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Gao N, Gao X, Du M, Xiang Y, Zuo H, Huang R, Wan W, Hu K. Lutein protects senescent ciliary muscle against oxidative stress through the Keap1/Nrf2/ARE pathway. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 134:155982. [PMID: 39244941 DOI: 10.1016/j.phymed.2024.155982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2024] [Revised: 07/30/2024] [Accepted: 08/22/2024] [Indexed: 09/10/2024]
Abstract
BACKGROUND Aging-induced decline in ciliary muscle function is an important factor in visual accommodative deficits in elderly adults. With this study, we provide an innovative investigation of the interaction between ciliary muscle aging and oxidative stress. METHODS Tricolor guinea pigs were used for the experiments in vivo and primary guinea pig ciliary smooth muscle cells were used for the experiments in vitro. RESULTS We enriched for genes associated with muscle-aging-lutein relationship using bioinformatics, including Nuclear factor-erythroid 2-related factor-2 (Nrf2), Glutathione Peroxidase (GPx) gene family, Superoxide Dismutase (SOD) gene family, NAD(P)H: Quinone Oxidoreductase 1 (NQO1) and Heme Oxygenase-1 (HO-1). After gavage to aged guinea pigs, lutein reduced Reactive Oxygen Species (ROS) and P21 levels in senescent ciliary muscle; lutein decreased refractive error and restored accommodation of the eye. In addition, lutein increased GPx, SOD, and Catalase (CAT) levels in serum; lutein increased GPx and CAT levels in ciliary bodies. Lutein regulated the expression of proteins such as Nrf2, Kelch-like ECH-associated protein 1 (Keap1), and downstream proteins in senescent ciliary bodies. Similarly, guinea pig ciliary muscle cell senescence was associated with oxidative stress. In vitro, 100 μM lutein reversed the damage caused by 800 μM H2O2; it reduced Senescence-Associated β-galactosidase (SA-β-Gal) and ROS activites, cell apoptosis and cell migration. Also, lutein increased the expression of smooth muscle contractile proteins. Lutein also increased the expression of Nrf2, GPx2, NQO1 and HO-1, decreased the expression of Keap1. A reduction in Nrf2 activity led to a reduction in the ability of lutein to activate antioxidant enzymes in the cells, thus reducing its inhibitory effect on cell senescence. CONCLUSION lutein improved resistance to oxidative stress in senescent ciliary muscle in vivo and in vitro by regulating the Keap1/Nrf2/Antioxidant Response Element pathway. We have innovatively demonstrated the molecular pharmacological mechanism by which lutein reverse age-related ciliary muscle systolic and diastolic deficits.
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Affiliation(s)
- Ning Gao
- The First Affiliated Hospital of Chongqing Medical University, Ophthalmology, Chongqing 400016, PR China; Key Laboratory of Prevention and Treatment on major blinding diseases, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing 400016, PR China
| | - Xiang Gao
- The First Affiliated Hospital of Chongqing Medical University, Ophthalmology, Chongqing 400016, PR China; Key Laboratory of Prevention and Treatment on major blinding diseases, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing 400016, PR China
| | - Miaomiao Du
- The First Affiliated Hospital of Chongqing Medical University, Ophthalmology, Chongqing 400016, PR China; Key Laboratory of Prevention and Treatment on major blinding diseases, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing 400016, PR China
| | - Yongguo Xiang
- The First Affiliated Hospital of Chongqing Medical University, Ophthalmology, Chongqing 400016, PR China; Key Laboratory of Prevention and Treatment on major blinding diseases, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing 400016, PR China
| | - Hangjia Zuo
- The First Affiliated Hospital of Chongqing Medical University, Ophthalmology, Chongqing 400016, PR China; Key Laboratory of Prevention and Treatment on major blinding diseases, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing 400016, PR China
| | - Rongxi Huang
- Chongqing General Hospital, Endocrinology, Chongqing 400013, PR China
| | - Wenjuan Wan
- The First Affiliated Hospital of Chongqing Medical University, Ophthalmology, Chongqing 400016, PR China; Key Laboratory of Prevention and Treatment on major blinding diseases, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing 400016, PR China.
| | - Ke Hu
- The First Affiliated Hospital of Chongqing Medical University, Ophthalmology, Chongqing 400016, PR China; Key Laboratory of Prevention and Treatment on major blinding diseases, Chongqing Eye Institute, Chongqing Branch (Municipality Division) of National Clinical Research Center for Ocular Diseases, Chongqing 400016, PR China.
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Borkenstein AF, Kormilina TK, Fitzek H, Rattenberger J, Kothleitner G, Charry FEM, Borkenstein EM. Incorrectly Focused Neodymium:Yttrium-Aluminum-Garnet (Nd:YAG) Laser Beam Leads to Massive Destructive Effects in Small-Aperture (Pinhole) Intraocular Lenses. Ophthalmol Ther 2024; 13:2745-2758. [PMID: 39153117 PMCID: PMC11408416 DOI: 10.1007/s40123-024-01007-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2024] [Accepted: 07/17/2024] [Indexed: 08/19/2024] Open
Abstract
INTRODUCTION Pinhole intraocular lenses (IOLs) were developed to improve reading by compensating for loss of accommodative function. The IC-8® Apthera™ is a small-aperture presbyopia-correcting IOL that combines the proven principle of small-aperture optics with an aspheric monofocal lens to deliver a continuous range of vision for patients with cataracts from distance to near vision. Posterior capsule opacification is the most common sequela after cataract surgery. It is effectively treated by laser capsulotomy. However, if the laser beam is incorrectly focused, the IOL can be permanently damaged (pits/shots). METHODS In this experimental study, yttrium-aluminum-garnet (YAG) pits were purposefully created. Defects were analyzed and compared between the periphery of the ring in the clear area of the hydrophobic acrylic lens and at the carbon black (CB)-polyvinylidene fluoride (PVDF) filtering component (FilterRing™) of the pinhole lens. All defects were made using identical settings/energy levels (2.6 mJ). The damage induced to the IC-8® Apthera™ IOL was examined by low-magnification images, light microscopy, scanning electron microscopy, and micro-computed tomography (micro-CT). RESULTS YAG defects in the carbon black filter ring were much more severe than those in the clear zone due to the high absorption of the carbon black. Massive defects and destruction of the lens with tearing out of fragments and particles were observed. The missing volume calculated from the micro-CT reconstruction was 0.266 mm3, which is 1.6% of the entire IOL volume, or more than 1000 times the volume damaged in the largest shot in the periphery. CONCLUSION Based on the results, we highly recommend using the lowest possible energy levels, posterior offset setting, and circular pattern for maximum safety when performing laser capsulotomy with pinhole implants. Care should be taken to avoid creating irreversible iatrogenic defects that may affect overall quality. The safest area for performing capsulotomy seems to be the periphery of the ring segment. Video available for this article.
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Affiliation(s)
- Andreas F Borkenstein
- Borkenstein and Borkenstein Private Practice, Privatklinik Der Kreuzschwestern Graz, Kreuzgasse 35, 8010, Graz, Austria.
| | - Tatiana K Kormilina
- Graz Centre for Electron Microscopy (ZFE), Steyrergasse 17, 8010, Graz, Austria
| | - Harald Fitzek
- Graz Centre for Electron Microscopy (ZFE), Steyrergasse 17, 8010, Graz, Austria
| | | | - Gerald Kothleitner
- Graz Centre for Electron Microscopy (ZFE), Steyrergasse 17, 8010, Graz, Austria
- Institute of Electron Microscopy and Nanoanalysis (FELMI), Graz University of Technology, Steyrergasse 17, 8010, Graz, Austria
| | - Fabio E Machado Charry
- Institute of Solid State Physics, University of Technology Graz, Petersgasse 16/2, 8010, Graz, Austria
| | - Eva-Maria Borkenstein
- Borkenstein and Borkenstein Private Practice, Privatklinik Der Kreuzschwestern Graz, Kreuzgasse 35, 8010, Graz, Austria
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Salas-Sanchez Á, González-Amador E, Padilla-Vivanco A, Toxqui-Quitl C, Arines J, Acosta E. Jacobi-Fourier phase masks as ophthalmic elements to correct presbyopia. Ophthalmic Physiol Opt 2024. [PMID: 39250191 DOI: 10.1111/opo.13389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2024] [Revised: 08/21/2024] [Accepted: 08/23/2024] [Indexed: 09/10/2024]
Abstract
PURPOSE Investigations into the correction of presbyopia have considered lens design, clinical implications and the development of objective metrics such as the visual Strehl ratio. This study investigated the Jacobi-Fourier phase mask as an ophthalmic element in the correction of presbyopia. The goal was to develop a contact or intraocular lens whose performance was largely insensitive to changes in pupil diameter. METHODS Numerical simulations based on Fourier optics were performed to evaluate three different Jacobi-Fourier polynomials, with the aim of providing a range of clear vision (1 Dioptre (D)). Performance was evaluated for three pupil sizes (6, 4 and 2 mm), while polychromatic images were simulated using three different wavelengths (656.3, 587.6 and 486.1 nm). The Neural Transfer function was included in the simulation. To validate the method and results, we used the Visual Strehl combined objective metric (VSCombined) currently used in visual optics. This metric gives more weight to the phase transfer function and is more suitable for non-symmetrical phase functions. RESULTS Numerical validation showed the suitability of the Jacobi-Fourier phase masks for extending the range of clear vision of presbyopic eyes, providing a visual acuity of at least 0.10 logMAR (6/7.5 Snellen) at all distances between 1 and 6 m. The results show a range of clear vision of 1D was not affected by changes in pupil size, an increase in retinal image contrast accompanied by image artefact reduction by increasing the radial order of the Jacobi-Fourier phase mask and a reduction of wavelength dependence of the retinal images. These results are supported by simulated images and the objective criterion VSCombined. CONCLUSIONS The use of Jacobi-Fourier phase masks as ophthalmic elements for presbyopic correction show promising results, with a good range of clear vision and reduced dependence on pupil size and chromatic aberration.
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Affiliation(s)
| | | | | | | | - Justo Arines
- Dept. Física Aplicada, Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
- iMATUS (Instituto de Materiales) Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Eva Acosta
- Dept. Física Aplicada, Facultade de Óptica e Optometría, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
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Ganesh S, Sriganesh SS. Laser refractive correction of presbyopia. Indian J Ophthalmol 2024; 72:1236-1243. [PMID: 39185826 DOI: 10.4103/ijo.ijo_3074_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/21/2024] [Indexed: 08/27/2024] Open
Abstract
Presbyopia is an inevitable and progressive loss of the eye's ability to focus on nearby objects due to aging, which affects everyone regardless of their refractive error. Uncorrected presbyopia is a significant burden worldwide and affects the quality of life. Conservative options include spectacle correction, contact lenses, and pharmacologic agents. Spectacles are commonly used to correct vision, but have certain drawbacks such as peripheral blur and impaired depth perception. These limitations have been associated with an increased risk of accidental falls. Several surgical options are available to address these issues, including cornea-based, lens-based, or scleral procedures. These procedures involve modifying the cornea's optics, replacing the crystalline lens, or attempting to restore accommodation. Each of the options has its benefits and limitations. One of the most common surgical methods of presbyopic correction that has recently become popular is presbyopic Laser assisted In situ keratomileusis (LASIK) due to its improved safety and efficacy. This article is a review of all the currently available data and studies regarding the various methods of correction of presbyopia, with an emphasis on the principles and outcomes of the corneal laser refractive procedures for presbyopia correction, such as PresbyLASIK, Supracor, PRESBYOND laser blended vision, and Custom Q.
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Affiliation(s)
- Sri Ganesh
- Department of Phaco and Refractive, Nethradhama Superspeciality Eye Hospital, Bengaluru, Karnataka, India
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Hanyuda A, Kubota M, Kubota S, Masui S, Yuki K, Ayaki M, Negishi K. Establishing the cutoff value of near visual acuity for assessment of early presbyopia. Jpn J Ophthalmol 2024:10.1007/s10384-024-01114-x. [PMID: 39215880 DOI: 10.1007/s10384-024-01114-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2024] [Accepted: 07/25/2024] [Indexed: 09/04/2024]
Abstract
PURPOSE There is limited evidence to evaluate the numerical cutoff point for detecting early presbyopia. Thus, we aimed to establish a clinically relevant optimal cutoff value of near visual acuity for detecting early presbyopia. STUDY DESIGN Prospective diagnostic accuracy study. METHODS We included consecutive individuals aged ≥ 20 years with a binocular-corrected distance visual acuity of ≥ 20/25 who did not undergo ophthalmic surgery between December 17, 2020 and December 19, 2021, at two healthcare facilities in Japan. Binocular distance-corrected near visual acuity at 40 cm, accommodative amplitude, awareness of presbyopia, and Near Activity Visual Questionnaire scores were examined. The optimal cutoff values of distance-corrected near visual acuity for diagnosing early presbyopia were evaluated using receiver operating characteristic plots. RESULTS Among 115 participants, 74 (64.3%) had presbyopia. The proportion of participants with no difficulty performing near-vision tasks decreased markedly when near visual acuity decreased to 20/20 (> 0.00 logMAR). A cutoff value of 0.00 logMAR for distance-corrected near visual acuity was optimal, showing high sensitivity of 56.76% and specificity of 92.68%, as opposed to the commonly used cutoff value of 0.40 logMAR (20/50; sensitivity, 9.46% and specificity, 100%) for diagnosing early presbyopia. CONCLUSION Near visual acuity of 0.00 logMAR (20/20) could be the optimal cutoff value for diagnosing early presbyopia.
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Affiliation(s)
- Akiko Hanyuda
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Epidemiology and Prevention Group, Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Miyuki Kubota
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Department of Ophthalmology, Shonan Keiiku Hospital, Kanagawa, Japan
- Graduate School of Median and Governance, Keio University, Kanagawa, Japan
| | - Shunsuke Kubota
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
- Department of Ophthalmology, Shonan Keiiku Hospital, Kanagawa, Japan
- Graduate School of Median and Governance, Keio University, Kanagawa, Japan
- Hazawa-Kubota Eye Clinic, Kanagawa, Japan
| | - Sachiko Masui
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kenya Yuki
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Masahiko Ayaki
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Kazuno Negishi
- Department of Ophthalmology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
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Bievel-Radulescu R, Ferrari S, Piaia M, Mandatori D, Pandolfi A, Nubile M, Mastropasqua L, Stanca HT, Ponzin D. Banking of post-SMILE stromal lenticules for additive keratoplasty: A new challenge for eye banks? Int Ophthalmol 2024; 44:355. [PMID: 39182212 PMCID: PMC11345333 DOI: 10.1007/s10792-024-03283-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Accepted: 08/17/2024] [Indexed: 08/27/2024]
Abstract
PURPOSE ReLEx (Refractive Lenticule Extraction) Small Incision Lenticule Extraction (SMILE), the second generation of ReLEx Femtosecond Lenticule Extraction (FLEx), is a minimally invasive, flapless procedure designed to treat refractive errors such as myopia, hyperopia, presbyopia, and astigmatism. This review aims to provide a comprehensive overview of the methods for preserving SMILE-derived lenticules and discusses their potential future applications. METHODS A narrative literature review was conducted using PubMed, Scopus, and Web of Science databases, focusing on articles published up to January 2024 and available in English. The authors also evaluated the reference lists of the collected papers to identify any additional relevant research. RESULTS No standardized protocols currently exist for the storage or clinical application of SMILE-derived lenticules. However, these lenticules present a promising resource for therapeutic uses, particularly in addressing the shortage of donor corneal tissues. Their potential applications include inlay and overlay additive keratoplasty, as well as other ocular surface applications. Further research is needed to establish reliable protocols for their preservation and clinical use. CONCLUSION SMILE-derived lenticules offer significant potential as an alternative to donor corneal tissues. Standardizing their storage and application methods could enhance their use in clinical settings.
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Affiliation(s)
- Raluca Bievel-Radulescu
- Fondazione Banca Degli Occhi del Veneto, Via Paccagnella, 11, 30174, Venice, Italy.
- Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, 030167, Bucharest, Romania.
| | - Stefano Ferrari
- Fondazione Banca Degli Occhi del Veneto, Via Paccagnella, 11, 30174, Venice, Italy
| | - Moreno Piaia
- Fondazione Banca Degli Occhi del Veneto, Via Paccagnella, 11, 30174, Venice, Italy
| | - Domitilla Mandatori
- Department of Medicine and Aging Science, Ophthalmology Clinic, University G. D'Annunzio of Chieti-Pescara, 66100, Chieti, Italy
| | - Assunta Pandolfi
- Department of Medicine and Aging Science, Ophthalmology Clinic, University G. D'Annunzio of Chieti-Pescara, 66100, Chieti, Italy
| | - Mario Nubile
- StemTeCh Group, Department of Medical, Oral and Biotechnological Sciences, Center for Advanced Studies and Technology-CAST, University G. D'Annunzio of Chieti-Pescara, 66100, Chieti, Italy
| | - Leonardo Mastropasqua
- StemTeCh Group, Department of Medical, Oral and Biotechnological Sciences, Center for Advanced Studies and Technology-CAST, University G. D'Annunzio of Chieti-Pescara, 66100, Chieti, Italy
| | - Horia Tudor Stanca
- Department of Ophthalmology, "Carol Davila" University of Medicine and Pharmacy, 030167, Bucharest, Romania
| | - Diego Ponzin
- Fondazione Banca Degli Occhi del Veneto, Via Paccagnella, 11, 30174, Venice, Italy
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Xu Y, Mao Y, Lin X, Gao Z, Ruan X. Trend and projection of the prevalence and burden of near vision loss in China and globally from 1990 to 2030: A Bayesian age-period-cohort modeling study. J Glob Health 2024; 14:04119. [PMID: 39091200 PMCID: PMC11294904 DOI: 10.7189/jogh.14.04119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/04/2024] Open
Abstract
Background Few studies have investigated near vision loss (NVL) in China. To address this gap, we aimed to explore trends in the prevalence and disease burden of NVL from 1990 to 2019 and to predict trends over the next decade. Methods Using data from the Global Burden of Disease 2019 study, we calculated the age-standardised prevalence rate (ASPR), age-specific disability-adjusted life years (DALYs), and annual percentage change (EAPC) in China and different regions. We then used the Bayesian age-period-cohort (BAPC) predictive model to predict the prevalence trends from 2020 to 2030 in both contexts. Results At the global level, ASPRs increased from 5613.27 in 1990 to 5937.81 per 100 000 population in 2019, with an EAPC of 0.06. The ASPR in China specifically decreased from 7538.14 in 1990 to 7392.86 per 100 000 population in 2019 (EAPC = -0.02). The age-standardised DALY rate was higher in women than in men, both globally and in China. The NVL burden was relatively higher in low-income regions, low sociodemographic index regions, and the South-East Asia Region compared to other regions. The predictive model indicated that the ASR trend for NVL slowly increased at a global level after 2020, yet decreased in China. Conclusions Despite a decline in the age-standardised prevalence of NVL in China over the next decade, the current burden remains substantial. To alleviate this burden, decision-makers should adopt inclusive approaches by involving all stakeholders.
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Affiliation(s)
- Yanxin Xu
- Department of Ophthalmology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Yan Mao
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Xuming Lin
- Department of Ophthalmology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China
| | - Zongyin Gao
- Department of Ophthalmology, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Xiaoting Ruan
- Department of Ophthalmology, Yantai Yuhuangding Hospital, Qingdao University, Yantai, Shandong, China
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Schnider C, Yuen L, Rampat R, Zhu D, Dhallu S, Trinh T, Gurnani B, Abdelmaksoud A, Bhogal-Bhamra G, Wolffsohn JS, Naroo SA. BCLA CLEAR presbyopia: Management with intraocular lenses. Cont Lens Anterior Eye 2024; 47:102253. [PMID: 39068141 DOI: 10.1016/j.clae.2024.102253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/30/2024]
Abstract
Cataract surgery including intraocular lens (IOL) insertion, has been refined extensively since the first such procedure by Sir Harold Ridley in 1949. The intentional creation of monovision with IOLs using monofocal IOL designs has been reported since 1984. The first reported implantation of multifocal IOLs was published in 1987. Since then, various refractive and or diffractive multifocal IOLs have been commercialised. Most are concentric, but segmented IOLs are also available. The most popular are trifocal designs (overlaying two diffractive patterns to achieve additional focal planes at intermediate and near distances) and extended depth of focus designs which leave the patient largely spectacle independent with the reduced risk of bothersome contrast reduction and glare. As well as mini-monovision, surgical strategies to minimise the impact of presbyopia with IOLs includes mixing and matching lenses between the eyes and using IOLs whose power can be adjusted post-implantation. Various IOL designs to mimic the accommodative process have been tried including hinge optics, dual optics, lateral shifts lenses with cubic-type surfaces, lens refilling and curvature changing approaches, but issues in maintaining the active mechanism with post-surgical fibrosis, without causing ocular inflammation, remain a challenge. With careful patient selection, satisfaction rates with IOLs to manage presbyopia are high and anatomical or physiological complications rates are no higher than with monofocal IOLs.
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Affiliation(s)
| | - Leonard Yuen
- ONE Medical Doctors Group & Day Surgical Centre, Quarry Bay, Hong Kong
| | | | - Dagny Zhu
- NVISION Eye Centers Rowland Heights, CA, USA
| | - Sandeep Dhallu
- Department of Clinical, Pharmaceutical and Biological Science, University of Hertfordshire, Hatfield, UK
| | - Tanya Trinh
- Mosman Eye Clinic, Sydney, New South Wales, Australia; Sydney Hospital and Sydney Eye Hospital, New South Wales, Australia
| | - Bharat Gurnani
- Gomabai Netralaya and Research Centre, Neemuch, Madhya Pradesh, India
| | | | | | - James S Wolffsohn
- College of Health & Life Sciences, Aston University, Birmingham, United Kingdom
| | - Shehzad A Naroo
- College of Health & Life Sciences, Aston University, Birmingham, United Kingdom.
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Markoulli M, Fricke TR, Arvind A, Frick KD, Hart KM, Joshi MR, Kandel H, Filipe Macedo A, Makrynioti D, Retallic N, Garcia-Porta N, Shrestha G, Wolffsohn JS. BCLA CLEAR Presbyopia: Epidemiology and impact. Cont Lens Anterior Eye 2024; 47:102157. [PMID: 38594155 DOI: 10.1016/j.clae.2024.102157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
The global all-ages prevalence of epidemiologically-measured 'functional' presbyopia was estimated at 24.9% in 2015, affecting 1.8 billion people. This prevalence was projected to stabilise at 24.1% in 2030 due to increasing myopia, but to affect more people (2.1 billion) due to population dynamics. Factors affecting the prevalence of presbyopia include age, geographic location, urban versus rural location, sex, and, to a lesser extent, socioeconomic status, literacy and education, health literacy and inequality. Risk factors for early onset of presbyopia included environmental factors, nutrition, near demands, refractive error, accommodative dysfunction, medications, certain health conditions and sleep. Presbyopia was found to impact on quality-of-life, in particular quality of vision, labour force participation, work productivity and financial burden, mental health, social wellbeing and physical health. Current understanding makes it clear that presbyopia is a very common age-related condition that has significant impacts on both patient-reported outcome measures and economics. However, there are complexities in defining presbyopia for epidemiological and impact studies. Standardisation of definitions will assist future synthesis, pattern analysis and sense-making between studies.
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Affiliation(s)
- Maria Markoulli
- School of Optometry and Vision Science, UNSW Sydney, Australia.
| | - Timothy R Fricke
- School of Optometry and Vision Science, UNSW Sydney, Australia; Department of Optometry and Vision Science, University of Melbourne, Australia; National Vision Research Institute, Australian College of Optometry, Melbourne, Australia
| | - Anitha Arvind
- Department of Optometry, School of Medical and Allied Sciences, GD Goenka University, India
| | - Kevin D Frick
- Johns Hopkins Carey Business School, USA; Johns Hopkins Bloomberg School of Public Health Departments of International Health and Health Policy and Management, USA; Johns Hopkins School of Medicine, Department of Ophthalmology, USA
| | - Kerryn M Hart
- School of Medicine, Faculty of Health, Deakin University, Australia; Member Support and Optometry Advancement, Optometry Australia, Australia
| | - Mahesh R Joshi
- School of Health Professions, University of Plymouth, United Kingdom
| | - Himal Kandel
- Save Sight Institute, Faculty of Medicine and Health, The University of Sydney, Australia; Sydney Eye Hospital, Australia
| | - Antonio Filipe Macedo
- Department of Medicine and Optometry, Faculty of Health and Life Sciences, Linnaeus University, Sweden; Centre of Physics of Minho and Porto Universities, School of Sciences, University of Minho, Braga, Portugal
| | | | - Neil Retallic
- Specsavers Optical Group, La Villiaze, St. Andrew's, Guernsey, United Kingdom; School of Optometry and Vision Science, University of Bradford, Bradford, United Kingdom
| | - Nery Garcia-Porta
- Applied Physics Department, Optics and Optometry Faculty, University of Santiago de Compostela, Spain; Institute of Materials (iMATUS) of the University of Santiago de Compostela, Spain
| | - Gauri Shrestha
- Optometry Department, BPK Centre for Ophthalmic Studies, Institute of Medicine, Nepal
| | - James S Wolffsohn
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom
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Morgan PB, Efron N, Papas E, Barnett M, Carnt N, Dutta D, Hepworth A, Little JA, Nagra M, Pult H, Schweizer H, Shen Lee B, Subbaraman LN, Sulley A, Thompson A, Webster A, Markoulli M. BCLA CLEAR Presbyopia: Management with contact lenses and spectacles. Cont Lens Anterior Eye 2024; 47:102158. [PMID: 38631935 DOI: 10.1016/j.clae.2024.102158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/19/2024]
Abstract
This paper seeks to outline the history, market situation, clinical management and product performance related to the correction of presbyopia with both contact lenses and spectacles. The history of the development of various optical forms of presbyopic correction are reviewed, and an overview is presented of the current market status of contact lenses and spectacles. Clinical considerations in the fitting and aftercare of presbyopic contact lens and spectacle lens wearers are presented, with general recommendations for best practice. Current options for contact lens correction of presbyopia include soft simultaneous, rigid translating and rigid simultaneous designs, in addition to monovision. Spectacle options include single vision lenses, bifocal lenses and a range of progressive addition lenses. The comparative performance of both contact lens and spectacle lens options is presented. With a significant proportion of the global population now being presbyopic, this overview is particularly timely and is designed to act as a guide for researchers, industry and eyecare practitioners alike.
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Affiliation(s)
- Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, University of Manchester, United Kingdom.
| | - Nathan Efron
- Optometry and Vision Science, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Eric Papas
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | | | - Nicole Carnt
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Debarun Dutta
- Optometry and Vision Science Research Group, Aston University, Birmingham, United Kingdom
| | - Andy Hepworth
- EssilorLuxottica Europe North, Bristol, United Kingdom
| | - Julie-Anne Little
- Centre for Optometry and Vision Science, Biomedical Sciences Research Institute, Ulster University, Coleraine, United Kingdom
| | - Manbir Nagra
- Vision and Eye Research Institute, ARU, Young Street, Cambridge, United Kingdom
| | - Heiko Pult
- Dr Heiko Pult - Optometry and Vision Research, Weinheim, Germany
| | - Helmer Schweizer
- CEO Helmer Schweizer Consulting Group (HSCG), Bassersdorf, Switzerland
| | - Bridgitte Shen Lee
- Vision Optique and Ocular Aesthetics dba Ocular Clinical Trials, Houston, TX, United States
| | | | - Anna Sulley
- CooperVision International Ltd, Chandlers Ford, United Kingdom
| | | | | | - Maria Markoulli
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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11
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Wolffsohn JS, Naroo SA, Bullimore MA, Craig JP, Davies LN, Markoulli M, Schnider C, Morgan PB. BCLA CLEAR Presbyopia: Definitions. Cont Lens Anterior Eye 2024; 47:102155. [PMID: 38609792 DOI: 10.1016/j.clae.2024.102155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2024]
Abstract
Presbyopia is often the first sign of ageing experienced by humans. Standardising terminology and adopting it across the BCLA CLEAR Presbyopia reports, improves consistency in the communication of the evidence-based understanding of this universal physiological process. Presbyopia can be functionally and psychologically debilitating, especially for those with poor access to eyecare. Presbyopia was defined as occurring when the physiologically normal age-related reduction in the eye's focusing range reaches a point that, when optimally corrected for far vision, the clarity of vision at near is insufficient to satisfy an individual's requirements. Accommodation is the change in optical power of the eye due to a change in crystalline lens shape and position, whereas pseudo-accommodation is the attainment of functional near vision in an emmetropic or far-corrected eye without changing the refractive power of the eye. Other definitions specific to vision and lenses for presbyopia were also defined. It is recommended that these definitions be consistently adopted in order to standardise future research, clinical evaluations and education.
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Affiliation(s)
- James S Wolffsohn
- College of Health & Life Sciences, Aston University, Birmingham, United Kingdom.
| | - Shehzad A Naroo
- College of Health & Life Sciences, Aston University, Birmingham, United Kingdom
| | | | - Jennifer P Craig
- Department of Ophthalmology, The University of Auckland, Auckland, New Zealand
| | - Leon N Davies
- College of Health & Life Sciences, Aston University, Birmingham, United Kingdom
| | - Maria Markoulli
- School of Optometry & Vision Science, University of New South Wales, Sydney, Australia
| | - Cristina Schnider
- Eurolens Research, Division of Pharmacy and Optometry, University of Manchester, United Kingdom
| | - Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, University of Manchester, United Kingdom
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12
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Craig JP, Barsam A, Chen C, Chukwuemeka O, Ghorbani-Mojarrad N, Kretz F, Michaud L, Moore J, Pelosini L, Turnbull AMJ, Vincent SJ, Wang MTM, Ziaei M, Wolffsohn JS. BCLA CLEAR Presbyopia: Management with corneal techniques. Cont Lens Anterior Eye 2024; 47:102190. [PMID: 38851946 DOI: 10.1016/j.clae.2024.102190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2024]
Abstract
Corneal techniques for enhancing near and intermediate vision to correct presbyopia include surgical and contact lens treatment modalities. Broad approaches used independently or in combination include correcting one eye for distant and the other for near or intermediate vision, (termed monovision or mini-monovision depending on the degree of anisometropia) and/or extending the eye's depth of focus [1]. This report reviews the evidence for the treatment profile, safety, and efficacy of the current range of corneal techniques for managing presbyopia. The visual needs and expectations of the patient, their ocular characteristics, and prior history of surgery are critical considerations for patient selection and preoperative evaluation. Contraindications to refractive surgery include unstable refraction, corneal abnormalities, inadequate corneal thickness for the proposed ablation depth, ocular and systemic co-morbidities, uncontrolled mental health issues and unrealistic patient expectations. Laser refractive options for monovision include surface/stromal ablation techniques and keratorefractive lenticule extraction. Alteration of spherical aberration and multifocal ablation profiles are the primary means for increasing ocular depth of focus, using surface and non-surface laser refractive techniques. Corneal inlays use either small aperture optics to increase depth of field or modify the anterior corneal curvature to induce corneal multifocality. In presbyopia correction by conductive keratoplasty, radiofrequency energy is applied to the mid-peripheral corneal stroma, leading to mid-peripheral corneal shrinkage and central corneal steepening. Hyperopic orthokeratology lens fitting can induce spherical aberration and correct some level of presbyopia. Postoperative management, and consideration of potential complications, varies according to technique applied and the time to restore corneal stability, but a minimum of 3 months of follow-up is recommended after corneal refractive procedures. Ongoing follow-up is important in orthokeratology and longer-term follow-up may be required in the event of late complications following corneal inlay surgery.
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Affiliation(s)
- Jennifer P Craig
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand; College of Health & Life Sciences, Aston University, Birmingham, UK.
| | | | - Connie Chen
- Department of Optometry, Chung Shan Medical University, Taichung City, Taiwan
| | - Obinwanne Chukwuemeka
- Cornea, Contact Lens and Myopia Management Unit, De-Lens Ophthalmics Family and Vision Care Centre, Abuja, Nigeria
| | - Neema Ghorbani-Mojarrad
- School of Optometry and Vision Science, University of Bradford, Bradford, UK; Wolfson Centre for Applied Health Research, Bradford Royal Infirmary, Bradford, UK
| | | | | | | | | | - Andrew M J Turnbull
- Royal Bournemouth Hospital, University Hospitals Dorset, UK; Faculty of Life and Health Sciences, Ulster University, UK
| | - Stephen J Vincent
- Optometry and Vision Science, Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Australia
| | - Michael T M Wang
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - Mohammed Ziaei
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand
| | - James S Wolffsohn
- Department of Ophthalmology, Aotearoa New Zealand National Eye Centre, The University of Auckland, Auckland, New Zealand; College of Health & Life Sciences, Aston University, Birmingham, UK
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Davies LN, Biswas S, Bullimore M, Cruickshank F, Estevez JJ, Khanal S, Kollbaum P, Marcotte-Collard R, Montani G, Plainis S, Richdale K, Simard P, Wolffsohn JS. BCLA CLEAR presbyopia: Mechanism and optics. Cont Lens Anterior Eye 2024; 47:102185. [PMID: 38796331 DOI: 10.1016/j.clae.2024.102185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2024]
Abstract
With over a billion adults worldwide currently affected, presbyopia remains a ubiquitous, global problem. Despite over a century of study, the precise mechanism of ocular accommodation and presbyopia progression remains a topic of debate. Accordingly, this narrative review outlines the lenticular and extralenticular components of accommodation together with the impact of age on the accommodative apparatus, neural control of accommodation, models of accommodation, the impact of presbyopia on retinal image quality, and both historic and contemporary theories of presbyopia.
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Affiliation(s)
- Leon N Davies
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK.
| | - Sayantan Biswas
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
| | | | - Fiona Cruickshank
- Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, UK
| | - Jose J Estevez
- Caring Futures Institute, College of Nursing and Health Sciences, Optometry and Vision Science, Flinders University, Adelaide, Australia; Flinders Centre for Ophthalmology, Eye and Vision Research, Department of Ophthalmology, Flinders University, Adelaide, Australia
| | - Safal Khanal
- Department of Optometry and Vision Science, The University of Alabama at Birmingham, USA
| | | | | | | | - Sotiris Plainis
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK; Laboratory of Optics and Vision, School of Medicine, University of Crete, Greece
| | | | - Patrick Simard
- School of Optometry, Universite de Montreal, Montreal, Quebec, Canada
| | - James S Wolffsohn
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
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14
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Wolffsohn JS, Berkow D, Chan KY, Chaurasiya SK, Fadel D, Haddad M, Imane T, Jones L, Sheppard AL, Vianya-Estopa M, Walsh K, Woods J, Zeri F, Morgan PB. BCLA CLEAR Presbyopia: Evaluation and diagnosis. Cont Lens Anterior Eye 2024; 47:102156. [PMID: 38641525 DOI: 10.1016/j.clae.2024.102156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
It is important to be able to measure the range of clear focus in clinical practice to advise on presbyopia correction techniques and to optimise the correction power. Both subjective and objective techniques are necessary: subjective techniques (such as patient reported outcome questionnaires and defocus curves) assess the impact of presbyopia on a patient and how the combination of residual objective accommodation and their natural DoF work for them; objective techniques (such as autorefraction, corneal topography and lens imaging) allow the clinician to understand how well a technique is working optically and whether it is the right choice or how adjustments can be made to optimise performance. Techniques to assess visual performance and adverse effects must be carefully conducted to gain a reliable end-point, considering the target size, contrast and illumination. Objective techniques are generally more reliable, can help to explain unexpected subjective results and imaging can be a powerful communication tool with patients. A clear diagnosis, excluding factors such as binocular vision issues or digital eye strain that can also cause similar symptoms, is critical for the patient to understand and adapt to presbyopia. Some corrective options are more permanent, such as implanted inlays / intraocular lenses or laser refractive surgery, so the optics can be trialled with contact lenses in advance (including differences between the eyes) to better communicate with the patient how the optics will work for them so they can make an informed choice.
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Affiliation(s)
- James S Wolffsohn
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom.
| | - David Berkow
- Department of Ophthalmology, Rambam Health Care Campus, Haifa, Israel
| | - Ka Yin Chan
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong
| | - Suraj K Chaurasiya
- Department of Contact Lens and Anterior Segment, CL Gupta Eye Institute, Moradabad, India; Department of Optometry and Vision Science, CL Gupta Eye Institute, Moradabad, India
| | - Daddi Fadel
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Mera Haddad
- Faculty of Applied Medical Sciences, Department of Allied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Tarib Imane
- Department of Ophthalmology and Visual Sciences, Illinois Eye and Ear Infirmary, College of Medicine, University of Illinois at Chicago, United States
| | - Lyndon Jones
- Centre for Eye and Vision Research (CEVR), 17W Hong Kong Science Park, Hong Kong; Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Amy L Sheppard
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom
| | - Marta Vianya-Estopa
- Vision and Hearing Research Centre, Anglia Ruskin University, Cambridge, United Kingdom
| | - Karen Walsh
- CooperVision Inc., San Ramon, CA, United States
| | - Jill Woods
- Centre for Ocular Research & Education (CORE), School of Optometry & Vision Science, University of Waterloo, Waterloo, Canada
| | - Fabrizio Zeri
- School of Optometry, Health and Life Sciences, Aston University, Birmingham, United Kingdom; University of Milano-Bicocca, Department of Materials Science, Milan, Italy
| | - Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, University of Manchester, United Kingdom
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15
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Qiu D, Liao Y, Wang Y, Liu K, Jin C, Du F. Impact of Refractive Status on Presbyopia Progression among Patients with Presbyopia. Graefes Arch Clin Exp Ophthalmol 2024; 262:2695-2701. [PMID: 38512509 DOI: 10.1007/s00417-024-06455-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 03/03/2024] [Accepted: 03/16/2024] [Indexed: 03/23/2024] Open
Abstract
PURPOSE To explore the impact of refractive status on presbyopia progression among patients with presbyopia. METHODS This retrospective observational study included patients with presbyopia who visited the Seventh Affiliated Hospital of Sun Yat-sen University and Shenzhen Polytechnic Medical College between May 2018 and August 2022. The amplitude of accommodation (AMP) and near addition power (ADD) at 6 months and 1 year were collected. RESULTS A total of 103 patients with presbyopia were included in this study: 42 patients with myopia, 23 patients with emmetropia, and 38 patients with hyperopia. There were significant differences in ΔAMP(6-month) and ΔADD(6-month) among patients with different refractive statuses, and the values of emmetropic patients and hyperopic patients were higher than in myopic patients (all P < 0.001). The ΔAMP(1-year) and ΔADD(1-year) of hyperopic patients were significantly higher than in emmetropic patients and myopic patients (all P < 0.001). The ΔADD(1-year) of emmetropic patients was greater than in myopic patients (P = 0.045), but there were no significant differences in ΔAMP(1-year) between patients with emmetropia and myopia (P = 0.090). CONCLUSIONS The progression of presbyopia in hyperopic patients was relatively more significant than for emmetropia, followed by myopia. The prescription of presbyopia glasses might need to be replaced more frequently in patients with hyperopia.
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Affiliation(s)
- Dongrong Qiu
- Optometry Technology Major, College of Medical Technology and Nursing, Shenzhen Polytechnic University, Shenzhen, 518000, China
| | - Youfen Liao
- Department of Ophthalmology, The Eighth Affiliated Hospital Sun Yat-Sen University, Shenzhen, 518000, China
| | - Ying Wang
- Optometry Technology Major, College of Medical Technology and Nursing, Shenzhen Polytechnic University, Shenzhen, 518000, China
| | - Keyou Liu
- Optometry Technology Major, College of Medical Technology and Nursing, Shenzhen Polytechnic University, Shenzhen, 518000, China
| | - Chenhui Jin
- Optometry Technology Major, College of Medical Technology and Nursing, Shenzhen Polytechnic University, Shenzhen, 518000, China
| | - Fangfang Du
- Department of Ophthalmology, The Seventh Affiliated Hospital Sun Yat-Sen University, Shenzhen, 518000, China.
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16
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Haddad MF, Abdo N, Bakkar MM. Public Awareness, Knowledge of Presbyopia and Compliance to Eye Examination in Jordan. CLINICAL OPTOMETRY 2024; 16:191-199. [PMID: 39100731 PMCID: PMC11296362 DOI: 10.2147/opto.s467933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 07/18/2024] [Indexed: 08/06/2024]
Abstract
Purpose To assess public awareness and knowledge about presbyopia and their compliance to ocular examination in Jordan. Patients and Methods A cross-sectional survey was designed to interview people in different provinces of Jordan. Socio-demographic data such as age, gender and level of education and region was reported. The first part of the questionnaire assessed awareness of presbyopia in terms of the need for spectacles with age, age of onset, possible causes of presbyopia and methods of presbyopia management. The second part of the questionnaire evaluated compliance of the participants with ocular examination in terms of frequency and motive to do general eye check, intraocular pressure (IOP), fundus exam and visual acuity. Results A total of 802 participants (232 males, 570 females) with an average age of 28 (±11.6) completed the questionnaire. Most participants (84.2%) knew that glasses are needed for near vision as age increases, and 62.8% estimated the age at which spectacles are required (40 years or older). Over half understood that presbyopia is correctable and progressive. Age significantly influenced knowledge about the need for near vision spectacles, and whether presbyopia is preventable and progressive (both p < 0.05). Females were more knowledgeable about these aspects. The frequency of eye examinations, particularly fundus exams and IOP tests, was significantly influenced by age but not by education. Gender only significantly affected the frequency of vision checks (p = 0.01), with females being more likely to adhere to them. Conclusion This study demonstrated a good level of awareness and knowledge about presbyopia among Jordanians, especially those over 40 and females. Regular eye check-ups were more common among young participants and females. Addressing misconceptions about presbyopia's preventability and promoting regular eye exams are crucial for early diagnosis and management of presbyopia and other serious eye conditions.
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Affiliation(s)
- Mera F Haddad
- Department of Allied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Nour Abdo
- Department of Public Health, Jordan University of Science and Technology, Irbid, Jordan
| | - May M Bakkar
- Department of Allied Medical Sciences, Jordan University of Science and Technology, Irbid, Jordan
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17
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Chen L, Sun L, Tang Y, Sui W, Bian A, Zhang X, Wang Z, Zhong Y, Zhang S. Visual performance, safety, and patient satisfaction after binocular clear lens extraction and trifocal intraocular lens implantation in Chinese presbyopic patients. BMC Ophthalmol 2024; 24:305. [PMID: 39044126 PMCID: PMC11264366 DOI: 10.1186/s12886-024-03573-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Accepted: 07/12/2024] [Indexed: 07/25/2024] Open
Abstract
BACKGROUND Addressing presbyopia in the aging population, particularly in non-cataractous patients, remains a challenge. This study evaluates the outcomes of refractive lens exchange (RLE) with AT LISA tri 839MP trifocal intraocular lens (IOL) implantation in a Chinese presbyopic population without cataracts. METHODS The study included 164 eyes from 82 patients undergoing bilateral RLE at Peking Union Medical College Hospital. Comprehensive evaluations encompassed visual acuities, refraction, ocular aberrometry, and subjective outcomes via the VF-14 questionnaire. The focus was on postoperative visual performance, refractive outcomes, safety, objective optical quality, and patient satisfaction. RESULTS 100%, 90.2%, and 89.0% of patients achieved binocular UDVA, UNVA, and UIVA of logMAR 0.1 or better at 6 months postoperatively. 97.6% of eyes were within ± 1.00 D of emmetropia postoperatively. Optical quality assessments showed increases in modulation transfer function and Strehl ratios (p < 0.05). High-order aberrations decreased significantly (p < 0.05). Despite the high incidence of posterior capsule opacification (83.2%), managed with early Nd: YAG capsulotomy, no other severe complications were reported. Patient-reported outcomes indicated high satisfaction, with an average VF-14 score of 94.3 ± 10.2 and 93.5% achieving complete spectacle independence. Halo (66.2%) was the most commonly reported optical phenomena, followed by glare (18.2%), and starburst (7.8%) after surgery. CONCLUSIONS Bilateral RLE with trifocal IOLs in presbyopic patients without cataracts significantly improves visual acuity and reduces ocular aberrations in presbyopic patients. The procedure offers high patient satisfaction and spectacle independence, though it requires careful patient selection and management of expectations regarding potential photic phenomena.
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Affiliation(s)
- Lulu Chen
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1, Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Lu Sun
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1, Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Yongxiang Tang
- Department of Ophthalmology, The Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, Guizhou, China
| | - Wenda Sui
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1, Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Ailing Bian
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1, Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Xia Zhang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1, Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Zaowen Wang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1, Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Yong Zhong
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1, Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China
| | - Shunhua Zhang
- Department of Ophthalmology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, No.1, Shuaifuyuan Wangfujing Dongcheng District, Beijing, 100730, China.
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18
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Alsaqr AM, Alasmi AM, Fagehi R, Ali A. Perception and awareness of the public about presbyopia and its corrective approaches in Saudi Arabia: a population-based survey. BMC Public Health 2024; 24:1950. [PMID: 39033287 PMCID: PMC11265060 DOI: 10.1186/s12889-024-19508-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Accepted: 07/16/2024] [Indexed: 07/23/2024] Open
Abstract
BACKGROUND This study investigated patients' awareness of presbyopia and its management approaches and their preferred methods for near vision correction. METHODS In Saudi Arabia, 785 participants (aged between 35 and 60 years) completed a structured survey online, consisting of hard copies and direct interviews. The survey consisted of twenty-eight items divided into three parts. It was designed to record participants' awareness of and preferences for presbyopia and its refractive corrections. Nonparametric tests and descriptive analyses were conducted to analyse participants' responses. RESULT Approximately half of the participants had difficulty with near vision activities, such as reading newspapers or using mobile phones. Among all the participants, 76% were not aware of presbyopia. The prevalence of uncorrected presbyopia was 48% of the 785. The majority (82%) felt that spectacles were acceptable for correction of presbyopia. Most reported that they did not experience social stigma when using reading spectacles (87% of participants). When asked if they were aware of management approaches other than spectacles, 72% responded with not at all. Most participants had no earlier knowledge of the use of multifocal contact lenses or eye drops for presbyopia correction (67% and 82%, respectively). In the present study, some tendencies to use corrective approaches to presbyopia other than spectacles were noted. Finally, participants' age, sex, region, education, and income had a statistically significant impact on essential parts of their responses (p < 0.05). CONCLUSION Presbyopia is a highly prevalent age-related ocular disorder, and a significant percentage of cases are uncorrected due to a lack of awareness or reluctance to wear spectacles. More efficient health education about presbyopia and its corrective alternatives is urgently needed.
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Affiliation(s)
- Ali M Alsaqr
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia.
| | - Abdulrahman M Alasmi
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Raied Fagehi
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | - Abusharha Ali
- Department of Optometry, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
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19
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Tuan KA, Benoit DP, O’Connor B. Evaluation of the Functional Visual Range of a Catenary Curve-Based, Extended Depth-of-Focus Contact Lens for Presbyopia. Clin Ophthalmol 2024; 18:2113-2123. [PMID: 39055378 PMCID: PMC11269816 DOI: 10.2147/opth.s468699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Accepted: 07/10/2024] [Indexed: 07/27/2024] Open
Abstract
Purpose Employing "relative plus" (Add) power to extend the functional vision range is a primary method to correct presbyopia with contact lenses. Simultaneous vision contact lenses are typically associated with visual disturbances at higher Add powers, often resulting in compromised vision and necessitating specialized fitting methods. Among mature individuals suffering from presbyopia, we evaluated the visual performance of a catenary curve-based extended depth of focus (EDOF) optical profile contact lens with a simplified fitting process. Methods Mature individuals suffering from presbyopia with Add requirements of +2.00 D or more were recruited. Monocular and binocular visual acuities were obtained across optical vergences ranging from -4.00 D to +2.00 D to generate defocus curves for best spectacle-corrected distance vision (baseline) and center-distance, catenary curve-based contact lenses (catenary). A subjective questionnaire evaluating the lenses was employed. Results Twenty-four mature individuals suffering from presbyopia, average age 59.2 (range: 51-68 years) and average Add requirement of +2.24 D (range +2.00 D to +2.50 D) were enrolled. Under high-contrast conditions, the catenary lens provided functional binocular vision (0.30 logMAR or better) at all optical vergences from distance to -3.50 D (equivalent to 28 cm). Participants demonstrated a significant improvement (p < 0.05) in binocular visual acuity while wearing the catenary lens with an imposed defocus of -1.50 D to -4.00 D (equivalent to object distances from 66 cm to 25 cm). Subjective ratings with the catenary lens were equivalent to those documented at baseline. Conclusion The catenary curve-based lenses provided a full range of functional vision while maintaining clear distance vision for individuals suffering from advanced presbyopia. Comparison with previous results involving this lens indicates that these findings are also generalizable to wearers with lower Add requirements. This EDOF design provides a universal Add which is sufficient for advanced presbyopia. Trial Registration ClinicalTrials.gov. Identifier: NCT05495971.
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Affiliation(s)
- K Ashley Tuan
- Visioneering Technologies, Incorporated, Medical Affairs, Alpharetta, GA, USA
| | - Douglas P Benoit
- Visioneering Technologies, Incorporated, Medical Affairs, Alpharetta, GA, USA
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Hernández-Lucena J, Alonso-Aliste F, Amián-Cordero J, Sánchez-González JM. Outcomes of Corneal Compound Hyperopic Astigmatism With Presbyopia by Zeiss PRESBYOND Laser Blended Vision LASIK Using Default Custom Refractive Software Master Target Refractions for Reduced Anisometropia. J Refract Surg 2024; 40:e480-e489. [PMID: 39007817 DOI: 10.3928/1081597x-20240506-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/16/2024]
Abstract
PURPOSE To evaluate the effectiveness, safety, and stability of a modified PRESBYOND Laser Blended Vision protocol (Carl Zeiss Meditec AG) for correcting hyperopic astigmatism and presbyopia, using Custom Refractive Software Master (CRSM) targeting over a 6-month period. METHODS A total of 636 eyes of 318 patients with a mean age of 51.05 ± 4.71 years (range: 40 to 60 years) met the inclusion and exclusion criteria. All patients completed a 6-month follow-up. CRSM software was used to generate ablation profiles for the MEL90 excimer laser (Carl Zeiss Meditec AG). The target refraction was emmetropic for the dominant eyes and between -0.75 and -1.12 diopters (D) for the near eyes. RESULTS Visual and refractive results were studied separately by the dominant and non-dominant eyes. The mean attempt to correct for spherical equivalent refraction was +2.17 ± 1.16 D (range: -1.00 to +5.37 D). The mean attempted cylinder was -0.60 ± 0.75 D (range: -4.00 to 0.00 D). All eyes monocularly achieved uncorrected distance visual acuity (UDVA) of 20/25 or better after refractive treatment and 88% achieved 20/20. Binocularly all eyes achieved UDVA of 20/25 or better and 96.54% achieved 20/20. Ninety-eight percent of the patients maintained their corrected distance visual acuity before surgery and UDVA 6 months after surgery. CONCLUSIONS This hyperopic micro-anisometropia protocol with PRESBYOND Laser Blended Vision was an effective, safe, and well-tolerated refractive treatment. It was an effective procedure with excellent results for UDVA and uncorrected near visual acuity and demonstrates that binocular summation exists. [ J Refract Surg. 2024;40(7):e480-e489.].
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Yu C, Kamiya K, Kawamorita T. Modulation transfer function of implantable phakic intraocular contact lens (IPCL) for myopia and presbyopia. Graefes Arch Clin Exp Ophthalmol 2024:10.1007/s00417-024-06539-1. [PMID: 38842594 DOI: 10.1007/s00417-024-06539-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 05/22/2024] [Accepted: 05/29/2024] [Indexed: 06/07/2024] Open
Abstract
PURPOSE This study aimed to assess the optical quality of myopic and presbyopic IPCLs with different additional powers, and to investigate the effects of pupil size on the optical quality of these IPCLs using an in-vitro modulation transfer function (MTF) measurement system. METHODS Linear scatter functions (LSFs) were recorded using the OPAL Vector system and an eye phantom consisting of wet cells filled with a balanced salt solution. A myopic IPCL or a presbyopic IPCL was placed in the posterior chamber of this model. The MTF was calculated from the LSF using the fast Fourier transform techniques. The effective apertures were set at 2.0 to 5.0 mm in 1.0 mm steps. RESULTS The in-focus MTF values of the myopic IPCL and presbyopic IPCL with additional powers of + 2.0 and + 4.0 diopters at 100 cycles/mm for an effective aperture of 3.0 mm were 43%, 27%, and 24%, respectively. The in-focus MTF value of both myopic and presbyopic IPCLs was the highest when the effective aperture was set at 3.0 mm, and it gradually worsened when the effective aperture became larger than 3.0 mm at 20, 60, and 100 cycles/mm. CONCLUSIONS Both myopic and presbyopic IPCLs provided excellent MTF values, but the additional power profile can deteriorate optical performance in presbyopic IPCL-implanted eyes, even with a low additional power. Pupil size can influence visual quality in IPCL-implanted eyes for both myopia and presbyopia.
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Affiliation(s)
- Chunjing Yu
- Department of Ophthalmology and Visual Science, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0373, Japan.
| | - Kazutaka Kamiya
- Department of Ophthalmology and Visual Science, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0373, Japan
- Department of Orthoptics and Visual Science, Kitasato University School of Allied Health Sciences, Sagamihara, Japan
| | - Takushi Kawamorita
- Department of Ophthalmology and Visual Science, Kitasato University Graduate School of Medical Sciences, 1-15-1 Kitasato, Minami, Sagamihara, Kanagawa, 252-0373, Japan
- Department of Orthoptics and Visual Science, Kitasato University School of Allied Health Sciences, Sagamihara, Japan
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22
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Smith SL, Maldonado-Codina C, Morgan PB, Read ML. Gaze and behavioural metrics in the refractive correction of presbyopia. Ophthalmic Physiol Opt 2024; 44:774-786. [PMID: 38578134 DOI: 10.1111/opo.13310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Revised: 03/19/2024] [Accepted: 03/20/2024] [Indexed: 04/06/2024]
Abstract
PURPOSE To investigate gaze and behavioural metrics at different viewing distances with multifocal contact lenses (MFCLs), single vision contact lenses (SVCLs) and progressive addition lenses (PALs). METHODS Fifteen presbyopic contact lens wearers participated over five separate study visits. At each visit, participants were randomly assigned to wear one of five refractive corrections: habitual PAL spectacles, delefilcon A (Alcon Inc.) MFCLs and three separate pairs of delefilcon A single vision lenses worn as distance, intermediate and near corrections. Participants wore a Pupil Core headset to record eye and head movements while performing three visual tasks: reading, visual search and scene observation. Data were investigated using linear regression and post-hoc testing. Parameters of interest included gaze (fixation duration, head movement) and behavioural (reading speed, reading accuracy, visual search time) metrics. RESULTS Reading speed in SVCLs was significantly faster than in MFCLs and PAL spectacles (F = 16.3, p < 0.0001). Refractive correction worn did not influence visual search times (F = 0.16, p = 0.85). Fixation duration was significantly affected by the type of visual task (F = 60.2, p < 0.001), and an interaction effect was observed between viewing distance and refractive correction (F = 4.3, p = 0.002). There was significantly more horizontal and vertical head movement (F = 3.2, p = 0.01 and F = 3.3, p = 0.01, respectively) during visual search tasks when wearing PAL spectacles compared to SVCLs or MFCLs. CONCLUSION This work showed that the type of refractive correction affects behavioural metrics such as reading speed and gaze behaviour by affecting horizontal and vertical head movements. The findings of this study suggest that under certain conditions, wearers of MFCLs make fewer head movements compared to PAL spectacles. Gaze behaviour metrics offer a new approach to compare and understand contact lens and spectacle performance, with potential applications including peripheral optical designs for myopia management.
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Affiliation(s)
- Sarah L Smith
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Carole Maldonado-Codina
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Philip B Morgan
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - Michael L Read
- Eurolens Research, Division of Pharmacy and Optometry, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
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23
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Zeri F, Di Vizio A, Lucia S, Berchicci M, Bianco V, Pitzalis S, Tavazzi S, Naroo SA, Di Russo F. Cortical dynamics in visual areas induced by the first use of multifocal contact lenses in presbyopes. Cont Lens Anterior Eye 2024; 47:102137. [PMID: 38485618 DOI: 10.1016/j.clae.2024.102137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Revised: 01/19/2024] [Accepted: 03/06/2024] [Indexed: 05/20/2024]
Abstract
A common non-spectacle strategy to correct presbyopia is to provide simultaneous images with multifocal optical designs. Understanding the neuroadaptation mechanisms behind multifocal devices usage would have important clinical implications, such as predicting whether patients will be able to tolerate multifocal optics. The aim of this study was to evaluate the brain correlates during the initial wear of multifocal contact lenses (CLs) using high-density visual evoked potential (VEP) measures. Fifteen presbyopes (mean age 51.8 ± 2.6 years) who had previously not used multifocal CLs were enrolled. VEP measures were achieved while participants looked at arrays of 0.5 logMAR Sloan letters in three different optical conditions arranged with CLs: monofocal condition with the optical power appropriate for the distance viewing; multifocal correction with medium addition; and multifocal correction with low addition. An ANOVA for repeated measures showed that the amplitude of the C1 and N1 components significantly dropped with both multifocal low and medium addition CL conditions compared to monofocal CLs. The P1 and P2 components showed opposite behavior with an increase in amplitudes for multifocal compared to monofocal conditions. VEP data indicated that multifocal presbyopia corrections produce a loss of feedforward activity in the primary visual cortex that is compensated by extra feedback activity in extrastriate areas only, in both early and late visual processing.
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Affiliation(s)
- Fabrizio Zeri
- Department of Materials Science. University of Milano-Bicocca, Milan, Italy; COMiB Research Centre in Optics and Optometry. University of Milano-Bicocca, Milan, Italy; College of Health and Life Sciences. Aston University, Birmingham, UK.
| | - Assunta Di Vizio
- COMiB Research Centre in Optics and Optometry. University of Milano-Bicocca, Milan, Italy; Department of Science, Roma Tre University, Rome, Italy
| | - Stefania Lucia
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy
| | - Marika Berchicci
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy; Department of Psychological, Humanistic and Territorial Sciences, University "G. d'Annunzio", Chieti-Pescara, Italy
| | - Valentina Bianco
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Sabrina Pitzalis
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy; IRCCS Santa Lucia Foundation Rome, Italy
| | - Silvia Tavazzi
- Department of Materials Science. University of Milano-Bicocca, Milan, Italy; COMiB Research Centre in Optics and Optometry. University of Milano-Bicocca, Milan, Italy
| | - Shehzad A Naroo
- College of Health and Life Sciences. Aston University, Birmingham, UK
| | - Francesco Di Russo
- Department of Movement, Human and Health Sciences, University of Rome "Foro Italico", Rome, Italy; IRCCS Santa Lucia Foundation Rome, Italy
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Li Q, Liu X, Yang J, Dai Y, Li W. Comparison of Barrett TK Universal II and Barrett Universal II TCRP Formulas in Power Calculations for 3 Presbyopia-Correcting Intraocular Lenses. Clin Ophthalmol 2024; 18:1457-1465. [PMID: 38818525 PMCID: PMC11137930 DOI: 10.2147/opth.s461195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 05/17/2024] [Indexed: 06/01/2024] Open
Abstract
Purpose To compare Barrett TK Universal II and Barrett Universal II TCRP calculations in the power calculations for 3 presbyopia-correcting intraocular lenses (PC-IOL). Methods This observational study involved 64 eyes from 64 patients who prepared to undergo extraction of crystalline lenses combined with PC-IOL (Symfony ZXR00, PanOptix TFNT00, or AT LISA tri 839MP) implantation. All eyes underwent ocular biometric measurements with IOLMaster 700 and Pentacam HR, and the interdevice agreement of measurements including total keratometry (TK, IOLMaster 700) and total corneal refractive power (TCRP, Pentacam HR) was evaluated. IOL power calculations were performed using TK-based Barrett TK Universal II and TCRP-based Barrett Universal II calculations, respectively. Results Paired t-tests showed that the differences in white-to-white diameter, central corneal thickness, anterior chamber depth, and mean TK between IOLMaster 700 and Pentacam HR were slight but significant (all P<0.05), and the differences in recommended IOL power for emmetropia between two Barrett calculations were also significant in 3 PC-IOLs (all P<0.05). The ROC curve showed that the AUC was 0.917 (95% CI, 0.820-0.971) for the absolute value of the difference between TK and TCRP in discriminating the difference of ≥ ±0.5 D in predicted IOL power with best cutoff values of 0.4 D. Conclusion The novel Barrett TK Universal II formula built in IOLMaster 700 is comparable to TCRP-based Barrett Universal II calculation for IOL power calculation of PC-IOLs, and the convenience of using the Barrett TK Universal II formula should be founded on measurement consistency between devices.
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Affiliation(s)
- Qingchen Li
- Shanghai Aier Eye Hospital, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Shanghai Aier Eye Institute, Shanghai, 201103, People’s Republic of China
- Department of Ophthalmology, the Second Xiangya Hospital of Central South University, Changsha, Hunan Province, 410011, People’s Republic of China
| | - Xinyi Liu
- Shanghai Aier Eye Hospital, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Shanghai Aier Eye Institute, Shanghai, 201103, People’s Republic of China
| | - Jiasong Yang
- Shanghai Aier Eye Hospital, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Shanghai Aier Eye Institute, Shanghai, 201103, People’s Republic of China
- Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, 410015, People’s Republic of China
| | - Yumeng Dai
- Shanghai Aier Eye Hospital, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Shanghai Aier Eye Institute, Shanghai, 201103, People’s Republic of China
| | - Wensheng Li
- Shanghai Aier Eye Hospital, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Shanghai Aier Eye Institute, Shanghai, 201103, People’s Republic of China
- Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, 410015, People’s Republic of China
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Hernández-Lucena J, Alonso-Aliste F, Amián-Cordero J, Sánchez-González JM. Outcomes of Corneal Compound Myopic Astigmatism with Presbyopia by Zeiss PRESBYOND ® Laser Blended Vision LASIK Using Default CRS-Master ® Target Refractions for Reduced Anisometropia. J Clin Med 2024; 13:3011. [PMID: 38792550 PMCID: PMC11122580 DOI: 10.3390/jcm13103011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 05/13/2024] [Accepted: 05/16/2024] [Indexed: 05/26/2024] Open
Abstract
Background/Objectives: Presbyopia, a common age-related refractive error, affects over a billion people globally and significantly impacts daily life. Methods: This retrospective study analyzed 288 eyes of 144 patients undergoing LBV PRESBYOND® treatment for myopic presbyopia with astigmatism, aiming to evaluate precision, efficacy, safety, and stability over six months. Results: Key findings include high efficacy, with 99% of distance-eyes achieving uncorrected distance visual acuity (UDVA) of 20/25 or better, and 85% of near-eyes achieving UDVA of 20/32 or better. The results show excellent refractive outcomes, with 99% of long-sighted eyes and 97% of near-sighted eyes having a postoperative spherical equivalent within ±1.00 D. Safety was demonstrated by no loss of two or more Snellen lines after treatment, with 94% of patients maintaining corrected distance visual acuity (CDVA) before and after surgery. Conclusions: Overall, LBV PRESBYOND® proved effective, safe, and well tolerated for myopic presbyopia correction, offering satisfactory visual outcomes and potential spectacle independence for various distances. This study underscores the importance of individualized treatment based on patient age, highlighting the positive impact of binocular summation on visual function. This study contributes to the growing body of evidence supporting LBV PRESBYOND® as a viable option for addressing presbyopic myopia, offering insights into its efficacy and safety profile. Further research could explore postoperative stereopsis and long-term outcomes to enhance understanding and refine treatment protocols.
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Affiliation(s)
- Julia Hernández-Lucena
- Department of Physics of Condensed Matter, Optics Area, University of Seville, Reina Mercedes S/N, 41012 Seville, Spain;
- Department of Ophthalmology (Tecnolaser Clinic Vision), Refractive Surgery Center, Juan Antonio Cavestany, 41018 Seville, Spain; (F.A.-A.); (J.A.-C.)
| | - Federico Alonso-Aliste
- Department of Ophthalmology (Tecnolaser Clinic Vision), Refractive Surgery Center, Juan Antonio Cavestany, 41018 Seville, Spain; (F.A.-A.); (J.A.-C.)
| | - Jonatan Amián-Cordero
- Department of Ophthalmology (Tecnolaser Clinic Vision), Refractive Surgery Center, Juan Antonio Cavestany, 41018 Seville, Spain; (F.A.-A.); (J.A.-C.)
| | - José-María Sánchez-González
- Department of Physics of Condensed Matter, Optics Area, University of Seville, Reina Mercedes S/N, 41012 Seville, Spain;
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Durkee H, Ruggeri M, Rohman L, Williams S, Ho A, Parel JM, Manns F. Dynamic refraction and anterior segment OCT biometry during accommodation. BIOMEDICAL OPTICS EXPRESS 2024; 15:2876-2889. [PMID: 38855690 PMCID: PMC11161352 DOI: 10.1364/boe.512193] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 06/11/2024]
Abstract
Accommodation is the process by which the eye changes focus. These changes are the result of changes to the shape of the crystalline lens. Few prior studies have quantified the relation between lens shape and ocular accommodation, primarily at discrete static accommodation states. We present an instrument that enables measurements of the relation between changes in lens shape and changes in optical power continuously during accommodation. The system combines an autorefractor to measure ocular power, a visual fixation target to stimulate accommodation, and an optical coherence tomography (OCT) system to image the anterior segment and measure ocular distances. Measurements of ocular dimensions and refraction acquired dynamically on three human subjects are presented. The individual accommodative responses are analyzed to correlate the ocular power changes with changes in ocular dimensions.
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Affiliation(s)
- Heather Durkee
- Ophthalmic Biophysics Center, Department of
Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10 Ave, Miami, Florida 33136, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, 1251 Memorial Drive, Coral Gables, Florida 33146, USA
| | - Marco Ruggeri
- Ophthalmic Biophysics Center, Department of
Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10 Ave, Miami, Florida 33136, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, 1251 Memorial Drive, Coral Gables, Florida 33146, USA
| | - Leana Rohman
- Ophthalmic Biophysics Center, Department of
Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10 Ave, Miami, Florida 33136, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, 1251 Memorial Drive, Coral Gables, Florida 33146, USA
| | - Siobhan Williams
- Ophthalmic Biophysics Center, Department of
Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10 Ave, Miami, Florida 33136, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, 1251 Memorial Drive, Coral Gables, Florida 33146, USA
| | - Arthur Ho
- Ophthalmic Biophysics Center, Department of
Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10 Ave, Miami, Florida 33136, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, 1251 Memorial Drive, Coral Gables, Florida 33146, USA
- Brien Holden Vision Institute Limited, Sydney, NSW, Australia
- School of Optometry and Vision Science, University of New South Wales, NSW 2052, Sydney, Australia
| | - Jean-Marie Parel
- Ophthalmic Biophysics Center, Department of
Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10 Ave, Miami, Florida 33136, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, 1251 Memorial Drive, Coral Gables, Florida 33146, USA
- Brien Holden Vision Institute Limited, Sydney, NSW, Australia
| | - Fabrice Manns
- Ophthalmic Biophysics Center, Department of
Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, 1638 NW 10 Ave, Miami, Florida 33136, USA
- Department of Biomedical Engineering, University of Miami College of Engineering, 1251 Memorial Drive, Coral Gables, Florida 33146, USA
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Sims J, Sloesen B, Bentley S, Naujoks C, Arbuckle R, Chiva-Razavi S, Pascoe B, Stochl J, Findley A, O'Brien P, Wolffsohn JS. Psychometric evaluation of the near activity visual questionnaire presbyopia (NAVQ-P) and additional patient-reported outcome items. J Patient Rep Outcomes 2024; 8:41. [PMID: 38592339 PMCID: PMC11004101 DOI: 10.1186/s41687-024-00717-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Accepted: 03/18/2024] [Indexed: 04/10/2024] Open
Abstract
BACKGROUND The Near Visual Acuity Questionnaire Presbyopia (NAVQ-P) is a patient-reported outcome (PRO) measure that was developed in a phakic presbyopia population to assess near vision function impacts. The study refined and explored the psychometric properties and score interpretability of the NAVQ-P and additional PRO items assessing near vision correction independence (NVCI), near vision satisfaction (NVS), and near vision correction preference (NVCP). METHODS This was a psychometric validation study conducted using PRO data collected as part of a Phase IIb clinical trial (CUN8R44 A2202) consisting of 235 randomized adults with presbyopia from the US, Japan, Australia, and Canada. Data collected at baseline, week 2, and months 1, 2, and 3 during the 3-month trial treatment period were included in the analyses to assess item (question) properties, NAVQ-P dimensionality and scoring, reliability, validity, and score interpretation. RESULTS Item responses were distributed across the full response scale for most NAVQ-P and additional PRO items. Confirmatory factor analysis supported the pre-defined unidimensional structure and calculation of a NAVQ-P total score as a measure of near vision function. Item deletion informed by item response distributions, dimensionality analyses, item response theory, and previous qualitative findings, including clinical input, supported retention of 14 NAVQ-P items. The 14-item NAVQ-P total score had excellent internal consistency (α = 0.979) and high test-retest reliability (Intraclass Correlation Coefficients > = 0.898). There was good evidence of construct-related validity for all PROs supported by strong correlations with concurrent measures. Excellent results for known-groups validity and ability to detect change analyses were also demonstrated. Anchor-based and distribution-based methods supported interpretation of scores through generation of group-level and within-individual estimates of meaningful change thresholds. A meaningful within-patient change in the range of 8-15-point improvement on the NAVQ-P total score (score range 0-42) was recommended, including a more specific responder definition of 10-point improvement. CONCLUSIONS The NAVQ-P, NVCI, and NVS are valid and reliable instruments which have the ability to detect change over time. Findings strongly support the use of these measures as outcome assessments in clinical/research studies and in clinical practice in the presbyopia population.
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Affiliation(s)
- Joel Sims
- Adelphi Values, Patient-Centered Outcomes, Bollington, UK.
| | | | - Sarah Bentley
- Adelphi Values, Patient-Centered Outcomes, Bollington, UK
| | | | - Rob Arbuckle
- Adelphi Values, Patient-Centered Outcomes, Bollington, UK
| | | | - Ben Pascoe
- Adelphi Values, Patient-Centered Outcomes, Bollington, UK
| | - Jan Stochl
- Adelphi Values, Patient-Centered Outcomes, Bollington, UK
- Charles University, Prague, Czechia
| | - Amy Findley
- Adelphi Values, Patient-Centered Outcomes, Bollington, UK
| | | | - James S Wolffsohn
- School of Optometry, College of Health and Life Sciences, Aston University, Birmingham, UK
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Zhang R, Yuan Y, Zhang Y, Chen Y. Visual Quality Assessment After FS-LASIK Using Customized Aspheric Ablation Profile for Age-Related Accommodation Deficiency Compensation. J Refract Surg 2024; 40:e245-e252. [PMID: 38593261 DOI: 10.3928/1081597x-20240311-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
PURPOSE To evaluate clinical outcomes and visual quality 12 months after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) performed with the Custom-Q algorithm for correction of myopia with or without astigmatism and compensate for age-related accommodation deficiency. METHODS Patients who had Custom-Q FS-LASIK for myopia and myopic astigmatism with age-related accommodation deficiency were included in this retrospective study. Distance, intermediate, and near visual acuities, objective and subjective refractions, Q-factor, corneal higher order aberrations (HOAs), accommodation function, defocus curve, contrast sensitivity, and a subjective questionnaire assessing visual quality were evaluated 12 months postoperatively. RESULTS Clinical data of 43 cases were analyzed. The mean age was 42.02 ± 1.85 years (range: 40 to 48 years). At the 12-month follow-up visit, there were 43 (100%), 42 (97%), and 33 (77%) patients who achieved a binocular uncorrected distance, intermediate, and near visual acuity, respectively, better than 20/20 separately. Defocus curves revealed better distance vision in the dominant eyes, and the nondominant eyes performed better at intermediate and near vergence (P < .001). The Q-value and corneal spherical aberration coefficient were more positive in the dominant eyes than those in the nondominant eyes (P < .001). The accommodative amplitude and relative accommodation improved binocularly (P < .001). The questionnaire demonstrated high patient satisfaction with near vision, and no one reported having severe visual disturbance. CONCLUSIONS For myopic patients with age-related accommodation deficiency, the Custom-Q algorithm proved to be an effective way to achieve acceptable near vision without compromising distance vision. [J Refract Surg. 2024;40(4):e245-e252.].
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Li Q, Xie X, Yang J, Gao P, Li W. Bilateral Femtosecond Laser-Assisted Clear Lens Extraction with Trifocal Intraocular Lens Implantation for Presbyopia Correction: A Short-Term Observational Study in Chinese Adults. Clin Ophthalmol 2024; 18:623-630. [PMID: 38481540 PMCID: PMC10936733 DOI: 10.2147/opth.s453143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/25/2024] [Indexed: 03/17/2024] Open
Abstract
Purpose To observe the outcome of bilateral femtosecond laser-assisted clear lens extraction with trifocal intraocular lens (IOL) implantation for presbyopia correction and evaluate its feasibility in early presbyopic adults. Methods Prospective case series of eyes with clear crystalline lenses that underwent femtosecond laser-assisted lens extraction and trifocal IOL (Acrysof IQ PanOptix, Model TFNT00, Alcon) implantation between 2021 and 2023 were followed up for at least 3 months after surgery. Outcome measures included monocular uncorrected visual acuity at near (UNVA, 40 cm), intermediate (UIVA, 60 cm), and distance (UDVA, 5 m), monocular manifest refraction, corrected distance visual acuity (CDVA), defocus curve assessment, and spectacle independence at both near and distance. Results A total of 60 eyes from 30 consecutive patients were included, and their mean age was 50.4±6.5 years. After surgery, the mean UNVA (LogMAR) increased from 0.28±0.16 to 0.08±0.07, UIVA increased from 0.25±0.12 to 0.09±0.06, and UDVA increased from 0.27±0.21 to 0.01±0.08. The enhancements of UNVA, UIVA and UDVA were all significant (P < 0.05). The optometric results showed that the mean postoperative spherical equivalent (SE) was -0.21±0.24 D, and the mean postoperative CDVA (LogMAR) was -0.00±0.06. The preoperative spectacle independences at near and distance were 46.7% (14/30) and 56.7% (17/30), respectively, and both increased to 100% at 3 months after surgery. Conclusion Satisfactory visual outcomes and safe surgical procedures were observed in this study, which demonstrate that bilateral femtosecond laser-assisted clear lens extraction with PanOptix IOL implantation could be a feasible approach for presbyopia correction in working-age Chinese patients.
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Affiliation(s)
- Qingchen Li
- Shanghai Aier Eye Hospital, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Shanghai Aier Eye Institute, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha, Hunan Province, 410011, People’s Republic of China
| | - Xiaolin Xie
- Shanghai Aier Eye Hospital, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Shanghai Aier Eye Institute, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
| | - Jiasong Yang
- Shanghai Aier Eye Hospital, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Shanghai Aier Eye Institute, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, 410015, People’s Republic of China
| | - Peng Gao
- Department of Ophthalmology, Shanghai Tenth People’s Hospital of Tongji University, Tongji University School of Medicine, Shanghai, 200072, People’s Republic of China
| | - Wensheng Li
- Shanghai Aier Eye Hospital, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Shanghai Aier Eye Institute, Aier Eye Hospital Group Co. Ltd, Shanghai, 201103, People’s Republic of China
- Aier School of Ophthalmology, Central South University, Changsha, Hunan Province, 410015, People’s Republic of China
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Onyszkiewicz M, Hilmers J, Rejdak R, Zrenner E, Straßer T. Effects of Miosis on the Visual Acuity Space under Varying Conditions of Contrast and Ambient Luminance in Presbyopia. J Clin Med 2024; 13:1209. [PMID: 38592033 PMCID: PMC10931829 DOI: 10.3390/jcm13051209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 04/10/2024] Open
Abstract
Background: Presbyopia is an age-related ocular condition, typically affecting individuals aged over 40 years, characterized by a gradual and irreversible decline in the eye's ability to focus on nearby objects. Correction methods for presbyopia encompass the use of corrective lenses, surgical interventions (corneal or lens based), and, more recently, the FDA-approved topical administration of 1.25% pilocarpine. While prior research has demonstrated the efficacy of daily pilocarpine eye drop application in enhancing near visual acuity by increasing the depth of focus leveraging the pinhole effect, limited knowledge exists regarding its influence on visual acuity under varying conditions of contrast and ambient luminance. Methods: This study aims to investigate the impact of these variables on visual acuity, employing the VA-CAL test, among 11 emmetropic and 11 presbyopic volunteers who reported subjective difficulties with near vision. This study includes evaluations under natural conditions with a pinhole occluder (diameter of 2 mm), and subsequent administration of 1% pilocarpine (Pilomann, Bausch + Lomb, Laval, Canada). Results: The VA-CAL results demonstrate the expected, statistically significant effects of contrast and ambient luminance on visual acuity in both emmetropic and presbyopic volunteers. Furthermore, in emmetropic individuals, the application of pilocarpine resulted in a statistically significant reduction in visual acuity. In contrast, presbyopes did not exhibit statistically significant differences in the visual acuity space under either the pinhole or pilocarpine conditions when compared to natural conditions. Conclusions: The pharmacological treatment of presbyopia with pilocarpine eye drops, intended to enhance near vision, does not adversely affect visual acuity in presbyopes. This suggests that pilocarpine may offer a viable alternative for individuals averse to wearing corrective eyewear.
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Affiliation(s)
- Maksymilian Onyszkiewicz
- Institute for Ophthalmic Research, University of Tuebingen, 72076 Tuebingen, Germany; (M.O.); (E.Z.)
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-059 Lublin, Poland
| | - Julian Hilmers
- Institute for Ophthalmic Research, University of Tuebingen, 72076 Tuebingen, Germany; (M.O.); (E.Z.)
- STZ Eyetrial, University Eye Hospital Tuebingen, 72076 Tuebingen, Germany;
| | - Robert Rejdak
- STZ Eyetrial, University Eye Hospital Tuebingen, 72076 Tuebingen, Germany;
| | - Eberhart Zrenner
- Institute for Ophthalmic Research, University of Tuebingen, 72076 Tuebingen, Germany; (M.O.); (E.Z.)
- University Eye Hospital Tuebingen, 72076 Tuebingen, Germany
| | - Torsten Straßer
- Institute for Ophthalmic Research, University of Tuebingen, 72076 Tuebingen, Germany; (M.O.); (E.Z.)
- Chair and Department of General and Pediatric Ophthalmology, Medical University of Lublin, 20-059 Lublin, Poland
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Privado-Aroco A, Romaguera M, Valdes-Soria G, Serramito M, Carracedo G. Visual quality assessment and comparison of two multifocal scleral lens designs. Cont Lens Anterior Eye 2024; 47:102098. [PMID: 38040556 DOI: 10.1016/j.clae.2023.102098] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/14/2023] [Accepted: 11/27/2023] [Indexed: 12/03/2023]
Abstract
PURPOSE To analyze the visual quality of a new multifocal scleral lens with a customized decentred optic zone compared to a conventional design by measuring visual acuity, contrast sensitivity function, stereopsis, subjective vision and comfort after one month of wear. METHODS Nineteen presbyopic subjects were fitted with two multifocal scleral lens designs: a conventional multifocal and a customized decentred optical zone design. All subjects wore both scleral lens designs for one month with a two-week washout period. The main variables evaluated included high and low-contrast visual acuity under photopic and mesopic light conditions, binocular defocus curves, contrast sensitivity function and a visual analogue scale (VAS) for subjective vision and comfort. RESULTS Comparing the two scleral lens designs, statistically significant differences in visual acuity were found, highlighting the improvement in more than one chart line (6 letters) for low contrast near tests under photopic light conditions with the decentred optics lens design. VAS questionnaire scores also showed a significant improvement in distance and overall subjective vision with the decentred optics lenses. Contrast sensitivity function showed an improvement with decentred multifocal lenses at all spatial frequencies measured, being statistically significant for 12 cycles per degree. No differences in stereoacuity were found. CONCLUSION Multifocal scleral lenses with a customized decentred optical zone proved to be a promising refractive correction in presbyopic subjects after one month of wear, offering good comfort and visual quality under photopic and mesopic light conditions.
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Affiliation(s)
- Ana Privado-Aroco
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, Spain; Ocupharm Research Group, Faculty of Optics and Optometry, Complutense University of Madrid, Spain
| | - María Romaguera
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, Spain; Ocupharm Research Group, Faculty of Optics and Optometry, Complutense University of Madrid, Spain
| | - Gonzalo Valdes-Soria
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, Spain; Ocupharm Research Group, Faculty of Optics and Optometry, Complutense University of Madrid, Spain
| | - María Serramito
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, Spain; Ocupharm Research Group, Faculty of Optics and Optometry, Complutense University of Madrid, Spain
| | - Gonzalo Carracedo
- Department of Optometry and Vision, Faculty of Optics and Optometry, Complutense University of Madrid, Spain; Ocupharm Research Group, Faculty of Optics and Optometry, Complutense University of Madrid, Spain.
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Knaus KR, Hipsley A, Blemker SS. A new look at an old problem: 3D modeling of accommodation reveals how age-related biomechanical changes contribute to dysfunction in presbyopia. Biomech Model Mechanobiol 2024; 23:193-205. [PMID: 37733144 DOI: 10.1007/s10237-023-01767-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 08/17/2023] [Indexed: 09/22/2023]
Abstract
Presbyopia is an age-related ocular disorder where accommodative ability declines so that an individual's focusing range is insufficient to provide visual clarity for near and distance vision tasks without corrective measures. With age, the eye exhibits changes in biomechanical properties of many components involved in accommodation, including the lens, sclera, and ciliary muscle. Changes occur at different rates, affecting accommodative biomechanics differently, but individual contributions to presbyopia are unknown. We used a finite element model (FEM) of the accommodative mechanism to simulate age-related changes in lens stiffness, scleral stiffness, and ciliary contraction to predict differences in accommodative function. The FEM predicts how ciliary muscle action leads to lens displacement by initializing a tensioned unaccommodated lens (Phase 0) then simulating ciliary muscle contraction in accommodation (Phase 1). Model inputs were calibrated to replicate experimentally measured lens and ciliary muscle in 30-year-old eyes. Predictions of accommodative lens deformation were verified with additional imaging studies. Model variations were created with altered lens component stiffnesses, scleral stiffness, or ciliary muscle section activations, representing fifteen-year incremental age-related changes. Model variations predict significant changes in accommodative function with age-related biomechanical property changes. Lens changes only significantly altered lens thickening with advanced age (46% decrease at 75 years old) while sclera changes produced progressive dysfunction with increasing age (23%, 36%, 49% decrease at 45, 60, and 75 years old). Ciliary muscle changes effected lens position modulation. Model predictions identified potential mechanisms of presbyopia that likely work in combination to reduce accommodative function and could indicate effectiveness of treatment strategies and their dependency on patient age or relative ocular mechanical properties.
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Affiliation(s)
- Katherine R Knaus
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA
- Department of Bioengineering, University of California San Diego, La Jolla, CA, USA
| | | | - Silvia S Blemker
- Department of Biomedical Engineering, University of Virginia, Charlottesville, VA, USA.
- Department of Ophthalmology, University of Virginia, 415 Lane Road, MR5 Room 2133, Box 800759, Charlottesville, VA, USA.
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Holland E, Karpecki P, Fingeret M, Schaeffer J, Gupta P, Fram N, Smits G, Ignacio T, Lindstrom R. Efficacy and Safety of CSF-1 (0.4% Pilocarpine Hydrochloride) in Presbyopia: Pooled Results of the NEAR Phase 3 Randomized, Clinical Trials. Clin Ther 2024; 46:104-113. [PMID: 38216351 DOI: 10.1016/j.clinthera.2023.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2023] [Revised: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 01/14/2024]
Abstract
PURPOSE This study was undertaken to evaluate the safety and efficacy of CSF-1 (0.4% pilocarpine hydrochloride ophthalmic solution) for use in individuals with presbyopia. METHODS Two Phase 3 multicenter, randomized, double-masked, vehicle-controlled, parallel-group clinical trials were conducted in 35 private ophthalmology clinics in the United States from October 2020 to February 2022. Key inclusion criteria were the following: (1) age 45-64 years, (2) distance-corrected near visual acuity (DCNVA) at 40 cm ≥0.40 and ≤0.90 logarithm of the minimum angle of resolution (logMAR, approximately 20/50-20/160 Snellen) in at least 1 eye, (3) manifest refraction (MR) between -4.50 and +2.00 diopter (D) sphere in each eye with ≤2.00D difference between eyes, (4) <2.00D of cylinder MR in each eye, (5) ≤0.04 logMAR (20/20-2 or better) corrected distance visual acuity (CDVA) at 4 m in each eye. Key exclusion criteria were the following: (1) >0.14 logMAR (7 letters) improvement in post-vehicle treatment in monocular DCNVA in either eye at visit 1, (2) introcular pressure (IOP) <9 or >22 mm Hg, (3) average dark-adapted pupillometry <3.5 mm in either eye, (4) prior refractive surgery or intraocular lens (IOL) implantation. Participants applied CSF-1 or vehicle twice per day for 2 weeks. Efficacy and safety assessments were performed at several times on days 1, 8, and 15. Response was defined as ≥3-line gain in DCNVA without loss of ≥1-line in CDVA in the study eye under mesopic room lighting conditions. The primary efficacy endpoint was measured 1 hour post-dose 1 on day 8. Key secondary endpoints were 2 hours post-dose 1, and 1 and 2 hours post-dose 2, also on day 8. Safety endpoints were ocular and non-ocular treatment-related adverse events (TRAE), conjunctival redness, drop comfort, slit-lamp biomicroscopy, intraocular pressure, indirect fundoscopy, and CDVA at 4 m. FINDINGS Six hundred thirteen participants were randomized to CSF-1 (n = 309) or vehicle (n = 304). Participants were predominantly White (80.8%) and female (62.0%), with mean age (standard deviation) of 54.7 (4.8). CSF-1 met the primary and key secondary endpoints. At the primary endpoint, 40.1% of the CSF-1 group achieved response versus 19.1% of the vehicle group (P < 0.0001). The percentage of responders was significantly greater in CSF-1 compared with vehicle at all tested times. Changes from baseline in all safety endpoints were comparable between groups. Most adverse events (AEs) were mild and transient. Neither serious nor severe AEs were reported with CSF-1. IMPLICATIONS CSF-1, a low-dose pilocarpine ophthalmic solution, demonstrated superiority to vehicle in improving near vision in individuals with presbyopia without compromising distance vision. CSF-1 demonstrated a favorable safety profile. CLINICALTRIALS gov identifier: NCT04599933 (NEAR-1), NCT04599972 (NEAR-2).
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Affiliation(s)
| | - Paul Karpecki
- The Kentucky College of Optometry, University of Pikeville, KY
| | - Murray Fingeret
- Department of Veterans Administration New York Harbor Health Care System, New York, NY
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Zhu D, Dhariwal M, Zhang J, Smith A, Martin P. Patient Perception and Self-Reported Outcomes with Presbyopia-Correcting Intraocular Lenses (PCIOLs): A Social Media Listening Study. Ophthalmol Ther 2024; 13:287-303. [PMID: 37948016 PMCID: PMC10776511 DOI: 10.1007/s40123-023-00840-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 10/19/2023] [Indexed: 11/12/2023] Open
Abstract
INTRODUCTION Presbyopia-correcting intraocular lens (PCIOL) implantation is a popular treatment option for cataract surgery patients who desire spectacle independence. This study aimed to understand patient perception and outcomes with PCIOLs by analyzing patient social media posts. METHODS This was a non-interventional retrospective study that used predefined search strings to identify publicly available social media data discussing patient perceptions and outcomes with seven PCIOLs (three trifocal, one multifocal with continuous range of vision, and three extended depth-of-focus [EDOF] PCIOLs). Relevant posts were searched from Reddit, YouTube, and Facebook and patient forums Patient.info, Medicine.net, Optiker-Forum, and Medizin Forum from September 2020 to October 2022 in four languages (English, German, French, and Spanish). RESULTS A total of 2237 posts were included, all in English, with 68% of posts identified on Patient.info. The themes most discussed by patients were quality of vision (69% of total posts), patient experience after PCIOL implantation (30%), patient perception before PCIOL implantation (26%), and visual disturbances (24%). Most discussed PCIOLs were Vivity® (58% of total posts), PanOptix® (38%), Synergy® (26%), and Symfony® (13%). Patient perception of PCIOLs was most frequently influenced by healthcare professionals, online reading, and online videos (31%, 18%, and 15% of posts, respectively). A total of 215 posts (10% of total) discussed glasses use after PCIOL surgery: for EDOF and trifocal/multifocal PCIOLs, 37% and 56% of posts discussing glasses use stated being glasses free, respectively. A total of 537 posts discussed visual disturbances: halos/rings (66%) and starbursts (36%) were the most discussed visual disturbances for all lens types. Being glasses free after PCIOL implantation appeared to be a key driver of patient satisfaction. CONCLUSION Social media provides a rich source of information on patient perception, experience, and overall satisfaction of PCIOLs that can be used to complement and guide the collection of further evidence generated through controlled trials.
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Affiliation(s)
- Dagny Zhu
- NVISION Eye Centers - Rowland Heights, 17980 Castleton St, Rowland Heights, CA, 91748, USA.
| | | | - Jun Zhang
- Alcon Vision LLC, Fort Worth, TX, USA
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Wolffsohn JS. 2022 Glenn A. Fry Award lecture: Enhancing clinical assessment for improved ophthalmic management. Optom Vis Sci 2024; 101:12-24. [PMID: 38350054 DOI: 10.1097/opx.0000000000002102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024] Open
Abstract
ABSTRACT Detailed clinical assessment is critical to allow sensitive evaluation of the eye and its management. As technology advances, these assessment techniques can be adapted and refined to improve the detection of pathological changes of ocular tissue and their impact on visual function. Enhancements in optical medical devices including spectacle, contact, and intraocular lenses have allowed for a better understanding of the mechanism and amelioration of presbyopia and myopia control. Advancements in imaging technology have enabled improved quantification of the tear film and ocular surface, informing diagnosis and treatment strategies. Miniaturized electronics, large processing power, and in-built sensors in smartphones and tablets capacitate more portable assessment tools for clinicians, facilitate self-monitoring and treatment compliance, and aid communication with patients. This article gives an overview of how technology has been used in many areas of eye care to improve assessments and treatment and provides a snapshot of some of my studies validating and using technology to inform better evidence-based patient management.
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Kanclerz P, Khoramnia R, Atchison D. Applications of the pinhole effect in clinical vision science. J Cataract Refract Surg 2024; 50:84-94. [PMID: 38133648 DOI: 10.1097/j.jcrs.0000000000001318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 09/09/2023] [Indexed: 12/23/2023]
Abstract
The pinhole effect is commonly used to discriminate uncorrected refractive error from ocular diseases. A small aperture limits the width of light beams entering the eye, thus increasing the depth of focus. The pinhole effect has also been used in spectacles, contact lenses, corneal inlays, and intraocular lenses (IOLs) to improve reading by compensating for loss of accommodative function. Pinhole spectacles improve near visual acuity, but reduce reading speed, increase interblink interval, and decrease tear break-up time. For contact lenses and IOLs, pinhole devices are usually used in the nondominant eye, which allow compensation of various refractive errors and decrease spectacle dependence. Pinhole corneal inlays are implanted during laser in situ keratomileusis or as a separate procedure. Pinhole IOLs are gaining popularity, particularly as they do not bring a risk of a local inflammatory reaction as corneal inlays do. Disadvantages of using the pinhole effect include high susceptibility to decentration, decrease in retinal luminance levels, and difficulties in performing fundus examinations or surgery in eyes with implanted devices. There are also concerns regarding perceptive issues with different retinal illuminances in the 2 eyes (the Pulfrich effect).
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Affiliation(s)
- Piotr Kanclerz
- From the Helsinki Retina Research Group, University of Helsinki, Finland (Kanclerz); Department of Ophthalmology, Hygeia Clinic, Gdansk, Poland (Kanclerz); The David J. Apple International Laboratory for Ocular Pathology, Department of Ophthalmology, University of Heidelberg, Heidelberg, Germany (Khoramnia); Centre for Vision and Eye Research, Queensland University of Technology, Brisbane, Australia (Atchison)
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Privado-Aroco A, Valdes-Soria G, Romaguera M, Serramito M, Carracedo G. Visual Quality Assessment and Comparison of Monofocal and Multifocal Scleral Lens Designs: A Pilot Study. Eye Contact Lens 2024; 50:35-40. [PMID: 38124285 DOI: 10.1097/icl.0000000000001046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/25/2023] [Indexed: 12/23/2023]
Abstract
PURPOSE To compare visual quality, contrast sensitivity, stereopsis, subjective vision, and comfort between monofocal and multifocal scleral lens (SL) designs. METHODS An experimental, cross over and short-term pilot study has been performed. Nineteen presbyopic patients (51.9±3.8 years) with regular corneas participated voluntarily in the study and Onefit MED monofocal and multifocal SL designs were fitted bilaterally. Subjective vision and comfort, contrast sensitivity function, stereopsis, high- and low-contrast visual acuity (VA) at 4 m and 40 cm under photopic and mesopic conditions, and defocus curves were measured. Data analysis was performed with nonparametric tests. P<0.05 was considered as statistically significant. RESULTS Mean addition power of the prescribed lenses was 1.72±0.38 diopters. Multifocal design showed a statistically significant improvement for intermediate and near vision in the defocus curve under photopic and mesopic conditions (P<0.05), however, worsening in stereopsis (P<0.05) and contrast sensitivity for high spatial frequencies (P<0.05). Distance visual acuity (VA) showed significantly lower values under mesopic conditions for high- and low-contrast tests (P<0.05), and on low-contrast test under photopic conditions (P<0.001) with the multifocal design. CONCLUSION Multifocal SLs showed better visual performance at intermediate and near distances without compromising distance vision under photopic conditions for a high-contrast test when compared with monofocal design.
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Affiliation(s)
- Ana Privado-Aroco
- Department of Optometry and Vision (A.P.-A., G.V.-S., M.R., M.S., G.C.), Faculty of Optics and Optometry, Complutense University of Madrid, Spain; and Ocupharm Research Group (A.P.-A., G.V.-S., M.R., M.S., G.C.), Faculty of Optics and Optometry, Complutense University of Madrid, Spain
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Garcia-Porta N, Gómez-Varela AI, Arines-Piferrer J. Visual performance of new affordable and auto-adherent lenses for presbyopia correction. Ophthalmic Physiol Opt 2024; 44:78-82. [PMID: 37888774 DOI: 10.1111/opo.13241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Revised: 10/09/2023] [Accepted: 10/13/2023] [Indexed: 10/28/2023]
Abstract
Presbyopia is a visual condition that affects all of us, evolving with time, reducing the range of accommodation and the ability to work at near. Reading glasses, bifocals or multifocal lenses are the most common solutions. In this work, we demonstrate the near visual performance of new elastomeric auto-adherent lenses developed for the correction of presbyopia. Visual acuity and contrast sensitivity were measured in 10 presbyopic subjects. The results showed that wearing either conventional trial ophthalmic lenses or the new elastomeric lenses provided similar visual quality. These elastomeric lenses can be placed in, or removed from the distance-vision spectacles of the wearers, providing an affordable solution for correcting presbyopia at its clinical onset, which might be especially useful in subjects with different refractive error in each eye and for those with astigmatism.
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Affiliation(s)
- Nery Garcia-Porta
- Applied Physics Department, Optics and Optometry Faculty, University of Santiago de Compostela, Santiago, Spain
- Institute of Materials (iMATUS) of the University of Santiago de Compostela, Santiago, Spain
| | - Ana I Gómez-Varela
- Applied Physics Department, Optics and Optometry Faculty, University of Santiago de Compostela, Santiago, Spain
- Institute of Materials (iMATUS) of the University of Santiago de Compostela, Santiago, Spain
| | - Justo Arines-Piferrer
- Applied Physics Department, Optics and Optometry Faculty, University of Santiago de Compostela, Santiago, Spain
- Institute of Materials (iMATUS) of the University of Santiago de Compostela, Santiago, Spain
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Khurana DA, Swathi N, Rajalakshmi AR. Factors influencing the need and willingness for presbyopic correction: a cross sectional study from south India. Sci Rep 2023; 13:22906. [PMID: 38129652 PMCID: PMC10739945 DOI: 10.1038/s41598-023-50288-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 12/18/2023] [Indexed: 12/23/2023] Open
Abstract
Presbyopia is an age-related physiological phenomenon in which eye gradually losses its ability to accommodate. It is one of the leading causes of visual impairment worldwide, especially in adults above the age of 40. If uncorrected, it can significantly impair a patient's quality of life. This study aims to evaluate the factors which affects patient's need and willingness to accept presbyopic correction. This cross-sectional analytical study was carried out in a semi urban tertiary care hospital from Jan 2021 to June 2022 among patients aged 40 and above who presented to Outpatient department (OPD). Demographic details, medical history, presenting ocular complaints pertaining to presbyopia, spectacle use and decision regarding using near vision correction were noted. Ocular examination included refraction and ocular biometry. Factors that may have influenced complaints of presbyopia or willingness to accept presbyopic correction were analysed. Three hundred and forty two patients with a mean age of 48.55 ± 6.68 years were included. Of these, 262 (76.61%) patients presented with chief complaints related to presbyopia. Those with higher educational qualification (p = 0.031), hypermetropia (p = 0.021), shallower AC depth (p = 0.028) and on medications for systemic ailments (p = 0.01), were more likely to present with chief complaints attributable to presbyopia. Among them, those with higher educational qualifications (p = 0.02) and skilled workers were more likely to accept near vision glasses (p = 0.02), while those with lower Hb (p = 0.01) and myopia (p = 0.01) were less likely to accept correction for presbyopia. Among the 80 patients without chief complaints related to presbyopia, 35 (43.75%) were not willing to accept near vision glasses. Those with higher BMI (p = 0.04) and hypermetropes (p = 0.05) were more willing to accept presbyopic correction. Presbyopia constitutes a significant reason for patients above the age of 40 visiting eye care facility. Multiple socio-economic, systemic and ocular factors influenced both the chief complaints related to presbyopia and willingness to accept presbyopic correction.
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Affiliation(s)
- Dhruval A Khurana
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry, India
| | - N Swathi
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry, India.
| | - A R Rajalakshmi
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Sri Balaji Vidyapeeth, Pondicherry, India
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Kohnen T, Nouri SA, Carson D. Vehicle Headlight Halo Simulation of Presbyopia-Correcting Intraocular Lenses. Transl Vis Sci Technol 2023; 12:19. [PMID: 38127324 PMCID: PMC10746926 DOI: 10.1167/tvst.12.12.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 10/16/2023] [Indexed: 12/23/2023] Open
Abstract
Purpose This optical bench study was designed to evaluate and compare the halos generated by presbyopia-correcting intraocular lenses (PCIOLs) and monofocal intraocular lenses (IOLs), with or without lens decentration, using an optical bench to simulate the headlight of a distant vehicle in mesopic conditions. Methods Halos generated by six nondiffractive and 10 diffractive IOLs with different dioptric add powers were evaluated using a high dynamic range bench system. Halo intensities were compared by assessing the area under the measured intensity profile curve to compute the relative halo magnitude (RHM). Results Nondiffractive PCIOLs produced smaller and less intense bench halo images than diffractive ones. RHM measurements ranged from 964 to 1896. Monofocal IOLs produced lower RHM values, whereas diffractive PCIOLs generated higher ones. When decentered by 0.5 mm with respect to the system aperture, more obviously asymmetric halo image profiles were observed in diffractive compared with nondiffractive PCIOLs. Conclusions Simulated bench halos of nondiffractive PCIOLs are smaller and less intense than those of diffractive PCIOLs. Additional clinical studies assessing standardized patient-reported outcomes measures are required to correlate these bench results with patient satisfaction. Translational Relevance This study contrasts the design-related simulated bench halos of nondiffractive and diffractive PCIOLs, aiming to elucidate their impact on halo perception.
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Affiliation(s)
- Thomas Kohnen
- Department of Ophthalmology, Goethe University, Frankfurt, Germany
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Goswami S, Bharadwaj SR. Temporal fluctuations in defocus may reverse the acuity loss encountered with induced refractive errors. JOURNAL OF THE OPTICAL SOCIETY OF AMERICA. A, OPTICS, IMAGE SCIENCE, AND VISION 2023; 40:2008-2018. [PMID: 38038066 DOI: 10.1364/josaa.497091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 10/02/2023] [Indexed: 12/02/2023]
Abstract
A recent template-matching model hypothesized that simulated visual acuity loss with uncorrected refractive errors may be recovered by adding temporal defocus fluctuations up to the magnitude of the refractive error. Acuity recovery saturates or gets attenuated beyond this magnitude. These predictions were confirmed for monocular high-contrast visual acuity of 10 young, cyclopleged adults with 0.5-2.0D of induced myopia combined with the same range of temporal defocus fluctuations at 4.0 Hz frequency. The outcomes reinforce that spatial resolution may be optimized by averaging time-varying defocus over the entire stimulus presentation epoch or around the point of least defocus within this epoch.
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Bafna S, Gu X, Fevrier H, Merchea M. IRIS ® Registry (Intelligent Research In Sight) Analysis of the Incidence of Monovision in Cataract Patients with Bilateral Monofocal Intraocular Lens Implantation. Clin Ophthalmol 2023; 17:3123-3129. [PMID: 37877114 PMCID: PMC10591682 DOI: 10.2147/opth.s424195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/06/2023] [Indexed: 10/26/2023] Open
Abstract
Purpose To determine the incidence of pseudophakic monovision among patients bilaterally implanted with monofocal intraocular lenses (IOLs) and to characterize the distribution of myopic offsets achieved. Patients and Methods This retrospective database study included data on patients receiving care from ophthalmologists who contributed to the Academy IRIS® (Intelligent Research In Sight) Registry. Anonymized data were collected, including patient age, ethnicity, procedure data (CPT code, date, laterality), and postoperative manifest refractive spherical equivalent (MRSE) in both eyes implanted with monofocal or monofocal toric IOLs. No data regarding IOL manufacturer, model, or power were collected. One primary outcome measure was the percentage of patients achieving monovision (defined as emmetropia within ±0.25 diopters [D] in one eye and a myopic offset of ≥0.50 D in the fellow eye) among all patients receiving bilateral monofocal IOLs at the time of cataract surgery between January 1, 2016, and September 1, 2019, with at least 90 days of follow-up. Other primary outcomes included the distribution and frequency of myopic offsets (anisometropia) between eyes. Results Of the 16,765 people receiving bilateral monofocal IOLs within the study period, 4796 (28.6%) achieved emmetropia in at least one eye, as defined by an MRSE within ± 0.25 D. The incidence of monovision among these patients was 34.2% (1638/4796). One-quarter (24.7%; 405/1638) of patients who achieved monovision had a myopic offset between 0.50 and 0.74 D, with more than one-third (35.2%; 576/1638) falling within 0.75-1.24 D and 18.0% within 1.25-1.74 D. A myopic offset ≥1.75 D was observed in 22.1% (362/1638) of patients who achieved monovision. Conclusion Pseudophakic monovision for presbyopia correction was achieved in ~34% of patients in the IRIS Registry bilaterally implanted with monofocal IOLs, with myopic offsets typically ranging from 0.5 to 1.24 D.
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Keskin Perk FFN, Taneri S, Tanriverdi C, Haciagaoglu S, Karaca ZY, Kilic A. Increasing depth of focus with allogeneic presbyopic inlays: 3-year results. J Cataract Refract Surg 2023; 49:1005-1010. [PMID: 37487178 DOI: 10.1097/j.jcrs.0000000000001270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 07/19/2023] [Indexed: 07/26/2023]
Abstract
PURPOSE To demonstrate the safety and efficacy of allogenic corneal inlays designed to increase the depth of focus (DoF) in treated eyes. SETTINGS Medipol University Hospital, Istanbul, Turkey. DESIGN Prospective case series. METHODS This study includes 50 eyes of 25 patients with a follow-up of 3 years. Emmetropic patients with presbyopia had implantation of allogenic corneal inlays in the nondominant eye. The uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), and uncorrected near visual acuity (UNVA) were evaluated in all eyes. A subjective visual acuity test system (Multifocal Lens Analyzer 3.0 application) was used to analyze the DoF by measuring the defocus curves. RESULTS No significant difference between the treated and fellow eyes in UDVA and CDVA was found, whereas UNVA was significantly better in the treated eyes ( P = .20, P = .07, P < .01, respectively). Comparing to the preoperative CDVA, there was a 1-line decrease in CDVA in 6 (%24) patients. The mean defocus curves reveal a DoF of 1.1 diopters (D) for the untreated eye at the logMAR = 0.2 threshold. By contrast, the mean DoF of the treated eye and binocularly was 2.8 D. The areas under the curve were significantly better in the near, intermediate, and total distances in the treated eyes, whereas it was better for the far distances in the untreated eyes. All values were significant ( P = .023 total, P < .01 others). CONCLUSIONS Allogenic presbyopic inlay implantation may be safe and provided a clinically and statistically significant increase in the DoF leading to good far, intermediate, and near-visual acuity in emmetropic presbyopic patients.
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Affiliation(s)
- Fatma Feyza Nur Keskin Perk
- From the Department of Ophthalmology, Istanbul Medipol University, Faculty of Medicine, Istanbul, Turkey (Keskin Perk, Tanriverdi, Haciagaoglu, Karaca, Kilic); Department of Ophthalmology, St. Franziscus Hospital, Münster, Germany (Taneri)
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Lan Q, Xu F, Sun T, Zeng S, Liu Y, Yang T, Li Y, Yao G, Ma B, Tao L, Ma B, Xiao X, Li M, Qi H. Comparison of binocular visual quality in six treatment protocols for bilateral cataract surgery with presbyopia correction: a prospective two-center single-blinded cohort study. Ann Med 2023; 55:2258894. [PMID: 37734409 PMCID: PMC10515669 DOI: 10.1080/07853890.2023.2258894] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 09/07/2023] [Indexed: 09/23/2023] Open
Abstract
OBJECTIVE To compare the postoperative binocular visual quality in six treatment protocols for bilateral age-related cataract surgery with presbyopia correction for clinical decisions. MATERIALS AND METHODS In this prospective two-center single-blinded cohort study, participants from North or South China who underwent bilateral phacoemulsification and intraocular lens implantation were divided into six protocols: monovision, diffractive bifocal, mixed, refractive bifocal, trifocal, and micro-monovision extended range of vision (EROV). Binocular visual quality was evaluated at 3 months postoperatively, including binocular uncorrected full-range visual acuity, binocular defocus curves (depth of focus [DoF] and area under the curve [AUC]), binocular visual function (fusion function and stereopsis), binocular subjective spectacle independence rates, visual analog scale (VAS) of overall satisfaction, 25-item visual function questionnaire (VFQ-25), and binocular dysphotopsia symptoms. RESULTS Of the 300 enrolled patients, 272 (90.7%; 544 eyes) were analyzed. The trifocal protocol showed excellent binocular full-range visual acuity and the best performance for most DoFs and AUCs. The monovision protocol presented the worst binocular visual quality in most perspectives, especially in convergence, distance, and near stereopsis (p < 0.001). The full-range subjective spectacle independence rates were sorted from highest to lowest as follows: trifocal (84.8%), refractive bifocal (80.9%), EROV (80.0%), mixed (73.3%), diffractive bifocal (65.2%), and monovision (32.6%) protocols, with no statistically significant differences between the former five protocols (p > 0.05). The EROV protocol achieved the highest VAS and VFQ-25 scores. The incidence of postoperative binocular dysphotopsia symptoms was comparable in all protocols. CONCLUSIONS The trifocal protocol showed the best performance, and the monovision protocol presented the worst performance in most perspectives of binocular visual quality for presbyopia correction. The refractive bifocal, mixed, or EROV protocols can provide an approximate performance as a trifocal protocol. Ophthalmologists can customize therapies using different protocols.
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Affiliation(s)
- Qianqian Lan
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, Beijing, China
- Guangxi Academy of Medical Sciences and Department of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region and Guangxi Key Laboratory of Eye Health and Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology (The People’s Hospital of Guangxi Zhuang Autonomous Region), Institute of Ophthalmic Diseases, Nanning, China
| | - Fan Xu
- Guangxi Academy of Medical Sciences and Department of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region and Guangxi Key Laboratory of Eye Health and Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology (The People’s Hospital of Guangxi Zhuang Autonomous Region), Institute of Ophthalmic Diseases, Nanning, China
| | - Tong Sun
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Siming Zeng
- Guangxi Academy of Medical Sciences and Department of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region and Guangxi Key Laboratory of Eye Health and Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology (The People’s Hospital of Guangxi Zhuang Autonomous Region), Institute of Ophthalmic Diseases, Nanning, China
| | - Yiyun Liu
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Tingting Yang
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Yaxin Li
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Gang Yao
- Guangxi Academy of Medical Sciences and Department of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region and Guangxi Key Laboratory of Eye Health and Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology (The People’s Hospital of Guangxi Zhuang Autonomous Region), Institute of Ophthalmic Diseases, Nanning, China
| | - Baikai Ma
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Liyuan Tao
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Boping Ma
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, Beijing, China
| | - Xin Xiao
- Guangxi Academy of Medical Sciences and Department of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region and Guangxi Key Laboratory of Eye Health and Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology (The People’s Hospital of Guangxi Zhuang Autonomous Region), Institute of Ophthalmic Diseases, Nanning, China
| | - Min Li
- Guangxi Academy of Medical Sciences and Department of Ophthalmology, The People’s Hospital of Guangxi Zhuang Autonomous Region and Guangxi Key Laboratory of Eye Health and Guangxi Health Commission Key Laboratory of Ophthalmology and Related Systemic Diseases Artificial Intelligence Screening Technology (The People’s Hospital of Guangxi Zhuang Autonomous Region), Institute of Ophthalmic Diseases, Nanning, China
| | - Hong Qi
- Beijing Key Laboratory of Restoration of Damaged Ocular Nerve, Department of Ophthalmology, Peking University Third Hospital, Beijing, China
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Lee BJH, Ong HS, Fenner BJ, Mehta JS. Surgical Technique to Treat Presbyopic Inlay-Associated Corneal Haze With Sequential Excimer Photoablation: A Case Series. J Refract Surg 2023; 39:639-646. [PMID: 37675910 DOI: 10.3928/1081597x-20230814-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023]
Abstract
PURPOSE To describe an approach using sequential excimer laser ablation of the stromal surface of the corneal flap with or without subsequent excimer ablation to the stromal bed to reduce presbyopic inlay-associated corneal haze. METHODS Twelve patients who underwent KAMRA inlay (Acufocus) explantation due to corneal haze were included. The mean interval between explantation and the primary surgery (phototherapeutic keratotomy [PTK] to corneal flap) was 16.2 ± 29.7 months (range = 1 to 83 months). The corneal flap was lifted and laid on an evisceration spoon and an excimer laser was used to ablate the flap stroma by 30 to 40 µm depth. Subsequently, an excimer laser was used to ablate and treat the stromal bed following a second flap lift according to the manifest refraction, leaving a minimal residual stromal bed thickness of greater than 300 µm. For both procedures, mitomycin C 0.02% was applied to the stromal bed before the flap was replaced and a bandage contact lens applied. RESULTS Reductions in corneal haze were observed, following PTK to the corneal flap with or without photorefractive keratectomy (PRK) to the stromal bed, both clinically and on imaging. No significant changes in uncorrected distance visual acuity (P = .442) and corrected distance visual acuity (P = .565) were observed. Improvements were observed for both spherical equivalent refractive errors (P = .036) and corneal light backscatter (P = .019). There were significant improvements in spherical aberrations (P = .014) but no changes in total lower and higher order aberrations. CONCLUSIONS PTK to the corneal flap with or without subsequent stromal bed PRK is an effective technique in treating corneal haze following presbyopic inlay explantation. [J Refract Surg. 2023;39(9):639-646.].
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Benyó F, István L, Kiss H, Gyenes A, Erdei G, Juhász É, Vlasak N, Unger C, Andorfi T, Réz K, Kovács I, Nagy ZZ. Assessment of Visual Quality Improvement as a Result of Spectacle Personalization. Life (Basel) 2023; 13:1707. [PMID: 37629564 PMCID: PMC10455981 DOI: 10.3390/life13081707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/04/2023] [Accepted: 08/06/2023] [Indexed: 08/27/2023] Open
Abstract
Personalized spectacles customized according to an individual's facial anatomy were developed to provide enhanced visual performance and overall comfort when compared to standard spectacles. In this comparative crossover trial, each subject was randomly assigned to wear either personalized spectacles or standard spectacles for two weeks and then tried the second pair for another two weeks. Visual acuity and reading speed were measured, and visual quality and comfort were assessed using specific questionnaires. The correlation of the wearing parameters with the subjects' satisfaction was calculated. According to our results, the subjects wearing personalized glasses reported significantly less experience of swaying and significantly higher overall satisfaction compared to those wearing the control spectacles. At the end of the study, 62% of subjects preferred the personalized spectacles, and visual quality was the primary reason for their spectacle preference followed by wearing comfort. The difference from the ideal cornea-vertex distance was significantly lower when wearing the personalized spectacles compared to the control frames. In addition, the absolute value of the difference from the ideal cornea-vertex distance was significantly correlated with patient satisfaction. These results suggest that personalized spectacles, customized according to an individual's facial anatomy for the ideal wearing parameters, result in both visual and comfort advantages for wearers.
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Affiliation(s)
- Fruzsina Benyó
- Department of Ophthalmology, Semmelweis University, 1085 Budapest, Hungary; (F.B.); (L.I.); (H.K.); (A.G.); (É.J.); (Z.Z.N.)
| | - Lilla István
- Department of Ophthalmology, Semmelweis University, 1085 Budapest, Hungary; (F.B.); (L.I.); (H.K.); (A.G.); (É.J.); (Z.Z.N.)
| | - Huba Kiss
- Department of Ophthalmology, Semmelweis University, 1085 Budapest, Hungary; (F.B.); (L.I.); (H.K.); (A.G.); (É.J.); (Z.Z.N.)
| | - Andrea Gyenes
- Department of Ophthalmology, Semmelweis University, 1085 Budapest, Hungary; (F.B.); (L.I.); (H.K.); (A.G.); (É.J.); (Z.Z.N.)
| | - Gábor Erdei
- Department of Atomic Physics, Institute of Physics, Budapest University of Technology and Economics, 1111 Budapest, Hungary
| | - Éva Juhász
- Department of Ophthalmology, Semmelweis University, 1085 Budapest, Hungary; (F.B.); (L.I.); (H.K.); (A.G.); (É.J.); (Z.Z.N.)
| | - Natalia Vlasak
- Hoya Vision Care, 1043NX Amsterdam, The Netherlands; (N.V.); (C.U.)
| | - Claudia Unger
- Hoya Vision Care, 1043NX Amsterdam, The Netherlands; (N.V.); (C.U.)
| | - Tamás Andorfi
- Department of Clinical Ophthalmology, Faculty of Health Sciences, Semmelweis University, 1088 Budapest, Hungary; (T.A.); (K.R.)
| | - Kata Réz
- Department of Clinical Ophthalmology, Faculty of Health Sciences, Semmelweis University, 1088 Budapest, Hungary; (T.A.); (K.R.)
| | - Illés Kovács
- Department of Ophthalmology, Semmelweis University, 1085 Budapest, Hungary; (F.B.); (L.I.); (H.K.); (A.G.); (É.J.); (Z.Z.N.)
- Department of Clinical Ophthalmology, Faculty of Health Sciences, Semmelweis University, 1088 Budapest, Hungary; (T.A.); (K.R.)
| | - Zoltán Zsolt Nagy
- Department of Ophthalmology, Semmelweis University, 1085 Budapest, Hungary; (F.B.); (L.I.); (H.K.); (A.G.); (É.J.); (Z.Z.N.)
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Plainis S, Ktistakis E, Tsilimbaris MK. Presbyopia correction with multifocal contact lenses: Evaluation of silent reading performance using eye movements analysis. Cont Lens Anterior Eye 2023; 46:101853. [PMID: 37164776 DOI: 10.1016/j.clae.2023.101853] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Revised: 04/27/2023] [Accepted: 05/01/2023] [Indexed: 05/12/2023]
Abstract
PURPOSE Many activities of daily living rely on reading, thus is not surprising that complaints from presbyopes originate in reading difficulties rather in visual acuity. Here, the effectiveness of presbyopia correction with multifocal contact lenses (CLs) is evaluated using an eye-fixation based method of silent reading performance. ΜETHODS: Visual performance of thirty presbyopic volunteers (age: 50 ± 5 yrs) was assessed monocularly and binocularly following 15 days of wear of monthly disposable CLs (AIR OPTIX™ plus HydraGlyde™, Alcon Laboratories) with: (a) single vision (SV) lenses - uncorrected for near (b) aspheric multifocal (MF) CLs. LogMAR acuity was measured with ETDRS charts. Reading performance was evaluated using standard IReST paragraphs displayed on a screen (0.4 logMAR print size at 40 cm distance). Eye movements were monitored with an infrared eyetracker (Eye-Link II, SR Research Ltd). Data analysis included computation of reading speed, fixation duration, fixations per word and percentage of regressions. RESULTS Average reading speed was 250 ± 68 and 235 ± 70 wpm, binocularly and monocularly, with SV CLs, improving statistically significantly to 280 ± 67 (p = 0.002) and 260 ± 59 wpm (p = 0.01), respectively, with MF CLs. Moreover, fixation duration, fixations per word and ex-Gaussian parameter of fixation duration, μ, showed a statistically significant improvement when reading with MF CLs, with fixation duration exhibiting the stronger correlation (r = 0.79, p < 0.001) with improvement in reading speed. The correlation between improvement in VA and reading speed was moderate (r = 0.46, p = 0.016), as was the correlation between VA and any eye fixation parameter. CONCLUSION Average silent reading speed in a presbyopic population was found improved with MF compared to SV CL correction and was faster with binocular compared to monocular viewing: this was mainly due to the faster average fixation duration and the lower number of fixations. Evaluating reading performance using eye fixation analysis could offer a reliable outcome of functional vision in presbyopia correction.
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Affiliation(s)
- Sotiris Plainis
- Laboratory of Optics and Vision (LOV), School of Medicine, University of Crete, Greece; Optometry & Vision Science Research Group, Aston University School of Life and Health Sciences, Birmingham, UK.
| | - Emmanouil Ktistakis
- Laboratory of Optics and Vision (LOV), School of Medicine, University of Crete, Greece
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Oscar GE, Irene S, Raul M. Visual satisfaction with progressive addition lenses prescribed with novel foveal fixation axis measurements. Sci Rep 2023; 13:11262. [PMID: 37438410 DOI: 10.1038/s41598-023-38446-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Accepted: 07/08/2023] [Indexed: 07/14/2023] Open
Abstract
Progressive addition lens (PAL) prescription is usually conducted using the pupillary centre as a reference, which in general does not coincide with the visual axis (kappa distance), and this difference could induce undesired prismatic effects in far and near vision distances and adaptation problems. This study aimed to assess the impact on subjects' visual satisfaction with PALs prescribed based on foveal fixation axis (FFA) measurements. Two different PALs (LifeStyle 3i, Hoya Lens Iberia) were randomly prescribed [one with a customized inset (the difference between the FFA measurements (Ergofocus®, Lentitech, Spain) at far and near distances and the second with a standard inset (2.5 mm)] to be used by 71 healthy presbyopic volunteers in a prospective double-masked crossover clinical study involving one month of use of each PAL. Patients were self-classified into four groups according to their previous experience with PALs: neophyte, PAL users, PAL drop-out, and uncomfortable PAL users. Visual function and overall satisfaction with each PAL were collected and compared. Ninety-seven percent (95% CI 93-100%) of participants successfully adapted to PALs prescribed with FFA without significant differences (P = 0.26) among the study groups (100% neophyte and uncomfortable PAL users (95% CI 100% in both groups), 89% (95% CI 67-100%) PAL users and 94% (95% CI 82-100%) PAL drop-out group). There were no statistically significant differences in visual function (P > 0.05) between customized and standard inset PALs. Customized and standard inset lenses showed similar satisfaction (P > 0.42) that increased significantly (P < 0.01 without any carry-over effect) after 30 days of wear. PALs prescribed with FFA measurements showed high visual satisfaction, suggesting that these measurements are suitable for prescribing PAL adaptation processes. Additional research is necessary to assess differences in PAL users' performance with different prescription methods and lens designs.
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Affiliation(s)
- Garcia-Espinilla Oscar
- Optometry Research Group, IOBA Eye Institute, School of Optometry, University of Valladolid, 47011, Valladolid, Spain
- Departamento de Física Teórica, Atómica y Óptica, Universidad de Valladolid, Paseo de Belén, 7 - Campus Miguel Delibes, 47011, Valladolid, Spain
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén, 17 - Campus Miguel Delibes, 47011, Valladolid, Spain
| | - Sanchez Irene
- Optometry Research Group, IOBA Eye Institute, School of Optometry, University of Valladolid, 47011, Valladolid, Spain.
- Departamento de Física Teórica, Atómica y Óptica, Universidad de Valladolid, Paseo de Belén, 7 - Campus Miguel Delibes, 47011, Valladolid, Spain.
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén, 17 - Campus Miguel Delibes, 47011, Valladolid, Spain.
| | - Martin Raul
- Optometry Research Group, IOBA Eye Institute, School of Optometry, University of Valladolid, 47011, Valladolid, Spain
- Departamento de Física Teórica, Atómica y Óptica, Universidad de Valladolid, Paseo de Belén, 7 - Campus Miguel Delibes, 47011, Valladolid, Spain
- Instituto Universitario de Oftalmobiología Aplicada (IOBA), Universidad de Valladolid, Paseo de Belén, 17 - Campus Miguel Delibes, 47011, Valladolid, Spain
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Ong LF, Oh A, Yi JK, Gu JS, Marvasti AH, Nguyen BB, Tran DB, Lee JK. Refractive lens exchange - who is getting it, what are they getting, how are they doing? Curr Opin Ophthalmol 2023; 34:280-289. [PMID: 37254862 DOI: 10.1097/icu.0000000000000956] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE OF REVIEW The purpose of this article is to provide a review of the literature on refractive lens exchange and present a retrospective analysis of 55 patients who underwent refractive lens exchange at a single practice. RECENT FINDINGS Our study substantiates refractive lens exchange as an important option for presbyopic patients, hyperopic patients or patients with extremely high refractive error who desire spectacle independence. SUMMARY Our study reveals that the refractive lens exchange population is younger than the average cataract population and their primary motivations are to resolve hyperopic or myopic refractive errors, gain spectacle independence, and address near vision loss. A variety of presbyopia-addressing intraocular lens options are available and we present our experience with multifocal, extended depth-of-focus, light-adjustable, and monofocal lenses.
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Affiliation(s)
- Lauren F Ong
- California Northstate University College of Medicine, Elk Grove, CA
| | - Alyce Oh
- Coastal Vision Medical Group, Orange, CA
| | - Joseph K Yi
- Albert Einstein College of Medicine, Bronx, NY
| | | | | | | | - Dan B Tran
- Coastal Vision Medical Group, Orange, CA
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Yalew AB, Alemu HW, Alemayehu AM. Factors Affecting Unmet Need for Presbyopia Correction Among School Teachers in Debre Tabor Town, Northwest Ethiopia. CLINICAL OPTOMETRY 2023; 15:129-138. [PMID: 37347095 PMCID: PMC10281454 DOI: 10.2147/opto.s411708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 06/12/2023] [Indexed: 06/23/2023]
Abstract
Background Uncorrected presbyopia is the leading cause of near visual impairment among working-age adults in the world. In Ethiopia, there was limited evidence on the magnitude of uncorrected presbyopia and its associated factors among school teachers. Therefore, this study aimed to determine the magnitude of untreated presbyopia and its associated factors among school teachers in Debre Tabor town, Northwest Ethiopia. Methods An institution-based cross-sectional study was conducted on 448 school teachers at Debre Tabor town using a simple random sampling technique. The data were collected using a face-to-face interview and a comprehensive ocular examination. A binary multivariable logistic regression model was conducted to identify associated factors of the uncorrected presbyopia. Results Generally, the prevalence of uncorrected presbyopia among school teachers was 63.62% (95% CI: 59.2-67.9). Age (35-45) (AOR: 4.56, 95% CI: 1.74, 11.91), female gender (AOR: 3.03, 95% CI: 1.75, 5.26), unaware of presbyopia (AOR: 2.35, 95% CI: 1.30, 4.25), unaware of refraction site (AOR: 4.21, 95% CI: 2.42, 7.33), no eye checkup history (AOR: 2.76, 95% CI: 1.52, 5.01), and no family history of spectacle use (AOR: 2.61, 95% 4.67) were significantly associated with uncorrected presbyopia. Conclusion In the current study, the magnitude of uncorrected presbyopia was high. Age below 45 years, female gender, lack of awareness of presbyopia and refraction site, lack of history of eye checkups, and family spectacle use were significantly associated with uncorrected presbyopia. The early correction of presbyopia, health education on presbyopia, and the provision of affordable spectacle corrections for school teachers were recommended.
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Affiliation(s)
- Amsalu Belete Yalew
- Department of Ophthalmology and Optometry, School of Medicine, College of Medicine and Health Sciences, Hawassa University, Hawassa, Ethiopia
| | - Haile Woretaw Alemu
- Department of Optometry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abiy Maru Alemayehu
- Department of Optometry, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
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