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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 (MTFcutoff), 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 MTFcutoff 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.
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RESUMO Ao remodelar a córnea usando um perfil de ablação individualizado para cada olho obtido por meio de aberrometria de frente de onda, o tratamento guiado por frente de onda tenta reduzir aberrações preexistentes e induzidas cirurgicamente, minimizando as aberrações de alta ordem (HOAs) visualmente significativas. No entanto, o aumento de HOA ainda é uma preocupação, mesmo com ablações personalizadas. Na cirurgia refrativa a laser miópica, como o feixe de laser entra na periferia, algumas partes são refletidas, e o feixe circular se torna elíptico, resultando em diminuição na eficácia da energia do laser. A subablação da córnea periférica pode ser induzida por esses fatores que aumentam a HOA, especialmente a aberração esférica. Este relato tem por finalidade mostrar uma paciente alto míope submetida à PRK guiada por frente de onda que evoluiu com aumento das HOAs.
ABSTRACT By reshaping the cornea using an individualized ablation profile for each eye obtained through wavefront aberrometry, wavefront guided treatment attempts to reduce preexisting and surgically induced aberrations while minimizing visually significant higher-order aberrations (HOAs). However, HOA enhancement is still a concern, even with custom ablations. In the myopic laser refractive surgery, as the laser beam enters the periphery, some parts are reflected, and the circular beam becomes elliptical, resulting in a decrease in the effectiveness of the laser energy. Peripheral corneal subablation can be induced by these factors that increase HOA, especially spherical aberration. This report aims to show a high myopic patient undergoing wavefront-guided PRK, who evolved with an increase in HOAs.
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Objective:To investigate the status of corneal epithelial remodeling and changes in corneal aberration after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) and FS-LASIK combined with corneal collagen cross-linking (FS-LASIK Xtra), and to analyze the relationship between corneal epithelial thickness (CET) and corneal aberration.Methods:A cohort study was conducted.A total of 172 patients (172 eyes) who underwent FS-LASIK at Yinhai Eye Hospital of Chengdu University of Traditional Chinese Medicine were enrolled from June 2021 to February 2022.The 172 eyes were divided into FS-LASIK group (94 eyes) and FS-LASIK Xtra group (78 eyes) according to the surgical procedure, with a total follow-up of 6 months.The cornea was divided into a central 2-mm ring and a ring of 2-5 mm centered on the central cornea.CET at 9 regions in the central 0-5 mm area was measured by OCT before and at 1, 3 and 6 months after surgery, and the corneal higher-order aberration (HOA) was measured by the iTrace visual function analyzer.The main outcomes were the increase in CET (ΔCET), and corneal HOA at 6 months after surgery.The relationship between central corneal ΔCET and corneal aberration was analyzed.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of Yinhai Eye Hospital of Chengdu University of Traditional Chinese Medicine (No.2021yh-009). Written informed consent was obtained from each subject.Results:At 1, 3 and 6 months after surgery, the central, superior, superior nasal, nasal, inferior nasal, inferior, inferior temporal, temporal and superior temporal ΔCET were significantly smaller in FS-LASIK Xtra group than in FS-LASIK group (all at P<0.05). In FS-LASIK Xtra group, 6-month postoperative central, superior, superior nasal, inferior and inferior temporal ΔCET were significantly larger than those at 1 month after surgery, and 3- and 6-month postoperative temporal ΔCET were significantly larger than that at 1 month after surgery, and 6-month postoperative superior temporal ΔCET was significantly larger than those at 1 and 3 months after surgery (all at P<0.05). In FS-LASIK group, 3- and 6-month postoperative central, superior, inferior and inferior temporal ΔCET were significantly larger than those at 1 month after surgery, and 6-month postoperative superior nasal ΔCET was significantly larger than that at 3 months after surgery, and 6-month postoperative nasal, inferior nasal, temporal, superior temporal ΔCET were significantly larger than those at 1 and 3 months after surgery (all at P<0.05). There was no significant difference in vertical trefoil, vertical and horizontal coma changes at different time points after surgery between both groups (vertical trefoil: χ2group=4.27, P=0.118; χ2time=0.01, P>0.05.vertical coma: χ2group=5.74, P=0.057; χ2time=0.08, P=0.957.horizontal coma: χ2group=3.97, P=0.137; χ2time=0.51, P=0.773). The tilted trefoil changes at 1, 3 and 6 months after surgery of FS-LASIK Xtra group were significantly larger than those of FS-LASIK group (all at P<0.05). The 6-month spherical aberration change in FS-LASIK Xtra group was significantly higher than that at 1 month after surgery, and the 6-month spherical aberration change in FS-LASIK group was significantly higher than that at 1 and 3 months after surgery (all at P<0.05). The 6-month total HOA change in FS-LASIK group was significantly lower than that at 1 and 3 months after surgery (all at P<0.05). In FS-LASIK group, central corneal ΔCET was weakly positively correlated with spherical aberration at 1 and 6 months after surgery ( rs=0.257, P=0.008; rs=0.244, P=0.012), and was weakly positively correlated with total HOA ( rs=0.253, P=0.009; rs=0.279, P=0.004). Conclusions:The postoperative ΔCET after FS-LASIK Xtra is smaller than that after FS-LASIK, but the homogeneity of ΔCET in each region is similar between the two groups.The changes in corneal HOA after surgery are similar in both groups, and there is a certain association between the overall epithelial distribution and corneal aberration.
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Objective:To investigate the differences and changes in early postoperative visual quality after small incision lenticule extraction (SMILE) and smart pulse technology-assisted transepithelial photorefractive keratectomy (SPT-TransPRK).Methods:A cohort study was performed.A total of 92 patients (92 eyes) who underwent corneal laser refractive surgery were enrolled in Dalian Third People's Hospital Affiliated to Dalian Medical University from February 2021 to May 2021.The data from the right eye were collected for analysis.The patients were divided into SMILE group (40 patients, 40 eyes) and SPT-TransPRK group (52 patients, 52 eyes). Preoperative, 1- and 3-month postoperative visual acuity were measured to calculate the effectiveness, which was defined as the ratio of postoperative uncorrected visual acuity (UCVA) to preoperative best corrected visual acuity.Refraction was measured by an AR-1 autorefractor.Corneal higher-order aberration (HOA) including total HOA, spherical aberration and coma was measured by Sirius corneal topographer.Objective scatter index (OSI), modulation transfer function cut-off frequency (MTF cut-off), Strehl ratio (SR), simulated contrast visual acuity VA100 (day), VA20 (dusk) and VA9 (night) were measured via OQAS II visual quality analysis system.This study adhered to the Declaration of Helsinki.The study protocol was approved by the Ethics Committee of the Dalian Third People's Hospital Affiliated to Dalian Medical University (No.2019-KT-010). Written informed consent was obtained from each subject.Results:There was no significant difference in 3-month postoperative UCVA and effectiveness between the two groups ( Z=0.880, P=0.380; t=0.920, P=0.058). Patients in SPT-TransPRK group showed mild hyperopia 3 months after surgery.Preoperative, 1- and 3-month postoperative total corneal HOA was (0.47±0.18), (0.70±0.22) and (0.74±0.19)μm in SMILE group, and (0.40±0.14), (0.98±0.35) and (0.94±0.22)μm in SPT-TransPRK group respectively, showing statistically significant differences ( Fgroup=13.851, P=0.001; Ftime=29.960, P<0.001). Preoperative, 1- and 3-month postoperative spherical aberration was (-0.20±0.09), (-0.44±0.14) and (-0.44±0.15)μm in SMILE group, and (-0.20±0.10), (-0.71±0.23) and (-0.75±0.20)μm in SPT-TransPRK group respectively, showing statistically significant differences ( Fgroup=31.037, P<0.001; Ftime=48.005, P<0.001). The postoperative total corneal HOA and spherical aberration were increased in both groups compared with before surgery, with statistically significant differences (all at P<0.05). The 1- and 3-month postoperative total corneal HOA and spherical aberrations were smaller in SMILE group than in SPT-TransPRK group, and the differences were statistically significant (all at P<0.05). The 1- and 3-month postoperative coma were increased in both groups compared with before surgery, showing statistically significant differences (all at P<0.05). In SMILE group, 1-month postoperative OSI was higher and 1-month postoperative MTF cut-off, SR, and VA9 were lower than those before surgery, and 3-month postoperative OSI was higher and 3-month postoperative SR and VA9 were lower than those before surgery, showing statistically significant differences (all at P<0.05). In SPT-TransPRK group, 1-month postoperative OSI was higher and 1-month postoperative MTF cut-off, SR, VA100, VA20, and VA9 were lower than those before surgery, showing statistically significant differences (all at P<0.05). There was no significant difference in OSI, MTF cut-off, SR, VA100, VA20, and VA9 between 3 months postoperatively and before surgery in the SPT-TransPRK group (all at P>0.05). There was no significant difference in coma, OSI, MTF cut-off, SR, VA100, VA20, and VA9 between two groups (all at P>0.05). Conclusions:Both SMILE and SPT-TransPRK are effective methods for correcting myopia and they have comparable visual quality.Compared with SPT-TransPRK, corneal total HOA and spherical aberration are smaller after SMILE.
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Objective:To analyze and compare the corneal higher order aberration (HOA) after femtosecond laser-assisted laser in situ keratomileusis (FS-LASIK) and small incision lenticule extraction (SMILE).Methods:A non-randomized controlled study was conducted.Sixty myopic patients (60 eyes) who underwent FS-LASIK or SMILE correction at Shandong Eye Hospital from April 2018 to January 2020 were enrolled and the data from the right eye were collected for analysis.Thirty cases (30 eyes) who received FS-LASIK in FS-LASIK group and 30 cases (30 eyes) who received SMILE in SMILE group had a preoperative equivalent spherical diopter of (-5.36±1.11)D and (-4.93±1.03)D, respectively.The HOA of the 6-mm anterior surface, posterior surface, and whole cornea were measured before surgery and at 1, 3, 6, and 12 months after surgery using Pentacam.The root mean square values (μm) of total corneal HOA, spherical aberration, coma and trefoil were obtained.Differences in the above root mean square values at different time points were compared between the two groups.The study protocol adhered to the Declaration of Helsinki and was approved by the Ethics Committee of Shandong Eye Hospital (No.SDSYKYY20180306). Written informed consent was obtained from each subject.Results:The preoperative and 1-, 3-, 6-, 12-month postoperative total HOA of the anterior corneal surface were (0.428±0.126), (0.775±0.169), (0.811±0.194), (0.759±0.214), (0.704±0.199)μm in the FS-LASIK group and (0.409±0.094), (0.656±0.148), (0.681±0.161), (0.668±0.175), (0.648±0.160)μm in the SMILE group, with a significant overall difference ( Fgroup=5.652, P=0.024; Ftime=107.169, P<0.01). Compared with SMILE group, the postoperative total HOA of anterior corneal surface and spherical aberration at different time points were increased in FS-LASIK group, showing statistically significant differences (all at P<0.05). Compared with before surgery, the postoperative total HOA of the anterior corneal surface and spherical aberration at different time points were increased in both groups, showing statistically significant differences (all at P<0.05). In the two groups, the 6- and 12-month postoperative total HOA of the anterior corneal surface were reduced in comparison with the 3-month postoperative ones of the anterior corneal surface, and the 12-month postoperative spherical aberrations of the anterior corneal surface were significantly reduced in comparison with the 1- and 3-month postoperative ones of the anterior corneal surface, showing statistically significant differences (all at P<0.05). There were significant differences in the coma and trefoil of the anterior corneal surface between before and after the operation (coma: Ftime=47.848, P<0.01; trefoil: Ftime=2.497, P=0.046). Compared with before surgery, the postoperative coma was significantly increased in the two groups (all at P<0.05). There were significant differences in total corneal HOA and spherical aberration at different postoperative time points between the two groups (total HOA: Fgroup=8.093, P=0.008; Ftime=125.019, P<0.01.spherical aberration: Fgroup=4.771, P=0.037; Ftime=34.033, P<0.01). Compared with SMILE group, the total corneal HOA and spherical aberration were significantly increased in FS-LASIK group at different postoperative time points (all at P<0.05). Compared with before surgery, postoperative total HOA of the anterior corneal surface and spherical aberration at different postoperative time points were significantly increased in both groups (all at P<0.05). In both groups, the 12-month postoperative corneal spherical aberration was significantly reduced in comparison with the 1- and 3-month postoperative ones (all at P<0.05). There was a significant difference in coma between before and after surgery ( Ftime=30.829, P<0.01). Compared with before surgery, the postoperative coma was significantly increased at different time points in both groups (all at P<0.05). Conclusions:Both FS-LASIK and SMILE increase the HOA of the anterior corneal surface and the whole cornea.Compared with FS-LASIK, SMILE introduces less HOA of the anterior corneal surface and the whole cornea as well as spherical aberrations.
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AIM: To evaluate the effect of anterior capsule polishing on visual quality after phacoemulsification.METHODS: Prospective randomized control study. A total of 65 patients(73 eyes)with age-related cataract who underwent phacoemulsification combined with intraocular lens(IOL)implantation in the Emergency General Hospital between November 2021 and June 2022 were included. These patients were randomly assigned to two groups, with one group(anterior polishing group)underwent anterior and posterior capsule polishing(30 cases, 35 eyes), while the other(control group)receive routine posterior capsule polishing(35 cases, 38 eyes). Best corrected visual acuity was observed at 1wk, 1, 3 and 6mo after operation. Area of anterior capsule orifice was measured at 3 and 6mo after operation. Meanwhile, posterior capsular opacification(P score), IOL tilt and decentration were recorded by Pentacam Scheimpflug system. In addition, wavefront aberration, Strehl ratio(SR)of point spread function(PSF)and modulation transfer function(MTF)were evaluated by OPD-Scan Ⅲ.RESULTS: At 1wk, 1, 3 and 6mo after operation, best corrected visual acuity in anterior polishing group is significantly better than that of control group(P<0.05). There were no significant differences in area of anterior capsule opening, P score, IOL decentration, SR of PSF and MTF between two groups at 3 and 6mo after operation(P>0.05). At 3mo follow-up, no significant differences in IOL tilt and wavefront aberration were measured between two groups either(P>0.05). However, IOL tilt [(1.65±0.60)° vs.(2.34±0.43)°, P<0.001] and wavefront aberration(0.03±0.01μm vs. 0.06±0.03μm, P<0.001)in anterior polishing group were significant lower compared to control group at 6mo after operation.CONCLUSION: 360° polishing of anterior and posterior capsule during phacoemulsification can improve best corrected visual quality, with reduced IOL tilt, lower wavefront aberration and better visual quality.
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Objective:To investigate the influence of angle Kappa on total high-order aberration (HOA) before and after small incision lenticule extraction (SMILE).Methods:An observational case series study was conducted.Right eyes of 98 patients with myopia and myopic astigmatism who underwent SMILE surgery at Tianjin Eye Hospital from April 2015 to May 2016 were selected.Uncorrected visual acuity (UCVA), spherical diopter and cylindrical diopter under cycloplegic condition were examined before the surgery and at l and 3 months postoperatively.The chord distance of angle Kappa was measured by Pentacam topography.Wavefront aberrations were measured by WaveScan aberrometer.Pre- and postoperative UCVA, refractive status and each HOA were analyzed.The relationship between angle Kappa and each HOA was analyzed by Pearson correlation.This study adhered to the Declaration of Helsinki.The study protocol was approved by an Ethics Committee of Tianjin Eye Hospital (No.TJYYLL-2017-17). Written informed consent was obtained from each subject.Results:The preoperative, postoperative 1-month and postoperative 3-month UCVA (LogMAR) were 0.06±0.23, -0.03±0.07 and -0.05±0.07, respectively, showing a statistically significant difference ( F=779.330, P<0.001). There were statistically significant differences in spherical diopter, cylinder diopter and spherical equivalent (SE) between before and after operation ( F=1 107.811, 127.786, 1 191.266; all at P<0.001), and the postoperative spherical diopter, cylinder diopter and SE were significantly lower than those before surgery (all at P<0.001). At 6-mm pupil diameter, significant differences were found between postoperative total HOA, spherical aberration, coma, the third-order aberration (S3), fourth-order aberration (S4), fifth-order aberration (S5) and sixth-order aberration (S6) and the preoperative values ( F=75.915, 78.231, 66.186, 64.521, 97.161, 36.623, 28.852; all at P<0.001). The postoperative 1- and 3-month total HOA, spherical aberration, coma, S3, S4, S5 and S6 were significantly increased in comparison with those before surgery (all at P<0.05). There was a positive correlation between angle Kappa and total HOA, coma and S3 at 1 and 3 months after surgery (total HOA: r=0.357, 0.363; both at P<0.001.coma: r=0.310, 0.341; both at P<0.01.S3∶ r=0.343, 0.371; both at P<0.01). Significant differences were found in preoperative, postoperative 1-month and 3-month total HOA, coma and S3 between groups with different angle Kappa ( Fgroup=3.363, 4.277, 4.029; all at P<0.05). The postoperative total HOA, coma and S3 of the larger angle Kappa group were greater than those of the smaller angle Kappa group, with statistically significant differences between them (all at P<0.05). Conclusions:A larger angle Kappa may induce HOAs in SMILE surgery.
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Adaptive optics (AO) can measure and correct wavefront aberrations in real time, which enables the optical system to adapt to external changes and maintain excellent optical performance, and has been gradually paid attention in the field of ophthalmology.AO technology can carry out optometry according to wavefront aberrations to improve the efficiency and accuracy of subjective and objective refraction, eliminate the influence of ocular aberrations on retinal imaging, provide more accurate data for the evaluation of optic nerve function, improve the effectiveness of visual perception training and provide vision care and treatment for special people, as well as simulate and predict postoperative visual outcome and give personalized schemes for refractive surgery and intraocular lens implantation.Moreover, AO combined with optical coherence tomography, optical scanning laser ophthalmoscope, and confocal scanning laser ophthalmoscope, can realize fundus imaging and retinal vascular imaging in real time, provide better sensitivity and resolution of retinal detection, distinguish fine details of retinal vessels and cone cells, and characterize retinal pigment epithelium topology and deformation, the application of which in posterior segment laser surgery, glaucoma diagnosis and follow-up, color blindness and retinal physiological activity research has been attracting attention.In this article, the principle and application of AO in ophthalmology were briefly reviewed.
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Femtosecond laser small incision lenticule extraction(SMILE)is one of the most advanced corneal refractive operations at present. Different from other traditional corneal refractive operations, SMILE achieves minimally invasive and valveless operation. Therefore, the evaluation of postoperative visual quality of SMILE also has its own characteristics, at present, the latest research at home and abroad has confirmed that the naked eye vision can be significantly improved and the refractive status is stable after SMILE. However, there are different understandings of the objective visual quality indexes and their influencing factors, such as higher-order aberration, modulation transfer function cut off(MTF cut off)and objective scatter index(OSI)after SMILE. This paper reviews the postoperative visual quality and its influencing factors after SMILE to provide clinical help.
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Wavefront aberration is an evaluation index of objective visual quality.In recent years, the relationship between the wavefront aberration compensation in human eyes and the visual quality has been paid more and more attention.There is a mutual compensation relationship between various aberration terms, between corneal aberration and intraocular aberration, and between the anterior and posterior corneal surfaces, and the visual nervous system compensates human eye aberrations.The characteristics of aberration compensation change with age, and are different in analysis of different regions.Vision correction methods, such as refractive surgery and contact lenses, will change the aberration compensation relationship in human eyes, and the changes caused may have an impact on visual quality.It is important to understand the relationship between the aberration compensation characteristics in human eyes and the visual quality.Therefore, not only the existing aberrations should be taken into consideration, but also the compensation characteristics of human eye aberrations must be elucidated to make personalized correction for the aberrations and improve the visual quality after correction.The research progress and significance on the relationship between human eye aberration compensation characteristics and visual quality were reviewed in this article.
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Humans , Astigmatism , Coma , Corneal Topography , Corneal Wavefront Aberration , Linear Models , Lotus , Myopia , Refractive Surgical Procedures , Retrospective Studies , Visual AcuityABSTRACT
@#AIM: To investigate the effect of inclination and eccentricity of intraocular lens(IOL),on optical imaging quality <i>via</i> wavefront aberration optical path system.<p>METHODS: The spherical IOL Sensar AR40e, the aspherical monofocal IOL Tecnis ZA9003, and the aspheric multifocal IOL Tecnis ZM900 were measured at the center of the center using a laboratory-built Hartmann-Shack IOL wavefront aberration path system at 5.0mm simulated pupil diameter. 0, 0.2, 0.4, 0.6, 0.8mm, the effect on the optical imaging quality when tilting 5°, 10°, 15°, 20°, 25° to the nasal side and the temporal side, and quantitative imaging quality by high-order aberration and modulation transfer function.<p>RESULTS: The Temnis ZA9003 MTF value was higher than AR40e and Tecnis ZM900 when inclinationed within 5°, while the three IOL MTF values were significantly different when inclinationed 5°, 10°, 15°, and 20°. Tecnis ZA9003 The IOL inclination angle was significantly positively correlated with the coma(<i>r</i>=0.842, <i>P</i><0.001), and there was no significant correlation with the spherical aberration(<i>r</i>=0.229, <i>P</i>=0.241). The three IOL MTF values were obtained when the eccentricity was 0.6 and 0.8 mm. Significant differences(both <i>P</i><0.001), the imaging quality of the Tecnis ZM900 eccentricity greater than 0.4mm decreased significantly.<p>CONCLUSION: When the inclination of aspheric IOL(-0.27μm spherical aberration)is less than 5°and the eccentricity is less than 0.4mm, aspherical IOL has a better imaging quality than that of spherical IOL. Tecnis ZM900 IOL has a lower optical imaging quality than that of spherical and aspheric IOL when the eccentricity of IOL is more than 0.4mm.
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PURPOSE: To compare corneal astigmatism, keratometry and corneal higher order aberrations between the light emitting diode corneal topography analyzer and Scheimpflug Imager. METHODS: This prospective study involved 45 patients (45 eyes) who visited Seoul St. Mary's hospital before cataract surgery from June 7, 2017, to August 2, 2017. For each eye, keratometry, astigmatism and its axis of cornea, higher-order aberrations were evaluated with a Scheimpflug Imager (Pentacam HR®, Oculus, Wetzlar, Germany) and a color-LED corneal topographer (Cassini®, i-Optics, Den Haag, The Netherlands). RESULTS: Astigmatism magnitude measured using Cassini® and Pentacam® showed no statistically differences but anterior and total astigmatic axes were significantly different, as measured by the two devices (p < 0.05). Anterior and total mean keratometry were statistically significantly different, as measured by the two devices (p < 0.05). J0 and J45 vectors of anterior and total cornea were statistically different (p < 0.05). In addition, Cassini® and Pentacam® showed discrepancies between total corneal astigmatism, total J0 and J45 vectors. Corneal anterior spherical aberration, vertical and horizontal coma, and oblique and horizontal trefoil aberrations were not statistically different between the two devices. CONCLUSIONS: Astigmatic axes obtained from the two devices based on different principles showed statistically significant differences. Astigmatism magnitude was not statistically different but showed a discrepancy between the two devices.
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Humans , Astigmatism , Cataract , Coma , Cornea , Corneal Topography , Corneal Wavefront Aberration , Lotus , Prospective Studies , SeoulABSTRACT
PURPOSE: This study aimed to evaluate the influence of varying concentrations of sodium hyaluronate (SH) eye drops on corneal aberrations in normal individuals wearing silicone hydrogel contact lenses. METHODS: Normal individuals wearing silicone hydrogel contact lenses were enrolled in this study. Subjects were classified into two groups depending on the concentration of the preservative-free SH used (group 1, 0.1% SH; group 2, 0.3% SH). All subjects were asked to blink five times after instillation of the SH eye drop and before the Galilei measurements. Corneal aberrations were measured over the contact lenses before and after SH eye drop instillation. Visual acuity (VA) over the contact lenses was also measured both before instillation of the SH eye drop and after the subjects completed the five blinks. RESULTS: There was no change in VA after SH instillation in group 1; however, group 2′s VA significantly deteriorated after SH instillation. Changes in VA after SH instillation compared to baseline were significantly higher in group 2 than in group 1. Similarly, the increase in corneal aberrations after SH instillation was significant in group 2 but not significant in group 1. Among the significantly increased corneal aberration parameters, defocus was the main type in group 2. Changes in corneal aberrations after SH instillation compared to baseline were significantly higher in group 2 than in group 1. CONCLUSIONS: A 0.3%-concentration of SH increases corneal aberration and decreases VA in soft contact lens wearers. Defocus is the main type of aberration that increased in the 0.3% SH instillation group.
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Contact Lenses , Contact Lenses, Hydrophilic , Hyaluronic Acid , Hydrogels , Ophthalmic Solutions , Silicon , Silicones , Sodium , Visual AcuityABSTRACT
Objective To observe the long-term visual quality and clinical effect of aspheric diffractive multifocal intraocular lens (IOL) implantation for congenital and developmental cataracts in childhood.Methods A retrospective cohort study on multifocal IOL implantation for congenital and developmental cataracts in childhood (aged 8 to 14 years) was performed in the First Affiliated Hospital of Zhengzhou University from August 2013 to January 2015.The clinical data of 67 eyes from 46 congenital cataract patients who received phacoemulsification with IOL implantation were collected.The AMO (ZMB00) IOL was implanted in 34 eyes of 24 patients in the multifocal IOL group,and Bausch & Lomb (MI60) IOL was implanted in 33 eyes of 22 patients in the monofocal IOL group.The distance,intermediate and near vision acuity were analyzed in 3,6 and 12 months after surgery,including uncorrected visual acuity (UCVA) and best corrected visual acuity (BCVA).The wavefront aberrations,modulation transfer functions (MTF) and stereopsis were obtained with iTrace Analysis System,Optec-6500 Visual Functional Analyzer and Titmus Stereo Test Chart,respectively in 12 months after surgery.The near additional degree,removing glasses rate and myopic shift were compared between the two groups in postoperative 12 months.Results The intermediate and near UCVA in the multifocal IOL group were obviously better than those in the monofocal IOL group 3,6 and 12 months after surgery (intermediate:Z=-3.74,-4.36,-3.66;all at P=0.00.near:Z=-2.67,-2.50,-2.33;all at P＜0.05).There were no significant differences between the two groups in total aberration,high and low order total aberrations,comatic aberration,trefoil aberration,spherical aberration and secondary astigmatism under the 5.0 mm optical zone in 12 months after surgery (all at P＞0.05).The MTFs under the 5.0 mm optical zone and 5,10,15,20,25,30 c/d in the multifocal IOL group were insignificantly lower than those in the monofocal IOL group (all at P＞0.05).In addition,the near stereopsis,near additional degree and myopic shift (AD) were reduced in the multifocal IOL group compared with monofocal IOL group (both at P＜0.05).The glasses removing rate was 93.3％ in the multifocal IOL group,which was significantly higher than 33.3％ in the monofocal IOL group (x2 =23.25,P =0.00).No significant difference in the incidence of posterior capsular opacification was found between the two groups (P＞0.05).The myopic shifting rates were 16.7％ and 83.3％ in the multifocal IOL group and monofocal IOL group,with a significant difference between the two groups (x2=15.02,P=0.00).Conclusions The aspheric multifical IOL implantation can achieve good and stable distance,intermediate and near visual acuities,provide better near stereopsis,reduce postoperative dependence on spectacles and decrease the incidence of myopic shift in child cataract patients.
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Objective To investigate the correlation of wavefront aberration and myopic development in school-age children.Methods Together 150 school-age children (300 eyes) in Beijing city were collected and underwent cycloplegic refractometry for detect the refraction status and Allegretto wavefront aberrometry for the measurement of wavefront aberration for 1-year follow up.Results Totally 132 children were successfully followed up and only 120 children were included in this study.The average increased diopter was (0.74 ± 0.55) D.It was found that the development of myopia was correlated with age,myopic duration and the baseline diopter (all P ＜ 0.01),and the wavefront aberration was correlated with age (P ＜ 0.05).There were significant difference in the third order RMS value and C7 (coma) between the myopic children with rapid progress and slow progress.C12 (spherical aberration) was significantly correlated with the change of diopter (P ＜ 0.05).Conclusion Both third order RMS and C7 (coma) may be the major contributors for myopia progress in school-age children,and the increased diopter may polarize the spherical aberration toward minus values.
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AIM:To compare the changes of wavefront aberrations in patients with diabetic retinopathy (DR) and with different degrees of dry eye and to explore the reasons of visual quality decline in them. METHODS: We randomly selected 40 eyes in our hospital for treatment with DR and varying degrees of dry eye, and 40 eyes of normal control group. Topcon KR-1W visual quality analyzer was used to record the mean square the total high order corneal aberration, spherical aberration, comatic aberration and trefoil aberration of cornea with pupil diameters of 4mm and 6mm. Analysis of variance were used to compare the wavefront aberrations and the aberration values in the control group and in patients with diabetic retinopathy and with different degrees of dry eye. RESULTS: For 4mm and 6mm pupil diameters, nondiabetic retinopathy (NDR) with dry eye group, the nonproliferative diabetic retinopathy (NPDR) with dry eye group and proliferative diabetic retinopathy (PDR) dry eye group had significantly increased tHOA, coma and trefoil compared with the contrast group (P<0.01),and PDR dry eye group were significantly higher than NDR with dry eye group and NPDR with dry eye group in tHOA,spherical aberration (SA), coma and trefoil (P<0.01). CONCLUSION: Dry eye of diabetic retinopathy with different degrees is closely related to the increase of wavefront aberration. lncreased wavefront aberration may be one of the reasons to reduced visual quality in patients with diabetic retinopathy and with dry eye, and provide the basis for the decline of visual function of diabetic patients with dry eye.
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@#Assessing tear film properties is essential for the diagnosis of dry eye. Although tear film break-up time and Schirmer scores have been widely accepted, they are single-value parameters and unable to evaluate the dynamics of tear film in an interblink interval. We reviewed three non-invasive and objective methods, including corneal topography, interferometry and aberrometry. And we also discussed the differences between dry eye patients and normal people detected by these methods.
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Objective To investigate the effects of the astigmatism values of children on wavefront aberration.Methods The children aged from 7 years to 10 years were dilated the pupils for 3 days,and the optometry examination was performed.Fifty-nine children who met the inclusion criteria were divided into three groups according to the degree of astigmatism:1.00 D ≤ astigmatism ＜2.00 D,2.00 D ≤ astigmatism ＜ 3.00 D,3.00 D ≤ astigmatism ＜ 4.00 D.In the meantime,OPD-SCAN-Ⅲ aberrometer was used to measure corneal topography,point spread function (PSF),modulation transfer function(MTF) and other optical images.Total higher order aberrations,total coma aberration,total spherical aberration,total trefoil aberration corresponding to the root mean square (RMS) value and the area ratio (AR) value of MTF,the strehl ratio (SR) value of PSF with a 4 mm pupil diameter were assessed.Three groups of higher order aberrations corresponding to the RMS value and the AR value of MTF,the SR value of PSF were respectively compared by one-way ANOVA.Results The RMS of total high-er order aberrations,coma aberrations and trefoil aberrations with a 4 mm pupil diameter of three groups significantly increased with the degree of astigmatism increase,and there were significant differences among three groups (all P ＜ 0.05).The RMS of total spherical aberrations of three groups significantly increased with the degree of astigmatism increase,and there was no significant difference among three groups (P ＞ 0.05).The AR and SR values decreased with the degree of astigmatism increase,and there were significant differences among three groups (all P ＜ 0.05).Conclusion Astigmatism has a significant influence on the higher-order aberrations,MTF and PSF in the children with the rule astigmatism.The rule astigmatism mainly has an effect on the asymmetric components of higher order aberrations.
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ABSTRACT Purpose: To investigate the relationship between biomechanical properties of the cornea and postoperative refractive changes in patients with low-level astigmatism after cataract surgery. Methods: This prospective study recruited patients undergoing cataract surgery involving 2.8-mm superior incisions. Biomechanical properties of the cornea were evaluated preoperatively using the Ocular Response Analyzer, and corneal profiles were evaluated using a Scheimpflug system (Pentacam HR). Topographic astigmatism, total corneal aberrations (TCA) and higher-order corneal aberrations (HOCA) analyses were performed preoperatively and during 1- and 3-month postoperative exams. The incidences of surgically-induced astigmatism (SIA) and HOCAs were calculated using vector analyses. Associations of the preoperative biomechanical properties of the cornea with SIA and HOCAs were evaluated. Results: This study included 28 eyes of 28 patients. The preoperative corneal hysteresis (CH) was 8.68 ± 1.86 mmHg, and the corneal resistance factor (CRF) was 8.66 ± 1.61 mmHg. At the 1-month postoperative evaluation, significant changes were observed in HOCAs (p=0.023), TCAs (p=0.05), astigmatism (p=0.02), and trefoil (p=0.033); in contrast, differences in coma (p=0.386) and spherical aberration (SA) were not significant (p=0.947). At the 3-month visit, significant changes were only observed in TCAs (p=0.02) and HOCAs (p=0.012). No relationships between the preoperative corneal hysteresis and corneal resistance factor and postoperative SIA and HOCA were identified, other than a positive correlation between the 3-month postoperative incidence of corneal hysteresis and spherical aberration. Conclusions: Despite the observed lack of relationships of preoperative biomechanical properties of the cornea with SIA and postoperative aberrations (except for SA), further studies involving larger patient groups are needed to explore the unexpected refractive deviations after cataract surgery.
RESUMO Objetivo: Investigar a relação entre as propriedades biomecânicas da córnea e as mudanças refrativas pós-operatórias em pacientes com baixa astigmatismo após a cirurgia de catarata. Método: Neste estudo prospectivo, recrutamos os pacientes submetidos a cirurgia de catarata com incisões superiores de 2,8 mm. As propriedades biomecânicas da córnea foram avaliadas no pré-operatório pelo Ocular Response Analyzer (ORA, Reichert, EUA) e o perfil corneano foi avaliado por um sistema Scheimpflug (Pentacam HR, Oculus Optikgeräte, GmbH). As avaliações do astigmatismo topográfico e das aberrações corneanas de alta ordem (HOCA) foram feitas no pré-operatório e no 1º e 3º mês pós-operatório. O astigmatismo induzido cirurgicamente (SIA) e aberrações corneanas de alta ordem foram calculados pela análise vetorial. Associações das propriedades biomecânicas da córnea no pré-operatório com astigmatismo induzido cirurgicamente e aberrações corneanas de alta ordem foram avaliadas. Resultados: O estudo foi realizado em 28 olhos de 28 pacientes. A histerese corneana (CH) pré-operatória foi 8,68 ± 1,86 mmHg, e o fator de resistência da córnea (CRF) foi de 8,66 ± 1,61 mmHg. No pós-operatório de 1 mês houve mudanças significativas aberrações corneanas de alta ordem (p=0,023), aberração total (p=0,05), astigmatismo (p=0,02) e trifóglio (p=0,033), mas as diferenças em coma (p=0,386) e aberração esférica (SA) foram insignificantes (p=0,947). No terceiro mês, a única mudança significativa foi em RMS total (p=0,02) e aberração total (p=0,012). Não houve relação entre histerese corneana e o fator de resistência da córnea pré-operatórios e astigmatismo induzido cirurgicamente e aberrações corneanas de alta ordem pós-operatórios, além de uma correlação positiva entre o histerese corneana e o aberração esférica do 3º mês pós-operatório. Conclusões: Apesar de não haver relação entre as propriedades biomecânicas pré-operatórias da córnea e astigmatismo induzido cirurgicamente e aberrações (exceto SA) após a cirurgia em nosso estudo, são necessários mais estudos com grupos de pacientes maiores de explicar os erros refrativos inesperados após a cirurgia de catarata.