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Esteban-Ibañez E, Montagud-Martínez D, Sawides L, Zaytouny A, de Castro A, Sisó-Fuertes I, Barcala X, Piñero DP, Furlan WD, Dorronsoro C, Gambra E. Simulation of daily soft multifocal contact lenses using SimVis Gekko: from in-vitro and computational characterization to clinical validation. Sci Rep 2024; 14:8592. [PMID: 38615153 PMCID: PMC11016090 DOI: 10.1038/s41598-024-59178-1] [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: 05/18/2023] [Accepted: 04/08/2024] [Indexed: 04/15/2024] Open
Abstract
Multifocal contact lenses (MCLs) are one of the solutions to correct presbyopia, but their adoption is not widespread. To address this situation, visual simulators can be used to refine the adaptation process. This study aims to obtain accurate simulations for a visual simulator (SimVis Gekko; 2EyesVision) of daily soft MCL designs from four manufacturers. In-vitro characterization of these MCLs-several powers and additions- was obtained using NIMO TR-1504. From the averaged relative power profiles across powers, phase maps were reconstructed and the Through-Focus Visual Strehl metric was calculated for each MCL design. The SimVis Gekko simulation corresponding to each MCL design was obtained computationally and bench-validated. Finally, the MCL simulations were clinically validated involving presbyopic patients. The clinical validation results show a good agreement between the SimVis Gekko simulations and the real MCLs for through-focus visual acuity (TF-VA) curves and VA at three real distances. All MCL designs showed a partial correlation higher than 0.90 and a Root Mean Square Error below 0.07 logMAR between the TF-VA of simulations and Real MCLs across subjects. The validity of the simulation approach using SimVis Gekko and in-vitro measurements was confirmed in this study, opening the possibility to accelerate the adaptation of MCLs.
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Affiliation(s)
- Eduardo Esteban-Ibañez
- 2EyesVision SL, Plaza de la Encina, 10, Nucleo 3, Planta 4ª, 28760, Tres Cantos, Madrid, Spain.
- Institute of Optics 'Daza de Valdés', Spanish National Research Council, IO-CSIC, Madrid, Spain.
| | - Diego Montagud-Martínez
- Centro de Tecnologías Físicas, Universitat Politècnica de València, Valencia, Spain
- Departamento de Óptica y Optometría y Ciencias de la Visión, Universitat de València, Valencia, Spain
| | - Lucie Sawides
- 2EyesVision SL, Plaza de la Encina, 10, Nucleo 3, Planta 4ª, 28760, Tres Cantos, Madrid, Spain
- Institute of Optics 'Daza de Valdés', Spanish National Research Council, IO-CSIC, Madrid, Spain
| | - Amal Zaytouny
- Institute of Optics 'Daza de Valdés', Spanish National Research Council, IO-CSIC, Madrid, Spain
| | - Alberto de Castro
- Institute of Optics 'Daza de Valdés', Spanish National Research Council, IO-CSIC, Madrid, Spain
| | - Irene Sisó-Fuertes
- 2EyesVision SL, Plaza de la Encina, 10, Nucleo 3, Planta 4ª, 28760, Tres Cantos, Madrid, Spain
| | - Xoana Barcala
- 2EyesVision SL, Plaza de la Encina, 10, Nucleo 3, Planta 4ª, 28760, Tres Cantos, Madrid, Spain
| | - David P Piñero
- Departamento de Óptica, Farmacología y Anatomía, Universidad de Alicante, Alicante, Spain
| | - Walter D Furlan
- Departamento de Óptica y Optometría y Ciencias de la Visión, Universitat de València, Valencia, Spain
| | - Carlos Dorronsoro
- 2EyesVision SL, Plaza de la Encina, 10, Nucleo 3, Planta 4ª, 28760, Tres Cantos, Madrid, Spain
- Institute of Optics 'Daza de Valdés', Spanish National Research Council, IO-CSIC, Madrid, Spain
| | - Enrique Gambra
- 2EyesVision SL, Plaza de la Encina, 10, Nucleo 3, Planta 4ª, 28760, Tres Cantos, Madrid, Spain
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Kaymak H, Neller K, Graff B, Langenbucher A, Seitz B, Schwahn H, Klabe K. Contrast Adaptation in Pseudophakic Patients with Macular Disorders. Curr Eye Res 2024; 49:207-213. [PMID: 37933837 DOI: 10.1080/02713683.2023.2273196] [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: 06/06/2023] [Accepted: 10/17/2023] [Indexed: 11/08/2023]
Abstract
PURPOSE To learn whether contrast adaptation, induced by positive spherical defocus, is compromised by macular disorders such as age-related macular degeneration (AMD) or epiretinal membranes (ERM) and to gain further insight in the functionality of the pathological macula and the level of "functional reserve" often postulated for the indication of presbyopia correcting IOLs. METHODS In a pilot study, patients with macular disorders, AMD and ERM, (n = 10) and healthy volunteers (n = 10) were tested to quantify contrast adaption after +4 D defocus for 10 min, by performing an interocular contrast matching task. Subjects manually adjusted the perceived contrast of the test patch as seen by the test eye to match to the contrast of a target patch with a fixed Michelson contrast of 0.2 as seen by the contralateral untreated eye. RESULTS Patients with macular disorders subjectively matched the 0.2 target contrast with a contrast of 0.24 ± 0.06 (mean ± SD) before adaptation and with a contrast of 0.19 ± 0.04 after adaptation (p < 0.05). Accordingly, patients with macular disorders showed an induced contrast gain by adaptation of 0.05 (27%), which was not different from the control group, which showed an induced contrast gain by adaptation of 0.06 (35%). CONCLUSION Patients with mild and moderate macular disorders, such as AMD and ERM, show an induced contrast adaptation, i.e. a gain in contrast sensitivity, at 3.2 cpd, which is not different in level from the induced contrast adaptation in healthy subjects. Macular disorders do not prevent adaptation of the patient's visual system to low contrast or blurred retinal images. Therefore, the implantation of presbyopia correcting IOLs is not a strict exclusion criterion for these patients, but the progressive nature of the macular disorder must be taken into account.
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Affiliation(s)
- Hakan Kaymak
- Internationale Innovative Ophthalmochirurgie GbR, Duesseldorf, Germany
- Institute of Experimental Ophthalmology, Saarland University, Homburg/Saar, Germany
| | - Kai Neller
- Internationale Innovative Ophthalmochirurgie GbR, Duesseldorf, Germany
- Institute of Experimental Ophthalmology, Saarland University, Homburg/Saar, Germany
| | - Birte Graff
- Internationale Innovative Ophthalmochirurgie GbR, Duesseldorf, Germany
- Institute of Experimental Ophthalmology, Saarland University, Homburg/Saar, Germany
| | - Achim Langenbucher
- Institute of Experimental Ophthalmology, Saarland University, Homburg/Saar, Germany
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Hartmut Schwahn
- Internationale Innovative Ophthalmochirurgie GbR, Duesseldorf, Germany
| | - Karsten Klabe
- Internationale Innovative Ophthalmochirurgie GbR, Duesseldorf, Germany
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Fernández J, Burguera N, Maldonado-Carmona C, Ginel J, Sáez-Martín Á, Rodríguez-Vallejo M. Simulations of Multifocal Vision in Patients With Previous Monofocal Intraocular Lens Implantation. J Refract Surg 2023; 39:831-839. [PMID: 38063826 DOI: 10.3928/1081597x-20231101-02] [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: 12/18/2023]
Abstract
PURPOSE To evaluate the effectiveness and patient acceptance of multifocal vision simulation in patients with previous monofocal intraocular lens (IOL) implantation, and to explore their willingness-to-pay (WTP) and willingness-to-accept (WTA) based on the perceived advantages and disadvantages of multifocal vision. METHODS Seventeen patients with previous monofocal IOL implantation participated in this cross-sectional study. The SimVis Gekko device (2EyesVision SL) was used to simulate monofocal (Evaluation B) and multifocal (Evaluation C) visual experiences, compared to their existing vision (Evaluation A). Visual acuity at three distances and defocus curves were measured. Patients responded to inquiries about visual quality in each evaluation, bothersomeness of photic phenomena, probability to select the visual experience, and the monetary value they associated with enhanced WTP or diminished WTA visual quality. RESULTS The simulations underestimated the visual acuity reported for the IOL in existing literature by one or two lines, depending on the testing distance. This underestimation was more pronounced in defocus curves. However, 70.6% of patients were likely or very likely to opt for multifocal vision, indicating they perceived the benefits of multifocality. The WTP for multifocal vision was twice that of monofocal vision, and the WTP/WTA ratio exceeded 1, suggesting the perceived vision benefits outweighed potential drawbacks. CONCLUSIONS Despite underestimating the expected postoperative visual performance, the multifocal simulation enabled patients to perceive the benefits of multifocal vision to some extent. This system could be beneficial in avoiding potential postoperative complaints, but the possible rise in false-positive results should be considered and evaluated in future research. [J Refract Surg. 2023;39(12):831-839.].
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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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Rodriguez-Lopez V, Geisler W, Dorronsoro C. Spatiotemporal defocus sensitivity function of the human visual system. BIOMEDICAL OPTICS EXPRESS 2023; 14:3654-3670. [PMID: 37497500 PMCID: PMC10368063 DOI: 10.1364/boe.486242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 05/31/2023] [Accepted: 06/01/2023] [Indexed: 07/28/2023]
Abstract
Tunable lenses make it possible to measure visual sensitivity to rapid changes in optical power, surpassing the limits imposed by mechanical elements. Using a tunable lens system, we measured, for the first time, the spatiotemporal defocus sensitivity function (STDSF), and the limits of human defocus perception. Specifically, we measured defocus sensitivity using a QUEST adaptive psychophysical procedure for different stimuli (Gabor patches of different spatial frequencies, natural images, and edges) and we developed descriptive models of defocus perception. For Gabor patches, we found on average (across seven subjects) that the maximum sensitivity to defocus is 0.22 D at 14 cpd and 10 Hz, and that the upper limits of sensitivity are 40 cpd and 40 Hz. Our results suggest that accommodation remains fixed while performing the defocus flicker-detection task. These results have implications for new technologies whose working principles make use of fast changes to defocus.
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Affiliation(s)
- Victor Rodriguez-Lopez
- Institute of Optics, Spanish National Research Council (IO-CSIC), IO-CSIC, Serrano 121, E-28006, Madrid, Spain
| | - Wilson Geisler
- Center for Perceptual Systems, The University of Texas at Austin, 1 University Station, A8000, E-78712, Austin, Texas, USA
| | - Carlos Dorronsoro
- Institute of Optics, Spanish National Research Council (IO-CSIC), IO-CSIC, Serrano 121, E-28006, Madrid, Spain
- Center for Perceptual Systems, The University of Texas at Austin, 1 University Station, A8000, E-78712, Austin, Texas, USA
- 2EyesVision SL, Plaza de la Encina, 10, núcleo 3, planta 4ª, E-28760 Tres Cantos, Madrid, Spain
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Torres-Sepúlveda W, Mira-Agudelo A, Barrera-Ramírez JF, Kolodziejczyk A. Objective method for visual performance prediction. JOURNAL OF THE OPTICAL SOCIETY OF AMERICA. A, OPTICS, IMAGE SCIENCE, AND VISION 2023; 40:C138-C149. [PMID: 37132983 DOI: 10.1364/josaa.478022] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
We propose, implement, and validate a new objective method for predicting the trends of visual acuity through-focus curves provided by specific optical elements. The proposed method utilized imaging of sinusoidal gratings provided by the optical elements and the definition of acuity. A custom-made monocular visual simulator equipped with active optics was used to implement the objective method and to validate it via subjective measurements. Visual acuity measurements were obtained monocularly from a set of six subjects with paralyzed accommodation for a naked eye and then that eye compensated by four multifocal optical elements. The objective methodology successfully predicts the trends of the visual acuity through-focus curve for all considered cases. The Pearson correlation coefficient was 0.878 for all tested optical elements, which agrees with results obtained by similar works. The proposed method constitutes an easy and direct alternative technique for the objective testing of optical elements for ophthalmic and optometric applications, which can be implemented before invasive, demanding, or costly procedures on real subjects.
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Experimental characterization, modelling and compensation of temperature effects in optotunable lenses. Sci Rep 2023; 13:1575. [PMID: 36709218 PMCID: PMC9884192 DOI: 10.1038/s41598-023-28795-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 01/24/2023] [Indexed: 01/30/2023] Open
Abstract
Most tunable lenses (TLs) are affected by deviations in optical power induced by external temperature changes or due to internal heating while in use. This study proposes: (1) An experimental characterization method to evaluate the magnitude of the optical power deviations due to internal temperature shifts; (2) three different mathematical models (experimental, polynomial, and optimized) to describe the response of the lens with temperature; (3) predictions of the internal temperature shifts while using the lens in time frames of minutes, seconds, and milliseconds and; (4) a real time optical power compensation tool based on the implementation of the models on a custom voltage electronic driver. The compensation methods were successfully applied to two TL samples in static and dynamic experiments and in hysteresis cycles. After 40 min at a static nominal power of 5 diopters (dpt), the internal temperature exponentially increased by 17 °C, producing an optical power deviation of 1.0 dpt (1.5 dpt when the lens cools down), representing a 20% distortion for heating and 30% for cooling. Modelling and compensation reduced the deviations to 0.2 dpt when heating (0.35 dpt when cooling) and the distortions to 4% and 7%. Similar levels of improvement were obtained in dynamic and hysteresis experiments. Compensation reduced temperature effects by more than 75%, representing a significant improvement in the performance of the lens.
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Barcala X, Zaytouny A, Rego-Lorca D, Sanchez-Quiros J, Sanchez-Jean R, Martinez-de-la-Casa JM, Dorronsoro C, Marcos S. Visual simulations of presbyopic corrections through cataract opacification. J Cataract Refract Surg 2023; 49:34-43. [PMID: 35971215 PMCID: PMC9794132 DOI: 10.1097/j.jcrs.0000000000001040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 08/01/2022] [Indexed: 01/07/2023]
Abstract
PURPOSE To study the viability of visual simulation of presbyopic correction in patients with cataract and the effect and impact of the cataract on the perceived visual quality of the different simulated presbyopic corrections preoperatively and postoperatively. SETTING San Carlos Clinical Hospital, Madrid, Spain. DESIGN Observational, noninterventional, pilot study, early feasibility of the device being studied. METHODS Cataract patients were tested preoperatively (n = 24) and postoperatively (n = 15) after bilateral implantation of monofocal intraocular lenses (IOLs). The degree of cataract was evaluated objectively with the objective scatter index (OSI). Visual acuity (VA) and perceived visual quality of natural scene images (Multifocal Acceptance Score) were measured before and after cataract surgery at far (4 m), intermediate (64 cm) and near distance (40 cm) with 4 binocular presbyopic corrections (single vision, bifocal, monovision and modified-monovision) simulated with a binocular Simultaneous Vision simulator based on temporal multiplexing. RESULTS VA was significantly correlated with OSI ( r = -0.71, P < .0005), although the visual degradation at far for each correction was constant and not correlated with OSI. The visual benefit at near distance provided by the presbyopic correction was noticeable (23.3% ± 27.6% across corrections) for OSI <5. The individual perceptual scores were highly correlated preoperatively vs postoperatively ( r = 0.64, P < .0005) for all corrections and distances. CONCLUSIONS Visual simulations of IOLs are an excellent tool to explore prospective postoperative vision. The high correlation in the perceptual scores pre- and post-cataract surgery demonstrates that SimVis Gekko can be used in cataractous patients to guide the selection of the optimal correction for a patient.
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Affiliation(s)
- Xoana Barcala
- From the Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain (Barcala, Zaytouny, Dorronsoro, Marcos); 2EyesVision SL, Madrid, Spain (Barcala, Dorronsoro); Servicio de Oftalmología, Hospital Clinico San Carlos, Universidad Complutense de Madrid, Spain (Rego-Lorca, Sanchez-Quiros, Sanchez-Jean, Martinez-de-la-Casa); Center for Visual Science, The Institute of Optics, Flaum Eye Institute, University of Rochester, Rochester, New York (Marcos)
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Marcos S, Artal P, Atchison DA, Hampson K, Legras R, Lundström L, Yoon G. Adaptive optics visual simulators: a review of recent optical designs and applications [Invited]. BIOMEDICAL OPTICS EXPRESS 2022; 13:6508-6532. [PMID: 36589577 PMCID: PMC9774875 DOI: 10.1364/boe.473458] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 05/02/2023]
Abstract
In their pioneering work demonstrating measurement and full correction of the eye's optical aberrations, Liang, Williams and Miller, [JOSA A14, 2884 (1997)10.1364/JOSAA.14.002884] showed improvement in visual performance using adaptive optics (AO). Since then, AO visual simulators have been developed to explore the spatial limits to human vision and as platforms to test non-invasively optical corrections for presbyopia, myopia, or corneal irregularities. These applications have allowed new psychophysics bypassing the optics of the eye, ranging from studying the impact of the interactions of monochromatic and chromatic aberrations on vision to neural adaptation. Other applications address new paradigms of lens designs and corrections of ocular errors. The current paper describes a series of AO visual simulators developed in laboratories around the world, key applications, and current trends and challenges. As the field moves into its second quarter century, new available technologies and a solid reception by the clinical community promise a vigorous and expanding use of AO simulation in years to come.
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Affiliation(s)
- Susana Marcos
- Center for Visual Sciences; The Institute of Optics and Flaum Eye Institute, University of Rochester, New York 14642, USA
| | - Pablo Artal
- Laboratorio de Optica, Universidad de Murcia, Campus Universitario de Espinardo, 30100, Spain
| | - David A. Atchison
- Centre for Vision and Eye Research, Queensland University of Technology, Brisbane Q, 4059, Australia
| | - Karen Hampson
- Department of Optometry, University of Manchester, Manchester M13 9PL, UK
| | - Richard Legras
- LuMIn, CNRS, ENS Paris-Saclay, Université Paris-Saclay, CentraleSupelec, Université Paris-Saclay Orsay, 91400, France
| | - Linda Lundström
- KTH (Royal Institute of Technology), Stockholm, 10691, Sweden
| | - Geunyoung Yoon
- College of Optometry, University of Houston, Houston, 77004, USA
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Vedhakrishnan S, de Castro A, Vinas M, Aissati S, Marcos S. Accommodation through simulated multifocal optics. BIOMEDICAL OPTICS EXPRESS 2022; 13:6695-6710. [PMID: 36589586 PMCID: PMC9774842 DOI: 10.1364/boe.473595] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 10/26/2022] [Accepted: 10/27/2022] [Indexed: 05/02/2023]
Abstract
We evaluated the interaction of multifocal patterns with eye's accommodation. Seven patterns were mapped on the spatial light modulator and the deformable mirror of an adaptive optics visual simulator, and projected onto the subjects' eyes, representing different contact lens designs: NoLens, Bifocal Center Distance (+2.50D), Bifocal Center Near (+2.50D) and Multifocal Center Near-MediumAdd (+1.75D) and Center Near HighAdd (+2.50D), positive and negative spherical aberration (±1µm). The change in spherical aberration and the accommodative response to accommodative demands were obtained from Hartmann-Shack measurements. Positive spherical aberration and Center Distance designs are consistent with a higher accommodative response (p=0.001 & p=0.003): steeper shift of SA towards negative values and lower accommodative lag.
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Affiliation(s)
- Shrilekha Vedhakrishnan
- Instituto de Optica ”Daza de Valdes”, Consejo Superior de Investigaciones Cientificas, IO-CSIC, Serrano, 121, Madrid 28006, Spain
| | - Alberto de Castro
- Instituto de Optica ”Daza de Valdes”, Consejo Superior de Investigaciones Cientificas, IO-CSIC, Serrano, 121, Madrid 28006, Spain
| | - Maria Vinas
- Wellman Center for Photomedicine and Harvard Medical school, Massachusetts General Hospital, 50 Blossom St, Boston, MA, USA
| | - Sara Aissati
- Center for Visual Science; The Institute of Optics; Flaum Eye Institute, University of Rochester, Rochester, New York, USA
| | - Susana Marcos
- Instituto de Optica ”Daza de Valdes”, Consejo Superior de Investigaciones Cientificas, IO-CSIC, Serrano, 121, Madrid 28006, Spain
- Center for Visual Science; The Institute of Optics; Flaum Eye Institute, University of Rochester, Rochester, New York, USA
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Barcala X, Vinas M, Ruiz S, Hidalgo F, Nankivil D, Karkkainen T, Gambra E, Dorronsoro C, Marcos S. Multifocal contact lens vision simulated with a clinical binocular simulator. Cont Lens Anterior Eye 2022; 45:101716. [PMID: 35606298 DOI: 10.1016/j.clae.2022.101716] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 11/23/2022]
Abstract
PURPOSE The purpose of this study is to compare the binocular visual perception of participants wearing multifocal contact lenses and these same lens designs viewed through a temporal multiplexing visual simulator. METHODS Visual performance and perceived visual quality at various distances were obtained in 37 participants wearing soft M-CLs and through the SimVis Gekko programmed with the same lenses. In a pilot study (n = 10) visual performance was measured in terms of LogMAR visual acuity (VA) at far (4 m), intermediate (64 cm) and near (40 cm) distances and through-focus VA (TFVA) curves with the simulated M-CLs. In the follow-up study (n = 27), LogMAR VA at far, intermediate and near distances were measured both with the actual and simulated M-CLs. Perceived visual quality was measured in both studies using the Multifocal Acceptance Score (MAS-2EV), and a Participants Reported Outcomes Vision questionnaire. Differences between the metrics obtained with simulated and actual lenses were obtained. RESULTS Both actual and simulated M-CLs increased depth-of-focus by a similar amount. Mean LogMAR VA differences with actual and simulated M-CLs ranged between 4 and 6 letters (0.08 ± 0.01, 0.12 ± 0.01 and 0.10 ± 0.01, for far, intermediate and near distances, respectively). MAS-2EV average score differences with actual and simulated M-CLs ranged between -1.00 and + 4.25. Average MAS-2EV scores were not correlated significantly with VA. However, MAS-2EV (average and individual scores) were highly correlated to visual quality questionnaire responses (p < 0.005). CONCLUSIONS A simultaneous vision simulator accurately represented vision with M-CLs both VA at various distances and perceived visual quality, as measured in a clinical setting. The MAS-2EV metric accurately captured participant reported outcomes of standard vision questionnaires. The combination of SimVis Gekko and MAS-2EV has the potential to largely reduce chair time in M-CLs fitting.
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Affiliation(s)
- Xoana Barcala
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain; 2EyesVision SL, Madrid, Spain.
| | - Maria Vinas
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain; Wellman Center for Photomedicine, Massachusetts General Hospital. Harvard Medical School, United States
| | - Sofia Ruiz
- Centro Boston de Optometría, Madrid, Spain
| | | | - Derek Nankivil
- Design Center of Excellence, Research & Development, Johnson & Johnson Vision Care Inc., Jacksonville, FL, United States
| | - Tom Karkkainen
- Clinical Sciences, Research & Development, Johnson & Johnson Vision Care Inc., Jacksonville, FL, United States
| | | | - Carlos Dorronsoro
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain; 2EyesVision SL, Madrid, Spain
| | - Susana Marcos
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain; Center for Visual Science, The Institute of Optics, Flaum Eye Institute, University of Rochester, NY, United States.
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Lopez-de-Haro AG, Barcala X, Martinez-Ibarburu I, Marrakchi Y, Gambra E, Rodriguez-Lopez V, Sawides L, Dorronsoro C. Closed-loop experimental optimization of tunable lenses. APPLIED OPTICS 2022; 61:8091-8099. [PMID: 36255931 DOI: 10.1364/ao.467848] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 09/01/2022] [Indexed: 06/16/2023]
Abstract
Tunable lenses (TLs) are optical devices that can change their optical power in response to an electrical signal. In many applications, they are often pushed to or beyond their temporal limits. Fast periodic and/or abrupt variations of the optical power induce undesired distortions in their transient response and produce a decrease in their performance. A low-cost focimetry system, along with a custom closed-loop iterative optimization algorithm, was developed to (1) characterize a TL's response at high speed and (2) optimize their performance in realistic TL working conditions. A significant lens performance improvement was found in about 23 iterations with a decrease in the area under the error curve and an improved effective time. Applying the closed-loop optimization algorithm in a depth scanning experiment enhanced the image quality. Quantitatively, the image quality was evaluated using the structural similarity index metric that improves in individual frames, on average, from 0.345 to 0.895.
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Fernandes P, Ferreira C, Domingues J, Amorim-de-Sousa A, Faria-Ribeiro M, Queirós A, González-Meijome JM. Short-term delay in neural response with multifocal contact lens might start at the retinal level. Doc Ophthalmol 2022; 145:37-51. [PMID: 35364776 DOI: 10.1007/s10633-022-09870-2] [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: 03/04/2020] [Accepted: 03/08/2022] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Multifocal simultaneous imaging challenges the visual system to process the multiple overlaps of focused and defocused images. Retinal image processing may be an important step in neuroadaptation to multifocal optical images. Our aims are, firstly to evaluate the short-term effect of different multifocal contact lenses (MF) on retinal activity in young healthy subjects (Experiment#1) and secondly, to evaluate any changes in retinal activity in presbyopic patients fitted with MF over a 15-day period (Experiment#2). METHODS In Experiment-#1, 10 emmetropic healthy young subjects were included to evaluate the short-term effect of different MFs designs. In Experiment #2, 4 presbyopic subjects were included to wear MF for 15 days. Following the ISCEV Standards, multifocal electroretinograms (mfERGs) were recorded to evaluate different retinal regions under different conditions: with single vision contact lens (SVCL) and with center-distance and center-near MF. RESULTS In Exp#1 the peak time of N1, P1 and N2 were found to be delayed with the MF (p ≤ 0.040). There was a significant reduction for N1 amplitude in all retinal regions (p < 0.001), while for P1 and N2 amplitudes this reduction was more significant in the peripheral regions (p < 0.005, ring 5 to 6). With center-near MF the mean response density (nV/deg2) showed a significant decrease in all wave components of the mfERGs response, particularly from Ring 3 to Ring 6 (p < 0.001, all Rings). In Exp#2, the mean mfERG response is similar between SVCL and center-distance MF, while center-near MF showed an increase in implicit time N1 and P1 on day 1 that tends to recover to baseline values after 15 days of MF wear. CONCLUSIONS significant changes in the mfERGs responses were found with the MF lens, being most noticeable with the center-near MF lens design. The present results suggest that the observed delay in cortical response described during the adaptation to multifocality may partially begin at the retina level.
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Affiliation(s)
- Paulo Fernandes
- Clinical & Experimental Optometry Research Lab (CEORLab), Physics Center of Minho and Porto Universities (CF-UM-UP), University of Minho, 4710-057 Gualtar, Braga, Portugal.
| | - Cesarina Ferreira
- Clinical & Experimental Optometry Research Lab (CEORLab), Physics Center of Minho and Porto Universities (CF-UM-UP), University of Minho, 4710-057 Gualtar, Braga, Portugal
| | - Joana Domingues
- Clinical & Experimental Optometry Research Lab (CEORLab), Physics Center of Minho and Porto Universities (CF-UM-UP), University of Minho, 4710-057 Gualtar, Braga, Portugal
| | - Ana Amorim-de-Sousa
- Clinical & Experimental Optometry Research Lab (CEORLab), Physics Center of Minho and Porto Universities (CF-UM-UP), University of Minho, 4710-057 Gualtar, Braga, Portugal
| | - Miguel Faria-Ribeiro
- Clinical & Experimental Optometry Research Lab (CEORLab), Physics Center of Minho and Porto Universities (CF-UM-UP), University of Minho, 4710-057 Gualtar, Braga, Portugal
| | - António Queirós
- Clinical & Experimental Optometry Research Lab (CEORLab), Physics Center of Minho and Porto Universities (CF-UM-UP), University of Minho, 4710-057 Gualtar, Braga, Portugal
| | - José M González-Meijome
- Clinical & Experimental Optometry Research Lab (CEORLab), Physics Center of Minho and Porto Universities (CF-UM-UP), University of Minho, 4710-057 Gualtar, Braga, Portugal
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Understanding In Vivo Chromatic Aberrations in Pseudophakic Eyes Using on Bench and Computational Approaches. PHOTONICS 2022. [DOI: 10.3390/photonics9040226] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Diffractive multifocal intraocular lenses (IOLs) modulate chromatic aberration and reduce it at certain distances due to interactions between the refractive and diffractive chromatic components. However, the extent to which computer modeling and on bench measurements of IOL chromatic aberration translate to chromatic aberration in patients implanted with these multifocal IOLs (MIOLs) is not yet fully understood. In this study, we compare the chromatic difference of focus and longitudinal chromatic aberrations in pseudophakic patients implanted with different IOL designs (monofocal and trifocal IOLs) and materials (hydrophobic and hydrophilic), and compared them with predictions from computer eye models and on bench measurements with the same IOLs. Patient data consisted of results from 63 pseudophakic eyes reported in four different studies and obtained psychophysically in the visual testing channel of a custom-developed polychromatic adaptive optics system. Computational predictions were obtained using ray tracing on computer eye models, and modulation transfer function (MTF) on bench measurements on physical eye models. We found that LCA (in vivo/simulated) for far vision was 1.37 ± 0.08 D/1.19 D for monofocal hydrophobic, 1.21 ± 0.08 D/0.88 D for monofocal hydrophilic, 0.99 ± 0.06 D/1.19 D for MIOL hydrophobic, and 0.82 ± 0.05 D/0.88 D for MIOL hydrophilic. For intermediate and near vision, LCA (in vivo/simulated) was 0.67 ± 0.10 D/0.75 D and 0.23 ± 0.08 D/0.19 D for MIOL hydrophobic and 0.27 ± 0.15 D/0.38 D and 0.15 ± 0.15 D/−0.13 D for MIOL hydrophilic, respectively. In conclusion, computational ray tracing and on bench measurements allowed for evaluating in vivo chromatic aberration with different materials and designs for multifocal diffractive intraocular lenses.
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15
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Visual performance with multifocal lenses in young adults and presbyopes. PLoS One 2022; 17:e0263659. [PMID: 35298476 PMCID: PMC8929584 DOI: 10.1371/journal.pone.0263659] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 01/24/2022] [Indexed: 12/22/2022] Open
Abstract
A better understanding of visual performance with Multifocal Contact Lenses (MCLs) is essential, both in young eyes, where MCLs may be prescribed to control the progression of myopia wherein the MCLs optics interact with accommodation, and in presbyopes, where MCLs are increasingly used to compensate the lack of accommodation. In this study, we evaluated the through focus visual acuity (TFVA) with center-near MCLs of three additions (low, medium and high) and without an addition (NoLens) in 10 young adults and 5 presbyopes. We studied the effect of accommodation, age and pupil diameter (in cyclopleged subjects) on visual performance. The MCLs produced a small but consistent degradation at far (by 0.925 logMAR, averaged across eyes and conditions) and a consistent benefit at near in young subjects with paralyzed accommodation (by 1.025 logMAR), and in presbyopes with both paralyzed and natural accommodation (by 1.071 logMAR, on average). TFVA in young adults with NoLens and all MCLs showed statistically significant differences (Wilcoxan, p<0.01) between natural and paralyzed accommodation, but not in presbyopes with MCLs. In young adults, VA improved with increasing pupil diameter with the HighAdd MCL (0.08 logMAR shift from 3 to 5-mm pupil size). Visual imbalance (standard deviation of VA across distances) was reduced with MCLs, and decreased significantly with increasing near add. The lowest imbalance occurred in young adults under natural accommodation and was further reduced by 13.33% with MCLs with respect to the NoLens condition. Overall, the visual performance with MCLs in young adults exceeds that in presbyopes at all distances, and was better than 0.00 logMAR over the dioptric range tested. In conclusion, the center-near lenses do not degrade the near high contrast visual acuity significantly but maintains the far vision in young adults, and produce some visual benefit at near in presbyopes.
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Na KS, Kim SJ, Nam G, Ha M, Whang WJ, Kim EC, Kim HS, Hwang HS. A Novel Intraocular Lens Simulator that Allows Patients to Experience the World Through Multifocal Intraocular Lenses Before Surgeries. Transl Vis Sci Technol 2022; 11:14. [PMID: 35275206 PMCID: PMC8934550 DOI: 10.1167/tvst.11.3.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Purpose The purpose of this study was to investigate whether the intraocular lens (IOL) simulator can simulate how the world appears to patients with multifocal IOLs by allowing the patients to see far and near objects through the IOL simulator. Methods Twenty eyes from 20 patients (age = 50-70 years old) were included in the study. The IOL simulator we developed consists of a trial lens frame adapter, a lens tube, a concave lens, a spacer, a wet cell, and an IOL. We used two IOLs: Tecnis monofocal and Tecnis bifocal IOL (add +3.25 diopter [D]). Patients wore a trial lens frame with an IOL simulator on distant corrected trial lenses and underwent the following tests: defocus curve, satisfaction with distance and near vision, halo around the light, and near point accommodation (NPA). To check how the world appears to the patients through this simulator, a machine vision lens and a scientific camera were attached to the simulator, and far and near objects were photographed. Results In the defocus curve of multifocal IOL, the visual acuity showed the second peak at -4 D. Compared to monofocal IOL, satisfaction with distant vision was slightly worse, more halos were felt, satisfaction with near vision was higher, and the NPA was shorter in multifocal IOL. In the scientific camera test, through the multifocal IOL, the waiting room was blurry, the halo around the ceiling light was prominent, and the characteristics on the near visual acuity chart were clear. Conclusion Subjects could experience the functions of multifocal IOLs with our newly developed IOL simulator. Translational Relevance This IOL simulator using geometric optics allows patients to experience the function of multifocal IOLs before cataract surgery.
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Affiliation(s)
- Kyung-Sun Na
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Seong-Jae Kim
- Department of Ophthalmology, Gyeongsang National University Hospital, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Gahee Nam
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Minji Ha
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Woong-Joo Whang
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Eun Chul Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Hyun-Seung Kim
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Ho Sik Hwang
- Department of Ophthalmology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
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Aissati S, Benedi-Garcia C, Vinas M, de Castro A, Marcos S. Matching convolved images to optically blurred images on the retina. J Vis 2022; 22:12. [PMID: 35179553 PMCID: PMC8859492 DOI: 10.1167/jov.22.2.12] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Convolved images are often used to simulate the effect of ocular aberrations on image quality, where the retinal image is simulated by convolving the stimulus with the point spread function derived from the subject's aberrations. However, some studies have shown that convolved images are perceived far more degraded than the same image blurred with optical defocus. We hypothesized that the positive interactions between the monochromatic and chromatic aberrations in the eye are lost in the convolution process. To test this hypothesis, we evaluated optical and visual quality with natural optics and with convolved images (on-bench, computer simulations, and visual acuity [VA] in subjects) using a polychromatic adaptive optics system with monochromatic (555 nm) and polychromatic light (WL) illumination. The subject's aberrations were measured using a Hartmann Shack system and were used to convolve the visual stimuli, using Fourier optics. The convolved images were seen through corrected optics. VA with convolved stimuli was lower than VA through natural aberrations, particularly in WL (by 26% in WL). Our results suggest that the systematic decrease in visual performance with visual acuity and retinal image quality by simulation with convolved stimuli appears to be primarily associated with a lack of favorable interaction between chromatic and monochromatic aberrations in the eye.
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Affiliation(s)
- Sara Aissati
- Instituto de Óptica 'Daza de Valdés', Consejo Superior de Investigaciones Científicas, CSIC, Madrid, Spain.,
| | - Clara Benedi-Garcia
- Instituto de Óptica 'Daza de Valdés', Consejo Superior de Investigaciones Científicas, CSIC, Madrid, Spain.,
| | - Maria Vinas
- Wellman Center for Photomedicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.,
| | - Alberto de Castro
- Instituto de Óptica 'Daza de Valdés', Consejo Superior de Investigaciones Científicas, CSIC, Madrid, Spain.,
| | - Susana Marcos
- Center for Visual Science, The Institute of Optics and Flaum Eye Institute, University of Rochester, NY, USA.,Instituto de Óptica 'Daza de Valdés', Consejo Superior de Investigaciones Científicas, CSIC, Madrid, Spain.,
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18
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Abdelazeem RM, Agour M. Optical inspection of single vision soft contact lenses based on an active adaptive wavefront sensor. APPLIED OPTICS 2022; 61:141-148. [PMID: 35200813 DOI: 10.1364/ao.441289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/28/2021] [Indexed: 06/14/2023]
Abstract
We present an experimental configuration for optical inspection of single vision soft contact lenses based on an active adaptive wavefront sensor. At first, the soft lenses were immersed in a saline filled wet cell to prevent surface deformation during measurements. Thereafter, refractive powers and aberrations were accurately measured before and after correcting illumination laser beam aberrations and wet cell-induced aberrations. The results reveal that there is a significant difference between the measured aberrations and refractive powers before and after aberration compensation. Accordingly, the proposed system is recommended as an optical inspection tool for precise assessment of commercially available contact lenses.
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19
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In Vitro Optical Performance of Multifocal and Extended Depth-of-Focus Intraocular Lenses in Spherical Aberration Conditions. J Cataract Refract Surg 2021; 48:616-622. [PMID: 34840253 DOI: 10.1097/j.jcrs.0000000000000869] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 11/17/2021] [Indexed: 11/26/2022]
Abstract
ABSTRACT PurposeTo evaluate and compare the optical performances of 4 different types of intraocular lenses (IOLs) in various spherical aberration (SA) conditions.SettingPOSTECH, Pohang, Republic of Korea.DesignIn vitro laboratory study.MethodsA custom optical bench system with adaptive optics (AO) was used. A monofocal IOL, a bifocal IOL, a trifocal IOL, and an extended depth-of-focus (EDOF) IOL from the Zeiss were evaluated by measuring through-focus modulation transfer function (MTF) as a function of vergence. MTF changes with SA from -0.1μm to +0.1μm with 0.05μm step size were analyzed and compared.ResultsIn aberration free condition, the 4 IOLs showed different MTF curves consistent with their designs In SA conditions, all the IOLs showed MTF value decreases and the decrease rates at the far focus varied from 28% to 38% per 0.1μm SAs. The trifocal IOL had low MTF values at the intermediate focus in the noise level with ±0.1μm SAs.ConclusionsAll the tested IOLs showed MTF decreases with SA in different levels. The trifocal and EDOF IOLs were the most and least sensitive to SA among the evaluated IOLs. The study results might be useful in the selection of IOLs for cataract patients with SAs.
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20
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Benedi-Garcia C, Vinas M, Lago CM, Aissati S, de Castro A, Dorronsoro C, Marcos S. Optical and visual quality of real intraocular lenses physically projected on the patient's eye. BIOMEDICAL OPTICS EXPRESS 2021; 12:6360-6374. [PMID: 34745742 PMCID: PMC8548014 DOI: 10.1364/boe.432578] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Revised: 08/11/2021] [Accepted: 08/11/2021] [Indexed: 05/06/2023]
Abstract
Visual simulators aim at evaluating vision with ophthalmic corrections prior to prescription or implantation of intraocular lenses (IOLs) in the patient's eye. In the present study, we present the design, implementation, and validation of a new IOL-in-cuvette channel in an Adaptive Optics visual simulator, which provides an alternative channel for pre-operative simulation of vision with IOLs. The IOL is projected on the pupil's plane of the subject by using a Rassow system. A second lens, the Rassow lens, compensates for an IOL of 20 D while other powers can be corrected with a Badal system within a 5 D range. The new channel was evaluated by through-focus (TF) optical quality in an artificial eye on bench, and by TF visual acuity in patients, with various IOL designs (monofocal, diffractive trifocal, and refractive extended depth of focus).
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Affiliation(s)
- Clara Benedi-Garcia
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain
| | - Maria Vinas
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain
- Currently with Wellman Center for Photomedicine, Massachusetts General Hospital Harvard Medical School, Boston, MA, USA
| | - Carmen M Lago
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain
- 2EyesVision, Madrid, Spain
| | - Sara Aissati
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain
| | - Alberto de Castro
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain
| | - Carlos Dorronsoro
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain
- 2EyesVision, Madrid, Spain
| | - Susana Marcos
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain
- Center for Visual Sciences, The Institute of Optics, Flaum Eye Institute, University of Rochester, Rochester, NY 14642, USA
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21
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Barbero S. Smooth multifocal wavefronts with a prescribed mean curvature for visual optics applications. APPLIED OPTICS 2021; 60:6147-6154. [PMID: 34613279 DOI: 10.1364/ao.428588] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 06/19/2021] [Indexed: 06/13/2023]
Abstract
Multifocal lenses comprising progressive power surfaces are commonly used in contact and intraocular lens designs. Given a visual performance metric, a wavefront engineering approach to design such lenses is based on searching for the optimal wavefront at the exit pupil of the eye. Multifocal wavefronts distribute the energy along the different foci thanks to having a varying mean curvature. Therefore, a fundamental step in the wavefront engineering approach is to generate the wavefront from a prescribed mean curvature function. Conventionally, such a thing is done by superimposing spherical wavefront patches and maybe adding a certain component of spherical aberration to each spherical patch in order to increase the depth-of-field associated with each focus. However, such a procedure does not lead to smooth wavefront solutions and also restricts the type of available multifocal wavefronts. We derive a new, to the best of our knowledge, mathematical method to uniquely construct multifocal wavefronts from mean curvature functions (depending on radial and angular coordinates) under certain numerically justified approximations and restrictions. Additionally, our procedure leads to a particular family of wavefronts (line-umbilical multifocal wavefronts) described by 2 conditions: (1) to be smooth multiplicative separable functions in the radial and angular coordinates; (2) to be umbilical along a specific segment connecting the circle center with its edge. We provide several examples of multifocal wavefronts belonging to this family, including a smooth variant of the so-called light sword element.
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22
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Vedhakrishnan S, Vinas M, Aissati S, Marcos S. Vision with spatial light modulator simulating multifocal contact lenses in an adaptive optics system. BIOMEDICAL OPTICS EXPRESS 2021; 12:2859-2872. [PMID: 34123507 PMCID: PMC8176799 DOI: 10.1364/boe.419680] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/12/2021] [Accepted: 03/23/2021] [Indexed: 05/06/2023]
Abstract
Visual simulators are useful tools to provide patients experience of multifocal vision prior to treatment. In this study, commercially available center-near aspheric multifocal contact lenses (MCLs) of low, medium, and high additions were mapped on a spatial light modulator (SLM) and validated on a bench. Through focus visual acuity (TFVA) was measured in subjects through the SLM and real MCLs on the eye. A correlation metric revealed statistically significant shape similarity between TFVA curves with real and simulated MCLs. A Bland-Altman analysis showed differences within confidence intervals of ±0.01 logMAR for LowAdd/MediumAdd and ±0.06 logMAR for HighAdd. Visual performance with simulated MCLs outperformed real MCLs by ∼20%. In conclusion, SLM captures the profile of center-near MCLs and reproduces vision with real MCLs, revealing that the MCL profile and its interactions with the eye's optics (and not fitting aspects) account for the majority of the contributions to visual performance with MCLs.
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Affiliation(s)
- Shrilekha Vedhakrishnan
- Instituto de Optica “Daza de Valdes”, Consejo Superior de Investigaciones Cientificas, IO-CSIC, Serrano, 121, Madrid 28006, Spain
| | - Maria Vinas
- Instituto de Optica “Daza de Valdes”, Consejo Superior de Investigaciones Cientificas, IO-CSIC, Serrano, 121, Madrid 28006, Spain
| | - Sara Aissati
- Instituto de Optica “Daza de Valdes”, Consejo Superior de Investigaciones Cientificas, IO-CSIC, Serrano, 121, Madrid 28006, Spain
| | - Susana Marcos
- Instituto de Optica “Daza de Valdes”, Consejo Superior de Investigaciones Cientificas, IO-CSIC, Serrano, 121, Madrid 28006, Spain
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Marcos S, Martinez-Enriquez E, Vinas M, de Castro A, Dorronsoro C, Bang SP, Yoon G, Artal P. Simulating Outcomes of Cataract Surgery: Important Advances in Ophthalmology. Annu Rev Biomed Eng 2021; 23:277-306. [PMID: 33848431 DOI: 10.1146/annurev-bioeng-082420-035827] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
As the human eye ages, the crystalline lens stiffens (presbyopia) and opacifies (cataract), requiring its replacement with an artificial lens [intraocular lens (IOL)]. Cataract surgery is the most frequently performed surgical procedure in the world. The increase in IOL designs has not been paralleled in practice by a sophistication in IOL selection methods, which rely on limited anatomical measurements of the eye and the surgeon's interpretation of the patient's needs and expectations. We propose that the future of IOL selection will be guided by 3D quantitative imaging of the crystalline lens to map lens opacities, anticipate IOL position, and develop fully customized eye models for ray-tracing-based IOL selection. Conversely, visual simulators (in which IOL designs are programmed in active elements) allow patients to experience prospective vision before surgery and to make more informed decisions about which IOL to choose. Quantitative imaging and optical and visual simulations of postsurgery outcomes will allow optimal treatments to be selected for a patient undergoing modern cataract surgery.
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Affiliation(s)
- Susana Marcos
- Instituto de Óptica "Daza de Valdés," Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid 28006, Spain;
| | - Eduardo Martinez-Enriquez
- Instituto de Óptica "Daza de Valdés," Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid 28006, Spain;
| | - Maria Vinas
- Instituto de Óptica "Daza de Valdés," Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid 28006, Spain;
| | - Alberto de Castro
- Instituto de Óptica "Daza de Valdés," Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid 28006, Spain;
| | - Carlos Dorronsoro
- Instituto de Óptica "Daza de Valdés," Consejo Superior de Investigaciones Científicas (IO-CSIC), Madrid 28006, Spain; .,2EyesVision, Madrid 28760, Spain
| | - Seung Pil Bang
- Flaum Eye Institute, The Institute of Optics, Center for Visual Science, Department of Biomedical Engineering, University of Rochester, Rochester, New York 14632, USA
| | - Geunyoung Yoon
- Flaum Eye Institute, The Institute of Optics, Center for Visual Science, Department of Biomedical Engineering, University of Rochester, Rochester, New York 14632, USA
| | - Pablo Artal
- Laboratorio de Óptica, Universidad de Murcia, Murcia 30100, Spain
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Akondi V, Dubra A. Shack-Hartmann wavefront sensor optical dynamic range. OPTICS EXPRESS 2021; 29:8417-8429. [PMID: 33820289 PMCID: PMC8237929 DOI: 10.1364/oe.419311] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/07/2021] [Revised: 02/18/2021] [Accepted: 02/23/2021] [Indexed: 06/12/2023]
Abstract
The widely used lenslet-bound definition of the Shack-Hartmann wavefront sensor (SHWS) dynamic range is based on the permanent association between groups of pixels and individual lenslets. Here, we formalize an alternative definition that we term optical dynamic range, based on avoiding the overlap of lenslet images. The comparison of both definitions for Zernike polynomials up to the third order plus spherical aberration shows that the optical dynamic range is larger by a factor proportional to the number of lenslets across the SHWS pupil. Finally, a pre-centroiding algorithm to facilitate lenslet image location in the presence of defocus and astigmatism is proposed. This approach, based on the SHWS image periodicity, is demonstrated using optometric lenses that translate lenslet images outside the projected lenslet boundaries.
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Affiliation(s)
- Vyas Akondi
- Byers Eye Institute, Stanford University, Palo Alto, CA 94303, USA
| | - Alfredo Dubra
- Byers Eye Institute, Stanford University, Palo Alto, CA 94303, USA
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Barcala X, Vinas M, Romero M, Gambra E, Mendez-Gonzalez JL, Marcos S, Dorronsoro C. Multifocal acceptance score to evaluate vision: MAS-2EV. Sci Rep 2021; 11:1397. [PMID: 33446794 PMCID: PMC7809428 DOI: 10.1038/s41598-021-81059-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Accepted: 01/04/2021] [Indexed: 11/30/2022] Open
Abstract
We present a new metric (Multifocal Acceptance Score, MAS-2EV) to evaluate vision with presbyopic corrections. The MAS-2EV is based on a set of images representing natural visual scenes at day and night conditions projected in far and near displays, and a near stereo target. Subjects view and score the images through different binocular corrections (monofocal corrections at far; bifocal corrections; monovision and modified monovision) administered with soft contact lenses (in cyclopleged young subjects) or with a binocular simultaneous vision simulator (in presbyopic and cyclopleged young subjects). MAS-2EV scores are visually represented in the form of polygons, and quantified using different metrics: overall visual quality, visual degradation at far, visual benefit at near, near stereo benefit, visual imbalance near-far, overall visual imbalance and a combined overall performance metric. We have found that the MAS-2EV has sufficient repeatability and sensitivity to allow differentiation across corrections with only two repetitions, and the duration of the psychophysical task (3 min for subject/condition/correction) makes it useable in the clinic. We found that in most subjects binocular bifocal corrections produce the lowest visual imbalance, and the highest near stereo benefit. 46.67% of the subjects ranked binocular bifocal corrections first, and 46.67% of the subjects ranked monovision first. MAS-2EV, particularly in combination with visual simulators, can be applied to select prospective presbyopic corrections in patients prior to contact lens fitting or intraocular lens implantation.
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Affiliation(s)
| | - Maria Vinas
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain
| | - Mercedes Romero
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain
| | | | | | - Susana Marcos
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain
| | - Carlos Dorronsoro
- Institute of Optics, Spanish National Research Council, IO-CSIC, Madrid, Spain
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Akondi V, Dubra A. Multi-layer Shack-Hartmann wavefront sensing in the point source regime. BIOMEDICAL OPTICS EXPRESS 2021; 12:409-432. [PMID: 33520390 PMCID: PMC7818966 DOI: 10.1364/boe.411189] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 12/07/2020] [Accepted: 12/08/2020] [Indexed: 05/08/2023]
Abstract
The Shack-Hartmann wavefront sensor (SHWS) is often operated under the assumption that the sensed light can be described by a single wavefront. In biological tissues and other multi-layered samples, secondary wavefronts from axially and/or transversely displaced regions can lead to artifactual aberrations. Here, we evaluate these artifactual aberrations in a simulated ophthalmic SHWS by modeling the beacons that would be generated by a two-layer retina in human and mouse eyes. Then, we propose formulae for calculating a minimum SHWS centroid integration area to mitigate these aberrations by an order of magnitude, potentially benefiting SHWS-based metrology and adaptive optics systems such as those used for retinal imaging and microscopy.
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Affiliation(s)
- Vyas Akondi
- Byers Eye Institute, Stanford University, Palo Alto, California 94303, USA
| | - Alfredo Dubra
- Byers Eye Institute, Stanford University, Palo Alto, California 94303, USA
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Vinas M, Gonzalez-Ramos AM, Aissati S, Garzón N, Poyales F, Dorronsoro C, Marcos S. Longitudinal Chromatic Aberration in Patients Implanted With Trifocal Diffractive Hydrophobic IOLs. J Refract Surg 2020; 36:804-810. [DOI: 10.3928/1081597x-20200930-01] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2020] [Accepted: 09/28/2020] [Indexed: 11/20/2022]
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Vinas M, Aissati S, Gonzalez-Ramos AM, Romero M, Sawides L, Akondi V, Gambra E, Dorronsoro C, Karkkainen T, Nankivil D, Marcos S. Optical and Visual Quality With Physical and Visually Simulated Presbyopic Multifocal Contact Lenses. Transl Vis Sci Technol 2020; 9:20. [PMID: 33005478 PMCID: PMC7509762 DOI: 10.1167/tvst.9.10.20] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Accepted: 08/24/2020] [Indexed: 11/24/2022] Open
Abstract
Purpose As multifocal contact lenses (MCLs) expand as a solution for presbyopia correction, a better understanding of their optical and visual performance becomes essential. Also, providing subjects with the experience of multifocal vision before contact lens fitting becomes critical, both to systematically test different multifocal designs and to optimize selection in the clinic. In this study, we evaluated the ability of a simultaneous vision visual simulator (SimVis) to represent MCLs. Methods Through focus (TF) optical and visual quality with a center-near aspheric MCL (low, medium and high near adds) were measured using a multichannel polychromatic Adaptive Optics visual simulator equipped with double-pass, SimVis (temporal multiplexing), and psychophysical channels to allow measurements on-bench and in vivo. On bench TF optical quality of SimVis-simulated MCLs was obtained from double-pass (DP) images and images of an E-stimulus using artificial eyes. Ten presbyopic subjects were fitted with the MCL. Visual acuity (VA) and DP retinal images were measured TF in a 4.00 D range with the MCL on eye, and through SimVis simulations of the same MCLs on the same subjects. Results TF optical (on bench and in vivo) and visual (in vivo) quality measurements captured the expected broadening of the curves with increasing add. Root mean square difference between real and SimVis-simulated lens was 0.031/0.025 (low add), 0.025/0.015 (medium add), 0.019/0.011 (high add), for TF DP and TF LogMAR VA, respectively. A shape similarity metric shows high statistical values (lag κ = 0), rho = 0.811/0.895 (low add), 0.792/0.944 (medium add), and 0.861/0.915 (high add) for TF DP/LogMAR VA, respectively. Conclusions MCLs theoretically and effectively expand the depth of focus. A novel simulator, SimVis, captured the through-focus optical and visual performance of the MCL in most of the subjects. Visual simulators allow subjects to experience vision with multifocal lenses prior to testing them on-eye. Translational Relevance Simultaneous visual simulators allow subjects to experience multifocal vision non-invasively. We demonstrated equivalency between real multifocal contact lenses and SimVis-simulated lenses. The results suggest that SimVis is a suitable technique to aid selection of presbyopic corrections in the contactology practice.
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Affiliation(s)
- Maria Vinas
- Instituto de Optica, Consejo Superior de Investigaciones Cientificas (IO-CSIC), Madrid, Spain
| | - Sara Aissati
- Instituto de Optica, Consejo Superior de Investigaciones Cientificas (IO-CSIC), Madrid, Spain
| | | | - Mercedes Romero
- Instituto de Optica, Consejo Superior de Investigaciones Cientificas (IO-CSIC), Madrid, Spain
| | | | - Vyas Akondi
- Instituto de Optica, Consejo Superior de Investigaciones Cientificas (IO-CSIC), Madrid, Spain.,Byers Eye Institute, Stanford University, Palo Alto, CA, USA
| | | | - Carlos Dorronsoro
- Instituto de Optica, Consejo Superior de Investigaciones Cientificas (IO-CSIC), Madrid, Spain.,EyesVision, Madrid, Spain
| | - Thomas Karkkainen
- Johnson & Johnson Vision, Inc., Research & Development, Jacksonville, FL, USA
| | - Derek Nankivil
- Johnson & Johnson Vision, Inc., Research & Development, Jacksonville, FL, USA
| | - Susana Marcos
- Instituto de Optica, Consejo Superior de Investigaciones Cientificas (IO-CSIC), Madrid, Spain
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Aissati S, Vinas M, Benedi-Garcia C, Dorronsoro C, Marcos S. Testing the effect of ocular aberrations in the perceived transverse chromatic aberration. BIOMEDICAL OPTICS EXPRESS 2020; 11:4052-4068. [PMID: 32923028 PMCID: PMC7449748 DOI: 10.1364/boe.396469] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 06/14/2020] [Accepted: 06/16/2020] [Indexed: 05/06/2023]
Abstract
We have measured the ocular transverse chromatic aberration (TCA) in 11 subjects using 2D-two-color Vernier alignment, for two pupil diameters, in a polychromatic adaptive optics (AO) system. TCA measurements were performed for two pupil diameters: for a small pupil (2-mm), referred to as 'optical TCA' (oTCA), and for a large pupil (6-mm), referred to 'perceived TCA' (pTCA). Also, the TCA was measured through both natural aberrations (HOAs) and AO-corrected aberrations. Computer simulations of pTCA incorporated longitudinal chromatic aberration (LCA), the patient's HOAs measured with Hartmann-Shack, and the Stiles-Crawford effect (SCE), measured objectively by laser ray tracing. The oTCA and the simulated pTCA (no aberrations) were shifted nasally 1.20 arcmin and 1.40 arcmin respectively. The experimental pTCA (-0.27 arcmin horizontally and -0.62 vertically) was well predicted (81%) by simulations when both the individual HOAs and SCE were considered. Both HOAs and SCE interact with oTCA, reducing it in magnitude and changing its orientation. The results indicate that estimations of polychromatic image quality should incorporate patient's specific data of HOAs, LCA, TCA & SCE.
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Affiliation(s)
- Sara Aissati
- Instituto de Óptica "Daza de Valdés", Consejo Superior de Investigaciones Científicas, IO-CSIC, Serrano, 121, Madrid 28006, Spain
| | - Maria Vinas
- Instituto de Óptica "Daza de Valdés", Consejo Superior de Investigaciones Científicas, IO-CSIC, Serrano, 121, Madrid 28006, Spain
| | - Clara Benedi-Garcia
- Instituto de Óptica "Daza de Valdés", Consejo Superior de Investigaciones Científicas, IO-CSIC, Serrano, 121, Madrid 28006, Spain
| | - Carlos Dorronsoro
- Instituto de Óptica "Daza de Valdés", Consejo Superior de Investigaciones Científicas, IO-CSIC, Serrano, 121, Madrid 28006, Spain
| | - Susana Marcos
- Instituto de Óptica "Daza de Valdés", Consejo Superior de Investigaciones Científicas, IO-CSIC, Serrano, 121, Madrid 28006, Spain
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Akondi V, Dubra A. Average gradient of Zernike polynomials over polygons. OPTICS EXPRESS 2020; 28:18876-18886. [PMID: 32672177 PMCID: PMC7340383 DOI: 10.1364/oe.393223] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 05/03/2020] [Accepted: 05/25/2020] [Indexed: 05/23/2023]
Abstract
Wavefront estimation from slope sensor data is often achieved by fitting measured slopes with Zernike polynomial derivatives averaged over the sampling subapertures. Here we discuss how the calculation of these average derivatives can be reduced to one-dimensional integrals of the Zernike polynomials, rather than their derivatives, along the perimeter of each subaperture. We then use this result to derive closed-form expressions for the average Zernike polynomial derivatives over polygonal areas, only requiring evaluation of polynomials at the polygon vertices. Finally, these expressions are applied to simulated Shack-Hartmann wavefront sensors with 7 and 23 fully illuminated lenslets across a circular pupil, with their accuracy and calculation time compared against commonly used integration methods.
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Bifocal and Multifocal Contact Lenses for Presbyopia and Myopia Control. J Ophthalmol 2020; 2020:8067657. [PMID: 32318285 PMCID: PMC7152962 DOI: 10.1155/2020/8067657] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 02/10/2020] [Accepted: 02/24/2020] [Indexed: 02/07/2023] Open
Abstract
Bifocal and multifocal optical devices are intended to get images into focus from objects placed at different distances from the observer. Spectacles, contact lenses, and intraocular lenses can meet the requirements to provide such a solution. Contact lenses provide unique characteristics as a platform for implementing bifocality and multifocality. Compared to spectacles, they are closer to the eye, providing a wider field of view, less distortion, and their use is more consistent as they are not so easily removed along the day. In addition, contact lenses are also minimally invasive, can be easily exchangeable, and, therefore, suitable for conditions in which surgical procedures are not indicated. Contact lenses can remain centered with the eye despite eye movements, providing the possibility for simultaneous imaging from different object distances. The main current indications for bifocal and multifocal contact lenses include presbyopia correction in adult population and myopia control in children. Considering the large numbers of potential candidates for optical correction of presbyopia and the demographic trends in myopia, the potential impact of contact lenses for presbyopia and myopia applications is undoubtedly tremendous. However, the ocular characteristics and expectations vary significantly between young and older candidates and impose different challenges in fitting bifocal and multifocal contact lenses for the correction of presbyopia and myopia control. This review presents the recent developments in material platforms, optical designs, simulated visual performance, and the clinical performance assessment of bifocal and multifocal contact lenses for presbyopia correction and/or myopia progression control.
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Marcos S, Benedí-García C, Aissati S, Gonzalez-Ramos AM, Lago CM, Radhkrishnan A, Romero M, Vedhakrishnan S, Sawides L, Vinas M. VioBio lab adaptive optics: technology and applications by women vision scientists. Ophthalmic Physiol Opt 2020; 40:75-87. [PMID: 32147855 DOI: 10.1111/opo.12677] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Accepted: 01/27/2020] [Indexed: 11/29/2022]
Abstract
PURPOSE Adaptive Optics allows measurement and manipulation of the optical aberrations of the eye. We review two Adaptive Optics set-ups implemented at the Visual Optics and Biophotonics Laboratory, and present examples of their use in better understanding of the role of optical aberrations on visual perception, in normal and treated eyes. RECENT FINDINGS Two systems (AOI and AOII) are described that measure ocular aberrations with a Hartmann-Shack wavefront sensor, which operates in closed-loop with an electromagnetic deformable mirror, and visual stimuli are projected in a visual display for psychophysical measurements. AOI operates in infrared radiation (IR) light. AOII is provided with a supercontiniuum laser source (IR and visible wavelengths), additional elements for simulation (spatial light modulator, temporal multiplexing with optotunable lenses, phase plates, cuvette for intraocular lenses-IOLs), and a double-pass retinal camera. We review several studies undertaken with these AO systems, including the evaluation of the visual benefits of AO correction, vision with simulated multifocal IOLs (MIOLs), optical aberrations in pseudophakic eyes, chromatic aberrations and their visual impact, and neural adaptation to ocular aberrations. SUMMARY Monochromatic and chromatic aberrations have been measured in normal and treated eyes. AO systems have allowed understanding the visual benefit of correcting aberrations in normal eyes and the adaptation of the visual system to the eye's native aberrations. Ocular corrections such as intraocular and contact lenses modify the wave aberrations. AO systems allow simulating vision with these corrections before they are implanted/fitted in the eye, or even before they are manufactured, revealing great potential for industry and the clinical practice. This review paper is part of a special issue of Ophthalmic & Physiological Optics on women in visual optics, and is co-authored by all women scientists of the research team.
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Affiliation(s)
- Susana Marcos
- Visual Optics and Biophotonics Lab, Instituto de Optica "Daza de Valdés" (IO-CSIC), Consejo Superior de Investigaciones Científicas, Serrano, Madrid, Spain
| | - Clara Benedí-García
- Visual Optics and Biophotonics Lab, Instituto de Optica "Daza de Valdés" (IO-CSIC), Consejo Superior de Investigaciones Científicas, Serrano, Madrid, Spain
| | - Sara Aissati
- Visual Optics and Biophotonics Lab, Instituto de Optica "Daza de Valdés" (IO-CSIC), Consejo Superior de Investigaciones Científicas, Serrano, Madrid, Spain
| | - Ana M Gonzalez-Ramos
- Visual Optics and Biophotonics Lab, Instituto de Optica "Daza de Valdés" (IO-CSIC), Consejo Superior de Investigaciones Científicas, Serrano, Madrid, Spain
| | - Carmen M Lago
- Visual Optics and Biophotonics Lab, Instituto de Optica "Daza de Valdés" (IO-CSIC), Consejo Superior de Investigaciones Científicas, Serrano, Madrid, Spain
| | - Aiswaryah Radhkrishnan
- Visual Optics and Biophotonics Lab, Instituto de Optica "Daza de Valdés" (IO-CSIC), Consejo Superior de Investigaciones Científicas, Serrano, Madrid, Spain
| | - Mercedes Romero
- Visual Optics and Biophotonics Lab, Instituto de Optica "Daza de Valdés" (IO-CSIC), Consejo Superior de Investigaciones Científicas, Serrano, Madrid, Spain
| | - Shrilekha Vedhakrishnan
- Visual Optics and Biophotonics Lab, Instituto de Optica "Daza de Valdés" (IO-CSIC), Consejo Superior de Investigaciones Científicas, Serrano, Madrid, Spain
| | - Lucie Sawides
- Visual Optics and Biophotonics Lab, Instituto de Optica "Daza de Valdés" (IO-CSIC), Consejo Superior de Investigaciones Científicas, Serrano, Madrid, Spain
| | - Maria Vinas
- Visual Optics and Biophotonics Lab, Instituto de Optica "Daza de Valdés" (IO-CSIC), Consejo Superior de Investigaciones Científicas, Serrano, Madrid, Spain
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Vinas M, Aissati S, Romero M, Benedi-Garcia C, Garzon N, Poyales F, Dorronsoro C, Marcos S. Pre-operative simulation of post-operative multifocal vision. BIOMEDICAL OPTICS EXPRESS 2019; 10:5801-5817. [PMID: 31799048 PMCID: PMC6865107 DOI: 10.1364/boe.10.005801] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Revised: 09/22/2019] [Accepted: 09/22/2019] [Indexed: 05/06/2023]
Abstract
While multifocal intraocular lenses (MIOLs) are increasingly implanted to correct for presbyopia, how one sees with a multifocal correction is hard to explain and imagine. The current study evaluates the quality of various visual simulating technologies by comparing vision with simulated MIOLs pre-operatively and the implanted MIOLs post-operatively in the same patients. Two simulation platforms were used: (1) a custom-developed adaptiveoptics (AO) system, with two visual simulator devices: a spatial light modulator (SLM) and an optotunable lens operating under temporal multiplexing (SimVis); and (2) a wearable, binocular, large field of view SimVis2Eyes clinical simulator (SimVis Gekko, 2Eyes Vision, Madrid, Spain). All devices were programmed to simulate a trifocal diffractive MIOL (POD F, FineVision, PhysIOL). Eight patients were measured pre-operatively simulating the trifocal lens and post-operatively with implantation of the same MIOL. Through-focus decimal visual acuity (TF VA) was measured (1) monocularly in monochromatic light using a four-alternative-forced-choice procedure in the AO system; and (2) binocularly using a clinical optotype in white light. Visual simulations pre-operatively predict well the TF VA performance found post-operatively in patients implanted with the real IOL. The average RMS difference between TF curves with the different visual simulators was 0.05 ± 0.01. The average RMS difference between the TF VA curves with the SimVis pre-operatively and the real MIOL post-operatively was 0.06 ± 0.01 in both platforms, and it was higher in cataract eyes (0.08 ± 0.01, on average across simulators) than in eyes with clear lens. In either group the shape of the TF curves is similar across simulators and pre- and post-operatively. TF curves cross-correlated significantly between simulators (lag k = 0, rho = 0.889), as well as with results with the real MIOL implanted (lag k = 0, rho = 0.853). Visual simulations are useful programmable tools to predict visual performance with MIOLs, both in an AO environment and in a clinical simulator. Pre-operative visual simulations and post-operative data are in good agreement.
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Affiliation(s)
- Maria Vinas
- Institute of Optics, Spanish National Research Council, IO-CSIC, Serrano, 121, Madrid 28006, Spain
| | | | - Mercedes Romero
- Institute of Optics, Spanish National Research Council, IO-CSIC, Serrano, 121, Madrid 28006, Spain
| | - Clara Benedi-Garcia
- Institute of Optics, Spanish National Research Council, IO-CSIC, Serrano, 121, Madrid 28006, Spain
| | | | | | - Carlos Dorronsoro
- Institute of Optics, Spanish National Research Council, IO-CSIC, Serrano, 121, Madrid 28006, Spain
| | - Susana Marcos
- Institute of Optics, Spanish National Research Council, IO-CSIC, Serrano, 121, Madrid 28006, Spain
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Radhakrishnan A, Pascual D, Marcos S, Dorronsoro C. Vision with different presbyopia corrections simulated with a portable binocular visual simulator. PLoS One 2019; 14:e0221144. [PMID: 31430328 PMCID: PMC6701771 DOI: 10.1371/journal.pone.0221144] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Accepted: 07/31/2019] [Indexed: 11/18/2022] Open
Abstract
Presbyopes can choose today among different corrections to provide them with functional vision at far and near, and the outcomes and patient satisfaction depend on the selection. In this study, we present a binocular and portable vision simulator, based on temporal multiplexing of two synchronized tunable lenses allowing see-through and programmable visual simulations of presbyopic corrections. Seventeen binocular corrections were tested: 3 Monofocal (Far, Intermediate, Near), 4 Simultaneous Vision (bifocal, trifocal), 2 Monovision (far and near in either eye) and 8 Modified Monovision corrections (Simultaneous vision in one eye, Monofocal in the other eye). Perceived visual quality was assessed through the simulated corrections in 8 cyclopleged subjects who viewed a composite realistic visual scene with high contrast letters and a landscape at far (4 m) and a high contrast text at intermediate (66 cm) and near (33 cm) distances. Perceptual scores were obtained on a scale of 0 to 5 (low to high perceived quality). Perceptual preference was assessed by judging 36 random image pairs (6 repetitions) viewed through 9 binocular presbyopic corrections using two-interval forced choice procedures. The average score, across far and near distances, was the highest for Monovision (4.4±0.3), followed by Modified Monovision (3.4±0.1), Simultaneous Vision (3.0±0.1) and Monofocal corrections (2.9±0.2). However, the mean difference between far and near was lower for Simultaneous Vision and Monovision (0.4±0.1 PS) than Modified Monovision (1.8±0.7) or monofocal corrections (3.3±1.5). A strong significant correlation was found between the perceptual scores and the percentages of energy in focus, for each correction and distance (R = 0.64, p<0.0001). Multivariate ANOVA revealed significant influence of observation distances (p<10-9) and patients (p = 0.01) on Perceptual Score. In conclusion, we have developed a binocular portable vision simulator that can simulate rapidly and non-invasively different combinations of presbyopic corrections. This tool has applications in systematic clinical evaluation of presbyopia corrections.
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Affiliation(s)
- Aiswaryah Radhakrishnan
- Laboratory of Visual Optics and Biophotonics, Instituto de Óptica, IO-CSIC, Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Daniel Pascual
- Laboratory of Visual Optics and Biophotonics, Instituto de Óptica, IO-CSIC, Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Susana Marcos
- Laboratory of Visual Optics and Biophotonics, Instituto de Óptica, IO-CSIC, Consejo Superior de Investigaciones Científicas, Madrid, Spain
| | - Carlos Dorronsoro
- Laboratory of Visual Optics and Biophotonics, Instituto de Óptica, IO-CSIC, Consejo Superior de Investigaciones Científicas, Madrid, Spain
- * E-mail:
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