative and postoperative adverse events and complications. Twenty-one patients (ages 35 to 85 years) were included. There was statistically significant improvement in uncorrected and corrected (CDVA) distance visual acuities. The median CDVA improved from 20/200 (range 20/800 to 20/60) preoperatively to 20/50 (range 20/200 to 20/20) in the first month postoperatively and remained stable over the following months. Manifest refraction remained unchanged, while a subjective visual performance questionnaire revealed perception of improvement in all the tested working distances. No major complication was observed. One case presented with decentration of the device, which required an additional surgical intervention. The intraocular pinhole device performed well in patients with irregular astigmatism caused by keratoconus, RK, PKP, and traumatic corneal laceration. There was marked improvement in visual function, with high patient satisfaction. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

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.

Changes in corneal astigmatism during 20 years after cataract surgery.

PubMed

Hayashi, Ken; Manabe, Shin-Ichi; Hirata, Akira; Yoshimura, Koichi

2017-05-01

To examine how corneal astigmatism changes with age over 20 years after cataract surgery and to assess whether the changes differ from those in eyes that did not have surgery. Hayashi Eye Hospital, Fukuoka, Japan. Retrospective case study. Using an autokeratometer, corneal astigmatism was measured preoperatively, at baseline (the day the surgically induced astigmatism stabilized), and 10 years and 20 years after baseline. The change in corneal astigmatism between baseline and 10 years, 10 years and 20 years, and baseline and 20 years was determined using power vector analysis and compared between the time intervals and between groups. The study assessed 74 eyes that had phacoemulsification with a horizontal scleral incision more than 21 years ago (surgery group) and 68 eyes that did not have surgery (no-surgery group). The mean vertical/horizontal change in corneal astigmatism (J0) between baseline and 20 years was -0.64 diopter (D) in the surgery group and -0.49 D in the no-surgery group. The oblique change (J45) was -0.03 D in the surgery group and 0.07 D in the no-surgery group. Using multivariate comparison, the mean J0 and J45 values were not significantly different between baseline and 10 years or between 10 years and 20 years in both groups (P ≥ .2350). The J0 and J45 values were not significantly different between the 2 groups at any time interval (P ≥ .1331). Corneal astigmatism continues to change toward against-the-rule astigmatism over 20 years after cataract surgery. This change was similar in eyes that did not have surgery. Copyright © 2017 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Effect of fronto-orbital advancement on astigmatism in patients with anterior plagiocephaly.

PubMed

Song, Hyun Beom; Yang, Hee Kyung; Baek, Rong-Min; Hwang, Jeong-Min; Kim, Namju; Wang, Kyu-Chang; Kim, Sukwha

2016-10-01

The purpose of this study was to determine the effect of unilateral fronto-orbital advancement (FOA) or bilateral FOA on ocular aspects of plagiocephaly. A retrospective review of ocular findings in 16 patients with plagiocephaly was performed. Patients were divided into 2 groups: 12 patients who underwent bilateral FOA (bFOA) and 4 patients who underwent unilateral FOA (uFOA), and ocular findings were compared. One-half of patients showed strabismus in both groups, and all had exotropia. Hypertropia was found only on the same side of the plagiocephaly in 17% of the bFOA group and 25% of the uFOA group. One-third of the patients in the bFOA group and one-half of patients in the uFOA group had oblique muscle dysfunction. In terms of astigmatism, the degree of with-the-rule astigmatism on the contralateral side was larger in the bFOA group compared to the uFOA group (p = 0.030). The degree of with-the-rule astigmatism was larger on the contralateral side than the ipsilateral side (p = 0.005) in the bFOA group. Patients with abnormalities in ductions/versions had larger astigmatism on the contralateral side than those without abnormalities in ductions/versions. In conclusion, bilateral FOA could induce unwanted outcomes of larger astigmatism on the contralateral side. Astigmatism should be carefully evaluated after bilateral FOA. Copyright © 2016 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

Refraction during incipient presbyopia: The Aston Longitudinal Assessment of Presbyopia (ALAP) study.

PubMed

Laughton, Deborah S; Sheppard, Amy L; Davies, Leon N

To investigate non-cycloplegic changes in refractive error prior to the onset of presbyopia. The Aston Longitudinal Assessment of Presbyopia (ALAP) study is a prospective 2.5 year longitudinal study, measuring objective refractive error using a binocular open-field WAM-5500 autorefractor at 6-month intervals in participants aged between 33 and 45 years. From the 58 participants recruited, 51 participants (88%) completed the final visit. At baseline, 21 participants were myopic (MSE -3.25±2.28 DS; baseline age 38.6±3.1 years) and 30 were emmetropic (MSE -0.17±0.32 DS; baseline age 39.0±2.9 years). After 2.5 years, 10% of the myopic group experienced a hypermetropic shift (≥0.50 D), 5% a myopic shift (≥0.50 D) and 85% had no significant change in refraction (<0.50 D). From the emmetropic group, 10% experienced a hypermetropic shift (≥0.50 D), 3% a myopic shift (≥0.50 D) and 87% had no significant change in refraction (<0.50 D). In terms of astigmatism vectors, other than J 45 (p<0.001), all measures remained invariant over the study period. The incidence of a myopic shift in refraction during incipient presbyopia does not appear to be as large as previously indicated by retrospective research. The changes in axis indicate ocular astigmatism tends towards the against-the-rule direction with age. The structural origin(s) of the reported myopic shift in refraction during incipient presbyopia warrants further investigation. Copyright © 2017 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

Internal limiting membrane peeling and gas tamponade for myopic foveoschisis: a systematic review and meta-analysis.

PubMed

Meng, Bo; Zhao, Lu; Yin, Yi; Li, Hongyang; Wang, Xiaolei; Yang, Xiufen; You, Ran; Wang, Jialin; Zhang, Youjing; Wang, Hui; Du, Ran; Wang, Ningli; Zhan, Siyan; Wang, Yanling

2017-09-08

Myopic foveoschisis (MF) is among the leading causes of visual loss in high myopia. However, it remains controversial whether internal limiting membrane (ILM) peeling or gas tamponade is necessary treatment option for MF. PubMed, EMBASE, CBM, CNKI, WANFANG DATA and VIP databases were systematically reviewed. Outcome indicators were myopic foveoschisis resolution rate, visual acuity improvement and postoperative complications. Nine studies that included 239 eyes were selected. The proportion of resolution of foveoschisis was higher in ILM peeling group than non-ILM peeling group (OR = 2.15, 95% CI: 1.06-4.35; P = 0.03). The proportion of postoperative complications was higher in Tamponade group than non-Tamponade group (OR = 10.81, 95% CI: 1.26-93.02; P = 0.03). However, the proportion of visual acuity improvement (OR = 1.63, 95% CI: 0.56-4.80; P = 0.37) between ILM peeling group and non-ILM peeling group and the proportion of resolution of foveoschisis (OR = 1.80, 95% CI: 0.76-4.28; P = 0.18) between Tamponade group and non-Tamponade group were similar. Vitrectomy with internal limiting membrane peeling could contribute to better resolution of myopic foveoschisis than non-peeling, however it does not significantly influence the proportion of visual acuity improvement and postoperative complications. Vitrectomy with gas tamponade is associated with more complications than non-tamponade and does not significantly influence the proportion of visual acuity improvement and resolution of myopic foveoschisis.

Optical analysis for simplified astigmatic correction of non-imaging focusing heliostat

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

Chong, K.K.

2010-08-15

In the previous work, non-imaging focusing heliostat that consists of m x n facet mirrors can carry out continuous astigmatic correction during sun-tracking with the use of only (m + n - 2) controllers. For this paper, a simplified astigmatic correction of non-imaging focusing heliostat is proposed for reducing the number of controllers from (m + n - 2) to only two. Furthermore, a detailed optical analysis of the new proposal has been carried out and the simulated result has shown that the two-controller system can perform comparably well in astigmatic correction with a much simpler and more cost effectivemore » design. (author)« less

Associations of reading posture, gaze angle and reading distance with myopia and myopic progression.

PubMed

Pärssinen, Olavi; Kauppinen, Markku

2016-12-01

To study the associations of habitual reading posture, gaze angle in reading and reading distance with myopia and changes in myopia among myopic children. A total of 240 myopic schoolchildren (mean age 10.9 years), with no previous spectacles, were recruited during 1983-1984 to a randomized 3-year clinical trial of bifocal treatment of myopia. Three annual examinations with subjective cycloplegic refraction were conducted for 237-238 subjects. A further examination was conducted at the mean age of 23.2 years for 178 subjects. Habitual reading posture was elicited by questionnaire at study outset. Reading distance was measured with a Clement Clark accommodometer and gaze angle with an angle scale at baseline and all three annual follow-ups. Height was measured by a school nurse. The connections between the variables were studied with the standard statistical methods. Higher myopia was connected with shorter reading distance among girls at follow-ups 2 and 3, but not at the other examinations. The correlation of spherical equivalent with height was non-significant at each follow-up. Myopic progression across the whole follow-up was highest among those who read sitting down at baseline (-3.58 ± 1.75 D) and lowest among those who read face up lying down (-2.35 ± 1.53 D) (p = 0.021). Reading with eyes at a more downward angle was slightly connected with greater myopic progression (r = -0.166, p = 0.028). Reading in a sitting posture at myopia onset predicted the greatest myopic progression to adulthood and reading face up on one's back the lowest. Reading with eyes on turned more downwards was slightly connected with greater myopic progression. © 2016 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Refractive astigmatism and the toricity of ocular components in human infants.

PubMed

Mutti, Donald O; Mitchell, G Lynn; Jones, Lisa A; Friedman, Nina E; Frane, Sara L; Lin, Wendy K; Moeschberger, Melvin L; Zadnik, Karla

2004-10-01

Many studies have characterized astigmatism in infancy, but few have been longitudinal or contained ocular component data. This study characterized the frequency, orientation, and longitudinal change with age of infant astigmatism. Additional factors investigated were the influence of early astigmatism on emmetropization and its relation to corneal and lenticular toricity. Three hundred two infants were enrolled in the study. Of these, 298 provided data for at least one visit at 3 +/- 1 months, 9 +/- 1 months, 18 +/- 2 months, and 36 +/- 3 months. Testing included cycloplegic retinoscopy (cyclopentolate 1%), video-based keratophakometry, and ultrasonography over the closed eyelid. Astigmatism > or =1.00 DC was common at 3 months of age (41.6%) but decreased in prevalence to 4.1% by 36 months (p < 0.0001). The most common orientation was with-the-rule at 3 months (37.0% compared with 2.7% for against-the-rule) but against-the-rule at 36 months (3.2% compared with 0.9% for with-the-rule). Most of the change in the average value of the horizontal/vertical component of astigmatism (J0) occurred between 3 and 9 months (-0.26 +/- 0.36 D; p < 0.0001) with no significant change between 9 and 36 months (-0.05 +/- 0.36 D; p=0.09). Spherical equivalent refractive error was not correlated with J0 at 3 and 9 months (R=0.002, p=0.48 and R=0.001, p=0.56, respectively). The two were only weakly correlated at 18 and 36 months (R=0.06 for each age, p <0.0001, p=0.0002, respectively). Changes in spherical equivalent between 3 and 9 months were unrelated to either the initial value of J0 (partial R for J0=0.0001; p=0.85) or the change in J0 (partial R for change in J0=0.0031; p=0.31). Across all the ages, corneal toricity was with-the-rule, and lenticular toricity was against-the-rule (produced by the toricity of the posterior lens surface). The cornea and anterior lens surface became more spherical with age, contributing to the shift away from with-the-rule refractive astigmatism

[Refractive errors as causes of visual impairment in children from public schools of the Botucatu region - SP].

PubMed

Oliveira, Claudia Akemi Shiratori de; Hisatomi, Kenia Scrocaro; Leite, Cristiano Pinheiro; Schellini, Silvana Artioli; Padovani, Carlos Roberto; Padovani, Carlos Roberto Pereira

2009-01-01

To evaluate the refractive errors as cause of visual impairment in school children from the Botucatu region. A sectional study was conducted evaluating preschool and elementary school students, according to gender, refractive error, visual acuity and treatment. Four thousand six hundred and twenty-three (4,623) children were submitted to visual acuity evaluation and 8.1% of them were submitted to complete ocular examination. There were 63.2% hyperopic astigmatism, 15.7% myopic astigmatism, 12.5% astigmatism, 4.9% hyperopia and 3.7% myopia. Corrective lenses were prescribed for 48.7% of the evaluated children. The most frequent refractive error was hyperopic astigmatism and 50% of the children received treatment. The frequency of refractive errors was 3.9% of the studied population.

Astigmatism correction in x-ray scanning photoemission microscope with use of elliptical zone plate

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

Ade, H.; Ko, C.; Anderson, E.

1992-03-02

We report the impact of an elliptical, high resolution zone plate on the performance of an initially astigmatic soft x-ray scanning photoemission microscope. A zone plate with carefully calibrated eccentricity has been used to eliminate astigmatism arising from transport optics, and an improvement of about a factor of 3 in spatial resolution was achieved. The resolution is still dominated by the source size and chromatic aberrations rather than by diffraction and coma, and a further gain of about a factor of 2 in resolution is possible. Sub 100 nm photoemission microscopy with primary photoelectrons is now within reach.

[Prevalence and age-related changes of corneal astigmatism in patients before cataract surgery].

PubMed

Michelitsch, M; Ardjomand, N; Vidic, B; Wedrich, A; Steinwender, G

2017-03-01

The aim of this study was to determine the extent and the distribution of corneal astigmatism in patients awaiting cataract surgery in a mid-European tertiary clinic centre and hence to establish the demand for methods reducing corneal astigmatism. Keratometry measurements of cataract surgery candidates assigned to a university clinic between January 2013 and October 2014 were recorded and analysed retrospectively. A total of 6900 eyes of 3450 patients with a mean age of 72.5 ± 12.2 were analyzed. The corneal astigmatism was more than 0.5 dioptres (D) in 5193 eyes (75.3 %), >1.0 D in 2641 eyes (38.3 %), >1.5 D in 1304 eyes (18.9 %), >2.0 D in 644 eyes (9.3 %), >2.5 D in 363 eyes (5.3 %), >3.0 D in 236 eyes (3.4 %) and >3.5 D in 149 eyes (2.2 %). With increasing age a shift from with-the-rule astigmatism towards against-the-rule astigmatism was observed. Of the patients admitted for routine cataract surgery at our clinic, 2641 eyes (38.3 %) had an astigmatism greater than 1.0 D. Our data could be helpful in establishing a protocol for using toric intraocular lenses and to determine the costs.

Prevalence of Corneal Astigmatism in an NHS Cataract Surgery Practice in Northern Ireland.

PubMed

Curragh, David S; Hassett, Patrick

2017-01-01

Post-operative corneal astigmatism following cataract surgery can leave the patient with visual impairment. Correcting it at the time of surgery with a toric intraocular lens (TIOL) can give patients a better final visual outcome. The purpose was to determine the prevalence of corneal astigmatism in a cataract population and assess the demand for TIOL. Keratometric data was collected and analyzed for all patients who attended for routine cataract surgery under the care of a single surgeon based in Altnagelvin Area Hospital, Northern Ireland (NI). All patients were included between January 2008 and December 2014. Data was collected retrospectively for this observational study. There were 2080 consecutive eyes of 1788 patients. The mean corneal astigmatism was 1.09 ± 0.83. Corneal astigmatism was 1.50D or less in 1621 eyes (78%). It was more than 2.00 D in 242 eyes (11.6%), more than 2.50 D in 127 eyes (6.1%), more than 3.00D in 68 eyes (3.27%) and more than 3.50 D in 45 eyes (2.16%). For routine cataract surgery, 41.3% of eyes had more than 1.00 D of corneal astigmatism and 11.6% had more and 2.00D. Females had more astigmatism than males. This shows the potential demand for the TIOL in this population.

New algorithm for toric intraocular lens power calculation considering the posterior corneal astigmatism.

PubMed

Canovas, Carmen; Alarcon, Aixa; Rosén, Robert; Kasthurirangan, Sanjeev; Ma, Joseph J K; Koch, Douglas D; Piers, Patricia

2018-02-01

To assess the accuracy of toric intraocular lens (IOL) power calculations of a new algorithm that incorporates the effect of posterior corneal astigmatism (PCA). Abbott Medical Optics, Inc., Groningen, the Netherlands. Retrospective case report. In eyes implanted with toric IOLs, the exact vergence formula of the Tecnis toric calculator was used to predict refractive astigmatism from preoperative biometry, surgeon-estimated surgically induced astigmatism (SIA), and implanted IOL power, with and without including the new PCA algorithm. For each calculation method, the error in predicted refractive astigmatism was calculated as the vector difference between the prediction and the actual refraction. Calculations were also made using postoperative keratometry (K) values to eliminate the potential effect of incorrect SIA estimates. The study comprised 274 eyes. The PCA algorithm significantly reduced the centroid error in predicted refractive astigmatism (P < .001). With the PCA algorithm, the centroid error reduced from 0.50 @ 1 to 0.19 @ 3 when using preoperative K values and from 0.30 @ 0 to 0.02 @ 84 when using postoperative K values. Patients who had anterior corneal against-the-rule, with-the-rule, and oblique astigmatism had improvement with the PCA algorithm. In addition, the PCA algorithm reduced the median absolute error in all groups (P < .001). The use of the new PCA algorithm decreased the error in the prediction of residual refractive astigmatism in eyes implanted with toric IOLs. Therefore, the new PCA algorithm, in combination with an exact vergence IOL power calculation formula, led to an increased predictability of toric IOL power. Copyright © 2018 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

Astigmatism Correction With Toric Intraocular Lenses in Descemet Membrane Endothelial Keratoplasty Triple Procedures.

PubMed

Yokogawa, Hideaki; Sanchez, P James; Mayko, Zachary M; Straiko, Michael D; Terry, Mark A

2017-03-01

To report the clinical efficacy of astigmatism correction with toric intraocular lenses (IOLs) in patients undergoing the Descemet membrane endothelial keratoplasty (DMEK) triple procedure and to evaluate the accuracy of the correction. Fifteen eyes of 10 patients who received cataract extraction, toric IOL placement, and DMEK surgery for Fuchs corneal dystrophy and cataracts were evaluated. The cylinder power of toric IOLs was determined by an online toric calculator with keratoscopy measurements obtained using Scheimpflug corneal imaging. Prediction errors were assessed as a difference vector between the anticipated minus postoperative residual astigmatism. At 10.1 ± 4.9 months postoperatively, 8/13 (61.5%) of eyes achieved uncorrected distance visual acuity better than 20/40. Mean best spectacle-corrected distance visual acuity (logMAR) improved from 0.21 ± 0.15 preoperatively to 0.08 ± 0.12 postoperatively (P < 0.01). The magnitude of refractive astigmatism was also significantly decreased from 2.23 ± 1.10 D (range 0.75-4.25 D) preoperatively to 0.87 ± 0.75 D (range 0.00-3.00 D) postoperatively (P < 0.01). In 1 eye with rotational misalignment by 43 degrees, we found no improvement of astigmatism. The prediction error of astigmatism at the corneal plane was 0.77 ± 0.54 D (range 0.10-1.77 D). Four eyes with preoperative "with-the-rule" corneal astigmatism had postoperative "against-the-rule" refractive astigmatism. For patients with Fuchs corneal dystrophy and cataracts, use of toric IOLs might be a valuable option in triple DMEK surgery. Additionally, care should be taken to prevent excessive IOL rotation.

Measurement centration and zone diameter in anterior, posterior and total corneal astigmatism in keratoconus.

PubMed

Fredriksson, Anneli; Behndig, Anders

2017-12-01

To investigate the central and paracentral astigmatism and the significance of centration and measurement zone diameter compared to a 3-mm pupil-centred measurement zone in keratoconus and in healthy eyes. Twenty-eight right eyes from 28 KC patients with an inferotemporal cone were selected according to specified criteria based on Oculus Pentacam HR ® measurements and were matched with healthy control eyes. The flat (K1) and steep (K2) keratometry readings were registered from the 'Total Corneal Refractive Power' (TCRP) display as well as the anterior and posterior corneal astigmatism displays (ACA and PCA, respectively). Astigmatic power vectors KP0 and KP45 were calculated and analysed for a 6-mm and two 3-mm zones centred on the corneal apex and the pupil, and for 8 paracentral 3-mm zones. The astigmatism was generally higher in KC. Many astigmatic values in KC differed between the 3-mm pupil-centred and the 3- and 6-mm apex-centred zones in KC. In the controls, no corresponding differences between measurement zones were seen, apart from PCA, which differed. The magnitude and direction of KP0 and KP45 varied greatly between the paracentral measurements in KC. Centration and measurement zone diameter have great impacts on the astigmatic values in KC. A small pupil-centred measurement zone should be considered when evaluating the astigmatism in KC. © 2017 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Myopic progression and dark focus variation in optometric students during the first academic year.

PubMed

Jiang, Bai-chuan; Schatz, Scott; Seger, Ken

2005-05-01

The aim of this research was to investigate the change in refractive error (RE) of optometric students during their first academic year and whether these changes relate to changes in their dark focus (DF). The RE and DF of 64 students were measured objectively every three months during the first academic year, a total of four times, using a Canon R-1 infrared optometer. Thirty-five of the 64 students had an additional RE and DF measurement three weeks immediately after their Summer vacation. Students completed a survey regarding the near work demands they experienced during the Winter break and the teaching semesters. Over nine months, the average RE of the students changed significantly from -2.22 +/- 1.93 (SD) D to -2.50 +/- 2.05 D (p = 0.0002). The rate of myopic progression averaged -0.37 dioptres per year. Inclusion of measurements taken on 35 students immediately after the Summer vacation showed that their change in RE during the Summer vacation was not significant (p = 0.79). For these subjects, the DF measured immediately after the vacation was significantly lower than the DF measured before the vacation (p = 0.007). The reduction in the DF after the vacations corresponded to a period of relative myopic stability in these subjects. The results of this study suggest that optometric students performing extensive near work are at risk of developing myopia. The variation of their DF values indicates the changing demand for near work during different periods of the year. After Winter and Summer vacations, the DF was lower and the myopic progression was suspended. These findings further support the notion that myopic progression is related to high near work demands and suggest that this progression can be slowed by a period of reduced near work, for example, vacation periods.

Comparison of astigmatism correction using either peripheral corneal relaxing incisions or toric intraocular lenses.

PubMed

Muftuoglu, Ilkay Kilic; Aydin Akova, Yonca; Aksoy, Sibel; Unsal, Erkan

2016-01-01

To compare the efficacy and short-term stability of toric intraocular lenses (tIOL) and peripheral cornea relaxing incisions (PCRI) during phacoemulsification. Patients with preexisting corneal astigmatism had cataract surgery either with tIOL (AcrySof Toric) (39 eyes of 35 patients) or standard intraocular lens (AcrySof) + PCRIs (38 eyes of 33 patients). Patients were retrospectively evaluated for manifest refraction, corneal topography, and uncorrected and corrected visual acuities preoperatively and at postoperative 1 and 6 months. The Alpins vectorial method was used to analyze the target induced astigmatism (TIA) and surgically induced astigmatism (SIA), magnitude of error (the difference between the magnitude of SIA and TIA) (ME), and correction index. Mean preoperative corneal astigmatism was 2.21 ± 1.32 D in the tIOL group and 2.24 ± 0.96 D in the PCRI group; the difference was not significant. The decrease in astigmatism was significant in both groups at last follow-up (64% tIOL group, 32% PCRI group, p<0.01, Wilcoxon signed rank test). The mean remaining refractive astigmatism was significantly higher in the PCRI group than in the tIOL group at 1-month (1.42 ± 1.22, 0.89 ± 0.68, respectively) and 6-month follow-ups (1.75 ± 1.37 D, 0.92 ± 0.72, respectively) (p<0.01). The mean ME was significantly lower (-0.35 versus -0.88) with a higher correction index (0.96 versus 0.56) in the tIOL group at 6 months postoperatively. Both tIOL implantation and using PCRI were effective methods to reduce preoperative astigmatism at the time of the cataract surgery. However, tIOLs provided better remaining astigmatism with a more stable refraction than PCRI.

The efficacy of a single continuous nylon suture for control of post keratoplasty astigmatism.

PubMed Central

Van Meter, W

1996-01-01

PURPOSE: Post operative adjustment of a single continuous suture is an effective means of reducing post keratoplasty astigmatism. This study evaluates post keratoplasty keratometry following suture adjustment with an adjusted suture in place and after the suture is removed. METHODS: Average keratometric astigmatism was measured over 24 months time in 26 patients with an adjusted continuous suture and 24 patients with a continuous suture that was not adjusted. Average keratometry in 43 patients with an adjusted continuous suture was compared with 37 patients with combined continuous and interrupted sutures. Finally, suture out astigmatism in 19 adjusted patients was compared to six patients with no adjustment. RESULTS: There was an increase in average corneal astigmatism over two years of 2.2 diopters in the adjusted group and 1.7 diopters in the non-adjusted group with sutures in place. One year following surgery, average keratometry flattened from 47.5 to 42.9 diopters in the adjusted continuous group and from 47.0 to 46.0 diopters in the group with combined continuous and interrupted sutures. Following suture removal, average astigmatism in patients who had suture adjustment was 4.4 diopters +/- 2.5 diopters (range 1-10 diopters), and 6.01 diopters (range 4-7) in the non-adjusted group. CONCLUSIONS: Average post keratoplasty astigmatism increases after a continuous suture is adjusted but the increase is comparable to patients with acceptable astigmatism who do not require adjustment. More progressive corneal flattening over 12 months time is seen with a continuous suture than which combined sutures. Average suture out astigmatism was 4.0 diopters following suture adjustment, compared to an average of 8.4 diopters prior to adjustment. Images FIGURE 1 FIGURE 2 FIGURE 3 FIGURE 4 FIGURE 7A FIGURE 7B PMID:8981721

Axis-free correction of astigmatism using bifocal soft contact lenses.

PubMed

Leube, Alexander; Kovats, Imre; Wahl, Siegfried; Sickenberger, Wolfgang

2017-12-01

Pilot study to investigate the feasibility of an axis-free correction approach of regular astigmatism using soft, bifocal contact lenses (CL). The investigation covers an optical simulation and a pilot study for the assessment of visual performance (over refraction OR, monocular visual acuity VA). The power of the two zones was adjusted according to the power of the astigmatic meridians, individually. Subjective performance was assessed in 30 participants with a mean horizontal cylindrical component of J 0 =- 0.65±1.29 D (cylinder from -0.75 to -4.00 DC). OR and VA were measured directly after fitting the CL, after one hour and after 5days (3FUP). Evaluating the modulation transfer function, CL increased the Strehl ratio by 10% and the transferred spatial frequency was improved from 6.6 cpd to 21.3 cpd. Analysis of Sturm's interval revealed a residual astigmatism of D Ast =0.73 D. OR revealed a statistically significant reduction of spherical error between baseline and all follow up (ΔM=-2.14 D, p<0.001) and between the J 0 from baseline to 3FUP (ΔJ 0 =-0.46 D, p=0.04). Wearing the CL for 5days did not result in a significant difference of VA (ΔVA 3FUP =+0.01 logMAR, p=0.99). Axis-free correction of astigmatism using bifocal CL resulted in reasonable performance based on computer simulation. Participants showed no clinically reduced visual acuity or contrast sensitivity. Further clinical studies are needed to show if this approach provides a good alternative to conventional astigmatic correction. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

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

PubMed

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

2016-01-01

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

Partial null astigmatism-compensated interferometry for a concave freeform Zernike mirror

NASA Astrophysics Data System (ADS)

Dou, Yimeng; Yuan, Qun; Gao, Zhishan; Yin, Huimin; Chen, Lu; Yao, Yanxia; Cheng, Jinlong

2018-06-01

Partial null interferometry without using any null optics is proposed to measure a concave freeform Zernike mirror. Oblique incidence on the freeform mirror is used to compensate for astigmatism as the main component in its figure, and to constrain the divergence of the test beam as well. The phase demodulated from the partial nulled interferograms is divided into low-frequency phase and high-frequency phase by Zernike polynomial fitting. The low-frequency surface figure error of the freeform mirror represented by the coefficients of Zernike polynomials is reconstructed from the low-frequency phase, applying the reverse optimization reconstruction technology in the accurate model of the interferometric system. The high-frequency surface figure error of the freeform mirror is retrieved from the high-frequency phase adopting back propagating technology, according to the updated model in which the low-frequency surface figure error has been superimposed on the sag of the freeform mirror. Simulations verified that this method is capable of testing a wide variety of astigmatism-dominated freeform mirrors due to the high dynamic range. The experimental result using our proposed method for a concave freeform Zernike mirror is consistent with the null test result employing the computer-generated hologram.

Enantiomorphism and rule similarity in the astigmatism axes of fellow eyes: A population-based study.

PubMed

Hashemi, Hassan; Asharlous, Amir; Yekta, Abbasali; Ostadimoghaddam, Hadi; Mohebi, Masumeh; Aghamirsalim, Mohamadreza; Khabazkhoob, Mehdi

2018-04-03

To evaluate the relationship patterns between astigmatism axes of fellow eyes (rule similarity and symmetry) and to determine the prevalence of each pattern in the studied population. This population-based study was conducted in 2015 in Iran. All participants had tests for visual acuity, objective refraction, subjective refraction (if cooperative), and assessment of eye health at the slit-lamp. Axis symmetry was based on two different patterns: direct (equal axes) and mirror (mirror image symmetry) or enantiomorphism. Bilateral astigmatism was classified as isorule if fellow eyes had the same orientation (e.g. both eyes were with-the-rule) and as anisorule if otherwise. Of the total cases of bilateral astigmatism, 80% were isorule, and in the studied population, the prevalence of isorule and anisorule astigmatism was 14.89% and 3.53%, respectively. The prevalence of isorule increased with age (p<0.001). The prevalence of both isorule and anisorule increased at higher degrees of spherical ametropia (p<0.001). Median inter-ocular axis difference was 10° in mirror symmetry and 20° in direct symmetry with no significant difference between two genders (p>0.288). Both symmetry patterns reduced with age (p<0.001). Among cases of bilateral astigmatism, 15.5% and 19.8% had exact direct and mirror symmetry, respectively. Bilateral astigmatism is mainly isorule in the population and anisorule astigmatism is rare. The enantiomorphism is the most common pattern in the population of bilateral astigmatism. Copyright © 2018 Spanish General Council of Optometry. Published by Elsevier España, S.L.U. All rights reserved.

Peripheral Defocus and Myopia Progression in Myopic Children Randomly Assigned to Wear Single Vision and Progressive Addition Lenses

PubMed Central

Berntsen, David A.; Barr, Christopher D.; Mutti, Donald O.; Zadnik, Karla

2013-01-01

Purpose. To determine the effect of progressive addition lenses (PALs) and single vision lenses (SVLs) on peripheral defocus in myopic children, and to compare the effect of myopic versus hyperopic peripheral defocus on foveal myopia progression. Methods. Eighty-four myopic children aged 6 to 11 years with spherical equivalent (SE) cycloplegic autorefraction between −0.75 diopters (D) and −4.50 D were randomly assigned to wear SVLs or PALs. Aberrometry measurements of the eye and spectacles were made centrally, 30° nasally, temporally, and superiorly, and 20° inferiorly on the retina using a Complete Ophthalmic Analysis System for Vision Research (COAS-VR). The association between peripheral defocus and the 1-year change in central myopia was investigated. Results. SVLs caused a hyperopic shift in peripheral defocus at all locations (all P ≤ 0.0003). PALs caused a myopic shift in peripheral defocus in three of four locations measured (all P ≤ 0.01) with the greatest shift superiorly due to the PAL addition (−1.04 ± 0.30 D). Superior retinal defocus when wearing either SVLs or PALs was associated with the 1-year change in central myopia. The adjusted 1-year change in central SE myopia was −0.38 D for children with absolute superior myopic defocus (n = 67) and −0.65 D for children with absolute superior hyperopic defocus (n = 17; difference = 0.27 D; P = 0.002). Conclusions. PALs caused a myopic shift in peripheral defocus. Superior myopic defocus was associated with less central myopia progression. These data support the continued investigation of optical designs that result in peripheral myopic defocus as a potential way to slow myopia progression. (ClinicalTrials.gov number, NCT00335049.) PMID:23838771

Effect of text type on near work-induced contrast adaptation in myopic and emmetropic young adults.

PubMed

Yeo, Anna C H; Atchison, David A; Schmid, Katrina L

2013-02-27

Contrast adaptation has been speculated to be an error signal for emmetropization. Myopic children exhibit higher contrast adaptation than emmetropic children. This study aimed to determine whether contrast adaptation varies with the type of text viewed by emmetropic and myopic young adults. Baseline contrast sensitivity was determined in 25 emmetropic and 25 spectacle-corrected myopic young adults for 0.5, 1.2, 2.7, 4.4, and 6.2 cycles per degree (cpd) horizontal sine wave gratings. The adults spent periods looking at a 6.2 cpd high-contrast horizontal grating and reading lines of English and Chinese text (these texts comprised 1.2 cpd row and 6 cpd stroke frequencies). The effects of these near tasks on contrast sensitivity were determined, with decreases in sensitivity indicating contrast adaptation. Contrast adaptation was affected by the near task (F2,672 = 43.0; P < 0.001). Adaptation was greater for the grating task (0.13 ± 0.17 log unit, averaged across all frequencies) than reading tasks, but there was no significant difference between the two reading tasks (English 0.05 ± 0.13 log unit versus Chinese 0.04 ± 0.13 log unit). The myopic group showed significantly greater adaptation (by 0.04, 0.04, and 0.05 log units for English, Chinese, and grating tasks, respectively) than the emmetropic group (F1,48 = 5.0; P = 0.03). In young adults, reading Chinese text induced similar contrast adaptation as reading English text. Myopes exhibited greater contrast adaptation than emmetropes. Contrast adaptation, independent of text type, might be associated with myopia development.

Microincision Hydrophobic Acrylic Aspheric Toric Intraocular Lens for Astigmatism and Cataract Correction.

PubMed

Bissen-Miyajima, Hiroko; Negishi, Kazuno; Hieda, Osamu; Kinoshita, Shigeru

2015-06-01

To evaluate the efficacy and safety of a new acrylic one-piece toric intraocular lens (IOL). This prospective multicenter clinical trial included 93 eyes of 61 patients that were implanted with a hydrophobic acrylic toric IOL from 2010 to 2012 and followed for 1 year. This IOL uses the platform of a microincision one-piece aspheric IOL, the NY-60 IOL (HOYA, Tokyo, Japan), with three increments in cylindrical power (NHT15, 1.5 diopters [D]; NHT23, 2.25 D; and NHT30, 3.0 D). The inclusion criterion was preoperative corneal astigmatism from 0.75 to 3.00 D. The primary endpoint was uncorrected distance visual acuity (UDVA) of 0.0 logMAR (20/20 Snellen) or better 6 months postoperatively. In addition to UDVA, corrected distance visual acuity (CDVA), residual astigmatism, stability of the IOL alignment, need of realignment, and the rate of Nd:YAG laser capsulotomy were evaluated up to 1 year postoperatively. Errors in astigmatic correction were assessed using Alpin's vector analysis. The primary endpoint was achieved in 54.8% of eyes. One year postoperatively, the logMAR UDVAs were 0.02 ± 0.13, 0.05 ± 0.17, and 0.09 ± 0.14 with models NHT15, NHT23, and NHT30, which corresponds to 0.96 (19/20 Snellen), 0.89 (18/20 Snellen), and 0.82 (16/20 Snellen), respectively. One year postoperatively, the residual astigmatism was 0.66 ± 0.58 D. In each evaluation, the mean absolute change in the position of the axis mark was between 1.93° and 2.32°. Three eyes required repositioning of the IOL axis and 2 eyes received Nd:YAG laser capsulotomy. The correction error showed an undercorrection with against-the-rule astigmatism and overcorrection with with-the-rule astigmatism. The new one-piece toric IOL provided desirable clinical outcomes and stability in eyes with corneal astigmatism. Copyright 2015, SLACK Incorporated.

Nonparaxial wave beams and packets with general astigmatism

NASA Astrophysics Data System (ADS)

Kiselev, A. P.; Plachenov, A. B.; Chamorro-Posada, P.

2012-04-01

We present exact solutions of the wave equation involving an arbitrary wave form with a phase closely similar to the general astigmatic phase of paraxial wave optics. Special choices of the wave form allow general astigmatic beamlike and pulselike waves with a Gaussian-type unrestricted localization in space and time. These solutions are generalizations of the known Bateman-type waves obtained from the connection existing between beamlike solutions of the paraxial parabolic equation and relatively undistorted wave solutions of the wave equation. As a technical tool, we present a full description of parametrizations of 2×2 symmetric matrices with positive imaginary part, which arise in the theory of Gaussian beams.

Plasma channels during filamentation of a femtosecond laser pulse with wavefront astigmatism in air

NASA Astrophysics Data System (ADS)

Dergachev, A. A.; Ionin, A. A.; Kandidov, V. P.; Mokrousova, D. V.; Seleznev, L. V.; Sinitsyn, D. V.; Sunchugasheva, E. S.; Shlenov, S. A.; Shustikova, A. P.

2014-12-01

We have demonstrated experimentally and numerically the possibility of controlling parameters of plasma channels formed during filamentation of a femtosecond laser pulse by introducing astigmatism in the laser beam wavefront. It is found that weak astigmatism increases the length of the plasma channel in comparison with the case of aberration-free focusing and that strong astigmatism can cause splitting of the plasma channel into two channels located one after another on the filament axis.

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

Pattern of refractive errors among the Nepalese population: a retrospective study.

PubMed

Shrestha, S P; Bhat, K S; Binu, V S; Barthakur, R; Natarajan, M; Subba, S H

2010-01-01

Refractive errors are a major cause of visual impairment in the population. To find the pattern of refractive errors among patients evaluated in a tertiary care hospital in the western region of Nepal. The present hospital-based retrospective study was conducted in the Department of Ophthalmology of the Manipal Teaching Hospital, situated in Pokhara, Nepal. Patients who had refractive error of at least 0.5 D (dioptre) were included for the study. During the study period, 15,410 patients attended the outpatient department and 10.8% of the patients were identified as having refractive error. The age of the patients in the present study ranged between 5 - 90 years. Myopia was the commonest refractive error followed by hypermetropia. There was no difference in the frequency of the type of refractive errors when they were defined using right the eye, the left eye or both the eyes. Males predominated among myopics and females predominated among hypermetropics. The majority of spherical errors was less than or equal to 2 D. Astigmatic power above 1D was rarely seen with hypermetropic astigmatism and was seen in around 13 % with myopic astigmatism. "Astigmatism against the rule" was more common than "astigmatism with the rule", irrespective of age. Refractive errors progressively shift along myopia up to the third decade and change to hypermetropia till the seventh decade. Hyperopic shift in the refractive error in young adults should be well noted while planning any refractive surgery in younger patients with myopia. © Nepal Ophthalmic Society.

Cigarette Smoking in Indonesia: Examination of a Myopic Model of Addictive Behaviour

PubMed Central

Hidayat, Budi; Thabrany, Hasbullah

2010-01-01

Using aggregated panel data taken from three waves of the Indonesian Family Life Survey (1993–2000), this article tests the myopic addiction behaviour of cigarette demand. Sensitivity analysis is done by examining a rational addiction behavior of cigarette demand. The results provide support for myopic addiction. The short- and long-run price elasticities of cigarette demand are estimated at −0.28 and −0.73 respectively. Excise taxes are more likely to act as an effective tobacco control in the long-run rather than a major source of government revenue. PMID:20644684

Assessment and statistics of surgically induced astigmatism.

PubMed

Naeser, Kristian

2008-05-01

The aim of the thesis was to develop methods for assessment of surgically induced astigmatism (SIA) in individual eyes, and in groups of eyes. The thesis is based on 12 peer-reviewed publications, published over a period of 16 years. In these publications older and contemporary literature was reviewed(1). A new method (the polar system) for analysis of SIA was developed. Multivariate statistical analysis of refractive data was described(2-4). Clinical validation studies were performed. The description of a cylinder surface with polar values and differential geometry was compared. The main results were: refractive data in the form of sphere, cylinder and axis may define an individual patient or data set, but are unsuited for mathematical and statistical analyses(1). The polar value system converts net astigmatisms to orthonormal components in dioptric space. A polar value is the difference in meridional power between two orthogonal meridians(5,6). Any pair of polar values, separated by an arch of 45 degrees, characterizes a net astigmatism completely(7). The two polar values represent the net curvital and net torsional power over the chosen meridian(8). The spherical component is described by the spherical equivalent power. Several clinical studies demonstrated the efficiency of multivariate statistical analysis of refractive data(4,9-11). Polar values and formal differential geometry describe astigmatic surfaces with similar concepts and mathematical functions(8). Other contemporary methods, such as Long's power matrix, Holladay's and Alpins' methods, Zernike(12) and Fourier analyses(8), are correlated to the polar value system. In conclusion, analysis of SIA should be performed with polar values or other contemporary component systems. The study was supported by Statens Sundhedsvidenskabeligt Forskningsråd, Cykelhandler P. Th. Rasmussen og Hustrus Mindelegat, Hotelejer Carl Larsen og Hustru Nicoline Larsens Mindelegat, Landsforeningen til Vaern om Synet

Analysis of corneal astigmatism with NIDEK axial length scan in caucasian cataract surgery candidates.

PubMed

Duman, R; Duman, R; Cetinkaya, E; Sabaner, M C; Inan, S; Doğan, M; Doğan, I

2018-04-01

The aim of the study was to analyze and quantify the pattern of corneal astigmatism in Caucasian cataract surgery patients using a new optical biometer (axial length [AL] Scan, NIDEK Co., Gamagori, Japan). The datasets of cataract surgery patients acquired between March 1, 2014, and April 15, 2016, were collected and analyzed. The corneal power (flat keratometry, steep keratometry, and mean keratometry), negative cylinder power, and axis of astigmatism were recorded. Keratometry values were optically measured by optical low coherence interferometry (AL-Scan, NIDEK Co., Ltd.,) before cataract extraction. The study comprised 1233 eyes of 838 consecutive cataract candidates with a mean age of 66.8 ± 10.7 years (range 40-97 years). The mean keratometry value and corneal astigmatism were 43.69 ± 1.61 D and 0.84 ± 0.70 D, respectively. Corneal astigmatism of 1.00 D or greater was found in 344 eyes (27.9%), and 548 eyes (44.4%) had against-the-rule astigmatism. A trend toward decreasing J0 and J45 with age was found by linear regression models. The per-year increase in age was associated with a J0 and J45 decrease of 0.002 D and 0.001D, respectively. This study provides the distribution of astigmatism axis and power for cataract patients in age subsets from Turkey.

Changes in corneal shape after suture cutting using the argon laser for postoperative astigmatism following cataract extraction.

PubMed

Hayashi, K; Nakao, F; Hayashi, F

1993-03-01

We studied the changes in corneal shape after suture cutting with an argon laser to reduce corneal astigmatism following cataract extraction. Sixty-two patients who exhibited high with-the-rule astigmatism (> 3 diopters [D]) following extracapsular lens extraction had argon laser suture cutting. The patients were classified into three groups: Group A comprised 30 patients whose sutures were cut two to three months after planned extracapsular cataract extraction (p-ECCE); Group B consisted of eight patients who had the same treatment five to nine months after p-ECCE; Group C comprised 24 patients who had the treatment one to two months after phacoemulsification (PE). The dioptric reduction of corneal astigmatism (the percent reduction of astigmatism) was 1.83 +/- 0.98 D (37.4 +/- 18.3%) in Group A, 3.20 +/- 2.35 D (55.6 +/- 34.4%) in Group B, and 2.08 +/- 1.20 D (41.4 +/- 20.4%) in Group C. There was no statistical significance in the dioptric reduction and the percent reduction among Groups A, B, and C. This suggests that the wound size and time of cutting are not directly correlated to the effect of argon laser suture cutting. To examine the relationship between the effect and changes in corneal shape from suture cutting, we divided the patients into two subgroups; one was Subgroup (+) in which the percent reduction of astigmatism was above 25%; the other was Subgroup (-) in which the percent reduction was below 25%.(ABSTRACT TRUNCATED AT 250 WORDS)

Sequential selective same-day suture removal in the management of post-keratoplasty astigmatism

PubMed Central

Fares, U; Mokashi, A A; Elalfy, M S; Dua, H S

2013-01-01

Aims In a previous study, we proposed that corneal topography performed 30–40 min after the initial suture removal can identify the next set of sutures requiring removal, for the treatment of post-keratoplasty astigmatism. The aim of this study was to evaluate the effect of removing subsequent sets of sutures at the same sitting. Methods 10/0 nylon interrupted sutures were placed, to secure the graft–host junction, at the time of keratoplasty. Topography was performed using Pentacam (Oculus) before suture removal. The sutures to be removed in the steep semi-meridians were identified and removed at the slit-lamp biomicroscope. Topography was repeated 30–40 min post suture removal, the new steep semi-meridians determined, and the next set of sutures to be removed were identified and removed accordingly. Topography was repeated 4–6 weeks later and the magnitude of topographic astigmatism was recorded. A paired-samples t-test was used to evaluate the impact of selective suture removal on reducing the magnitude of topographic and refractive astigmatism. Results Twenty eyes of 20 patients underwent sequential selective same-day suture removal (SSSS) after corneal transplantation. This study showed that the topographic astigmatism decreased by about 46.7% (3.68 D) and the refractive astigmatism decreased by about 37.7% (2.61 D) following SSSS. Vector calculations also show a significant reduction of both topographic and refractive astigmatism (P<0.001). Conclusion SSSS may help patients to achieve satisfactory vision more quickly and reduce the number of follow-up visits required post keratoplasty. PMID:23743526

Sequential selective same-day suture removal in the management of post-keratoplasty astigmatism.

PubMed

Fares, U; Mokashi, A A; Elalfy, M S; Dua, H S

2013-09-01

In a previous study, we proposed that corneal topography performed 30-40 min after the initial suture removal can identify the next set of sutures requiring removal, for the treatment of post-keratoplasty astigmatism. The aim of this study was to evaluate the effect of removing subsequent sets of sutures at the same sitting. 10/0 nylon interrupted sutures were placed, to secure the graft-host junction, at the time of keratoplasty. Topography was performed using Pentacam (Oculus) before suture removal. The sutures to be removed in the steep semi-meridians were identified and removed at the slit-lamp biomicroscope. Topography was repeated 30-40 min post suture removal, the new steep semi-meridians determined, and the next set of sutures to be removed were identified and removed accordingly. Topography was repeated 4-6 weeks later and the magnitude of topographic astigmatism was recorded. A paired-samples t-test was used to evaluate the impact of selective suture removal on reducing the magnitude of topographic and refractive astigmatism. Twenty eyes of 20 patients underwent sequential selective same-day suture removal (SSSS) after corneal transplantation. This study showed that the topographic astigmatism decreased by about 46.7% (3.68 D) and the refractive astigmatism decreased by about 37.7% (2.61 D) following SSSS. Vector calculations also show a significant reduction of both topographic and refractive astigmatism (P<0.001). SSSS may help patients to achieve satisfactory vision more quickly and reduce the number of follow-up visits required post keratoplasty.

Analysis of astigmatism of gain guided laser with a tapered-stripe geometry

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

Mamine, T.; Oda, T.; Yoneyama, O.

1984-12-01

The astigmatism of the tapered-stripe (TAPS) laser has been analyzed. Calculating the near-field spot size and the radius of curvature in the tapered-stripe region, the astigmatism is determined by using the expression of D = R/sub e/ (1+(lambdaR/sub e// ..pi..w/sup 2//sub e/)/sup 2/)/sup -1/. In our formalism we assume that the gain profile is parabola and the near-field spot size at the facet is determined by the diffusion length of injected carriers. So far as these assumptions are valid, it is concluded that the amount of astigmatism is reduced with the length of tapered stripe, using the refractive index changemore » due to the band-edge absorption of -10/sup -2/. The fundamental characteristics of the gain guided laser with TAPS structure such as the astigmatism, far-field radiation pattern, and the spontaneous emission factor are shown to be controlled by properly designing the stripe geometry and the thickness of the active layer.« less

A sample predictive model for intraocular pressure following laser in situ keratomileusis for myopia and an "intraocular pressure constant".

PubMed

Bahadir Kilavuzoglu, Ayse Ebru; Bozkurt, Tahir Kansu; Cosar, Cemile Banu; Sener, Asım Bozkurt

2017-06-24

To describe a sample predictive model for intraocular pressure (IOP) following laser in situ keratomileusis (LASIK) for myopia and an IOP constant. The records of patients that underwent LASIK for myopia and myopic astigmatism via WaveLight Allegretto Wave Eye-Q 400 Hz excimer laser and Hansatome XP microkeratome were retrospectively reviewed. Patients with no systemic or ocular disease other than myopia or myopic astigmatism were included in the study. Preoperative and postoperative month 1 data and intraoperative data were used to build the predictive model for IOP after LASIK. The IOP constant was calculated by subtracting the predicted IOP from preoperative IOP. The paired samples t test, Pearson's correlation analysis, curve estimation analysis, and linear regression analysis were used to evaluate the study data. The study included 425 eyes in 214 patients with a mean age of 32 ± 7.8 years. Mean spherical equivalent of the attempted correction (SE-ac) was -3.7 ± 1.7 diopters. Mean post-LASIK decrease in IOP was 4.6 ± 2.3 mmHg. The difference between preoperative and postoperative IOP was statistically significant (P < 0.001). SE-ac, preoperative IOP, and central corneal thickness had highly significant effects on postoperative IOP, based on linear regression analysis (P < 0.001 and R 2  = 0.043, P < 0.001 and R 2  = 0.370, and P < 0.001 and R 2  = 0.132, respectively). Regression model was created (F = 127.733, P < 0.001), and the adjusted R 2 value was 0.548. Evaluation of IOP after LASIK is important in myopic patients. The present study described a practical formula for predicting the true IOP with the aid of an IOP constant value in myopic eyes following LASIK.

Influence of Near Tasks on Posture in Myopic Chinese Schoolchildren

PubMed Central

Bao, Jinhua; Drobe, Björn; Wang, Yuwen; Chen, Ke; Seow, Eu Jin; Lu, Fan

2015-01-01

ABSTRACT Purpose To investigate near-vision posture in Chinese myopic schoolchildren and compare near-vision posture during different near-vision tasks (i.e., playing video games, reading, and writing). Methods The study investigated 120 myopic children (grades 1 through 6 and aged 6 to 13 years). An electromagnetic motion-tracking system was used for continuous measurements of the working distance and head declination of the subjects while they were playing video games or reading or writing at a desk. The reading and writing documents were adjusted by grade level (i.e., grades 1 to 2, 3 to 4, and 5 to 6). For analysis, the subjects were grouped in two refractive groups according to their median spherical equivalent refractive error (−1.50D). Results The myopic schoolchildren used close working distances for all tasks: 21.3 ± 5.2 cm (video games), 27.2 ± 6.4 cm (reading), and 24.9 ± 5.8 cm (writing). The mean head declinations were 63.5 ± 12.2 deg (video games), 37.1 ± 12.8 deg (reading), and 44.5 ± 14.1 deg (writing). Working distance decreased significantly across time for the reading and writing tasks (p < 0.001). Head declination increased significantly across time only for the reading task (p < 0.001). Grade level significantly influenced working distance, but the difference was not significant when working distance was adjusted by the subject’s size. No differences were observed within the refractive or the accommodative lag groups in terms of the posture data (p > 0.05). Working distance was negatively correlated with head declination (r = −0.53, p < 0.001). Conclusions Close working distances were observed for Chinese myopic schoolchildren. The attention dedicated to each task, the task difficulty, and the page/screen size may affect near working distance and head declination. Handheld video games were associated with the closest working distance, which may be a risk factor for myopia progression, according to previous studies. PMID:26107025

Generating high-peak-power structured lights in selectively pumped passively Q-switched lasers with astigmatic mode transformations

NASA Astrophysics Data System (ADS)

Chang, C. C.; Hsieh, Y. H.; Lee, C. Y.; Sung, C. L.; Tuan, P. H.; Tung, J. C.; Liang, H. C.; Chen, Y. F.

2017-12-01

Various high-order Hermite-Gaussian (HG) modes with high repetition rates and high peak powers are systematically generated by designing the cavity configuration to satisfy the criterion of the passive Q-switching. For the HG m,0 modes with the order m  =  1-9, the pulse repetition rate can exceed 100 kHz with peak power higher than 0.3 kW. For the HG m,m modes with the order m  =  1-10, the pulse repetition rate can be up to 37 kHz with peak power higher than 0.35 kW. Furthermore, the high-order HG beams is transformed by using an astigmatic mode converter to generate various structured lights with optical vortices. Experimental patterns of the transformed high-order HG beams in the propagation are theoretically analyzed and the phase structures are numerically manifested.

Average intensity and spreading of an astigmatic sinh-Gaussian beam with small beam width propagating in atmospheric turbulence

NASA Astrophysics Data System (ADS)

Zhu, Jie; Zhu, Kaicheng; Tang, Huiqin; Xia, Hui

2017-10-01

Propagation properties of astigmatic sinh-Gaussian beams (ShGBs) with small beam width in turbulent atmosphere are investigated. Based on the extended Huygens-Fresnel integral, analytical formulae for the average intensity and the effective beam size of an astigmatic ShGB are derived in turbulent atmosphere. The average intensity distribution and the spreading properties of an astigmatic ShGB propagating in turbulent atmosphere are numerically demonstrated. The influences of the beam parameters and the structure constant of atmospheric turbulence on the propagation properties of astigmatic ShGBs are also discussed in detail. In particular, for sufficiently small beam width and sinh-part parameter as well as suitable astigmatism, we show that the average intensity pattern converts into a perfect dark-hollow profile from initial two-petal pattern when ShGBs with astigmatic aberration propagate through atmospheric turbulence.

Measuring mental workload: ocular astigmatism aberration as a novel objective index.

PubMed

Jiménez, Raimundo; Cárdenas, David; González-Anera, Rosario; Jiménez, José R; Vera, Jesús

2018-04-01

This study assessed the effect of two perceptually matched mental tasks with different levels of mental demand on ocular aberrations in a group of young adults. We measured ocular aberration with a wavefront sensor, and total, internal and corneal RMS (root mean square) aberrations were calculated from Zernike coefficients, considering natural and scaled pupils (5, 4.5, and 4 mm). We found that total, internal and corneal astigmatism RMS showed significant differences between mental tasks with natural pupils (p < .05), and this effect was maintained with 5 mm scaled pupils (total RMS astigmatism, p < .05). Consistently, pupil size, intraocular pressure, perceived mental load and cognitive performance were influenced by the level of mental complexity (p < .05 for all). The findings suggest that ocular astigmatism aberration, mediated by intraocular pressure, could be an objective, valid reliable index to evaluate the impact of cognitive processing in conjunction with others physiological markers in real world contexts. Practitioner Summary: The search continues for a valid, reliable, convenient method of measuring mental workload. In this study we found ocular astigmatism aberration is sensitive to the cumulative effect of mental effort. It shows promise of being a novel ocular index which may help to assess mental workload in real situations.

PREDICTIVE FACTORS OF SURGICAL OUTCOMES IN VITRECTOMY FOR MYOPIC TRACTION MACULOPATHY.

PubMed

Hattori, Kyoko; Kataoka, Keiko; Takeuchi, Jun; Ito, Yasuki; Terasaki, Hiroko

2017-11-07

To assess predictive factors and surgical outcomes for myopic traction maculopathy. This retrospective observational case study enrolled 73 patients who underwent vitrectomy for myopic traction maculopathy. The 79 eyes obtained from our study sample were divided into 4 types: retinoschisis, lamellar macular hole (lamellar MH), foveal retinal detachment (FRD), and FRD + lamellar MH, or into 2 types according to the presence of FRD preoperatively. Dependent variables of interest were age, sex, pre- and postoperative best-corrected visual acuity (BCVA) at 6 months, and axial length. All the four types showed moderately strong-to-strong positive correlations with pre- and postoperative BCVA (retinochisisi: r = 0.61; lamellar MH: r = 0.62; FRD: r = 0.51; FRD + lamellar MH; r = 0.83). Preoperative BCVA was associated with postoperative BCVA (P < 0.0001), but age, axial length, and the types of preoperative foveal status were not. Eyes with FRD had significantly worse pre- and postoperative BCVA than eyes without FRD (P = 0.036 and P = 0.046, respectively). Postoperative full-thickness macular holes developed in 5.1% of cases and in all types but retinoschisis. Preoperative visual acuity and the presence of FRD should be considered for surgical indication of myopic traction maculopathy.

Relationship Between Anterior Lamina Cribrosa Surface Tilt and Glaucoma Development in Myopic Eyes.

PubMed

Lee, Eun Jung; Han, Jong Chul; Kee, Changwon

2017-05-01

To evaluate the anterior lamina cribrosa (LC) surface tilt angle in myopic eyes and associate it with glaucoma development. In this retrospective study, medical records of myopic patients referred for glaucoma examination from July 1, 2012 to March 30, 2016 were reviewed. Comprehensive ophthalmic examination including spectral-domain optical coherence tomography were performed. We measured the angle of anterior LC surface tilt against Bruch's membrane opening from optical coherence tomography images at the center of the clinical optic disc margin. In horizontal and vertical sections, the angles were defined as α and β, respectively. Patients were grouped according to the presence of glaucomatous damage and factors including optic nerve head morphologic parameters and LC tilt angles were compared between the 2 groups. Among 138 patients originally enrolled, 102 patients were finally analyzed. One eye from 1 patient was randomly chosen. Fifty-five eyes had glaucoma and 47 were normal. The degree of myopia and all optic nerve head morphologic parameters were not significantly different between the 2 groups. However, |α| and |β| were significantly larger in the glaucoma group (all P<0.001), and significances were maintained in multivariate analysis (P<0.001). Larger anterior LC surface tilt angles were related to the presence of glaucoma in normal-pressure myopic eyes. Angulation of the LC against Bruch's membrane opening plane might be associated with increased glaucoma susceptibility in myopic eyes. Further investigations are warranted before clinical utilization of LC tilt as glaucoma susceptibility biomarker.

Medical Services: Ophthalmic Services

DTIC Science & Technology

1986-01-01

pair of half-eye spectacles. These spectacles will not be requested when the prescrip- tion requires either a myopic correction or astigmatic ...addition, and the size is usually 7mm. Minimum power for near vision is +1.50 diopters. (5) Lenticular lenses. These lenses are available under

Comparison of surgically induced astigmatism following different glaucoma operations.

PubMed

Tanito, Masaki; Matsuzaki, Yukari; Ikeda, Yoshifumi; Fujihara, Etsuko

2017-01-01

To compare surgically induced astigmatism (SIA) among glaucomatous eyes treated with trabeculectomy (LEC), EX-PRESS ® shunt (EXP), ab externo trabeculotomy (exLOT), or microhook ab interno trabeculotomy (μLOT). Eighty right eyes of 80 subjects who underwent LEC (n=20), EXP (n=20), exLOT (n=20), or μLOT (n=20) were included. The dataset including the best-corrected visual acuity (BCVA), intraocular pressure (IOP), and keratometry recordings preoperatively and 3 months postoperatively was collected by chart review. The means of the vector magnitude, vector meridian, and arithmetic magnitude of the preoperative and postoperative astigmatism and SIA were calculated. The correlations among the SIA magnitude, postoperative BCVA, and IOP were assessed. The mean astigmatic arithmetic magnitudes did not differ significantly ( P =0.0732) preoperatively among the four groups, but the magnitude was significantly ( P =0.0002) greater in the LEC group than the other groups postoperatively. The mean SIA vectors were calculated to be 1.01 D at 56°, 0.62 D at 74°, 0.23 D at 112°, and 0.12 D at 97° for the LEC, EXP, exLOT, and μLOT groups, respectively. The mean SIA arithmetic magnitudes were significantly ( P <0.0001) greater in the LEC group than the other groups. Three months postoperatively, the SIA magnitude was correlated positively with the logarithm of the minimum angle of resolution (logMAR) BCVA ( r =0.3538) and negatively with the IOP ( r =-0.3265); the logMAR BCVA was correlated negatively with the IOP ( r =-0.3105). EXP, exLOT, and μLOT induce less corneal astigmatism than LEC in the early postoperative period.

Investigating the impact of preoperative corneal astigmatism orientation on the postoperative spherical equivalent refraction following intraocular lens implantation.

PubMed

McNeely, Richard N; Moutari, Salissou; Pazo, Eric; Moore, Jonathan E

2018-01-01

To investigate the impact of the orientation of preoperative corneal astigmatism on achieving the postoperative target refraction following monofocal intraocular lens (IOL) implantation. This study enrolled 339 eyes who had uneventful cataract surgery or refractive lens exchange (RLE) with subsequent monofocal IOL implantation. Eyes were initially categorized dependent upon axial length and then on the orientation of preoperative anterior corneal astigmatism. Group 1 had against-the-rule (ATR) anterior corneal astigmatism, group 2 had with-the-rule (WTR) anterior corneal astigmatism, and group 3 had oblique (OB) anterior corneal astigmatism. The preoperative corneal astigmatism was determined by the IOLMaster (Carl Zeiss Meditec AG). Postoperative refraction was completed for all eyes, and the results were calculated and compared for the separate groups. In eyes with axial lengths greater than 22.0 mm and less than 25.0 mm there was a significant difference between the magnitude of preoperative corneal astigmatism between groups 2 and 3 with 0.827 ± 0.376 D in group 2, and 0.677 ± 0.387 D in group 3. The mean postoperative spherical equivalent (SE) prediction error was - 0.132 ± 0.475 D in group 1, 0.026 ± 0.497 D in group 2, and - 0.130 ± 0.477 D in group 3. There was a significant difference between groups 1 and 2. There was no significant difference in the magnitude of preoperative corneal astigmatism and postoperative SE prediction error between the anterior corneal astigmatism orientation groups in eyes with axial lengths of less than or equal to 22.0 mm and greater than or equal to 25.0 mm. The orientation of preoperative anterior corneal astigmatism significantly affected the postoperative biometry prediction error in eyes with astigmatism of 1.75 D or less in eyes with the axial length between 22.0 mm and 25.0 mm. However, the results were not clinically significant.

Generally astigmatic Gaussian beam representation and optimization using skew rays

NASA Astrophysics Data System (ADS)

Colbourne, Paul D.

2014-12-01

Methods are presented of using skew rays to optimize a generally astigmatic optical system to obtain the desired Gaussian beam focus and minimize aberrations, and to calculate the propagating generally astigmatic Gaussian beam parameters at any point. The optimization method requires very little computation beyond that of a conventional ray optimization, and requires no explicit calculation of the properties of the propagating Gaussian beam. Unlike previous methods, the calculation of beam parameters does not require matrix calculations or the introduction of non-physical concepts such as imaginary rays.

Preliminary results of tracked laser-assisted in-situ keratomileusis (T-LASIK) for myopia and hyperopia using the autonomous technologies excimer laser system

NASA Astrophysics Data System (ADS)

Maguen, Ezra I.; Nesburn, Anthony B.; Salz, James J.

2000-06-01

A study was undertaken to assess the safety and efficacy of LASIK with the LADARVision laser by Autonomous Technologies, (Orlando, FL). The study included four subsets: Spherical myopia -- up to -11.00D, spherical hyperopia -- up to +6.00D. Both myopic and hyperopic astigmatism could be corrected, up to 6.00D of astigmatism. A total of 105 patients participated. Sixty-six patients were myopic and 39 were hyperopic. The mean (+/- SD) age was 42.8 +/- 9.3 years for myopia and 53.2 +/- 9.9 years for hyperopia. At 3 months postop. Sixty-one myopic eyes were available for evaluation. Uncorrected visual acuity was 20/20 in 70% of eyes and 20/40 in 92.9% of all eyes. The refractive outcome was within +/- 0.50D in 73.8% of eyes and within +/- 1.00D in 96.7 of eyes. Thirty-eight hyperopic eyes were available. Uncorrected visual acuity was 20/20 in 42.1% of eyes and 20/40 in 88% of all eyes. The refractive outcome was within +/- 0.50D in 57.9% of eyes and within +/- 1.00D in 86.8% of eyes. Complications were not sight threatening and were discussed in detail. Lasik with the LADARVision laser appears to be safe and effective.

Nonlocal conservation laws of the constant astigmatism equation

NASA Astrophysics Data System (ADS)

Hlaváč, Adam; Marvan, Michal

2017-03-01

For the constant astigmatism equation, we construct a system of nonlocal conservation laws (an abelian covering) closed under the reciprocal transformations. The corresponding potentials are functionally independent modulo a Wronskian type relation.

Fast myopic 2D-SIM super resolution microscopy with joint modulation pattern estimation

NASA Astrophysics Data System (ADS)

Orieux, François; Loriette, Vincent; Olivo-Marin, Jean-Christophe; Sepulveda, Eduardo; Fragola, Alexandra

2017-12-01

Super-resolution in structured illumination microscopy (SIM) is obtained through de-aliasing of modulated raw images, in which high frequencies are measured indirectly inside the optical transfer function. Usual approaches that use 9 or 15 images are often too slow for dynamic studies. Moreover, as experimental conditions change with time, modulation parameters must be estimated within the images. This paper tackles the problem of image reconstruction for fast super resolution in SIM, where the number of available raw images is reduced to four instead of nine or fifteen. Within an optimization framework, the solution is inferred via a joint myopic criterion for image and modulation (or acquisition) parameters, leading to what is frequently called a myopic or semi-blind inversion problem. The estimate is chosen as the minimizer of the nonlinear criterion, numerically calculated by means of a block coordinate optimization algorithm. The effectiveness of the proposed method is demonstrated for simulated and experimental examples. The results show precise estimation of the modulation parameters jointly with the reconstruction of the super resolution image. The method also shows its effectiveness for thick biological samples.