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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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Morgan JIW, Chui TYP, Grieve K. Twenty-five years of clinical applications using adaptive optics ophthalmoscopy [Invited]. BIOMEDICAL OPTICS EXPRESS 2023; 14:387-428. [PMID: 36698659 PMCID: PMC9841996 DOI: 10.1364/boe.472274] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 11/22/2022] [Accepted: 11/27/2022] [Indexed: 05/02/2023]
Abstract
Twenty-five years ago, adaptive optics (AO) was combined with fundus photography, thereby initiating a new era in the field of ophthalmic imaging. Since that time, clinical applications of AO ophthalmoscopy to investigate visual system structure and function in both health and disease abound. To date, AO ophthalmoscopy has enabled visualization of most cell types in the retina, offered insight into retinal and systemic disease pathogenesis, and been integrated into clinical trials. This article reviews clinical applications of AO ophthalmoscopy and addresses remaining challenges for AO ophthalmoscopy to become fully integrated into standard ophthalmic care.
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Affiliation(s)
- Jessica I. W. Morgan
- Scheie Eye Institute, Department of Ophthalmology, University of Pennsylvania, Philadelphia, PA 19104, USA
- Center for Advanced Retinal and Ocular Therapeutics, University of Pennsylvania, Philadelphia, PA 19104, USA
- Contributed equally
| | - Toco Y. P. Chui
- Department of Ophthalmology, The New York Eye and Ear Infirmary of Mount Sinai, New York, NY 10003, USA
- Contributed equally
| | - Kate Grieve
- Sorbonne Université, INSERM, CNRS, Institut de la Vision, 17 rue Moreau, and CHNO des Quinze-Vingts, INSERM-DGOS CIC 1423, 28 rue de Charenton, F-75012 Paris, France
- Contributed equally
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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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Lago CM, de Castro A, Benedí-García C, Aissati S, Marcos S. Evaluating the effect of ocular aberrations on the simulated performance of a new refractive IOL design using adaptive optics. BIOMEDICAL OPTICS EXPRESS 2022; 13:6682-6694. [PMID: 36589555 PMCID: PMC9774854 DOI: 10.1364/boe.473573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 10/30/2022] [Accepted: 11/01/2022] [Indexed: 05/02/2023]
Abstract
Adaptive optics (AO) visual simulators are excellent platforms for non-invasive simulation visual performance with new intraocular lens (IOL) designs, in combination with a subject own ocular aberrations and brain. We measured the through focus visual acuity in subjects through a new refractive IOL physically inserted in a cuvette and projected onto the eye's pupil, while aberrations were manipulated (corrected, or positive/negative spherical aberration added) using a deformable mirror (DM) in a custom-developed AO simulator. The IOL increased depth-of-focus (DOF) to 1.53 ± 0.21D, while maintaining high Visual Acuity (VA, -0.07 ± 0.05), averaged across subjects and conditions. Modifying the aberrations did not alter IOL performance on average.
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Affiliation(s)
- Carmen M. Lago
- Visual Optics and Biophotonics Laboratory, Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Calle Serrano 121, Madrid, 28006, Spain
- 2EyesVision S.L., Plaza de la Encina 10, Madrid, 28760, Spain
| | - Alberto de Castro
- Visual Optics and Biophotonics Laboratory, Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Calle Serrano 121, Madrid, 28006, Spain
| | - Clara Benedí-García
- Visual Optics and Biophotonics Laboratory, Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Calle Serrano 121, Madrid, 28006, Spain
| | - Sara Aissati
- Visual Optics and Biophotonics Laboratory, Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Calle Serrano 121, Madrid, 28006, Spain
- Center for Visual Sciences; The Institute of Optics and Flaum Eye Institute, University of Rochester,14642, New York, USA
| | - Susana Marcos
- Visual Optics and Biophotonics Laboratory, Instituto de Óptica, Consejo Superior de Investigaciones Científicas, Calle Serrano 121, Madrid, 28006, Spain
- Center for Visual Sciences; The Institute of Optics and Flaum Eye Institute, University of Rochester,14642, 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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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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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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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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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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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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