Measurement of accommodative amplitude using wavefront aberrometer

@#<p style="font-size: 12.16px; text-align: justify;"><strong>OBJECTIVE:</strong> To measure and compare the accommodative amplitude of Filipino patients with different accommodative conditions using a wavefront aberrometer.</p> <p style="font-size: 12.16px; text-align: justify;"><strong>METHODS:</strong> A total of 120 eyes of 67 patients seen in a private eye center were included and divided into two groups (phakic and pseudophakic). After undergoing routine ophthalmologic examination that included manifest refraction and visual acuity testing, accomodative amplitude was measured using the iTraceTM wavefront aberrometer. Comparison of the measurements was made between the accommodative amplitude of phakic pre-presbyopes and presbyopes, and between eyes implanted with monofocal and accommodating intraocular lenses (IOLs).</p> <p style="font-size: 12.16px; text-align: justify;"><strong>RESULTS</strong>: The mean age of the pre-presbyopes was 27 years, presbyopes 50 years, monofocal IOL 69 years and accommodating IOL 67 years. The mean accommodative amplitude of the pre-presbyopes was 1.64 ± 1.06D, presbyopes 0.99 ± 0.42D, monofocal IOL 0.36 ± 1.16D, and accommodating IOL 0.94 ± 0.89D. The pre-presbyopes had a higher accommodative amplitude than the presbyopes (p=0.008), while the accommodating IOL subgroup had a higher amplitude than the monofocal IOL subgroup (p=0.02). Increasing age was correlated with decreasing amplitude in the phakic group (r2=0.926). There was no correlation between refractive error and amplitude of accommodation in the phakic and pseudophakic groups (r2=0.02 for both groups).</p> <p style="font-size: 12.16px; text-align: justify;"><strong>CONCLUSION:</strong> The wavefront aberrometer is a reliable tool in objectively measuring accommodative amplitude. Pre-presbyopes and accommodating IOLs were shown to have higher amplitudes of accommodation than presbyopes and monofocal IOLs.</p>

The quality of life in patients with non-surgical and surgical presbyopic corrections

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To compare the quality of life using the National Eye Institute Refractive Error Quality of Life (NEI-RQL) instrument in 40-60 year-old patients with reading glasses and presbyopic LASIK correction and in 60-80 year-old patients with monofocal and multifocal intraocular lenses (IOLs).</p> <p style="text-align: justify;"><strong>METHODS:</strong> Patients aged 40-80 years old with reading glasses (group 1a) or presbyopic LASIK treatment (group 1b) and bilateral pseudophakia with monofocal (group 2a) or multifocal IOLs (group 2b) were recruited. All patients answered the NEI-RQL questionnaire. The responses in the self-administered questionnaires were collated, analyzed, and compared between the subgroups.</p> <p style="text-align: justify;"><strong>RESULTS</strong>: One hundred fifty patients (median age 60 years, range 41-80 years) completed the NEI-RQL questionnaire. Subjects (age 41-59 years) who underwent presbyopic LASIK correction had a higher mean NEI-RQL (p=0.19) and higher subscale score for satisfaction (p=0.42) than those wearing reading glasses. However, the differences were not satistically significant.</p> <p style="text-align: justify;"><strong>CONCLUSION:</strong> Presbyopic LASIK improved uncorrected near visual acuity and provided spectacle independence in presbyopes; however, patient satisfaction was similar to those who with reading glasses. Multifocal IOLs significantly improved uncorrected near visual acuity and spectacle independence in pseudophakic patients with high patient satisfaction.</p>

Comparison of the rotational stability of different toric intraocular lens implants

@#<p style="text-align: justify;"><strong>OBJECTIVE:</strong> To compare the rotational stability and cylinder reduction of different toric intraocular lenses (IOLs).<br /><strong>METHOD:</strong> This was a prospective, cross-sectional study of 68 eyes that had at least 0.75 diopters (D) of corneal astigmatism prior to cataract surgery and were at least 3 months post-toric IOL implantation (Envista, AcrySof, FineVision). Patients recruited underwent visual acuity testing, manifest refraction, pupil dilation, and toric IOL axis determination. Actual axis position was obtained and compared to the intended axis calculated from the tonic IOL calculator. Any difference between the two was considered an axis deviation. Main outcome measures were postoperative deviation of the IOL axis from the intended axis, uncorrected distance visual acuity (LIDVA), best corrected distance visual acuity (BCDVA), manifest refraction, and cylinder reduction.<br /><strong>RESULTS:</strong> There was no significant difference in the rotational stability of the three different types of toric IOLs (p=0.95). Mean axis deviation for .AcrySof, Envista, and FineVision were 2.43, 2.66, and 2.75 degrees, respectively. There was a significant decrease in the cylinder from preoperative to postoperative levels for all groups (p=0.00 for Envista, p=0.03 for AcrySof, and p=0.00 for Fine-Vision). There were significant improvements in the mean UCVA and BCDVA after cataract surgery and implantation of toric IOLs for all three groups.<br /><strong>CONCLUSION:</strong> The three IOL platforms (AcrySof, Envista, and FineVision) showed good rotational stability and significant cylinder reduction:Visual and refractive outcomes improved after surgery.<br /><br /></p>

Visual outcomes and higher-order aberrations of wavefront vs. combined wavefront aspheric

Objective@#We compared the efficacy, safety, refractive and visual outcomes, and aberrometry results of wavefront-guided aspheric treatment (WTA) versus wavefront-guided treatment (WT).@*Methods@#This prospective, contralateral, comparative study included 60 eyes of 30 patients who underwent myopic LASIK. One eye of each patient was randomized to either WTA or WT. Patients were followed up for 3 months postoperatively. Two-tailed paired t-test was used to determine statistical significance.@*Results@#At 3 months, 93% of eyes in the WTA group and 83% in the WT group had high-contrast uncorrected distance visual acuity (UDVA) of 20/20, while 87% in both groups achieved low-contrast UDVA of 20/40 or better. Sixty-four percent in the WTA gained 1 or more lines of low-contrast corrected distance visual acuity (CDVA) compared to 50% in the WT group. The mean sphere was 0.17D in the WTA and 0.14D in the WT (p = 0.63). The mean spherical equivalent was –0.04D for WTA and –0.03D for WT (p = 0.88). All eyes in both groups were within ±1.00D of the target emmetropia. The mean change in total higher-order aberration (HOA) was 0.07 μm in the WTA compared to 0.15 μm in the WT group (p = 0.04). The mean change in spherical aberration was –0.01 μm in the WTA and 0.18 μm in the WT group (p < 0.001). The mean change in Q value was significantly lower in the WTA (0.31) than in the WT group (0.63) (p < 0.001).@*Conclusion@#Wavefront aspheric LASIK (WTA) is a safe and effective treatment for myopic astigmatism. Refractive and visual outcomes were similar for both groups. WTA had less induction of higher-order aberration, lower spherical aberration, and better preservation of corneal asphericity (Q value). This translated to more lines of low-contrast vision gained compared to WT. Keywords: LASIK, Wavefront-guided, Aspheric, Spherical aberration, higher-order aberration, Corneal curvature