Distribution of angle α and angle κ in a population with cataract in Shanghai

Relationship of Angle Kappa with Ocular Parameters using Swept-Source Ocular Coherence Tomography in Cataract Surgery Patients

PURPOSE

To assess the relationship between angle kappa (apparent chord mu) and ocular parameters in cataract patients.

METHODS

In this cross-sectional study, the data on apparent chord mu, age, axial length, anterior chamber depth, anterior and posterior mean keratometry, mean total keratometry, white-to-white, central corneal thickness and lens thickness were collected for consecutive cataract patients. Correlation (Pearson) between chord mu and the other ocular parameters was calculated. A stepwise backward multiple regression analysis was performed to identify the combination of ocular parameters strongly correlating to chord mu.

RESULTS

Two thousand four hundred and sixty-four eyes (1232 patients) were included in this study. The mean age was 72.7 ± 12.7 years (18-97 years). Univariate analysis showed a significant positive correlation of chord mu to age (R = 0.06, p = .01), lens thickness (R = 0.12, p < .01), mean keratometry (R = 0.08, p < .01), and mean total keratometry (R = 0.08, p < .01). Whereas there was a significant negative correlation with white-to-white (R = -0.04, p = .03), axial length (R = -0.19, p < .01), and anterior chamber depth (R = -0.2, p < .01). Male gender (R = -0.04, p = .05) and central corneal thickness (R = 0.04, p = .06) were not significantly correlated. Multivariate stepwise backward regression analysis showed a combination of four factors (female sex, reduced axial length and anterior chamber depth and steep mean keratometry) significantly related to chord mu (angle kappa).

CONCLUSION

Female gender, reduced axial length and anterior chamber depth, and higher mean keratometry correlate to apparent chord mu (angle kappa) in cataract patients. These findings can help identify vulnerable patients who can have appropriate counseling on the prognosis of postoperative optical and visual outcomes.

Replacing Theories with Evidence Around the Axes of the Eye in Intraocular Lens Selection: A Review for the Clinician

The prevailing narrative in scientific literature has long overemphasized the role of ocular axes in intraocular lens (IOL) implantation, perpetuating misconceptions that have led to unnecessary exclusions of patients. Historical assumptions, coupled with inconsistent terminology and statistical inaccuracies, have muddled clinical decision-making. This review delves into these misconceptions, offering a critical reassessment of their relevance. Drawing from a non-systematic search across PubMed, the IOLEvidence App Database, and additional sources through snowballing, the review includes diverse studies exploring the relationship between ocular axes (angles, chords, kappa, alpha, lens, …) and IOL implantation. The findings reveal widespread confusion in terminology, particularly the interchangeable use of terms like 'angles' and 'chords', and highlight device-specific variability in parameters such as Chord-mu, Chord-alpha, and Chord-lens. Despite these inconsistencies, no robust evidence supports using these measures as grounds for excluding patients from IOL procedures. Interestingly, postoperative IOL centration (Chord-iol) emerged as a more critical factor for visual outcomes than preoperative ocular axes. The evidence suggests that values for Chord-mu, Chord-alpha, and Chord-lens should prompt further evaluation of atypical cases but are not reliable exclusion criteria. Moreover, a shift in focus toward aligning the IOL slightly temporal to the vertex normal appears to optimize visual acuity and minimize photic phenomena, challenging the established paradigm of knowledge about IOL centration.

Distribution of angle alpha and angle kappa offsets among adult candidates for cataract surgery

PURPOSE

The current study aimed to describe the distribution of angle alpha and angle kappa offsets as well as their associated ocular biometric parameters in a large population of candidates for cataract surgery.

METHODS

This cross-sectional retrospective study included 8,119 eyes of 4,781 candidates for cataract surgery (mean age 70.7 ± 12.9 years). There were 49.9% right eyes, and 53.0% patients were females. The angles offset and ocular biometric parameters were measured by the IOLMaster 700 (Carl Zeiss Meditec, AG, Germany).

RESULTS

Patient's age and gender, and most of their ocular biometric measurements were similar for the right and left eyes except for pupil diameter (4.01 ± 1.18 vs. 3.92 ± 1.14 mm, respectively, P < 0.001). The angle alpha offset magnitude was similar for the right and left eyes (0.50 ± 0.20 and 0.51 ± 0.21 mm, P = 0.08), whereas the angle kappa offset magnitude was greater in the right eyes (0.37 ± 0.21 vs. 0.33 ± 0.20 mm, P < 0.001). The angle kappa offset magnitudes were greater in the right eyes compared to the left eyes for both males (0.36 ± 0.21 vs. 0.33 ± 0.21 mm, respectively, P < 0.001) and females (0.37 ± 0.20 vs. 0.34 ± 0.20 mm, respectively, P < 0.001). The offset magnitudes of both angles varied significantly according to gender, eye laterality, angle location, and biometric parameters (e.g., axial length). The offset magnitudes of both angles were positively correlated in both right and left eyes.

CONCLUSIONS

The offset magnitudes of both the angle alpha and angle kappa present significant variations according to gender, eye laterality, angle location, and biometric parameters, such as AL. These values are also population-specific.

Correlation of angle kappa and angle alpha on visual outcomes in eyes implanted with three types of multifocal intraocular lenses

To evaluate the correlation between preoperative, postoperative, and change in angle kappa and alpha to visual outcomes following implantation of three multifocal intraocular lenses. This is a retrospective study which included 122 eyes of 61 patients. There were 38 eyes in the Synergy (Johnson & Johnson, USA) group and 42 eyes each from both the Panoptix (Alcon Laboratories, USA) and FineVision (Physiol BVI, Belgium) groups. Visual outcome parameters (uncorrected distance, intermediate, near vision, halo and starburst) and angle kappa and alpha were recorded preoperatively and at three months postoperatively. The preoperative, postoperative and the amount of change in angle kappa and alpha were correlated to visual outcomes and photic phenomena among the three different diffractive trifocal IOLs. There were no significant differences in the preoperative and postoperative magnitude of angle kappa and alpha among the Synergy, Panoptix, and FineVision groups. There was no significant correlation between the preoperative and postoperative magnitude, and change in angle kappa and alpha with the postoperative uncorrected distance, intermediate and near visual acuity, and halo and starburst scores of the three different diffractive IOLs. The frequency of eyes with greater than 0.5 mm angle kappa and alpha values were low. Visual outcomes can be good even in eyes in which the angle kappa and alpha were greater than 0.5 mm. The newer diffractive multifocal IOLs were observed to be more tolerant to low and intermediate levels of angle kappa and alpha.

Tolerance to decentration of biaspheric intraocular lenses with refractive phase-ring extended depth of focus and diffractive trifocal designs

PURPOSE

This study aimed to investigate the in vitro tolerance to decentration of biaspheric intraocular lens (IOLs) with refractive phase-ring extended depth-of-focus (EDOF) and diffractive trifocal designs.

METHODS

This experimental study was carried out at the Department of Optics and Optometry and Vision Science, University of Valencia, Spain. The modulation transfer function (MTF) of the ETLIO130C EDOF and the TFLIO130C trifocal IOLs (AST Products Inc., Billerica, MA, USA) were determined at different levels of decentration for a given wavelength and pupil diameter using the PMTF optical bench (Lambda-X Ophthalmics, Nivelles, Belgium). The modulation transfer function (MTF) curves, the through-focus MTF curves, and the Strehl ratios were measured at 3-mm pupil aperture for 0.25-, 0.50- and 0.75-mm decentration.

RESULTS

The optical design of the trifocal TFLIO130C IOL is robust to small decentrations, with virtually no change in MTF response for 0.25 mm decentration. For greater decentration levels, the MTF response is slightly reduced with increasing decentration. The ETLIO130C EDOF design is robust to decentration, as the MTF response is only minimally affected when increasing the decentration up to 0.75 mm.

CONCLUSIONS

MTF responses are slightly reduced with greater levels of decentration, but the range of focus provided by both trifocal and EDOF designs are preserved. The effects for average levels of decentration reported in the literature are minimum for both IOL designs.

Effect of mydriasis on chord mu value in cataract surgery candidates

PURPOSE

This study investigates the relationship between pupil size during biometry examinations and the chord mu value in candidates for cataract surgery.

METHODS

Retrospective analysis of ocular biometry measurements was performed on consecutive cataract surgery candidates above 50 years of age, examined between 2018 and 2020 at a single tertiary referral center. Statistical analysis assessed the association between pupil size and the chord mu value. The population was categorized into groups based on pupil size, and an analysis was conducted on the barycenter positions of the iris and pupil center for each group.

RESULTS

The analysis included 2877 patients. A weak positive correlation was observed between the chord mu value and pupil size using Pearson's test (r = 0.160, p < 0.01). Group stratification by pupil size indicated temporal and inferior shifts in pupil center barycenter as pupil size increased, reflecting asymmetrical pupil dilation during mydriasis. A moderate positive correlation between the chord mu value and chord alpha value was identified (Pearson's test, r = 0.641, p < 0.01). As expected, no correlation was found between chord alpha value and pupil size.

CONCLUSIONS

Chord mu values were higher in patients with mydriatic pupils, likely due to asymmetric pupil dilation and center displacement. Evaluating chord mu values requires considering pupil status and conducting biometry under standardized lighting to prevent misinterpretation caused by pharmacological dilation. This caution is crucial to avoid erroneously excluding eligible patients from multifocal IOL implants. Alternatively, the chord alpha value could serve as a more appropriate alternative in such scenarios.

Correlation analysis of angles κ and α with the refraction and anterior segment parameters in children

AIM

To investigate the correlation of angles α and κ with the refractive and biological parameters in children.

METHODS

This case-series study included 438 eyes of 219 children (males/females = 105/114, age: 3-15 years). Ocular biometric parameters, including axial length, corneal radius of curvature (CR), white-to-white distance (WTW), angle κ and angle α, were measured using IOL Master 700; auto-refraction were assessed under cycloplegia. The eyes were assigned to different groups based on CR, WTW, and gender to compare the angles α and κ, and analyze the correlations between the differences of biological parameters on angles α and κ.

RESULTS

The means of axial length, CR, WTW, angle α, and angle κ were 23.24 ± 1.14 mm, 7.79 ± 0.27 mm, 11.68 ± 0.41 mm, 0.45 ± 0.25 mm, and 0.27 ± 0.22 mm, respectively. Angle α was correlated with CR and WTW (fixed effect coefficient [FEC] = 0.237, p = 0.015; FEC = -0.109, p = 0.003; respectively), and angle κ also correlated with CR and WTW (FEC = 0.271, p = 0.003; FEC = -0.147, p < 0.001, respectively). Comparing subgroups, the large CR and small WTW group had larger angles α (0.49 ± 0.27 vs. 0.41 ± 0.21, p < 0.001; 0.46 ± 0.27 vs. 0.44 ± 0.21, p < 0.05, respectively) and κ (0.29 ± 0.25 vs. 0.24 ± 0.15, p < 0.01; 0.29 ± 0.25 vs. 0.26 ± 0.19, p < 0.05, respectively). The differences in interocular angles α and κ showed correlation with interocular WTW (r = - 0.255, p < 0.001; r = - 0.385, p < 0.001). Eyes with smaller WTW tended to have larger angle κ (0.28 ± 0.27 vs. 0.25 ± 0.15, p < 0.05).

CONCLUSION

The size of angle α/κ may be correlated to CR and WTW, and a larger WTW eye may suggest a smaller angle κ compared with the fellow eye.

Measurement of the distance between corneal apex and pupil center in patients following small-incision lenticule extraction or implantable collamer lens implantation and its correlation with the surgical-induced astigmatism

BACKGROUND

To investigate the change in the distance between corneal apex and pupil center after small-incision lenticule extraction (SMILE) or implantable collamer lens (ICL) implantation and its correlation with surgical-induced astigmatism (SIA).

METHODS

This study included patients who had undergone SMILE (n = 112) or ICL implantation (n = 110) to correct myopia and myopic astigmatism. The angle kappa was measured using a Scheimpflug imaging device (Pentacam) and represented as Cartesian values between the pupil center and the corneal vertex (X, Y) and chord u ([Formula: see text]orientation), and was compared pre- and post-operative.

RESULTS

Following SMILE, the magnitude of chord u[Formula: see text]) significantly increased in both eyes (Wilcoxon signed-rank test, OD: P<0.001; OS: P=0.007), while no significant change was observed in the orientation. A significant correlation was found between the J0 component of SIA and the change in the magnitude of chord u for both eyes (OD: R2=0.128, P<0.001; OS: R2=0.033, P=0.004). After ICL implantation, the orientation of the chord u was significantly different in the right eye (Wilcoxon signed-rank test, P = 0.008), and the Y-intercept significantly decreased in both eyes (Wilcoxon signed-rank test, P<0.001). A significant correlation was found between J0 of SIA and the change in the magnitude of chord u for the right eyes (R2=0.066, P=0.002). A significant correlation was found between J45 of SIA and the change in the magnitude of chord u for the left eyes (R2=0.037, P=0.044).

CONCLUSIONS

The magnitude of the chord u increased following the SMILE procedure, whereas the Y-intercept significantly decreased after ICL implantation. SIA was related to the change in the magnitude of chord u.

Angle Kappa and angle Alpha agreement between Pentacam Scheimpflug system, swept source optical coherence tomography and ray-tracing aberrometry

PURPOSE

To compare the consistency of Pentacam Scheimpflug system (Pentacam® HR), ray-tracing aberrometry (iTrace), and swept source optical coherence tomography (IOLMaster 700) measurements for Angle Kappa and angle Alpha.

METHODS

A prospective randomized cohort study. 86 individuals (86 eyes) aged 19-45 years with best corrected vision of 4.9 or better were randomly selected from January 2022 to December 2022 in a tertiary-level hospital. Angle Kappa and angle Alpha were measured or calculated using Pentacam, iTrace, and IOLMaster 700, respectively.

RESULTS

The mean difference of angle Kappa between any two instruments was not statistically significant, but the mean difference of angle Alpha between both Pentacam and iTrace, Pentacam and IOLMaster 700, and iTrace and IOLMaster 700 was statistically significant (p value <0.001, 0.003, <0.001). The highest consistency of angle Kappa and the narrowest 95% LoA (-0.20 to 0.21) were found between Pentacam and iTrace according to Bland Altman plots, but between Pentacam and IOLMaster 700 according to Mountain plots. Both Bland Altman plots and Mountain plots showed the highest consistency of angle Alpha and the narrowest 95% LoA (-0.14 to 0.24) between Pentacam and iTrace.

CONCLUSION

The mean angle Kappa among Pentacam® HR, iTrace, and IOLMaster 700 had good agreement, and the value of angle Kappa could be output directly, making it more convenient for clinical application. The measured or calculated angle Alpha had poor agreement, and ophthalmologists could refer to measurements from multiple instruments.

Influence of a multifocal intraocular lens centration and eye angles on light distortion and ocular scatter index

PURPOSE

To assess how eye axes and multifocal intraocular lens (MIOL) centration may impact the light distortion index (LDI) and ocular scatter index (OSI).

METHODS

Fifty-eight subjects implanted with the trifocal MIOL Q-Flex M 640PM or Liberty 677MY (Medicontur) were included in this retrospective analysis. The following variables were collected with the Pentacam Wave (Oculus) considering the vertex normal as the coordinates center: chord-mu to the center of the pupil, chord-alpha to the geometrical center of the cornea, and chord-MIOL to the center of the diffractive ring. These measurements were correlated with OSI (HD Analyzer, Visiometrics) and LDI (light distortion analyzer, CEORLab).

RESULTS

Chord-MIOL centroid was 0.12 mm at 62°, chord-mu was 0.09 mm at 174°, and chord-alpha was 0.38 mm at 188°. A relationship was found between OSI and LDI, rho = 0.58, p < 0.0005). No relationships were found between chord-mu or chord-alpha and the LDI or OSI, neither for the total magnitude, nor the decomposition in orthogonal components (p > 0.05). The LDI was significantly correlated with the temporal centration of the MIOL versus the vertex normal (rho = 0.32, p = 0.02).

CONCLUSIONS

As opposed to what has been previously described, the temporal centration of the MIOL was related to a decrease in the LDI. Future studies with extreme values of the included variables are required to establish cut-offs for considering these variables as exclusion criteria in the implantation of a MIOL.

Visual satisfaction with progressive addition lenses prescribed with novel foveal fixation axis measurements

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.

SS-OCT-based ocular biometry in an adult Korean population with cataract

PURPOSE

To evaluate the characteristics of ocular biometric parameters in adult Korean patients with cataract.

SETTING

Department of Ophthalmology, Seoul National University Hospital, Seoul, South Korea.

DESIGN

Retrospective case series.

METHODS

Ocular biometric values of 5273 eyes of 5273 Korean patients undergoing cataract surgery measured with the IOLMaster 700 at the Seoul National University Hospital between November 2019 and December 2021 were reviewed.

RESULTS

A total of 5273 eyes of 5273 Korean patients were analyzed. The mean ± SD age was 66.1 ± 12.8 years, and 62% were female. Overall, age and ocular biometric parameters were correlated with each other. Particularly, age showed a negative correlation with anterior chamber depth (ACD; r = -0.357), axial length (AL; r = -0.344), and posterior keratometry (PK; r = -0.054) and a positive correlation with lens thickness (LT; r = 0.484), angle α ( r = 0.194), total keratometry (TK; r = 0.137), anterior keratometry (AK; r = 0.129), and angle κ ( r = 0.071). AL showed a positive correlation with ACD ( r = 0.503) and PK ( r = 0.339) and a negative correlation with AK ( r = -0.342), TK ( r = -0.334), LT ( r = -0.288), angle α ( r = -0.220), and angle κ ( r = -0.040). With age, anterior and total corneal astigmatism changed from with-the-rule (WTR) to against-the-rule (ATR) astigmatism. Posterior corneal astigmatism was ATR regardless of age; however, the magnitude decreased with age.

CONCLUSIONS

Age showed a significant correlation in the order of LT, ACD, and AL. With age, angle α and κ increased, and total corneal astigmatism changes from WTR to ATR, which is mainly affected by changes in anterior corneal astigmatism. AL showed a significant correlation in the order of ACD, AK, PK, and TK. These data are pertinent for improving the result after cataract surgery, especially when using premium intraocular lenses.

Intrasession repeatability and agreement of a new method to measure the foveal fixation axis

Purpose

Ophthalmic lens adaptation, particularly with progressive addition lenses, requires accurate measurements of the patient nasopupillary distance (NPD) and interpupillary distance (IPD), which are usually collected using the pupil centre as a reference. However, differences between the pupil centre and visual or foveal axis could induce some subsidiary effects of correcting lenses. This study aimed to assess the intrasession repeatability of a new prototype (Ergofocus®; Lentitech, Barakaldo, Spain) that can measure the foveal fixation axis (FFA) distance and assess the agreement with the NPD measurements collected using a traditional method (frame ruler).

Methods

The FFA at far and near distances was measured three consecutive times in 39 healthy volunteers to determine the intrasession repeatability according to the British Standards Institute and International Organization for Standardization. Additionally, the FFA and NPD (standard frame ruler) were measured in 71 healthy volunteers and compared using Bland-Altman analysis. Two blinded experienced practitioners conducted each FFA and NPD measurement.

Results

The FFA measurements showed acceptable repeatability at far distances (right eye (RE): Sw = 1.16 ± 0.76 mm and coefficient of variation (CV) = 3.92 ± 2.51%; left eye (LE) Sw = 1.11 ± 0.79 mm and CV = 3.76 ± 2.51%) and at near distances (RE: Sw = 0.97 ± 0.85 mm and CV = 3.52 ± 3.02%; LE: Sw = 1.17 ± 0.96 mm and CV = 4.54 ± 3.72%). Additionally, agreement with the NPD showed large differences at far distances (RE: -2.15 ± 2.34, LoA = -6.73 to 2.43 mm (P < 0.001); LE: -0.61 ± 2.62, LoA = -5.75 to 4.53 mm (P = 0.052)) and near distances (RE: -3.08 ± 2.80, LoA -8.57 to 2.42 mm (P < 0.001); LE: -2.97 ± 3.97, LoA: -10.75 to 4.80 mm (P < 0.001)).

Conclusions

FFA measurements showed clinically acceptable repeatability at both far and near distances. Agreement with the NPD measured using a standard frame ruler showed significant differences, suggesting that both measurements are not interchangeable in clinical practice to prescribe and center ophthalmic lenses. Further research is necessary to assess the impact of FFA measurement in ophthalmic lens prescriptions.

Evaluation of angle kappa using the autorefractometer front monitor image

Purpose The aim of this study was to present a novel angle kappa (k) measurement method and grading scale using the autorefractometer front monitor image. Methods Two hundred sixty eyes of 130 subjects were included in the study. All eyes were evaluated using the front monitor image from an autorefractometer (ARFMI) (Canon, RK-F1, Japan). The distance from the center of the pupil to the visual axis on the ARFMI was measured using Image J software (http://rsbweb.nih.gov/ij). Sixty eyes of 30 subjects were evaluated using the Lens Star 900 (Haag-Streit AG, Koeniz, Switzerland), and Lens Star 900 angle-k values were compared with autorefractometer measurements to analyze the reliability of the method. Factors that may influence angle-k value were analyzed, and an ARFMI angle-k grading scale was developed and presented in the study. Results The mean ARFMI angle-k was 0.41 ± 0.22 mm, and the Lens Star 900 angle-k was 0.38 ± 0.24 mm. The Pearson correlation test was used to evaluate the reliability of the method, and there was a statistically significant positive correlation between the two methods (r: 0.628, p < 0.001). The mean ARFMI angle-k was higher in old and adult subjects when compared with young subjects, and the difference was statistically significant (p: 0.02 and p: 0.04, respectively). According to the ARFMI analysis, old subjects had narrow and nasally decentralized pupils when compared with young subjects, and the difference was statistically significant (p < 0.00 and p < 0.03, respectively). According to the ARFMI angle-k grading scale, 36.1% of subjects were grade 1, 38.3% were grade 2 on the x axis, and 58.5% were grade 1 on the y axis. Conclusions A novel angle-k measurement method and grading scale is presented in this study. In addition, the factors influencing the ARFMI angle-k and pupillary properties obtained from the ARFMI are evaluated. According to the results, angle-k and pupil properties may be evaluated using an easily evaluable, cost-effective device, which is present in every ophthalmic clinic.

Agreement of anterior segment measurements between LenStar LS 900 optical biometer and OPD Scan III wavefront aberrometer devices in eyes with cataract

PURPOSE

To compare the inter-device agreement of anterior eye segment measurements between LenStar LS 900 optical biometer and OPD Scan III wavefront aberrometer.

METHODS

This is a retrospective study involving 59 patients (78 eyes) with cataract. Their angle Alpha, angle Kappa, pupil size and white-to-white (WTW) distance were measured by LenStar LS 900 optical biometer and OPD Scan III wavefront aberrometer, respectively, and pairwise agreement comparisons were performed between them.

RESULTS

The most agreement of various parameters was occurred, with intraclass correlation coefficient (ICC) of WTW = 0.930; angle Alpha = 0.853; angle Kappa = 0.898; and pupil size = 0,976 in bright environment. Furthermore, in dark environment, the ICC of WTW, angle Alpha, angle Kappa, and pupil size were 0.927, 0.791, 0.915, and 0.990, respectively. Bland-Altman plot showed similar excellent agreement in the outcomes of the two devices for these measurements testing.

CONCLUSIONS

There was an excellent agreement between the LenStar LS 900 optical biometer and OPD Scan III wavefront aberrometer for WTW, angle Alpha, angle Kappa, and pupil size measurements. In clinical practice, these measurements obtained by LenStar LS 900 optical biometer and OPD Scan III wavefront aberrometer can be used interchangeably.

Characteristics of Pupil Offset in Young Asian Adults With Mild-Moderate and High Myopia

Purpose

The purpose of this study was to explore the characteristics of pupil offset in young Asian adults with myopia.

Methods

In total, 1200 eyes (600 young adults, 18–35 years old) were divided into mild-moderate and high groups according to equivalent spherical diopters (SEQ). The pupil offset and its X and Y components were compared between the groups. Linear correlation was analyzed among pupil offset, X and Y components, and SEQ. Multiple linear regression analysis was conducted for pupil offset and eye parameters.

Results

The mean age of all subjects was 22.5 ± 4.8 years. The mean magnitude of the pupil offset (0.18 ± 0.09 mm vs. 0.15 ± 0.08 mm) and Y component (0.12 ± 0.08 mm vs. 0.10 ± 0.07 mm) were larger in the high group than in the mild-moderate group (P < 0.05). The magnitude of pupil offset, X and Y components, and SEQ were positively correlated. The pupil center (PC) of the right eye in the mild-moderate group was mainly superotemporal to the corneal vertex and mainly superonasal for the left eye and both eyes in the high group. Multiple linear regression analysis revealed that the magnitude of pupil offset correlated with central corneal thickness, intraocular pressure, and mean corneal curvature (P < 0.05).

Conclusions

The magnitude of the pupil offset that correlated with partial eye parameters and its X and Y components increased as the SEQ increased, and the PC gradually shifted toward the superonasal direction in young Asian adults with myopia.

Translational Relevance

Subjects with high myopia with a larger pupil offset should be considered for better postoperative visual quality during refractive surgery.

Ocular Biometric Characteristics Measured by Swept-Source Optical Coherence Tomography in Individuals Undergoing Cataract Surgery

PURPOSE

To study the distribution of ocular biometric parameters using a swept-source optical coherence tomography (SS-OCT) biometer in adult candidates for cataract surgery.

DESIGN

A retrospective cross-sectional study.

METHODS

This is a single-center analysis of consecutive eyes measured with the IOLMaster 700 SS-OCT biometer at a large tertiary medical center between February 2018 and June 2020.

RESULTS

Three thousand eight hundred thirty-six eyes of 3836 patients were included in the study. The mean ± SD age was 72.3 ± 12.8 years and 53% were female. The mean biometric values were as follows: total corneal power (44.17 ± 1.70 diopters [D]), total corneal astigmatism (TCA; 1.11 ± 0.87 D), mean posterior keratometry (-5.87 ± 0.26 D), posterior corneal astigmatism (-0.26 ± 0.15 D), axial length (AL; 23.95 ± 1.66 mm), anterior chamber depth (ACD; 3.18 ± 0.42 mm), lens thickness (LT; 4.49 ± 0.47 mm), white-to-white distance (WTW; 11.92 ± 0.44 mm), central corneal thickness (CCT; 0.54 ± 0.04 mm), angle alpha (0.49 ± 0.17 mm), and angle kappa (0.34 ± 0.17 mm). There were sex-related differences in all biometric parameters save for LT (P = .440), angle kappa (P = .216), and corneal astigmatism (P = .103). Biometric parameters demonstrated correlations between AL, WTW distance, ACD, and LT (P < .001). Age correlated with all parameters (P < .001) except CCT and posterior keratometry. Angle alpha and angle kappa magnitudes also correlated (P < .001). The prevalence of patients with TCA ≥0.75 D, 1.0 D, and 1.5 D were 59.1%, 43.4%, and 22.6%, respectively.

CONCLUSIONS

Age significantly correlated with most of the biometric parameters and significant differences between sexes were noted. In addition, the high prevalence of TCA and relatively large angle alpha and angle kappa magnitudes were noted among subjects. These data can be relevant in planning local and national health economics.

Visual outcomes of a novel non-diffractive extended depth-of-focus IOL targeted for mini-monovision: 3 month results of a prospective cohort study

PURPOSE

Evaluating visual outcomes, spectacle independence, and optical phenomena after bilateral implantation of a non-diffractive extended depth-of-focus (EDOF) IOL targeted for mini-monovision.

SETTING

University Eye Clinic Maastricht, the Netherlands.

DESIGN

Prospective case series.

METHODS

Patients with age-related cataract were bilaterally implanted with a non-diffractive EDOF IOL (Alcon Acrysof IQ Vivity), targeted for mini-monovision. Outcome measures were the uncorrected distance visual acuity (UDVA), corrected distance visual acuity (CDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), distance corrected intermediate visual acuity (DCIVA), distance corrected near visual acuity (DCNVA), refractive outcomes, defocus-curves, spectacle independence, photic phenomena and Catquest-9SF questionnaires.

RESULTS

44 eyes of 22 patients were included. Binocular UDVA, UIVA and UNVA were -0.07 (± 0.10), 0.04 (± 0.09) and 0.23 (± 0.12) logMAR, respectively. The percentage of eyes within 1.0D and 0.5D of target was 100% and 95% for the dominant eye, 100% and 86% for the nondominant eye. The binocular defocus-curve was better than 0.10 logMAR over a range from -2.0D to +0.5D. The percentage of patients who reported no or rarely using glasses for distance, intermediate and near viewing distance was 96%, 68%, 38%, respectively. The percentage of patients who experienced no halos, glare or starbursts were 91%, 91%, 100%, respectively. Catquest-9SF showed a high patient satisfaction for daily life activities.

CONCLUSION

Bilateral Acrysof IQ Vivity IOL implantation targeted for mini-monovision, provides good visual acuity results for far and intermediate with functional near vision, high level of patient satisfaction and spectacle independence, and a monofocal disturbance profile.