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Pérez-Sanz L, Vega F, Azor-Morón JA, Cuellar F, Millán MS, Garzón N. Tolerance to residual astigmatism of an isofocal intraocular lens. Graefes Arch Clin Exp Ophthalmol 2024; 262:1169-1180. [PMID: 37950754 DOI: 10.1007/s00417-023-06305-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 10/12/2023] [Accepted: 10/23/2023] [Indexed: 11/13/2023] Open
Abstract
PURPOSE To evaluate the impact of residual astigmatism on the optical and visual performance of an enhanced-monofocal isofocal intraocular lens (EM Isopure, BVI medical, Belgium) compared to a monofocal one (Micropure, BVI medical, Belgium). METHODS Laboratory investigation and prospective, comparative and randomized clinical study. Optical quality was assessed on an optical bench for 2.0, 3.0, and 4.5 mm pupils. The effect of residual astigmatism was investigated from through-focus images recorded with increasing amounts of regular positive astigmatism induced with a deformable mirror. To evaluate the impact of residual astigmatism, 28 eyes of 28 patients were randomly assigned to either group. Residual astigmatism was induced with positive and negative cylinder lenses at 90 and 180°. Visual acuity (VA) was measured at each step. RESULTS The optical performance of both IOLs was quite similar for 2.0 and 3.0 mm pupils. For 4.5-mm pupil, the EM Isopure showed a significant reduction of its optical quality in comparison with the monofocal IOL. When visual performance was evaluated, no statistically significant differences were found for any power of induced astigmatism. More differences were found when positive induced astigmatism was compared within each group, and VA was better when the astigmatism was induced at 180° vs. 90°. The greatest differences were found for and induced positive astigmatism of + 1.50D (p = 0.009 for Isopure and p = 0.023 for Micropure). CONCLUSIONS The tolerance to residual astigmatism of the EM Isopure lens is similar to that of a reference monofocal lens with pupils up to 3.5 mm.
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Affiliation(s)
- Lidia Pérez-Sanz
- Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, Avda. Arcos de Jalón 118, 28037, Madrid, Spain.
- Miranza IOA. C/Galileo 104, 28003, Madrid, Spain.
| | - Fidel Vega
- Grupo de Óptica Aplicada y Procesado de Imagen (GOAPI), Department of Optics and Optometry, Universitat Politècnica de Catalunya BarcelonaTech, Violinista Vellsolà 37, 08222, Terrassa, Spain
| | - Juan A Azor-Morón
- Grupo de Óptica Aplicada y Procesado de Imagen (GOAPI), Department of Optics and Optometry, Universitat Politècnica de Catalunya BarcelonaTech, Violinista Vellsolà 37, 08222, Terrassa, Spain
| | - Fátima Cuellar
- Grupo de Óptica Aplicada y Procesado de Imagen (GOAPI), Department of Optics and Optometry, Universitat Politècnica de Catalunya BarcelonaTech, Violinista Vellsolà 37, 08222, Terrassa, Spain
| | - María S Millán
- Grupo de Óptica Aplicada y Procesado de Imagen (GOAPI), Department of Optics and Optometry, Universitat Politècnica de Catalunya BarcelonaTech, Violinista Vellsolà 37, 08222, Terrassa, Spain
| | - Nuria Garzón
- Optometry and Vision Department, Faculty of Optics and Optometry, Complutense University of Madrid, Avda. Arcos de Jalón 118, 28037, Madrid, Spain
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Chang JSM, Liu SCT, Ma NTC, Ng JCM. Comparative Analysis of Tolerance to Experimentally Induced Astigmatism with Three Types of Multifocal Intraocular Lenses. Clin Ophthalmol 2024; 18:139-149. [PMID: 38235488 PMCID: PMC10793118 DOI: 10.2147/opth.s429630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2023] [Accepted: 11/02/2023] [Indexed: 01/19/2024] Open
Abstract
Purpose The effect of residual astigmatism and its axis on distance and near visual acuities (VAs) with multifocal intraocular lenses (IOLs) has not been studied extensively. This study compared the tolerance to experimentally induced residual astigmatism among bifocal, trifocal, and extended depth-of-focus (EDOF) IOLs. Patients and Methods This retrospective, comparative study included 70 eyes of 70 patients implanted with bifocal, trifocal, or EDOF IOLs. Distance and near VAs were assessed with experimentally induced astigmatism by placing positive cylindrical lenses in increments of 0.50 diopters to 2.00 diopters at 90° and 180° axes over the best distance correction. Results Both distance and near VAs worsened with increasing magnitudes of experimentally induced astigmatism except in the EDOF group, in which the near VA remained within a clinically acceptable limit, ie, within one line from the best corrected VA under all ranges of experimentally induced astigmatism. Furthermore, the EDOF group showed the highest astigmatic threshold for losing VA lines following experimental astigmatic induction at both distance and near. The distance VA was generally better at with-the-rule (WTR) than against-the-rule (ATR) astigmatism for all three IOL groups. On the other hand, the near VA was generally better at WTR than ATR astigmatism in the bifocal group, comparable between WTR and ATR astigmatism in the trifocal group, and generally better at ATR than WTR astigmatism in the EDOF group. Conclusion The EDOF IOL demonstrated the highest tolerance to experimentally induced astigmatism at both distance and near. VA was generally less affected by WTR astigmatism than ATR astigmatism, especially at distance. We proposed the residual astigmatism thresholds for clinically acceptable VA reduction in all three IOL groups.
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Affiliation(s)
- John So Min Chang
- Department of Ophthalmology, Hong Kong Sanatorium & Hospital, Hong Kong
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Gantz L, Paritzky D, Wunch I, Kageyama AH, Wolf N, Cherny C, Rosenfield M. Validation of the DYOP visual acuity test. JOURNAL OF OPTOMETRY 2023; 16:268-276. [PMID: 36400682 PMCID: PMC10518763 DOI: 10.1016/j.optom.2022.09.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 09/27/2022] [Accepted: 09/30/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE The dynamic optotype (DYOP) visual acuity (VA) test is based on motion detection rather than element resolution and has been proposed for routine clinical assessment. This investigation examined the validity, inter- and intra-session repeatability and subjective preference for the DYOP versus a static letter chart and examined its utility in detecting astigmatic defocus. METHODS VA of 103 participants was measured three times with the letter and DYOP charts and repeated within two weeks in 75 participants who also rated their subjective experience. The VA of 29 participants was measured using DYOP, letter, Landolt C, and Tumbling E charts, with habitual correction and astigmatism induced with +1.00, +2.00 or +3.00 cylinders at 45, 60, 90 and 180°. RESULTS The charts differed by a mean of 0.02 logMAR, with 81% of the measurements within one line of acuity. Inter-session, intraclass correlation coefficients, within-subject SD and repeatability were 0.03 logMAR, 0.95, 0.11 and 0.30 versus 0.01 logMAR, 0.92, 0.15 and 0.42 for the DYOP and letter charts, respectively. The DYOP was significantly more frustrating (1.79 vs.1.36), with 59% preferring the letter chart. The DYOP was least affected by induced astigmatism. CONCLUSIONS The DYOP and letter charts differed significantly in their mean values with wide limits of agreement. DYOP had better within-subject SD and narrower limits of agreement between sessions, though clinically insignificant, and performed significantly worse for the detection of uncorrected astigmatism. Thus, it is difficult to recommend this test for the clinical determination of refractive error.
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Affiliation(s)
- Liat Gantz
- Department of Optometry and Vision Science, Hadassah Academic College, Haneviim 37, Jerusalem 91010, Israel.
| | - Dinah Paritzky
- Department of Optometry and Vision Science, Hadassah Academic College, Haneviim 37, Jerusalem 91010, Israel
| | - Inbar Wunch
- Department of Optometry and Vision Science, Hadassah Academic College, Haneviim 37, Jerusalem 91010, Israel
| | - Andrew H Kageyama
- SUNY College of Optometry, 33 West 42(nd) Street, New York, NY 10036, United States
| | - Nadav Wolf
- Department of Optometry and Vision Science, Hadassah Academic College, Haneviim 37, Jerusalem 91010, Israel
| | - Christina Cherny
- SUNY College of Optometry, 33 West 42(nd) Street, New York, NY 10036, United States
| | - Mark Rosenfield
- SUNY College of Optometry, 33 West 42(nd) Street, New York, NY 10036, United States
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Tavazzi S, Vlasak N, Zeri F. Effects of Lens-Induced Astigmatism at Near and Far Distances. CLINICAL OPTOMETRY 2023; 15:105-117. [PMID: 37181864 PMCID: PMC10171221 DOI: 10.2147/opto.s405472] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Accepted: 04/13/2023] [Indexed: 05/16/2023]
Abstract
Purpose To investigate and compare the degradation of visual acuity (VA) in myopic presbyopes due to lens-induced astigmatism at near and at far distance. Patients and Methods Fourteen corrected myopic presbyopes were recruited. VA (logarithm of the minimum angle of resolution) was measured binocularly for different conditions of lens-induced astigmatism: cylindrical powers of -0.25, -0.50, -0.75, -1.00, -1.50, and -2.00 diopters (and positive spherical power of half the cylindrical power) with two axis orientations (with-the-rule WTR and against-the-rule ATR) were added to their optical correction. Measurements were carried out at far and near distance both in photopic and mesopic conditions, and for high and low contrast (HC/LC) stimuli. The paired Wilcoxon signed-rank statistics test was used to evaluate difference between conditions. Results The measured VA as a function of the lens-induced astigmatism was described by regression lines in all investigated experimental conditions. The angular coefficients (slopes) of these lines represent the VA degradation, ie, the variation in logMAR corresponding to the addition of 1.00 diopters of cylindrical power. In photopic HC conditions, the VA degradation is significantly more pronounced at far distance than at near distance (0.22±0.06 diopters-1 vs 0.15±0.05 diopters-1, p = 0.0061 in WTR conditions; 0.18±0.06 diopters-1 vs 0.12±0.05 diopters-1, p = 0.0017 in ATR conditions), although VAs at near and at far with zero cylinder were similar (-0.14±0.10 vs -0.14±0.08, p = 0.824). Conclusion The better tolerance to lens-induced astigmatism blur at near than at far distance in photopic conditions with HC stimuli is tentatively attributed to a possible experience-mediated neural compensation associated to the tendency of the eye toward an inherent astigmatism at near.
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Affiliation(s)
- Silvia Tavazzi
- Materials Science Department, University of Milano-Bicocca, Milam, I-20125, Italy
- University of Milano-Bicocca, COMiB Research Centre in Optics and Optometry, Milan, I-20125, Italy
- Correspondence: Silvia Tavazzi, Department of Materials Science, University of Milano-Bicocca, Via Roberto Cozzi 55, Milan, I-20125, Italy, Tel +39 02 6448 5035, Email
| | | | - Fabrizio Zeri
- Materials Science Department, University of Milano-Bicocca, Milam, I-20125, Italy
- University of Milano-Bicocca, COMiB Research Centre in Optics and Optometry, Milan, I-20125, Italy
- College of Health and Life Sciences, Aston University, Birmingham, B4 7ET, UK
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Son S, Moon J, Kang H, Kim Y, Lee J. Induced astigmatism biases the orientation information represented in multivariate electroencephalogram activities. Hum Brain Mapp 2021; 42:4336-4347. [PMID: 34060695 PMCID: PMC8357008 DOI: 10.1002/hbm.25550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 05/20/2021] [Accepted: 05/23/2021] [Indexed: 01/23/2023] Open
Abstract
A small physical change in the eye influences the entire neural information process along the visual pathway, causing perceptual errors and behavioral changes. Astigmatism, a refractive error in which visual images do not evenly focus on the retina, modulates visual perception, and the accompanying neural processes in the brain. However, studies on the neural representation of visual stimuli in astigmatism are scarce. We investigated the relationship between retinal input distortions and neural bias in astigmatism and how modulated neural information causes a perceptual error. We induced astigmatism by placing a cylindrical lens on the dominant eye of human participants, while they reported the orientations of the presented Gabor patches. The simultaneously recorded electroencephalogram activity revealed that stimulus orientation information estimated from the multivariate electroencephalogram activity was biased away from the neural representation of the astigmatic axis and predictive of behavioral bias. The representational neural dynamics underlying the perceptual error revealed the temporal state transition; it was transiently dynamic and unstable (approximately 350 ms from stimulus onset) that soon stabilized. The biased stimulus orientation information represented by the spatially distributed electroencephalogram activity mediated the distorted retinal images and biased orientation perception in induced astigmatism.
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Affiliation(s)
- Sangkyu Son
- Center for Neuroscience Imaging ResearchInstitute for Basic Science (IBS)SuwonRepublic of Korea
- Department of Biomedical EngineeringSungkyunkwan UniversitySuwonRepublic of Korea
| | - Joonsik Moon
- Center for Neuroscience Imaging ResearchInstitute for Basic Science (IBS)SuwonRepublic of Korea
| | - Hyungoo Kang
- Department of OptometryCatholic Kwandong UniversityGangneungRepublic of Korea
| | - Yee‐Joon Kim
- Center for Cognition and SocialityInstitute for Basic Science (IBS)DaejeonRepublic of Korea
| | - Joonyeol Lee
- Center for Neuroscience Imaging ResearchInstitute for Basic Science (IBS)SuwonRepublic of Korea
- Department of Biomedical EngineeringSungkyunkwan UniversitySuwonRepublic of Korea
- Department of Intelligent Precision Healthcare ConvergenceSungkyunkwan UniversitySuwonRepublic of Korea
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Hopkins S, Narayanasamy S, Vincent SJ, Sampson GP, Wood JM. Do reduced visual acuity and refractive error affect classroom performance? Clin Exp Optom 2021; 103:278-289. [DOI: 10.1111/cxo.12953] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2019] [Revised: 07/03/2019] [Accepted: 07/08/2019] [Indexed: 12/18/2022] Open
Affiliation(s)
- Shelley Hopkins
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia,
| | - Sumithira Narayanasamy
- Programme of Optometry & Vision Sciences, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia,
| | - Stephen J Vincent
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia,
| | - Geoff P Sampson
- School of Medicine (Optometry), Faculty of Health, Deakin University, Geelong, Australia,
| | - Joanne M Wood
- School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia,
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