Corrigendum: Possible risk factors of opaque bubble layer and its effect on high-order aberrations after small incision Lenticule extraction

[This corrects the article DOI: 10.3389/fmed.2023.1156677.].

Possible risk factors of opaque bubble layer and its effect on high-order aberrations after small incision Lenticule extraction

Purpose

To evaluate the possible risk factors of opaque bubble layer (OBL) formation in small incision lenticule extraction (SMILE) surgery and its effects on visual quality.

Methods

Fifty-six eyes from 28 patients were included in this study. The preoperative parameters and intraoperative designs were recorded. Corneal high-order aberrations (HOAs), point spread function (PSF), and modulation transfer function (MTF) were measured using iTrace at pre-operation, 1 week, 1 month, and 3 months after SMILE. Generalized Estimating Equation and Linear Mixed Effects Model were employed for statistical analysis.

Results

The mean OBL area in SMILE surgery was 2.75% ± 1.25%. The patients were divided into groups based on whether the OBL was greater than the mean group or less than the mean group. Compared to the group with a smaller OBL area, the group with the larger OBL area had steeper corneal curvature and thinner cap thickness, the OBL area was positively correlated with the preoperative keratometry (r = 0.21, p = 0.04) and preoperative spherical value (r = 0.47, p = 0.01). The group with the larger OBL area induced more corneal SA and trefoil at 1 week postoperatively, but the difference was not significant at 1 month and 3 months postoperatively.

Conclusion

A steep corneal curvature, thin cap thickness, and high preoperative spherical value are possible risk factors for OBL formation in SMILE surgery. The OBL increased the ocular and corneal HOAs postoperatively for a short period (1 week), while it did not affect the long-term outcomes.

Optimal Bowel Preparation Method to Visualize the Distal Ileum via Small Bowel Capsule Endoscopy

Small bowel capsule endoscopy (SBCE) is a convenient and minimally invasive method widely used to evaluate the small intestine. However, especially in the distal ileum, visualization of the intestinal mucosa is frequently hampered by the remaining intestinal contents, making it difficult to detect critical lesions. Although several studies have reported on the efficacy of bowel preparation before SBCE, no standardized protocol has been established. Herein, we determined the optimal preparation method for better visualization of the distal ileum using SBCE. We retrospectively analyzed 259 consecutive patients who had undergone SBCE between July 2009 and December 2019, divided into three groups: Group A (no preparation except overnight fasting), Group B (ingestion of 1-2 L polyethylene glycol 4 h before colonoscopy after overnight fasting and performing SBCE immediately after colonoscopy), and Group C (ingestion of 0.9 L magnesium citrate [MC] before SBCE after overnight fasting). The visibility of the intestinal mucosa in the first 10 min and at the last 10 min during the period of observation of the distal ileum was examined using a scoring system and compared. The visibility of the images captured by SBCE was assessed based on the scoring of the degree of bile/chyme staining, residual fluid and debris, brightness, bubble reduction, and visualized mucosa. The status of intestinal collapse was also assessed. In the first 10 min of observation of the distal ileum, no significant differences were detected among the groups. In the last 10 min, significantly better images were acquired in Group C in terms of bile/chyme staining, brightness, bubble reduction, and visualized mucosa. Bowel preparation using a low-dose MC solution 2 h before SBCE provided significantly higher-quality images of the distal ileum. Further optimization, such as the timing of initiating the preparation, is necessary to determine the optimal regimen for bowel preparation prior to SBCE.

Comparison of cataract patients with regular corneal astigmatism after implantation of extended range-of-vision and bifocal toric intraocular lenses

Purpose

To compare the postoperative visual acuity and visual quality between extended range-of-vision and multifocal toric intraocular lens (IOLs) after implantation in cataract patients with regular corneal astigmatism.

Setting

Department of Ophthalmology, the Second Hospital of Jilin University, Changchun, Jilin Province, China.

Design

Retrospective and single-center study.

Methods

The study involved implanting the Tecnis Symphony (ZXR00IOL) or the bifocal toric (ZMTIOL) in patients undergoing cataract surgery. Three months after surgery, lens performance was evaluated using distance, intermediate, and near visual acuity tests, defocus curves, the modulation transfer function (MTF), a visual function index questionnaire (VF-14), and the adverse optical interference phenomena.

Results

The 3-month postoperative follow-up found that both groups had good corrected distance vision. The ZMT group had better-uncorrected distance visual acuity and near visual acuity (p < 0.05). However, the ZXR group showed better uncorrected intermediate visual acuity (p < 0.05) and visual continuity. Overall astigmatism in the postoperative ZMT group was significantly lower than that in the pre-operative group (p < 0.05). The ZMT group had lower total high-order aberrations (tHOs), higher MTF values, and higher VF-14 scores (p < 0.05). Finally, the ZXR group exhibited reduced halo and glare phenomena (p < 0.05).

Conclusion

We found that ZMT can effectively correct a corneal astigmatism of 1.0-1.5 D and ZXR can improve patient outcomes regarding subjective optical quality and range of vision. These findings have the potential to improve future astigmatism treatment options.

Effect of Aloe vera gel coating on organoleptic and nutritional quality of minimally processed carrot

Demand for fresh vegetables has led to development studies in postharvest area mainly focused on minimizing and look for alternatives to chemical additives for food preservation. The use of natural derived edible coatings emerges as a promising alternative for maintaining quality of vegetables. The objective of this study was to evaluate the effect of Aloe vera gel in minimally processed carrot during postharvest storage. Samples with different degrees of processing were immersed in Aloe vera gel, packaged polyolefin bags, and stored in refrigerated chambers at 5 °C for 12 days. Different organoleptic and quality parameters were evaluated. In general, the samples treated with Aloe vera gel showed less quality loss and a lower increment in the bleaching index. Moreover, sensory analysis allowed to establish that carrots processed in slices and shredded and coated with the gel had a more flavorful taste and higher moisture content. Aloe vera treatment did not influence the microbiological growth of bacteria and fungi during storage. Regarding nutritional quality, the treated samples showed a higher accumulation or lower degradation of phenols, flavonoids, and carotenoids, probably generating in this way, a higher antioxidant capacity in these samples. Finally, Aloe vera gel treatment did not influence sugar dynamics in any of the samples. It can be concluded that the treatment with Aloe vera gel allows maintaining a better organoleptic and nutritional quality of carrots with different degrees of processing during refrigerated storage.

Visual Quality, Motility Behavior, and Retinal Changes Associated with Reading Tasks Performed on Electronic Devices

BACKGROUND

The purpose of this study was to objectively evaluate visual discomfort using an eye tracker and aberrometer after a 21-min reading session on an iPad and an Ebook. Additionally, retinal changes were analyzed using optical coherence tomography (OCT).

METHODS

A total of 31 young subjects (24 ± 4 years) participated in this study. They read for 21 min on an Ebook and for another 21 min on an iPad under controlled lighting conditions while their eye movements were monitored using an eye tracker. Aberrometry and retinal OCT measurements were taken before and after each reading session. Parameters such as pupil diameter, fixations, saccades, blinks, total aberration, high-order aberration, low-order aberration, and central and peripheral retinal thickness in the nine early treatment diabetic retinopathy study (ETDRS) areas were measured for each reading situation. Statistical analysis was performed on the collected data.

RESULTS

No statistically significant differences (p > 0.05) between the two devices were observed in terms of the different types of eye movements or the changes in retinal thickness. However, the aberrometric analysis showed variations in post-reading situations depending on the device used.

CONCLUSION

Reading speed and visual discomfort resulting from electronic device usage can be objectively assessed using an eye tracker and aberrometer. Additionally, changes found in central and peripheral retinal thickness between the two devices and the baseline measurements were not significant and remained relatively stable.

Assessment of Visual Quality Improvement as a Result of Spectacle Personalization

Personalized spectacles customized according to an individual's facial anatomy were developed to provide enhanced visual performance and overall comfort when compared to standard spectacles. In this comparative crossover trial, each subject was randomly assigned to wear either personalized spectacles or standard spectacles for two weeks and then tried the second pair for another two weeks. Visual acuity and reading speed were measured, and visual quality and comfort were assessed using specific questionnaires. The correlation of the wearing parameters with the subjects' satisfaction was calculated. According to our results, the subjects wearing personalized glasses reported significantly less experience of swaying and significantly higher overall satisfaction compared to those wearing the control spectacles. At the end of the study, 62% of subjects preferred the personalized spectacles, and visual quality was the primary reason for their spectacle preference followed by wearing comfort. The difference from the ideal cornea-vertex distance was significantly lower when wearing the personalized spectacles compared to the control frames. In addition, the absolute value of the difference from the ideal cornea-vertex distance was significantly correlated with patient satisfaction. These results suggest that personalized spectacles, customized according to an individual's facial anatomy for the ideal wearing parameters, result in both visual and comfort advantages for wearers.

Long-term observation on safety and visual quality of implantable collamer lens V4c implantation for myopia correction: a 5-year follow-up

AIM

To elucidate the safety and visual quality of implantable collamer lens with central hole (ICL V4c) implantation for correcting moderate and high myopia for at least 5y.

METHODS

This retrospective study was conducted on 58 patients (114 eyes) who were followed up for at least 5y after ICL V4c implantation. The observation was done before and on 1d, 1mo, 1 and 5y or more after the surgical procedure. The visual acuity, subjective refraction, intraocular pressure, vault, axial length, central hole position, pupil diameter, visual quality, and adverse events were analyzed. The visual quality includes aberration, the modulation transfer function cutoff frequency (MTF cutoff), objective scattering index (OSI), Stroller's ratio (SR), and visual quality questionnaire.

RESULTS

The average follow-up period was 69.25±3.80mo (range 60-82mo) and the preoperative spherical equivalent (SE) was -8.66±1.97 D. At 5y after operation, the safety index was 1.01±0.02 and the efficacy index was 0.99±0.42 and SE was -0.65±0.63 D. The 59.6% of the eyes achieved an uncorrected distance visual acuity of 20/20, 76.3% of the eyes had SE within ±1.0 D at the last visit. The axial length increased by 0.29±0.71 mm 5y after the surgery (t=-3.843, P<0.001). The mean vault at the last follow-up was 510.59±245.61 µm. The central hole was on the temporal side in 80 eyes (84.2%). The visual quality questionnaire showed that 98.2% patients were satisfied with the surgical procedure. Adverse events occurred in 4 eyes (3.5%), including the posttraumatic toric ICL rotation (2 eyes), iris incarceration (1 eye), and posttraumatic ICL displacement (1 eye) at the last follow-up.

CONCLUSION

Long-term ICL V4c implantation is safe, effective, and stable for correcting moderate and to high myopia, and the visual quality with patients is excellent and satisfactory, but the progression of axial length still needs attention after surgery.

Effects of brimonidine tartrate 0.2 and 0.15% ophthalmic solution on the static and dynamic pupil characteristics

Aims

To investigate the differences between 0.2 and 0.15% brimonidine tartrate eye drops for anti-mydriatic effects and the optical quality under different light conditions.

Methods

This prospective study involved 80 consecutive high myopia patients undergoing implantation of a V4c ICL. The patients were randomly instilled with brimonidine 0.2 and 0.15% 2 weeks postoperatively. Visual quality, pupil center, pupil size, and refraction under different light conditions were measured before and 0.5 h after brimonidine administration. A symptom questionnaire was also evaluated.

Results

There was no statistical difference in the static and dynamic pupil diameters and velocity after LS between the two groups (p > 0.05). The 0.2% group had significant changes in pupil center before and after treatment, while there was no obvious movement of the 0.15% group under all illumination condition (p > 0.05). The OSI after treatment of the 0.15% group was lower than that of 0.2% group (p = 0.012). The PVA9% and PVA100% of the 0.15% group was higher than that of 0.2% group in the dark (p = 0.009, p = 0.012). The HOA RMS of the 0.15% group was lower than that of 0.2% group (p = 0.016). The QIRC score in the 0.15% group was significantly higher than that in the 0.2% group (p = 0.043).

Conclusion

0.15 and 0.2% brimonidine tartrate eye drops had similar anti-mydriatic ability, while 0.15% group had better visual quality than 0.2% concentration, and hardly introduced pupil shift. 0.15% brimonidine tartrate eye drops may be more suitable for patients with nocturnal glare symptoms in the early postoperative period after ICL implantation.

Higher-order aberrations and visual quality after incision lenticule extraction surgery with intraoperative angle kappa adjustments between small and large kappa patients: A 2-year follow-up

Purpose

To evaluate the postoperative visual outcomes, that is, corneal higher-order aberrations (HOAs) and visual quality, of patients with an angle kappa greater than 0.30 mm who underwent angle kappa adjustment during small-incision lenticule extraction (SMILE) 2 years after surgery compared to eyes with an angle kappa less than 0.30 mm.

Methods

This was a retrospective study and included 12 patients from October 2019 to December 2019 who underwent the SMILE procedure for correction of myopia and myopic astigmatism and had one eye with a large kappa angle and another eye with a small kappa angle. Twenty-four months after surgery, an optical quality analysis system (OQAS II; Visiometrics, Terrassa, Spain) was used to measure the modulation transfer function cutoff frequency (MTF_cutoff), Strehl2D ratio, and objective scatter index (OSI). HOAs were measured with a Tracey iTrace Visual Function Analyzer (Tracey version 6.1.0; Tracey Technologies, Houston, TX, USA). Assessment of subjective visual quality was achieved using the quality of vision (QOV) questionnaire.

Results

At 24 months postoperatively, the mean spherical equivalent (SE) refraction was - 0.32 ± 0.40 and - 0.31 ± 0.35 in the S-kappa group (kappa <0.3 mm) and the L-kappa group (kappa ≥0.3 mm), respectively (P > 0.05). The mean OSI was 0.73 ± 0.32 and 0.81 ± 0.47, respectively (P > 0.05). There was no significant difference in MTF_cutoff and Strehl2D ratio between the two groups (P > 0.05). Total HOA, coma, spherical, trefoil, and secondary astigmatism were not significantly different (P > 0.05) between the two groups.

Conclusion

Adjustment of angle kappa during SMILE helps reduce the decentration, results in less HOAs, and promotes visual quality. It provides a reliable method to optimize the treatment concentration in SMILE.

Biostimulants for Sustainable Management of Sport Turfgrass

Research on the efficacy of innovative, ecofriendly biostimulants in sport turf management is scarce, with less information available from open-field experiments, and even less pertaining to thatch control-related problems. The objective was to investigate the open-field effectiveness of a commercial product, EM-1, and two newly developed products, ExpA and ExpB, in improving both rhizosphere and turfgrass, Agrostis stoloniferous L., characteristics on a golf green. ExpA and ExpB, identical in microbial composition, were equally effective in significantly increasing chlorophyll synthesis and visual turf quality, as well as in resistance to tearing out, compared to the untreated control 56 days after treatment (DAT). EM-1 showed intermediate trends between the control and novel biostimulants. The inclusion of humic acids and mycorrhizal fungi to the microbial composition in ExpB significantly improved some rhizosphere properties 56 DAT relative to the control. Results on ExpB evidenced a significant decrease in the thatch layer thickness and fresh leaf weight, associated with a significant increase in the humus thickness, organic matter decomposition and evapotranspiration efficiency. An increased dry leaf biomass was also shown. ExpA and EM-1 showed either marginal or intermediate improvements relative to the control. ExpB represents a promising alternative to alleviate negative environmental impacts associated with turf maintenance-related activities.

Effects of Postoperative Atropine Eye Drops on Visual Quality in Patients Undergoing Trabeculectomy

The aim of this study was to investigate the effects of atropine on patients' perception of visual quality after trabeculectomy. Forty patients undergoing standard trabeculectomy with mitomycin C were enrolled in this prospective randomized study. All surgeries were conducted at the ophthalmology department of the University Medical Center of Mainz, Germany. All patients received the same postoperative treatment with ofloxacin and dexamethasone eye drops. Following randomization of patients into two groups of 20 patients, the intervention group also received atropine eye drops three times daily for the first 2 days after surgery to stabilize the anterior chamber. All patients completed a visual quality questionnaire before surgery and 2 and 6 weeks after surgery. Results were compared using the Wilcoxon test. After surgery, there was a reduction in visual quality in all patients. Patients who received atropine eye drops described a greater and longer-lasting reduction in visual quality than those who did not receive atropine eye drops. Trabeculectomy often leads to a transient reduction in visual quality. This reduction was greater in severity and duration in patients who received postoperative atropine eye drops. Thus, unless there is an underlying medical necessity, we would discourage the application of atropine as a standard therapy for trabeculectomy surgery.

The Effect of Sodium Nitroprusside Treatment on Storage Ability of Fresh-Cut Potato

Quality deterioration is a major problem restricting the fresh-cut potato industry. The present study investigated the effect of sodium nitroprusside (SNP) treatment on the quality of fresh-cut potatoes during short-term storage. The treatment was carried out immediately either before or after cutting, using an SNP concentration of 200 μmol/L. The results showed that SNP treatment inhibited the accumulation of malondialdehyde (MDA) and total soluble solids (TSSs). SNP treatment also decreased the firmness, chewing properties, and ascorbic acid (AsA) content in potatoes, maintaining high levels of total phenols (TPs), total flavonoids (TFs), nitric oxide (NO), and superoxide dismutase (SOD). Furthermore, SNP treatment restrained the rise of phenylalanine ammonia-lyase (PAL), peroxidase (POD), and polyphenol oxidase (PPO), as well as the electrolyte leakage (EL) rate. After SNP treatment, the nitrite content in the potatoes was within security scope. Comparing potatoes treated before and after cutting, the best result was noted in the potatoes soaked in SNP before cutting, which displayed the smallest losses in firmness (11.24%), chewing properties (34.30%), and AsA (40.35%), and maximum increases in TPs (32.84%), TFs (2.83-time), NO (76.11%), and SOD activity (93.15%). Moreover, this group presented the minimum MDA content, EL rate, and TSS values and the lowest PAL, POD, and PPO activities. These results indicated that 200 μmol/L SNP applied for 20 min, particularly before cutting, is an efficient alternative technology that can be used in the fresh-cut potato industry.

Comparison of Postoperative Safety, Efficacy, and Visual Quality after SMILE for Myopic Patients with Different Corneal Thicknesses

PURPOSE

To investigate the safety, efficacy, and visual quality of small incision lenticule extraction (SMILE) in different corneal thickness patients with myopia or myopic astigmatism.

METHODS

This prospective cohort study included 191 right eyes of 191 patients. Eyes were divided into three groups according to preoperative central corneal thickness (CCT) (Preoperative central corneal thickness (CCT) was the group indicator.) There were 31 eyes in the thin cornea group (CCT ≤500 um (μm), TC), 94 eyes in the moderate corneal thickness group (CCT ≥501 um (μm) and ≤550 um (μm), MD) and 66 eyes in the thick cornea group (CCT ≥550 um (μm), TK). Comparisons in uncorrected (UDVA) and best-corrected distance visual acuity (BDVA), manifest refractive spherical equivalent (SE), preoperative mesopic/photopic contrast sensitivity (CS), ocular higher-order aberrations (HOAs) at a 6mm analytical pupil diameter, and visual quality questionnaires were made (performed) among the three groups during the postoperative six months. Subgroup analyses were made based on preoperative SE.

RESULTS

The safety indices at six months were 1.15 ± 0.18, 1.14 ± 0.17, and 1.18 ± 0.17, respectively (p = 0.374), and the efficacy indices at six months were 1.07 ± 0.25, 1.12 ± 0.22, and 1.11 ± 0.21, respectively (p = 0.599). The postoperative SE was -0.07 ± 0.52D, -0.14 ± 0.38D, and -0.05 ± 0.46D after SMILE in the three groups, respectively (p = 0.376). No significant difference was found in mesopic/photopic CS, HOAs, and visual quality among different corneal thickness groups and SE groups. Postoperative SE and efficacy indices were the lowest in thin cornea eyes with ultra-high myopia (over -9.00 D).

CONCLUSIONS

SMILE provides comparable safety, efficacy, and visual quality results in different corneal thickness patients. Those with myopia higher than -9.00 D had less efficacy after surgery, especially in thin cornea patients.

Comparison of visual performance between two aspheric monofocal intraocular lens models

CLINICAL RELEVANCE

It is important to distinguish between visual acuity, optical quality and quality of vision when outcomes obtained with intraocular lenses are evaluated. These parameters, that includeobjective and subjective tests, should be assessed to obtain results that are not biased.

BACKGROUND

To assess the difference in visual and optical quality between two monofocal intraocular lens models.

METHODS

: This was a prospective, parallel and randomised clinical study conducted at Miranza IOA, a private clinic in Madrid, Spain. Sixty patients were implanted bilaterally, 30 per group, with two aspheric IOLs with induced spherical aberration of -0.27 μm for Group A and -0.20 μm for Group B. Visual outcomes obtained at 1 and 3 months after surgery included both uncorrected (UCVA) and corrected monocular distance visual acuity (DCVA), objective scattering index (OSI), modulation transfer function (MTF) cut-off, Strehl Ratio (SR), contrast sensitivity defocus curve (CSDC), intraocular lens spherical aberration (SA), and longitudinal chromatic aberration of the eye. Activity limitations in daily life were assessed using CatQuest-9SF questionnaire.

RESULTS

There were statistically significant differences for DCVA (0.04 LogMAR; p = .008) and SR (0.03; p = .003) between groups. Outcomes related to CSDC showed statistically significant differences for vergences between -0.50 D and +1.00 D (3 mm pupil) and for vergences of 0.00 D and +0.50 D (4.5 mm pupil) between groups. Overall, Group A showed better results regarding visual and optical quality, including a lower longitudinal chromatic aberration result in comparison to Group B. Patient satisfaction evaluated with CatQuest-9SF showed that Group A achieved better outcomes, although the differences were statistically significant only for the 'Reading text on television' item (p = 0.027).

CONCLUSIONS

Both intraocular lens models showed excellent quantity of vision, optical and visual quality as well as high patient satisfaction. Despite this, the the Group A model provided slightly better outcomes than the Group B model.

Effect of larger corneal spherical aberration in improving the near visual acuity of eyes implanted with the TECNIS Symfony

Purpose

To explore the effect of corneal spherical aberration on the visual acuity and visual quality of eyes implanted with the TECNIS Symfony intraocular lens (IOL).

Methods

A total of 43 patients with age-related cataract (60 eyes) undergoing phacoemulsification and TECNIS Symfony IOL implantation were enrolled in this study. The uncorrected distance (UDVA), intermediate (UIVA), near visual acuity (UNVA), corrected distance visual acuity (CDVA), contrast sensitivity, and ocular spherical aberration were recorded 3 months after surgery. Preoperative and postoperative corneal spherical aberration were also measured using the iTrace device. Objective scattering index (OSI), modulation transfer function cut-off frequency (MTF cut-off), and Strehl ratio (SR) were measured by the Optical Quality Analyzing System. Catquest-9SF questionnaire were applied too. Spearman's correlation analysis was used to evaluate the relationship between spherical aberration and visual quality parameters.

Results

Patients were satisfied with their postoperatively visual quality. And the postoperative logMAR UDVA, UIVA, UNVA, and CDVA was 0.05 ± 0.07, 0.04 ± 0.06, 0.15 ± 0.07, and 0.03 ± 0.05, respectively. The mean preoperative corneal spherical aberration was 0.24 ± 0.10 μm, which is the only factor influencing postoperatively UNVA, and it was negatively correlated with UNVA and glare contrast sensitivity under 18 cpd (cycle/degree, cpd) spatial frequency (r = -0.403, -0.300, -0.360; all P < 0.05). Additionally, the greater the residual spherical aberration of the cornea, the better the near vision after operation. The mean postoperative ocular spherical aberration was -0.03 ± 0.07 μm, it was not correlated with visual acuity, contrast sensitivity, and visual quality (all P > 0.05).

Conclusion

Preoperative positive spherical aberration can benefit near vision while decrease contrast sensitivities at high spatial frequencies when implanted with the TECNIS Symfony IOL.

Visual quality analysis using the Chinese Catquest-9SF scale following different spherical aberration IOL implantation

Purpose

Based on the Chinese version of the Catquest-9SF scale, the contrast sensitivity meter and wavefront aberrometer were used to evaluate the visual quality of cataract patients implanted with different spherical aberrations IOL.

Design

Retrospective Observational Study.

Methods

Patients who had the lens implantation in our department from January 2020 to December 2021 were enrolled. All patients underwent uncorrected visual acuity, best corrected visual acuity and slit lamp microscope, high-order aberrations and contrast sensitivity test. The KR-1W wavefront analyzer (Topcon Medical System, Tokyo, Japan) was used to measure wavefront aberrations post-operation. The Chinese Catquest-9SF scale was used to score the postoperative visual satisfaction of the patients.

Results

145 patients were screened according to the exclusion criteria, including 51 patients in the zero aspherical IOL (SOFTEC HD) group, 42 patients in the negative aspherical IOL (ZCB00) group, and a total of 52 patients in the spherical IOL (HQ-201HEP) group. The score was the highest in the zero spherical aberration group, followed by the negative spherical aberration group with the lowest scores in the spherical IOL group. Higher-order aberrations are relatively low in eyes implanted with the zero spherical aberration group. Contrast sensitivity with spherical lenses under glare-free and glare conditions was lower than those with aspheric lenses, and at higher frequencies the zero-aberration aspheric lens performed the best.

Conclusion

The Chinese Catquest-9SF scale provides an indication of visual quality after aspheric IOL implantation.

Comparative analysis of visual quality between unilateral implantation of a trifocal intraocular lens and a rotationally asymmetric refractive multifocal intraocular lens

AIM

To compare visual quality after unilateral cataract surgery with implantation of trifocal intraocular lens (IOL) and asymmetric refractive multifocal IOL.

METHODS

The prospective nonrandom, comparative study consisted of 60 eyes of 60 patients suffering unilateral cataract surgery with implantation of two different IOLs: AT LISA tri 839MP (30 eyes; Carl Zeiss Meditec, Germany) and LS-313 MF30 (30 eyes; Oculentis GmbH, Germany). Visual acuity, refractive outcome, contrast sensitivity, defocus curves, quality of vision, and optical phenomena were evaluated at 3mo postoperatively.

RESULTS

There were no statistical differences between groups in uncorrected distance visual acuity (P=0.13) and uncorrected near visual acuity (P=0.54). In contrast, uncorrected intermediate visual acuity was better in trifocal group compared to the refractive multifocal group (P=0.02). No significant statistical between-group difference was detected in cylinder (P=0.43). Compared to trifocal group, spherical refraction and spherical equivalent in refractive multi focal group were more myopic (P<0.01). Under photopic conditions, no significant statistical differences were found between groups in contrast sensitivity at 3 and 6 cycles per degree (cpd). The refractive multifocal group performed better at 12 and 18 cpd than the trifocal group (P=0.01, P=0.034, respectively). The questionnaires of quality of vision and optical phenomena showed no differences between groups.

CONCLUSION

Trifocal IOL is superior to refractive multifocal IOL in intermediate visual acuity. Rotationally asymmetric refractive multifocal IOL is more myopic in automated refraction and significantly better for the photopic contrast sensitivity at high frequency.

Short-term tear film stability, optical quality and visual performance in two dual-focus contact lenses for myopia control with different optical designs

Purpose

To assess and compare short‐term visual and optical quality and tear film stability between two dual‐focus (DF) prototype myopia control contact lenses (CLs) having different inner zone diameters.

Methods

Twenty‐eight myopic subjects were included in this randomised, double‐masked crossover study. Refraction, best‐corrected visual acuity (VA) and tear film stability were measured at baseline (i.e., when uncorrected). Subjects were then binocularly fitted with the DF CLs, with only the sensorial dominant eye being assessed. Lenses were of the same material and had inner zone diameters of either 2.1 mm (S design) or 4.0 mm (M design). Visual and physical short‐term lens comfort, over‐refraction, best‐corrected VA, stereopsis at 40 cm, best‐corrected photopic and mesopic contrast sensitivity (CS), size and shape of light disturbance (LD), wavefront aberrations, subjective quality of vision (QoV Questionnaire) and tear film stability were measured for each lens.

Results

Both CL designs decreased tear film stability compared with baseline (p < 0.05). VA and photopic CS were within normal values for the subjects' age with each CL. When comparing lenses, the M design promoted better photopic CS for the 18 cycles per degree spatial frequency (p < 0.001) and better LD (p < 0.02). However, higher‐order aberrations were improved with the S design (p = 0.02). No significant difference between the two CLs was found for QoV scores and tear film stability.

Conclusions

Both DF CLs provided acceptable visual performance under photopic conditions. The 4.0 mm inner zone gave better contrast sensitivity at high frequencies and lower light disturbance, while the 2.1 mm central diameter induced fewer higher‐order aberrations for a 5 mm pupil diameter. Both CLs produced the same subjective visual short‐term lens comfort.

Two-Year Visual Outcomes of Evolution Implantable Collamer Lens and Small Incision Lenticule Extraction for the Correction of Low Myopia

Purpose

To investigate the 2-year visual quality of Evolution Implantable Collamer Lens (EVO-ICL) and small incision lenticule extraction (SMILE) for the correction of low myopia.

Methods

In this prospective study, we included 25 eyes of 25 patients (7 men) who underwent EVO-ICL and 36 eyes of 36 patients (16 men) who underwent SMILE between January 2018 and December 2018. Subjective and objective visual outcomes were compared between ICL and SMILE. All patients were followed for 2 years.

Results

At the postoperative 2-year visit, the percentage of patients with uncorrected distance visual acuity (UDVA) greater than or equal to preoperative corrected distance visual acuity (CDVA) was comparable in the ICL group (80%, 20/25) and SMILE group (88.89%, 32/36). Spherical equivalent (SE) was within ± 0.50 D in 96% (24/25) of the ICL group and 94.44% (34/36) of the SMILE group. No eyes lost more than 2 lines of CDVA. Postoperative high-order aberrations (HOAs) were significantly increased in the ICL group (p < 0.01) and in the SMILE group (p < 0.01). The most common visual complaint was halo after ICL and starburst after SMILE. There was no correlation between HOAs and visual complaints (p > 0.05).

Conclusion

Evolution Implantable Collamer Lens provides comparable safety, efficacy, long-term visual stability, and high patient satisfaction when compared to SMILE in correcting low myopia. EVO-ICL could be a favorable alternative for low myopia.

Key messages What was known?

What this paper adds?

Reinforced Palmprint Reconstruction Attacks in Biometric Systems

Biometric signals can be acquired with different sensors and recognized in secure identity management systems. However, it is vulnerable to various attacks that compromise the security management in many applications, such as industrial IoT. In a real-world scenario, the target template stored in the database of a biometric system can possibly be leaked, and then used to reconstruct a fake image to fool the biometric system. As such, many reconstruction attacks have been proposed, yet unsatisfactory naturalness, poor visual quality or incompleteness remains as major limitations. Thus, two reinforced palmprint reconstruction attacks are proposed. Any palmprint image, which can be easily obtained, is used as the initial image, and the region of interest is iteratively modified with deep reinforcement strategies to reduce the matching distance. In the first attack, Modification Constraint within Neighborhood (MCwN) limits the modification extent and suppresses the reckless modification. In the second attack, Batch Member Selection (BMS) selects the significant pixels (SPs) to compose the batch, which are simultaneously modified to a slighter extent to reduce the matching number and the visual-quality degradation. The two reinforced attacks can satisfy all the requirements, which cannot be simultaneously satisfied by the existing attacks. The thorough experiments demonstrate that the two attacks have a highly successful attack rate for palmprint systems based on the most state-of-the-art coding-based methods.

[Changes in the quality of vision after intrastromal allokeratoplasty for keratoconus (clinical observation)]

Scleral lenses, corneal collagen crosslinking, corneal implants and deep anterior keratoplasty are used to correct deforming changes in the cornea at advanced stages of keratoconus, which improves the quality of vision (QoV). The article presents an analysis of changes in QoV in a 30-year-old patient with stage III keratoconus who underwent intracorneal implantation of an allograft with a width of 2.75 mm and thickness of 300 µm at a depth of 370 µm. The following parameters were measured before and 6 months after the procedure: uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), VA with glare, higher order aberrations (HOA), thickness of the lipid layer of the tear film, spatial contrast sensitivity, visual productivity. Observation results show that the K_max index decreased from 55.9 D to 48.0 D, K_min - from 39.8 D to 39.4 D, UCVA increased from 0.1 to 0.8 and BCVA - from 0.35 to 0.8. Thickness of the lipid layer of the tear film remained the same. The glare effect with different degrees of brightness did not affect visual acuity. Spatial contrast sensitivity in photopic conditions at medium frequencies increased from 19 to 37 dB, at high frequencies from - 0.5 to 22.5 dB, in mesopic conditions at medium frequencies from 11 to 28 dB, at high frequencies from - 0.5 to 12 dB. The «coma» and «spherical» aberrations decreased by 2 and 3 times, respectively, while «trefoil» increased by 3 times. Visual productivity increased by 36.8%. It may be concluded that the use of a wide intrastromal allograft in keratoconus improves the patient's visual quality and visual productivity. At the same time, the «vignetting» effect from the graft side is negligible in photopic conditions and is significant in mesopic conditions.

Comparison of small incision lenticule extraction and transepithelial photorefractive keratectomy in terms of visual quality in myopia patients

PURPOSE

To comprehensively compare visual quality between small incision lenticule extraction (SMILE) and transepithelial photorefractive keratectomy (tPRK).

METHODS

Sixty-four eyes in the SMILE group and 42 eyes in the tPRK group were enrolled in this study. In both groups, visual acuity, manifest refraction, higher-order aberrations (HOAs), contrast sensitivity (CS) at four spatial frequencies (3, 6, 12, 18 c/d) under three conditions (photopic, low glare, high glare), the cut-off value of the modulation transfer function (MTFcut-off), the objective scatter index (OSI) and the Strehl ratio (SR) were measured preoperatively and 1, 3 and 6 months postoperatively.

RESULTS

At 6 months postoperatively, the SMILE and tPRK groups showed similar safety, efficacy and predictability. Additionally, MTFcut-off, SR and OSI exhibited comparable results. In contrast, the photopic area under the logarithm of the CS function (AULCSF) showed better outcomes in the tPRK group than in the SMILE group (SMILE versus tPRK: 1.21 ± 0.10 versus 1.25 ± 0.09, p = 0.014). Furthermore, the induced coma aberrations were larger in the SMILE group (SMILE versus tPRK: 0.10 ± 0.16 versus 0.06 ± 0.12, 95% CI [0.08, 0.31], p < 0.0001).

CONCLUSIONS

Both SMILE and tPRK obtained comparable visual quality at 6 months postoperatively, accompanied by better photopic CS and smaller induced coma aberrations with tPRK. Paying more attention to alignment or developing a centration technique would be beneficial for visual quality when performing SMILE.

The Effect and the Mechanism of Comprehensive Treatment on the Ocular Surface and the Visual Quality of Online Teachers with a Mild-to-Moderate Dry Eye Condition During the Early Phase of Coronavirus Disease 2019

Objective

To investigate the effect of comprehensive treatment on ocular surface function and the visual quality of online teachers with a mild-to-moderate dry eye condition during the early phase of coronavirus disease 2019 (COVID-19).

Methods

Secondary school online teachers diagnosed with a mild-to-moderate dry eye disease in our outpatient clinic from February to May 2020 were enrolled in this retrospective cross-section study, and all patients received dry eye comprehensive treatment. A questionnaire survey on eye-use habits, visual quality and dry eye-related indicators was collected before and after treatment (2 and 4 weeks). The changes and the correlations between indicators before and after treatment were compared.

Results

A total of 30 patients (15 females and 15 males) were included. After comprehensive treatment, patients had significantly higher central tear meniscus height (TMH), non-invasive first tear film breakup time (NIBUTf) and non-invasive average tear film breakup time (NIBUTav) than those before with statistical significance (P < 0.05). Lower ocular surface disease index (OSDI) and Meibomian gland scores were observed after treatment with statistical significance (P < 0.05). Objective scatter index (OSI), modulation transfer function (MTF) cutoff, strehl ratio (SR), and tear film objective scatter index (TF-OSI) were significantly improved after treatment (P < 0.05). Besides, TF-OSI was positively correlated with the changes in OSDI, Meibomian gland score, eye-use duration and OSI with statistical significance (P < 0.05), while it was negatively correlated with NIBUTf, NIBUTav, the TMH of the central lower eyelid, SR, sleep duration, conjunctival congestion and the MTF cutoff (P < 0.05), respectively. No correlation between TF-OSI and ciliary congestion was found (P > 0.05).

Conclusion

Comprehensive treatment could effectively improve the symptoms and visual quality of online teachers with a mild-to-moderate dry eye condition during the early stage of COVID-19 pandemic.

Comparative analysis of the clinical outcomes between wavefront-guided and conventional femtosecond LASIK in myopia and myopia astigmatism

AIM

To compare the clinical outcomes of wavefront guided femtosecond LASIK (WFG LASIK) and conventional femtosecond LASIK (NWFG LASIK) in eyes with myopia and myopia astigmatism.

METHODS

This was a retrospective, nonrandomized, comparative investigation enrolling 236 eyes of 122 patients (18-50y) with low & moderate and high myopia. The WFG group including 97 eyes (50 patients) undergone WFG LASIK and the NWFG group including 139 eyes (72 patients) undergone conventional LASIK. Mean efficacy index, high order aberrations (HOAs), pupil size and the quality of visual questionnaire were evaluated 6mo postoperatively.

RESULTS

There is no difference between WFG group (-0.054±0.049 in logMAR) and NWFG group (-0.040±0.056) in uncorrected distance visual acuity (UDVA) postoperatively. The myopia astigmatism is higher in WFG group than that in NWFG group (P<0.05). However, the mean efficacy index (MEI) in the WFG group (1.09±0.106) is better than that in the NWFG group (1.036±0.124; P<0.001). Increased HOAs were observed in NWFG group (0.30±0.196) than that in WFG group (0.146±0.188; P<0.001). The pupil size is larger in WFG group (5.15±0.76 mm) than that in NWFG group (4.32±0.52 mm). The patients are satisfied with the clinical surgery, yet WFG group showed better visual quality using the questionnaire survey. Meanwhile, high myopia would result in worse MEI, HOAs and visual quality than low & moderate myopia.

CONCLUSION

WFG and NWFG FS-LASIK are both effective and safe procedures to correct low & moderate and high myopia, but WFG FS-LASIK gives a better postoperative MEI, aberrometric control and predictable outcome. Meanwhile, WFG FS-LASIK is better than NWFG FS-LASIK in correction of myopia astigmatism. Low & moderate myopia allow better clinical outcomes than high myopia using any surgical method.

Visual Performance Following Bilateral Implantation of Refractive Rotationally Asymmetric Bifocal Intraocular Lens (LS-313 MF30) or Apodized Diffractive Bifocal Intraocular Lens (ReSTOR SN6AD1)

Purpose

This study compared the clinical outcomes after cataract surgery with implantation of refractive rotationally asymmetric bifocal intraocular lens (IOL) (LS-313 MF30) and apodized diffractive bifocal IOL (ReSTOR SN6AD1).

Methods

This was a prospective, non-randomized, controlled study, where patients diagnosed with age-related cataracts were selected for phacoemulsification combined with bilateral IOL implantation. Based on the type of IOL voluntarily implanted, the patients were divided into two groups, ie, refractive and diffractive groups. In total, 30 cases (60 eyes) were in a refractive group, while 30 cases (60 eyes) were in diffractive group. Three months after surgery, we examined the uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), defocus curve, objective visual quality, and subjective questionnaire.

Results

Three months after surgery, the UIVA of the refractive group (0.18 ± 0.08) logMAR was better than that of the diffractive group (0.29 ± 0.16) logMAR (P < 0.05). No significant difference in UDVA and UNVA was noted between the two groups. For a 4mm pupil diameter, the intraocular and total eye aberration, higher-order aberration (HOA), coma, spherical aberration, and trefoil in the refractive group were significantly higher than those in diffractive group (P < 0.05). The intraocular modulation transfer function (MTF), intraocular strehl ratio (SR), total eye MTF, and total eye SR in the refractive group were lower than those in diffractive group (P < 0.05). No significant difference in glare incidence, spectacle independence rate, and patient satisfaction was observed between the two groups (P > 0.05). The halos incidence in the refractive group was lower than the diffractive group (P < 0.05).

Conclusion

Both bifocal IOLs obtained satisfactory UDVA and UNVA, with higher patient satisfaction. Unlike the apodized diffractive bifocal IOL, the refractive rotationally asymmetric bifocal IOL yielded slightly better UIVA, lower halos incidence, whereas the apodized diffractive bifocal IOL showed a better objective visual quality.

Effects of Combined Aerosolization with Ultraviolet C Light-Emitting Diode on Enterohemorrhagic Escherichia coli and Staphylococcus aureus Attached to Soft Fresh Produce

Washing soft fresh produce such as strawberries, baby leaves, and sliced onions with sanitizing agents is challenging due to their fragile texture. Thus, treatments like aerosolization using slightly acidic electrolyzed water (SAEW) and ultraviolet C light-emitting diode (UVC LED) irradiation may be good alternatives. In the present study, the reduction effects of a combined treatment of aerosolization using SAEW and UVC LED irradiation on enterohemorrhagic Escherichia coli (EHEC) and Staphylococcus aureus attached to strawberries, baby leaves, and sliced onions were investigated. The behaviours of EHEC and S. aureus, moisture loss, colour measurement, and visual appearance were also analyzed at 10 and 15 °C for 7 days. The reduction effect of the combined treatment with 100 SAEW and UVC LED was higher (0.53–0.92 log CFU g⁻¹) than a single aerosolization treatment (0.11–0.41 log CFU g⁻¹), regardless of samples or pathogens. A greater effect on EHEC and S. aureus reduction was observed in strawberries (0.74 and 0.92 log CFU g⁻¹) than in baby leaves (0.62 and 0.53 log CFU g⁻¹) and sliced onions (0.55 and 0.62 log CFU g⁻¹). The combined treatment further reduced the EHEC and S. aureus populations in strawberries during 7 days of storage at 10 and 15 °C. However, the EHEC and S. aureus populations were maintained in baby leaves and sliced onions at 10 °C for 7 days. Additionally, the greatest effect on the maintenance of colour and appearance was obtained in the combined treatment. Since the combined treatment reduces EHEC and S. aureus populations and preserves visual quality, it could be expected to extend the shelf life of soft fresh produce at the retailer stage of the supply chain.

Factors associated with corneal high-order aberrations before and after femtosecond laser-assisted in situ keratomileusis

Background

Corneal high-order aberrations (HOAs) are related to visual quality. However, the factors associated with corneal HOAs before and after femtosecond laser-assisted in situ keratomileusis (FS-LASIK) have not yet been elucidated. The aim of this study is to observe the factors related to corneal HOAs before and after FS-LASIK.

Methods

Prospective observational study was designed to measure corneal HOAs in 149 eyes of 75 patients before and 6 months after FS-LASIK. The relationship between spherical diopter and corneal parameters, including K1 and K2 (horizontal and vertical refractive power of the cornea, respectively), the aspheric characteristics of the cornea (Q), mean radius of the curvature of the cornea (Rm), and central corneal thickness (CCT), with corneal HOAs were analyzed.

Results

The spherical diopter was correlated with trefoil at 30° before surgery and with vertical coma, four-order astigmatism at 0°, trefoil at 30°, spherical aberration, and six-order spherical aberration after surgery (P<0.05). CCT was correlated with vertical coma, four-order astigmatism at 0°, trefoil at 30°, and six-order spherical aberration after surgery (P<0.05). K1 was correlated with spherical aberration and six-order astigmatism at 0° before surgery (P<0.05). K2 was correlated with spherical aberration, six-order astigmatism at 45°, astigmatism at 0°, six-order astigmatism at 0° before surgery, and trefoil at 30° after surgery (P<0.05). Q was correlated with spherical aberration, six-order spherical aberration, and six-order astigmatism at 45° (P<0.05). Rm was correlated with six-order astigmatism at 0°, spherical aberration, six-order astigmatism at 45° before surgery, and astigmatism at 0° after surgery (P<0.05)

Conclusions

Corneal parameters and spherical diopter are related to the HOAs of the cornea before and after FS-LASIK.

Educational Value of Endoscopic Versus Microscopic Ear Surgery

OBJECTIVE

To compare the educational value of endoscopic ear surgery versus microscopic ear surgery among medical students.

METHODS

Medical students anonymously completed a cross-sectional survey immediately after observing endoscopic or microscopic ear surgery. A Likert scale (1 = worst, 5 = best) was used to analyze variables across 3 domains including: (1) area of interest visibility, (2) optical quality, (3) education and understanding. The Mann-Whitney U-test and multivariable linear regression were used to compare mean scores of individual items and domain means between endoscopic and microscopic groups.

RESULTS

Forty-four surveys were analyzed (20 endoscopic and 24 microscopic ear surgeries). Across domains, the endoscope was superior to the microscope (adjusted P < .05) for visibility of the area of interest (mean ± SD: 4.74 ± 0.26 vs 4.28 ± 0.50), optical quality (4.78 ± 0.38 vs 4.28 ± 0.64), and education and understanding (4.70 ± 0.47 vs 4.13 ± 0.61). In multivariable linear regression, the mean domain score for visibility of the area of interest was 1.23 (95% CI = 0.56, 1.90; adjusted P < .01) points higher for the endoscopic group, compared to the microscopic group, adjusting for surgeon, procedure, and student type. The mean domain score for education and understanding was 1.19 (95% CI = 0.49. 1.90; adjusted P < 0.01) points higher for the endoscopic group, compared to the microscopic group, adjusting for the same confounders.

CONCLUSIONS

Among medical students, endoscopic ear surgery was superior to microscopic ear surgery for several visual quality indicators and perceived educational benefit. These findings have implications for medical student education and surgical training.

Strehl Ratio and Myopia in Chinese Adolescents: The Tuyou County Pediatric Eye (TYPE) Study

Aim

To investigate the relationships between property of the visual quality, Strehl ratio (SR) and the degree of myopia.

Methods

A total of 444 anatomically normal eyes of 222 adolescents were enrolled in the TYPE study. Based on spherical equivalent (SE), subjects were divided into four groups: emmetropia/control (SE: +0.75 to −0.75 D), low myopia (SE: −0.75 to −3.00D), moderate myopia (SE: −3.00 to −5.00D), high myopia (SE: <−5.00D). Axial length (AL) was measured. SR was attained with an OPD-III SCAN and calculated under a 3 mm pupil diameter.

Results

The overall SR (mean ± SD) was 0.40 ± 0.08. Among all included eyes, the SR in eyes with the emmetropia, low myopia, moderate myopia and high myopia was 0.80 ± 0.11, 0.31 ± 0.04, 0.21 ± 0.11, and 0.11 ± 0.02, respectively. Furthermore, the K2 in eyes with the emmetropia, low myopia, moderate myopia and high myopia was 43.83±1.50, 43.96±1.37, 43.4±5.52, and 45.16±1.43, respectively. Significant differences were detected within the four groups in terms of SR and K2 (P < 0.001). Multiple regression analysis confirmed that AL negatively affected SR independently (P < 0.001).

Conclusion

Our findings provide a useful basis for the conclusion that myopia affects visual quality SR in Chinese adolescents. Besides, when performing visual quality SR, axial length must be taken into consideration, as it will influence SR.

Aggressive Driving Behaviours in Cannabis Users. The Influence of Consumer Characteristics

This study analysed dangerous driving behaviours in twenty young occasional cannabis users through objective and self-reported data, studying the relationship between the two aspects. Visual function was assessed in a baseline session and after smoking cannabis, as well as speed-related behaviour in a driving simulator. The participants responded to questionnaires on sociodemographic factors, their consumption profile, and the incidence of dangerous behaviours (Dula Dangerous Driving Index; DDDI). After cannabis use, the results revealed a significant deterioration in visual function. In terms of speed management, they showed significantly greater acceleration force in the two different sections of the route, and they drove significantly faster. Our correlations indicate that males and heavier users display more risky speed management. Likewise, the heavier cannabis users admitted to increased dangerous driving behaviour, and an accident in the preceding year was associated with a trend towards aggressive driving behaviour according to the DDDI questionnaire. The findings of this study suggest that cannabis users adopt dangerous behaviours when driving, despite the effect this drug has on certain important functions, such as vision. The results suggest a need for awareness-raising and information campaigns.

A picture is not always worth a thousand words: The visual quality of photographs affects the effectiveness of interpretive signage for science communication

Photographs are widely used to visualise science. However, the influence of visual quality of photographs on the effectiveness of science communication is often disregarded and seldom tested. This study examines how the visual quality of photographs affects science communication on interpretive signage within Xixi National Wetland Park, China. Results show that a high-quality photograph on the signage significantly increased the following affective and cognitive aspects of communication: (1) a visitor's intention to read the signage, (2) enjoyment of reading the interpretive information, (3) understanding and (4) recall of the information on the signage. This study offers empirical evidence for the benefits of using high-quality photographs to visualise science. To improve the effectiveness of science communication in interpretive products, we argue that the quality of the selected photographs should be considered seriously.

Do Radiographic Assessments of Periodontal Bone Loss Improve with Deep Learning Methods for Enhanced Image Resolution?

Resolution plays an essential role in oral imaging for periodontal disease assessment. Nevertheless, due to limitations in acquisition tools, a considerable number of oral examinations have low resolution, making the evaluation of this kind of lesion difficult. Recently, the use of deep-learning methods for image resolution improvement has seen an increase in the literature. In this work, we performed two studies to evaluate the effects of using different resolution improvement methods (nearest, bilinear, bicubic, Lanczos, SRCNN, and SRGAN). In the first one, specialized dentists visually analyzed the quality of images treated with these techniques. In the second study, we used those methods as different pre-processing steps for inputs of convolutional neural network (CNN) classifiers (Inception and ResNet) and evaluated whether this process leads to better results. The deep-learning methods lead to a substantial improvement in the visual quality of images but do not necessarily promote better classifier performance.

Objective visual quality one year after toric IOL implantation for correction of moderate and high corneal astigmatism

AIM

To compare the objective visual quality after implantation of a toric intraocular lens (IOL) in order to correct moderate or high corneal astigmatism at the one year postoperative follow-up.

METHODS

From December 2017 to June 2018, 66 patients (90 eyes) with simple age-related cataract with regular corneal astigmatism greater than 1.5 D were enrolled in this prospective self-control study. The patients were implanted with Proming^® toric IOL (model: AT3BH-AT6BH). The subjects were divided into moderate astigmatism group (46 eyes, 1.5-2.5 D) and high astigmatism group (44 eyes, >2.5 D). The uncorrected distance visual acuity, residual astigmatism and axial position of IOL were observed before operation, 3, 6mo and 1y after operation. Modulation transfer function cutoff (MTF cutoff), Strehl ratio (SR), object scatter index (OSI) were observed by OQAS II to evaluate the objective visual quality of patients.

RESULTS

There was no significant difference in UCVA, residual astigmatism, axial deviation, MTF cutoff, SR and OSI between moderate and high astigmatism group (all P>0.05). After 3mo, UCVA, MTF cutoff and SR were significantly increased (all P<0.05), residual astigmatism and OSI were significantly decreased (all P<0.05). After 3mo, all the indexes remained stable.

CONCLUSION

Proming toric IOL can effectively treat age-related cataract patients with moderate-to-high regular corneal astigmatism, correcting corneal astigmatism, improving UCVA, ensuring long-term stability in the capsule, and providing patients with better visual quality.

Comparison of the visual performance between Oculentis MF30 and Tecnis ZMB00 multifocal intraocular lenses

Background

To compare the visual performance of MF30 asymmetric refractive multifocal intraocular lenses (MIOLs) with ZMB00 all optic zone diffractive MIOLs.

Methods

This is a prospective study. Patients that underwent phacoemulsification were divided into two groups according to the type of MIOLs used: 35 patients were implanted with asymmetric refractive MIOLs and 35 patients with all optic zone diffractive MIOLs. Visual acuity (VA), refraction, defocus curves, objective optical quality, and a questionnaire evaluating quality of life were measured at 3 months postoperatively.

Results

There were no significant differences between the two groups in uncorrected distance visual acuity (UDVA), uncorrected near visual acuity (UNVA), best-corrected distance visual acuity (BCDVA), or distance-corrected near visual acuity (DCNVA). However, the uncorrected intermediate VA was 0.24±0.10 in the refractive group and 0.31±0.13 in the diffractive group (P<0.05), and the distance-corrected intermediate VA was 0.22±0.09 in the refractive group and 0.31±0.14 in the diffractive group (P<0.05). Defocus curves showed two peaks of maximum vision in both groups. However, the curve between the two peaks in the refractive group was smoother than that of the diffractive group. The modulated transfer function cut-off frequency was 22.74±12.29 c/d in the refractive group and 30.50±10.04 c/d in the diffractive group (P<0.05). The Optical Quality Analysis System (OQAS) values 100% (OV100%) was 0.75±0.41 in the refractive group and 1.02±0.34 in the diffractive group (P<0.05), while the OV20% was 0.52±0.34 in the refractive group and 0.71±0.25 in the diffractive group (P<0.05). There was no significant difference between the two groups in overall satisfaction, spectacle independence ratio, or visual interference phenomenon.

Conclusions

Both MIOLs achieve good VA at distance and near vision. Oculentis MF30 showed better intermediate VA, and Tecnis ZMB00 appears to have better objective visual quality.

Trial registration

NCT02234635 (http://www.clinicaltrials.gov).

Comparison of objective and subjective visual quality early after implantable collamer lens V4c (ICL V4c) and small incision lenticule extraction (SMILE) for high myopia correction

PURPOSE

To investigate differences in the objective and subjective visual quality of patients with high myopia following implantable collamer lens V4c (ICL V4c) versus small incision lenticule extraction (SMILE) early postoperatively.

METHODS

This prospective analysis included 94 eyes of 57 patients (8 males) in the ICL V4c group (mean spherical equivalent (SE), -8.07 ± 1.03 dioptres (D)) and 103 eyes of 57 patients (13 males) in the SMILE group (mean SE, -7.85 ± 0.78 D). Refractive parameters and wavefront aberrations were recorded preoperatively and 6 months postoperatively. Subjective visual quality was scored with the Quality of Vision questionnaire, and operation satisfaction was evaluated 6 months postoperatively.

RESULTS

At 6 months postoperatively, the efficacy index was 1.17 ± 0.16 in the ICL and 1.09 ± 0.20 in the SMILE group; the safety index was 1.21 ± 0.18 in the ICL and 1.12 ± 0.16 in the SMILE group. A significant increase in total higher-order aberrations (HOAs) in both the ICL and SMILE groups was observed, but to a lesser degree in ICL (p < 0.05). In the ICL group, trefoil significantly increased (p < 0.05), whereas in the SMILE group, coma, trefoil and spherical aberration significantly increased (p < 0.05). Glare, haloes and blurred vision had the highest incidences after both types of surgery, and postoperative haloes were significantly more common following ICL; 96.1% of ICL-treated and 94.9% of SMILE-treated patients were satisfied with their visual outcomes.

CONCLUSION

ICL V4c caused lower HOAs induction than SMILE. Despite the postoperative visual disturbances, both ICL and SMILE provided good efficacy, safety, predictability and high satisfaction in correcting high myopia.

Management of cap striae following challenging small incision lenticule extraction surgery - A case report

A 24-year-old female underwent small incision lenticule extraction (SMILE) for myopic astigmatism OU. In the left eye, cap-lenticular adhesion along with tearing of the cap occurred, resulting in a gaped incision and transverse striae involving the visual axis on the first post op day. Uncorrected distance visual acuity (UDVA) was 20/32. The case was managed with interface wash and stretching of the cap, in order to iron out the striae. Post intervention, the UDVA improved to 20/20, striae resolved, and interface remained clear through a follow-up of nine months, suggesting that cap striae in SMILE may be similarly managed as the flap striae in laser-assisted in situ keratomileusis (LASIK), resulting in satisfactory visual outcomes.

Comparison of visual quality after implantation of A1-UV and SN60WF aspheric intraocular lens

AIM

To compare the visual performance of pseudophakic eyes implanted with A1-UV and SN60WF aspheric intraocular lens (IOL), and to investigate the correlations between visual quality parameters and pupil size.

METHODS

This prospective comparative study included 105 eyes of 90 patients with age-related cataract who underwent uneventful phacoemulsification. The subjects were divided into two groups according to the implanted IOL type. Three months postoperatively, visual acuity and contrast sensitivity were measured, wave-front aberrations were assessed using a KR-1W aberrometer (Topcon), and objective optical quality parameters were performed using an optical quality analysis system-OQAS II (Visiometrics). Independent sample t-test and Spearman correlation analysis were used for data analysis.

RESULTS

There were no significant differences found in visual acuity, contrast sensitivity and visual quality parameters between the two groups (P>0.05). The measured intraocular spherical aberration (SA) in A1-UV IOL eyes of -0.19±0.05 µm was close to the designed SA value of -0.20 µm. The modulation transfer function cutoff, Strehl ratio and OQAS values were negatively correlated with pupil size in both groups (P<0.01).

CONCLUSION

The subjective and objective visual quality in pseudophakic eyes with A1-UV and SN60WF IOLs are comparable. For aspheric IOL eyes, visual quality decreases with increasing pupil size.

Corneal wavefront aberrations and subjective quality of vision after small incision lenticule extraction

PURPOSE

To analyse in depth the associations between objectively measured corneal higher-order aberrations (HOAs) and subjectively perceived visual quality after small incision lenticule extraction (SMILE) as quantified with the standardized and clinically validated quality of vision (QOV) questionnaire.

METHODS

This cross-sectional study included patients after bilateral simultaneous SMILE for the treatment of myopia and/or myopic astigmatism with plano target refraction. Scheimpflug imaging (Pentacam HR; Oculus Optikgeräte GmbH, Wetzlar, Germany) was used to objectively quantify corneal HOAs. The standardized and validated QOV questionnaire was employed to gauge patients' subjectively perceived visual quality regarding frequency, severity and bothering effect of visual disturbances.

RESULTS

A total of 394 eyes of 197 patients with a mean age of 32.4 ± 7.7 years and a mean postoperative follow-up of 24.3 ± 14.1 months were included. SMILE induced a statistically significant (p < 0.001) increase in spherical aberration (0.074 ± 0.131 µm), coma (0.142 ± 0.179 µm), trefoil (0.018 ± 0.067 µm) as well as in total HOAs (0.191 ± 0.176 µm). Surgically induced and postoperative levels of HOA showed no correlation with the three QOV scores representative of overall visual symptom frequency, severity and bothering effect (all R² values ≤ 0.016). In addition, the associations between specific visual symptoms (e.g. starburst) and singular HOA terms (e.g. haloes) were very weak (all Rho values ≤ 0.164).

CONCLUSIONS

Small incision lenticule extraction induced significant amounts of corneal HOAs that, however, showed no clear relationships to patient-reported QOV or specific long-term visual symptoms.

Implantable collamer lens with a central hole for residual refractive error correction after corneal refractive surgery

The present study aimed to assess the visual and refractive outcomes of an implantable collamer lens with a central hole (ICL V4c) for residual refractive error correction after corneal refractive surgery in individuals with myopia. A total of 16 eyes of eight consecutive patients with myopia undergoing ICL V4c implantation after corneal refractive surgery were investigated. The uncorrected visual acuity (VA) and best-corrected VA were examined prior to surgery and at 1, 3 and 6 months after surgery. The post-operative values of the modulation transfer function (MTF) cutoff frequency, Strehl ratio (SR), objective scattering index (OSI) and Optical Quality Analysis System (OQAS) values (OVs) were quantitatively assessed using an OQAS. At 6 months after surgery, the mean uncorrected LogMAR VA was 0.06±0.10 and the values had improved in 100% of the eyes. The mean MTF cutoff frequency, SR, OSI, OV 100%, OV 20% and OV 9%, were 31.294±4.321 cycles/degree, 0.187±0.039, 1.399±0.274, 1.066±0.261, 0.748±0.287 and 0.509±0.229, respectively. In conclusion, ICL V4c implantation for the correction of residual refractive error after corneal refractive surgery appeared feasible and safe and also had an excellent optical performance. However, long-term changes in visual quality require further investigation.

Influence of angle kappa-customized implantation of rotationally asymmetric multifocal intraocular lens on visual quality and patient satisfaction

PURPOSE

To evaluate the visual outcomes and patient satisfaction with angle kappa-customized implantation of SBL-3 (Lenstec, Inc.; +3 D), a rotationally asymmetric multifocal intraocular lens (MIOL).

METHODS

This was a prospective randomized control study. Data from consecutive patients, who underwent bilateral implantation of SBL-3 MIOL from June 2017 to August 2018, were enrolled in the study. One eye of each patient was randomly chosen to receive a horizontal IOL placement (control group), while the other eye received angle kappa-customized placement (design group). The outcomes include uncorrected distance visual acuity (UDVA), uncorrected intermediate visual acuity (UIVA), uncorrected near visual acuity (UNVA), defocus curve, contrast sensitivity, quality of vision and patient satisfaction. The follow-up was 3 months.

RESULTS

The study enrolled 80 eyes of 40 patients. There was no significant difference in mean UDVA, UIVA and UNVA between the two groups. The design group showed significantly better visual acuity at -1.50 D of defocus, based on the defocus curve (p = 0.022), and less vertical coma (p = 0.002) than the control group. No significant differences in contrast sensitivity, modulation transfer function, Strehl ratio and patient satisfaction were found between the two groups.

CONCLUSION

Angle kappa-customized implantation of SBL-3 had little impact on visual outcomes and patient satisfaction, except for a moderate impact on intermediate visual acuity.

Clinical results of orthokeratology therapy in adolescents with low to moderate myopia

OBJECTIVES

To observe the clinical results of orthokeratology therapy in adolescents with low to moderate myopia after wearing the lens for 6 months.

METHODS

The data of 69 adolescents with low to moderate myopia were retrospectively analyzed. According to the degree of spherical power before treatment, the adolescents were divided into a low myopia group (34 cases, with spherical diopter from -3.00 to -0.75 D) and a moderate myopia group (35 cases, with spherical diopter from -5.75 to -3.25 D). The changes of the uncorrected distance visual acuity (UDVA), intraocular pressure, count of endothelial cell, eye axis length, Strehl ratio (SR), modulation transfer function (MTF), Q value, and wavefront aberrations before the treatment and 6 months after the treatment were compared and analyzed between the 2 groups.

RESULTS

Compared with before the treatment, the UDVA improved significantly in the 2 groups (both P<0.05); the intraocular pressure and the count of endothelial cell did not change obviously in the 2 groups (all P>0.05), the eye axial length in the 2 groups was increased significantly (both P<0.05), but there was no significant difference between the 2 groups (all P>0.05); the Q value in the 2 groups was increased significantly, and the change was more obvious for the moderate myopia group (all P<0.05); the SR and MTF were increased remarkably in the 2 groups (all P<0.05), and there were no significant difference in the changes of SR and MTF between the 2 groups (both P>0.05); a considerable decrement was found for the total aberration, the total low-order aberration, and defocus (all P<0.05), and the changes were more significant in the moderate myopia group (all P<0.05); the total high-order aberrations were increased in the low myopia group (P<0.05); the increment of the vertical astigmatism, spherical aberration, horizontal coma, vertical coma, and horizontal trefoil were noticeable (all P<0.05), and the changes of the spherical aberration, vertical coma, and horizontal trefoil were more obvious in the moderate myopia group (all P<0.05).

CONCLUSIONS

Orthokeratology can effectively improve the visual results of the adolescents with low to moderate myopia, and the corrective effect is more obvious for the adolescents with moderate myopia than those with low myopia.

Visual quality observation of clear lens extraction by ultrasonic phacoemulsification and intraocular lens implantation in a child with microspherophakia: A case report

RATIONALE

Microspherophakia is characterized by a small, spherical crystalline lens with increased sagittal diameter. Because of the uncertainty about the outcome, as well as the complexity of the operation and development of complications, the management and timing of surgical intervention for microspherophakia are still debated. Lens extraction is effective for avoiding the risk of pupillary blockage, but the outcome after operation is controversial. The iTrace (Tracey, USA) report shows the influence of low-order aberrations (LOA) and high-order aberrations (HOA), which may be valuable in predicting postoperative outcome. Our report concerns a child with microspherophakia who underwent lens extraction via the analysis of visual quality by iTrace.

PATIENT CONCERNS

Our report is on the case of a 7-year-old girl whose parents observed she had to bring her papers and books extremely close to her face to read. On examination, the girl was bilaterally diagnosed microspherophakia with a small tremble lens. The objective refraction was -15.0 diopter of spherical power (DS)/-1.00 diopter of cylindrical power (DC) × 180 right eye (OD) and -12.5 DS/-1.50 DC × 20 left eye (OS). The HOA of OD and OS were high up to 0.926 and 0.659, respectively by iTrace. The visual quality remained terrible after correcting LOA (high myopia and astigmatism). According to iTrace report, the patient would get a good visual quality by extracting the clear lens with HOA from cornea after correcting LOA. The girl's parent opted for surgery on the left eye.

DIAGNOSIS

Due to the patient's symptoms, examination results, she was diagnosed with microspherophakia.

INTERVENTIONS

The patient underwent clear lens extraction by ultrasonic phacoemulsification and intraocular lens implantation.

OUTCOMES

The first day after operation, total HOA was decreased to 0.077. Total LOA was 0.713. Corrected distance visual acuity (CDVA) is 20/20. One week after surgery, HOA was 0.110 and LOA was 0.328. CDVA was 20/25. CDVA was still 20/25 one month after surgery. The total HOA was 0.110 and the LOA was 0.334 by iTrace.

LESSONS

ITrace not only plays an important role in analyzing potential reasons of undesirable preoperative visual quality but also can predict postoperative outcomes. All these functions are helpful for determining surgical intervention of microspherophakia cases.

Understanding the Impact of Individual Perceived Image Quality Features on Visual Performance

Purpose

This study aimed to quantify the impact of blur, contrast, and ghosting on perceived overall image quality (IQ) as well as resultant predicted visual acuity, utilizing simulated acuity charts from objective refraction among eyes of individuals with Down syndrome (DS).

Methods

Acuity charts were produced, simulating the retinal image when applying 16 different metric-derived sphero-cylindrical refractions for each eye of 30 adult patients with DS. Fourteen dilated adult observers (normal vision) viewed subsets of logMAR acuity charts displayed on an LCD monitor monocularly through a unit magnification 3-mm aperture telescope. Observers rated features blur, ghosting, and contrast on 10-point scales (10 = poorest) and overall IQ on a 0- to 100-point scale (100 = best) and read each chart until five total letters were missed (logMAR technique). Mixed modeling was used to estimate feature influence on overall perceived IQ and relative acuity (compared with an unaberrated chart), separately.

Results

Perceived IQ spanned the entire scale (mean = 59 ± 22) and average reduction in relative acuity was two lines (0.2 ± 0.14 logMAR). Perceived blur, ghosting, and contrast were individually correlated with overall IQ and relative acuity. Blur, contrast, and ghosting exert unique effects on overall perceived IQ (P < 0.05). Blur (b = -.009, P < 0.001) and ghosting (b = -.003, P < 0.001) influence relative acuity over and beyond their effects on overall IQ (b = .001, P < 0.0001) and contrast.

Conclusions

Objectively identified refractions would ideally provide high contrast, low blur, and low ghosting. These data suggest that blur and ghosting may be given priority over contrast when improving acuity is the goal.

Translational Relevance

Findings may guide objective refraction in clinical care.

VioBio lab adaptive optics: technology and applications by women vision scientists

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.

Personalized aspheric intraocular lens implantation based on corneal spherical aberration: a review

With the evolution of cataract surgery from visual rehabilitation to refractive surgery, aspheric intraocular lenses (IOLs) are being increasingly used in the field of ophthalmology. This increased use can be attributed to negative or zero spherical aberrations with unique optical designs, which counteract some of the positive spherical aberrations of the cornea. These alterations reduce the total spherical aberration of human eyes and improve the visual acuity in patients with cataract postoperatively. At present, various types of aspheric IOLs are used worldwide. Although the implantation of aspheric IOL is beneficial to the patients who need correction of spherical aberrations, much controversy is still associated with ocular residual spherical aberrations that facilitate the best visual quality for patients postoperatively. In order to provide reference for future clinical work and scientific research, this report reviews the relationship between the ocular residual spherical aberration of human eyes and visual quality.

Evaluation of visual quality after EVO-ICL implantation for hypermyopia: An observational study

The purpose of this retrospective study was to evaluate the visual quality, objective scattering index, aberration, etc after Implantable Collamer Lens with center hole (EVO-ICL) implantation to treat patients with hypermyopia (diopter > -10 D).A total of 30 eyes underwent EVO-ICL implantation. The uncorrected distance visual acuity (UDVA), best-corrected visual acuity (BCVA), equivalent spherical degree, aberration, visual quality parameters, and corneal endothelial cell density were compared preoperative and postoperative. Fill in the National Eye Institute Refractive Error Quality of Life Instrument-42 before and after surgery.The modulation transfer function (MTF), Optical Quality Analysis System (OQAS) II values (OV 100%, 20%, 9%), and Stahl ratio 1 and 3 months after surgery were higher than the respective preoperative values. The objective scatter index value increased 1 week after surgery, but decreased 1 and 3 months after surgery compared with the preoperative values. Total aberration (TA), total low-order aberration (tLOAs), and defocus decreased at 1 week and 3 months after EVO-ICL implantation. Total high-order aberration (tHOAs) and spherical aberration were significantly increased 1 week after surgery and decreased 3 months after surgery, and the difference was statistically significant. Astigmatism, coma, and clover were not significantly different in each time period. TA, tLOAs, tHOAs, defocus, and spherical aberration were higher at 1 week than 3 months after surgery. At 3 months after surgery, the scores of the patients' NEI-RQL-42 scale were all improved except that the glare was lower than that before surgery. There was no significant difference in the density of corneal endothelial cells before and 3 months after surgery.For patients with hypermyopia, the postoperative subjective and objective visual quality of EVO-ICL implantation was better than preoperative.

Early outcomes of vision and objective visual quality analysis after cataract surgery with trifocal intraocular lens implantation

AIM

To investigate the early outcomes of vision, objective visual quality and their correlation after cataract surgery with trifocal intraocular lens implantation.

METHODS

The visual examination and objective visual quality analysis using Optical Quality Analysis System (OQAS) at 1mo and 3mo, and defocus curve examination at 3mo were performed in 20 patients (27 eyes) after phacoemulsification combined with trifocal intraocular lens implantation surgery.

RESULTS

The uncorrected distant (UD), intermediate and near visual acuity (VA) were significantly improved after surgery (P<0.001). UDVA at 1mo after the surgery was slightly better than that after 3mo (P=0.026). The defocus curve after 3mo indicated that the peak of distant vision was close to 0 logMAR, and UDVA was lower than 0.3 logMAR in the range of -1.5 D to -3.0 D. The modulation transfer function (MTF) cutoff frequency, strehl ratio (SR), Optical Quality Analysis System values (OVs), includes OV100, OV20 and OV9 after the surgery were significantly better than before surgery (P<0.001), but the objective scattering index (OSI) was significantly decreased (P<0.001). UDVA at 3mo after the surgery had correlations with MTF cutoff, OSI, OV100 and OV20 (r=-0.400, 0.431, -0.437, -0.411, P=0.039, 0.025, 0.023, 0.033). The uncorrected intermediate VA after 3mo of the surgery had correlations with OSI and OV100 (r=0.478, -0.411, P=0.012, 0.033).

CONCLUSION

Trifocal intraocular lens implantation can provide good distant, intermediate and near VA, and the vision shows a well correlation with objective visual quality during early surgery.

Evaluation of Visual Quality in Pseudophakic Eyes with Different Ocular Spherical Aberrations

Purpose: To evaluate the effects of different residual total ocular spherical aberration (SA) on objective and subjective visual quality in pseudophakic eyes. Methods: This prospective consecutive study comprised 171 patients with age-related cataract and undergone unilateral uneventful phacoemulsification. All participants were divided into four groups based on residual ocular SA at 6 mm pupil: negative SA (≤-0.10 μm, group A), neutral SA (0.00 ± 0.05 μm, group B), slightly positive SA (0.10 ± 0.05 μm, group C), and more positive SA (0.20 μm, group D), respectively. Subjective visual acuity and contrast sensitivity, and objective optical quality and ocular aberrations were analyzed 3 months postoperatively. Results: There was no significant difference in baseline measurements across all groups. Postoperatively, no statistically significant differences were found in visual acuity between groups (P > .05), while differences reached statistical significance in mesopic contrast sensitivity at 12 and 18 cpd (P < .01). There were significant differences in ocular SA and higher-order aberrations at 6 mm pupil, as well as in optical quality parameters (P < .05). Group C showed a minimum value of objective scatter index (1.17 ± 0.55) but maximum values of modulation transfer function cutoff (31.94 ± 9.18) and optical quality value OV 100% (1.07 ± 0.31), indicating lower intraocular scattering and superior optical quality. Conclusions: This comprehensive evaluation is conducive to deepening the understanding of visual and optical performance of pseudophakic eye. A modest amount of positive ocular SA seemed to be a more preferable option for enhancing visual quality after aspheric ntraocular lense (IOL) implantation.

Contralateral eye comparison of the long-term visual quality and stability between implantable collamer lens and laser refractive surgery for myopia

Purpose

To investigate the long‐term visual quality and stability of implantable collamer lens (ICL) and laser refractive surgery (LRS) for myopia.

Methods

This study comprised 52 eyes of 26 high‐myopia anisometropia patients who were suitable for surgical treatment. In each patient, the higher‐myopia eye was implanted with ICL and the lower‐myopia eye was treated with LRS. The patients were followed for 3 years. During that time period, uncorrected (UDVA) and corrected distance visual acuity (CDVA), refraction, wavefront aberration and visual quality were evaluated.

Results

The spherical equivalent refractive error changed from −14.11 ± 3.39 D preoperatively to −1.27 ± 1.05 D 3 years after ICL implantation and from −8.75 ± 2.76 D to −1.12 ± 1.30 D after LRS. The changes in refractive error from 1 month to 3 years were −0.52 and −0.77 D for the ICL and LRS groups, respectively. The safety indices (postoperative CDVA/preoperative CDVA) were 1.84 ± 1.00 and 1.32 ± 0.40, and the efficacy indices (postoperative UDVA/preoperative CDVA) were 1.40 ± 1.10 and 1.11 ± 0.44, respectively. The postoperative coma, spherical and total higher‐order aberrations in the ICL group were lower than those in the LRS group.

Conclusion

Both ICL implantation and LRS are safe and effective procedures for myopia with suitable indications, but ICL implantation is more stable. Fewer induced aberrations are gained after ICL implantation.