Optical Quality Analysis System Research Articles

Comparison of objective visual quality between SMILE and FS-LASIK in moderate-to-high myopia.

This study aims to compare the changes in the corneal wavefront aberrations and the objective visual quality resulting from two types of eye surgery-small incision lenticule extraction (SMILE) and femtosecond laser-assisted in situ keratomileusis (FS-LASIK)-in patients with moderate-to-high myopia. A prospective analysis was performed on 98 eyes of 51 patients who underwent SMILE. Additionally, 88 eyes of 45 patients who underwent FS-LASIK were analyzed. All patients underwent ocular examination preoperatively and at 1 day, 1 week, 1 month, and 3 months postoperatively. Corneal aberrations and objective visual quality were measured using the Optical Quality Analysis System II (OQAS II) and Optical Path Difference Scan III (OPD-Scan III). At postoperative 1 day and 1 week, there was a statistically significant difference in uncorrected distance visual acuity (UDVA) between SMILE and FS-LASIK (P < 0.05). Postoperative spherical (S), cylinder (C) and spherical equivalent refraction (SE) were similar between the two groups (P > 0.05). In both groups, the absolute magnitude of total higher-aberrations (tHOA), piston, vertical tilt, vertical coma, and spherical aberration (SA) increased after surgery compared to preoperative values (P < 0.05). There was no significant difference in Δhorizontal tHOA, Δhorizontal tilt, Δhorizontal coma, and Δhorizontal trefoil between the two groups (P > 0.05), and the FS-LASIK had higher Δvertical trefoil and ΔSA (P < 0.05) but lower Δpiston, Δvertical tilt, and Δvertical coma than the SMILE group (P < 0.05). There was a rise in objective scattering index (OSI) and a decline in both modulation transfer function (MTF) cutoff and Strehl ratio (SR) after surgery compared to preoperative values in both groups (P < 0.05). There was a statistically significant difference in the OSI at 1 day and 3 months between the two groups (P < 0.05). Postoperative MTF cutoff and SR were similar between the two groups (P > 0.05). Postoperative OSI was positively correlated with corneal tHOA (0.261 ≤ R ≤ 0.483, P < 0.05) and was negatively correlated with vertical tilt and vertical coma (-0.315 ≤ R ≤ -0.209, P < 0.05) in both groups. While both SMILE and FS-LASIK can effectively correct moderate-to-high myopia, there is an increase in corneal aberrations and a postoperative delay in objective visual quality. The cornea may require a longer recovery period in the SMILE. OPD-Scan III combined with OQAS II is a useful supplementary inspection for assessing the optical quality following refractive surgery.

Application of objective optical quality analysis system in guiding early posterior capsule opacification laser treatment: An observational study.

In the present study, we aimed to demonstrate the objective guiding role of objective scatter index (OSI) in patients with early stage posterior capsule opacification (PCO), especially in patients with multifocal intraocular lens (IOL) implantation. A prospective randomized case analysis was conducted on elderly patients experiencing PCO, exhibiting best-corrected visual acuity (BCVA) below 0.2 LogMAR. Exclusion criteria comprised patients with diabetes, glaucoma, high myopia, trauma, endothelial dystrophy, maculopathy or prior eye surgery affecting visual acuity. The main observational indicators were patient gender, age, post-cataract surgery duration, BCVA (LogMAR), and OSI values. For patients undergoing laser posterior capsulotomy, meticulous documentation of pre-laser OSI values and post-laser OSI values was undertaken. Subjective visual quality was then compared using the Chinese version visual function index-14 (VF-14-CN). The study comprised 65 eyes from 56 patients. PCO developed, on average, 2.06 ± 0.94 years (ranging from 0.5 to 4 years) after the initial surgery, with the OSI consistently exceeding 3.0. Among these cases, only 40 eyes underwent laser posterior capsulotomy using Nd:YAG laser, including 26 eyes implanted with monofocal IOLs and 14 eyes implanted with multifocal IOLs. Following laser posterior capsulotomy for early-stage secondary cataracts, there was a significant decrease in OSI values compared to the presurgery state, coupled with a notable increase in VF-14-CN scores. Among the 14 cases with multifocal IOL implantation, pre-laser VF-14-CN scores were lower compared to those with monofocal IOLs. Post-laser posterior capsulotomy, patients reported a marked improvement in self-perceived symptoms. The OQAS functioned as an objective assessment metric for the laser treatment of early stage PCO. In cases involving multifocal IOL implantation, the visual disturbance caused by PCO was more pronounced, underscoring the significance of OSI as a valuable guide for laser treatment in these patients.

Effects of visual neuroplasticity training on visual perception, visual quality, and macular blood flow in patients with strabismus.

To observe the effects of visual neuroplasticity training on visual perception, visual quality, and macular blood flow in patients with concomitant strabismus postoperatively. In total, 108 patients underwent binocular strabismus correction operation, and some patients underwent neuroplasticity training. All patients underwent clinical ophthalmic examination, including measurement of best-corrected visual acuity, spherical equivalent, axis length, optical coherence tomography angiography, optical quality analysis system, and visual perception examinations. A total of 78 patients received neuroplasticity training for 1 month postoperatively, and 30 patients did not receive training. All patients underwent a visual perception examination preoperatively and at 1 day, 1 week, and 1 month postoperatively. Macular blood flow and visual quality were examined preoperatively and at 1 month postoperatively. Postoperative visual perception was better than preoperative visual perception (P < 0.05). After neuroplasticity training, the visual perception of the trained subjects was better than that of the untrained subjects (P < 0.05), and the blood flow in the macular area of the trained patients was lower than that of the untrained subjects (P < 0.05). The visual quality of the untrained subjects was lower than that of the trained patients (P < 0.05). Visual inspection system could accurately evaluate binocular visual perception in patients with concomitant strabismus. After surgical alignment of the strabismus patient, training can stimulate and integrate the formation of stereovision in a short period of time, maintain the visual quality of patients after surgery, and provide conditions for the formation of binocular visual signals and binocular stereovision, but in the short term, it will lead to the decrease of macular blood vessel density and perfusion density. However, the long-term effects of training have not been proven.

Effect of low-degree astigmatism on the objective visual quality.

To evaluate the effect of low-degree astigmatism on objective visual quality through the Optical Quality Analysis System (OQAS). This study enrolled 46 participants (aged 23 to 30y, 90 eyes) with normal or corrected-to-normal vision. The cylindrical lenses (0, 0.5, 0.75, 1.0, and 1.25 D) were placed at the axial direction (180°, 45°, 90°, and 135°) in front of the eyes with the best correction to form 16 types of regular low-degree astigmatism. OQAS was used to detect the objective visual quality, recorded as the objective scattering index (OSI), OQAS values at contrasts of 100%, 20%, and 9% predictive visual acuity (OV100%, OV20%, and OV9%), modulation transfer function cut-off (MTFcut-off) and Strehl ratio (SR). The mixed effect linear model was used to compare objective visual quality differences between groups and examine associations between astigmatic magnitude and objective visual quality parameters. Apparent negative relationships between the magnitude of low astigmatism and objective visual quality were observed. The increase of OSI per degree of astigmatism at 180°, 45°, 90°, and 135° axis were 0.38 (95%CI: 0.35, 0.42), 0.50 (95%CI: 0.46, 0.53), 0.49 (95%CI: 0.45, 0.54) and 0.37 (95%CI: 0.34, 0.41), respectively. The decrease of MTFcut-off per degree of astigmatism at 180°, 45°, 90°, and 135° axis were -10.30 (95%CI: -11.43, -9.16), -12.73 (95%CI: -13.62, -11.86), -12.75 (95%CI: -13.79, -11.70), and -9.97 (95%CI: -10.92, -9.03), respectively. At the same astigmatism degree, OSI at 45° and 90° axis were higher than that at 0° and 135° axis, while MTFcut-off were lower. Low astigmatism of only 0.50 D can significantly reduce the objective visual quality.

Compound electrolyte intraocular irrigating solution produces better effects on vision recovery of cataract patients after surgery than Ringer lactate solution.

Intraocular irrigating solution is extensively applied in cataract surgery. This paper explored the difference and relationship between optical coherence tomography (OCT) and optical quality analysis system (OQAS) parameters induced by compound electrolyte intraocular irrigating solution (CEIIS) or Ringer lactate (RL) solution during uncomplicated cataract surgery. Totally 200 senior cataract patients were randomly divided into the CEIIS and RL groups (N = 100 patients/group). The anterior chamber was irrigated by CEIIS or RL during phacoemulsification. Patients were subdivided into diabetes mellitus (DM)+ and DM- groups. The central macular thickness (CMT), hyper reflective foci (HF), modulation transfer function cutoff frequency (MTF cutoff), Strehl ratio (SR), objective scatter index (OSI), and OQAS values (OVs) at 100%, 20%, and 9% contrast levels were measured preoperatively and 1day and 1week after operation using spectral-domain optical coherence tomography and OQAS II, respectively. Best-corrected visual acuity (BCVA) was assessed using the Snellen scale, followed by statistical analysis of its logarithm of the minimal angle of resolution. There were no significant differences in clinical characteristics between the CEIIS and RL groups. Both groups exhibited notably increased postoperative CMT, MTF cutoff, SR, OV at 100%, 20%, and 9% contrast levels, and reduced OSI, indicating CEIIS and RL improved postoperative visual quality. CEIIS surpassed RL solution in improving postoperative visual quality, decelerating the increase of macular HF numbers and CMT in DM+ patients and postoperative BCVA. There was no difference between CEIIS and RL in long-term vision improvement. CEIIS surpasses RL in postoperative visual recovery and retards increases of macular HF numbers and CMT in senior DM+ cataract patients.

Serum miR-26a level is decreased in cataract patients with glaucoma and related to visual quality

ABSTRACT Clinical relevance microRNAs have been found to be involved in the progression of a variety of ocular diseases. Background Cataract and glaucoma often coexist, and combined surgery is a common treatment. The aim of this study is to analyse the correlation between miR-26a and visual quality in cataract patients with glaucoma. Methods Seventy patients with cataract and glaucoma and 70 healthy volunteers were enrolled and received phacoemulsification and trabeculectomy. The patients were divided into low and high miR-26a expression groups according to miR-26a mean expression. The objective scattering index, strehl ratio, and modulated transfer function cut-off were analysed by optical quality analysis system II. The changes of miR-26a, objective scattering index, strehl ratio, modulated transfer function cut-off, and the correlation between the indicators were analysed. The downstream genes of miR-26a were analysed by Gene Ontology and Kyoto Encyclopaedia of Genes and Genomes functional enrichment. Results There were significant differences between patients and controls in lipid biomarker levels and visual indicators. miR-26a was decreased in the patient group. Strehl ratio and modulated transfer function cut-off in the miR-26a low-expression group were lower than in high-expression group, while mean defect of the visual field and objective scattering index were higher than in high-expression group. The miR-26a expression was negatively correlated with the severity of disease and objective scattering index, and positively correlated with strehl ratio and modulated transfer function cut-off. After surgery, miR-26a, strehl ratio, and modulated transfer function cut-off were increased, and objective scattering index was decreased. The downstream genes of miR-26a were related to several biological processes and signalling pathways. Conclusion In cataract patients with glaucoma, miR-26a expression was lower than matched controls and increased following combined cataract removal and trabeculectomy.

A comparative study of two phakic posterior chamber implantable lenses.

This study aimed to compare the postimplantation clinical outcomes of 2 types of posterior chamber phakic intraocular lenses (IOLs): Visian™ implantable collamer lenses (ICL; EVO+ V5; Staar Surgical, Monrovia, CA) and an implantable phakic contact lens (IPCL) (IPCL V2.0, Care Group Sight Solution, India) to correct high myopia and myopic astigmatism. This retrospective study included patients who had undergone phakic IOL implantation performed by a single surgeon between March 2021 and March 2022. Preoperative assessments included slit-lamp examination, fundus examination, spherical equivalent, uncorrected distant visual acuity (UDVA), corrected distant visual acuity (CDVA), specular microscope parameters, and optical quality analysis system parameters. Postoperative assessments after 1 year included slit-lamp examination to detect adverse effects and spherical equivalent, UDVA, CDVA, specular microscope, optical quality analysis system, and anterior-segment optical coherence tomography. Eighty eyes from 42 patients (47 eyes from 24 patients in the ICL group and 33 eyes from 18 patients in the IPCL group) were included. No statistically significant differences were observed between the 2 groups regarding preoperative parameters. At 1-year postoperatively, the mean UDVA in the ICL and IPCL groups was 0.019 ± 0.040 logMAR and 0.019 ± 0.041 logMAR, respectively. The mean CDVA was 0.001 ± 0.008 logMAR and 0.001 ± 0.007 logMAR in the ICL and IPCL groups, respectively, showing no statistically significant differences. The postoperative parameters did not differ significantly between the 2 groups. The visual acuity and refractive results of both groups were excellent, and both groups exhibited similar efficacy and safety profiles.

Tolerance to induced astigmatism of patients with trifocal or extended depth of focus intraocular lens implantation.

Residual astigmatism is common after cataract surgery involving implantation of an intraocular lens, yet the tolerance of presbyopia-correcting intraocular lens to astigmatism of different magnitudes and axes is poorly understood. Here we compared visual acuity and quality in the presence of induced astigmatism after implantation of a trifocal or extended-depth-of-focus (EDOF) intraocular lens, the two widely used presbyopia-correcting intraocular lenses. At least 3 months after implantation of a TFNT00 or ZXR00 intraocular lens, patients were analyzed by slit-lamp examination, non-contact tonometry, subjective refraction, iTrace aberrometry, and corneal topography. After correction of residual astigmatism, astigmatism of different magnitudes on different axes was induced using cylindrical lenses, and overall visual acuity was measured, while objective visual quality was measured using the Optical Quality Analysis System II. Subjects were also asked about subjective visual quality using the Visual Function-14 questionnaire. Comparison of 18 individuals who received a trifocal lens and 19 who received an EDOF lens showed that objective visual quality was better in the EDOF group regardless of the magnitude or axis of the induced astigmatism. In both groups, astigmatism of at least -1.00 DC influenced distant vision more severely when the axis was 45° than 0° or 90°, meanwhile astigmatism of at least -1.50 DC influenced near and intermediate vision more severely when the axis was 45° than 0° or 90°. Trifocal or EDOF intraocular lenses are less tolerant of oblique astigmatism than astigmatism with or against the rule. EDOF lenses may provide better objective visual quality than trifocal lenses in the presence of astigmatism, regardless of its magnitude or axis.

Therapeutic effect of a new implantation method of rotationally asymmetric multifocal intraocular lenses on visual quality.

To assess the visual quality after implantation of a rotationally asymmetric multifocal intraocular lens (IOL) using a new method according to the angle kappa. Qingdao Eye Hospital, Qingdao, China. Prospective case series. Patients with the implantation of SBL-3 IOLs for age-related cataract from September to December 2019 had the distance-horizontal zone of the IOL placed at the center of the optic axis using the Callisto Eye System. Postoperative visual acuities and defocus curves were recorded. Modulation transfer function cutoff frequency, Strehl ratio, and objective scatter index were measured using the Optical Quality Analysis System. The decentration and tilt of IOLs were analyzed by iTrace aberrometry and anterior segment optical coherence tomography. A questionnaire of patient satisfaction was also collected. Thirty patients (60 eyes) were involved, with a balanced sex ratio. Their average age was 56.04 ± 10.83 years. The average angle kappa distance was 0.23 ± 0.121 mm. At 3 months after surgery, the mean uncorrected and corrected distance visual acuities were 0.01 ± 0.07 logMAR and 0.01 ± 0.06 logMAR. The uncorrected intermediate and near visual acuities were 0.09 ± 0.11 logMAR and 0.09 ± 0.11 logMAR. The mean horizontal and vertical tilts of IOLs were 0.67 ± 0.52 degrees and 0.47 ± 0.32 degrees. The mean decentration of IOLs was 0.17 ± 0.08 mm. Most patients were satisfied with their distance, intermediate, and near vision. There was mild glare in 58.3% of the eyes. Locating the center of the optic axis in the distance-horizontal zone during the implantation of SBL-3 IOLs could provide satisfactory visual acuity and quality.

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.

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. 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. 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. 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.

Intense pulsed-light treatment improves objective optical quality in patients with meibomian gland dysfunction

BackgroundTo evaluate changes in objective optical quality following intense pulsed light (IPL) treatment combined with meibomian gland (MG) expression (MGX) in patients with MG dysfunction (MGD).MethodsThis retrospective cross-sectional study included MGD-related dry eye disease (DED) patients who received IPL treatment between March and December 2021 at Kim’s Eye Hospital, Seoul, Republic of Korea. Each patient underwent four sessions of IPL treatment using Lumenis M22 (Lumenis Ltd., Yokneam, Israel) and MGX at three-week intervals.ResultsThis study included 90 eyes from 45 patients with MGD. The mean age was 52.3 ± 16.1 years (range, 20–75 years), and 53.3% (24/45) of patients were female. Compared with the baseline, all clinical symptoms and signs significantly improved after IPL treatment combined with MGX. All optical quality parameters obtained with an optical quality analysis system (OQAS: Visiometrics, Castelldefels, Spain) have improved significantly over the baseline (p < 0.001).ConclusionsIn patients with MGD, IPL treatment combined with MGX improved the objective optical quality and clinical signs and symptoms of DED.

Forward-scattered and backward-scattered light in moderate keratoconus.

To evaluate the backscattered light, objective scatter index (OSI) and retinal straylight in patients with moderate keratoconus and healthy control subjects. A prospective observational study was developed with 33 patients in the moderate-keratoconus group (KC) and 34 in the non-keratoconus group (NKC). Corneal densitometry was obtained using Scheimpflug corneal tomography and measurements were expressed in grayscale units (GSU) over four zones within a 12.00 mm diameter around the corneal apex. A straylight meter was used to determine the amount of intraocular straylight under scotopic conditions, and the straylight parameter (LOG(s)) and test duration were recorded. The Optical Quality Analysis System based on the double-pass technique determined the OSI value. Significant differences were observed between the KC and NKC groups for corneal densitometry (except in the 6-10 mm zone), OSI and retinal straylight. A moderate and significant correlation was found between OSI and retinal straylight LOG(s) (r=0.52, p=0.002). Weaker and non-significant correlations were found between corneal densitometry and the other parameters analysed (i.e., OSI, retinal straylight LOG(s) and retinal straylight times). Backscattered light, retinal straylight and the OSI show clear differences between healthy eyes and those with moderate KC. The changes present in the stages of KC evaluated in the current study (stages II and III according to the Amsler-Krumeich classification) might alter the scattering of the light entering the eye.

Femtosecond Laser-Assisted Cataract Surgery versus Conventional Phacoemulsification Surgery: Clinical Outcomes with EDOF IOLs.

In this study, we evaluate and compare the outcomes of conventional phacoemulsification cataract surgery (CPS) and femtosecond laser-assisted cataract surgery (FLACS) with the implantation of an extended depth of field (EDOF) intraocular lens (IOL). A prospective, consecutive cohort study was conducted. Patients were given the option to choose FLACS or CPS and were implanted with an EDOF IOL. Refractive data, visual acuity data, ocular aberration measured with a wavefront aberrometer, and optical quality measured with an optical quality analysis system II were collected at one month postoperatively. A total of 92 eyes of 64 patients were enrolled in this study; 35 eyes of 26 patients were treated with FLACS, whereas 57 eyes of 38 patients were treated with CPS. Uncorrected visual acuity at far, intermediate, and near distance and best-spectacle-corrected visual acuity were not statistically significantly different between the groups (all p > 0.05), nor were the mean cylinder and mean spherical equivalent refraction (both p > 0.05). The FLACS group had a lower ocular trefoil than the CPS group (p = 0.033), and there was no significant difference between the two groups considering other aberration parameters, whether ocular or internal (all p > 0.05). Optical-quality-related parameters showed also no significant difference between the two groups (all p > 0.05). In conclusion, there was no significant difference between FLACS and CPS with implantation of EDOF IOLs in postoperative ocular parameters, refractive outcomes, ocular aberration, optical quality, and aberration parameters, except a lower ocular trefoil in the FLACS group. In terms of these indicators, FLACS does not provide an additional clinical benefit for patients over CPS.

Effect of illuminance and colour temperature of LED lighting on asthenopia during reading.

A self-controlled study to determine the influence of illuminance and correlated colour temperature (CCT) of light-emitting diode (LED) lighting on asthenopia. Twenty-two healthy postgraduates (nine women) were recruited to read under eight LED lighting conditions with four illuminances (300 lx, 500 lx, 750 lx and 1000 lx) and four CCTs (2700, 4000, 5000 and 6500 K) for 2 h. A subjective asthenopia questionnaire, the optical quality analysis system (OQAS) and an inflammatory cytokine assay were used to assess the levels of asthenopia. Increased asthenopia was observed after reading, but the degree varied with lighting conditions. There were significant differences among the groups in terms of subjective symptoms (inattention, eye pain, dry eye and total score), optical performance parameters (modulation transfer function [MTF] cut-off frequency, Strehl ratio [SR], objective scattering index [OSI], mean OSI and accommodative amplitude [AA]) as well as inflammatory cytokines in the tears (epidermal growth factor [EGF], transforming growth factor [TGF]-α, interleukin [IL]-6, IL-8, macrophage inflammatory protein [MIP]-1β, tumour necrosis factor [TNF]-α, TNF-β and vascular endothelial growth factor [VEGF]-A). All of the subjective and objective measurements collectively suggested that asthenopia was lessened for the 500 lx-4000 K condition. However, asthenopia was significantly worse for 300 lx-2700 K and 1000 lx-6500 K in terms of subjective symptoms and objective optical performance, respectively. LED illuminance and CCT do have a significant effect on asthenopia during reading. 500 lx-4000 K lighting resulted in the lowest level of asthenopia. Conversely, low illuminance at low CCT (300 lx-2700 K) and high illuminance at high CCT (1000 lx-6500 K) promoted more severe asthenopia.

Short-term Evaluation of Visual Quality, Amplitude of Accommodation, and Stereoacuity Between Patients With Moderate-to-High Myopia Who Underwent ICLV4c Implantation and SMILE.

To compare the visual quality, accommodation, and stereoacuity between patients with a myopia magnitude of -3.00 to -8.50 diopters (D) who underwent ICLV4c (STAAR Surgical) implantation and small incision lenticule extraction (SMILE). The visual quality parameters, amplitude of accommodation (AMP), and stereoacuity were compared between and within the ICLV4c and SMILE groups (40 eyes/group) with a mean spherical equivalent (SE) of -6.14 D. Differences in these parameters before and after surgery were analyzed using SPSS 22.0 software (SPSS, Inc). Modulation transfer function (MTF) cut-off increased significantly by 3.24 cycles/degree (t = -2.111, P = .041) and AMP decreased significantly by 1.66 D (t = 7.519, P < .001) from baseline to 3 months after surgery in the ICLV4c group. However, the MTF cut-off was significantly lower (t = 2.123, P = .037) and the AMP was significantly better (t = -3.605, P = .001) in the SMILE group than in the ICLV4c group at 3 months postoperatively. Other parameters such as Objective Scatter Index, Strehl ratio, and Optical Quality Analysis System (Visiometrics) under different contrast values did not show significant changes (P > .05). Stereoacuity did not improve significantly, except in a patient with anisometropia (2.50 D) in the ICLV4c group. The ICLV4c implantation yielded a better visual quality but worse AMP than did SMILE in patients with a myopia magnitude of -3.00 to -8.50 D in the short term. [J Refract Surg. 2022;38(10):632-640.].

Clinical outcomes of new multifocal intraocular lenses with hydroxyethyl methacrylate and comparative results of contrast sensitivity, objective scatter, and subjective photic phenomena

BackgroundWe investigate the performance of new hydrophobic diffractive multifocal intraocular lenses (IOL) with hydroxyethyl methacrylate (HEMA) and compare their optical quality, contrast sensitivity, and subjective photic phenomena.MethodsMedical records of patients who underwent routine simple cataract surgery and insertion of an existing multifocal IOL (TFNT, TF group) or a new multifocal IOL (CNWT, CN group) were retrospectively reviewed. Clinical data was collected 2 months postoperatively and included optical quality analysis system (OQAS) indices, contrast sensitivity, and subjective degrees of photic phenomena.ResultsOne hundred thirty-five eyes of 135 patients were included (CN group, 71; TF group, 64). There was no significant difference between the two groups in the visual acuity and defocus curve. The indices of OQAS did not show a significant difference between groups. Contrast sensitivity was significantly better in the CN group at all degrees, including the area under the log contrast sensitivity function (p = 0.01). The subjective photic phenomena survey showed better results for the CN group, with the proportion of patients reporting no photic phenomena as 9.9% and 3.1% in the CN and TF groups, respectively. The proportion of patients who reported severe photic phenomena was 11.3% in the CN group and 25.0% in the TF group. Although the follow-up period was only 2 months, glistening, surface scattering, and posterior capsule opacity were not observed in any patient.ConclusionsThe new multifocal IOL with HEMA is safe, and provides stable visual acuity as well as superior contrast sensitivity and lower subjective photic phenomena, over the prior IOL.

Long-term changes in the ocular surface during orthokeratology lens wear and their correlations with ocular discomfort symptoms

PurposeTo evaluate the changes in ocular surface parameters during orthokeratology lens wear and determine their correlations with ocular discomfort symptoms. MethodsFifty individuals were enrolled in this prospective pilot study. Clinical evaluation of the ocular surface included the ocular surface disease index, slit-lamp examination, Keratograph 5M, optical quality analysis system, and corneal staining. After baseline examinations, clinical tests were performed at 1 day, 1 week, 1 month, 3 months, 6 months, and 12 months after orthokeratology lens wear. Correlations between ocular discomfort symptoms and signs of ocular discomfort were evaluated. ResultsOverall ocular surface disease index score and two subscale scores (ocular symptoms and vision-related function) significantly increased at the 3-month visit (P < 0.05), and decreased to levels close to baseline at the12-month visit (P > 0.05). The basic objective scatter index and the mean tear film objective scatter index increased, peaking at 3-month visit (P < 0.05) and gradually decreased thereafter. The modulation transfer function cut-off significantly decreased at the 3-month visit (P < 0.05). During the 12-month study period, the overall ocular surface disease index score and vision-related function score were significantly and positively correlated with the basic objective scatter index and mean tear film objective scatter index (P < 0.05). After 1 week of lens wear, Grade 1 corneal staining increased to 16.4 %, mostly involving the central and inferior cornea. ConclusionsOrthokeratology lens wear increased ocular discomfort symptoms and decreased the function of tear film, mainly within 3 months of lens wear. Tear-related visual function parameters were correlated with ocular discomfort. A new parameter, tear film objective scatter index, measured with the optical quality analysis system, was more sensitive in detecting the quality and stability of tear film than traditional indicators.

Five-year clinical outcomes of rigid iris-fixated phakic intraocular lens in northern Chinese

To investigate the 5-year clinic outcomes of rigid iris-fixated pIOL on the visual performance, complications and intraocular light scattering in northern Chinese. Thirty eyes implanted with iris-fixated phakic IOLs (pIOLs group) and 34 eyes with high myopia (myopia group) were involved in this study. At preoperatively, 6months, 1, 3, and 5years postoperatively, the uncorrected visual acuity (UCVA), best-spectacle corrected visual acuity (BSCVA), endothelial cell density (ECD), and intraocular pressure (IOP) were measured in pIOLs group. The objective scatter index (OSI), modulation transfer function cut off (MTF cut off), and Strehl ratio were measured by Optical Quality Analysis System and a pseudophakic dysphotopsia questionnaire (PDQ) was used to evaluate the subjects' satisfaction in pIOLs and myopia groups. At 5years postoperatively, an UCVA of 20/20 or better was found in 43.33% of eyes in pIOLs group. At 6months, 1, 3, and 5years postoperatively, the mean ECD decrease were 1.29% ± 0.45%, 2.59% ± 1.30%, 6.67% ± 2.26%, and 10.80% ± 3.48%. The value of OSI in pIOLs group was significantly higher than that in myopia group (P < 0.001). The PDQ results showed that the subjects in myopia group complained less with intolerance of bright lights than those in pIOLs group. The values of Strehl ratio and MTF cut off in pIOLs group were significantly lower than that in myopia group (P < 0.001). Iris-fixated pIOL induce more intraocular light scattering. A significant decrease in ECD was observed at 5years postoperatively. An annual evaluation of ECD is necessary for patients undergoing pIOL implantation.

Comparative study of objective visual quality between FS-LASIK and SMART in myopia.

To compare the changes in the objective visual quality of patients with low and moderate myopia postoperatively after transepithelial photorefractive keratectomy using the smart pulse technology (SMART) and femtosecond laser in situ keratomileusis (FS-LASIK). Corneal higher-order aberrations (HOAs), horizontal coma, vertical coma and spherical aberration were measured using Pentacam, and cutoff for modulation transfer function (MTF cutoff), objective scatter index (OSI) and Strehl ratio (SR) was measured using an optical quality analysis system (OQAS-II), before and after operation at 1, 3, and 6mo, and data were analyzed by repeated measurement two-way analysis of variance. The difference in uncorrected distance visual acuity between SMART and FS-LASIK was statistically significant only 1wk postoperatively. Approximately 86.36% and 80.69% of patients with spherical equivalent (SE) in ±0.50 D were observed in the SMART and FS-LASIK groups, respectively. No significant difference was observed in SE between the two groups (P=0.509). The HOAs increased postoperatively compared with those before surgery in both groups (P<0.05). No significant difference in HOA, corneal horizontal coma, spherical aberration, ΔHOA, Δhorizontal coma, and Δspherical aberration were observed between the two group (P>0.05). Corneal vertical coma and Δcorneal vertical coma in the FS-LASIK group were higher than those in the SMART group (P<0.05). The OSI of both groups at 1mo after surgery was higher than that before surgery (P<0.05). At 3 and 6mo postoperatively, the OSI in the FS-LASIK group was slightly higher than that in the SMART group (P=0.040 and 0.047, respectively). At 6mo after surgery, the MTF cutoff was statistically significant different between the two groups (P=0.026). No significant difference in SR between the FS-LASIK and SMART groups was observed at 1, 3, and 6mo postoperatively (P>0.05). The HOAs increase and visual quality is delayed in both groups postoperatively, and the long-term objective visual quality after SMART is slightly better than that after FS-LASIK.

Extended Depth of Focus Versus Monofocal IOLs in Patients With High Myopia: Objective and Subjective Visual Outcomes.

To compare the objective and subjective outcomes between the extended depth of focus (EDOF) Mini Well intraocular lens (IOL) and the aspheric monofocal Mini-4-Ready IOL (both SIFI S.p.A.) in patients with high myopia. In this prospective comparative study, 40 patients with high myopia (axial length ≥ 26 mm) were enrolled: 20 patients were bilaterally implanted with the EDOF Mini Well IOL (EDOF group) and 20 patients were bilaterally implanted with the Mini-4-Ready IOL (monofocal group). Three-month follow-up data included corrected and uncorrected distance visual acuity at 4 m and 80, 67, and 40 cm, defocus curves, subjective and objective contrast sensitivity, objective optical quality (calculated with Optical Quality Analysis System; Visiometrics SL), halometry, and reading performance. Subjective visual quality was evaluated with National Eye Institute Refractive Error Quality of Life Instrument 42 scores. All visual acuities were significantly better in the EDOF group (P ⩽ .04) except monocular and binocular uncorrected and corrected distance visual acuities for distance (P ≥ .50). Defocus curves for myopic and hyperopic values were better in the EDOF group (P ⩽ .05), apart from +0.50 to -0.50 D (P ≥ .16). Contrast sensitivity curves was worse in the EDOF group in the mesopic-with-glare condition (P ⩽ .04). No differences were found in halometric values (P ≥ .15) and OQAS outcomes (P ≥ .47). National Eye Institute Refractive Error Quality of Life Instrument 42 subscale scores were better for expectation, near vision, activity limitations, and dependence on correction in the EDOF group (P ⩽ .04). Intermediate and near visual acuities were better in the EDOF group than in the monofocal group, with a comparable visual quality index between groups. [J Refract Surg. 2022;38(3):158-166.].