The effect of fractal contact lenses on peripheral refraction in myopic model eyes.

PURPOSE: To test multizone contact lenses in model eyes: Fractal Contact Lenses (FCLs), designed to induce myopic peripheral refractive error (PRE). METHODS: Zemax ray-tracing software was employed to simulate myopic and accommodation-dependent model eyes fitted with FCLs. PRE, defined in terms of mean sphere M and 90°-180° astigmatism J180, was computed at different peripheral positions, ranging from 0 to 35° in steps of 5°, and for different pupil diameters (PDs). Simulated visual performance and changes in the PRE were also analyzed for contact lens decentration and model eye accommodation. For comparison purposes, the same simulations were performed with another commercially available contact lens designed for the same intended use: the Dual Focus (DF). RESULTS: PRE was greater with FCL than with DF when both designs were tested for a 3.5 mm PD, and with and without decentration of the lenses. However, PRE depended on PD with both multizone lenses, with a remarkable reduction of the myopic relative effect for a PD of 5.5 mm. The myopic PRE with contact lenses decreased as the myopic refractive error increased, but this could be compensated by increasing the power of treatment zones. A peripheral myopic shift was also induced by the FCLs in the accommodated model eye. In regard to visual performance, a myopia under-correction with reference to the circle of least confusion was obtained in all cases for a 5.5 mm PD. The ghost images, generated by treatment zones of FCL, were dimmer than the ones produced with DF lens of the same power. CONCLUSIONS: FCLs produce a peripheral myopic defocus without compromising central vision in photopic conditions. FCLs have several design parameters that can be varied to obtain optimum results: lens diameter, number of zones, addition and asphericity; resulting in a very promising customized lens for the treatment of myopia progression.

Corneal and refractive astigmatism in adults: a power vectors analysis.

PURPOSE: In this article, we examine the relationship between corneal and refractive astigmatism (including with the rule, against-the-rule, and oblique astigmatism) in an adult population using power vectors. METHODS: Refractive and keratometric measures of astigmatism were conducted on right eyes of 105 white subjects aged 18 to 59 years. We performed a linear regression of refractive astigmatic error on corneal astigmatism, using the J0 and J45 components of the astigmatism. RESULTS: We obtained a statistically significant regression relationship between the corneal (C) and refractive (R) astigmatism for both J0 and J45 components, namely, RJ0 = 1.07 × CJ0 - 0.28; and RJ45 = 1.46 × CJ45 + 0.03. This results is a kind of generalized Javal rule for an adult population, because it is extended to include oblique astigmatism. We also found that the internal astigmatism is against-the-rule and uniform in our sample. CONCLUSIONS: This vector-based approach is equivalent to the traditional Javal rule, but it has the ability to make predictions about oblique astigmatism, rendering it more general and more accurate.